Monday, May 24, 2010

Bipolar Judo: Rolling with the Fall (Saturday, 22 May 2010)

If you work hard to cultivate a regular sleep cycle, your body will learn your rhythms and help you protect them. Though in my slight manic spike I stayed up until 1:30 a.m. journaling, my body woke me up at 6:30 a.m., which was too early so I rolled over and went back to bed, and then at 7:30 a.m., which I accepted.

There's a tradeoff with these things. Get too little sleep and your day is shot, so you have to decide whether you can afford to be less than fully functional in return for protecting your sleep cycle. If your immune system is like mine, another risk of inadequate sleep is falling sick - no risk at all but an easy recipe for bronchitis in my case if I let it go on for a few days in a row - but even I can short myself sleep for one or two days in a row without risk. Get all the sleep you want after staying up too late and you risk not being sleepy when bedtime comes. Six hours seemed a reasonable compromise.

If you're bipolar, the other risk of inadequate sleep is further destabilizing your mood. Since I was a bit up the night before and come from a family of rapid cyclers, I knew the odds were high that my mood on inadequate sleep would overcorrect downward, and so it did.

Knowing it would, I could prepare a little judo for it.

Some people try to fight the downward swing, but that's a mistake. It's not just an arbitrary change, an undesirable symptom you need to suppress. If you're bipolar you're swinging downward because you emotionally overextended yourself with your manic spike. Mania may feel good but it burns through your neurotransmitters and other emotional-nutritional reserves too quickly, leaving you depleted. Afterward, you physically need the recovery time; trying to keep yourself amped up when you need to swing down just results in a larger and more catastrophic crash later, so go with the flow to help keep it mild.

Some people just ride the rollercoaster downward revelling in the plummet, though many won't admit they do this. This is also destructive. The point of the drop is not fun or drama; it's healing. Your body needs to recover.

If you choose the golden mean here, a low-energy recovery day structured around what your mood and body need, you can gently recover from a manic spike without crashing.

So I took the day off from my exercise program to lighten the load, but ate nutritious food high in amino acids, essential fatty acids, complex carbs, and vitamins and minerals to help my body reload my neurotransmitters.

Another problem with bipolar days - spikes or crashes - is a lack of continuity with the days before and after. It makes it difficult for your mind to create a whole out of your life when each day is too radically different; the high days can feel like bizarre adventures and the low days like black holes, making them impossible to knit together into any coherent life story. The best days for trying new things are neither the highs nor the lows, but the ones in between, when your emotional baseline is most stable and therefore best able to fully accept the novelty as real.

For a post-manic crash, even a mild one like mine, I've found mild entertainment and mild socializing with a high degree of continuity to the day before and the day after to be the best recipe. It helps fight the impulse the withdraw into a shell - which isn't actually what you need, just what you feel like you need on a crash day - and it deliberately weaves the days together into a multi-day story, a whole, part of a life, not just disjointed events.

For the entertainment and socializing, Beverly and I decided to spend the day catching up on the TV shows we follow, which had piled up on our Tivo during my two-week absence. We watched The Mentalist, In Plain Sight, Castle, and Gray's Anatomy over the course of the day - nothing too emotionally overwhelming, but gently stimulating and diverting, and B and I talked over the episodes in between. We always enjoy disecting Hollywood's efforts to depict highly intelligent people.

For the continuity with Friday, I finished cycling through some laundry and continued journaling. I wrote Honesty as Faux Pas in the morning, which I greatly enjoyed writing, and then after discussing my posts with B added Nephews and Nieces.

For continuity with Sunday, I made plans. I called my sister-in-law Niki to catch up on life then texted all day with my nieces Elizabeth and Wyatt, discussing everything from family dynamics to kittens to silly You Tube videos to Navajo culture. By the time I went to bed (on time, around 10:30), I had Sunday scheduled up to be an active day. I planned to sleep in to recover from today's sleeplessness and from Friday night's mild manic spike, and then to use Sunday's activities to get me good and tired in time for bed Sunday night.

The little bipolar judo worked out just right. By Sunday morning I had my emotional feet back on the ground.

Considering how mild the manic spike was Friday night, this might all seem like overkill to the casual observer, but it's not. The way to keep bipolar in check is to stay right in sync with your mood, learn its patterns, and use them to help yourself keep an even keel.

There was nothing florid or dramatic about my ungrounding Friday night - those who let Hollywood define their understanding of mania would have had no idea anything at all was amiss - but after twenty-two years of therapy I know my patterns well enough to know that my oscillations always amplify over time if I let them. The trick for my emotional wellbeing is to nip them in the bud when the oscillation first begin, to damp them back down gently and naturally and recenter my mood so I can experience the full range of emotions without swinging my mood along with my emotions.

To put it more bluntly, if I keep my mood on an even keel, my emotions are free to range widely because they have a home base to return to. And - bonus - I can use my more clearly expressed emotions to help diagnose whether my mood is stable by whether the emotions return there or not, which lets me plan corrective days like this one for when they don't.

Days like Saturday are an essential part of my mental health, part of what keeps me fit for life in general, and particularly part of what keeps me fit for the work I do for my nonprofit, where reliability and consistency are crucially important. In my experience, managing your mood with responsible life choices is a far more effective treatment for bipolar than artificially damping down your emotions with prescription drugs.

Your mileage may vary, especially if you have a different form of bipolar than I do (type two), but this strategy has been working well for me for seven years now, and it's the first strategy I can say that about. As other elements of my lifestyle management approach come up over the days ahead, I'll point them out so that over time you can get a good picture of how I keep my life together despite the rollercoaster our family's moods predispose us to.

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