Some thoughts from the silence

5:08am

The interleaving months have been filled with various struggles, though none new.

Recent stress has brought a level of anxiety that I haven’t had to deal with in quite some time. Physical tics, itches, and muscle adjustments; stress from travel, extroversion, difficult memories, and reduced time to restore myself. These stresses exacerbated the anxiety but I don’t think they were the cause – the anxiety started before the stresses.


Coming out of the anxiety somewhat was unusual. The anxiety got dramatically better in the span of a day. I had spent time trying to relax and restore. This time I had scheduled, knowing I’d need the time and space following other stressful events.

However, it didn’t seem to help. And, after a weekend, I was at my worst – far and away. I continued with some activities intended to help, but wasn’t optimistic.

But, in that day, things shifted. As usual, it’s more of a realization noted while looking in the rearview mirror not in the moment. But I did realize that evening that I was better.

Despite thinking back on my activities, I couldn’t pinpoint a likely cause for the improvement. Not that I really think it works in an obvious deterministic fashion, but still worth the question for potential learning of how to care for myself.


On the whole time more broadly, being more conscious of my anxiety greatly improves my ability to handle it. Likely via a mechanism of distance and perspective. Simply being aware of mental health issues and thinking of them as such is the single more useful thing I’ve learned in the previous year.


As usual, entries here slant towards times of being up. Time of being down fill the silence. By definition, less energy to accomplish things translates into fewer entries. More nights of disturbed sleep, more entries.

Even keeled time also tend to reflect as quiet periods with fewer entries here.


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Some thoughts from the silence

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.

Silly

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

Steady River

basecamp-coming-down

If the usual sub mania is the rush of white water rapids, then the last couple of weeks have been a steady river.

From manic periods, I usually come down into a level plateau and then eventually am down, mildly depressed, can’t work. But this time has been so different from any experience that I recall.


 

So far, there is always a big disclaimer on what I remember of previous manic/depressive experiences, since I’ve only started to view my experiences through the lens of cyclothymia for the last 18 months. Before that time, at best, I would think of long periods of “crazy productivity” and times of being “somewhat down or depressed.” So any recall of up/down and the changes is limited since I wasn’t actively remembering experience in the those terms.[1]


 

This time, I haven’t quite plateau as normal – more like descended from the summit of my hypo-mania into one of the basecamp: the flat ground is still thousands of feet lower.

Which feels nice, if I take the feeling at face value. I’m productive, without having overly-rushed brain[2] and without having it impact my life in a negative way.

But as I expressed elsewhere, any change is scary. Will it get worse? Will my symptoms become unmanageable? Some percentage of cyclothymia goes on to become bipolar. That is a scary thought.

 


 

[1] That being said, once I starting thinking of myself as cyclothymic I had the common experience of re-casting previous memories in this list and seeing how well it explains a lot of my experiences. Whether it is remembering periods of being super-productive and having rushed-speech (now I know that’s a hypo-manic period). Or periods where I would just go-go and do so much only to crash for multiple naps a day in between the insane activity. In particular, these are activities that I now know “drain” me quite a bit so I see why I would just go at 1,000 miles-an-hour at these activities only to then find the nearest couch or bed and sleep for an hour or two before going right back at it: a bit like race cars and pit-stops: either full speed or stopped and refueling: no middle ground.

[2] I’m pretty sure that my natural state is “slightly rushed thoughts” – that has always felt normal for me.


Photo Credit: Andrew E. Larsen

Steady River

Sleeping Again: That Guy with the Energy

zebra-at-work-coffeeshop-flickr-3231240180_560762c9c1_o

Ah, the joy of sleep. After nights of waking at two, three, or four am – sleeping through until six feels more normal. Waking up at two, I can’t make it through a whole day, I’m going to have to get back to bed at some point or take a nap later. But five am is “an early start” and I can make it through a day.

Coming down this time feels different. There is still a lot of that “overwhelming optimism” symptom and my thoughts are definitely at an accelerated pace – but not the full “facing thoughts”. So this is a “very subdued mania”. If I wasn’t watching myself for symptoms of mania I would think of these days in that way.

It is subtle enough that I might not have noticed it. If I hadn’t just come off an obvious – and, for me, more pronounced than is common recently – manic period, then I might have read the symptoms as “productivity” and just some particular mix of increased energy. But I did just come off a really strong sub-manic period[1], so I know this isn’t just a boost of energy translating into productivity that came.

This is the level of hypo-mania that is almost nice. Because I know the double-edged sword of it[2], I can’t just being blissfully ignorant of the downsides of this.

Let me describe it as: someone who seemed to need about six hours or fewer of sleep, felt energetic upon waking up and through the whole day[3], felt exceptionally clear-headed and whose boundless optimism seemed to attract luck and reciprocal good feelings from others.

Someone who goes out for drinks with you, comes home and works while you can’t even, catches that last work email from the boss and then goes to bed later than you only to bounce out of bed several hours before you and has read and responded with alacrity and insight to the client document before you’ve found the coffee as you stagger around grumbling.

Isn’t that someone who you’d envy a bit?[4] And I’ve certainly had my time as the grumbler staggering around seeking more coffee.

As usual, this post brought to you by our sponsor: coffee. Now let me go find some.

 


 

 

[1] Even in this stronger/more pronounced manic period, I’m still confident it’s “sub mania” or “hypomanic” and not full on mania as clinically described. My symptoms just aren’t the same as described for full mania. I am so thankful that I only have the level of symptoms that I do and I can watch and handle them – along with help from friends and family who know what to look for and help tip me off sometimes.

[2] The cycling and also, because even in my current optimism, I know that there is a “down” coming from this “up” – I can start to feel it lurking and am a bit scared of it and what it will entail.

[3] I like to think the even energy all-day is also partly nutrition that I take care of. But certainly having a (temporarily) limitless of energy supply helps.

[4] I know I envy that person when I’m not that person. When I’m down, obviously anything that is more positive would be nice. And when I flatten out for long-periods then I wish for the productive, energetic days. This was especially true when I didn’t recognize that as part of the broader cyclothymia.


I just realized that I didn’t wake up with music in my head. Makes me wonder if music in my head is a symptom of my manic periods as well.
(Not that I can’t have music in my head at other times, but maybe the racing thoughts often spawn music.)


 

Photo Credit: Marco Raaphorst

Sleeping Again: That Guy with the Energy

Coming Down (again)

It is a cyclical thing, this experience. And coming down is such a relief this time. Three nights running of way too little sleep – but yet being unable to sleep – was taking its toll.

I feel like I learned two new, subtle, signals of a coming f”up” / manic period:

  1. Not being tired. This one may seem obvious, but it manifests in some ways I hadn’t noticed previously.
  2. Flurry of thoughts but not “pressured speech” or “rushed brain”. Again, the concept seems obvious, but the subtleties are new to me.

 


1.

Waking up in the middle of the night is a non-subtle symptom. But “being less tired than I’d expect” is more subtle. It’s easy to miss: you just move along through your day just without being really tired.

But if you stop. And add up the hours of sleep you actually got. And think about how little caffeine you actually ingested. You realize, “I should be tired”.

Sometimes it’s just “I should be tired”. But sometimes, like yesterday, it’s “I shouldn’t be able to stand up – I haven’t had the caffeine or the sleep or even the food to sustain this level of activity and alertness”.

Which is why I think realize this might be helpful to me in the future. If it’s not sleep or caffeine or food driving my energy, it must be something else. So what is that? Well, it’s whatever chemical process drives the mania. And so if that “energy that shouldn’t exist” is present then it may be an early warning of coming mania.

I’ll watch for this in the future and maybe it helps me expect the coming flurry of energy, activity, and disrupted sleep.


 

2.

I realized that I spent some time before my manic period* where, in retrospect, my thoughts were already moving abnormally quickly.

Again, this is subtle. It isn’t the non-subtle feeling of “I can’t talk or type fast enough to keep up with all these genius ideas that are sparking in my brain”.

If I had sat down at the end of a day and tried to recollect how many “great ideas” or “possibilities” or “interesting connecting ideas” I had thought of that day, it would have been maybe several multiples more than usual.

I don’t know a good number. But let’s say that, depending on the day’s activities and who I interact with maybe 5-15 is the normal range. Probably around 5-10 all day. Whereas the days leading up to the mania, each day there were several hours where it was 5-10 in that hour – so easily 25-40 for a day and the range is probably 25-75. I’ve compared it to a feeling of “Jason Bourne blue pills” (from the movie: The Bourne Legacy).

For comparison, a day of mania is probably a similar feeling just accelerated further: the active hours are 20+ / hour and the biggest difference is that instead of an hour here and there in a day, it’s 4-10 hours mostly sustained with few breaks of slowing down**.

At this point, those numbers are guesses, but they feel approximately right. I’ll definitely watch for them going forward to have a better sense of what the numbers actually are so I can better identify what is happening as it happens.

 


 

I’m counting the number of “ideas” because that is a large part of how this manifests for me. (And probably why one of my possible “triggers” is new ideas and the situations and conversations that spark them.)

I wonder if for others it isn’t ideas, but other things.


 

 

* I’m counting the first day of awakening in the middle of the night as the start of the manic period. I don’t know how else to signal it, count it, or measure it. That is a clear moment that I can use as the signpost for “started”.

** The feeling that you have 200 “great ideas” in a day I’ve learned can make the coming down periods worse: if you remember even a portion of those, you feel like a failure for doing so little about all the possibility you once saw. This reinforcing cycle feels like a very common part of cyclothymia for me.

 

Coming Down (again)

Slump

I expected more of a slump – it never came. I don’t know whether to be happy that I didn’t have a valley of despair that I needed traverse and come up out of. Obviously, I’m happy about avoiding the down/depression symptoms directly.

I’m also worried that it means my disease is changing.

It could get worse.

It could just be different: which is, by definition, somewhat worse as understanding it I can manage it better. If my symptoms keeps changing, they might become different enough that I can’t manage them. So change in symptoms is scary, even if the symptoms are less bad.

 

So, cheers that I didn’t get depressed. But fear of what that means. One cycle does not a pattern make. I just need to stay on my toes.

Slump