Bipolar Recovery Update 4

So this will be the last of these updates for a while since it will catch everything up to where I am more or less right now (I’m writing this in the third week of February, 2015) following what I wrote in Part 3.

Note: I want to make it very clear that everything I’m going to talk about is meant to be descriptive NOT prescriptive. This is simply a look at some of what happened to me, what’s happening now, etc. So don’t read anything I’m writing as a recommendation for self-treatment or anything like that. This is only about me.

Changing Old Habits

At this point, about the second week in January, I was now back in Austin, freezing my ass off (I’d get the furnace fixed in about a week) and wondering what would happen next.  As part of my interest in my field, I’ve actually looked into the topic of habits, how they do or don’t change, what drives them, etc.  I knew full well that a lot of the reason that habits are driven is that we are surrounded by conditioned cues that trigger them.

In this vein, studies show that the best time to change a habit is when you change environments; like moving to a new town or going off to college.  A new environment means no conditioned cues and you can start somewhat fresh habit wise.  Of course, that wasn’t the situation I was in.

I knew that Austin held some baggage from me, bad habits established in my late 20’s and early 30’s (during a depression) originally and then further cemented when I moved back in 2010. Mind you, I was in a very different situation now due to the aftermath of the previous year and that would help me avoid some of my bad habits.  Even if I wanted to engage in some previous habits, I was no longer in the financial boat to do so.

But the other part of it was simply not to fall back into the pit of inertia that tends to haunt me in Austin. It’s way too easy for me to get back home and go right back to my old life goofing around on the Internet interspersed with workouts, PS3 and Netflix.   It’s not the most fulfilling life.

I had joked with my counselor that not only do I not have interests, I don’t have interest in having interests.  But it’s not really a joke: for 20+ years I’d pursued a singular goal with little interest in much else (certainly nothing that was social, or healthily social) and since that faded a bit, my life was kind of empty.  I lacked meaning, value, purpose (MVP) as he put it and had for a while.

I wasn’t volunteering (I had fallen out with the Austin Humane Society during a previous hypomanic phase), outside of the occasional piece I hadn’t done any new writing in years, I had a very tiny group of (always busy) friends and it made for a very solitary and boring life.

I really had no good social outlets and I was in a quandry.  But I knew that, fundamentally, the only way to change it was to change it and then make myself do it for a while (hopefully getting enough positive reinforcement for it to continue).

I also knew that if I didn’t start pretty much right away I’d get sucked right back into my old life.  Whatever I was going to start changing needed to happen right away.

Getting Back into Shape

I’d only been back in the gym for a couple of weeks in Nashville before getting back to Austin but now I was back in my normal environment.  My gym is 5 minutes from me and it wasn’t terribly difficult to continue the habit.

I’d stick with 2 days of basic weights (essentially a general prep phase) since I had no real goal beyond getting back into training and 3-4 days of cardio.  I always give myself a day off per week or I go a little bit nutso.   Especially when it’s all indoors (I’m a wimp about cold).

Perhaps the oddest occurrence getting back to Austin was that my appetite and carb self-medication simply disappeared.  Mind you, this sometimes happens as a normal process of my swinging out of my Phase II depression but this was profound.  I had been eating like utter crap for not only the month in Nashville but months before that and it all just went away.  Like overnight.

Fairly rapidly, I started leaning out (regular training plus not eating donuts every day tend to do that), and it would only take 3 weeks for me to regain the belt hole (the easiest measure I have of where I’m at) I had lost and get closer to where I’m most comfortable.

What strength I had was returning gradually but I wasn’t pushing anything.  I do not enjoy volume training or high reps in the weight room but this was probably the most of either I’d done in years.

Medication and Such

I finally got to the full dose of lamictal, as well as getting my Deplin prescription and I just took both every morning when I woke up.  Finding  research that gut health impacts on mental health, I’d add a probiotic (Pearls so I can feel pretty).  Fish oils and Vitamin D would be taken with a meal but I did this every day already.

The headaches and eye pressure side effects went away fairly quickly although there was one kind of odd side effect (let’s say that it’s personal and sexual and I won’t go into details).  But no rash, no problems and I still felt stable and productive.  I was still doing work on reformatting my books although I’m still waffling on the Kindle platform for various reasons.

At this point my sleep schedule was ok.  Rather than waking up every couple of hours as I had been, I’d get maybe 3-4 hours before waking up (usually to pee but that’s just because I’m old) but go rapidly back to sleep.  So I was getting full (if slightly interrupted) nights of sleep.

Too little sleep can actually trigger a hypomanic episode so making sure that that was on track was important.  One of my personal first signs of impending hypomania is neither wanting nor needing much sleep.

Support Meetings and Safety Nets

Although I still don’t really get much out of them, I knew that it was important to keep going to the DBSA support meetings.   A lot of it was just so that I would have at least one thing a week to get me out of the house to be around other human beings.

As well, folks at these meetings usually have a lot of experience with bipolar; it’s often hard for me to see small changes in behavior that indicate that I’m moving back towards hypomania and folks with a background can often identify it even if I can’t.   But only if they’ve seen me when I’m reasonably stable for baseline.

The first meeting I went to wasn’t really for me.  It’s not worth detailing, just not a good fit.  I’d find a different meeting that was a better fit and go there once/week (it meets twice a week but I’m not fighting Austin traffic on a Friday night).

Like the one in Nashville, I would feel a bit guilty.  Most were reporting these horrid weeks, experiences (and truly awful therapists and treatment issues) and when I’d share it was just “Oh, I’m good, sleeping well, stable, working, it’s all good.”  I know, it’s absurd, but whatever.

In that vein, I’d also explicitly make a point to check in with my mother weekly and I tried to set up other safety nets, meeting at least occasionally with my long-term friends.

Basically I wanted various people having contact with me on various schedules so that, if a problem started to present itself I’d have some feedback (once you get beyond a certain point, you kind of refuse to listen to anybody anyhow).  Majority rules here; if the majority feel like I’m losing it, they’re right and I get no say in the matter.

The Followup

I’d follow up again with my NP via Skype in the third week of January.  I really didn’t have anything to report to her. No side effects, I had hit the higher dose of Lamictal she wanted me at and since I was stable she felt no reason to raise it.

I reported that I was on track with everything else: Deplin, exercise 5-6 days/week, supplements, diet, sleeping well, etc.  Rather than her waiting to even ask me about it, I just gave her the rundown.  It’s quicker than 20 questions.

As I’ve said before, I have a thing about women yelling/being disappointed in me so even if those habits weren’t critical to my own health (physical and mental), I’d have done it to avoid her grousing at me.

I had trouble answering questions about how I felt, if I were depressed or up or whatever. Phase III of my own personal cycle tends to be “Meh.”  The lack of MVP in my life and just general boredom is part of it.

I just sort of exist. Not happy, not sad, I just am.  Wake up, dogs, train, eat, online, PS3, Netflix, sleep.  It’s probably another reason I had avoided dealing with the mania; compared to being meh or depressed, hypomania is that much MORE awesome

But it’s hard to separate boredom from depression for me sometimes.  I also offered to her that my mood states seem to be fairly seasonal and that I didn’t honestly expect to even begin a ramp up to hypomania until April or May and that that would be the time to really test if this medication was right or if I was keeping it under control.

I’ve watched this pattern for years and unlike some people who have triggers or can flip rapidly, mine seems to be be mainly seasonal.  She told me that was very insightful (ok) and that, if I started to ramp up, we could always double my medication and then bring it back down when things were controlled.

I actually just had another check-in with her with nothing profound to report.  My next checkup is in April (2 months) although I can always call if I’m losing it.  But that’s when I really expect everything to get tested if it’s going to.

Socialization

So my meds, support and activity were all in check, the last thing I needed to deal with was socialization and finding a life again.  I was still on the Meetup.com site and had found a bunch of different gamer/geek groups in town (Austin is pretty nerdy but so am I).

I’m a long-term nerd and gamer from way back.  I grew up in arcades (played Space War in the original cabinet), computer and console games (Intellivision to Apple II to Genesis to Playstation) and did the D&D/Rolemaster/Car Wars thing in high school.  I even skipped senior prom to go to gaming group.  Yeah, nerd.

I find it interesting to see that board games have made a HUGE resurgence in recent years.  I played back in the 80’s then everything went online but due to games like Settlers of Catan, and the fact that I think many people prefer the social nature (and I imagine not being cursed at/having racial slurs thrown at them on XBoxLive), boardgames are back.

So I found a couple of meetups that seemed a good place to start.  The first was actually at a crowded bar which is currently NOT within my wheelhouse; I got anxious and left.  The next was simply a weekend gamer meetup at a restaurant near my house.

I’d go and it was sufficient to start. It gets me out of the house, gets me around people, reminds me how to actually talk to (dressed) human beings.  It’s a little dull, the games don’t super appeal to me (they seem over complicated for no reason) and folks don’t really talk that much but it gets me around people for now.  My goal is to add the occasional other activity over time (I went to another nerd meetup at the local old school arcade a couple of weeks ago).

Again, I’m not trying to force it or jump in too quickly, hating it and stopping.  It takes me about 3 weeks to get used to a change in my environment so I just planned on adding stuff gradually as stuff became more normal.

And That’s Where Things are Now

The aftermath of the hypomanic phase continues to wind down and resolve itself.  And the further I got away from the experience the less real it seems.  It was weird, almost as if it had never happened.  As well, any urges to return to that environment were basically gone.   I had seen the ultimate aftermath and wasn’t even willing to risk going down that path again.

And things are honestly pretty good.  Especially given where it started a short few months ago.  Inasmuch as I won’t know anything for sure until April or May, the meds are working with no major side effects.  Appetite is in check, activity is consistent and I’m getting back into shape.   Slowly I’m finding social outlets and getting around people again so I can relearn/remember how to do it.

Given where I was not only a couple months ago, it would be difficult to be unhappy with the situation.   Even the GSR (guilt, shame, regret) is more or less gone.  Sure, I wish it hadn’t happened at all but that isn’t useful.  I can’t make it not happen retroactively, I can only make sure it NEVER HAPPENS AGAIN.

It appears that almost losing it all was required to force me into dealing with an issue I had ignored for a while.  Right or wrong, I have to see that as a positive.  It could have been worse, I could have ignored this and had an even worse something happen because of it.  What happened in 2014 may be the best thing that could have happened to me.

I’m medicated, healthy, currently stable, doing some work daily, and finding a life again, something I haven’t had for a lot of years and that will prevent me from slowly going nuts (nuttier) over the next half of my life.  Yes, I said work and it only took me a couple of weeks to reformat the others books so it must be something else.

And, and this is the announcement that I wanted to get to on Monday: I’ve even started writing again.  Like a new project.  It actually started out as a rewrite of an earlier book (fuelled primarily by annoyance), then took on a life of it’s own.

While researching that, I came across some literature that led me back to a previous project from years ago which I finished this past Friday.  I mean done, not “2 weeks from now done.”

And will release next week.  It’s an odd little booklet, not long and, well, you’ll find out about it soon enough.  I’ve also gotten caught up to 2015 and it will be available in PDF as well as both .epub and .mobi for non- and Kindle readers respectively.  Both on my site for now, by the way.  Not Amazon.  Not yet.

So Am I Fixed?

Of course not.  I know full well that this is a long-term thing.  Probably the single most common piece of advice I was given in the deluge of emails I got was not to think I’m cured and go off my meds.

I already knew that this was very common with mental illness: you take your meds for a few months, feel fine and go off them.  And then go off the rails.  Rinse and repeat.  I know better.

Bipolar is part of me and it doesn’t ever go away.  It’s not curable right now, it’s only treatable.  I’ve seen the highs and lows and the severe consequences of not dealing with it and I won’t ever let it happen again.

If that means meds for the rest of my life, well, I’ll take that rather than what I know is behind door #2.  Because nothing related to treatment could ever be as bad as what happened in 2014.

Somehow, given what happened a mere 4 months ago, things seem to be pretty good.

Read Bipolar Recovery Update 5

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