Silly

5:18am

I really thought yesterday was the anomaly. Since my brain didn’t wake itself up and even though I recognized the “immediately awake” state of my brain. I still somehow thought I wasn’t kicking off another “up” period of hypo-manic lack of sleep. Silly me.

jonathan-gross-delusional

It’s so alluring, the thought of being normal. And, when I am normal for long periods, I forget or convince myself that that normal is the new normal[1]. I forget that the very nature of cyclothymia (or manic depressive / bi polar) is literally the cycles or the shifting from one pole to another. The cycling from one state to another is the definition of the condition. It’s right there in the name, just what it says on the tin.


However much I may be lulling myself into forgetting that normal isn’t for me normal, I am not forgetting how to manage. I’m not frustrated by this wakefulness. I am not confused and running through a list of things that may have triggered “bad sleep” (Did I exercise too late at night? Did I have caffeine too late in the day? Is the bedroom uncomfortable?). Sleep problems are a symptom, and so solving them isn’t the ultimate goal. And this is just a state to be accepted and managed – fighting against it only brings frustration when the fighting doesn’t work in promoting sleep.


The song in my head this morning


[1] Not so dissimilar to how when I’m “down” it feels like I’ll be down forever. Though¬† I usually have a voice in the back of my brain reminding me that this isn’t normal – except for the darkest of days when there is no such voice. And when I’m “up” I’m very clear that this is a temporary state of affairs and will soon pass.


Photo Credit: Jonathan Gross


For the record, did get out and exercise yesterday. Streak of 1 so far.

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Silly

Anxiety, continued normal

5:33am

Not as crazy early, thankfully.

Been doing much better recently. I’d like to think that this is due to taking better care of myself, but I’m not so delusional as to think my conscious actions are the primary driver of my health. I do have some power here, but it’s far from completely within my control.

I have been having more anxiety in general. That has been a bit of a learning experience to feel otherwise well and healthy but yet have this anxiety to contend with. Previously, I hadn’t really thought through how my anxiety interacted with my up-down cycles. It seems completely independent. Looking back, I can identify other periods where my main struggle is just experiencing anxiety.

I haven’t been particularly “up” recently. Definitely not down – mostly middling, slightly up. The anxiety comes, as it often does, in periods of repetition. There will be a trigger or two and anxiety will well up, threatening to overtake me. I’ve experienced a few instances in public where I wasn’t able to handle it very well though I suspect no one but me really knew the inner turmoil – it didn’t spill outside me too far.


It wasn’t my brain that initially woke me up tonight. It was obviously an external environmental factor. But my brain was instantly alert. Not any rushed thoughts, but I suspected that I was now “awake”. As it was, I tried to settle back down only to have one thought after another pop into my brain, insisting on being dealt with, resolved, or investigated. That was my final tip-off that this wasn’t going to be just a brief period of wakefulness, but that my mind was up and running at full.


Trigger check-in:

Information diet: Many cutbacks.

I cut back several weeks ago, and also made a more concerted effort to cut back further a week ago. I’ve been allowing myself more of various types of information input and realized that some of it, while not immediately obviously a problem, was in the longer-term detrimental to my health and happiness.

I think that’s what is so insidious about the information inputs: some things aren’t really a problem immediately. It’s only by allowing them for longer periods that I feel they are detrimental – and it’s really not obvious that they are the culprit.

That non-obviousness makes me wonder if my current anxiety is exacerbated by my current information diet and whether it would be helpful to cut back further. I’ll probably try to cut back further and see how it helps.

 

Caffeine: Strictly controlled.

I had been hoping to have it occasionally at most. But I find it very helpful to get my day started. So I have a very precise, controlled, amount and otherwise avoid all caffeine.

I also use it as an aid when dealing with the outside world. Prior to a situation that I know will be stressful, I may plan to have another small amount of caffeine. This week, prior to going out for a longer period of personal interaction in the evening, I scheduled a smaller morning amount of caffeine so that I could have a second small dose of caffeine prior to going out. (Still not late when I consumed it.) I’ve done this a few times and find it can be very helpful by setting up my internal feelings well for navigating social situations. I attribute it to the general positive outlook that it engenders.

 

Diet: Mostly good.

I’ve been predominantly eating well throughout, with a few occasions of eating in a celebratory manner with friends. This is now a relatively long stretch of holding a pretty good diet.

 

Interaction: More than usual.

Definitely a higher level of interaction than usual. Some work events, and some increased personal social times. Mostly this hasn’t felt as draining as expected. Though I may be just more attuned to expecting this than I have in the past, so it’s just as draining as it has ever been and I’m just monitoring more closely and expecting worse results than normal by being hyper-aware of this.

 

Exercise: None.

This has been sadly lacking. The small amounts that I had been doing previously, I haven’t even achieved to maintain. Some of this driven by scheduling conflict (or lack of prioritizing it), some just lack of effort in this area. I should prioritize it a bit higher. But, other than that, I’m not sure what to do and I don’t think that will be sufficient to get exercise to the point that I think it will be helpful.

 

Stress: Relatively low, some high spots.

Mostly the bits of higher stress have been covered previously: some stress from social interactions, but also a few other stressors from outside forces beyond my control. Two in particular come to mind that triggered a good deal of anxiety for me.


 

Anxiety, continued normal

The Progress is Slow & Thanks to Helpers

5:07am – again. So many days in a row too early.

A bit stuck and confused these days.

strong

I haven’t dipped back into being down, but I’ve been struggling more than I’d expect for being up. Some of the difficulty is anxiety that may be orthogonal to the up/down of the cyclothymia. But I had expected to struggle less while I was, overall, up.

So that’s not fun.

 


Check-in: (aka “reviewing my triggers and coping mechanisms”)

“Information Diet”?: New category, this title isn’t right. This also overlaps / is similar to “interaction”.

I’ve been far more liberal with information recently. Both in ingesting but also participating online. And, while I think that can be OK, I know it can be difficult for me. With some other increased anxiety this week, I decided that I had to reduce this drastically to mostly not ingesting/participating. I can’t control all the inputs of anxiety but this can be a source of trouble and I can control it. So, no more for now.

Ingesting: this is mostly about news. And this can be problematic in two ways.

  1. More outside news input takes effort to cope with.
    This isn’t my primary concern as, usually, I can handle this fairly well. However, when I’m low on overall energy or have acute stress, I’ll take all the energy & effort that I can muster and so if cutting this down helps me even a little, that’s worth it.
  2. Participating.
    The boon that is social media and online communities takes a bit toll on me. I know this clearly and, mostly, don’t participate very much. However, there are a few places where I do enjoy and get sucked in. And I’ve been doing more of that.
    I’ve had the energy and “mental overhead” to handle this, so that’s a valid decision. But, as I mentioned, recent shifts mean I need to conserve energy. So I’m reducing this for the next while.

 

Caffeine: Strict none/little continuing.

At this point, I feel like this is probably more or less the life-long choice. It’s still to early to know, but it feels like having extremely little is sustainable long-term. Also, that little bit allowed just “starts” my brain & mood in the morning. It’s probably worth trying a longer period of no caffeine again to see if I can normalize to that. But it is helpful to have it now, so that’s where I am at.

 

Diet: Eating well, long stretch of this.

I’ve got several weeks in a row (two brief pauses) of eating well. I haven’t seen much effect of this one way or the other, I don’t think. But increased anxiety, stress, or down = less likely to be eating well. I think that’s the correct causal direction, not diet –> mood.

 

Interaction: Limited amount over the last few weeks. I’ve handled it exceptionally well.

I’ve allowed several interactions that are normally stressful and I’ve managed them like¬† a champ. My ability to manage them is probably the mot positive indicator of all in my list.

Part of the coping is simply being more aware of the cost and then allowing myself time to recover from the items that I know are going to be stressful.

So, part realist expectation for myself: “The day after X, I’m going to feel very down but that’s just my reaction to expending that energy. So plan to chill out and have a lot of quiet time / rejuvenating activity”. I try to remind myself that there is a physical element to this and it’s similar to sleep: I can choose to stay up all night or run a marathon – but then I’m going to be tired and will need sleep and rest. Same applies to my mental “energy”: I can spend it where I want, but some things “tire” it out and I need rest.

And part of my success is… mindfulness? I’m not sure if that’s right. But the “being aware” of the reaction and not having it “own you” or “define you”. The expectations and coping stem from the awareness, but the awareness is itself beneficial. It provides a level of separation that is helpful on its own.

 

Exercise: Not so good. I hate having this item here, since I continually fail.

Over the last few weeks, it’s been a mixed bag: a bit of good effort and then less so. However, having this item on my list reminds me that there is another thing I can do to help my mental health. And, given that I need more help, I’m going to do it more starting today.

That said, I have invested some time to get myself ready to exercise more (reviewing current exercise tools and resources and testing/fixing them). So that is a small step in the right direction, and something that needs to be done before I will exercise more.

 

Stress: Mostly low. But this week has been rough.

The stress this week came from unexpected sources, making it harder to handle, and I didn’t even realize its effect at first. That lack of realization is such a source of frustration on its own. But that’s part of my journey: recognizing what this mental health looks like and learning to manage and identify inputs and efforts.

There was a particularly acute source of stress and it wasn’t until a few hours after that I caught myself behaving in a stress-induced anxious way. Seeing those symptoms of anxiety was what made me realize that I was having a problem. In this case, it was the OCD-like symptoms (wanting to be ultra-precise and repeating something as needed to get it “right”) that I caught myself doing automatically.

 


It’s not ideal that I have to deal with these things. But that’s part of who I am right now, so I do manage them. And I’m getting better at doing so.

I do have some control: I’ll continue with the low caffeine, I’ve cut down my “information diet” (still the wrong name), and I’ll do some exercise that helps my mood and overall evenness. I am not without agency. Feels good even to say that and to know it is true.

In a moment like this where I feel like I understand the long-term nature of my mental illness, feel some power and ability to grow and manage better as a human, I’d like to thank those who have helped me get to this point. So far, those people haven’t been people who I know in person, so I can’t yet – but may some day. Because I can’t thank them, I feel a burden – they have gifted me this hope, and I want to return the favor. That’s probably part of why I seek to help others around me with their mental health, where I can.

So I’m saying thanks for helping: R, W, M, & J. You have guided and inspired and I’m better for your effort.

 

… also, this blog was started on just a “do it” feeling. But I think it’s been very helpful for me. The thoughts are nascent in my head, but the thinking is refined when worked into full sentences for the blog. And I benefit from understanding myself better.


Hey look, a song in my head.


Photo Credit: eltpics


 

The Progress is Slow & Thanks to Helpers

Stuck in a loop

3:07 am

Well, so much for being past the hypo-mania-induced sleep issues. I really thought I was over this particular blip, but I’m clearly not – still stuck in this loop.


Check-in:

Caffeine: Not an issue today – continued with having very little / none.

Diet: Continued eating “less well” so I don’t know what impact this may be having – but no change recently.

Interaction: This past week has been far more taxing. And, while I’ve been trying to be judicious and careful, sometimes I end up doing a bit more than I’d choose based solely on what I think I can manage.

Exercise: Continued doing very little. I haven’t taken the time recently that I should. That isn’t helpful my overall mental state.

Stress: No particular stress, but my anxiety has been flaring up recently: the feeling of small things that suddenly feel huge, the inability to make decisions (without running through all possible scenarios in my brain for ten minutes to make a minute decision), and general anxiety around inter-personal interactions.


Not taking the needed time to do activities that help me be healthy can be a side-effect of the hypo-mania, particularly lack of sleep. If I am having trouble sleeping and it takes more of my day, then I feel like I have less time in a day. And inevitable make some decisions to skip those activities (like exercise) that I need to do to manage better.

I’m skeptical that these things would solve where I’m at currently. Maybe there is a limit to how well I can manage sometimes and just have to suffer through a bit. I don’t feel like I have many answers or good ideas right now.


Not related, but what was in my head upon waking today

Stuck in a loop

Riding the high

Sometimes, when I’m in a bit of a hypo-mania, I just lean into it for a few minutes or a few hours where I know that some stimulus (extra caffeine, or positive music cranked to a high volume) will push me into a particular state of near-bliss. It’s such an enjoyable feeling, sometimes it’s an indulgence.

I don’t do this often anymore with caffeine, I know the long-term ramifications. A particular high achieved through caffeine for a few hours I may end up paying for for several following days with broken up sleep and other problems. And the brief high may even trigger a low period lasting longer. It’s way too much risk. Music is a briefer and less potent high, but also dramatically less risky.

Riding the high

I’m going to miss coffee

3:52am

Here I go again.

coffee-drips-daniel-go

I had stayed off the mania portion of the cycle for a good long time[1]. I hadn’t been particular up, mostly even with brief dips lower[2]. And, Murphy’s law, today is particularly inconvenient day for this – time commitments in place for later this day that will be more difficult now that my sleep is interrupted.

Without any great solution visible, I’m going to try taking stock of the usual elements and see how they compare.


Caffeine: I was on caffeine for a longer period than I prefer to be as I was trying to get a work project down. As I my mood trended down, one of the changes I made was to take a really long break from caffeine. Initially this didn’t help my mood: I was in a longer down period recently. But my body adjusted to it. And it’s possible being off caffeine helped me level back out.

And then, I allowed myself a small amount of caffeine. Really tiny amounts, like a quarter of a cup of coffee before noon only. It had the obvious productivity boost, and may have boosted my mood. That has been more or less where I’ve been for the last ten days.

And then, I had more and a bit later the last two days.

Hmmm… this could easily be the cause. I’ll come back to this in a minute.

Diet: Again shifting my diet. I had spent a lot of the down time eating “less well” and as a positive outcome of being more up I got back into a better groove. The last few days have been different. Timewise, that correlates positively with this shift but I’m not sure that is the cause or part of it. Interesting data point for future reference: shifting to eating less well correlated with an up period.

Interaction: Unsurprisingly, I spent a lot of the down period without a lot of interaction. And, even while being more level and up over the last few weeks, I haven’t resumed a normal schedule of external interactions. Last week more interaction, this week (including today), far more interaction. Again, positive correlation with the hypo-mania. A data point worth noting for future reference.

Exercise: I’ve been less regular, but doing reasonably well at getting a bit more regular exercise. No particular changes over the last week or so.

Stress: For the first time in a long time, I noted a particular sense of stress a few days ago. I chalked it up to a combination of being tired (hadn’t slept well: possible initial mania coming on[3]), the most caffeine I’d had had in a while (and part of the anxiety was just caffeine-induced), and then a few more unclosed loops – particular around social items and also some lack of tracking things well[4].[5]

 


Aside on caffeine and sleep. The above caffeine log and my lack of sleep would, for most people seem ridiculous. But this is how I think about caffeine more now: a mood booster. So, it isn’t caffeine’s well known effects as a stimulant on sleep. Since obviously have a quarter of a cup of caffeinated coffee between noon and 2pm today isn’t what “woke me up” directly.

However, as an additional element of pushing my mood into the “up” areas, kicking a hypo-manic period, that is how I think caffeine may be part of the problem. And the hypo-mania has as a symptom, being awake in the middle of the night.

As has been increasingly often, I am thinking of caffeine as a double edged sword: I like it and it can be positive to boost my mood when used wisely. But it seems like it is particularly dangerous.

And it might be particularly difficult to modulate when used regularly. Other than as an occasional boost to mood, it may be best to leave it alone. Not just temporarily, forever. As medicine, it’s useful when used for a specific application, but not something I should ingest regularly.

I’ll probably keep experimenting, but the above paragraph seems like a rational approach.


Not sure why, but this is the music in my brain this morning.


[1] Checking this diary, looks like it’s been the better part of a month since I’ve struggled with a hypo-manic period that robbed me of sleep.

[2] The dips were often less than a day.

[3] A few nights of waking up too early, though not in the dead of night, and without the “instant on” feeling that, together, are symptomatic of the hypo-manic sleepless period. Like tonight. And so many other nights.

[4] leaving generalized anxiety around having to do some tasking but not doing a good job of tracking the state of thing. In GTD terms: unclosed loops where the task then repeats in your brain and you don’t have the “mind like water” state.

[5] Some low-level exercise completely resolved this stress and even bounced back to a great state of contentedness.


Photo Credit: Daniel Go

I’m going to miss coffee

Frustrated

4:10am

scream

I was naive enough to think I was doing better. I knew I wasn’t “cured” – I’m pretty certain there isn’t such a thing, this is a chronic, lifetime condition and I’ve accepted that. There is likely something I could learn from other chronic health conditions to apply to my perspective.

But I had begun to hope that I had it well under control.

I hadn’t experienced any low / down periods in some time.

I had managed to level out the up times to be far less intrusive to life. While I still had some symptoms that intruded on life (e.g. sleeplessness), I felt I had it managed and minimized the impact on life.

And then I had another bout of being down. For several weeks. Mostly I managed and it wasn’t too bad[1], though the final week or so was pretty rough and it was difficult to get anything done.

I had allowed myself to hope this was going to happen less often and so I’m still working through the frustration of again being there: down, unable to function well, unable to accomplish much.


In addition to this frustration from being not well again, I’m also realizing how powerless I am in solving this. Not just the various things I was doing to manage better, but more in the moment. I think understanding this, and handling it accordingly, is helpful.

When I’m up, I can just do things. Whether it is sit down and focus on work, or errands, or chores around the house. It’s simply a matter of deciding. And making a decision is relatively straight-forward: evaluate things I want to get done, prioritize, time & energy available, decide, do.

When I’m down, it’s completely different. I should work but I just can’t. I try various tricks I’ve learned to get started working and… still can’t. My brain just refuses to get moving.

When I’m down, even deciding can be crippling. I feel like I have to loop through all options and possibilities of a decision several times, even if that’s just a deciding between going for a walk or going to the store to get groceries. It can be completely incapacitating. Sometimes I just sit down in a quiet place and need ten minutes of quiet to make that decision. And sometimes I’ll make that decision, start moving and any extra difficulty[2] will completely derail my ability to perform the simple task.

When I’m up, there is no internal fight, I can do the things that I want to do and I do them.


I feel like someone who is further along in their journey (quite possibly my future self), will read this and be screaming at the me to go get help.

And I’ve decided that I need to do that. I knew before that I should do this, but I think the helpless feeling is what is really pushing me on this decision[3].

I barely know how to start this process. I feel like it will take months of trying to work with different therapists and that each time it will take a lot of effort to stop and try a new one. And there is a risk that I’ll be demotivated after quitting a few therapists, not having found one who I seem to work with very well[4].

Thankfully, I’m at least in a place where I have the energy to attack that problem. And if I don’t solve it entirely in this period, I can keep trying – there are a lot of years left and room to improve in the future.


Frustrated, just want to scream.


[1] Mainly, just cutting out any “extra” things beyond regular daily life and work was sufficient to manage. Trimming social engagements, reducing any extra promises or

[2] Minor things: I left my keys in the other room as I am about to walk out – and I feel like I should just give up on the whole endeavor. Or, I was maybe going to make dinner in two nights and hadn’t thought about what I’d make, so that feels like my whole shopping list is invalid – and I just want to give up. Sometimes this requires stopping, sitting down, and another five or ten minutes of silent thinking to get back on track.

[3] And oddly, it’s more the helplessness of being up. In that, I have some internal self-talk congratulating myself on getting various things done: “Good for me,” I thought. Then I realized how silly that sounded. It felt like congratulating someone on their height or their hair color. Congratulations may be valid, but there is nothing someone did to be over six feet tall or to have blond hair; that’s just how they are.

And when I get things done while being up, I feel like it’s just nature not something I deserve any credit for: it wasn’t extra willpower, effort, or “pushing through” that got me to do that, I just felt like I could.

[4] Excuse the terrible grammar and odd sentence construction: I wanted to be sure that I phrased it not as the therapist failing me, but that I will be the one doing the work and that the therapist doesn’t jive with me. It’s all on me, no therapist will magically fix something for me.


Photo Credit: Maks Karochkin

Frustrated