A darker time than usual.

I don't want to alarm anyone, but I'm struggling right now and I don't know why.  I post a lot of more positive things usually, however that does not mean my life is all sunshine and rainbows.  As a matter of fact, most days it is a numbing grey sensation.  Right now seems a bit darker than usual though.  I can't quite put my finger on it.  The sensation for harming myself is high, and with each passing day it gets higher.  Don't panic, I've already told people and have plans in place to ensure my safety.  I'd like to take this time to talk about these urges though.

These urges have come with an increase in nightmares and closed eye hallucinations.  What do I see when I close my eyes?  Random patterns of light at first, then flashes of images that I can't control, usually disturbing in nature.  This leads to me not getting restful sleep, which in turn leads to depression.

Currently however I am experiencing a mixed state.  Which is when I am experiencing both a high and a low all at the same time.  Which is confusing to imagine, I know, but I assure you that such a thing exists.  This makes it hard to identify what is going on with me because on the one hand I may have a lack of interest in things that I normally would, conversely I have more ambition for things that I haven't done in a while.  I also am aware that this is the time when I am most prone to actually committing suicide.  All my attempts in the past have been during mixed episodes.

I'm not sure why I'm feeling this way, or even if anything can fix it.  Maybe it is time to see about getting my medications changed.  I've thought about getting another evaluation done, because I'm thinking there's more at work that just bipolar and social anxiety disorder.  New country, new rules though, so I'm not even sure how to go about getting that done.

Or even if they will, given how long I have had this diagnosis.  Not being believed is something that bothers me.  Especially after an event that occurred about four years ago during a hospitalization.  The doctor asked me where my scars were.  If I cut, I would surely have scars.

This upset me greatly, and makes me hesitant to share my experiences honestly for fear of being judged like that again.

At any rate, I have been given the task to figure out what is wrong.  What if nothing triggered the episode and I am just chemically deprived?  I suppose that would be what is wrong.  I suppose trying to figure out how to get to a doctor is a good first step.

What do you do to help in times of darkness?  I'm looking for any suggestions you may have.  Thanks for taking the time to read.

--JJM

Dealing with general anxiety (a short introduction to my experience)

I often get stressed about things and I don't understand why.  Even better than that, I often get stressed about things and I don't know that I am even stressed about anything in particular.  This leads to many things, including fatigue, anger, and general unrest.  This often comes out in my being particularly cantankerous at times.  I fully realize that I may need to focus on this and am mostly writing to brainstorm on what I can do differently to help recognize my triggers and how to deal with them in a healthy and productive way.

Perhaps I should look at things in reverse.  Perhaps I should notice when I am being particular on edge and stop and evaluate, in more detail, why I am feeling that particular way.  In the past this has been less than ideal because I would find something external to focus on as the trigger for my current issue instead of what was really bothering me.  This led to many arguments that could only be classified as extraneous.

One thing that seems to help is to have someone understanding who is able to "check" me.  That is, ask me why I'm upset and understand that my stated reason may not be the true reason.  Though, as understanding as she is she sometimes upset that I am not more able to identify my emotions and thoughts.  She touts "mindfulness," but I try.  The issue is my mind wanders, and I mean goes out for a walk to end no others.  So many thoughts occurring simultaneously in such a way that they are like fish swimming in a school:  hard to track down and catch a single one.

This is apparent in the way I write.  More free-form I suppose.

Anyway.  The way things are going right now, I know that I'm stressed about work (I've now got two jobs), but is that all?  I know right now I think I'm struggling with things emotionally, but I'm not sure how much of that is work, and how much of that is me going so long without "professional" support.  Perhaps a mixture of both?

I just know that I am lucky that the Universe has conspired to guide my actions in such a way that I wound up with my wife.  I could have theoretically wound up with her if things had gone ideally with university and other aspects of my life, but I would not be the person I am nor have the things I do.  It is a wonderful conspiracy to be sure.

I should probably end this bit of a rant before it becomes totally derailed.  I will write again soon with regards to what I am struggling with specifically.

--JJM

Yet another hiatus, hopefully my last.

There seems to be a pattern with my writing, where I write for a month or two and then stop.  I must analyze this and figure out why I fall into this pattern.  My wife seems to think that I only write when I am going into a manic state.  Based on the two years I actually wrote it seems that I then “get manic” in the early spring.  This all leads to the notion of self-awareness.  I am not the most self-aware when it comes to my emotional state.

So, how do I become more aware of my mental state?  My wife bought me a book on mindfulness for the holidays last year, which I read, but it was more on mindfulness meditation.  That is great and all, but I do not know how that would translate into becoming aware of my emotional state when it changes so frequently.

Enough of the negativity with that, what changes have I made to help prevent my mood swings from becoming too frequent or extreme?

Whereas I had always awoke at the same time regardless of when I had gone to bed, I have again changed my sleeping patterns.  I have two times that my alarm is set for, an earlier alarm for the weekday, and a later alarm for the weekend.  But, what I have done differently is decided that I will go to bed at such a time that I always get eight or fewer hours of sleep.  This coupled with a much more strict control over caffeine intake has led to far fewer manic episodes over the past two and a half years.

I have also began using a bullet journal.  What is a bullet journal you ask?  It is a journal with a set of bullet points that correspond to things that I need to keep track of, such as chores, hours of sleep, naps, energy levels, mood levels, and making sure I shower, eat, and other such day to day activities I sometimes struggle with.

What has helped with the depressive side of things is being out of the house on a nearly full time basis during the day, giving me something to occupy my time so that I don’t have the ability to ruminate over things as easily as I used to.

That is not to say that medication hasn’t played a huge role in my continued stability--it has.  I have been careful to keep track of the days I miss my medication and how that impacts my mood.  All in all, these things have all led me to be very stable with only minor fluctuations that are to be expected, and almost always they have some sort of event that triggered a, usually depressive, episode lasting usually just a day.

These things have led me to believe that I can, and will, be better at maintaining the blog.

I am not going to make any kind of false promise that I will update as regularly as I should, but will only do my best to honestly report what is happening with me, my mental health issues, and the so called “good fight.”

But, why would I want to continue writing when I am so notoriously bad at keeping up with it?  Before I would look at my numbers and get discouraged that they weren’t higher.  This was utter nonsense as, firstly, such things shouldn’t matter.  Secondly it takes time, time that I have, time that I want to put in, but had an inflated sense of purpose due to hypo-mania.  I strongly believe that by starting writing with no clear goal, as well as during a time that I am generally unmotivated to do things could very well lead to building writing into a habit rather than an exciting new venture.

Also, I was in contact from some people from the psycho-social rehabilitation centre I was a client of several years ago, and it turns out that they have used some of my postings as a point of education.  This fills me with a sense of actual purpose, as now I know people read, enjoy, and benefit from my ramblings.

So, now I turn to you, readers, what would you like for me to talk about?  What should I do to help keep me focused on the long term goal instead of such short term goals that burn me out?
--JJM

The importance of routine.

     Every weekday morning I wake around 7:15 AM, take my medication, and get ready for the day.  After returning for the day I wash the dishes and start dinner.  After eating I sit and attempt to write for at least an hour.  After writing I have about an hour’s free time before taking care of the cats and getting ready for bed.  I am usually in bed between 10:00 and 10:30 PM, and fall asleep around 11:00.

     Weekends are a bit more lax, in the waking time, but I still go to bed at about the same time.

     It is important to have a routine, especially with bipolar.  Routine keeps me stable; at least it helps.  I know I get very upset when my long time routine is disrupted; specifically when I am informed of plans at the “last minute.”  I need at least a week, preferably two, to process the plan and become okay with it.  This is partially due to a disruption in my schedule needing to be taken into account and worked around, but another large factor is the anxiety associated with change.

     Routine makes it harder to forget things like showering or taking medication.  Also, and perhaps most importantly, sleep routine regulates my mood.  If I stay awake all night (something I haven’t done in over a year) I almost certainly swing into a manic state.  Going hand in hand with this, I limit my caffeine intake to about two cups of coffee a day, in the morning, and no more throughout the day.  This gives me the little pick-me-up I seem to need in the morning without keeping me up at night.

     My wife helps me stay on track with my daily and weekly routines, making sure I do what is needed.  She also asks why I didn’t stick to my regimen.  Adhering to a strict schedule can be difficult at times, but I know it is what is needed to keep me well, and that is very important to me.

     What types of routine do you have?  How does it impact your life?

--JJM

My experiences with sleep paralysis.

     Amongst other things, I suffer from bouts of sleep paralysis.  Sleep paralysis is when your brain wakes up before your body.  I have had many varied episodes and can give an account of them.  Firstly, my sleep paralysis occurs when I am waking up, and usually lasts somewhere between ten seconds to two or three minutes.  Those longer episodes are the more frightening (I will get to why shortly).

     Often these episodes are accompanied by hallucinations.  These can take the form of out of body experiences, feeling as though someone or something else is in the room with me, or some other vivid dream like experience.  When I am having a hallucinatory episode involving something else in the room, I am often filled with a great sense of dread, as though whatever is in the room is going to try and hurt me.  Sometimes this is accompanied by the sensation that something is on my chest making it difficult to breathe.

     While this is occurring I try to move my arms and legs but can’t.  It is as though some unseen force is pinning me down.  I usually also attempt to scream, but cannot.  The most frightening of all is when almost all of these things occur simultaneously; that feeling that something in the room is trying to harm me, while choking the life out of me, as I try to scream to no avail.

     These episodes often leave me feeling very tired for the rest of the day, and when one occurs it is very likely more will as well.  This makes napping a very “risky” choice.  If I fall asleep during the day, there is a good chance that I will have another sleep paralysis episode making me just as tired as I was before the nap.

     I do not remember having an episode until I was in my early to mid-twenties, with no particular trigger that I can remember.  This is not uncommon.  According to webMD, these episodes are supposed to be fairly common with people who suffer from mental health conditions such as anxiety, bipolar, depression, and post traumatic stress disorder (PTSD).  It is also associated with some physical conditions, particularly narcolepsy and sleep apnea.  Despite all of this, by itself sleep paralysis is not considered a major debilitating condition.

     Have you ever experienced sleep paralysis?  What are your experiences with it?  Or, even better, if you’ve overcome it, how?

--JJM

Should you tell other people about mental health conditions?

     When is a good time to tell someone you suffer from a mental health condition?  The answer, as you may have guessed, is highly subjective.  Many factors play a role in the time, place, and manner in which this information should be relayed.  The biggest question, I suppose, is “does this person need to know?”  For instance, it is important when talking to a doctor or other professional about health concerns and medication that you fully disclose your diagnosis, current symptoms, and your list of medications.  It may factor into things like why your blood pressure may be high, or why you are overweight.  Many psychiatric medications are known to cause weight gain, or you may be a binge/emotional eater, in which case they may suggest therapy in conjunction with diet and exercise.

    Telling a partner, or potential partner, can be a rather tricky situation.  I have always made it a point to tell people I am dating very early on that I have bipolar.  This is because it goes to explain some of my behaviours and lets them decide if they want to invest the emotional energy in the relationship beforehand, especially while I was attempting to manage my conditions without medication.  Another important factor is that many mental disorders have a genetic component and therefore may be potentially passed on to children.  As with any genetic consideration you should always tell anyone you may have children with of your contributing factors.

     Letting a friend know of your condition is something that is far more subjective than others.  Does this person need to know?  Exactly how close are you?  Is it something that is likely to impact their life as well?  Depending on how well you know someone it may strengthen the relationship by giving a reason as to why you behave the way you do.  For instance, if you have social anxiety and often cancel plans, letting a friend know that this is the reason you cancel plans could very well lead to understanding and compassion.  If they react negatively or abandon you, chances are they were not a very good friend to begin with.  Strangers and casual acquaintances almost never need to know.

     As I have stated before, having a mental illness is not unlike having any other kind of illness, and a good guideline is if you would tell a particular person about a hypothetical physical illness, then telling them about a mental one is probably okay.  Of course, this is all highly subjective and no one should be forced into telling another person something they are not comfortable with.  If you are not comfortable telling someone something as intimate as your mental health, then don’t.  However, keep in mind that only by openly talking about it can we eliminate the stigma surrounding mental illness.

     I was once talking to someone in the mental health field; they said something along the lines of being less forthcoming about our mental state to those that do not need to know.  I think there is a clear cut difference between being proud of something and being accepting of it.  I do not think that the condition itself is something to be proud of; however a person should take great pride in their victories over their illness.  Just because you shouldn’t necessarily be proud doesn’t mean you should be ashamed either.  No one should be ashamed of something they cannot help or change.

     What are your guidelines for telling someone that you have a mental health issue?  Or, on the flip side, what would you be comfortable hearing someone tell you about their issues?

--JJM

Thoughts on therapy.

     I would imagine a lot of people are afraid of the idea of therapists.  The idea of allowing yourself to be so vulnerable to a complete stranger is very alien.  I have only had two therapists for any extensive amount of time; and both experiences are completely different.  During my first session with my therapist in the United States, she completed a rather comprehensive sort of evaluation that allowed her to recommend a diagnosis to the psychiatrist.  After that she dove right into problems I was currently having.

     Here in Canada, a much more basic evaluation was given, more as a general psychiatric and psychological history than anything else.  The next few sessions were a getting to know each other period where I didn’t talk much and answered her questions directly.  There was a great period of time in both instances where I needed to become comfortable with talking to them about my issues.  In both cases, there was very little talk about my past and instead a focus on how to deal with my current problems.

     I have been undergoing a form of therapy known as cognitive behavioural therapy (CBT), which has less of a focus on past trauma and instead focuses on the present and changing your thought-feeling interaction.  It is especially useful for people with anxiety or other issues dealing with irrational thoughts affecting moods.  My current therapist does most of the talking during our sessions.  Given my various issues this is not necessarily a bad thing.  It does, however, go to show that the pressure is not on you to talk if you don’t want to.  It can be beneficial to “interview” your therapist to see what types of therapy they offer, credentials, and other things important to you in a potential therapeutic partner.

     I am in a position where I cannot “shop” for a therapist, though it is recommended that you do so that you can find one that is right for you.  Generally therapy is not cheap, but keep in mind that there are usually options for those who cannot afford regular therapy costs, such as sliding scales, government-assisted payment, and non-profit organizations that help people with mental health conditions.  I am fortunate enough to be in a position where I do not have to pay for the therapy I receive; the trade-off is that I am limited to a very small circle of therapists I can see.  Even in my position, I still have the right to seek another therapist if this one does not meet my needs.

     Seeing some sort of therapist does not make a person any weaker.  Therapists are often nothing more than a sounding board or tool to get alternative ideas that you ordinarily would not have thought of on your own.  Often my therapist gives my thoughts validity and gives me the courage to actually do what I know needs to be done.  A therapist is just another, as mine would say, tool in your toolbox of mental health.

     What are your thoughts on therapy?  Do you see a therapist, do they work for you?  How long did it take for you to find one you liked?  What sorts of questions would be helpful while “interviewing” a new therapist?

--JJM