Living Well with Bipolar Disorder Part Three

I had decided early on that I wanted medication for a short while. I felt that I needed that kick-start – that clarity of mind and emotion that the medication brought – to be able to effectively step back and decide what is best for me. It would be like asking a schizophrenic if he is sick, when he thinks he is the other person. I felt this was the smartest decision for me. It worked well. Six months later, I was off medication and doing well on my own. For the first time, I could be hit with blows and they would sting, but I could bounce back with a smile. Life felt great.

This is not always an option for people with bipolar disorder. For those with Bipolar One whose mood swings are so frequent and so severe, becoming non-medicated is not plausible. I did meet one person who was a Bipolar One who used the same method I did to be able to reduce her medication. Her doses were not so high and as a result they did not make her feel so bad. In talking to many people who have studied bipolar disorder and who suffer from it, my situation is rather unusual. Very few of us can successfully be off medication permanently. And even I understand that permanent is not always so. I have medication in my cupboard just in case. I know how to start myself and then get to a doctor for blood checks. This is just as important as knowing how to control myself, knowing when I no longer can. I am not the only one who knows this either, that would be dangerous. My husband knows what warning signs to look for, as do several friends.

I have not had a serious manic phase in a few years. I have learned to feel them coming on, and have discovered effective ways to stop them, or at least ride them out in a non-extreme way. The first thing I notice is the lack of sleep. If I don't get eight hours, I feel bad all day. When I get less than eight hours and still feel great, that's a warning sign. A few more days of this and I know I need to take sleeping pills to break this habit. Many people say that using sleeping pills are bad for you. Lithium, Depakote and other "downers" we were worse for me. Usually at least once a week I think back on my week and analyze how it went. If I start seeing a trend of over scheduling paired with a lack of exhaustion, I know to take action. Forcing myself to slow down is important for me. Since I started taking my disease into my own hands, I have yet to have a manic phase I could not stop in it's tracks, before it ever takes hold. To me, that is a huge accomplishment.

Depression is much harder to combat than a manic episode, but is easier to spot coming. Sleeping too much, feeling overwhelmed, worrying about unimportant things, all are signs that I need to pay attention to. I am a worrier by nature. I worry about my family, my friends, and the future. But there is a limit where it becomes unhealthy and I have had to work hard to define when I cross that line. For me, when I am driving is a good time to assess whether or not I am heading toward a depression.

When I drive, I am left alone with my own thoughts. I do not like talk radio, so it’s just my own head for conversation. It’s hard to ignore negative thoughts when left with only yourself for periods of time. If too many worries come up without me working toward a solution for them, it’s a warning. If all I want to do is cry, it’s a warning. The days I cannot distract my unhappy thoughts are the hardest. I have become skilled at distraction, at leading my mind away from the destructive path. I am a dreamer, a storyteller at heart. I’ve written books and short stories from the time I was very young. Often when I am driving I write stories in my head, some make it to paper and others don’t. It’s the perfect time for the creative process to flow, because there are few interruptions. Turn on the right background music and off my brain goes into the land of a fictional character. Those days, I know I am in a good place. The days when all I can focus on is the negative, then I need to take action.

The hard part comes when I know I am heading toward a depression. It truly is a fight to stay well. I have to be very strict with my sleep schedule. Allow enough time to sleep, but don’t allow myself to sleep too much. Naps are important, but in moderation. A conscious effort is involved. Negative thoughts have to be taken care of immediately, by forcing a solution, or coming to terms with the fact that no solution is available. In early stages, if the episode is caught early enough - and it almost always is now, I am capable of turning around my thoughts and actions. I have not been in a serious depression in years, save for my divorce. I do not consider what I went through during the divorce comparable, because the circumstances were so unusual that they do not rank with ordinary life.

I am now affected so very little by my bipolar that most people don’t even know I am, don’t notice the changes in me when I am fighting off an episode. It’s not because I am a good actor, it’s because I am healthy, dedicated and rational. I have now been free from medication for six years. It has not been easy – in fact it has been very, very difficult. But I feel like I have had a higher quality of life because of it, that makes everything worth it.