Backpacking and Bipolar II. Taking Manic Depression on tour.
#Bipolar #Manicdepression #Seroquel #Quetiapine #MentalIllness
The last few days, as you may have read, have been varied. It has been tempting to not write anything at times for fear of the embarassment of seeming to be scattergun, or wildly inconsistent. I feel that I would be doing a disservice to myself and to anyone who enjoys reading this if I didn’t communicate candidly and for that reason I am willing to write things that may not be applicable twenty four hours later.
At one point I was concerned that I would never again feel the euphoria and certainty of mania. Not long after I felt myself riding an emotional thermal and I was convinced that I would wake up the morning after having plunged willfully and excitedly headfirst into a hypomanic episode. The beginnings of that light, adrenaline buzzed, hyperactive happiness had run down my spine. When I finally did get to sleep that night (sorry – Morning) – I drifted off supremely relieved.
Then the morning came and I woke up feeling…
…tired because I’d gone to bed much later than I wanted to. And that was it.
Retrospectively I feel quite confident to say that what I have been experiencing is the closest ever to what I have heard ‘normality’ described as. My mood is influenced more by the real world than I’ve ever known it and when depression comes, it comes less suddenly, and more obviously. I suspect that my medication has just taken full effect and that I’m on my own from here unless I add to it (which I’ve said I won’t do for six months unless there is a dire need). It feels as though it is time to learn how to manage my temperament and emotions from a more stable platform. It may be quiet enough that I can clearly assess and recognise my triggers and learn to pull myself back from the brink. The mood that I have been unable to really understand thus far has turned out to be – calm, tedious and safe normality, or as close to it as I think I’ll get from medication alone. So I will implement safeguards and routines that are conducive to a lasting peace of mind, including (though it may be amusing to read it in the context of this post) learning to not over-think and over optimise.
My reality changes with my moods so much. One day I can tell you how terrible my depression is and how I’ve been racked with it all my life; and then if it seems to be more under control the next day, I can say that everything’s just fine. I try to think of happy times. I try to do things to prevent me from introspection, which leads to depression fast. I feel ashamed of everything about myself when I am depressed. I can’t take on board the idea that probably everyone else is also a human being and also going through various emotional states. I have humiliating dreams even in my sleep I can’t get away from this horrendous, weighty feeling of being oppressed, and life being hopeless. Hope is the first thing that goes.
–Andrew Solomon quoting Claudia Weaver in The Noonday Demon
Remission from mental illness requires maintenance: all of us periodically encounter physical and psychological trauma, and chances are pretty good that those of us with a significant vulnerability will all have moments of relapse in the face of problems. A lifetime of relative freedom can unfold best with careful and responsible attention to medication, balanced with steadying, insight-producing talk.
-Andrew Solomon in The Noonday Demon
I’m entering a new phase of my treatment, where I can hold myself to a higher standard and where I REALLY have a chance to avoid a crushing relapse any time soon. Things FEEL different to how they felt before my diagnosis and early treatment, in ways that I can’t fully describe. I read earlier that the best defense against depression was to not make a friend of it. To challenge it as it happens. I aim to learn what best distracts me and what I can focus on to beat back the rising tide of self-criticism. I have a list that I have started carrying with me. On it I have written:
The names of people I am glad to love and be loved by.
Events in the future that I have to look forward to.
A note to myself from myself when not badly ill.
This may seem a rather trite and pathetic attempt at armor but I believe it will work. I intend to walk every day before the sun goes down for an hour. I will be mindful of exactly what is happening if I feel my mood become jeopardised and the final commitment I make to myself is that, unless things begin to go downhill, these are all the ‘optimisations’ I will permit myself for a month or so until I go and see my doctor. I’ve decided tonight that in a month’s time I will book to see him so that I can ask his opinion on whether I am taking too high a dose of Seroquel. I’ve had to add a new Category to the blog: stable.
When it came to maintenance after you had gotten a reasonably balanced medication regime – What did you do to combat depression as it came? What worked? What didn’t? Have any of you felt like I describe on 600mg of Seroquel and then changed your dose? I’d love to hear from you.
All the best,