Sleep: When is too much of a good thing or not?

When I was in the early stages of bipolar disorder, a gap of 2 nights sleep was a trigger that I might need to be hospitalized for bipolar disorder or go to my sister’s house for in-home care.

Some 25 years later, I find that sleep is also an indicator of how I am doing with the bipolar. If I have interrupted sleep or sleep less than 7 to 8 hours, the next day is a struggle and a warning sign for the next few days to come that things are fragile.

In semi-retirement and as an empty nester, I allow myself more sleep than I normally would. I go to bed around 9:30 or 10:00pm and wake up between 8:00 and 10:00am the next day after several interruptions in the night. I know some people might see this as a sign of depression. I actually don’t. I have come to rely on the good nights sleep with clozapine since 2008. And this sleep generally helps keep me feeling relaxed and less anxious through the day. It is not a cure-all for anxiety, but being well-rested does mean I am less likely to expect the worst in whatever situations cross my path that following day.

I am not tied to the schedule of ten to twelve hours per say. I do get up and go to early doctor’s appointments and the like. I just like being completely exhausted of the need to sleep. If I can put it that way.

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?

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?

Do you experience inertia surrounding your to-do list for the day?

There are days when I feel like getting things done and there are days when I don’t really feel up to doing much. This post is about the days when I don’t feel like doing much of anything.

I am a planner so I always have a list of things to get done each day more or less. Some days are busier than others. Some days are more motivated than others. This post is about the days that I don’t feel particularly motivated and/or may also feel that I am just not up to the task of going to the grocery or fixing a home-cooked meal that day.

So I am assuming we all know what inertia looks like on those days when the to-do list is not a source of help for organizing the day. Inertia looks like: I don’t feel like doing anything other than the most rudimentary things like caring for the dog or taking a bath or shower and maybe not even these items. Additional items on the to-do list are just more a source of stress than anything else. It is as if there is a pile-up accident on the highway up ahead and I am just caught in a huge traffic snarl and cannot get through the pile-up of vehicles (to-do items) up ahead on the highway. In other words, I just don’t feel like getting things done.

So what is it that can help with all this inertia and being caught in a multi-car pile-up (metaphorically speaking)? I have found that there is not a cure for this inertia. It rears its ugly head from time to time and does not truly disappear. I am certain it is a by-product of depression associated with my bipolar condition. But there are some ways of managing this inertia or countering it.

I find that if I can muster the energy to do just one small thing on my to-do list for the day like the simple act of emptying the dishwasher, I am all of a sudden ready to tackle another thing that is important but may or may not be on my to-do list for that day. And the trend continues to a third or maybe even fourth item on the list (or off). The key appears to be true to the idea of inertia. If I set my body in motion (by acting on the dishwasher) I have a tendency to keep moving forward (by either doing another item on my to-do list or some other task that may be equally important).

This also means being flexible with the items on my to-do list. I may be motivated to do items not on that list and need to be aware that doing these items is progress even if those items are not on the original list for the day.

Inertia exists in both directions. A body will stay at rest if it is put to rest. A body will be set in motion if there is movement. This idea of setting a body in motion really helps me get over the hump in my day and move onto the next item on my to-do list. It is a matter of changing the force of inertia for the day from a resting place to a movement place.

For example, I did not feel like doing much today and did not feel like going to the grocery store at all. I was able to get the dishwasher unloaded and felt afterward good about writing this blogpost and did. In the meantime my husband went for a short grocery run and I was somehow able to plan and prep for a nice home-cooked meal of marinated salmon steaks, couscous and cabbage. My day went from standstill to pretty busy and fairly fulfilling.

Does this inertia metaphor ring true for anyone else? What helps you to pick up your to-do items when you are not motivated to do so?

A way toward stigma reduction?

A blogging colleague of mine have been talking a little bit about stigma reduction associated with keeping mental illness symptoms associated with the illness itself rather than with the person. For example, the anxiety that I experience is a feature of my bipolar illness rather than some character defect or short-coming of my person. What if we were to try to represent and talk about mental illness symptoms as being features of the illness or diagnosis itself rather than characteristics of the person or the patient? By way of example, we do not think a breast cancer survivor is cancerous. Instead we say she has had cancer and fought it and is still fighting it and/or is in remission. The disease and its symptoms are not synonymous with the patient. In fact with cancer it is the other way around. People always talk about those people who are able to beat the illness cancer — it it not a part of who that person is but rather a fight to fight and to win and to overcome.

So why do we think of mental health symptoms as somehow the failure of the person experiencing the symptoms such as anxiety, depression, PTSD or some form of psychosis? When it’s mental we tend to assign the symptoms to the patient rather than to the illness. This person is anxious. This person is depressed. This person is psychotic. This makes overcoming the stigma of mental illness even tougher.

So what would it look like if we started talking about mental illness symptoms as part of the illness rather than part of the person experiencing them? It might make us more inclined to believe that getting over anxiety or depression or PTSD or psychosis is a matter of the treatment of the illness rather than the integrity of the patient or the person experiencing the symptoms.

What do you think? Do you think mental health patients are asked “to own” their symptoms in a way that cancer patients are not? Do you feel mental health stigma could be reduced if we were to more often disassociate mental health symptoms from the person experiencing them? Could mental illness be considered a challenge to fight and/or to get through like a cancer but not the result of some character defect on the part of the patient? Do we need ways of talking about mental health that include giving credit for actively working to keep symptoms under control and/or having them be in remission for a time? Do we need ways of talking about successes we have had in combatting our mental illness diagnoses even if those troubles still exist for us on some level? What of all this might help to address the stigma of mental illness?

Dear Reader,

Dear reader I am writing to ask you a question. What happens after a person has had some reconciliation of the fact that he/she was very much abused as a small child? If this doesn’t pertain to you, please disregard this post.

I have just undergone gut-wrenching and extensive therapy since December 2020 which for me had its origins in treatment I received as a small child of about 6.

I have been clinging to the earth these last few weeks so as not to slip again into the abyss where for some extended period of time a portion of my psyche had been living.

According to my own assessment, I have successfully crawled and clawed my way out of a 100 foot deep pit with slippery mud sides.

Now that I am completely out of the pit ( I hope), I am wondering what to do with myself, what to work on, what to avoid, what to learn, what to enjoy. Take a shower and wash off the mud? Take into account exactly where the pit is so as not to fall into it again? Designate this exit from the abyss as my new “rock bottom” and be thankful for hitting it so as to get the $%^&* out of there? Allow myself to tell myself, I deserve happiness? I deserve good health and fitness?

As fodder for knowing I have exited the abyss, for the first time in 20 years I have been able to stick to an exercise routine composed of mostly yoga and some walking in the neighborhood. I have recorded a log which is two weeks long and growing which for me is super progress. In my youth I was very, very fit, so getting back to that place with mindfulness is huge for me.

So if anyone here or there has also climbed out of their own pit of abuse or anxiety or depression, I would love to hear your story as to what you decided to do next once you found yourself alongside the edge of that pit but no longer in it.

Of course I will talk my therapist about it, but I thought I would ask you dear reader in the meantime.

What about weight gain? Anybody experiencing that?

Asking about memory issues is popular on my blog, so I thought I would start a similar discussion on weight gain.

Back in 1985 when I was diagnosed with bipolar disorder, I was prescribed a combination of lithium and tegretol. There was a five to ten pound weight gain associated with those meds. With a diligence for exercise I managed the weight implications associated with lithium without a problem. As long as I stayed on lithium off and on until about 2004 my weight seemed largely manageable.

Fast forward to 2004 after the birth of my daughter. I never got off my baby weight. Also due to the postpartum depression, I suffered additional weight gain in that I ceased to be motivated to run 4 to 5 times a week. In fact, I am doing well now to get a short walk in.

In 2008, I was prescribed clozapine / clozaril which largely became therapuetic for me but also was associated with a good bit of weight gain. To this day I am 20 to 30 pounds heavier than I want to be. I also want to be walking regularly. In addition to the meds’ impact on weight, I began to eat as a nervous eater and a stress eater. This did not help with the weight issues.

I am hopeful if I can jumpstart myself back into an exercise regime, I can begin to address the weight-gain and the stress eating. Because my daughter is pescatarian we largely eat healthily as a family but portions are too large and snacking is too much.

My Sojourn through Bipolar Illness – Coming up Last on the Funding List?

Has behavioral health always been the red-headed step-child in terms of funding levels for medical research and treatment?

If the statistics on mental health and addiction were more widely publicized, would we begin to see more clearly the widening funding gap between dollars to treat and cure mental illness versus research and treatment dollars dedicated toward heart disease, diabetes or cancer?  Currently, while mental health and behavioral health including the opioid epidemic and addiction pose tremendous challenges, the funds and expertise to tackle behavioral health and addiction just aren’t forthcoming at the same rate say for cancer research or funding.  What would happen if we as a society could place as much money and effort into mental health and addiction research and treatment as we do into cancer?  The projected impacts would likely be enormous.

  1. For one we would have adequate beds to treat people who need inpatient care for behavioral health or addiction. 
  2. For another, we would have adequate funding to develop psychotropic drugs and other interventions without such severe side effects as weight gain and Type II Diabetes onset and memory loss. 
  3. Additionally, we would be treating war veterans for mental health or behavioral impacts that often can go untreated or undiagnosed.
  4. Fourthly, we would have enough resources to fund a Cohort Model of support for those in a crisis or post-crisis state. 
  5. Fifthly, with more co-mingling of people with and without a behavioral health or addiction diagnosis we might be able to reduce stigma substantially.
  6. Finally and most importantly, by being proactive in our behavioral health and addiction programs in the United States, we may be able to develop awareness of early warning signs among people struggling with mental health and addiction before their symptoms become dire. 

It only follows that research for and treatment of mental illness and addiction is proportional to the level of medical challenge that is presented with these diagnoses.    

My Sojourn through Bipolar Illness – Life before Anxiety

I have limited or very limited memories of what life was like for me as a child and/or a teen before bipolar illness hit me in my twenties as a college student.   This is particularly true of my early childhood years before middle school. These memories before middle school are largely blank. They are not bad memories, per say, they are just not memories at all. Like a blank screen on a TV set — all images gone with little sound either. I am seeking to explore the lack of early memories as time moves forward and as my therapy progresses.

In high school, I was a typical over-achiever and straight A student.  I graduated at the top of my high school class and was voted by high school peers to be “the most likely to succeed.”  I had a steady high school boyfriend for my Junior and Senior years in high school.  My study peers were the Advanced Placement teens while my social peers were “the in-crowd.”  Somehow it was important for me to feel that I was part of “the in-crowd” rather than just being satisfied with my academic peer group. Most of my memories of high school are very strong as I was able to hold onto this vision of myself as “successful.” These memories are much more vigorous than memories from the years before middle school.

Most of my memory absence appears to be before middle school years. When I was in sixth grade, my parents divorced.  I tended to manage what I now recognize as what may have been anxiety and feelings of depression by becoming a great student and high achiever.  I felt somehow if I could be a straight A student, there was no wrong happening in my life and all was right with the world. 

My Dad remarried a short time after I transferred in sixth grade to a private school. When I was a Sophomore in high school, my Mom also remarried.   With both parents happily remarried, I continued to live life relatively anxiety-free or so it seemed.  I was a super student and a valued member of the cheerleading squad, the track team and the student council.  I was the top student in my Senior class and voted in as “the May Queen” by my Senior class peers. 

It was not until I arrived at Ivy College that I first experienced anxiety that I was aware of.  Suddenly everybody was as smart as I was.  Suddenly my coping mechanisms for stress – being the top in my class – seemed very very far away.  I took to studying all the time to keep my grade point average in the “A” zone rather than adopting an acceptance for “B” work.  This preponderance for “A” work I think was a factor in my inability to distance myself from the come-on’s and other subpar behaviors of my college thesis professor–  Professor Flannigan — during my Senior year.   The coping mechanisms I had adopted in my middle school and upper school years were inadequate for coping with the challenges in college days, particularly those challenges of my late Junior and early Senior year days.  Perhaps unlike many college students, in college I did not appear to grow out of or beyond coping mechanisms that were helpful in my younger years in middle and high school.    

In addition, it may have been that Professor Flannigan, untrained therapist that he was, was somehow trespassing dangerously into the “safe world” of that six-year-old child while that six-year-old child was striving desperately to stay on course.  Once again, Flannigan’s assuming to be a trained therapist or acting like one was likely very, very dangerous for me particularly if sexual or other abuse was present for me as a young child.

What has changed since college days? There is still a blank screen there where there should be early memories, but at least now I am in a place to work through those voids with a trained therapist rather than an emotionally immature egotist.