Manic Episode

I hadn't been writing much on the blog.  After all, there hadn't been much to write about.  I'd been going along doing quite well.  Sleeping right.  Eating right.  My mood had been stable.  More stable than it had been in a long time in fact.  Then Bam!

I don't know what all of the "triggers" for the episode were, but letting my program of self-care go a little bit was one of the triggers for sure.

My wife left town for a couple of days.  Friday night I fell asleep on the couch and forgot to take my evening meds.  In the morning, I somehow rationalized that this would be a good opportunity to drink a whole bunch of caffeine.  So I started hitting the iced tea and triple iced espressos.  By the time evening rolled around I was feeling so good, so hypomanic, that I didn't want to take my evening meds again.  I guess I was figuring they would bring down the ecstatic mood I was in.  Then it turned on a dime and morphed into a full blown mania.  Complete with agitation, feelings of impending doom, panic, paranoia, and yes even mild delusions.  I was watching the two older boys, but by this time they were asleep.  I was feeling like I was incapable of being a responisible parent should there be some emergency although was probably not the case in reality.  I was wondering if I should call a friend to come over to be with me.  I was feeling like perhaps I should take a ride in to the hospital to come down.  I was feeling as if the episode would never end although I know that they always end.  Knowing that I was out of control I began reaching out and connect with anyone who would listen on Facebook chat.  Why I didn't call someone on the phone I don't know.  By this time I was jumping at every little noise in the night.  Finally a friend of mine convinced me to take my meds.  He suggested drinking a bunch of water and lying down.  I finally slept for a little bit and the meds knocked the whole episode down a notch.  Sunday came and I was still pretty wrecked.  I managed to go to an NA meeting which helped.  All though Sunday I continued with a moderate mixed state mania.  Another night of two hours of sleep.  By this time I had only slept 4 hours in the last 48.  Finally on Monday morning I got a hold of my psychiatrist.  She suggested that I immediately stop drinking caffeine and dramatically increase my lithium dose.  This I did and within a couple of hours the episode was over.

This was the worst manic episode I had had in years.  I was shocked.  Only a couple of days of shoddy self-care and I was out of control.  What a wake up call.

In the aftermath the increased lithium was making me feel like a zombie, but anything was better than the mania.  Later in the week, working with my doctor, we managed to lower the dosage to where I was neither manic or a zombie.  I'm feeling pretty good, although sleeping was a little harder.

On the bright side the episode helped me recognize and reaffirm how important self care is.  I need to take care of myself especially when my wife is out of town.  I realize now how "addictive" my behavior was.  What I fine line I was walking.  In a scary way it could have easily been alcohol I was drinking instead of caffeine.

I made a nice little checklist of the 10 or so things I need to do for my bipolar and recovery self-care.

No Booze

No Drugs

No Caffeine

Moderate Nicotine

Daily exercise

Sleep hygiene

Prayer

Meditation

Meetings

Eat Right

I have another chance to cope better this weekend.  My wife is going out of town again.  I'm going to try to stick to my regimen as closely as possible.

Wish me luck!

Caffeine addiction

I quite drinking caffeine five days ago.  It was contributing to my insomnia and fueling my mania.  I have no moral problem with caffeine just as I have no moral problem with alcohol or other drugs.  I just know that I can't have a safe relationship with any of them.  Including caffeine, apparently.  A cup of coffee a day might not have been much of a problem, but staying up all night drinking quarts of iced tea was just like banging myself in the head with a frying pan.

So, in any event, I quit drinking the stuff.  I felt miserable for several long, long days.  I did start sleeping though.  I had headaches, stomach aches, a small fever, and was extremely irritable.  Another difficulty I had with the caffeine withdrawals was that they felt reminiscent to alcohol and drug withdrawals.  This is always a tricky spot for me as my mind likes to play tricks.  I might think, for example, "gee, these are withdrawals.  What is the appropriate response to withdrawal symptoms?  More drugs, of course.  Coffee, alcohol, pills...anything would work just as long as the withdrawal symptoms stop."  What could be more logical, right?  Except that for me it is pretzel logic.  The appropriate answer to withdrawal symptoms is total abstinence from the drug (s) you are addicted to.  And as for me, I happen to be addicted to just about every form of mind or mood altering substance. 

As you might expect, the caffeine withdrawals stopped eventually and I feel quite well.  In fact, I feel better than I did before because I am not staying awake all night feeding the mania machine.  In fact, after a pleasant 8+ hours of sleep last night I feel downright balanced.  Balance is something unusual in my life.  Normal just doesn't quite feel normal. 

Today I am trying to make a new cheese.  Havarti.  It doesn't look imposable but there are certainly a lot of different steps.  I'm making a goat's milk Feta at the same time, but that is pretty routine.  Making cheese seems to be a part of my daily and weekly routine.  And now that that routine doesn't involve quarts of iced tea every day, I feel much more balanced and at peace.  For today, at least, I am neither manic nor depressed, and I am clean and sober off of both caffeine and other even more dangerous substances.  And that makes it a very good day indeed.

Hypocritical?

It’s kind of funny, or at least it would be if I weren’t  so tired and frustrated.  It is easy for me to write about techniques for staying healthy.  It’s easy to write about how great everything is.  But  fact is, I’m having some fairly significant symptoms concerning my bipolar disorder.  Or maybe it would be more accurate to say that some of my behaviors are off the mark. 

I haven’t been sleeping, and I have been using caffeine.  It’s been like this  all week. I’ve been averaging about three to four hours of sleep a night. Today I had to make a two hundred mile drive and I got sleepy behind the wheel.  So, of course, I drank a 20 ounce truck stop  coffee.  It didn’t keep me awake behind the wheel.  I still ended up pulling off the road and taking a nap.  But boy is it keeping me awake now.  It’s now 2:30 am and I’m wide awake. 

I know what to do to address the situation.  I just don’t seem to be able to do it.  As tough as insomnia can be, the treatment is, at least, fairly straightforward.  Establishing good sleep hygiene can be incredibly hard to do.  My day has almost been the opposite of the list provided in the “sleep hygiene” link. 

Caffeine and nicotine-yup.

Naps-yup

Spicy food-oops guess I shouldn’t have just eaten that jalepeno omelet.

Exercise-nope, not today.  Spent  all day in the car.

Regular, relaxing bedtime routine-actually my routine has been to crank up the rock-and-roll and dance around the kitchen doing dishes.  Not exactly a relaxing bedtime routine, but at least the dishes are getting done.

Tough part about addressing my sleep hygiene and getting to bed is that I enjoy staying up.  Some nights I enjoy staying up clear through. The problem lies in the consequences of not sleeping.  There is always a reckoning.  When the reckoning comes it is not just me who pays the price but my family as well.  When I finally do crash, I am not able to participate in family life.  Not able to be a good parent or partner.  Ultimately poor decision making in the sleep department can lead to significantly for serious bipolar symptoms later.

All this said, it is important to remember one of the most important positive behaviors for treating the bipolar is not to beat myself up. I need to remember that bipolar is an illness and that my symptoms are just that.  Symptoms.  Getting angry at myself doesn’t help anything.  I am responsible for my choices and behavior, but it is important to remember that poor decision making is part of the disorder.

Well, blessings and good night. 

Lack of structure and routine...

Had a rather hectic day yesterday.  I forgot to take any of my medications until about 8:00 pm.  Not only that, I drank two cups coffee at a 7:00 pm Narcotics Anonymous meeting.

I had a pretty good day despite the forgotten medication.  Kind of pumped up and jazzy (hypomania?), but I  didn't think anything of it. As is always the case with hypomania, it always ends badly.  I did end up taking my medication after the meeting, but by that time it was too late to have a peaceful, relaxing evening and a good night's sleep.

:Instead I feel agitated, sick to my stomach, and wide awake.  Agitation and irritability can all be symptoms of the downside of hypomania.  Trouble with insomnia is a chronic problem for me.  It is made even more problematic because insomnia is both a cause and effect of further bipolar symptoms.

Caffeine is another problem for me.  I had been abstinent from caffeine for 3-4 months and found that living caffeine free resulted in an improvement in some of my bipolar symptoms.  About a week ago, I started drinking a little coffee and tea.  Now, in the grand scheme of things, a few cups of coffee is not the end of the world, but I do notice a difference.

So, as much as I would like to spend my time writing about my successes, there are always setbacks as well.  Tomorrow is a new day.  Hopefully one which involves a more stable routine, attention to detail, and less caffeine.