When Erratic Energy meets with Despair

This is where it gets dicey.  If you are familiar with bipolar disorder, you have probably heard the term 'mixed states.' You probably also know that suicide is attempted more often when the sufferer is considered 'agitated.'

In terms of energy, the state of 'mixed state' can best be described ( in my view) as rapidly changing and erratic.  Think of problems with the power lines when the lights flicker or glow brighter than usual, power surges cause appliances and electronics to pop and trip breakers, and computers don't know what to do and often shut down.

If you are attempting to monitor your energy, in conjunction with circumstances, it is nearly impossible to gauge.  At times like that, the state of your circumstances governs what you should do.  For example, if circumstances are okay, walking or meditation may be helpful to even out the energy.  Avoiding problematic situations (shopping, conversations which can go awry, or dealing with potentially stressful issues) is probably a good idea.

If circumstances suck, the combination of that with erratic energy can be dangerous.  Psychiatrists use the term "agitation" to describe the feelings of confusion, despair, hopelessness and panic...and all kinds of red flags fly up. Inappropriate outbursts at just about any frustration are likely.  Poor concentration and the inability to put things in perspective can lead to suicidal thoughts.

It is my suggestion to first 'table' all concern for the circumstances, if possible.  My table of choice is at the feet of Jesus.  Then get thoughts about the circumstances out of your head.  Write them down if you feel the need to keep track of the details but do what you must to quiet your mind.

Then, address the energy.  If it is intense, find a way to release some.  I listen to music that makes me cry...and I usually listen to it really really loud.  The first audition of Charlotte and Jonathan singing "My Prayer," does it for me; or Samuel Barber's "Adagio for Strings" (The premier performance by Arturo Toscanini, if you can find it); or "Bring Him Home" (Colm Wilkinson or Alfie Boe); Nessun Dorma (Pavarotti or, a personal favorite, Alfie Boe "warbles a bit").  I even cry when listening to "NASA's Orion Space Launch set to Interstellar Soundtrack (the 1st one listed)"

But, I digress.  The idea is to expel some energy in a safe and healthy way...and I think crying is healthy.

Before picking the circumstances back up, if you must, you should assess your energy.  If your energy is too low to deal with the issues, and if they can wait, let them wait.  Napping is good.

If circumstances are dire, you need to establish a safe situation for yourself.  Call someone who has experience with such matters.  Let someone, someone who will respond with compassion and strength, know what you are going through. Do not go through it alone.  Being aware of His presence will help, but if your thinking is distorted, your perception of His voice may be, too.

If you do not feel safe, take yourself to the hospital; let someone else do the thinking for a while.  You need to build up your strength so you can see things clearly again, so you can accurately assess your energy and your options and make good choices.

Jesus is there; help is available; you are not alone.  I know what of I speak.

Taking care of myself, wherever I am.

It occurs to me that I may not change.  This may be how it is going to be for however long I remain alive.  (deep sigh.)  Medications are not working like they used to.  I have been on them for too long.  I might as well not be on medication, or so it seems.  I cycle wildly and rapidly, regardless.

I can not stay in bed all day.  I do not sleep.  Even at night I do not sleep.  My hands and feet are constantly in motion.  I wake up stiff from being in motion all night.

So what do I do?

I make plans, plans of how best to take care of myself, depending on what state of disorder I am in.  For example, when I am manic, I will be careful not to start any new projects or make any new goals.  They tend to be unrealistic, overwhelming, and disappointing.  Also when I am manic, I will take advantage of the energy and get some exercise.  Long vigorous walks tend to burn out the jitters.  Walking and talking with someone makes it even better.  Manic energy is also good for cleaning out places like the basement, shoving stuff around and sweeping up dust and dirt.  Manic energy is good for mopping floors.  It is not good for filing paperwork, unless I am taking on the entire filing system.

If I had a good yard, manic energy might be good for gardening.  HOWEVER, over the years I have spent thousands of dollars at garden supply stores.  Not a good place for me.  So, I must limit my 'gardening' to raking, weeding, pruning, and sweeping.

Depression is good for inspirational reading, slow walks, writing, catching up on movies, watching the dog breathe, watching the snow fall, belly breathing, meditation, hand-washing dishes, clothes, windows.

Mixed states are tricky.  If I am depressed and agitated, it may be best to nap.  I'm not sleeping my life away, just this short phase of my life.  If I am manic and full of negative energy, I can write blogs or letters that I just don't post or mail.  And walk.

Today, I intend to look into what diets are best for which states of disorder.  In the meantime, I will head back down to the basement and work on the studio.

Pain and Comfort

I'm on the path to gaining weight:  cereal at night, frozen yogurt, sugar in my coffee.  I have been needing comfort.  Broken sleep isn't going to help, either.

I have had a toothache for three or four weeks...ever since I had a tooth filled.  But that is not where it hurts. In fact, we can not tell exactly where the pain is coming from.  It hurts all over the side of my head and down my jaw.  I have been taking ibuprofen and Tylenol around the clock for weeks.  I hate to think what that is doing to my lithium levels...or my kidneys and liver, for that matter.

I'm tired of pain.  I'm tired of dry mouth.  I'm tired of non-stop tongue and jaw movement (tardive dyskinesia).  I'm tired of sighing.  I'm tired of not sleeping through the night. But, what I am doing for comfort is sabotaging the one aspect of my life that is going right for me these days:  My weight is down.  I have 15-25 lbs. to go but I've lost 25 lbs. since last Fall...when I stopped taking Abilify and we jacked up the Lithium...and I became so sick.

The challenge now is to identify some other activity that will comfort me and not harm me or my efforts.  For example...

• There are beneficial foods that can be comforting, like fruit, small amounts of protein, even cereal...just not in the middle of the night.
• There are books of inspiration and comfort.  (I may elaborate on this in a later post.) 
• There are music, candles, and incense.
• Favorite movies.
• Gentle yoga
• A long walk
• A short walk
• Bubble bath
• Hair cut (my beautician gives an incredibly nice head massage)
• Putting an area of the house in order, like my desk or dresser.  I find cleared, smooth surfaces (especially wood surfaces) soothing.
• Sweeping the floor (again with the wood surface). Of course, having someone else sweep the floor would be nice...but that requires a struggle...and that is a whole other post.

I need pain relief...I need comfort.  Do you have any ideas?  What do you do for comfort?  I'd love to know...

A Rough Winter

A while back I posted (railed, actually) about an incredibly insensitive pharmacist who declared that bipolar women my age quite often committed suicide because their medications quit working.  Well, it seems that has come back to bite me...the 'quit working' part, anyway.  Last summer/fall I developed Parkinsonian symptoms...tremor, primarily, but also dizziness, confusion, memory loss, hesitation, etc.  My doctor suspected the Abilify so we tapered that off and increased the Lithium. I wasn't sleeping so I was prescribed Lunesta.  A short time after that I developed Tardive Dyskinesia...my tongue and jaw would not stay still.  It affected my speech and eating...not to mention my appearance...and eventually affected my ability to swallow.  Then came the bitter tongue, dry mouth, and metallic taste.  Blood tests revealed that my lithium level was 1.2...within published therapeutic range, but way too high for me.  We lowered my dose of lithium and that helped the metallic taste.  We lowered it some more and added Mirapex to help with the other symptoms.

Long story short, everything got better...for a while.  I stopped the Lunesta.  It had quit working and apparently caused the bitter tongue.  But everything is back...Parkinsonian symptoms, slightly improved, tongue/jaw movement, dry mouth...and because I am on a lowered dose of Lithium, I'm cycling.  Some days I can't sit still and build 2-full page to-do lists, cleaning house all day; Other days, I'm so uncomfortable and foggy headed I just stand in the middle of the room and stare into space.

That is when I start wondering, "What is my life?"  I feel miserable, I don't want to be around anybody, everything tastes bad,...  On 'good' days I devise plans of attack.  Because I have lost 15 lbs. from not eating much (everything tastes bad and eating is difficult) I have decided to continue the trend by walking and eventually running.  I have decided that I want to run before I die; If not now, when?  Well, one week into the 7-week training plan, I develop sciatica.  Have I mentioned that I also have Fibromyalgia?

Another area for attack is my house.  When I was happily on Abilify, I wasn't paying too much attention to the state of things.  Without the happy-filter, I see how much needs to be done...hence the two pages of to-do's ...and that's just to get started.

In unrelated matters, I had a molar filled and the dentist owned up to lacerating my gum and hyper-extending my jaw joint.  I have been on Ibuprofen for days, which increases my blood lithium levels, which exacerbates my adverse side effects.  To top it off, my sewer backed up into the basement and there is 10-inches of snow on the ground.  I'M READY FOR SPRING in oh, so many ways!!

Thoughts of suicide?  Oh, they have been there.  I know how I would do it and I have even told my doctor and therapist.  I really have nothing more to say about that.  I don't want to prove that pharmacist right nor do I want to devastate my children.  So I continue to work with my doctors, try to exercise and eat right, take the current collection of meds, meditate/nap, and read for inspiration...except when I stand in the middle of the room and stare into space.

This post is probably not going to help anybody beyond letting you know that I understand.  Let me know if you want to chat.