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It is very important for someone with bipolar to have routines for daily living.  

Equally important are keeping stress levels down and getting enough sleep.  I’ve been doing very well in these areas but the past three days have been a reminder of how hard it is for parents, especially for parents with bipolar or another mental illness.
We had the privilege of babysitting our two grandsons in our home for three whole days.  They are very well behaved but that doesn’t mean it wasn’t a challenge.  They are seven and nine years old and full of energy.  The challenge was keeping them entertained and answering the questions with which they peppered us.  We took them to a park, bike riding around our development, played a board game and gave them a contraption building set to use with the action figures they brought to play with.  They did have a few times where they entertained themselves with the building set and action figures but the noise and chatter never stopped.  And I’m not saying  it should have.  It’s just that I had forgotten what went on when we were raising our own three boys.  It didn’t seem quite so exhausting when we were young with children.  Now we’re older and out of practice.  They wore us out but it was worth it.  We love them and cherish our time with them.  And hopefully our bonds are stronger.
My routine was shot to pieces and the noise and constant activity all contributed to feeling stressed.  I was determined to not let it set off a mood swing.  I forced myself to stay focused on each moment through mindfulness.  And I reminded myself that the situation was not permanent and would end soon.  I would get my orderly life back.  When I would feel guilty for feeling that way during our grandsons’ stay with us, I would tell myself what I would tell someone else going through the same situation, “I have a mental illness that I control by keeping daily routines, planning for activities outside and inside the home, keeping the house clean and free of clutter and avoiding loud noise at home (it’s hard to do outside the home).  Maintaining these things is essential for my well being.  Disruption of these areas causes stress and anxiety which are triggers for mood swings.  I need to care for myself to stay mentally healthy and strong.”  But my coping skills were in place and I used them well.  There were no mood swings.  And I was able to enjoy the boys while we had them.  I wasn’t as outgoing as I would have liked to have been but I’m an introvert anyway.   

It’s been nearly 9 months and I have maintained a normal mood state. I am very grateful. I didn’t realize the amount of energy it took to keep myself functioning at as regular a level as possible while dealing with bipolar mood swings. It’s wonderful to live on an even keel without an enormous effort. Of course it’s not just the skills I’ve learned that keeps me so steady now but finally getting the right mix of meds too.

The dilemma I find myself in now is how much do I give up to maintain this wonderful state. There are side affects to these medications. I have fine tremors in my hands which make writing difficult. My beautiful handwriting is gone. My kidney function is down a bit – not at all enough to worry yet but enough that my primary doctor wants to run tests every 3 months to monitor whether or not it progresses. Then there’s the problem of me losing my voice. It started after taking these meds. It is a known side affect though not as common as the others. My primary doctor wants me to see an ear, nose and throat doctor (ENT) to find out if it’s due to another reason. It could be and I hope it’s reversible. It’s sad because I can’t sing anymore. Sometimes I can barely talk. I am constantly hoarse. If I drop and change any of these meds, I am risking upsetting this balance I’ve finally achieved after 6 years of trying different mixes of them. I am reluctantly willing to sacrifice my handwriting and have a slight tremor. I am willing to live with a very slight decrease in kidney function as long as my primary doctor keeps monitoring it. But losing my voice, if it is due to the meds, is difficult to accept. I need my voice to communicate with the world. It’s tiring to try to speak up when you are hoarse. People ask what’s wrong with my voice. If I tell them it’s my meds they’ll wonder why I just don’t stop them. How do I explain?

But then I look back and realize I need to keep everything in perspective. I suffered severe depressions far more often than hypomania and a few of those depressions were dangerous. I don’t want to go back to that so I can understand why my psychiatrist is against changing anything. He weighs what I have to give up against finally achieving balance and normalcy after so many years. He doesn’t want to put me at risk again. Giving up my voice is a tough one, though.

 

But in spite of the difficulties, I am very grateful for a normal life. Finally.

 

I’ll let you know what the ENT discovers.

It’s a New Year.  It’s a time for reflection on the events of the past year, how I handled them and then evaluate how I can improve during this new year.

What are my goals for this year?

I want to keep working at self mastery as far as bipolar disorder is concerned; controlling my thoughts and not allowing myself to ruminate helps to control and/or prevent anxiety’ which is a trigger for me. This is something I’ve already been working on but I want to perfect it.

I want to pursue strengthening friendships with a few people. I find relationships outside of my immediate family difficult so this will take a lot of effort to prevent anxiety from building and being a possible trigger. Some people might say , “Then why try to accomplish this?” Because having friends is important to me and to my husband. Friends enrich our lives and hopefully we do theirs. My disorder doesn’t affect only me. If I say I can’t have people over, my husband doesn’t get to do it either and he thrives on interaction with people. So I’m trying and will make a greater effort this year.

Every year that I work hard at strengthening and expanding my control and capabilities, the more improvement I see in my life.

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?

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