More on Bipolar Depression and Anxiety

It has been about three weeks since my husband and I dropped my daughter at college in New England. There was one day out of about 5 that I was extremely anxious on the border of being non-functional. I have bipolar illness and do not travel well and do not do so well outside my daily routine.

Since my husband and I have returned from this trip I have felt depression kicking in and replacing some of my chronic anxiety. I have talked to my therapist about it and am currently exploring whatever linkages there may be causal or correlative between my depression and my anxiety.

Depression has a certain feel. Anxiety has a certain feel as well. I can tell the depression is coming on due to a generalized feeling of dread and a physical expression of being low energy or down in my mood. It is like a wet blanket all over everything. This feeling of depression is very different from my generalized anxiety. With the anxiety there is always something specific that I am worried about. The source of the anxiety has a specific source in mind: Did my daughter find out how to print her assignments? Is my daughter eating well and eating enough? Is she isolating or making friends? Are her finances for groceries in order?

However with the depression there is not such a direct connection to current events that are on-going in my daughter’s collegiate life. Instead, the depression appears to be me re-living my experiences and hardships in college and projecting them onto my daughter. The depression is not so much about what is going on presently and how can I fix it by being a helicopter Mom (stated objective is to move from this helicopter to supportive Mom) as it is a replay or reminder of events from my past that were not fun at all at the time I was in college.

My depression is all about me resurrecting or reliving past experiences that occurred to me and with me in college. During college was when my bipolar started so that may help to explain things.

The depression is a general malaise. The anxiety is tied to specific details of my life or my daughter’s life.

What does this indicate about the relationship between my anxiety and my depression? I have largely been somewhat anxious since I began treatment with clozapine in 2008. I have not really experienced a depressive state since that I can recall at this time. My current struggles from depression have really just started since we got home from dropping my daughter at college.

If the anxiety is generally topic specific, the depression and malaise are generally not so much so. The anxiety is hard to contain and hard not to push onto other people in my life including my husband and my daughter – as if this impacts my boundaries with each of them. The depression for the most part is not so invasive to boundaries as it is something I sit with while those around me continue with their lives.

I keep asking myself which is better and which is worse? If I am imposing my anxiety on others, that feels like a worse way of managing my health than experiencing my depression and allowing those feelings to occur so that feelings and emotions are not so much being projected on those around me. My depression like it or not is mine while the anxiety I experience is a state I extend to others in my life while not meaning to.

So what is the connection if anything between my anxiety and my depression? Is it possible that underlying all those anxious thoughts about school schedules, meal routines, printer access, train trips at Thanksgiving is a generalized experience of depression that is difficult to distance myself from because the depression echoes experiences of depression or uneasiness when I was in college. If I confront my demons about my own college experience more fully, will I be able to stop experiencing and therefore projecting that experience on my daughter in terms of anxiety checklists?

Can I learn to allow my own college experiences to flow through or wash through my emotional registrars and stand up and say: This was not a good time in my life (for reasons explored in other posts) and I do not wish this on anyone including my college aged daughter. If I can release these depressive experiences as I relive them on my daughter’s college timeline, can I be less likely to project my specific anxieties on my daughter? Is the depression the root cause of the anxieties? Or do they just co-occur? If I finally came to terms with what happened to me during my college years, would I be less likely to project worries upon my daughter or to extend checking behaviors to her.

Bottom line is that I did not feel safe when I was in college (for a variety of reasons outlined in other posts). Now some 40 years later can I just own the fact that I felt unsafe and that I currently do feel safe more or less. If I can recognize that safety is an issue of the past and not so much of the present, will there be less room for that litany of anxious thoughts about this and that specific thing to occur?

Does Your Blood Pressure Vary Due to Anxiety?

I am in the process of adjusting my blood pressure medicine. This has been on-going since about February of this year. I have been tracking my readings for about 7 to 8 months.

The trouble is my blood pressure varies widely over the course of the day I think due to the stress and anxiety and erratic nature of my bipolar illness. Also if I go to an appointment that is stressful like the dentist or for a mammogram, my stress level soars and my blood pressure climbs.

My dental hygienist indicated yesterday there is something called “white coat syndrome” where your blood pressure rises upon seeing someone in the medical establishment (doctor or dentist or someone in that profession) wearing a “white coat.” When I first arrived for my dental cleaning yesterday, my blood pressure levels were very high. I asked again at the end of the appointment whether my levels could be checked again — and they were normal.

Does anyone else have volatile blood pressure readings? That might be tied to anxiety levels? Or suffer from high blood pressure readings when stress is high?

This is a work in progress regarding depression and anxiety

In this post, I am exploring the relationship between anxiety and depression. I originally thought that most people either experience anxiety OR depression, but I have been corrected that this is not always the case. A large percentage of people with depression also experience anxiety.

My therapist has told me in her opinion anxiety and depression are often two sides of the same coin. I am using this post to explore that concept. This post is a work in progress.

Since becoming an empty nester in the last several weeks, I find my old friend depression to be creeping in. I have been wondering how this depression relates to chronic anxiety. As an FYI, I manage bipolar illness and have for more than half of my life.

Yesterday, my husband and I catalogued and bundled five or six huge garbage bags of my daughter’s old clothes. Going through them and bundling them for GoodWill felt both depressing and productive at the same time. The process reminded me of going through belongings after my father died. It was a time of great loss and also a time to look forward to a better day as he had been ill for quite some time.

I suppose getting my daughter’s items together for GoodWill meant that a part of my relationship with her was going away forever. That is the Mom role taking care of all the details for my daughter. There is loss associated with letting go of the hovering Mom even though I am 100% sure it is the healthy thing for me to do as well as what is healthy for her. She is soon to be 19 and very able to manage things in her life that I used to (and still do at times) worry about.

The idea that all these sweaters, and pants and shirts and skirts will have a second life at GoodWill once purchased by a new owner is a reminder to me that my daughter also is embarking on a new chapter in her life. As her belongings move to new owners, so too is her life migrating to a new phase where she and I will continue to relate but relate differently. I will not manage her life so much as support her emotionally and financially. I am learning to do this but am not a pro at it yet (at all). Perhaps as I experience the loss, there will be more room for experiencing the joy of her moving forward in her life with this critical milestone.

The depression I feel is that I am losing the child I have worked so hard to raise. There is sadness in letting go. There is anxiety in letting go. I need to let myself experience the sadness and the sorrow and the anxiety of her moving from one phase in her life – childhood – to another phase in her life – young adulthood.

Clearly there are related joys and moments of extreme happiness that also accompany this transition. My daughter is embarking on a journey of higher education, deliberate self-management and self-initiated problem solving as she maneuvers these first several weeks and months in college. My husband and I are in effect setting her free.

However, I am not quite feeling celebratory yet. I am still in the remembering and experiencing the loss phase of things.

I think perhaps loss can be attributed to a child leaving home for the first time. There is a kind of loss that is similar to loss when someone dies though not so dire and not so extreme. I believe that if I can learn to grieve that loss, I will be more able to embrace the positive developments and positives sides of this lifetime transition. There is also this issue of abandonment. I suffer abandonment issues as a child of divorce. I have bent over backwards so my daughter will not experience abandonment issues – if anything I have overdone it with my hovering Mom role.

So how does all this relate to my chronic anxiety? Is it possible that the anxiety is a symptom or manifestation of the depression I feel in letting go of my daughter’s life details? If I am able to let myself experience the sadness associated with this change, will that allow me to free up or tackle some of my anxious thoughts and give room to feelings of joy, pride, love and support for my daughter and her pending journey of self discovery?

Finally, does anyone else experience depression and anxiety as being related? Do you believe that if you allow yourself to mourn the loss of a prior mode of relationship that that will free you up to embrace the new phase or mode of that relationship? Or might this give less room to feelings of anxiety?

Sorry to ramble on. I am clearly still exploring and processing these thoughts and feelings.

When Depression Creeps in Where Does Anxiety Go?

Soon after becoming an empty nester I have begun to experience some feelings of depression. This is understood as I have bipolar illness. But the depression phases of my bipolar history are fewer and less extreme than the mania phases. Since 2008 while prescribed clozapine, I have been experiencing mixed states that manifest themselves in acute anxiety.

In addition to just becoming an empty nester, there have been two recent deaths (in the past two weeks or so) in my social/family circles (both expected) and my Psyche doctor is experiencing severe back issues and lack of feeling in his feet.

So my question today is where does that long-standing anxiety go when feelings of depression are accepted as part of life’s challenges and puzzles? Is the depression the root cause of the anxiety? Have I been experiencing loads of anxiety because I have not been able to process sadness, pain, separation and depression?

I don’t have the answers to these questions right now. But it seems to me if I am going to come out of this series of mixed states, it is important to acknowledge the depression and allow it to pass. Perhaps then the anxiety will be less so. Any thoughts?

What Does It Look Like When Civil Society Is Threatened as Perceived by a Person with Mental Illness?

1. Politics is more a question of love versus hate instead of an identification of ideological differences.

2. A peaceful transition of power is shunned or completely denied by leadership.

3. Rights that were once attainable or available become threatened.

4. Leaders are noted and supported for their charisma more than their actual accomplishments.

5. Behavior at the national level looks more like kindergarteners hoarding the ball to take home rather than leaders with their heads in the game.

6. Communication about other people is reduced to name-calling and slurs on character.

7. Hate is a regular feature in communications and positioning that is generally directed at people who “are not like me.” This hate is often extended beyond words to actions.

8. Gun ownership and gun violence are condoned or encouraged as a means of protecting civil liberties.

9. Political differences between family members are so extreme that family relationships may become strained or damaged.

10. People are not willing to curb their actions even when political mechanisms are faltering or threatened.

Thanks for Being Part of the Solution!

Recently I wrote a very long email to my high school peers and included a recounting of what I thought were mental health / addiction challenges affecting someone in that group who died suddenly. After reaching out to high school peers and receiving a full gamut of responses including both positive and negative, I want to say how much I value this on-line “community” at this blog site where people can talk freely about mental health and addiction full-throttle or head-on.

Over the past few years, I have grown accustomed to talking openly here at this blog and at others’ blogs about mental health challenges I experience that include the full gamut of symptoms including mania, depression, mixed states, sometimes crippling anxiety, body image challenges, hallucinations, hospitalizations and others.

I just want to say thank you to those of you who are in this on-line “community” for helping to provide an atmosphere that allows people with mental health and addiction issues to talk freely without a whole lot of push-back or stigma. Ten to fifteen years or so ago, such an online “community” possibly or probably did not exist? Not sure when people started blogging about mental health? For me, following posts and posting posts is an important part of my self-care. I thank you for your contributions even if you are in the “reader” versus “reply/writer” category. Everyone plays a part.

Finally, thank you again for participating in this “community.” I believe that stigma reduction is a crucial by-product of the collective posts here at these blogs about mental health and addiction. Thanks for being part of the solution!

Various Interventions for Stress?

Plans to take my daughter to college next week are leaving me stressed with a capital S. I have scheduled an extra appointment with my therapist for tomorrow. I have gone up a little on my Clozapine. Perhaps not enough…? Everything feels very stressful. Making plans for wisdom teeth removal in December. Making plans to board the dog. Consider changing meds – this will be held off until September. Making sure my daughter is OK during move-in. Friends and family say this stress is normal when sending a child off to college. OK so it’s normal. Why do I feel so un-normal?

I have been taught not to be afraid to ask for what you need….. I am asking now for your understanding and support. The more “yeah it’s normal” s I get the better I think I will feel. Brother can you spare a dime? Or a least a word of support that this too will pass?

Does Anyone Have Information on Loxapine for Bipolar?

I am in the process of looking into a new psyche med. I currently use Clozapine as my main psyche med but it requires a monthly blood test and causes weight gain. I have also been on Clozapine since 2008 and wonder if its effectiveness is waning.

The drug I am considering is Loxapine which is structurally very similar to Clozapine. Both meds are used for schizophrenia mostly but have been successful in treatment of resistant bipolar which is my gig.

Does anyone have stories to tell about Loxapine for bipolar? Or for other off-label uses? Thanks in advance for sharing.

As an update: I talked to my doc yesterday about switching from Clozapine to Loxapine. He indicated it was not a good idea. And while I am somewhat disappointed, I trust his judgement completely. So there will be no switch to Loxapine. I am however still interested in stories of how Loxapine might have helped in your treatment if you have used before?

Thanks to all of you who have reached out here and before.

Night and Day – Living with Bipolar Disorder out of or in a Routine

I do not know if the experience is similar for other people with a serious mental health diagnosis, but I find myself to be very anxious and irritated when I am not in my regular routine. If I am able to function at a 9 or a 10 (on a scale of 1 to 10) while I am home, I am able to function at a 5 or a 6 when I am out of town and out of my routine. And that is just for domestic travel and travel to a familiar spot. If I have to travel to someplace new or abroad I would have to rate myself even lower due to the adjustment and/or the jet lag and jet lag recovery. As an aside, I have discovered that melatonin does help tremendously with jet lag.

What does it mean to be so tied to a routine? Doing things like taking meds, going to bed, waking up, taking morning meds and taking noon meds are all things that function pretty much on their own when I am at home. I am more or less on auto-pilot with these activities. When I am out of town, I have to create this structure that punctuates my day at several intervals. Things go wrong or even slightly wrong and I have upset the apple cart. Everything starts to tumble and there I am trying to pick up all the apples. Little things like eating dinner at 8:00pm instead of 6:00pm gets my evening off to a rocky start. Things like placing my meds in a different location than I am used to can be a form of stress as well. Sleeping in a strange bed can also be a pain. Having to get somewhere early in the morning is also a challenge as my day starts around 8:00 or 9:00am at home.

I have often thought that because of my bipolar illness I have damaged my hippocampus in some way due to all the trauma over the years of accelerated and then slowed thought processes. So there may be a real medical explanation for all this routine dependency. As I understand things, the hippocampus helps orient you through time and space and helps you keep pace with your general well-being. Getting to a new location that used to be a breeze now with hippocampus damage may seem a daunting task. I have trouble with spatial sense of direction which is one of those skills you need when you are traveling in a new or relatively new spot. This was not the case when I was in my twenties and thirties. This is also one of those problems that is self-fulfilling. The more I tell myself how difficult it is to get somewhere new, the harder it becomes.

So much for loving to travel. I much prefer to be at home in my own routine however boring that may sound. What about you? Do you find that routine is a critical element of your functioning or can you pretty much establish your day and night in a new place without much thought or effort?

Do you stockpile meds?

In the US under my insurance you can usually get meds refilled about 3 days earlier than the full month that they are covered. This allows me to create a med stockpile month upon month when those three days earlier to pickup are multiplied times twelve over the course of the year. I also tend to keep at an old prescription dosage amount even if that dosage has been changed/reduced. To explain, say my doctor originally prescribed me with 500 mg of Clozapine and then over time I reduced to 350 mg. My doctor keeps the prescription at the higher level in case I need to go back up.

The result? I tend to stockpile meds which drives my husband crazy. But for me it means being ready for a sudden trip out of town or having meds in place when I am on summer vacation. My insurance does not do vacation overrides. Not sure why. So if I need meds filled during vacation I need to use GoodRX coupons the week prior to leaving town. GoodRX allows you to fill prescriptions with a discount and they do not care whether your insurance says it’s time to fill or not. It used to be that my pharmacy would do a vacation override but I think the problem is with my current insurance.

I have also been told that you can ask your doctor to send the prescription to a pharmacy out of town (where you’ll be vacationing) and that that pharmacy will fill the prescription. But I have also been told that that fill is up to the pharmacist’s discretion. Don’t want to wait until I am out of town and have run out of meds for that to happen!

So, what do you to to be sure you have meds before vacation or before traveling in general? Do you have a stockpile like me? Does your insurance do vacation overrides? I have been told that even if you can get a vacation override it is only for once in the calendar year. Are you blessed to have universal healthcare that doesn’t penalize you for filling early? Or do you use something like GoodRX to get a prescription fill a little early before you have to leave for out of town and use that coupon for filling the med outside of insurance approval windows?