Getting Through a Bad Day

It's very curious to me how little professional information there is on living with bipolar disorder.  That may be because chemical treatment was embraced so enthusiastically last century.  Also because psychiatrists are first M.D.s, and Western medicine is simply not holistic.  It embraces a very limited "science" which is constantly proven wrong (e.g. mice are not much like people, see today's NY Times). But I digress.

As that digression suggests, I'm writing on a good day.  Perhaps because of going off the Seroquel, and  perhaps because it's February, I am back into that peculiar schedule of good day/bad day.  Having exhausted the resources of Google, I've come up with a plan for tomorrow, which may well be a bad day made worse by this cold (4th day) and even worse by Tom going out of town all day.  If I don't leave the house I might not see another human face all day.  

The only useful idea I was reminded of as I researched managing bipolar was the idea of putting a certain scheduling and regularity in the day.  I knew this experientially, and am pleased that it's now recognized as a form of therapy, interpersonal and social rhythm therapy (IPSRT).  Here is a quote from an article in Psych Central: 

Social rhythm focuses on developing and maintaining regular routines. Research has shown that “disturbances in circadian biology are associated with bipolar disorder,” but “there are social cues that can help entrain one’s underlying biological rhythms,” Dr. [Holly] Swartz said. Such social cues include keeping a consistent schedule of sleeping, eating and other daily activities.

Add to that getting dressed with shoes on and coming out of that dark room, which are things they make you do in psych wards.  So I have scheduled my day tomorrow.  Unless the weather is awful, I'll even leave the house to go to the library, a nice low-stress place where I might get to smile at someone.

The single most important thing on my schedule, though is . . . I know, you guessed:  my practice.  I have learned that unless I'm physically very ill and fatigued, I can do my morning spiritual practice.  Interestingly, that is the least depressed half-hour of a bad day.  I suppose that's because I'm focused on what I'm doing and not indulging in the dark thoughts or clinging to the pains and other unpleasant sensations.  

My practice has two parts, bodywork and sitting meditation, and I've spent many years learning how to do both of these in a way that works best for me.  I'll discuss what I do in future posts.  Here I'll say, my habit is to do it after my morning coffee but before breakfast.  It is very easy to form bad habits, and hard to form good ones, but a good habit has a lot of encouragement power.  It's like, I don't feel like it, but this is what I do.

And this . . .

. . . is what I do on a good day.  You are looking at the large mirror that covers one small wall in my bathroom.  You see the toilet reflected in it - see what I mean?  Those colorful stick-on Glitterpuff flowers are something I picked up on sale a while back (I sometimes get high, shopping) and sort of hid from Tom, as they looked garish when I got them home.  But then you find yourself in just the right mood one day.  (And if he's noticed them, he hasn't said anything yet.)  I must say, good day or bad, they make me smile.  Color therapy.  I'm serious about that.

Living With a Chemical Imbalance

When I woke up this morning, I knew this was a good day.  Actually, that's the schedule lately, good day, bad day, like clockwork.  Very strange, but then the bipolar mind is different than boring old sanity. As I was being glad I felt good, the koan came in, the one I've been carrying around for about thirty years.  I've written about it before.

If you do not say good
and you do not say not-good
then what is the nature of reality?

That got me thinking how I could describe these days without the evaluative terms good and bad. 

one type of day is -
high-energy in all chakras - it's remarkable
active,
interested in ideas
tend to talk and write a lot
very creative
motivated to do things,
enjoy art and beauty,
filled with loving impulses -
and I like that kind of day.  Who wouldn't?

the other type is -
low-energy all around
passive,
quiet,
uninterested,
unmotivated,
struggle to just do essential things
vaguely dissatisfied with everything, little feeling
tendency to sad, morbid thoughts - 
A mood too many people are familiar with, and no one I know likes it.

Like/don't like is about preference.  You may say everybody would prefer that high-energy day, and that wouldn't surprise me.  Still, the day is not intrinsically good or bad.  Those words are assessments.

If you just describe these moods, they are primarily different energy states.  There are roughly three approaches to any mood or condition:
.  just experience it
.  try to change it
.  try to escape it
I almost left out approach #4
.  grouse and whine.

Changing the state - You learn to do that when you feel too high. Sit down, shut up, breathe. Meditation is obviously good practice for this. And a bipolar needs to do it or come across like a Labrador Retriever puppy.  Changing the low state is harder, and often I just try to escape/endure.  Now that I think of it, there are ways to work with your own energy.  I studied kundalini with an excellent teacher once (Hi, Kit), and I know there are yoga poses that build energy.  I've also done some chi gung. There's a course in that at our local rec center, and I'm planning to sign up for that.

But what about the "just experiencing" part?  That sounds very Zen. Yet - who wouldn't want to pull the thorn out of your paw?  Enduring a mood is easy to do when it's high-energy full of dopamine and serotonin; I lose myself in whatever I'm doing.  Experiencing the low-energy state - not. I'm really fond of escaping it when I can find fiction to read or a movie.  This kind of chemically-based condition doesn't seem to benefit from self-examination and self-talk the way situational depression can.  And that's all I know.  Your thoughts are welcome.

The Koan of My Life

I may have just realized the koan of my life - at least, my life just now:

Can you be depressed without blaming yourself? 

I know, this is not the major conundrum of the average life, though severe depression can hit anyone.  But it is for those of us who are bipolar or chronically depressed, or subject to the lows of illness, such as migraines or chronic pain- so as I think about it, a lot of us have this problem.

There could be other approaches for me, such as really thinking about the classic koan, "What was your original face before your mother and father were born?"  That points me to the highly hereditary nature of the kind of brain I have, which is called an illness or disorder.  Dis-order seems to fit pretty well.

If you start thinking how your parents were made by their culture and the events of their lives, you get insight into how they made you.  If I really sink into all that, and understand that this is how I was made before I had anything to say about it, that can solve the riddle above.  It is not my fault that I experience long periodic depressions.  I don't choose to feel like that.

And actually, that kind of penetration into the issue suggests to me that my habit of self-blame was also conditioned into me.  Therefore -

It doesn't make sense to blame yourself for your self-blame. 

But it is perfectly logical that you do that.  Of course you do.  You were conditioned to blame yourself.  So don't blame yourself for blaming yourself.  But obviously you have to blame yourself, because it is perfectly logical that, given your heredity and conditioning, you will do that. 

You have to love it.

There is something profound here that I won't attempt to explain any further.  But on a lighter note, it reminds me of the value of lightening up.  Though I don't know if you can do that by force of will . . . 

[image: tree peonies as van Gogh might have seen them in his worst mood]

When blue days are golden

Today I talked with a friend who suffers from depression, a more pervasive kind than the mood swings I have been experiencing since the steroids used during my transplant surgery in October.  She is a person who works on herself, and she's looking for what you could call coping skills. My doctors and I would rather not add to the medications I have to take, so I've also been working on how to be okay despite not feeling good.

A good color to look at when you're depressed

 Just now something came in my mail that ought to sober anyone up:  a letter from the veterinary clinic explaining why our favorite doctor has not been available for some months:  a neurological disease that began as a virus has attacked his spinal cord and brain stem.  It could have killed him and, the letter says, has left him with a lot of physical therapy to do.  He is young, compared to me, and so caring, so nice.  He always seemed healthy and full of life.

When you feel bad, you just feel bad, regardless of cause.  Depression is complicated.  You perceive the world differently, you think differently, you feel lifeless, you have no enthusiasm.  When I feel like this, it helps me to remember how bad off I could be, to remind myself what other people are going through - people like my doctor, his wife and kids and parents. 

On a bad day, remembering that I am not at all bad off has to take place in my logical left brain, a statement that seems detached from "me."  Nevertheless, it is true, as it is true that a feeling is just a feeling; a mood is just an emotion that is stuck, emotions have no reality, but come and go like the wind.  And there are plenty of things to be grateful for.

A couple of years ago a friend of mine had a heart attack.  I can imagine how frightening that must be, because I've since had two episodes of my heart going out of rhythm.  The second one was so big that I knew - didn't think it, knew - that I could die right then, with no warning, no chance to prevent it.  So I understand when Chris says that every morning now when he wakes up he feels grateful to be alive.  Me too.  Even - if you know what I mean - even when I'm not.