Coping with Bipolar

If there is one thing that a bipolar person struggles with on a daily basis, it is how to cope with the inevitable ups and downs.  For many years, I fought the roller coaster tooth and nail.  I would refuse to admit I was going into a depression or a hypomanic episode.  I would continue with the things I had to do no matter what, until eventually I completely crashed.  Finally one of these crashes landed me in partial inpatient program.

I was forced to use FMLA time at work to cut my hours in half while I recovered.  Three days a week, I spent half my day at the program (IOP) and the other half the day at work.  The other two days, I took the morning for myself and spent the afternoon at work.  This lasted for nearly two months.

At first, I hated going to IOP.  I felt like a failure.  I was failing my job, my boss, my family, my friends, my psychiatrist, and anyone else who ever tried to help me manage my bipolar.  How could I possibly have let myself get so bad?  But that is just the thing.  I didn't let myself get that depressed.  It is a chemical reaction in my brain that I can't completely control.  I can mess with it a little through medication and lifestyle choices (a regular schedule, plenty of sleep, exercise, etc.), but even when I do everything exactly right, I will still have episodes.  It is hard to see that when you are in the midst of a deep depression though.  At that moment in time, I was convinced I could have controlled it and I failed.  I was worthless because I couldn't control my own emotions.

As I continued this program, which is really like an intense therapy program, I grew to appreciate it.  I had weekly contact with my psychiatrist for quick med adjustments, I had daily contact with multiple therapists, but most importantly, I learned a huge number of new coping skills to replace the unhealthy ones and the ones that stopped working all together.  These coping skills help me prevent a return to IOP.  And now I want to share some of these tips and tricks with you.  For the next couple days or weeks (depending on how often I post), I will pull out a coping skill from my stash to highlight.  Learn it.  Practice it.  Love it.  Add them to your arsenal.  Then come back here and let me know how it worked for you. *

Focused Breathing*

For today, we will start simple with focused breathing.  This is a very simple coping tool, but it is very effective for some people.  This technique works best with your eyes closed.

Try your best to block out the sounds and noises around you and focus only on the sound of your breath.  Listen closely as you inhale deeply, hold your breath for a few seconds, and then exhale slowly.

Now inhale again while counting to 5, focusing on the sound and feel of your breath.  Hold your breath for a count of 5.  Now exhale while counting to 10, focusing on the feel as you release the air from your lungs.

Again, inhale, really filling those lungs, feeling your chest expand in all directions, for 1-2-3-4-5.  Hold for 1-2-3-4-5.  Now exhale slowly and revel in the release for 1-2-3-4-5-6-7-8-9-10.

Repeat this process, focusing more and more on your breath until you feel relaxed.  Always remember to take longer to exhale than inhale.  This will prevent hyperventilation.

Once you are relaxed, you have two choices according to how you feel.  You can continue what you were doing before you became overwhelmed, or you can take a break completely and do something else that makes you happy.  If you simply cannot complete the task, it is ok!  Hand it off to someone else or put it off til tomorrow (or another time you are feeling more stable).  There is absolutely nothing wrong with this.  You don't have to be Superman/Superwoman.  Chances are whatever it is will not be the cause life or death (unless you are a surgeon or something, then finish the surgery.  hehe.).

*Note:  I feel like I need to put a disclaimer of some sort.  I am NOT a doctor of any sort.  I am a bipolar patient merely sharing tools that help me cope.  If you have concerns about anything I post, please consult with your psychiatrist or primary care doctor first!

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Case of the Blahs

For the last 6 weeks, I have lived in San Francisco with my husband.  In two weeks I return to Tucson for school.  If you are confused about this, read about me Living in Two States.  Got it?  Good.

During these 6 weeks in San Francisco, I have learned several things.

1) I am totally into living where I don't have to have a car.
2) I am totally digging this cute little town we settled in.
3) My body totally does not dig the cold weather (high of 65 in August? really?).
4) My mind totally does not dig the frequently overcast skies.
5) Meter maids are ridiculously on time.
6) I love my living room!  Seriously, it is adorably awesome.
7) There is so much to do when you don't have a television.
8) There is so little to do when you hurt too much (mentally or physically) to go anywhere or do anything.

And now that I only have 2 weeks left before I leave again, I am increasingly frustrated with my mind and body.  I wanted these last two weeks with my husband to be amazing where I am the fun and energetic woman he met 4 1/2 years ago.  But that is proving to be a challenge.  2 of the last 3 days, I have been totally blah.  I've had a headache  that won't go away and next to no appetite.  Whether it is the symptoms bringing me down emotionally or the blah-ness (yes, that is a word in my dictionary) causing the symptoms doesn't matter.  All that matters is that it is screwing up my plans!

Now I know some of you may be thinking that it is only 2 days, but when you only have 14 left, that 2 can grow into 10 quickly and easily.  And rarely do I pull out of a blah episode in a mere 2 days.  Add onto this situation by throwing in some joint pain after 2 weeks nearly pain free and I am utterly blah-ed out.  Is it too much to ask for my body and mind to work with me for a change?  All I am asking is for 12 freakin days!  At least I feel like I have made the most of the time that has already passed.  I may not be able to play the role of the perfect, fun, energetic wife right now, but its the thought that counts...right?

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How Many Spoons Do YOU Have Today?

It's that time of year again where someone says something or a I read an article that reminds me of The Spoon Theory.  If you, or anyone you know has what many like to call "an invisible illness," you can understand the frustration when someone doesn't look sick even though they are.  The Spoon Theory is an excellent analogy to describe what it is like to live with "an invisible illness" every second of every day.  I know it looks long, but trust me, it is worth the read.  And now I share it with you, courtesy of ButYouDontLookSick.com.

The Spoon Theory, by Christine Miserandino

My best friend and I were in the diner, talking. As usual, it was very late and we were eating French fries with gravy. Like normal girls our age, we spent a lot of time in the diner while in college, and most of the time we spent talking about boys, music or trivial things, that seemed very important at the time. We never got serious about anything in particular and spent most of our time laughing.

As I went to take some of my medicine with a snack as I usually did, she watched me with an awkward kind of stare, instead of continuing the conversation. She then asked me out of the blue what it felt like to have Lupus and be sick. I was shocked not only because she asked the random question, but also because I assumed she knew all there was to know about Lupus. She came to doctors with me, she saw me walk with a cane, and throw up in the bathroom. She had seen me cry in pain, what else was there to know?

I started to ramble on about pills, and aches and pains, but she kept pursuing, and didn’t seem satisfied with my answers. I was a little surprised as being my roommate in college and friend for years; I thought she already knew the medical definition of Lupus. Then she looked at me with a face every sick person knows well, the face of pure curiosity about something no one healthy can truly understand. She asked what it felt like, not physically, but what it felt like to be me, to be sick.

As I tried to gain my composure, I glanced around the table for help or guidance, or at least stall for time to think. I was trying to find the right words. How do I answer a question I never was able to answer for myself? How do I explain every detail of every day being effected, and give the emotions a sick person goes through with clarity. I could have given up, cracked a joke like I usually do, and changed the subject, but I remember thinking if I don’t try to explain this, how could I ever expect her to understand. If I can’t explain this to my best friend, how could I explain my world to anyone else? I had to at least try.

At that moment, the spoon theory was born. I quickly grabbed every spoon on the table; hell I grabbed spoons off of the other tables. I looked at her in the eyes and said “Here you go, you have Lupus”. She looked at me slightly confused, as anyone would when they are being handed a bouquet of spoons. The cold metal spoons clanked in my hands, as I grouped them together and shoved them into her hands.

I explained that the difference in being sick and being healthy is having to make choices or to consciously think about things when the rest of the world doesn’t have to. The healthy have the luxury of a life without choices, a gift most people take for granted.

Most people start the day with unlimited amount of possibilities, and energy to do whatever they desire, especially young people. For the most part, they do not need to worry about the effects of their actions. So for my explanation, I used spoons to convey this point. I wanted something for her to actually hold, for me to then take away, since most people who get sick feel a “loss” of a life they once knew. If I was in control of taking away the spoons, then she would know what it feels like to have someone or something else, in this case Lupus, being in control.

She grabbed the spoons with excitement. She didn’t understand what I was doing, but she is always up for a good time, so I guess she thought I was cracking a joke of some kind like I usually do when talking about touchy topics. Little did she know how serious I would become?

I asked her to count her spoons. She asked why, and I explained that when you are healthy you expect to have a never-ending supply of “spoons”. But when you have to now plan your day, you need to know exactly how many “spoons” you are starting with. It doesn’t guarantee that you might not lose some along the way, but at least it helps to know where you are starting. She counted out 12 spoons. She laughed and said she wanted more. I said no, and I knew right away that this little game would work, when she looked disappointed, and we hadn’t even started yet. I’ve wanted more “spoons” for years and haven’t found a way yet to get more, why should she? I also told her to always be conscious of how many she had, and not to drop them because she can never forget she has Lupus.

I asked her to list off the tasks of her day, including the most simple. As, she rattled off daily chores, or just fun things to do; I explained how each one would cost her a spoon. When she jumped right into getting ready for work as her first task of the morning, I cut her off and took away a spoon. I practically jumped down her throat. I said ” No! You don’t just get up. You have to crack open your eyes, and then realize you are late. You didn’t sleep well the night before. You have to crawl out of bed, and then you have to make your self something to eat before you can do anything else, because if you don’t, you can’t take your medicine, and if you don’t take your medicine you might as well give up all your spoons for today and tomorrow too.” I quickly took away a spoon and she realized she hasn’t even gotten dressed yet. Showering cost her spoon, just for washing her hair and shaving her legs. Reaching high and low that early in the morning could actually cost more than one spoon, but I figured I would give her a break; I didn’t want to scare her right away. Getting dressed was worth another spoon. I stopped her and broke down every task to show her how every little detail needs to be thought about. You cannot simply just throw clothes on when you are sick. I explained that I have to see what clothes I can physically put on, if my hands hurt that day buttons are out of the question. If I have bruises that day, I need to wear long sleeves, and if I have a fever I need a sweater to stay warm and so on. If my hair is falling out I need to spend more time to look presentable, and then you need to factor in another 5 minutes for feeling badly that it took you 2 hours to do all this.

I think she was starting to understand when she theoretically didn’t even get to work, and she was left with 6 spoons. I then explained to her that she needed to choose the rest of her day wisely, since when your “spoons” are gone, they are gone. Sometimes you can borrow against tomorrow’s “spoons”, but just think how hard tomorrow will be with less “spoons”. I also needed to explain that a person who is sick always lives with the looming thought that tomorrow may be the day that a cold comes, or an infection, or any number of things that could be very dangerous. So you do not want to run low on “spoons”, because you never know when you truly will need them. I didn’t want to depress her, but I needed to be realistic, and unfortunately being prepared for the worst is part of a real day for me.

We went through the rest of the day, and she slowly learned that skipping lunch would cost her a spoon, as well as standing on a train, or even typing at her computer too long. She was forced to make choices and think about things differently. Hypothetically, she had to choose not to run errands, so that she could eat dinner that night.

When we got to the end of her pretend day, she said she was hungry. I summarized that she had to eat dinner but she only had one spoon left. If she cooked, she wouldn’t have enough energy to clean the pots. If she went out for dinner, she might be too tired to drive home safely. Then I also explained, that I didn’t even bother to add into this game, that she was so nauseous, that cooking was probably out of the question anyway. So she decided to make soup, it was easy. I then said it is only 7pm, you have the rest of the night but maybe end up with one spoon, so you can do something fun, or clean your apartment, or do chores, but you can’t do it all.

I rarely see her emotional, so when I saw her upset I knew maybe I was getting through to her. I didn’t want my friend to be upset, but at the same time I was happy to think finally maybe someone understood me a little bit. She had tears in her eyes and asked quietly “Christine, How do you do it? Do you really do this everyday?” I explained that some days were worse then others; some days I have more spoons then most. But I can never make it go away and I can’t forget about it, I always have to think about it. I handed her a spoon I had been holding in reserve. I said simply, “I have learned to live life with an extra spoon in my pocket, in reserve. You need to always be prepared.”

Its hard, the hardest thing I ever had to learn is to slow down, and not do everything. I fight this to this day. I hate feeling left out, having to choose to stay home, or to not get things done that I want to. I wanted her to feel that frustration. I wanted her to understand, that everything everyone else does comes so easy, but for me it is one hundred little jobs in one. I need to think about the weather, my temperature that day, and the whole day’s plans before I can attack any one given thing. When other people can simply do things, I have to attack it and make a plan like I am strategizing a war. It is in that lifestyle, the difference between being sick and healthy. It is the beautiful ability to not think and just do. I miss that freedom. I miss never having to count “spoons”.

After we were emotional and talked about this for a little while longer, I sensed she was sad. Maybe she finally understood. Maybe she realized that she never could truly and honestly say she understands. But at least now she might not complain so much when I can’t go out for dinner some nights, or when I never seem to make it to her house and she always has to drive to mine. I gave her a hug when we walked out of the diner. I had the one spoon in my hand and I said “Don’t worry. I see this as a blessing. I have been forced to think about everything I do. Do you know how many spoons people waste everyday? I don’t have room for wasted time, or wasted “spoons” and I chose to spend this time with you.”

Ever since this night, I have used the spoon theory to explain my life to many people. In fact, my family and friends refer to spoons all the time. It has been a code word for what I can and cannot do. Once people understand the spoon theory they seem to understand me better, but I also think they live their life a little differently too. I think it isn’t just good for understanding Lupus, but anyone dealing with any disability or illness. Hopefully, they don’t take so much for granted or their life in general. I give a piece of myself, in every sense of the word when I do anything. It has become an inside joke. I have become famous for saying to people jokingly that they should feel special when I spend time with them, because they have one of my “spoons”.

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Living in Two States

So if you are close to me, you know I am living my life in two states right now -- Arizona and California.  If you are not close to me, you are probably asking why.  See, my husband and I had been living together in Arizona for the last year or so because he got a job with Sony Online Entertainment, his dream job (making computer games), in Tucson.  Unfortunately, after about a year and a half of employment, Sony shut down the Tucson office and laid off just about everyone.  This led to a job hunt which netted results in San Francisco.

When he took the new job, we had some decisions to make.  I was and still am in school to become a teacher.  If I were to transfer my schooling to California, it would add 2-3 years onto my completion date.  Seeing as I was only about a year and a half out at the time, that just seemed silly.  Why pour more time and money into something that can be done quicker and risk having to move again and add more time on should another unforeseen circumstance come up?  And so came our decision to split our household.

At this time, 98% of our belongings are in our beautiful 2 bed, 2 bath duplex in San Francisco with my husband, including the 2 cats and 1 dog.  I usually reside in Tucson in a studio apartment with nothing but a bed, a dresser, a TV, a few select kitchen items, and a bookshelf I adopted after the move.  Oh!  I adopted some chairs too.  Can't forget the chairs.  You know, the plastic patio chairs?  Yea, those.

Anyway, so usually I live in Tucson.  It is very lonely.  Yes, I have friends there and they keep me distracted from my loneliness as much as possible, but when I lay in bed at night, I miss being wrapped up in my husband's arms.  I miss the good night kisses and the good morning smiles.  The plan is to have me fly back to San Francisco every couple months for a long weekend or a short week to visit.  Even better, I managed to work my school schedule around so I have been able to reside in San Francisco for the last 6 weeks!  Oh how nice to live with my husband again!

But now my time in San Francisco is drawing to an end.  In two weeks (and 12 hours), my bags will be packed and I will be headed back to Tucson until the holidays.  I look forward to the warmth of Arizona (San Francisco is too damn cold!) and I look forward to seeing my friends.  I look forward to getting back to school on campus instead of online, and I look forward to swimming.  But once again, I will be living on my own.  I will miss my husband madly.  I will probably cry when I leave and I will probably bury myself in distractions once I get "home" while I adjust again.  I will probably cry myself to sleep a few nights as well.  But we love each other and we know we can make it through this as long as we support each other.  We also know this way will work out better in the long run than any of the other options.


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My Latest "Great" Idea

So I came across this wonderful article today about the writing process and how it is a journey of trial and error, blood, sweat, and tears.  It was written so well that I was inspired to revisit an old idea of mine.  I have played with this idea for years.  It has lingered in the back of my mind, just waiting for the right time to come bursting out onto paper...or the keyboard.

The idea?  Oh, its a book.

In the past, I have pushed the idea back into its dark hole, convincing myself it would be a horrible idea.  I mean, first of all, we all know how sucky of a writer I am (yea right).  Second, I get writer's block so easily with academic papers, what makes me think I could come up with enough to fill an entire book?  Obviously, not possible.  Third, the book I am thinking of writing is all about me, which we know would be boring as hell.  Fourth, it would focus on my journey through health issues and life in general as, what I like to call, a Bipolar Survivor.  Who the hell would want to read that crap?  And finally, it would require me opening up and sharing deep, dark, personal secrets and thoughts for all the world to read.

Yep.  Totally a horrible idea.  What the hell was I thinking.  I should abandon this quest line immediately.

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