My Experience Only. YMMV.

Posts tagged ‘coping mechanisms’

From Panic to Manic to Proactive

Hypomania isn’t all bad. Right now I’m facing one of my worst triggers, and instead of retreating into depression, I kicked into hypomania. Then I harnessed as much of it as I could and channeled it to work for me.

Here’s the sitch. My longest and most vicious major depressive episode (which lasted literally several years, even when I was under treatment and on medication) was triggered by, among other things, massive financial problems. (There were other factors involved: health problems, family health problems, family problems, irrational thinking, strained relationships, and bad ol’ neurotransmitters.) I was unable to work. There was plenty of anxiety along with the depression, you can be sure.

So here I am again, almost a decade later, once again in dire financial straits. I’m able to work, but only part-time and telecommuting. Then one of my biggest, most reliable clients cut way, way back. I made the mortgage this month, but next month looks iffy at best.

In the past, this would have resulted in major mental symptoms, and physical ones as well. (Better you shouldn’t ask, but my digestive tract responds to stress in an overwhelming manner. I know, TMI.) I would be immobilized, unresponsive, and spend most of my days on the sofa when I wasn’t in the bathroom. I would abandon the financial problems – and myself – to my husband’s care, for as long as he could keep everything together. Until he burned out too.

During this new version of assorted crises, I seem to have a better handle on things, and I credit hypomania. I am trying to better the situation, though not yet particularly effectively, but steadily.

I am looking for new clients and more work from my old ones. I am looking for other sorts of telecommuting jobs, and even part-time outside work that seems to be within my modest-at-this-point capabilities.

(This process is hindered by the fact that all the job search engines are lousy. When I say I am a writer, I get leads for technical aerospace writing and service writers for car repair shops. When I say I’m an editor, I get invitations to become a driver for Uber. True story.)

I pursue these avenues every day. Soon after this post goes up, I have a networking “date” with a former client and a former co-worker.

And in the meantime? When the days stretch out with nothing happening and the sofa calling my name?

I blog. I work on my novel. And I take surveys.

Admittedly, none of these pursuits brings in mortgage-payment-sized money. But the surveys bring in a couple of dollars a day, which is pitiful, but helping with a getaway my husband and I planned before the finances went belly-up. (My husband is still working, but his wages alone aren’t enough to pay all the bills. We need both of us, a situation familiar to millions of people in the U.S., with or without mental illness.)

And, aside from the getaway, which it’s too late to cancel, we’ve instituted cutbacks. We typically spend way too much on food and now must revisit our newly married days, when we subsisted on mac-n-cheese and tomato sandwiches. It’ll be good for us, I tell myself. We could both stand to lose some weight.

I don’t know how long my “proactive hypomania” will last, when our financial situation will improve, or whether my energy level will survive after it does. Or, for that matter, whether we’ll end up eating cat food under the Third Street Bridge and fighting stray dogs for cold french fries.

But right now, for now, I’m dealing. And that’s something I couldn’t do before.

Cheerleading or Celebrating?

I was prejudiced. I admit it. When I was in high school, I believed that all cheerleaders fit the stereotype – “buoyant and busty and just plain dumb,” as the singing group Uncle Bonsai put it in “Cheerleaders on Drugs.”

I still don’t really understand cheerleading, especially on the scale of professional sports. But I know some good people who have participated in cheerleading and cheer coaching, so I’m willing to give them the benefit of the doubt.

But that’s not what I wanted to write about today. I want to discuss the kind of cheerleaders that offer support to those of us with bipolar disorder.

I suppose traditional-style cheerleaders are supposed to give encouragement before a thing is done. But I prefer ones who cheer after something, no matter how small, is accomplished.

That is to say, I prefer cheerleaders who say, “You did it!” to those who say, “You can do it!” (This is another YMMV post. This is just my own experience. Your mileage may vary.)

Cheerleaders-before-the-event are common in mental health circles. “Smile! You can do it!” “Do volunteer work! Give it a try!” “Get out there and meet new people! You’ll feel better!” “Get some fresh air and exercise! It’s easy!” But the fact is, no, I can’t always do it or give it a try. No, it’s not easy, and I don’t feel better.

It’s good to know that someone believes in you, but to me, cheerleaders set me up for failure. If I can’t manage to smile or exercise or whatever, I have disappointed not just myself, but the person who thought that I could do it, whatever “it” is. Remember the Little Engine That Could? It was thinking, “I think I can,” not “Someone else thinks I can.” What does that someone else really know about how severe my symptoms are today or whether my meds are having their desired effect or how many spoons I have?

I prefer cheerleaders-after-the-fact – those who join me in celebrating victories, no matter how small or insignificant they may seem to others. “Hurray! You paid a bill today!” “Congratulations! You phoned your mother!” “Good job! You took a shower!” “Go you! You put on pants three days this week!”

These are accomplishments – things you actually did, not things that you might or might not do. They’re tiny victories, maybe, and you don’t see memes that encourage you to do them. To neurotypical people, they wouldn’t be accomplishments at all, just normal functions of everyday living. It’s too easy to picture cheerleaders-before-the-fact saying these things half-heartedly or sarcastically. “Oh, great. You fed the dog. Woo-hoo.”

I don’t want cheerleaders so much as celebrators, people who can join me in acknowledging that it is a victory to write my blog post, or even to make notes for it. Or even, some days, to get out of bed.

I don’t expect someone to follow me around all day applauding every little thing I do. But on days when I feel useless and unproductive, like a failure or a slug, I do like having someone remind me that I do make progress, that my struggles have value, that – as a friend of mine said – not fucking things up worse is at least half a win.

I’ll take half a win when I can get it. And a pat on the back whether I smile and get out and make new friends, or simply make it to my doctor’s appointment.

That doesn’t make me a glass-half-full person. It just means I’m grateful that the glass isn’t completely empty.

 

 

Tracking Your Moods: Low-Tech, High-Tech, and In Between

Many therapists and people with bipolar disorder recommend journaling as a practice that allows you to track your moods and figure out what your triggers are. And many individuals do well with journaling.

I didn’t, however. I tried starting a journal of what I was doing and what I accomplished daily. It rapidly turned boring and whiny. My entries looked like this:

Accomplishments:

  1. Paid cell phone.
  2. Forced myself to finish work assignment.
  3. Finally got off that stupid level of that horrible Candy Crush.

Writing is what I do, but journaling, especially when depressed, was an unrelenting series of pitiful nothing. Instead, I started this blog (on 1/7/14). In my blog, I could write about anything. Still, it wasn’t much good as a way to track my daily moods.

Technology is starting to address that problem. Recently some inventions have come on the market that promise to help you track your moods not just daily, but hourly (or even more often). Most of these devices resemble what would happen if a Fitbit and a mood ring had a child.

Most of them claim to monitor your moods by tracking your heart rate and/or your breathing. (One notes that it tracks your steps too, so you don’t need an extra device to do that. Another promises to monitor galvanic skin response, pulse, and skin temperature, which sounds more like a lie detector than mood tracking.) Then you take that data and compare them with what you were doing at the time and voilà – a mood journal.

Of course, these devices make certain assumptions – for example, that when your heart rate is elevated, you are anxious or tense. Needless to say, there are plenty of other things that can raise your heart rate and breathing. Sex, for one. Or running. Neither one of which is necessarily a source of anxiety for everyone. There is, as far as I can see, no way for the device to tell when you are depressed. They appear to assume that everything except anxiety is normal.

Then there’s the fact that you still have to journal. The devices work on the theory that you can look for patterns in your breathing and respiration, then figure out what you were doing when that happened. Upgraded devices and apps are planned that will add calendar and location functions to make this easier. But if you’re in your house the whole time the moods are happening, it won’t tell you much.

(One brand of these devices is available only from an employer, health plan, or EAP, which, if you ask me, is pretty creepy. If there’s anyone I don’t want to have information about my moods, it’s my employer.)

My friend Mike came up with an in-between solution that uses both higher-tech and lower-tech approaches to monitoring his moods. Over a period of several months, Mike had been on four different drug regimens for depression. Not all of them worked, and he was unsure which did the most good.

His idea was to go to his social media and chat apps and take a look at when he was the most active, engaged, and responsive. Then he looked at what medication he was on at the time. He noticed, for example, that in the first few weeks of April, he was posting more about accomplishments and responding to others’ posts and chat messages. A quick check of his pharmacy records and he had a pretty good idea of which medications were working best. No journaling involved – the evidence of his increased energy was right there in front of him, already recorded. And no $150 expense for an emotional tracking device.

Maybe journaling is right for you. Maybe a wearable mood tracker is the thing that will help. But don’t overlook the tools you already have. Think about them in new ways and you may already have a handle on understanding your moods and meds.

Sources

https://www.l2inc.com/daily-insights/spire-wants-to-be-the-fitbit-for-your-emotions

https://www.entrepreneur.com/article/239743

http://nerdist.com/sentios-feel-wristband-fitbit-for-your-emotions/

Picking Up on Feelings

As if it weren’t difficult enough to deal with my own feelings, at times I’ve had to wrestle with the feelings of others.

It started when I was a teen. I had already experienced my first major meltdown and was trying to put myself back together. Like most teens, I wasn’t really sure who I wanted to be. But unlike most teens, I was dealing with undiagnosed bipolar disorder and a shredded sense of self-esteem that made me even less sure of who I was, who I wanted to be, and who I ought to be.

I began to notice that I was picking up the characteristics of whomever I was with. When I was around Binky, I was light-hearted. When I was around Marie, I was a misfit. When I was around Fran., I was trying to fit in. And so on. Intellectual, silly, moody, outdoorsy, smart-alecky, boisterous, quiet – I became them all, in turn. None of them, it turns out, was really me. Or at least not completely me.

And when I was alone – who was I then? I was alone a lot of the time, and my default setting was depressed. I cried at unlikely songs. I hid in books. I cocooned before cocooning was a thing. I had a banner on my wall that said, “I’ve got to start acting more sensible – tomorrow!” I blamed my troubles on living in Ohio. I got drunk on ginger ale.

I was a fractured mess.

Later, in my 20s, as I went out in the world and began to interact with different people, I realized that I was picking up on their moods, rather than their character traits.

Most of those moods were unpleasant ones. And I reacted to them with – you guessed it – fear and depression.

Even if I was in a hypomanic state, I couldn’t maintain it if anyone around me was angry or depressed or resentful, or even just crabby. It felt like I was hanging on to my good feelings by my fingernails, and the least inattention would cause me to lose hold and crash.

As for anger and blame, there was no way I could do anything but cringe and apologize endlessly. (It was only much later that I learned how annoying apologizing and self-deprecation can be to those in the vicinity.)

One person became a master at using this to control me. A sigh and a glare were all it took.

Nor did the bad feelings have to be directed at me. I couldn’t be in a room with people who were yelling at each other. At times even disagreements on television would bother me.

I did develop a few coping mechanisms. If other people were the source of the bad feelings, I would make an excuse to leave the room. A breath of fresh air was usually too transparent, and you can only plead a bathroom break so many times, so making myself a cup of tea was my go-to excuse (which also led to a believable increase in bathroom breaks).

My husband has caught on to my interior mood sensor and reactions. Since even raised voices can trigger me, we’ve developed a signal that he needs to take it down a notch, usually when we’re talking politics – sometimes he even manages to chill out the emotional temperature of an entire room. And if he’s having a snit, I can ask him how long it will be till he gets over it and he lets me know whether it’s a big deal or not.

Now even sighing and glaring is a joke with us. He’ll puff like a steam engine and lower his eyebrows until they touch. Then we’ll both start laughing.

After my most recent and worst meltdown (which I’m surprised to realize was about ten years ago), my therapist told me that my shattered, scattered emotional state gave me a rare opportunity to choose which pieces of my former life I wanted to incorporate into my rebuilt self.

Maybe it’s a good thing I tried on those different identities as a teen, so I don’t have to now.

I know it’s a good thing that I’ve learned better ways to manage what emotions I allow into my life.

The Tools for Tackling Bipolar Disorder

When you’re facing bipolar disorder – which is, when you have it, nearly every day – there are some things you can do to lessen its hold on you. But in order to do so, you’ve got to have the right tools. Try to collect as many as possible for best effect.

Shall we take a look at what they are?

The Usual Suspects

  • medication – to tame your symptoms, level your moods, get your brain back in gear, and/or regulate your energy
  • psychiatrist – to prescribe your medications (a primary care physician may also do this)
  • psychotherapist – to discuss with you the issues you haven’t resolved, the problems you still have, and the things the medication can’t do

Self-Care 

The two most important tools you need for self-care are sleep and food. Without either, the body can’t function properly, and if the body doesn’t function, the brain is less likely to function properly either.

Ideally, the food should be nutritious and eaten regularly, but let’s face it, that doesn’t always happen. But you’ve got to give your body something to run on. If there are carrot sticks there, eat them; if there is mac-n-cheese, eat that. If there’s Raisin Bran, well, it’s easy to eat and requires no preparation. Try for at least one substantial meal per day – two is better, if you can manage it.

(Of course, this advice doesn’t count if you have an eating disorder. In that case, see your doctor or psychotherapist or support group.)

Support

Find support where you can – a friend who’s willing to listen, a support group online or in real life. Try for a combination of these and don’t rely on any one of them for too much. Maybe you have a friend you can phone once a week; a support group that meets every two weeks; and an online group or two of people who really understand, with links to helpful articles and blogs. Before you know it, you’ve got a support system, especially if you count your therapist (which I do) or have a supportive family (which I don’t).

Spoon Theory

If you don’t know what this is, see https://butyoudontlooksick.com/articles/written-by-christine/the-spoon-theory/. Basically, Spoon Theory is a way to measure how much energy you have on any given day – and an understandable metaphor for explaining your symptoms to others, and a shorthand for other people who are also up on the theory. It can also help alleviate the guilt of not being able to do all the things you are “supposed” to do in a day. It’s not an excuse, but an explanation.

Distraction

Let’s face it, it’s all too easy to dwell on your symptoms and how miserable you are. And if you’re at the bottom of the depressive well and your meds haven’t kicked in yet, there may be nothing you can do about it.

But maybe there is. Do you know a person who tells good jokes – or really bad ones? Do you have music you used to play but have forgotten about? Do you know of a TV show that features people whose lives are an even worse train wreck than yours? Do you have a go-to movie that never gets old no matter how many times you see it? (Mine is The Mikado. )

Creativity

If that distraction involves creativity, so much the better. Coloring books and pages for adults have been the trend for a while now. (Some of them are really for adults.) Jenny Lawson draws and also puts together tiny little Ferris wheels. I know someone who can make little sculptures out of drink stirrers or paper clips. The point is, you don’t have to paint masterpieces. Just keeping your brain and your hands occupied is a good idea.

Comfort

Soft warm, fluffy things and smooth, silky things are soothing. They just are. Cats and dogs come instantly to mind (they also provide distraction). But I also have a collection of teddy bears and other plushies that I sometimes cuddle with. These are “comfort objects,” which is an actual psychological Thing. (I wrote about them once: http://wp.me/p4e9wS-k9.) I even took a plush bunny with me when I went to have a sleep study.

Stubbornness

This may be the most important tool of all. Be stubborn. Take those meds, even if you hate them. Eat that egg, even if you don’t feel like it. Go to that appointment, even if will take all your spoons for the day. Call that friend, even if you don’t think a joke will help. Post on your support group, even if you feel you are alone.

We can’t let bipolar disorder beat us. Not when we’ve got so much to beat it back with.

Self-Care for Overwhelming Days

It’s been said that time is nature’s way of keeping one damn thing after another from being every damn thing all at once … However, every now and then the damn things gang up on you.

– me, “The Overwhelming Problem,” http://wp.me/p4e9Hv-hy

It’s also been said, by Canadian astronaut and all-around awesome guy Chris Hadfield, that he managed to stay alive in space by always asking himself, “What’s the next thing that might kill me?” If, for example, the most immediate danger were running out of oxygen, the next thing to do would be to check your tank and hoses.

I find that attitude soothing in a way, and helpful in getting through one of those every-damn-thing days. It’s not traditional positive thinking, but it does help you set your priorities.

Today and yesterday and the day before have been examples of every-damn-thing days. I’ve gotten through by asking myself, “What’s the next thing I absolutely have to do?”

It starts when I wake up and can involve the simplest of decisions: Do I take my meds first or do I pee first? Pee first. Pee first is almost always the correct answer and is one of the Mystic Rules of Self-Care.

Do I get dressed or do I eat something? I don’t absolutely have to get dressed yet, because I’m not going out anywhere yet, so eat something. Eat something is almost always the correct answer and is another of the Mystic Rules of Self-Care.

This can get me through the entire day. What is the next thing I absolutely have to do? Get dressed. What is the next thing? Go to the bank and get money. What is the next thing? Pay the power bill. Those are absolutes if I want to have a functioning computer. And I do. Very much.

Next comes a real decision: K-Mart is right next door to where I pay the power bill. Do I stop in and get the loaf of bread I need and maybe some underwear, or do I eat first? I eat first. (See above Mystic Rules.) By the time I finish my banh mi (if I’m out and dressed and in motion, I may as well make the most of it), it’s pouring rain. Do I absolutely have to go back to K-Mart, walk through a wet parking lot, and get that loaf of bread? I do not. I go home. One errand (two if you count the bank, and I do) is a major accomplishment for me.

After I get home, there is no “next thing I absolutely have to do,” so I switch to “What is the next thing I could do?” Say there are three choices: take a nap, watch TV, do some work. Obviously, the work is out. I am spoonless by now. I decide to watch TV until closer to bedtime, then go to bed.

If there is work that absolutely has to be turned in the next day, I get up early and do it when I have a fresh supply of spoons. (After peeing first and taking my meds.)

There is also an element of creative procrastination to this. (See http://wp.me/p4e9wS-ct.) It’s like sorting your tasks into three piles: absolutely, would be nice, and meh. Not that I’m recommending writing them down. That’s not flexible enough. Throughout the day, an event can wander down the progression. “Buy loaf of bread” started out as Category 2, but the rain pushed it into Category 3. I ate the other half of my banh mi for dinner and bought bread the next day. And if I hadn’t had the banh mi, I still had a jar of peanut butter as a back-up plan. Eating it straight out of the jar is pretty depressive, but you do what you have to do when your spoons run out and you still need self-care. (Have I just discovered another Mystic Rule?)

Of course, I’m describing a moderately-functioning day. There are other days when the categories shut down after peeing and meds.

When You Think Other People Are Talking About You

You know when you feel sure that other people are talking about you? You notice them whispering, or looking at you, or studiously not looking at you, and you think, what are they saying about me?

Two smiling friends sharing secret in coffee talkPsychologists call those feelings “ideas of reference.” (If you alter your behavior because of the supposed scrutiny, they’re known as “delusions of reference.”) Ideas of reference are often associated with paranoia. However, if you ask clinically depressed or bipolar people, you will find that many of them have them as well.

I know I have. It’s hard not to. You already feel that you’re not really normal (whatever that means) and you’re afraid that it shows. If people can see that you’re not like everyone else, they’re bound to be talking about it. Never mind that your difference is a mental one; you’re sure that everyone can tell just by looking at you that you’re crazy.

In actual fact, the people you think are talking about you usually aren’t – until you go over to them and defensively berate them or accuse them of doing so. Then you can be sure they will be talking about you after you leave.

Except perhaps in junior high school, most people in everyday life do not spend their time discussing how odd the people around them are. (Except for those people who take pictures of others at Walmart and then post them on the internet.) But the average person is too involved in his or her own daily life to give more than a passing glance to a stranger. The people you see whispering behind their hands are most likely developing their own secrets or gossiping about someone you don’t even know.

Even if the people are talking about you, ask yourself – so what? Do their opinions really matter? I know that you want to say yes, they do. But in the larger scheme of things, they don’t. Your life will not change in the slightest if they are saying they don’t like your haircut or that they heard you bite your nails. Malicious gossip and social bullying are separate matters. But again, you don’t really know that these people are saying anything that’s actually harmful.

Perhaps you feel it’s more significant if the people you think are talking about you are family members, coworkers, or friends. They may really be talking about you. The point is, even if they are, you have no idea what they’re saying. Most of the time they speak in low tones so as not to upset you, never realizing that that upsets you more. Tell yourself they could be planning a surprise party or talking about Aunt Edna’s affair with a younger man. Not everything is about you.

Ideas of reference may be a factor in imposter syndrome – the feeling that you are not really successful, competent, or talented, but are just faking it, and that everyone around you can tell. Or perhaps your ideas of reference are like intrusive thoughts – sudden, distressing notions that pop into your head, seemingly without cause or warning. These can be anything at all, from “I wonder if my passport has expired” to “Who would miss me if I died?” to “Those people are talking about me.”

What can you do if you have ideas of reference? Resist the urge to ask if the people are really talking about you. That will only make things awkward and worse. Ignore them if you can. (This is not the same as the bad old non-advice about ignoring bullies. You know when a bully targets you. With ideas of reference, you never really know if your fears are true.) Since you didn’t actually hear what the people said, you can realistically assume they were talking about someone or something else entirely. Imagine that one is telling the other that her slip is showing. (Do people still wear slips? I know they don’t wear pantyhose anymore.)

If you feel you must react, use a minimal response such as the good ol’ side-eye, which is sufficiently ambiguous that the person (who may also have ideas of reference) can assume it’s directed at someone else.

Another suggestion I’ve heard is to work with your therapist on issues of self-esteem and self-concept, or to try cognitive behavioral therapy. Some medications may help too. Still, if you feel you can manage it, I think the best idea is to tell yourself “So what?” and move on.

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