Riding the Weight Rollercoaster

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.

Food and Mood

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.

The New Me

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.

The Road to Recovery

After the episode in 2010, I continued to take my anti-depressant and anti-psychotic, but they left me feeling a little like a robot that was just going through the motions.  I felt numb and could hardly stay awake in the evenings.  I continued seeing the nurse practitioner, but we struggled to find the right meds.  She would constantly look up different meds in her book and a lot of the time I felt like I knew more about them her.  I had tried almost every anti-depressant out there.  I was losing confidence by the fall of 2011 so I decided to see a psychiatrist that I saw briefly during my outpatient therapy at the hospital for a second opinion.  The psych decided to do a DNA test to find which meds I would get the most benefit from.  The test showed that none of the selective serotonin reuptake inhibitors worked well for me and a selective serotonin-norepinephrine reuptake inhibitor called Pristiq would be better as well as an anti-psychotic called Geodon.  If anyone out there is struggling to find the right meds, I strongly suggest you find a doctor that will do this test for you.

I started the new meds right away and it took a while to adjust.  The Geodon made me so tired at first that I sometimes had to pull over on the way to and from work to sleep.  There were many mornings that I almost drove off the road from nodding off.  Eventually we found the right dose and I stayed on them until the summer of 2012 when we decided to try to get pregnant.  The withdrawal symptoms from the Geodon were intense.  They say there are not any problems with withdrawal, but I definitely experienced some.  When I first started tapering off I would wake up every hour the nights I didn’t take it.  I would have chills the following day and difficulty thinking clearly.  It is hard to explain, but it was an awful feeling.

Once I was tapered off I did fine for about 9 months without them, but in the spring of 2013 I was hit hard with a mixed episode and extreme anxiety.  Thankfully I caught it before I went into psychosis again.  I went back on meds and I started seeing naturopath that prescribed vitamins.  I also had cranial sacral therapy done which relieved so much tension in my face and jaw that the look of my face changed completely.  It was amazing and I recommend it to anyone who needs relief from anxiety and stress.  It took months to recover from the episode.  I had so much anxiety at times that I got lost driving home from work.  I ended up working full-time from home for 3 months then I worked 2 days in the office and 3 from home for six weeks.  I was very lucky that my employer accommodated my needs.

I stayed on meds until January of 2014 when I thought I was doing so well on the vitamins that I didn’t need it, but by June I was depressed and anxious and had to go back on them.  I’ve been on them ever since.  I’ve been pretty stable for the past two years, but I still experience depression in the winter months and the one symptom that has been the hardest to shake is fatigue.  However I am starting to see improvements in that area as well.  I started a prescription vitamin called Deplin in March and it is really helping with the mild depression and fatigue that has lingered on.  The big test is this winter, but things are definitely looking up!

Stigma

If you’ve read my previous posts, I hope you have a better understanding of what living with a mental illness can be like.  I let some of my skeletons out of the closet so you can see how debilitating it can be and how difficult it is to get help sometimes.  It is far from what you see on the commercials for anti-depressants.  You know the person lying around looking sad one minute and the next is out riding a bike in the sunshine.  I wish it was that simple.  There is no cure for Bipolar and it is not something you can turn on and off unfortunately.  It is not mind over matter.  It is not a choice.  It is biological illness just like diabetes or heart disease and it should be treated as such.  We should not feel guilty or ashamed because of a possible imbalance of chemicals in our brain but a lot of us do because of stigma surrounding mental illness.  We need to have an open dialogue about mental illness and stop sweeping it under the rug.  Not doing so perpetuates stigma.

One of the first times I witnessed stigma involved a primary care physician that was trying to treat me for anxiety and depression.  He was so rude and disrespectful that the visit ended with me walking out and my husband announcing to the staff that the guy was a “fucking asshole”.  I received a letter about a week later asking me not to come back. No problemo!  Another time I was picking up some supplements from my naturopath when I overheard the staff talking about a new patient who was receiving the same treatment as myself at the time.  They referred to her as the crazy one and questioned how she could afford the treatment.  They went on and on right in front of me.  I mentioned it to the doctor who was somewhat understanding, but said something about not being able to see mental illness so people don’t know.  So that makes it ok to degrade someone who is ill in what is supposed to be a professional environment?  They didn’t know I was mentally ill as well so I should understand that?  The therapy wasn’t working so well for me anyway so I decided to spend my $1,000 per month elsewhere.

This year I had a minor gynecological surgery to check for endometriosis.  A few days after I was feeling extremely lethargic and became short of breath after I walked up a couple of flights of stairs.  I called my doctor to see if I should be concerned and the nurse told me to go to the ER.  After reviewing my medications, the attending doctor asked me if I was depressed about not getting pregnant and if that’s why I was there.  Yeah, you’re exactly right. I’m depressed about not conceiving so I decided to come to the ER by myself on a Friday night.  She said something like “If you were to tell the toe doctor after surgery that you were short of breath they would send you to the ER”.  Yes, the moron actually said toe doctor.  She was dismissive and rude.  I was dehydrated so I got my fluids and left.

I had a friend tell me once that I should volunteer to help my depression.  I should spend time with others that are worse off than myself.  I should hold babies in the NICU.  Let’s see…I am so completely fatigued that it takes everything I have to work all day and come home and make dinner, but I should volunteer to help others.  I knew what she was trying to say, but it was still hurtful.  I’ve also been told to take a brisk walk when I was losing my mind.  Yeah, that should do the trick!  Then there is my favorite, you should have a baby to help your depression.  Not sure how that would balance my neurotransmitters especially while I have raging hormones, but ok.  I’ve noticed that people want to give advice when you talk about your illness, but most of the time what we really need is just to be heard and little empathy.

Psychosis: Part Deux

I experienced psychosis again in the fall of 2010 (I guess fall is not a good time for me).  I struggled with finding the right meds after my hospital stay in 2008.  I eventually stopped taking Risperdal (anti-psychotic) because it made me feel like a zombie.  I could hardly stay awake in the evening.  I made up excuses as to what went wrong a couple of years back and why I did not need that med.  Just saying that I was on an anti-psychotic was difficult for me.  At that time I did not have a Bipolar diagnosis so I thought that it would not happen again.  I was seeing a nurse practitioner at the time and I did not tell her I stopped it.  I was dealing with stress at home and work (stress is often a trigger in Bipolar).  I was on a different anti-depressant (Welbutrin), but my emotions started changing rapidly and I was in tears constantly for no reason.

I was working in a department with only one other person and both of our plates were way too full.  My co-worker was on a business trip and I was covering the entire country for the week when my symptoms became too much to handle.  I had so much anxiety that I could not keep up with my workload.  I started to forget how to do things that I had done every day for years.  It completely freaked me out which made trying to work even worse.  My manager was out of town so I went into my VP’s office and told him I was not doing well and I needed his help.  He listened as I cried and rambled on.  He was very kind and calmed me down.  He took my laptop and helped me go through what needed to be done.  He forwarded my emails to someone who could help me.  He promised me that he would not share what happened with anyone.  I took the next day off to go to see my nurse.

My emotions continued to bounce around that Friday and through the weekend.  I went back on Risperdal hoping it would keep things in check.  I went to work on Monday, but I shouldn’t have.  I promised my VP that I was well enough to work, but by Tuesday I was a complete mess.  As my luck would have it, I went into psychosis during a business meeting with a supplier. It continued during lunch with them and some co-workers.  I was having religious delusions and I thought the world was ending.  I kept quiet so I don’t think others knew what was going on, but I know they noticed that I was a little out of it.  Eventually my co-worker said I looked like I was going to pass out and I should go talk to my boss.  I broke down in his office and told him I was not thinking clearly.  He said I didn’t look well enough to drive so he drove me to my friend’s house.  As soon as I left work, my head started to clear a little.  I believe getting away from the stress relieved some of my symptoms.  I called my nurse and she suggested that I take some time off work and go to outpatient behavioral therapy at the hospital.

I continued having intense emotions and crying spells that week, but somehow I was able to throw a Halloween party for my husband’s family that weekend and pretend that everything was fine.  I attended four-hour group therapy sessions three days a week for a month.  At my first session I hardly spoke or made eye contact with anyone, but the psychiatrist increased my meds and by the end of the month I was sharing and making connections with others.  I was once again misdiagnosed with Major Depression with Psychosis. On my days off I would go to the park by our house sometimes three times a day and just stare at the pond and ducks.  It was unseasonably warm that November and all the time spent in nature helped soothe my soul.  Somehow I was able to find enough courage to go back to work.  Thankfully, my co-workers did not mention the episode to me.  To this day I am blessed to have a great work family that supports me.

I learned quite a bit from this experience.  I learned how to set boundaries, especially when it comes to work.  I no longer work a lot of hours or go in when I am not feeling right.  I take more breaks and make sure I eat and drink on a regular basis.  I watch my stress levels and rest when I need it.  I put my health first and most importantly I’ve learned how to say no when I need to.

 

Psychosis

When was the last time you heard a story about psychosis?  I’m guessing it’s been a while for most of you.  Bipolar is a bitch, but psychosis is the bitchiest of bitches.  Imagine a nightmare you can’t awake from or possibly a bad acid trip.  I am one of the lucky 50% of Bipolar patients that experience psychosis.  My first experience with this monster happened in the fall of 2008.  I had been off meds for a few years and was in the middle of planning my wedding.  The week before Thanksgiving I decided to go to my family doc because I was having some pretty intense anxiety.  I briefly explained my symptoms and history of depression and he gave me a prescription for Zoloft.  He patted me on the knee and said “If I were to pull over 10 cars on the street, 1 in 10 drivers would have clinical depression.  This pill will make you be you without all those bad feelings.”  It was a rushed visit and I quickly went to the pharmacy to get this happy pill then to the grocery for a bottle of wine which I drank all by myself (this is never a good idea when you’re having symptoms).   I started the drug the next day.  Didn’t notice many side effects for the first couple days, but at some point I stopped sleeping and was eating and drinking very little.  I was in a full-blown manic episode (anti-depressants can induce mania in people with bipolar).

This is where it starts to get blurry.  Even though I was extremely sleep deprived and was on an emotional rollercoaster, I continued going to work.  I was so worried about letting people down and afraid of losing my job.  I managed to complete my work, but at some point I took my boss into an office and completely went off.  I have no idea what I was saying, but my anger exploded on her.  I walked out and drove straight home.  I emailed my boss in the middle of the night to let her know I would not make it in the next day.  That was the Wednesday before Thanksgiving.

On Thanksgiving Day I had gone about 4 days with little to no sleep and I was officially in Crazyville.  Somehow I got dressed, did my make-up and hair, and showed up at my future husband’s grandfather’s house with a smile on my face.  I can remember my vision being blurry and I was talking a lot.  I kept smiling and rolling my eyes back in my head.  I was very confused during conversations with Chad’s family and I kept stopping them to ask questions.  It was obvious to others that something was wrong, but Chad either didn’t see it or didn’t want to see it.  As we were driving home, Chad put his hand on my knee and asked if I had a good time.  I just smiled and nodded.

Later that night I fell asleep for a bit then awoke suddenly with what felt like an alarm clock going off inside my body.  I was panicked.  Something was terribly wrong.  I looked in the mirror and my pupils were completed dilated.  My senses were in overdrive.  I was experiencing hypervigilance.  I called my mom in the middle of the night and talked for hours.  I remember telling her that my body had been shut down for so long and it was waking up.  I was extremely paranoid.  I tried all day Friday to sleep and it was torture.  I went from the bed to the couch in the basement to the couch in the living room.  I couldn’t sleep at all.  I had racing thoughts that wouldn’t quit for second. I was obsessing over my behavior at Thanksgiving.  I was filled with worry and fear.  Chad took me to the hospital in the middle of the night.  We waited for hours, but decided to go home.  The paranoia continued and I can remember crawling around the basement in complete darkness.  I called my best friend Monica for help and she showed up super early Saturday morning with her husband and three-month old daughter to take me to their house (God bless them).  I got to stare at her daughter’s beautiful face the whole way there which was healing for me (I think we have a special bond because of that.  Love her to pieces).

My dear friend made me a bed on the couch and took care of me like I had the flu.  She called an old therapist of mine to see what we needed to do.  She called my dad and had him check with my insurance to see which hospital I should go to.  My dad drove from Akron, picked up Chad on the way, and met us at Monica’s.  I remember yelling at both my dad and Chad when they got there.  I have no idea why I was so angry with them.  We all went to Kettering Medical Center.  It felt like we were there all day.  I told the doctor that I wasn’t sleeping and I was hearing voices.  She prescribed Ambien and sent me home.  I took it and slept for only two hours.  I woke Chad up in the middle of the night and screamed at him for hours.  I’m sure my dad heard all of this from the basement. When I saw my dad in the morning I told him to leave.  I tried to sleep again and again.  I seriously thought I was going to die in my bedroom.

I believe it was Sunday when I was finally admitted to Kettering Behavioral Hospital.  I told a nurse that I did not feel safe at home and I signed myself into treatment.  I was diagnosed with Major Depression with Psychosis.  I think it was really a mixed state (depression and mania at the same time).  I was also dehydrated and my potassium was low.  My mom flew from Florida that day and arrived right before they took me in the ambulance over to the psych ward.  I was so happy to see her.  She said I looked like I just gave birth.  My cheeks were flushed and my lips were bright purple.  I showed up to the hospital wearing jeans and a sweatshirt, but no underwear or bra (stay classy Emily).  I had a roommate the first night and I kept her up all night as got up at least 20 times to go to the bathroom. I had constant diarrhea and I couldn’t get enough to drink.  It felt like my body was shutting down.  The majority of my stay is a blur, but I can remember bits and pieces of my delusional thoughts and they followed the consistent themes of delusions. I believed I was dead (cotard delusion).  I thought I was in hell (delusion of guilt and sin).  I believed that several objects around the hospital were mine or were there to make me remember something from my past (delusion of reference).  I was prescribed Remeron (an anti-depressant taken at night that makes you drowsy) and Risperdal (anti-psychotic).  It took about 5 days for me to become coherent. It was a wild ride, but I survived.

I left the hospital after 8 days and my mom stayed with me for a coupe weeks while I recovered. I was on short-term disability for three weeks.  I was still a little paranoid at home and extremely drowsy from the meds.  I had difficulty driving and doing everyday things like going to the grocery and making dinner.  It took several months to feel somewhat normal.  Chad and I decided to cancel the wedding we were planning because it was too much for me to handle.  We ended up having a small ceremony with only our parents then a reception with a few close friends and family.  My mom told me that the night they left me at the hospital Chad played the song we intended to use for our wedding dance and sobbed because he didn’t want to go inside the house without me.  It breaks my heart that we didn’t get to dance to that song.

This post was not easy to write, but it is helping me release some of the shame and guilt I carry around.  I spent a long time feeling like I should have had some control over my thoughts and behavior, but this is an illness that is sometimes completely out of my control.  Through this experience and others I have realized that I am a lot stronger than I thought I was.  My brother was right, I am a fighter and I will just keep fighting.

A little bit of my story

So here it goes.  I’m starting this blog to share my stories about living with Bipolar Type II with the hope of shedding more light on mental illness and helping others cope.  I wasn’t diagnosed with Bipolar Type II until 2013, but I started struggling with it in my teens.  I was misdiagnosed with Major Depressive Disorder several times beginning at age 23.  Depressive episodes are more frequent with type II so being misdiagnosed with unipolar depression is common.  I’ve tried a litany of meds (I could start a side business with the leftovers).  I was even prescribed GHB for sleep (Yes, the date rape drug.  It didn’t help). I’ve experimented with alternative therapies as well.  Cranial Sacral Therapy, Reiki, and Yoga (all of which did provide some relief).  I was determined to get off meds at one point to start a family so I donated ten grand to a Naturopath that promised to cure my illness with high doses of amino acids.  Instead of relieving my symptoms permanently, it gave me nausea and diarrhea for months while I took up to 65 pills a day.  Ain’t nobody got time for that especially when the runs hit you in the middle of a work meeting.  Good times.  I’ve tried gluten-free, sugar-free, paleo, and veganism.  These restrictive diets caused even more symptoms.  I’ve learned that changing my diet so drastically affects my mood and energy in a big, not so great way.  I function better when I eat sensibly and don’t cut out entire food groups.  Cleanses are not my friends.  I once eliminated all sugar, dairy, meat, caffeine, and alcohol.  I became so depressed after three weeks that only a cheeseburger and milkshake from McDonald’s could ease the pain.  Currently I’m focusing on finding my balance with eating more fruits, veggies, and protein, while cutting back on processed sugar and grains.  I also take my meds religiously as well as prescription l-methylfolate (increases the effectiveness of my anti-depressant).  I’m beginning to exercise again, a natural anti-depressant for me.  I’m taking it day by day and learning how to keep from sliding up and down this pole.