Well That Didn’t End Well…

As you may already know, I tapered off medications in July to do IVF (which failed to work).  I was fairly stable until around the middle of March when I became depressed, but didn’t realize it (that’s common for me).  Looking back I can see I was, but didn’t connect the dots until I got hit with a mixed (mostly manic) episode on March 31st.  So how do I not know I am depressed you may ask?  Well depression is such a natural state for me that it doesn’t feel much different than everyday life.  I’ve spent the a lot of my life depressed on some level.  Usually it’s just mild depression, kind of going through the motions, somewhat apathetic and displaying a flat affect.  I am a very driven person so you won’t see me staying in bed and calling into work sick (haven’t taken a real sick day in almost two years) and if I do stay home, I’ll still work all day.  Ah, the life of a workaholic!  But I usually burn up the energy I do have working and if I am really in a depressive state, I have a hard time doing anything when I get home.  Sometimes it will take all I have just to cook and clean up afterwards.  It really freaking sucks and often causes problems in my marriage because my husband basically does all the heavy lifting at home during those times.

So this depressive episode looked like going to bed early, eating too many Girl Scout cookies, watching super depressing stuff on television, having weird aches and pains, experiencing sleep disturbances, feeling super weak especially in my hands, and feeling EXTREMELY irritable (my poor husband).  I had some work and personal drama going on and I was freaking STRESSED.  I kept trying to excuse it away, like “I’m not sleeping well because of the annoying foot cramps I’ve been getting at bedtime, and maybe the coffee I’ve been drinking is making me anxious, maybe my diet isn’t right.”  Then I worked seven hours one Saturday on something that required tons of concentration and by Sunday I could barely complete a task because my head was spinning and my emotions were jumping quickly from happy to sad, to irritable and angry.  One minute I was laughing, the next yelling then crying.  That’s when I knew something was up so I put myself on an antipsychotic/mood stabilizer and called my psychiatrist the following day.  I could have easily stopped sleeping and gone into psychosis at that point so I did what I HAD to do.

Much to my surprise, my doctor wanted to see me immediately and saw me on a day he doesn’t usually see patients.  He commended me for calling and was supportive during my appointment (I had a terrible doctor who made me feel like I couldn’t see her for months even while I was in the middle of an episode).  My doctor knew and I knew that no amount of exercise (exercise can sometimes increase mania), healthy eating, or fish oil was going to shut that shit down.  I needed medicinal help and I needed it quickly.  He started seeing me weekly and we started playing with my dosage.  Sometimes it takes a lot of trial and error to get it right.  In the midst of this, I had leave the country for vacation and I was nowhere near where I needed to be.  I struggled controlling my elevated mood while also dealing with random outbursts of tears (talk about embarrassing) throughout the trip.  When my head gets messed up so does my digestion so I dealt with IBS on vacation as well and eventually got really sick after a day in Cozumel.  I don’t know if it was the water or my IBS, but I spent a morning in my room with the runs and when I called the medic for something to help, they quarantined me to my room for the last day on the cruise ship just in case it was a virus.  I was ready for a quiet day to myself, but I wasn’t hoping for constant diarrhea.  We did get free room service that day so that was pretty rad.

It has been 11 weeks since I had to make the call to my doctor and I think we finally have my meds just about right.  I was on the highest dose of the antipsychotic/mood stabilizer at one point which made it difficult to do anything in the morning for at least an hour, sometimes longer.  It wasn’t really safe for me to be walking around.  I was very unsteady on my feet and I actually had to buy a slip resistant shower mat because I was so out of it in the shower.  I felt like a fucking zombie for half the day sometimes, but I somehow found the strength to get to work every day.  I filed for ADA Accommodations to make sure my job was covered when I was coming in sometimes a few hours late.  The HR department approved it and provided a monitor and keyboard so I could make up time at home.  What a relief that was!  The medication I was on was sort of pain in the ass because if I didn’t take it with dinner before 7:00 pm, I would struggle to function in the morning.  I work until 6:00 so having dinner on the table at 7:00 was challenging unless my husband prepared a simple meal for us.  My doctor added an anticonvulsant 5 weeks ago that works as a mood stabilizer and an antidepressant that makes me drowsy at night and those additions have helped immensely.  I recently tapered off the antipsychotic/mood stabilizer and switched to a new one to help with the grogginess that was pretty much debilitating in the morning.  I’ve been on the new med for about a week and it has helped my mornings, but I’m feeling a little irritable again.  Luckily I see my doctor this week and I’m hoping some exercise will help with the slight bitchiness.

It’s hard to describe what I’ve been through over these last few months.  Staying sane during a mixed episode with rapid cycling has been freaking HAARRDD!  I can function ok when I am depressed, but mania is a completely different animal.  If I didn’t start back on meds when I did, it could have turned into a really terrible situation.  I could have destroyed relationships, I could have lost my job, I could have gone so far into psychosis that it would have taken possibly a year or more to recover or I could have even lost my life.  People can poo poo meds all they want, but I am so incredibly grateful for them.  They have legit saved my life several times.  I’ve learned during this episode that I never want to purposely stop medication ever again.  The risk is just too great and I am no longer willing to take it.  Yeah, maybe the meds will eventually destroy my liver and kidneys, but I’d rather have a good quality life so that’s the risk I am willing to take.

 

Life Without Meds

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So it has been almost eight months since I stopped psychotropic meds.  I took a huge leap of faith tapering off medications under my psychiatrist’s supervision before we did IVF in July 2018.  I worried about withdrawals, sleep disturbances, and mood regulation.  After all I had been on them consistently for over five years.  I thought they were my lifeline and couldn’t imagine functioning without them.  Surprisingly, the process of stopping meds was a piece of cake and the past several months have been an eye-opening experience.  In fact, it seems like a lot of the symptoms I was experiencing while taking these medications were actually induced by those same medications. Like seriously, WTF?

For instance, that nagging need to spend tons of money on shit I don’t need has virtually vanished.  That my friends makes the hubs incredibly happy and helps the checking account balance substantially. Whoo hoo!  It’s freeing not to need to run to the store to boost my endorphins and saves a lot of time as well.  I recently Marie Kondo’d my closet and it blew my mind seeing clothes with the tags still attached that didn’t even match my style.  Like bright green capris with a tropical green and blue shirt.  I was obviously manic when I bought that shit.

And sleep, beautiful sleep!  I haven’t slept this great in years.  For years, I would have to adjust my work schedule a few times a month because I couldn’t get to sleep because I was anxious.  Not worrying about anything in particular, just a experiencing a buzzing feeling in my body that was difficult to ignore.  Often I had to take a Klonopin to calm my mind and body down to fall asleep.  It was super frustrating to say the least.  If I didn’t go into work late, I’d struggle to function through the day and wouldn’t accomplish anything when I got home.  I’m happy to report I haven’t had one of those nights since.  I now fall asleep easily and wake up not feeling zombified, relying on stimulants to feel alert.

And the panic, the dreadful panic that would show up out of nowhere and last for months that would make me feel stressed and in turn cause me to overwork myself and eventually burn out.  It was a sneaky little shit though and somehow I didn’t even realize it was happening until it was over and I felt relief.  It made me short-tempered and exhausted and it is no way to go through life.  I was actually on the verge of going on disability last January because I just couldn’t go through another episode.

I still meet with my psychiatrist monthly and we’ve agreed to ride this out for as long as it lasts (fingers crossed).  It’s important I check in with him often because I am not always aware when I start having a manic or depressive episode.  My symptoms usually come on fast and often skew my perception of what’s really going on inside.  I’m very good at faking it which complicates things.  It’s a natural defense mechanism of mine and a very dangerous one.  So I keep up with my appointment schedule and I take exceptional care of myself.  I fuel my body with the best nutrition with some cheat days thrown in to keep me fulfilled and I abstain from alcohol.  It has kept me grounded while my husband and I have dealt with an incredibly stressful life event these past two months.  The fact that I’ve made it through without medical assistance is quite extraordinary and I am grateful.

***I’ve had success without meds, but that does not mean you should stop medications on your own.  You should only do so while working with a medical professional.***

So much is happening, yet nothing is happening at all…

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I totally weirded out my doctor last week.  Twelve days without an antidepressant and I had no symptoms, none.  Six weeks ago I decided to taper off my meds so we could try IVF.  I had initially decided to stay on meds while we tried to conceive and throughout pregnancy after discussing with my a perinatal specialist and my former psychiatrist.  Chad and I thought it would be best considering my past episodes of psychosis and the risks that could pose for me and our child.  It was a tough decision, but I had tried to stop in the past and ended up having a fairly intense episode in March of 2013.  That’s when I started seeing a naturopath and began taking loads of amino acids that caused major digestive issues.  I stuck it out for 18 months, but when I was up to 62 pills a day and still couldn’t go without an antidepressant for long, I threw in the towel.  Not to mention we were spending $1,000 per month.

Recently though my gut starting telling me I should stop meds.  I’ve been stable for over 3 years and my new psychiatrist considered me to be in remission.  I began cutting my antipsychotic dose in half for a week then my antidepressant.  I then cut the antidepressant in half again for a week and stopped.  I didn’t have any Bipolar symptoms at all and started sleeping better than I had in years.  I had struggled for years with anxiety and racing thoughts at bedtime which caused onset insomnia.  It was so frustrating and sometimes I wouldn’t fall asleep until the middle of the night which made getting up for work on time almost impossible.  I’m lucky my work is flexible with my hours and last year I started supporting California so I was able to change my schedule.  Right now I am still on an antipsychotic, but my last dose is tomorrow.  I haven’t missed a dose in years, but when I have in the past I barely slept and struggled to get through the following day.  I felt completely off and uncomfortable in my own skin, counting down the hours to dinner when i could take my med and go to sleep.  Antipsychotic withdrawal is no joke so I decided to take two weeks off work after i stop to give me time to adjust.

I am a little nervous about stopping this last med.  It is going to take a lot of strength and patience to get through the first few days.  My psychiatrist said stopping the antidepressant should have been harder than stopping the antipsychotic, but miraculously I’ve been doing fine.  This gives me hope.  I am in such a good place right now.  I couldn’t have asked for a better time to go through this process.  The timing is perfect and I am so incredibly grateful.  Good things are on the horizon.  I can just feel it.

Master of Routine

clocks-1098080_1920My illness has totally turned me into a creature of habit.  Studies have shown that routines can ease Bipolar and I have found that to be true as well.  I typically eat at the same time every day (5 times a day) which helps keep my blood sugar stable and in turn regulates my moods and energy.  I try my best to go to sleep every night and wake every morning at the same time also.  I’ve found planning my meals and snacks and having good sleep hygiene to be keys to managing my illness.  If you aren’t on a good eating and sleeping routine, I suggest you work on that first and foremost.  I also try to plan my work days by scheduling tasks on my calendar.  I get what’s most important done first thing in the morning before my territory gets going and I also schedule weekly and monthly responsibilities to make sure I stay on track.

My mind likes life to be predictable and I always feel the need to be in control so when change happens it often leaves my head spinning.   For instance, I recently had two full days of meetings at work and team activities after work.  It completely threw me for a loop and gave me some pretty intense anxiety.  I had to be at work an hour and a half earlier than normal which I found to be stressful.  That is a big change for someone who is on a strict schedule.  I had to take medicine to put myself to sleep earlier to ensure I got enough rest.  This would be probably be no big deal for a lot of people, but I was experiencing a bout of Irritable Bowel Syndrome also during this time so the thought of not having control over when and what I ate as well as being stuck in a room for hours on end really freaked me out.  So I decided to take some of my control back by bringing my own food for breakfast and lunch.  I left the room during lunch to eat my own food in peace and be close to a bathroom in case my stomach acted up.  This helped ease my anxious mind.

I find traveling work to be challenging as well, but I am getting better at managing it.  The first time I travelled for work, I had my first and only panic attack.  I was not medicated at the time and not doing so well mentally when I was asked to drive to Illinois and Wisconsin with a co-worker.  The first day we spent at a job site watching an installation of one of our stormwater quality units followed by lunch with a sales person then a visit to one of our supplier’s warehouses.  Something I ate during lunch upset my stomach and when we got the supplier I found myself getting sick in the bathroom while everyone was waiting on me to go on a plant tour.  I tried to pull myself together and go on the tour, but i became worried about having an accident as I wandered around the huge warehouse not knowing where the closest bathroom was.  My heart started pounding and I found it difficult to breathe and I high tailed it to the car where I sat for the rest of the visit.  I was completely panicked and mortified.

That first work trip made me terrified to travel for work again and I did everything I could to avoid it.  It almost became a phobia of sorts.  So when my boss called me into his office a little over three years ago and told me I was getting promoted and I had to fly to Oregon and present in front of over 100 of my co-workers, I freaking flipped.  I have little experience presenting and public speaking is my number one fear.  That combined with my fear of traveling for work threw me into a Bipolar episode that lasted for months.  I ended up traveling to the meetings, but I made sure my flight times fit into my normal daily schedule and I did not present.  I did it on my terms and I survived.  Each time I have travelled since, it has gotten a little easier and my last work trip was even my idea.  I refuse to take super early flights so my sleep routine is not disturbed and I also book the shortest travel time (even if that means flying into LAX or traveling on a weekend, ugh).  I bring snacks with me so my blood sugar doesn’t get too low and I try to set my own schedule, always.

This might sound like a boring way to live, but my routines help keep me stable.  The consistency they provide in my life make them worthwhile to me.  If you are struggling to stabilize your moods, I highly suggest you try to your best to stick to a schedule.  It could be exactly what you are missing.

The Dreaded “T” Word

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I recently broke up with my therapist of 3 1/2 years.  Well she doesn’t know it yet, but I’m not going back.  For one thing, her office is now way out of the way since we moved.  For another, I feel like it has been a waste of my time for over two years.  We basically just chat about a few things that are going on in my life and I often run out of things to say and constantly glance at the clock.  I’ve been seeing her every 3-4 weeks just to check in and make sure I’m ok.  Sometimes I’m not the best judge of how I’m doing and I’m really good at faking it and covering up ally shit.  I also tend to be fairly quiet so Chad isn’t always clued in either. I’ve been pretty stable since the spring of 2015 and I am tired of throwing twenty-five dollars away each month so I’ve decided to cut the cord.  I need to give her a call and explain.  I’m sure she will understand.

I first started seeing a therapist in 2005 when I was 27.  She was a hippie that didn’t believe in medication unless it was absolutely necessary.  She believed I learned to be depressed by seeing others in my family depressed, said I was an alcoholic and love addict, recommended self-help books along with some crazy bovine liver supplements from her chiropractor and told me to go to Alcoholics Anonymous meetings for support.  I was nearly suicidal at the time, thinking of garages I could park my car in and end the pain easily.  She dragged up the past during every visit and I left feeling worse than when we started.  I basically cried the entire visit.  She had me doing mirror work and affirmations to improve my self-esteem.  I repeated “I am enough” while staring at myself in the mirror.  None of these approaches worked for me.  If she were a responsible therapist she would have recommended I see a psychiatrist first.  As I look back now, I can see it was very dangerous not to do so.

I saw another therapist in my late twenties for a few visits that thought I had Bipolar Disorder and wanted to me to see a psychiatrist so I could get on a mood stabilizer, specifically Depakote.  I can’t remember what happened there, but I don’t think I liked what she had to say and the psychiatrist she wanted me to see was not taking new patients so I missed my opportunity to get my diagnosis earlier.  In my early thirties I saw another one for a few months.  Again, the visits made me feel worse than I normally did and I didn’t get anything out of it.  After the psychotic episode in 2010, I saw a therapist that my nurse practitioner referred me to.  She was really aggressive and I was so doped up on an antipsychotic the first visit that she couldn’t get anywhere with me because I could hardly answer her questions.  I just kept saying I don’t know.  I went back a couple more times and she was really pushing me to work on myself, but I was still recovering from psychosis and not thinking clearly so we didn’t accomplish much.

I decided when I started seeing my most recent therapist that we would not discuss the past and I would not let her try to figure out why I am the way I am.  I was upfront about that on my first visit.  I wanted to focus on the present.  I wanted her to help me determine if my mind was healthy, a monthly check-in to make sure I was on the right track.  We both followed that protocol and I found that it was a much better way for me personally.  What a freaking relief.  I believe I am the way I am because I have a chemical imbalance.  I inherited it from my family (I have it on both sides).  Digging around in my past trying to find some reason for it is absurd to me.  I have no history of trauma or abuse.  I was raised by parents who love me and would do anything for me.  We had our issues like all families do, but my environment did not trigger this illness.  So please for the love of God, don’t try to psychoanalyze me.  So I’m closing the book on therapy for now and if things work out they way I have planned, I will not be opening it anytime soon.

I Still Stumble

stumblingConfession time.  I had a total meltdown the week before Christmas.  I cried all evening.  I woke up completely exhausted with my eyes so swollen I could barely see.  I took a half day to get my shit together.  I had not cried in several months.  My emotions reached a boiling point.  Weeks of stress from work, preparing for Christmas, and taking on too much at once took its toll on me.  Apparently working a demanding job full-time, starting a side hustle, writing a book, thinking about my biological clock ticking with my 40th birthday on the horizon, and managing a chronic illness was a little too much for me.  Go figure.  I was totally overwhelmed, had difficulty concentrating, and had a seriously short fuse.  I started slacking with my eating habits.  I wouldn’t eat enough during the day because of the stress then when it was time to relax, I would eat too much. I had trouble sleeping and started to feel fatigued because I was pushing myself too hard and trying to do everything perfectly.  When my perfectionism becomes obsessive, I start to feel exhausted and procrastination inevitably creeps in.  So basically I procrastinate then worry about all the shit I have to do.  It’s a vicious and super frustrating cycle.

After the cry-fest, I knew I had to make some changes.  I immediately asked my husband for help and intentionally started to slow down.  I limited my time on social media to cut down on distractions, began nightly yoga nidra meditations, and put my book on hold.  I did my best to focus on the present so I wouldn’t get caught up worrying about the future.  Luckily Chad’s schedule was starting to slow down and he helped me stay on track with the Christmas stuff and manage all the day-to-day things at home.  He helped me decide what to eat for dinner and went to the grocery with me.  If you deal with any type of depression or anxiety you know how overwhelming the grocery store can be.  It’s like the worst place to go.  Too many decisions and if you go without a list it can be a freaking nightmare.  There have been times when I desperately wanted to leave my cart half full and freaking bolt.

I somehow managed to get through ending the fiscal year at work while preparing for vacation with only cussing out one person on our sales team (I later called and apologized in my super sweet voice). Vacation could not have come at a better time.  Because I did what I needed to do to get control of myself, I was able to be present and thoroughly enjoy the holidays.  I had 12 wonderful days off and came back refreshed with a much better mood and outlook for the new year.  So there you have it, I still have my moments when this illness tries to knock me down.  I still stumble every now and then, but I’m much, much better at knowing what to do to stay standing.

 

Overcoming Fatigue: My 5 Secret Weapons

shutterstock_468543974Fatigue has been a real bitch for me.  The kind of bitch that lingers on and won’t let go.  It was the one symptom I couldn’t shake until recently.  Fatigue from Bipolar can be debilitating.  I’m not talking about being tired after a meal or a long day.  I’m talking about complete exhaustion, bone-tired, total energy depletion.  There were many days when I woke up feeling this way, but went to work anyway and pushed through.  By the end of the day I could hardly make dinner or do the dishes.  I’ve had to take vacation days and lie in bed for 24 hours when I pushed myself too hard.  I’ve had to plan my weeks out knowing that I wouldn’t be able to do much of anything after a day at work.  It was frustrating to say the least and my quality of life was seriously suffering.  Through the years I’ve experimented in several different ways to find relief.  The following are my  5 secret weapons to keep fatigue at bay.

  1. Limit Caffeine: I cut way back on caffeine a couple of years ago and I noticed a difference within a couple of days.  I was drinking 3-4 cups of coffee a day.  That combined with constant stress from my illness did a number on my adrenal glands.  These endocrine glands above your kidneys produce several hormones including adrenaline and cortisol.  Caffeine stimulates these glands and when your adrenals are overworked, production of cortisol can decrease in turn causing fatigue.  I also noticed that I had trouble balancing my blood sugar when I drank too much caffeine.  I was starving an hour or so before lunch time and if I didn’t eat, my energy would crash.  I slowly began lowering my caffeine intake over a few days to avoid getting headaches from withdrawal, mixing regular coffee with decaf.  I then switched to all decaf.  I still have green tea and the occasional chai, but I’m careful not to overdo it.
  2. Move Your Body:  I have a small gym at work and one of the best things I can do is a little workout at lunch.    Nothing crazy, just a brisk walk on the treadmill or workout on the elliptical for a half hour.  It breaks up my day, boosts my mood, and keeps me going for the rest of the day and evening.  If it’s nice outside, I’ll talk a walk.  The fresh air really helps and getting my heart rate up a little kicks my energy up a notch.  I sit at work for long amounts of time and work on a computer which often kills my energy.  Having this break and time to myself really pays off.  If I am too busy to fit this in, I’ll do it when I get home at night.  JessicaSmithTv on YouTube has tons of great low impact workouts to try as well and they are free.  I am not a morning person, but I am sure a little exercise in the morning can rev you up for the day too.
  3. Ask Your Doctor about Deplin: Deplin is a prescription medical food that can help fight fatigue caused by depression.  It contains l-methylfolate, an active form of folate (B vitamin).  L-methylfolate is different from non-prescription folic acid which has to be activated by the body before it can be used.  Up to 70% of people with depression have limited ability to complete this activation.  I began Deplin about a year and a half ago and I noticed a change in my fatigue right away.  It can also help other symptoms of depression.  I encourage you to ask your doctor.  This could be one of your tickets to a happy and energized life.
  4. Reduce Stress: Stress is a total energy zapper.  I still struggle with fatigue when I’ve had a taxing day at work.  I’ve found meditating to be helpful.  I use an app on my phone called Insight Timer to help me.  My mind tends to wander when I try to do it on my own.  Listening to guided meditations on this app keeps me in the moment.  I also use a HeartMath monitor.  It is a techie way to meditate.  It monitors your heart rate as you follow a visual to control your breathing.  It doesn’t take long to reap the benefits.  Essential oils are great too.  I like to use a diffuser next to my bed with lavender, bergamot, or rose for relaxation.  Reach out and ask for help when your feeling stressed.  When work becomes too much for me, I raise my hand and ask for help.  I am a little Type A and a perfectionist, but I’ve learned that I don’t need to pretend like I’m Superwomen.  It’s ok to ask for help when you need it.
  5. Get Proper Nutrition: Nutrition is key in controlling fatigue.  Pay attention to what you are putting in your body.  Processed food will deplete your vitality.  Sugar will give you a temporary boost, but then you’ll crash and burn out.  I’ve recently found a super convenient and yummy way to get nutrients in the form of a super food shake.  It has been extremely helpful in getting over the last bit of fatigue that was holding on to me.  It has as much nutrients as three plated organic meals. I feel like I hit the jackpot.  I had been looking for a meal replacement for a while, but I couldn’t find a clean one until I was introduced by a friend to these gems.  I was spending hours on the weekend planning and prepping food for the week which got old fast.  This plan requires much less effort and the results have blown me away.

What are your weapons against fatigue?  I would love to hear your tips and tricks to stop fatigue in the comments.  If you are interested in learning more about my nutrition plan, please reach out.  I would love to give you the scoop.