Awareness is crucial in managing bipolar disorder off meds

Our circumstances can make us depressed. Seems like a fairly obvious statement, yes?

Sadly though, this fact is overlooked in the mental health field a lot, and even in our own personal lives. I know after being diagnosed with bipolar, I started to buy into all the messages out there – I NEEDED meds, it was bipolar that was making me depressed, I should monitor my moods so that I could alter my meds, etc. Sure, I had counseling but it mainly focused on – bipolar! Everything in a round about way came back to bipolar. I thought I was gaining clarity by listening to these messages. After all, these doctors and nurses and counselors were the experts, right?

During that time I was making videos a lot and still journaling so I have a lot of detailed accounts of how I was feeling and what was going on in my life. It is amazing to me looking back how unaware I was the vast majority of my life! I had a great deal of INSIGHT into my FEELINGS but very little AWARENESS of WHY I felt that way. I made one video about depression in 2010 and how nothing was going on in my life to make me depressed, and that it must have been bipolar. Yet, I was completely unaware of my surroundings and how they were affecting me.

During that particular time I made that video, I recall exactly what was going on, and my life was NOT going great at all. My husband and I were having major conflicts. It had been going on for months though so I think I just discounted it as having an effect on me, when I now see it was one of the main causes of my depression. Also, we were living with relatives at the time which was becoming stressful. We were looking for our own house, also stressful. I was taking care of twin 2 year olds, stressful. I can’t believe I didn’t take all that into account when looking at my mental state and the way it would fluctuate!!! I just thought, ohhhh, it’s bipolar…that stinks…maybe tomorrow would be better. In a way it kept me from addressing things in my life that were affecting me, because I was putting too much emphasis on the wrong things (bipolar/biological/medical problem) and not enough on other things (relationships/family life/stress level).

I guess I felt compelled to make this blog today because I think the current message in the mental health field is doing a disservice to those diagnosed with depression or bipolar. Here is my 2 cents…

I believe that many mental illnesses (including depression and bipolar) begin with an inherent sensitivity. This is something currently being researched in the mental health field and I do believe this is barking up the right tree, so to speak. I believe this sensitivity makes a person more likely to be affected by external stimuli. This can then manifest as many different things – anxiety, depression, mania.

For example – take an average person and a person with bipolar. Put them in a situation where they are going through a break-up. The average person will feel sad and maybe even depressed. The bipolar person may dwell on it incessantly, feel suicidal, perhaps even attempt suicide. The same stimuli but much more intense emotions related to that stimuli. (Keep in mind this is just a random example, of course this isn’t true of every average person or bipolar person! I’m just making a generalization.)

So, if I were to go to my psychiatrist and tell them all this, (in my fictional example) one of the first things they would be concerned with is: medication! Upping meds, changing meds, etc. They have the viewpoint that these things must be dealt with by pharmaceuticals. I used to believe that and I went along with it all. Now, I feel differently.

So many times over the course of my treatment, everything got lumped under the category “It’s because you have bipolar.” Is it? Well, no not really. Does being depressed because I have marital conflict mean it’s related to bipolar? Hardly. If I addressed the bigger issue (marital problems) could I help mediate the effects on my “illness”? I say yes.

Bipolar or not, we are all human beings. We feel low when we get divorced, lose a friend, have a family member that dies, lose a pet. Now, those are BIG things. But even little things affect us too. Having a stressful day at work. A sick child. An upcoming deadline. Interpersonal conflict. Too often, these things are not addressed in psychiatry or in counseling as far as ways to cope with these issues in healthy, non-medical means. Somehow, everything always comes back to an illness, even if it is a legitimate problem. To this day, within the bipolar community, whenever I say things that others view as extreme, they caution me that I must be having an episode. I deeply appreciate the care and concern. But it really goes to show just how ingrained the idea has become even within OURSELVES and TO ourselves that mental illness is WHAT we are. That we are helpless. That we cannot change or improve without meds. That any sort of variation means we better get some new meds, pronto, and that will help our situation.

Now, I think at times, medication plays a role but that often, when we learn to be aware of ourselves, our moods, our surroundings and WHAT is causing these feelings we can address them in a more pro-active way. Many people in the mental health system (including myself) did everything “right”. We went to counseling, we took the meds, we followed the regime for YEARS. But that is only addressing one small piece of the puzzle. We are multi-faceted individuals and must deal with our lives in a holistic manner, instead of focusing everything on ONE THING – our illness. That doesn’t help us, but instead keeps us trapped in a cycle we can never get out of. I often wondered WHY I wasn’t getting better despite doing all the “right” things (and believe me, I have heard the same thing from others about a million times! People want to know WHY these meds aren’t fixing their depression or their mood swings, WHY they aren’t getting better. Ultimately it can lead to a worse feeling of depression, because on top of the initial depression, there is depression for having “failed” to get better.)

I am now almost a year off meds and am so much more aware of myself than I was at the beginning of my mental health journey almost 5 years ago, and I am so thankful for that. Like I said, I could identify my feelings but not WHY I felt that way. I now understand: all the variation of mood, how various social cues trigger my moods or affect them (positive or negative), how the behaviors I engage in affect me, how all of this affects others. It’s not something that occurs overnight but is a learning process that occurs over time and with observation. Does that mean I’m now “fixed”? No. But it puts me ahead of the game because I can anticipate things before they happen. I can be prepared. I minimize the chances of being caught off guard. When bad things do happen, I can learn from them and try to adjust things/situations in the future. I know my weaknesses and limitations and try to take those into account when making plans or scheduling particular outings or things of that nature. For example, I now know that working hard on something can trigger elevated mood or “mania” for me. So, I don’t avoid working hard, but if I notice signs, I can either enjoy the ride or if it becomes extreme, back off and try to do calming activities to mediate the excitation happening in my brain. If I start feeling depressed and notice I’m ruminating on negative thoughts, I can purposely cut off the train of thought and engage in something more uplifting – some happy music, or watching a funny video, or talking to a close friend. If I weren’t aware of the effects of my environment on me, I couldn’t do any of these things! Awareness is SO important. I think it is THE most important thing in dealing with mental illness, period.

So my advice to anyone new to the mental health system or newly diagnosed is this – FIRST, take stock of your own life. No one knows you like YOU. You are the best advocate for yourself. We may like the idea of a fairy godmother or white knight swooping in and fixing us or fixing our lives but that isn’t reality. We must be our own advocates in life. Understanding yourself better can help you understand your moods and ways of coping or self-medicating (drugs/alcohol/self-injury/bingeing/social withdrawal, etc.) that are unique to you. You can in turn begin to address these things. SECOND – Don’t believe the hype. Even if you’ve been diagnosed with bipolar (or even if you just think you may have it) not everything about you is “because you have bipolar”! Bipolar in itself doesn’t make a person inherently – quiet, loud, obnoxious, generous, loving, selfish or any other thing. We all have to accept that we have our own traits regardless of bipolar. Don’t fall into the trap of believing “I’m a thrill seeker…it’s because I have bipolar!” or “I don’t like people. It’s because I have bipolar.” Not only is that boxing yourself in, but some of it isn’t even true (bipolar is simply a tendency for extreme mood experiences and shifts.) While you may be able to say you’re a thrill seeker while in an elevated mood state, if you’re like that all the time, it’s just your personality. (I’m going to go ahead and say that most people realize a lot of their own personality traits, good or bad. We don’t all admit them openly to others though!) Lumping all these things under the heading of “bipolar” may make you feel better for a while and you may feel validated that it’s not all in your head, (I know I did) but eventually it will consume you. Bipolar will become the only thing you see about yourself and in a weird way, it becomes a self-fulfilling prophecy. You believe you’re nuts and so you act nuts, so people treat you nuts and so you believe you’re nuts…It will make you feel worse and not better. And that isn’t what any of us want, bipolar or not.

LASTLY, Many times, bipolar or not, addressing the true issues in life can bring more happiness than simply relying on a pill. There is no miracle pill to cure bipolar or depression. But healing starts with AWARENESS. A person can never change something they are unaware of. If you walked around with spinach in your teeth all day and never looked in a mirror, would you think to floss your teeth right away? Probably not. You wouldn’t even be aware of it. But if you thought to yourself while you were eating your salad that you better head to the bathroom after you eat and make sure your pearly whites were white instead of green, you’d head off any unforeseen embarrassment. Point is, be aware. Aware of YOURSELF, aware of what is AROUND you. Notice how things affect you, what your particular “weaknesses” are, what triggers your moods (both down and up). Is it having too much to do in a short time? Is it dealing with money troubles? Relationship troubles? Is it being involved in a cool class? Experiencing something new? Really take a step back and assess your own life. You can be your own best friend or your own worst enemy. Only by truly looking at yourself as a whole can you begin to understand how to take steps that will bring the improvements you seek.

Hypersexuality and sensory seeking in bipolar mania and elevated states

I originally was going to write this blog and somehow wound up writing 6 other blogs about mania and mental health…everything BUT this. HA! There goes my wonky brain :/

I warn up front there may be some content some find offensive. However, I can’t fully address the issue without expanding on a few subjects within this idea of sex.

Many people have commented that hypersexuality must be great and they wish THEY had it! It’s funny how anything related to sex, people think is just the most amazing thing.

In reality, hypersexuality isn’t fun at all. I’ve been experiencing it to a huge degree lately and I hate it. Let me tell you why.

People envision being hypersexual as having the most or best pleasure when it actually does not bring pleasure at all.

In normal life, people can get sexual or sensual pleasure in lots of (healthy, non-morally ambiguous) ways. You can get pleasure from, say, kissing your boyfriend, or reading a risqué note from your husband. You can get pleasure from a nice body massage or receiving a “for your eyes only” photo from your wife. That’s normal sexuality, normal sexual feelings.

When you’re in a hypersexual state, the craving for pleasure is magnified hugely. And it is exactly that – a craving, at times an overwhelming, unbearable and unstoppable compulsion. Does it sound fun to have an unbearable compulsion that you don’t really want to give into but feel as if you can’t control? No. It’s horrible. It can be a super difficult battle.

I personally am a wife and mother. Granted my marriage is not great. But I am not the cheating type. I find it to be morally wrong, regardless of if my marriage is bad or any other factors. Not to mention I am also a Christian and I believe that cheating as well as sex outside of marriage (meaning, sex as a single person with another single person) is spiritually wrong. I believe we have a moral obligation to ourselves, to each other and to God to be morally upright and not slaves to sexual pleasure. As I mentioned there are plenty of healthy ways to express sexual feelings. But random sexual hookups, booty calls and inappropriate sexual behavior isn’t one of them.

So you can see how having intensely overbearing impulses to have sex with a stranger or to broadcast naked pictures or videos of yourself, or any related thing would be a huge moral conflict. Unfortunately, being in a hypersexual state is often accompanied by other cognitive dysfunction which can then lead a person to being ruled by the compulsion to act out. I can compare it to trying to restrain a wild bear with a cage made of cardboard. That bear is just itching to break out and the cardboard won’t hold indefinitely. If it somehow manages to, that cardboard will no doubt be shredded and crumpled in a heap at the end.

So it is with our sexual state when altered. Trying to bridle and restrain the compulsive sexual urges can seem impossible. It causes physical discomfort when in an extremely elevated state. The average man who goes without sex for long periods of time or becomes excited and then must stop sometimes complain about the physical discomfort of a heightened state of being aroused without getting a release. I would describe these hypersexual feelings for a woman as the female equivalent of that. It becomes physically painful to the point where a person feels they must have a release of some sort. It may be enjoyable at first to have that slight pain but after a while it is sheer torture.

Here’s the second problem. Even if you have someone to (legitimately) give you a release, most of the time, it IS NOT SATISFYING. Imagine it. That intense sexual craving, feeling that you need it or you may possibly explode, heightened to a point that will not “simmer down”. You expect you will have mind blowing sex, that you will release the tension and it will be glorious.

That’s not what happens. What happens is you have those sexual experiences and 30 minutes later…it’s as if it never happened. The horrible sexual tension and physical aching are there. What do you do?!?!? You feel like you must get it out. You need sex again…you need more of it. So you do. Annnnd….30 minutes later, the feeling is creeping up there again, tormenting you.

It is horrible, a feeling of intense need for release yet getting NO release, despite what you do, for how long or with whom. I believe this is why people with bipolar who are promiscuous behave in such a manner while elevated or altered. I personally do believe cheating is morally wrong and not acceptable to give into such desires. However, logically knowing and believing it does not stop the thoughts, feelings and compulsions. If a person DOES do something, it often leads to guilt and shame when “coming down” from the elevated state. Even if a person doesn’t do anything, there can be guilt and shame associated simply for letting the mind stray into inappropriate territory or entertaining the thoughts at all. The inability to control thoughts or feelings is a great cause of pain (emotionally), not pleasure.

In an early manic period I had, I recall the intense hypersexuality…dressing provocatively, flirting with anyone who came around, the whole deal. My husband and I had sex constantly for probably a week. Was it fun? No. It was awful. Because no matter what I did, the feeling DID NOT GO AWAY!!! I felt as if I were being slowly tortured. It reached a point where my muscles were physically sore and tired, I was raw and uncomfortable. Yet I STILL had this overbearing compulsion!!! Talk about agonizing. There was nothing good about it. Not. One. Thing.

I’ve been in a hypersexual state intermittently for a few weeks now, and much as all the times before, it is awful. I’d much rather go back to my normal state of hardly caring about sex at all to this!!! The cravings remain yet I know logically nothing I do will satiate them. In fact, a way I now try to control such compulsions is by thinking to the future. I remind myself how acting on any inappropriate sexual impulse ultimately leads to no reward. My body thinks it will, but my deep mind knows it won’t. I know the result will be: guilt, damage to relationship with spouse, damage to relationship with God, damage to self-esteem, embarrassment, a whole host of negative feelings and consequences that will last far longer than the sexual act (whether that be through text, email, video, or in person) would.

Trying to consciously fight the feelings away though is very exhausting. I have in the past few days begun taking anti-psychotic meds again because I have enough insight to realize that some compulsions I have are beyond my ability to consciously control.It just stinks.

External triggers are huge in bipolar and mental illness

So I finally after all these years realized that my outside environment triggers me constantly. There is this misconception in the mental health field I think that certain mental disorders are “all in the mind” or “biologically based” meaning not much influenced by outside factors. Well, that is just WRONG. Saying something is biologically based is kind of nonsense. If you want to break it down literally EVERYTHING we do is biologically based. Eating, drinking, talking, our personality traits, behavior, perceptions, sensations, every single thing about us originates in our brain and nervous system. So yes, everything can be found to have a biological basis. But that discounts the fact that we are indeed influenced by outside factors regardless of whatever our particular biology may be, whether we have this illness or that illness or NO illness. One thing that is really irking me lately is this argument about “bipolar depression” vs. “unipolar depression”. There really is no distinction. Both are influenced by internal and external factors. But instead of digressing, I wanted to talk about triggers, meaning external sources that influence mood or mental state.

I’ve noticed that I’m incredibly sensitive to outside stimuli. Lights, noise, textures, anything that relates to the senses or sensory processing affects me in a huge way. In fact, so much so that it can bring on altered mood state where there were none previously occurring.

Let me give you an example. I’ve been in the throes of some pretty extreme rollercoaster “episodes” if you will for a while. Yesterday I woke up the feeling OK – neither up nor down. I felt slightly bored as I was going through the motions of getting kids off to school, picking up the house etc. I decided to put on some upbeat music. I almost never watch TV but was in the mood for something “poppy” so I turned on MTV. Seeing people dancing and hearing the beats made my mood start rising. Well it rose a little too much, pretty fast. I got up to the edge where excitement and agitation combine.

My heart was racing non-stop, I was short of breath. I felt like I was going to have a pleasure explosion and anxiety attack at the same time. This went on for hours. I was jumping all around and just had to talk to someone, just HAD TO. I started texting random people, a couple that I barely know or don’t know at all. I was really impatient when some didn’t respond immediately and then began to feel irritated that they DIDN’T respond. Why didn’t they respond? I’M FUN!!!! LET’S TALK!!! NOW!!!

So after some people responded I was laughing and LOL’ing non-stop over my phone for a couple of hours, music still playing in the background. I’d dance and laugh and totally just surrender to the feeling of pleasure spreading through my body, sexual surges pulsing in and out.

Then some slow songs would come on and the texting would slow down. FLIP. I’d sit and start drifting off. My heartbeat would go down, and I felt tired and bored yet again. I’d go to some calm activity to try to keep from being bored. Then it would get annoying. On comes my iPod, different peppy songs. FLIP.

Back to sensation overload. I really didn’t want to feel either extreme…I didn’t want to be blah and bored and I didn’t want to be so overly excited or agitated. I was completely influenced by the music and the conversations.

Eventually the day went on and I did my chores. I showered. My husband got home from work. I immediately dragged him into the bedroom for wild sex. I got dressed, we ate dinner. He watched the kids so I could get out of the house. I got in my truck and listened to some music and found myself giddily driving and completely distracted. I went to run some errands. I got to the store and wandered aimlessly, thoughts drifting. Texted some people to “come play hide and seek”. There was nothing to fuel my mind or body in the half dead store at night, no real stimulation or interaction, save with the cashier. I got into my car with a slight headache, went home. Was tired and blah when I got back. Hyperactivity = gone. I picked up a tiny bit and just went to sleep.

I see how everything around me was a trigger. Either a trigger to go up or a trigger to come down. The more stimulation I had, the higher I rose and the less I had the more I drifted down.

It’s an interesting observation, one that I have noted consistently over the course of the last year. So, if you’re reading this and have the same issues, keep an eye on the stuff around you. Beware that you aren’t unduly causing (or severely exacerbating) your own moods. Yeah I know, easier said than done, ha.