Cyclothymia is a chronic mood disorder characterized by numerous mood swings, alternating between hypomania and mild to moderate depression. This showed up on my psychiatrist visit report about 5 months ago. So does this mean I no longer have Bipolar II? Who knows since my gem of a psychiatrist failed to discuss it with me. It showed up again last month, but I was in such a rush to get back to work that I didn’t mention it to my doctor. I can only assume that because I have not had an episode in over two years that I no longer meet the criteria for Bipolar II.
It is a cause of confusion for me since Bipolar II is a lifelong illness with no cure. Also confusing is that diagnosis of Bipolar II requires that an individual has never experienced a full manic episode. Um, I totally have experienced a couple of these if you recall the time I didn’t sleep for 5 days, thought I was in hell, and ended up in the hospital for 8 days. Also, when I went into psychosis at work and thought the world was ending. I was so out of it that my boss had to drive me to my friend’s house and I later spent one month in outpatient care at the hospital. But what do I know?
I also found out from a piece of paper about my Bipolar II diagnosis. In March of 2013, I had been off meds for about 5 months when I starting having severe anxiety and difficulty sleeping. I was only sleeping a couple hours a night and was having extreme highs and lows. One minute I thought I had the solution to all of my problems and the next I felt like I wanted to die. I was completely freaked out and I tried desperately to get in to see my psych. Problem is she has too many patients so she is always overbooked. I think it took a week before I was able to schedule an appointment. I was barely functioning so I asked for short term disability. She gave me only a week off because she said she was afraid I was going to lose my job. I had not taken sick time in over two years and I’m pretty sure it is illegal to let an employee go because of a health issue, but again what do I know? I was too out of it to argue and I was by myself so I just took my scripts and my visit report and left.
As I was leaving I looked down and saw Bipolar II on the report. It was like someone stabbed a knife in my chest. What?!? I have Bipolar? I immediately got defensive. I don’t have Bipolar! That doctor is a quack! For years I had been trying to find excuses for my mental issues. For instance, I blamed dehydration on my first full manic episode because I was on a diuretic for my skin and my potassium was low when I went to the hospital. I thought I just had some depression and anxiety that were exacerbated by the dehydration. I also thought I was working too hard and not taking enough time for myself. When my head started to slow down, the diagnosis began to sink in. As I looked back at my life I could see the cycles. It made sense. It felt so final. This is it. I am stuck with this for the rest of my life. It made me feel separate, different, and even more alone.
As time has gone on, I’ve gotten more comfortable with the diagnosis. Going to the NAMI support group helped with that. Listening to others share their stories , giving support, and receiving support has helped me realize that I am not alone in this. I encourage anyone who is struggling with a mental health issue to reach out to NAMI. Sharing my story in this blog has also helped. Covering up a mental health diagnosis takes a lot of energy. Owning it and not being afraid to share it with others gives you your power back and helps fight stigma. May is Mental Health Awareness Month so I am going to do my best to get the word out by writing and supporting others. Please reach out to me if you need any support. You are not alone.
January has historically been a tough month for me. I think it is tough for a lot of people, especially those of us in Ohio. The days are shorter, the skies are gray, the weather is dreary, and if you’re like me you want to curl up and hibernate until spring. I spend a lot of time alone in the winter because of Chad’s sports schedule and that in itself affects my mood and energy. I was hoping the Deplin vitamin that I started last March would help fight off my winter depression, but when I came back to work after Christmas break I could feel it starting to creep in. Instead of succumbing to the blues, I pulled out my bag of tricks that I have collected over the years.
I had stopped smoking (again) and was working on a strict detox diet from my doctor. I realized that attempting both of those at the same time was not a good idea so I decided to just focus on eliminating smoking and gluten. I knew cutting out everything (sugar, gluten, dairy, coffee, alcohol, and cigarettes) would have an impact on my mood so I chose to ease into it. I also chose to cut back on alcohol after a few glasses of wine turned into a grumpy mood for two days. Alcohol is a depressant and although I have had lots of fun with it in the past, I just don’t think it is worth it anymore. I can have a couple of gluten free beers occasionally, but that is my limit.
I also started to get more active, by exercising in the gym at work in the afternoon on most days. The exercise boosts my mood, gives me extra energy for the rest of the day, and provides a break from my computer. It is not as great as exercising in the fresh air, but it definitely helps. Using an activity tracker helps me make goals and stick to them. Something about seeing those stars light up makes me happy. I think it produces endorphins just like making check marks on a list. I also eat lunch with friends at work on most days. I’m an introvert, but I have learned that being around people is important for my mental stability. People need people.
On particularly a dark day (after the wine incident), I gave myself permission to eat some comfort food and I also asked a friend to stop by for company. She brought her little ones and spending time with all of them really helped. It is important to have a support system you can rely on. Phone a friend when you are feeling down. Also getting out of the house helps. I didn’t want to go home and sit in an empty house last night so I went to the mall. Didn’t spend a lot of money, but just wandered around browsing and it got me some more steps.
My friend gave me a great birthday present that helps beat the winter blahs, a “Happy Light”. I have it on my desk at work and I use it for a few hours in the morning. Natural spectrum light helps reduce fatigue and increase alertness. I use it during the winter months. I’ve found that watching positive television shows and listening to my favorite music also helps my mood. These tricks help my depression along with medication and therapy. I can’t rely on these alone, but they definitely help pull me out of the hole.
I have a lot to be thankful for this Thanksgiving. I’m thankful that my health has been fairly stable for the past 6 months. I’m thankful that I believe I’ve found the missing piece with Deplin. I’m thankful that I no longer feel like I’m dragging my ass around constantly. I ran errands for 6 hours yesterday without getting fatigued. I’m thankful I have energy to cook a meal after a long workday. I’m thankful that I’m getting appropriate sleep almost every night. I’m thankful that I’m not so doped up from meds in the morning that I fall asleep during my drive to work. I’m thankful I don’t have to nap in my car during lunch to make it through the day. I’m thankful that I can cope with everyday stresses without panicking. I’m thankful that I don’t have to take vacation time just to rest because I’m so exhausted. I’m thankful that I no longer live in fear of going into psychosis during a work meeting again. I’m thankful that I don’t constantly worry about losing my job because of my illness. I’m thankful that I can think clearly enough to perform my job and be productive every day. Hell I’m thankful that I don’t get lost driving home at night because that has actually happened before because my brain was so scattered. I’m thankful I don’t spend my weekends curled up in my bed. I’m thankful that I don’t spend hours staring off into space while my mind races frantically from one thought to the next. I’m thankful that I don’t cry for hours for no reason. I’ve come a long way since that Thanksgiving in 2008 when I enjoyed my turkey while having serious delusions at the dinner table. A long way. Life is good.
I’m a planner so of course I like to try to plan Bipolar episodes. Making lists and checking them off is such a turn-on. A few months ago a friend of mine suggested I prepare a plan in case I end up in the hospital again. I jumped right on it and quickly emailed “In Case I go to Crazyville” to my husband and parents. Now the last time I ended up at the behavioral ward all I had on was jeans and a sweatshirt. No underwear or bra or bag packed with clothing. I am not about to let that happen again. My husband showed up the next day with some clothes, but most of the items had strings which is a no-no in the looney bin. I don’t think he brought me any toiletries so I was stuck using the nasty shampoo from the hospital. I didn’t have a blow dryer or flat iron. What a nightmare! I also learned the hard way that tampons are difficult to come by at the hospital. I think I waited an entire day for them.
I started my “Crazyville” email with a list of my meds, doctor & therapist info, and the hospital my doctor is associated with. I asked them to inform intake that I have Bipolar Type II with a history of psychosis. It is important that they advocate for me because I might not be able to articulate what is going on with me at the time. I asked them to try to stay calm and take care of me like I am physically ill. I might need help remembering to eat, drink, and take my meds. I’ll need their full support even if I am acting irrationally.
I then gave them a list of clothing to pack for me. I requested comfy clothes like yoga pants, sweatshirts, and sweaters because it gets chilly. I also gave them a list of toiletries including tweezers because I don’t want funky eyebrows even when I’m sick. I made it very detailed so I can be as comfortable as possible.
Hopefully there won’t be a next time, but I feel a little relieved and I’ve given my voice just in case I am not able in the future.
Right now I have 4 different sizes of clothing in my closet. My moods sometimes make me feel like I’m on a rollercoaster and my weight follows. All it takes is an episode of hypomania and I can lose 15 lbs in two weeks. I’ll eat like crazy. I’m ravenous. My mind and body move so fast that I burn up the calories at an alarming rate. When I landed in the hospital in 2009, I had lost 20 lbs in a month with no diet or exercise. In my twenties I almost became addicted to it. It made me feel good because I was constantly trying to lose weight. It was a boost to an already elevated mood. Hypomania is not always a high though. There are times when it causes so much anxiety that I can hardly eat or drink. I’m in a constant state of fear and I can barely sleep. I’ll get compliments on my weight. I say thanks, but I really want to say I’m dying inside. It is rare that I get the super elevated mood. Hypomania usually happens for me in the spring as soon as the weather breaks. I truly believe that the seasons affect my disorder.
Then there’s the winter depressions where I pack on the pounds. It is super frustrating. My energy is so low that I can’t get myself to exercise and it doesn’t help that I sit all day at work. There have been days where I’ve taken less than 500 steps. I inevitably gain back all the weight that I’ve lost during the hypomania plus some. This past winter was a tough one. I put on at least 10 lbs and I’m still struggling to get rid of it. I think the Deplin put the smack down on the mania so here I sit with a pooch. It is definitely better than the alternative, but I have to admit that I miss the super highs and the benefits.
Then there are the meds that cause weight fluctuations. When I left the hospital I was given Remeron which is an anti-depressant taken at night that makes you drowsy. It also made me want nothing but sweets. I ate chocolate peanut butter clusters and toast with honey for dinner several nights. That is a really good way to pack on the pounds. I’ve also been on the highest dose of Welbutrin which made me drop weight like crazy. I spent most of my twenties on a high from Prozac where I could eat whatever I wanted and not gain an ounce. It has been a struggle to change my eating habits to adapt to my mood and meds especially since I am an emotional eater, but I’m learning.
For now I’m trying to be content with my body no matter what size I am, not pay attention to the scale, and just focus simply on nutrition and my well-being. I am truly thankful that I have been healthy since the spring and I will continue to work on maintaining my health.
So here I am once again trying to play with my diet to see if it makes a difference. I’ve been attempting to get off caffeine, gluten, and dairy for the last couple of weeks. So far it has been going well, but I am definitely craving some comfort food. Eliminating caffeine has been fairly easy. I just tapered down for a couple of days then stopped. Wow, what a difference it has made in my energy level! It is easy to stay on track when you immediately get results. If you are struggling with fatigue, you should experiment with cutting out caffeine. Fatigue has been the one symptom I haven’t been able to shake, but this seems to be doing the trick. Gluten has been tricky because it is seemingly in everything and I’ve had long love affairs with bagels and pizza. I haven’t had much time to prep and cook my own meals so I’ve been living off veggies, hummus, and nuts during the day then cooking a meal in the evening. Dairy hasn’t been too bad so far, but again I keep fantasizing about Donato’s pizza.
So why gluten and dairy? I’ve done a lot of reading about diet and mental illness and I keep seeing gluten and casein (protein found in milk) as being the culprit in many mental illnesses. I got my health coach certificate from The Institute of Integrative Nutrition last year and I was introduced to Dr. Mark Hyman in my studies. I read his book “The UltraMind Solution” and he suggests getting rid of all processed, high-sugar foods and the two main allergens (gluten and dairy). He has seen depression and anxiety symptoms improve in his patients while on this diet. So I am working on these two then it will be my crutch, sugar. I’ve grown to love Dr. Hyman so much that I’ve made an appointment at The Cleveland Clinic Center of Functional Medicine where he is the director. I’ll be meeting with a functional medicine doctor, a nutritionist, and health coach. I’m super excited! Hoping to see if I can manage my illness through diet and lifestyle changes and get rid of meds while we try to conceive again. If you’re interested in reading about food and mental illness, you should also check out “Nutrition Essentials for Mental Health: A Complete Guide to the Food-Mood Connection” by Leslie Korn and “Grain Brain” by Dr. David Perlmutter.
These drastic changes to my diet can sometimes be a struggle since eating has been one of my coping mechanisms when dealing with depression and anxiety. I’ve turned to food often in the past to comfort myself. Giving my favorite foods up has always been difficult for me (especially when I’m not smoking). So I am slowly learning how to deal and trying to find healthy foods to love. I’m hoping to see some improvements in the next month or so. I’ll keep you posted on my progress.
After the episode in 2008, I kept mentioning to my nurse practitioner that I did not feel like myself. At one point she told me that I might not ever feel like “myself” again. Those of you of in recovery can probably relate. The anti-psychotics can relieve the negative symptoms, but they can also take away the good feelings and in my opinion, change aspects of your personality. My illness caused me to have intense emotions including positive ones. Hypomania can be a beautiful thing. The meds calm my mind, but they make me less creative and dull my sense of humor as well. I don’t laugh as often and it takes more to get me excited.
I had to give up alcohol for the most part. Drinking with the meds did not mix well. I became overly emotional after only a couple of drinks. This was a big adjustment for me and my husband. We spent our twenties partying so it was a major lifestyle change when I stopped. Hanging out with drunk people was annoying to me when I was sober. I wasn’t as much fun and stopped wanting to go out to bars with friends. The anti-psychotic that I took in the evening made me so drowsy that I could barely stay awake when we were out. This caused Chad and I to argue. He got tired of making up excuses for me and missed that time with me. I’m on the right combo of meds now that I can go out and enjoy a few drinks and still keep my illness in check.
I also had to start taking better care of myself. I had to eat on a regular basis. I went into psychosis briefly while standing in entryway of the Indiana Pacer’s stadium because I had not eaten anything all day. I can’t eat a lot of junk either. I have to watch the caffeine, sugar, and processed carbs which can make me anxious and affect my sleep. I started having issues with my blood sugar as well. I don’t know if either it causes some of my symptoms or if the illness causes the blood sugar fluctuations. I feel better when I eat every few hours and drink plenty of water. Sleep is also very important. I have to make sure I am getting plenty of rest. No more late late nights for me. I’ve been told that I should be going to sleep at the same time every night and waking up at the same time every morning. This has been a challenge for me since I still struggle with insomnia a couple of times a week.
Checking in with my therapist every 2-3 weeks also keeps me on track and I look forward to our talks. I also attend a NAMI support group that gives me support and allows me to help others. Overall life is much better than it was before meds. It has just been an adjustment. I still miss parts of the old me, but the stability that the meds provide is totally worth it.