Thursday, August 31, 2006

Mood Watch - 8

The night before last, I was sleeping just fine, thank you, until an excruciating muscle spasm in my calf brought me wide awake. After that, there was no chance of returning to sleep. Instead I got up and I got started on my day, having had maybe four hours of sleep.

I felt reasonably upbeat about the world — how different life seems during the “normal” times — and had a good, solid, productive day. True, I was kind of red-eyed throughout, but it was no big deal. Slept just fine last night: a full seven hours of deep, uninterrupted sleep. And when I awoke, I was glad to face the new morning. Is life routinely like this for most people?

This afternoon I fly to Washington to be interviewed tomorow for a prospective History Channel documentary on Sherman’s March. I was supposed to return tomorrow night, but asked to have the flight pushed back a day when I learned a good friend and fellow Civil War historian would also be in town. I’d like to see and catch up with her a bit. I’ll also be visiting a couple of other friends, including the Army officer with whose family I recently vacationed in the North Carolina Outer Banks. He’s back at the Pentagon now.

Tuesday, August 29, 2006

Mood Watch - 7

I didn’t sleep at all last night, Ambien CR notwithstanding. It’s a bit frustrating when that occurs but not, in itself, cause for alarm. I just keep an eye on how I’m doing otherwise. Do I feel tired, the way one normally would if sleep-deprived, or do I feel energetic and raring to go? Are any other symptoms present? If not, my usual practice is to work through the day without a nap, so as not to throw off my normal routine. As they say, good “sleep hygiene” is an important element in combatting the disorder.

The one downside, and it can’t really be helped, is that I’m too tired to do anything that requires serious mental creativity. I can answer email and do more or less mechanical tasks, but that’s about the extent of it. Actually, “downside” is probably the wrong word. It would be cause for alarm if my brain were anything else but sluggish.

Monday, August 28, 2006

Mood Watch - 6

People unacquainted with bipolar disorder typically think of the mood swings as being like those of a pendulum: a period of elevated mood, followed by a gradual shift to “normal,” and then eventually on to a period of depression. In fact, for many people with the disorder it isn’t like that, and in my own case I would say that the simile doesn’t apply at all. Instead I tend to drop quite suddenly into depressive spells and recover from them almost as abruptly. When I do, I generally feel a great deal of energy and a certain resistance to going to sleep. That’s how it’s been for the past few days.

The energy is, not, in and of itself, a bad thing. To some extent I think it owes to sheer relief at being part of the human race again. The things I have to look out for are along these lines: flight of ideas, pressured speech, distractibility, reduced impulse control — e.g., making a lot of sudden unplanned purchases — and so on. As long as these symptoms are absent, and especially provided I can focus on the main tasks at hand, things are more or less okay. I say “more or less” because I can never let down my guard. This is an illness that is trying to kill me, one way or another, and if it can’t kill me it wants to derail my life. I never forget that.

As for sleep: I’ve always been a night owl and the sort of person who lies awake for an hour or two before drifting off. At times such as this, when I feel a decreased need for sleep, it’s imperative to intervene with something that can reliably put me out. Historically that proved fairly hard to do. I went through quite a few medications before getting a prescription that worked — in my case Ambien CR. The previous options tended to be too clever by half; e.g., anti-seizure meds that had the side effect of causing drowsiness.

Sometimes — not at the moment, but sometimes — even the Ambien CR won’t put me down. I start feeling like a zombie in a Grade B movie: The Thing That Would Not Sleep. Luckily about a year ago my psychiatrist and I discovered, almost by accident, that Geodon is the equivalent of a headshot to that metaphorical zombie. The only problem is, when I wake up I’m groggy for hours afterward.

One final observation is in order concerning the relationship between the illness and working for long periods at the computer. Without a PC I simply could not get my work done. Even so, a hallmark of the disorder, as I have experienced it, is that working with a computer functions somewhat as catnip to the manic side of the illness. I can’t exactly dispense with it. The best I can do is walk away from it and do something else for a while.

I noticed this yesterday, for instance, while refurbishing . . . a political blog I started briefly in early 2005 before realizing I simply didn’t have time for it. For reasons I’ll get into some other time, it’s a blog I need for the next few months, so I didn’t begrudge the time. And I enjoy tweaking the templates and HTML code, etc. For me it’s like doing the New York Times crossword puzzle. But it can really suck you in. You fiddle with the code, check to see how it works, tweak it until you get it right. . . . The continuous incremental feedback seduces you to stick around for just one more fix.

The odd thing about it is, there are other times when I can scarcely stand to look at a blog, much less post an entry or do any fine-tuning.

Anyway, that’s the status for today.

Sunday, August 27, 2006

Mood Watch - 5

Had enough energy yesterday to take care of a back log of chores, most notably the laundry, of which there was quite a stack following my return from vacation. Also spent at least a couple of hours uploading our new church directory to the web site, though for privacy reasons, I’ve limited access to church members only. And I caught up with the ceaseless rain of incoming email correspondence. Doesn’t seem like much. Point is, I felt like a member of the human race again.

Recently this blog has been getting a number of visits from one Shazer, aka Shae (hi there, Shae!), a 20-year old undergraduate at Brigham Young University. Shae, as you can see from her blog, has been writing with unusual honesty about her own experiences with counseling. As I’ve watched her blog evolve to incorporate a short blogroll, I’ve naturally been intrigued by her selections and this has led to my discovering several other interesting blogs, all of them concerned, in some way, shape, or form, with mental health issues.

Finally I stumbled upon Bipolar Planet, a recently created blog that serves as a gateway to a Net Ring devoted to blogs whose prominent theme is the struggle with bipolar disorder. It occurred to me that this was both an audience inclined to be supportive of my venture and also one to which I might have something to contribute. So I threw my blog into the ring, so to speak, and embedded the relevant code at the bottom of the main page. It isn’t active yet, since apparently someone has to visually inspect each applicant blog to make sure it’s indeed appropriate for the ring and not something like Manic Nymphos on Webcam.

A reader comment about the stigma that still attaches to mental illness got me poking around the web in search of sites devoted to extinguishing it. I was particularly interested in finding a sort of patch, like “Another straight for GLBT rights,” that would be a suitable addition to the blog’s sidebar. I did find a few things here and there, but not as much as you’d think, and certainly nothing of the scope that is usual for many other social concerns. And no patch; at least, not one that was sufficiently self-explanatory.

Well, anyway, I’m out of time for this entry. It’s off to church. Oh joy: another chance to warm a pew!

Saturday, August 26, 2006

Mood Watch - 4

Woke up this morning feeling like a normal human being again, whatever that is. In my case, it means waking up from a good night's sleep -- 7 or 8 hours -- and wanting to get up and on with my day. Over the years I've learned to trust this as a good augury.

It also highlights the nature of my depressions. They are not, as some might suppose, like the swinging of a pendulum, with a series of up tempo days eventually giving way, gradually, to a series of bad one, and then slowly vice versa. In my case, depressions arrive and depart quite abruptly, like wading in the ocean and suddenly stepping into a hole in the bottom.

Anyways, it's about time. I've got a lot of chores to catch up on.

Mood Watch - 3

I'm back from vacation. In general I had a great time with some terrific people, but about midway through I could begin to feel my spirits slip. It's almost impossible to pinpoint a significant change in mood within a day or two, because it takes time for the pattern to become obvious. But by the weekend I definitely felt out of sorts, and for most of this week I've been so low that I've had little energy or interest in anything.

In some ways I've come to regard such times as no different from having a bad chest cold. You don't beat yourself up about having a cold and you give yourself permission to be ill. But in others I still retain a gut-level feeling that this is something to be ashamed of, or at least hidden discreetly away. It's only now that my spirits are improving that I can nerve myself to compose this post.

Coincidentally I saw my psychiatrist today. I have an appointment with her about every other month, mostly just to manage my medication. There's a small arsenal of meds available to deal with bipolar disorder -- both the underlying illness and its symptoms -- but the two principal ones are 1) a prophylactic against manic episodes (typically lithium carbonate or, in my case, depakote), and 2) an antidepressant, for obvious reasons. The depakote works fine for me but in two decades I've never yet found an antidepressant that did any good. I've tried at least a dozen at various dosages and so far, no dice.

The latest candidate is Lamictal. Like any drug it has potential side effects, the worst of which, in this case, is a horrible death, to wit: "severe and/or life-threatening rashes and hypersensitivity reactions." For that reason you begin by taking a 25-day starter regimen that builds up the dosage very gradually so that if you're one of the unfortunate small minority who develops "skin rash; fever; hives; swelling of the lips, tongue, or face; sores in the mouth or around the eyes; or swollen lymph glands," you can discontinue the drug in time to avert the worst.

The fact that anyone would even fool with this should give some indication of just how bad these depressions can be. Actually, it's not how bad they are per se; it's how unrelenting they are.

Tuesday, August 15, 2006

Mood Watch - 2

Third day of vacation. Mood still good and I'm sleeping better. Got nearly ten hours last night, and needed it after two days on the road.

Sunday, August 13, 2006

Mood Watch - 1

A couple of days ago I was talking with my therapist as I usually do most weeks. Since I have bipolar disorder my insurance is happy to pay for the visits. It's a lot cheaper to spend money paying for a therapist to supplement my psychiatrist and meds than it is to pay for a two-week hospitalization.

Anyway, I invariably begin the sessions by reporting on my mood. After that we typically move on to other subjects. Because my therapist -- a clinical psychologist -- is a standout in her profession and because I've been seeing her for a bit over eight years now, the experience has proven very helpful in coming to grips, not just with the bipolar disorder, but also with a lot of old wounds. Since I doubt I would ever have landed in her office except for the bipolar disorder, I suppose having this particular illness has not been entirely devoid of an upside.

On Friday we talked mainly about this blog and the direction I've decided to take it. I think she has seen this coming for a long time. She wasn't surprised. She thinks, more than I do, that I know what I'm doing. But at the same time when I mentioned the idea of using the blog as a place to keep regular track of my moods, she thought that was a good idea too. Hence the first in what I expect will be a series of posts published every day, or nearly so.

For the uninitiated, here's the basic symptomology, shamelessly cribbed from Harbor of Refuge.

Bipolar disorder involves cycles of mania and depression.

Signs and symptoms of mania include discrete periods of:
  • increased racing and rapid talking
  • Excessive "high" or euphoric feelings
  • Extreme irritability and distractability
  • Decreased need for sleep
  • Unrealistic beliefs in one's abilities and powers
  • Uncharacteristically poor judgment
  • A sustained period of behavior that is different from usual
  • Increased sexual drive
  • Abuse of drugs, particularly cocaine, alcohol, and sleeping medications
  • Provocative, intrusive, or aggressive behavior
  • Denial that anything is wrong
Signs and symptoms of depression include discrete periods of:
  • Persistent sad, anxious, or empty mood
  • Feelings of hopelessness or pessimism
  • Feelings of guilt, worthlessness, or helplessness
  • Loss of interest or pleasure in ordinary activities, including sex
  • Decreased energy, a feeling of fatigue or of being "slowed down"
  • Difficulty concentrating, remembering, making decisions
  • Restlessness or irritability
  • Sleep disturbances
  • Loss of appetite and weight, or weight gain
  • Chronic pain or other persistent bodily symptoms that are not caused by physical disease
  • Thoughts of death or suicide; suicide attempts
Got all that?

My mood for the past two weeks has been good. I have been able to focus and enjoy my work and I have not experienced any racing thoughts, euphoric feelings, or increased distractability. The one thing I have noticed is a decreased need for sleep. I get maybe five or six hours in any twenty-four hour period, and usually not all at one time. For instance, in the day just past I slept a total of six hours but in three two-hour increments. That's the one element right now that bears watching.

I'm up early this morning because I'm about to leave for a week or ten days of vacation. I travel first to Abingdon, Virginia, to see some old friends, and then on the Outer Banks of North Carolina where I've been invited by an Army lieutenant colonel to spend a few days with his family at their seaside condo in Duck, just north of Nags Head. As far as I know, I'll have regular Internet access, so at the moment I see no reason I won't be able to compose these daily posts. But if I miss a day or two, consider it no big deal.

Saturday, August 12, 2006

This Is NOT the First Post

The actual maiden post for this blog is here.
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