Bi-Polar, Depression

Depressive Illness – The curse of the strong

IMG_5311Depressive Illness (The curse of the strong)   Dr Tim Cantopher   Sheldon Press 2003

I picked this book up at our local support group and from the very first page I knew that this was the best book on Depression that I have read over the years.

 

His introduction starts with typical Monday morning blues after a restful weekend as he explores all the feelings this brings. The point he makes is that those who feel down on Monday mornings or dip into low mood occasionally, for example when they are tired or getting over a virus, are not what the medical profession would call ‘depressed’ although many people do use this expression to describe their moods. He cites those who say ‘oh I get like that and I just pull myself together and get over it’. They don’t ‘get it’ and he comes down heavily against people who make such comments to those with depressive illness. It is not helpful.

 

This book is not as heavy as some I have ploughed through. It is accessible and an easy read. Cantopher has an engaging tone and he certainly knows what he is talking about. He describes what happens to the brain when people fall into the depths of. In depression, the levels of the chemicals in the synapses of the limbic system plummet and the nerves get less sensitive to the chemicals too. This is usually brought on by stress or other triggers. Basically if the limbic system is taken beyond its design limits it will malfunction and a gap will appear between the end of one nerve and the other (the synapse)

 

His list of symptoms is the most comprehensive I have seen. Most symptoms involve ‘loss’.

Loss of sleep, appetite, energy, enthusiasm, concentration, memory, self-esteem, sex drive, drive, enjoyment, patience, feelings, hope and love. However, loss of memory, according to the author is caused by the loss of concentration and does not mean the memory is impaired.

 

Chapter 5 is What to do when you get ill and he devotes three pages to ‘rest’, likening it to a thermostat which has got too hot and has to be switched off. While he accepts that sufferers initially spend long periods in bed, he advocates a preference for plonking yourself on the settee and watching mindless day time tv or romantic films ie nothing too taxing.

 

His chapter on Staying Well is excellent. If nothing changes and the same choices continue to be made in your life then the depression will come back to hit you again and again. He equates ‘crisis’ with a ‘time of opportunity’ as it allows you to switch off, cancel your busyness and all those activities which led you to ignore your self-care. This is the opportunity to make changes. If nothing changes, everything remains the same.

 

Once recovery has begun the author describes a stage when he visits a patient and finds the hoover in the middle of the room. We feel better and the mess is at last irritating us and making us want to ‘clear up’. However, we get the hoover out and start hoovering only to find that within 5-10 minutes we are exhausted and abandon it. We can’t even put it away.

 

When I recounted this stage to my partner he immediately recognised it. The spirit is willing but the body has not recovered enough. The lack of exercise over even two or three weeks will take its toll. Also lethargy is one of the symptoms. Rather than hoovering the whole house and leaving ourselves exhausted and back ‘down the hole’, he advocates increasing such activity slowly. For example, rather than push yourself to go to the supermarket and feel drained, make your first outing a trip to the shop on the corner. Oh yes, I have found myself there a few times since Christmas.

 

There is much more in the book to explore. As the author says, if you are reading it when you are first unwell just read the first five pages in two or three efforts. Even the most avid reader cannot concentrate on a complicated novel when they are depressed.

 

I have to return the book in ten days time so I intend getting my own copy.

 

Do try it and see if it makes a difference to you. I did it for me!

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Bi-Polar

Alternative Therapies

 

Many years ago when I was ill for the first and second time, I knew little about strategies for regaining my sense of well-being. I was only offered tablets but, while in hospital, I did go to relaxation sessions. However, there was nothing more on offer. This was in 1989 and the early 1990s.

How much has changed now. Mental Health is on the agenda and discussed openly. Only this weekend, a Times Journalist wrote in the Times Magazine about his descent into and recovery from depression. Sports personalities also discuss their own predisposition to this debilitating condition. We are often surprised as we have only seen them as successful sportsmen.

However, stress and over activity can tip successful people away from being at the top of their game and they can find this difficult to cope with.

Over recent years I have used yoga and, more recently, Mindfulness, to bring myself back to some sense of normality. I have also found a therapist who is trained in several techniques. I have had Indian Head Massage, full massages and facial massage. The latter is wonderful when anxiety is at its worst and I wake up to puffy eyes.

But the most recent therapy I find beneficial has been Reflexology. This, I found more relaxing than a body massage. After one session about two years ago I walked home completely disconnected with the world around me, save for a wide smile on my face. The feeling of well-being was immense. I stopped at the cash point, inserted my card, requested the cash and took my card. I walked away without the money only to realise half way down the street but when I ran back it had gone. Luckily my bank was able to resolve the problem.

A few years ago I visited a Reiki therapist and found it helpful. The therapist then moved away. My love of reflexology over the last few years has caused me to forget that experience but when I discussed my recent acute anxiety with my therapist she suggested that I try Reiki again and, at the end of my reflexology session, she gave me five to ten minutes of the technique.

We have decided that I will have 50/50 Reflexology and Reiki for the next few sessions. I try to visit her once every three to four weeks but during a bad phase I will go more often. I am not rich but I have learnt how to economise in other areas of my life to enable me to afford these treatments. They are the gold dust.

Reiki is apparently particularly beneficial in dealing with anxiety.

I will be writing about my Reiki treatments on this blog so watch this space.

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Bi-Polar

‘Down Days’ or normal life?

What are ‘Down Days’?

I follow a mental health blogger, Natasha Tracey, and, while some posts don’t resonate with me every time, most of what she talks about I can identify with completely.

Many people will refer to being ‘down’ and they do not have clinical depression or a Bi Polar diagnosis. Sadly, these comments do not help those with serious mental health conditions as they trivialise what is, for those of us with such disorders, something debilitating and immobilising.

In her latest blog, Natasha talks about someone referring to ‘Down Days’ and she makes the point that hers are not days but more likely weeks and months. You can read her blog here and, if you find it of interest you can follow her and receive updates in your inbox.

http://natashatracy.com/bipolar-disorder/down-day-bipolar-mean/?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+natashaTracy+%28Bipolar+Burble+by+Natasha+Tracy%29

I, too, don’t have ‘down days’. I know immediately that my mood has dropped. It will follow a period of busyness, project building, possibly excessive spending which, at the time, seems absolutely necessary but, in the time that follows, reality tells me that I did not need whatever it was I spent my money on.

I used to ruminate about recent spending but have learnt over the years not to take off labels, to keep receipts and seriously consider returning items, if that is possible. If I decide to keep some dubious purchases, I have discovered that a few months or a year or two down the line these items can be used and are not a waste. If you suffer from this behaviour, take heart that all is not lost.

But back to ‘Down days’. I recently had an email from a ‘friend’ who referred to her ‘highs’ and ‘lows’. She does not have Bi Polar or mental health issues. Her ‘high’ was related to a holiday or some success and her ‘low’ was linked to losing a relative to cancer. And this is where the boundaries between what is normal and what is a serious mental health condition become blurred. Hers were the ‘normal life’ happenings with natural emotional responses. Mental illness is something else altogether.

I do wish those who do not have mental health issues would not trivialise the emotional states of those who do by referring to themselves, as if they suffer the same states. They do not. The extremes with Bi Polar are so great that normal living becomes almost impossible. A high state can result in losing sense of reality and psychotic symptoms such as believing you can achieve the well-nigh impossible or drift into some paranoid state whereby one believes the people waiting on the street are police about to arrest you, when in fact, they may be Jehovah Witnesses discussing where next to visit. The ‘crash’ that follows a ‘high’ involves much regret at spending or actions taken and are far deeper than simple ‘down days’.

I know that some people suffer rapid cycling and can experience both high and low states in one day or in a few weeks but most people with Bi Polar will go through a period of wellness when their activity increases, their happiness is unbounded, optimism is high and life is good. That is fine until the mood slips slightly higher and the behaviour is more erratic.

The low period that follows such a ‘high’ period is not just a ‘down day’. It can suddenly envelop you in total inertia, lack of motivation and anxiety which can lead to an inability to get out of bed each morning. Even when up and moving, the brain and body are so slow that taking a shower is a major undertaking and simple activities such as making a cup of tea become increasingly difficult. The weight on my shoulders is so great that, after a cup of tea and a small breakfast, I am so exhausted I have to lie down and this repeats itself through the day as I try to overcome the lethargy and feelings of ‘walking through treacle’. Minor day to day happenings can appear insurmountable.

I dread the warning sign that I am sinking low as, unless I am very lucky and can stop it in its tracks, I know I am in for at least a month, possibly two when normal life will cease. It is, as I have said, more than just a ‘down day’, more like a ‘down month’. Luckily my medication means that I rarely go into deep depression for longer periods and I employ strategies to bring me back to a fully functioning human being. However, I am not complacent. I know that I could sink for longer periods as I did in the past.

But I have had help and advice, counselling and support.

So I know the following:

SLEEP is the key. If necessary I will take a small dose of Zopiclone for a few days to regulate my sleep pattern. I can increase my medication slightly .

RELAXATION is absent but must be reclaimed. I have a reflexologist who also has trained me in ‘tapping’ techniques. One or two visits will set me on the path to recovery.

EXERCISE is vital. Mornings are rubbish so an early lunch and then a long walk in the afternoon is called for. I combine this with sitting in the sun watching the waves roll in – the joy of living at the seaside.

CREATIVITY is absent so I try to write in my notebook each day. The entries make sorry reading later but I do include TO DO lists and the POSITIVES of each day. Re-reading these entries demonstrates how each time I sink low I need to explore why this has happened and how I can reclaim my equilibrium.

YOGA is essential for my wellbeing but is something I have often neglected before this phase. I start with 20 minutes on a blanket and try to increase it each day. This can strengthen the muscles which when we are inactive become weak.

DAYLIGHT is another essential. Sitting outside in the daylight, walking or gardening all helps.

DEEP BREATHING – also used in yoga – helps anxiety and aids relaxation.

LISTENING TO MUSIC is a recent addition to my strategies. Listening to classical music has been found to have positive effects on the brain. Uplifting music and dance tunes can also help. You may find yourself singing or jigging away, perhaps even dancing. Creating your own music ie playing the piano or another instrument can take you out of yourself.

As a writer, I need to WRITE but this is hard at these times. This when I turn to blog posts such as this which I hope will help others. One thousand words is an achievement. Of course, I would prefer it was a chapter in a long abandoned novel but it is keeping the creative writing juices lubricated.

COMMUNICATION – is so important, with family, friends but is one of the hardest parts of the illness. Keep TALKING even if only to yourself while out walking. I try to talk to someone every day when I am out for a walk. It keeps me connected.

Depression is often a state of disconnectedness where we have lost some of our ability to relate to others and the world around us. However, it will return. It will pass.

What helps you cope with these low periods?

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Bi-Polar

There is always hope

I was told once by a consultant that the important part of coping with depression is to ‘keep striving’.

Keep striving, doing the things that help.

Keep striving to be active.

Keep striving, doing normal daily activities.

Keep seeing people. Don’t shut yourself away.

Keep talking to those nearest to you.

Keep looking after yourself.

I would add:

keep writing ‘to do’ lists and ticking off what you have achieved.

keep a routine – this can be the hardest and often is the first to fail

keep in the moment – as in Mindfulness

keep hoping and don’t give up.

 

As my doctor said, ‘you know this will pass,’

And I have found that it does, eventually.

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Bi-Polar, Uncategorized

Suicide in those with Bi Polar

Living at the coast I am well aware of the power of the sea and how it should not be underestimated but in coastal areas there are other dangers, one of which is the accessibility to cliffs for someone wishing to end their life.

Recently this happened near to where I live. The person was Bi Polar and had stopped taking her medication a week prior to the incident. The dangers of ceasing taking medication when one is Bi Polar are profound. A friend whose Bi Polar son passed through a difficult phase, was advised by a doctor to cease taking one of his mood levelling medications. Within weeks he had committed suicide with devastating effects on his family.

It is easy for me as a compliant BPD sufferer to say we should never, ever cease taking our medication even if we feel particularly well. In fact this is the dangerous point in this most evil of diseases. Sufferers pass through a well phase, feel they can cope with anything and stop taking their tablets. The effect is to cause a sudden sharp dip in mood when the person will become suicidal.

While not wanting to cast an opinion on the role of relatives in this case, those close to the patient should be alert, particularly if they appear resistant to taking medication which is common. If you have a relative who appears reluctant and complains that the medication makes them drowsy and complains about other side effects, this relative is probably vulnerable to believing he or she can do without it.

Those close to me know I am such a fan of my medication they need not worry. This is because for years my non-aware GP failed to refer me for psychiatric help despite the fact that I had received regular checkups at my previous address and all this was documented on my notes. The result was a few years of miserable times coupled with manic highs when I risked much financially and fell out with people. When I was finally referred after the intervention of my partner’s GP, I was put on Quetiapine and immediately felt the effects (once the initial dizziness and muzziness had passed). Eight years later and this has changed my life. I sleep well – Quetiapine has a sedative combined – and the regular sleep has made a difference. Whereas before I had weeks without sleeping or only sleeping 2-3 hours and long periods of early waking – that awful jump start at 5am and the sinking feeling in the stomach that reminds you how depressed you are – I now sleep a regular eight hours and wake refreshed. At night, I fall asleep quickly which prevents rumination and anxiety.

I am not saying it is all plain sailing. There are difficult life events and periods when I may wake on and off and wake up anxious but I use Mindfulness and take a herbal remedy such as Kalms for a week or so until  the symptoms subside.

Years ago I often had suicide ideation – when you do not make plans but the idea is there that one day you might use that way out but this has passed. This is partly because of the medication and partly that I have seven grandchildren and made the decision some years ago that I would not want them to live with the knowledge that their grandmother had taken that route out of life. I want to be a role model for them so they have been my salvation.

My writing is also my therapy and absolutely free. I make sure I write something every day even if it is only a diary entry – when low sometimes the creative juices dry up. However, depression is common amongst writers and research has not established whether it is because depressed people turn to writing as therapy or whether writers are more vulnerable. It is a solitary occupation so writers need to have networks to keep up social interaction.

I feel intense sadness for the family of the person who chose to jump from our nearby cliffs. I can only guess at their heartache and the possible guilt they may feel that they did not recognise the signs or take any action. In mitigation I would say that Bi Polar sufferers are canny hiding their symptoms and mood swings. I am sure that, in this case, the nearest relatives were kept completely in the dark. We are quite private people. We may talk a lot at times and disclose much but we do not wish to burden people with tales of our darker mental states. Also those who sink to such low levels become quite secretive and quiet.

It is therefore no wonder that relatives find themselves unable to prevent such a tragedy. Beyond investigating if medical intervention and monitoring was sufficient – and lets’ face it the mental health services are in disarray with lack of funding, all of which is a disgrace to our present government –  all I can say is they should take some comfort from the fact that this was an action of choice albeit an unfortunate one.

If you know someone who might have stopped taking their medication you need to speak to a medical professional ideally someone with experience and expertise in mental health. Some years ago, it was planned that there would be a point of contact in each GP surgery – a mental health professional or counsellor who could deal with distressed patients or worried relatives on a ‘walk-in’ basis. As far as I am aware this has not happened.

It is time for the government to place importance on mental health services with a view to preventing such tragedies in the future.

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