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.
My 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.
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.
2018 has been a little bit of a rollercoaster so far. I started it off sick with a sinus infection which was annoying. I felt pretty rotten, but Chad would not let me cancel the little 40th birthday party he had planned. He is so freaking stubborn. I returned to work after 12 days off and it was quiet for a change. I was busy, but it wasn’t crazy hectic like it normally is. We had some bitterly cold days that had me wanting to stay in bed the whole day, but I didn’t. I never do. No matter how I am feeling, I get up and “get my day going” as Chad likes to say. For one thing Chad WILL NOT let me stay in bed. No way. Really though, even when I’ve been incredibly depressed, I have always pushed through. I always got up. I always went to work. I have a strong will, sometimes too strong. I have pushed through and continued on with things when I should have been taking care of myself. That’s what caused me to go into psychosis at work 8 years ago. I am getting much better at it, but I still rarely take a sick day. If I stay home sick, I still work basically all day. Anyway…I’ve been having a midlife crisis of sorts. Turning 40 triggered something in me. It has me reevaluating everything in my life. I mean EVERYTHING. It also triggered a mini Bipolar episode. I say mini because I caught it before it got out of control.
Turning 40 without children has been fucking hard. I am not going to lie. This is not the life I pictured for myself when I was younger. I am really good a faking it, having this facade that life is good and fun all the time and I’ve got my shit together, but that number started to make my head spin. I started putting all this pressure on myself. OK, this is it. This is your last year to try to have a baby. You’ve gotta figure this out right now! Then the fear kicked in. You can’t give birth to a healthy child with this illness. You can’t raise a child and work full time with this illness. How can you take care of another human when there are times when you can barely take care of yourself? I’ve been conflicted about starting a family for years. I have a lot of fears. That’s probably part of the reason why I haven’t been able to conceive even with the assistance of fertility treatments. I haven’t had the right energy around having a baby. I’m fully aware of that.
So…along with this pressure and fear came some depression. I started to feel very apathetic which is not like me at all. I usually care too much. I started to lose hope and I started to feel trapped. I began to want to isolate. I felt like I was alone in the world. I started to focus on all the things that make me feel separate from the rest of the world. I no longer drink alcohol (I’ve given it up for good this time, 6 weeks alcohol free!) and sometimes that makes me feel like an alien at social events. That and not having children to talk about with other women my age frequently makes me feel like I’m from another planet in social situations. I live in a small suburban town in Ohio. Literally everyone around me has kids and drinks on the weekends (at least). The depression lasted about a week then the mania kicked in. I was rapid cycling (going from depression to mania quickly). The mania showed up as wanting to spend money on shit I didn’t need, obsessively cleaning out my closet and wanting to get rid of half my clothes, having zero appetite, and insomnia. I barely sat down or ate anything last Sunday. When I had trouble sleeping that night and felt like my head was in the clouds on Monday, I knew I had to do something.
I called my psychiatrist and had him increase my antipsychotic to stabilize my mood. The higher dose put the smack down on the mania instantly. Praise Jesus for atypical antipsychotics! It could have been a lot worse if I let it continue and didn’t call my doctor. While we are on the topics of meds, I want to clear something up. Sometimes people are surprised when I tell them I take medication because I am so focused on having a clean lifestyle. I have been on medication consistently for the last 5 years. It has greatly improved my quality of life. I’ve tried in the past to go without meds and it has not worked for me. I went to the Cleveland Clinic and saw a Functional Medicine doctor for the sole purpose of stopping meds. Functional Medicine looks that the root cause of illness. I had a shit ton of tests done to see if there was some underlying problem causing my illness, they found nothing and the doctor advised me to stay on a mood stabilizer for the rest of my life. She told me even if I ate perfect organic paleo meals, I would still need to be on meds. Now don’t get me wrong, cleaning up your diet and lifestyle helps a ton, but it may not always keep you sane. That is not a risk I am willing to take right now. Due to my history of psychosis, I have chosen to stay on meds.
So…I am just taking it day by day now. I’m doing much better than I was a week ago and I am grateful for that. I am blessed to have family and friends that support me and a doctor who actually listens and cares. I thank God that we have excellent health insurance and can afford everything I need to take care of myself. I have so much to be thankful for. I realize that I have it easy compared to others that struggle with mental health issues. My prayer is that one day everyone will have access to to the medical care they need. I also pray that my words help people feel less alone and give them courage to speak up about mental illness instead of being ashamed. That is what it is all about friends.
Confession 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.
Fatigue 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.
- 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.
- 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.
- 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.
- 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.
- 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.
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.
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.