Sensitive to Light and Shorter or Longer Days? What about the Holidays?

I have never been diagnosed with Seasonal Affective Disorder. But from most of the people I have talked to who have a mental health diagnosis, there is some fluctuation in symptoms (maybe just minor or maybe not) that follows the seasons and/or the time of the year. At least that’s what I think is so.

For me now, the most impacting seasonal symptoms occur during the shorter days of fall and winter. We are coming up on that time. I am a person who likes the daylight. When daylight is scarce, I am more inclined to have bipolar symptoms. My therapist talks about how spring/summer months are another time to experience symptoms seasonally and that this time may be more prone to mania or hypomania or mood sensitivity.

For me in the past when I was first diagnosed with bipolar 35 years ago and getting used to taking meds on a regular basis, I routinely had mini-breaks or break-throughs around the time of the seasonal changes. Once during the fall season and once during the spring season. This pattern lasted about 5 to 6 years.

More recently in the last 15 years, I have not observed the spring/summer highs to the extreme as much as the fall/winter lows oftentimes accompanied by anxiety. This was worse for me when I was in New England for college and 8 years after that. The shorter days did a number on me. I did notice when I moved back South that I did feel better in the longer days even in winter. (As a note – I did experience heightened anxiety this summer with regard to taking my daughter to college but I consider that anxiety as situational and not so much seasonal.)

This dislike for shorter days goes along with not liking the cold much. I am much more prone to keeping with my daily walk-the-dog-for-two-miles-routine if it is not freezing cold out. The regular exercise is really great for my mental health (obviously).

It could also be that winter is more difficult for me in that that’s when the holidays occur. The extra stress of being out of routine and being immersed in family matters may play a large part in my fall/winter moods and anxiety.

Do you feel your moods or behaviors are impacted by the amount of daylight in the day? Are shorter days and longer days something you watch throughout the course of the year? Are your symptoms harder to manage during the holidays and family visits and travel? Does this all feel like a bundle of triggers and symptoms that are sometimes difficult to sort out and manage?

Irony or Contradiction – Med Impacts throughout the Day?

For many of us with mental illness, psyche meds are part of the package for movement forward from illness into remission. What I am wondering about today is why my anxiety is the worst when I first wake up for that first hour or two of the day?

The main psyche med I take is Clozapine. The other two are Clonazepam and Oxcarbazepine. I typically take an extended dose of the Clozapine at night before bed around 9:00pm or 9:30pm with a smaller dose of Clonazepam and Oxcarbazepine.

Logically I would think that the time I would feel most vulnerable is the time that is the furthest away from when I last took the Clozapine. In other words, after 24 hours I would expect the medicinal effects of the Clozapine to begin to wear off. What I would expect is that my symptoms would be worse (not better) right before bed at around 9:30pm since that is about 24 hours since my last Clozapine dose.

On the other hand what happens is that my anxiety peaks about 12 hours (not 24 hours) after I take the Clozapine. This peak is at about 9:30am the following day. On the morning after the 9:30pm dose at 9:30am or thereabouts is when I experience the most anxiety.

To complicate matters, the time before bed from 4pm to 9:30pm is usually the least anxiety ridden part of my day. How does that make sense if it is almost 24 hours (not 12hours) since my evening dose of Clozapine? Is it just the routine at that part of the day that calms me?

Overall, these time-frames don’t make sense to me. Again, I would have thought that 24 hours after my last Clozapine dosage would be my most vulnerable time? Not my most anxiety-free time? I also would have expected 12 hours since the last med dose to be a stable time? Not when my morning anxiety peaks?

Does anyone else experience a disconnect between when they take their meds and when symptoms are at their best?

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!

Working for Myself as a Project Manager / Circumnavigating Stigma but Forfeiting Income

For two distinct periods in my career which includes the present day, I became a self-employed project manager so as to be able to manage both work and illness (bipolar illness).  During these times, I dedicated / have dedicated myself mostly to environmentally based volunteer work in my community.  In later years this often has translated to work in new measures for the environment and new measures in health.  Work also includes a period of service on the mayor’s environmental board in the town where I live.  In earlier years, I submitted grants for environmental development on behalf of my community.  In later years, I began to write papers that were accepted for presentation at the US government and at academic institutions in the US and abroad, including two acceptances from overseas groups.  This work includes being published by one overseas organization dedicated to sustainable development.

During both of these periods, I was able to put my health first and manage whatever bipolar symptoms or needs presented such as therapy appointments, psyche doctor appointments, meds management, or lab tests.  I also did not experience stigma in the workplace as I was working for myself. The first period was 1998 to 2001 and the second period was 2005 to the present with 5 plus jobs in the marketplace scattered among the second volunteer period and duration.  (I will recount the stories of these jobs at a later date.)  The downside of these two periods is that I was not able to make any income associated with these many accomplishments.  Work was volunteer in the community or involved publishing/posting papers that I developed on my own time. 

During this first juncture as a volunteer in my neighborhood, I was able to make important contributions to my community.  One effort resulted in a near million-dollar creek clean-up and naturalization effort about ten minutes from my house.  Another effort resulted in a survey-based community development plan for an in-town neighborhood including such priorities as walkability and economic development. I also developed three community-based sustainability grant applications to the United States Department of Agriculture recommending an environmental approach for managing agricultural waste and converting it into biofuels. 

During my later juncture of self-employment as a member of a city sustainability board, I worked on a variety of environmental agendae items including climate change.  I chaired one of the four subcommittees for a time.  This subcommittee worked on recommendations for the local tree ordinance, storm water management, and reforestation and trails development at a near-by park that was newly acquired by the city. 

Papers that I wrote and presented during the second timeframe focused on systems-based orientations to and measurements of environmental development.  The idea of much of the work at this time was that proposed adoption of systems-based measures in the Health, Energy and Food industries would correlate with simultaneous advances in all three industries.  Aligning measures for Health, Energy and Food advances means we can promote Energy work that allows for climate change concerns and we can promote Health work that allows for citizen well-being in the face of extreme weather events and the like.  This work and related work was presented and/or posted at a US government website in 2009, presented at a well-known public health university in the US in 2011, presented at a US academic non-profit geared to values in higher education (several submissions/presentations from 2010 forward), and submitted/presented/posted at two overseas non-profits dedicated to health economics and/or sustainability. 

Overall, my accomplishments during these two periods of self-employment are/were notable.  I am proud of these accomplishments, but I would not have been able to pursue this work if it had not been for support both financial and otherwise from my husband and my husband’s family.  Basically all this work in environmental development and new measures for the economy in terms of health economics and the like was financed by my family at that time.  This self-financing continues today with my blog writing and other work with which I am involved.

Brain Tumor is fine

I got results yesterday from my Primary Care Physician that my Brain MRI is just fine. It was a good thing to do since it had been 15 years since any follow-up. There is nothing much to do going forward except look for new symptoms like headaches, dizziness, etc. Follow-up MRI in another 10 plus years.

Clean bill of health! As far as that goes! Yeah!

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?

If you had a wish list for your mental health, what would it look like?

Here goes nothing….

  1. I wish for psyche meds to be 100% therapeutic 100% of the time.
  2. I wish for no side effects to meds like drowsiness or weight gain or Type II Diabetes.
  3. I wish to recover all those times when I was emotionally inaccessible to those closest to me due to my bipolar illness condition – this is mostly having to do with family and definitely has to do with my daughter.
  4. I wish for my bipolar condition not to be genetically an issue for my daughter.
  5. I wish to undo any harm / make amends for any harm I have brought to people because of or during my bipolar condition.
  6. I wish for the stigma associated with mental illness and addiction in society to magically disappear.
  7. I wish for the United States to have a healthcare plan that covers everybody at a reasonable cost including pre-existing conditions and including mental health and addiction benefits.
  8. I wish for the covid-19 virus to become a thing of the past as quickly as possible since it has so many emotional components that impact my mental health and the mental health of others.
  9. I wish for a covid-19 vaccine in the next 4 to 6 weeks or better yet now.
  10. I wish for a support team for anyone experiencing any sort of mental health or addiction diagnosis / symptoms and that that support team is always there for you.
  11. I wish for everyone with mental illness or addiction issues to never feel alone or never feel separate from the rest of the world.
  12. I wish the world to embrace and include all people no matter what their diagnosis, skin color, religion, etc.
  13. I wish I could return to the weight I was when I married or close to it…..

What would your wish list look like?

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.