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, 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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Early Warning Signs (EWS) and how to deal with them

There was a time when, following a move and a new GP, I struggled with my Bi Polar and would pay visits to the surgery in the hope that some help would be forthcoming. When I related my symptoms I was told that I was being super sensitive to the feelings and frightened of descending into previous illness that had resulted in hospitalisation. I often wondered if she had read my notes.
After attending a Living with Bi-Polar course I learnt that these thoughts, feelings and behaviour are important for they are our EWS (early warning signs). While these may differ between us, many are commonly experienced by sufferers of BPD.

If you are reading this because you suspect you may have the condition I hope you will be heartened by the knowledge that all these feelings will pass but there are some things you can do to make yourself feel better in the meantime. However, if you identify with the symptoms you should consult your GP who may refer you for further assessment.

My trigger is usually a period of stress even if I think, at the time, that I am coping. Sometimes, I have a fall, a sign my balance is off centre or that I am not concentrating. I may have been exceptionally busy with normal activities but not manic. Holidays and Christmas can cause this.

So what are my early warning signs of bipolar depression? First I begin to wake up tired rather than refreshed and find it difficult to get up. I am aware that something in my life is missing and that is the sense of joie de vivre, being able to enjoy simple activities and generally looking forward to what life has to offer. I begin to lose interest in activities I previously enjoyed. Over a few days I notice I am feeling overwhelmed with a range of daily activities that I would normally take in my stride. I begin to forget things and find it difficult to plan ahead. Time becomes short and I cannot fit in what needs to be done. This causes some anxiety and I become aware of a few worries. These increase over a few days. My sleep is disturbed. Whereas my medication usually knocks me out, suddenly I either cannot get off to sleep or I wake with a start in the night. Early waking might happen but if I am lucky my medication will allow me to drop off again. While I have been enjoying my food when well, now I feel sick in the mornings and may feel giddy or uninterested in food. I may have difficulty swallowing, particularly where tablets are concerned. As a writer, one sign is that I stop writing or find it difficult to engage with a manuscript that previously had excited me. I begin to spend more time sitting on the sofa but achieving little. I get things out and do nothing with them, start to read an article but fail to finish. A number of half read papers start to pile up. By now the kitchen is untidy and my normal attention to cleanliness is notably absent. Dishes in the sink and cold cups of tea sit forgotten on the table, made before I wandered off to do something else. I am now feeling unsociable and am reluctant to answer the phone or make arrangements to meet with friends. If one of my friends cannot meet up I may experience a feeling of relief.

Now none of the above is a serious warning sign on its own. As the peer specialist told us, ‘it is when several EWS are observed and they hang around for a while.’ The key is being aware. Unsurprisingly most of the delegates on my refresher course last year identified with many of the above signs.

Luckily I now recognise these signs and rather than ignore them which my GP thought I should, I know that I need to take some action.

There are a few strategies which can bring you back on to a previous mood level before depression takes hold. Some cost money and others are there for free. The following ideas are a mix. You may not find them all helpful but some should suit where you find yourself at the moment.
• Getting out for a walk, however short, in the fresh air and, hopefully, sunshine, will boost endorphins.
• Writing a mood diary and recording daily activities will get you writing.
• Reading poetry takes less concentration and might help. Try humorous poetry.
• Set achievable goals especially when tidying up neglected areas. Choose a few shelves or one file at a time. To plan to tidy the whole house will result in failure and increase your despondency.
• If you can find a reasonably priced therapist book a reflexology session for deep relaxation.
• Experiment with ‘tapping’ techniques. Tapping therapy or EFT (Emotional Freedom Techniques) is explained on various websites. If you are unsure it would be worth paying for half an hour of therapy for a demonstration and help with setting intentions.
• Write a To Do list every day with achievable tasks. Keep it short and cross off those completed. This aids memory too.
• Phone or visit a member of your family.
• Watch ‘happy’ television programmes and avoid the news which can increase anxiety.
• If reading is a problem, watch an interesting documentary dealing with a topical debate.
• Write down three positives for each day. These could include cooking a meal, phoning a friend or watching tv. A walk in the sun, sending an email to a friend or writing your diary also qualify.
• Take the pressure off yourself. Instead of berating yourself for not getting out of bed in the morning, give yourself permission to stay in bed for a short time. If it is a choice you will feel better. You will soon be getting up more smartly when you feel better.
• Accept you have an illness and that this phase is part of your illness. I was told this a year ago and found it liberating.
• Tell yourself that your brain worked hard and was overstimulated before this phase. Depression is often the brain’s way of ‘having a rest’. Let it rest and don’t fight it or force yourself to do things you find difficult at this time. Make a choice to rest your brain and keep occupied with physical activities that are possible at the moment. This is NOT giving in or being lazy. It is allowing your brain to recover.
• Listen to music or play an instrument.
• Do some stretching exercises each day. Practise yoga and feel the difference.
• Remember depression does pass.

Some of the points above I have already written about on my blog eg the idea of writing down 3 positives each day. Other points here will be expanded on in future posts.

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Party Girl

Once again on New Year’s Eve I found myself in a conundrum.

Friends for drinks, more friends to meet in town and someone’s idea to go to another pub at the other end of our town where there would be a Karaoke.

it has happened before. By 10pm I have had a few wines – even the mulled variety has its effects – and much excitement donning fancy dress to march up and down our seaside high street trying to spot those we know despite the vast amount of makeup, wigs and costumes.

It is lovely to laugh and joke with friends and I didn’t want the evening to end. We saw in the New Year on the street and then were driven to the pub. By then it was nearly 1am, I sang my Karaoke song very badly following another large wine and then had to wait for my friend to have her name called to sing.

We didn’t come away until 2am which is early for most on New Year’s Eve. But not if you are Bi Polar. I knew at 1 am that I really needed my night time medication and to curl up in my bed to sleep for 9-10 hours. It is the only way I can cope with my condition. Luckily I did not get carried away and stay on until 4am which some other friends did in a pub elsewhere in the town.

Once through my front door I fell on my meds pouch like a starving child being offered food. I drank plenty of water and made for my bed.

Of course I didn’t go to sleep for a long, long time. Disrupted routine, alcohol and excitement do not go hand in hand nicely with Bi Polar. So I am still lying awake at 4 am thinking I could have stayed out but, actually, no, that would have made it worse. It takes me time to ‘come down’ from being a Party Girl and the insomnia is caused by a lurking worry that this disruption may signal a ‘bad week’. I do so well coping with my Bi Polar that I really do not relish the idea of a spell of bad mood.

But this year I am in luck. I eventually drop off and do not wake up until 10.30 and I know that the following evening I can go to bed earlier and catch up. Well, perhaps not that night as we have family visiting but by the evening of 2nd January I know that I am stabilising and my late night has not put me into a low and spoilt my grandchildren’s visit.

Phew, I have escaped. Next year I may decline to go to the pub following Auld Lang Syne. For now I am getting through January without the terrible debilitating depression I experienced last year.

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Three Positives Each Day

A few months ago a friend on Facebook was nominated to write three positives in her life for each day and to keep it going for a week. This was before the ice bucket challenge.

I have since read that writing down three positive things that have happened to you each day can bring happiness and change your attitude to your life. So I have been doing this for a week – in the name of research of course. I am really quite happy at the moment.

So, in my writer’s notebook I date each entry and, somewhere during that day, when I am writing down profound thoughts, ideas for the next novel, the first lines of a new poem or a list of things to do with regard to my soon-to-be-published poetry book, Grandma’s Poetry Book, I then jot down ‘3 pos’ followed by whatever pleasurable activities I want to list.

A week ago I wrote ‘3 pos for 17/9’ but actually wrote SEVEN including sniffing the seaweed in the sea air, eating a sausage roll sitting on a wall looking across bay towards the Isle of Wight, listening to the roar of the east wind, walking down to the Coastguard station and lying on a towel in the sun for half an hour. Another day my 3 positives were reading two poems at an open mic night in a local pub, dropping off to sleep more quickly after a slight change in medication and writing two more poems.

This has now become part of my routine, usually towards the evening as I reflect on what I have done or enjoyed. I have made a pact with myself not to put purchases on the list of positives although buying a lovely gilet in a charity shop for a mere £4.50 did feature yesterday. Buying things does not always give us the payback that we believe it will so I am keeping my positives to activities or shared moments such as a walk with my partner and enjoyable tv viewing such as Downton Abbey.

Which reminds me. Downton’s first episode is awaiting my attention on my Freeview recorder so I am off to watch it now!

Then I can add it to today’s positives.

Why don’t you try it and let me know how you get on?

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