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I always had more than enough to do, meaningful things, important things. I worked, took time off to raise three boys, went back to work for twenty-three years, was involved with church ministries, volunteered, enjoyed time with family and friends. So now that my family has grown up and moved across the country, we’ve (hubby and me) moved from up north to down south. We found a church and I’m slowly getting to know people during these four years in our new location. Painfully slow. And I’m no longer working. It’s been difficult to form ties down here.

I don’t know about you or anyone else but I know me and as I’ve gotten older I stink at forming deep and strong relationships. It is hard and exhausting work. And can I attribute it to the bipolar worsening over that same timeframe? Absolutely. I know that when I am seriously depressed it’s difficult to even talk to people. Word retrieval takes a nosedive during depression—I lose a good portion of my vocabulary. It’s embarrassing. I feel like a child. Even recall of events or conversations suffer. It is as though my brain, or part of my brain, actually shuts down. Cognitive side effects from medications add to these difficulties. So does aging. This makes nurturing relationships difficult. It makes getting a job difficult if not impossible. I’ve given up on the idea of working. I had to give up my volunteer job (one morning a week) during my last bout of severe depression.  Finding purpose is difficult without having strong ties to a job and/or other people. Word retrieval and memory issues feel like stumbling blocks to me. Sometimes they feel like walls. I find I have to make the most of the times when I am doing well and the problems are not as pronounced.

I haven’t found any solutions but I have found doing word and number puzzles helps me to sharpen my mind a bit. Exercise is a great way to help keep the brain functioning well. I know that from experience yet I have a hard time pushing myself out of the house to walk or ride my bike. I do heavy gardening work and wield around a huge hedge trimmer to trim and shape our bushes. When I’m done, I’m tired but feel better. My mood is better and my mind is functioning faster and clearer. It’s not a huge difference but better than before exercising. What if I kept this up consistently, gardening, walking and biking? Would there be a cumulative effect? Science has long been telling everyone the benefits of getting moving.

This article talks about bipolar issues and exercise:  http://www.ncbi.nlm.nih.gov/pubmed/21084787

This article talks in depth about various facets bipolar and cognitive issues. Exercise is not mentioned here, but this article made me feel validated. I can finally stop beating myself up for my periods of major deficits. It’s major in my eyes because I am painfully aware of what I lose when symptoms are very active:  http://www.medscape.org/viewarticle/457153

I am determined to make the most of my life and touch as many lives for good as I can.  Hopefully I’ll form those friendships I long for but if not, I’ll enjoy the many acquaintances we have.  I’m determined to overcome bipolar issues and love this life as best I can.

Merry Christmas, Happy Holidays and Happy New Year to you and your loved ones.

Two months have gone by without me posting anything. I’d been having medication woes. I’ve been on three medications to lessen the bipolar swings up and mostly down and the side affects were impacting my daily life. I was given another medication to counteract the side affects but the side affects from that newly introduced medication were far worse. I stopped taking it. My perception was changed, my saliva was reduced to almost nothing. My mouth was dry which made it hard to eat so I drank lots of water with my meals. And to top all that, I almost completely lost my voice.

So now I’m back to just the three medications my psychiatrist gave me. The side affects aren’t as bad. I guess I’ve adapted. In addition the three medications have helped me experience a long stretch of “normal”. And the downward swing I took this last week was not very low and easy to handle.

I don’t know how long these results will last. Hopefully for the rest of my life—why not—I’m shooting for the stars. But really, I’m hoping the meds keep working this way for a long, long time.

I am very grateful for this respite from severe swings.   I can feel joy today and everything seems brighter.  No, it’s not a hypomanic swing.  Its the joy of feeling good and normal again.  It’s been a long time, years actually, but our persistence in trying to find the right combination of medications has paid off.  The future looks brighter and that brings me joy too.

After fighting a deep depression for 1½ months, I finally came out and settled in at “normal”.   After a few days I should have been very pleased but I was frustrated. I felt bored. Totally and hopelessly bored and I didn’t know why or what to do with myself.

I had an appointment with my therapist. We talked about my sleep problems, I’d been getting only a couple of hours per night for a few weeks and by afternoon I would feel starved for sleep. We determined it was either my new meds causing it or a rebound effect from coming off the old meds if they helped me sleep.   It could also be a combination of both.

Finally, I told her how bored I felt. She asked me what I have been doing and I told her it was just the same routine stuff—nothing had changed. She said, “Oh, but it has.   How are you feeling?” “Normal.”, I said. And then she blew me away. She said that “normal” has left me with nothing to work hard at. When I’ve been at anything but normal, which is usually most of the time, I’ve had to work hard to continue to live a normal productive life.   It can be incredibly hard work but now I had nothing to work hard at, just routine chores or errands. She was right! It made perfect sense.

I’ve achieved 12 days of “normal”! And I feel free and content. Boredom fled when I realized the reason for it. This is bliss and I have to believe it will stay this way. I know in reality the odds are stacked that I’ll slide up or down again. But negative thinking brings me down. The work now is to stay positive, believe for the best outcome and live in the moment. That’s not very hard work at all.

Last week I went with my husband to see a psychologist he had an appointment with – it was supposed to be about him and how he supports me.  Somehow, the attention turned to me.  The therapist took great interest in me, my bipolar experience and some issues I have.  She asked if I would like to be her patient.  I like her, she’s very direct so I said yes. (My husband will now come with me only occasionally. He is no longer the patient, which was his intent anyway.)  Tomorrow is my very first visit as her patient.

I know she will be asking tons of questions, but I have a few of my own for her too:

  1.  What methods will we be using, CBT or others?  If others please explain them.
  2.  How do you treat a bipolar patient when all goals have been reached?.  When you feel your
    client has mastered all the coping skills, and we have completely covered any other life
    issues, are we done until I have a problem again? Or in the beginning, do we have regular
    follow-up visits every 3 or 6 months to be sure I stay on track? (Past therapists just cut me
    off until I had another problem. I’m not sure if this is good or bad.)  I think 6 month
    or even yearly follow-ups might be a good idea to help me remain focused and tweak coping
    approaches.  Why wait until there is a fire to put out?
  3. Besides honesty, what do you need from me?  What are your expectations so I have a clear
    understanding?

Then there is what I want her to know:

  1. I am a hard worker, compliant with medications and doctors instructions, and I do my best, whatever
    it takes, to achieve wellness and order.
  2. I am a quick learner and will ask questions if I need to understand a concept completely.
  3. I appreciate directness, even if it hurts sometimes. It brings me to the heart of a matter much
    more quickly than dancing around an issue to spare my feelings.

It should prove to be an interesting morning.

What are some questions you would to pose to a therapist you are just getting to know?

One of the first coping skills I learned about after my bipolar diagnosis was that meditation is important to our well-being. It’s a time to quiet down our racing thoughts, emotions and negative thinking. It relaxes the mind and body. I’ve heard some people say they feel rejuvenated after spending awhile meditating.

Some people like to sit and use a particular scent that is pleasing and focus quietly on that. Others like to hold and feel a textured item that is pleasing to focus on. Some focus on something in their minds. Some people like to use prayer as meditation. While focusing on whatever one chooses, it is important to breathe deeply.

Although I pray often, that is not usually my form of meditation. Mine is to go to a special place in my mind. I wrote about it and I want to share it with you. See if you can picture yourself there.

River Peace

Stresses peel away while I listen
Dark, murky water
Lazily follows a ribbon pathway
Gurgling, lapping at the shoreline.
Trees shield the forest floor from afternoon sun
Grateful, I find rest in the cool shade.
Rustling leaves, quiet songs of nature,
Soothing, comforting,
Reassuring that all is right in my world
God is in control.

I sit here for the solitude
Yet life teems all around.
Spiders spin, ants gather food,
Birds chirrup in the green ceiling above me.
Dragonflies flit to and fro above the cool water
Prism wings of purple, green, red-violet.
I belong here, joining God’s creation
Celebrating life’s pure joy in being, simplicity.
I wait to hear His voice.

© Jeanette Chiapperino 9/21/2000

A few years before I received my diagnosis, my doctors were scrambling to find out what was wrong with me. I was referred to a neurologist and then to another group with neurologists and a psychoneurologist. They had me fill out a form with all kinds of questions about what types of things I may or may not have experienced.

Some were: hearing voices, seeing beings that no one else saw, delusions, unreasonable beliefs and on and on it went for many pages.

The problem with this is that I was terrified of giving any positive answers to anything except things about what I was feeling, down, sad, fatigue, etc. I was afraid if I admitted to seeing or hearing things I’d be labeled crazy and thrown in an institution for a long time. My mother had instilled that fear in me because that’s how it used to be years ago. She was terrified that it could happen to her because she suffered with depression. A relative’s first wife was institutionalized at some point for the rest of her life so that compounded her fears. So, full of fear, I was dishonest about a few things.

The result was I was diagnosed with major depression and referred to a psychiatrist who put me on antidepressants, which made me worse.

A year later I moved and was diagnosed as having bipolar disorder. My meds were changed and my life began to get better.

Had I been truthful from the beginning when filling out that sheet, I may have received a correct diagnosis a few years sooner. I wouldn’t have been given antidepressants, which are known for worsening bipolar symptoms. I probably wouldn’t have suffered so much.

So my takeaway from that experience is that I must be completely truthful with my psychiatrist, therapist and physician.   They can’t help me properly if I don’t provide them with the correct information, and all of it—no omissions. Why risk suffering with a problem and it possibly growing worse?

It has been worth the truthfulness. My doctors and I have grown to trust and respect each other and they do their best to help me get and stay well.

When I was first diagnosed with bipolar disorder, my psychiatrist and my husband were the only people that knew. And only my psychiatrist and I knew what meds I was on and why. My family physician didn’t know and I didn’t have a therapist yet.

 I read an article about the importance of sharing information between doctors so that they and I would be my healthcare team. A loved one (my husband) would also take part and be prepared to act as an advocate in case I can’t speak for myself. This really made me think hard.

Why is it so important? Most of us don’t have doctors who talk to each other. My family physician knows my diagnosis so she can be aware of improvements or declines in my condition. She also checks my thyroid and cholesterol levels along with a few other tests to know whether or not my medications are impacting my health. They have in a couple of areas so I was able to report back to my psychiatrist exactly what my physician found. We were then able to discuss whether or not I needed an adjustment or change in my meds

 I eventually did find a therapist and kept him informed of all that was going on medically. He could often tell if there were changes for better or worse and suggest what I might want to discuss with my doctors. He also helped me deal with my early frustrations with just having bipolar and my fears about what the meds might do and were doing to my body. (I just started seeing a new therapist and like her so far.)

I keep my husband informed of all that is discussed with all of these doctors and the therapist. Often, he goes with me to the psychiatrist so he can ask questions because he wants to be a strong support for me..

I am the one at the core of this team, keeping each of them informed of what is happening with the others. And I work hard at leading a healthy and active life. I’ve learned numerous coping skills to help me live a productive and normal life as best as is possible.   And the coping skills that I use are discussed with everyone on my team. I have been reminded by one or the other of them a couple of times to remember to use music or some other method that slipped my mind

My husband, my psychiatrist, my physician, my therapist and I make a good team and I can say I’m quite healthy because of it.

Have you put together a team or plan and has it worked well for you?

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