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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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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A drug less slow

I have been on Quetiapine since early 2008 and from the outset I knew immediately that this was the drug that I had been waiting for. It did not leave me seeing life through a net curtain which is the case with so many psychiatric drugs. For the first time in many years I fell asleep quickly usually within fifteen minutes of taking the tablets. I then slept each night for around 8 hours and this became such a regular pattern that my sleep was predictable, something that the mind needs. Routine and predictability are key needs when someone suffers with a mental illness so the provision of this drug saved me much distress, previously caused by lack of sleep. the drug is used as a mood stabiliser and it does contain a sedative but, more importantly, it comes under the umbrella of anti-psychotics. Gone were the feelings I was being watched or that people were talking about me. I no longer feared opening the door. I knew the police were not outside unlike previous spells prior to taking this medication.

Last year I became physically ill and immediately went into a full blown episode partly caused by kidney failure and partly by some family difficulties I was unable to resolve. During my hospitalisation my Quetiapine was changed to a ‘slow release’ type. The aim apparently was to allow the drug to work over a 24-hour period. The slow action, however, meant that, after five years of good sleep patterns I found myself lying awake at night for up to three hours or more only to wake late and struggle with drowsiness until mid morning. No doubt I had to some extent become dependent on the drug to help me sleep and I was not getting enough injection of it at bedtime to bring about the desired result.

The change in medication had not been explained to me but, like so many people who have learnt to cope with their mental health issues through a process of trial and error, I worked it out for myself. I began to take the tablets earlier in the evening and for a while this worked but I still slept excessively late and crawled out of bed in a drug filled haze.

However, social occasions mean that I cannot always take my tablets during the evening and visiting friends and relatives involved excessive wakefulness until the early hours of the mornings. I became more and more frustrated and resorted to the use of Zopiclone when away from home. Deep down I was not happy with my disturbed nights but provided I slept late and clocked up 8-9 hours I knew I would stay well.

For some reason this form of Quetiapine (also known as Seroquel) remained on my repeat prescription and it was only when I saw a different GP for another non-mental-health reason that the subject of the type of medication and my dissatisfaction with it was discussed. Simple, he said, ask your named doctor to change you back to the regular type of Quetiapine. So I did. I wrote a note explaining that I would like to be taken off the slow release and a new prescription followed in days.

What joy! Now I drop off to sleep within 15-20 minutes of settling into bed. Reading in bed has become a shortened affair! But, undeterred, I have resolved this by reading before I go to bed. Not only do I go to sleep quickly and have found little need for a sleeping tablet but I do not sleep too late in the morning. I wake up refreshed and can deal with tasks almost immediately rather than dragging my feet around the kitchen waiting to ‘wake up’.

It is definitely a case of returning to a drug less slow.

And I am loving it!

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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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