break
I’ll be back after Easter.
I’ll be back after Easter.
Lent is the 40 day period of fasting, repentance, and spiritual discipline before Easter, not including Sundays. My usual ritual is to give up something that I enjoy or something that is bad for me, pick days to fast, and choose a spiritual discipline like meditation, prayer, or Bible reading.
My question this year is whether or not fasting is ok for someone with bipolar. I ran across the following article, Who Should Not Fast on fasting.com. It says
Additionally, fasting is contraindicated for those who are severely weak and debilitated, or with diseases caused by undernourishment or malnutrition, severe anemia and porphyria (a hereditary defect of blood pigment metabolism); bleeding disorders of the stomach and intestines; FSGS (familial focal segmental glomerulosclerosis); psychiatric disorders including severe manic-depressive illness (a.k.a bipolar disorder)and/or taking Lithium, schizophrenia, severe neuroses, severe anorexia nervosa or severe bulimia, and finally, those with insufficient understanding of the fasting process leading to their perceived inability to do without solid food for a prolonged period (despite countless hundreds of millions having done so before us).
A study in the International Journal of Neuropsychopharmacology, studies Muslim people with bipolar during Ramadan.
Twenty bipolar patients were enrolled during the month of Ramadan in 1997. Diagnosis of bipolar disorder was according to ICD-10 criteria. Patients were assessed during the week before Ramadan, the second and the fourth weeks of the fasting month and the first week after its end, with the Hamilton Depression and Bech–Rafaelsen scales. The plasma concentration of lithium was also assessed. The main finding of the study was that 45% of the patients relapsed, 70% during the second week and the remaining patients at the end of Ramadan. These relapses were not related to plasma concentration of lithium. Most of the relapses were manic (71.4 %). Patients who did not relapse had insomnia and anxiety during the second and third weeks of the study. Side-effects of lithium increased and were observed in 48% of the sample, mostly dryness of the mouth with thirst and tremor. The result of this pilot study indicates that the Ramadan month may disrupt the mood state of bipolar patients.
My conclusion is that all day fasting is not an acceptable practice for someone with bipolar. There are, however, other ways of fasting. I could give up certain kinds of food. I could give up sweets, red meat, or some such.
This is a very meaningful time of the year for me. I’m never more peaceful then during Lent. If you’ve never practiced it, I encourage you to do so. It doesn’t really even have to be a religious observance for you. It’s good to practice denial and be introspective. This would be a good time to cultivate a new daily discipline like yoga or breath work or exercise. For me, it is deeply spiritual. It’s a time to focus on my relationship with God. It’s a time to simplify and shed all the bullshit that I’ve picked up over the year.
It starts with Ash Wednesday, which is today. Tonight, I’ll go to church, and the pastor will make the sign of the cross on my forehead, and my journey will begin.
Last week I saw my psychiatrist and this morning I saw my psychologist. My psychiatrist said, “Ok, be sure not to take Klonopin with alcohol. Ok? Oh, and by the way, I’d like to get you stable enough for you to have a glass of wine once and awhile. Just not with Klonopin.”
This really surprised me. Both of my docs have held a hard line against me drinking alcohol under any circumstance for the rest of my blinkin’ bipolar life. So I’m thinking “Hell yeah! I might get to have a beer at the ball game. Or wine with dinner. Or maybe a sip of scotch once in awhile.”
Now, if you’ve read my blog at all, you know that I’m uber compliant. I do whatever they say. And if I break the rules, I don’t lie about. So this morning in my therapy session, I brought up what the psychiatrist said. She threw a little fit. She said that she’s going to have a little chat with the good doctor and she will win. ”I ALWAYS win,” she exclaimed, “And besides, he’s a little afraid of me.” Wow. So that’s how it is? The medical doctor who knows more about my body’s chemical makeup than anyone else in the world is going to have to answer to a psychologist?
In the end, I believe my psychiatrist will recant what he said because he is a little meek and she is a little scary. But you know what? It’s my body. In the end, it’s up to me to decide. I hired these two professionals to give me information, but it’s up to me to decide what to do with it.
Now, I know what’s going to happen. If I do have a drink, then I’ll have to decide whether or not I’m going to tell her. And if I do, I have to be prepared to catch some flack for it. I don’t think she’ll just give up without a fight. It could, in fact, end our relationship. I do not want this. This might be something I have to hold back information on so that I can continue to see her.
It’s hard for me to know who to trust when my doctors disagree.
So, I started Lithium a few weeks ago. I have no idea if it’s working or not. I suppose it is. I haven’t gone nuts yet. I was warned that there might be side effects. So far, I’ve only had one side effect: it is screwing with my sense of taste.
I have a very strong sense of taste. I can sort out very complex flavors and smells. This is why I love single malt scotch so much. It seems to have an infinite variety of flavors and smells. So this side effect is really bothering me! It adds a metallic tang to some foods and some drinks. It gives me weird after tastes that linger for hours.
But hey, if it keeps me healthy, then I suppose it’s a small price to pay. But if I was a professional spirit and wine critic, my career would be over!
[EDIT: Although the lithium gives me a metallic taste it was Orchex that was making it really bad. It's call and glandular and it doesn't work]
I’m a software developer for the Federal Aviation Administration, and I used to write a blog to share technical tips and ideas. Even though I haven’t touched it in a couple of years, it still gets a lot of traffic due to the helpful content. I decided to post something on it yesterday; just a tiny contribution to the programming blogosphere. Then I started to read some of my old posts. Mania is all over this blog. I wasn’t surprised to find that, but what I was surprised to find is the passion and brilliance expressed in many of my posts.
I didn’t just imagine that I was extremely adept, I really was. Grandiosity breeds confidence; over-confidence in some cases. It makes me believe that I can accomplish anything. But sometimes it works, sometimes I do accomplish something. And that’s just what I was able to do with this blog. I believed that through my blogging, I would eventually get to the point where I could speak at an international conference. And you know what? I did get there. I was asked to speak at an international conference. I wasn’t able to get away to do it, but I was asked. I don’t even hold a degree in computer science (music degree). But it was my grandiose belief that gave me the passion to really master my subject matter and share it with other programmers around the world.
It’s like mania gives me a high gear that’s isn’t accessible when I’m level. I WANT that gear. I need to believe that it wasn’t just the mania talking. My brain has that gear somewhere, and I feel like there’s got to be some way of getting to it without becoming ill.
I’m exploring it right now. To be honest, I’m feeling a little speedy, but I really want that passion and brilliance in my work again.
As I’ve written before, I go through periods of doubt about my diagnosis. I’m less than a year into my treatment, so I’m still adjusting. But I’ve had a breakthrough that I feel is worth sharing.
I took my wife out to dinner for Valentine’s Day. We were having a lovely time together, and then I brought up something my therapist said. She said I should try light box therapy to help with my anxiety. I expressed my concern about this therapy because of something I’d read in the DSM IV concerning light therapy and Bipolar Disorder.
Note: Hypomanic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar II Disorder.
This statement brings up two issues for me. One, I was on anti-depressants when I had my manic episode. So, have I been misdiagnosed? Two, should I be doing light therapy? Will it make me manic? I asked the therapist and she said no.
As I talked about this with my wife, she stopped me asked, ”Seriously? Do you still doubt your diagnosis?”
I told her that I did sometimes. Then we got into. Why don’t I trust my doctors. Why don’t you trust me. Wouldn’t it just be easier if I let this go. She was really pushing me on this.
Then she asked a really good question. “What is it that you are afraid of?”
Then something crystallized in my brain. I was afraid of something. I was afraid that my family just sees this as yet another way for me to be special. Another way for me to get attention. That I’m just making a big deal out of nothing.
But the truth is, my family accepts my diagnosis because they’ve seen what this illness has done to my life. They watched me turn into someone else entirely. They watched as I tried to destroy everything good in my life.
No one who knows me doubts my diagnosis. It’s a real thing. It’s not going away.
What a silly thing for me to be afraid of. Will they think I’m just not crazy enough to have Bipolar? No. Will they think I’m just seeking attention? No. In fact, they’re probably glad that I’m finally getting the attention that I need to treat the problem.
Doubts released.
For more information about light therapy as a treatment for bipolar, read Bright Light Therapy for Bipolar
For seven years I was a member of a meditation group. It bordered on cult, but I didn’t care. It’s kind of fun to be a part of a cult with secret knowledge and rituals. It don’t hurt noboooody. Plus, meditation does wonders for the mind and temperament, and lead to spiritual enlightenment. We met a couple of times a week and had group meditations, initiation ceremonies, and retreats. During that period, I meditated nearly every day for anywhere between thirty minutes to two hours. It was a very calm period for me, but there were catches
Bipolar and meditation. Here’s the thing. If you struggle with grandiosity, delusions, and obsession as a component of your bipolar, then meditation can become a problem. It’s a mind expanding activity already, but when you add those components to the mix, things can get out of control. You might believe that you have special powers, for example. It also can make things totally amazing. I was tripping big time…drug free. Also, group meditation opens up the possibility of boundary issues. Group meditation is a very intimate experience.
After having a serious boundary issue with a female member of the group (in a fit of mania), I withdrew myself. I stopped meditating altogether. That was three years ago.
Then a couple of weeks ago, I was starting to sink into depression and anxiety. I decided to try meditating. And within a few minutes, something unlocked in me and I felt good. I felt better than I had felt in months. It faded after a few days, because I didn’t meditate again.
Then my sister-in-law invited me to join the 21-Day Meditation Challenge. I think it’s time to make this a habit again. Even with the knowledge that I might get a little grandiose about it. Meditation is a good thing.
I’ll be sure to share whether or not it helps me with mania, depression, anxiety, or insomnia. And if I have any crazy trips, I’ll share it as well. For example, if I should happen to encounter a deathless, disembodied, thousand-year-old naked yogi named Babaji, I’ll give you all the details.
According to the article, Loving Someone with Bipolar, as much as 50% of people with Bipolar Disorder refuse to accept their diagnosis or refuse to accept help.
I’m going through another questioning phase. I recently read the criteria for a bipolar diagnosis in the DSM IV. At the bottom it says,
I’ve always believed that my manic episodes were at least in part due to the Cymbalta I was taking, and I wish that they would have just weaned me of the Cymbalta before starting other drugs. Maybe I’m not so bad as long as I’m not taking an anti-depressant? I feel like I’ll just never know. The doctors are dead set on their diagnoses.
But every so often, I begin to doubt my diagnosis. I mean, how do they really know? Have they ever seen me in a manic episode? Have they ever seen me depressed? It’s all based on what my wife and I have said.
But you know? I’m never going to know one way or the other. I see no way of getting out of this, while keeping my marriage intact. I’ll never be able to experiment with this theory. She would leave me. And honey, if you’re reading this, I know you are agreeing with me. And you’re probably angry that I would even consider this at all. No worries. I’m sticking with it.
Perhaps my questioning is irrational. Perhaps the anti-depressants just exacerbated my disorder to the point at which it was just so blatantly obvious that I’d have to do something about it. And maybe it’s just so easy to question when I’m well. My meds are working.
I’m sticking to the program. But it’s still hard to accept.
Even before I knew that I had bipolar disorder, I knew that I had cycles. I had enough self-awareness to know that I was productive in six week cycles. This is how I did my job, six weeks at a time. I would go weeks or months without accomplishing hardly anything and then BOOM I would get the juice and do six months worth of work in six weeks. During these weeks, I could hardly tear myself away from my desk. I skipped breakfast and lunch. I lived off coffee.
And in those six week spurts, which I now know were hypo-manic episodes, I was confident, arrogant, brilliant and successful. And when they were over I would become listless, unmotivated, dull-witted, and depressed.
Well now, I have no bursts of productivity. No innovation. No confidence. I’m trudging along. I only do what’s asked of me, and I’m struggling to even do that. Sometimes I look at my software code, and can’t even understand how I did what I did.
On the upside, I don’t get into endless debates. I don’t make inappropriate comments in meetings. And I don’t try to fuck my coworkers.
So how do I work without mania? Well, I suppose I get my work done one little bit at a time. I take it in little bites. It’s hard. I waste a lot of time blogging or listening to music or reading because some days my brain just can’t break through to get the job done.
I worry that they’ll notice, and that my job will be in jeopardy. Technically, I can cry disability. But I’d rather not. I’d rather be back on top. I wonder if my boss misses manic me. I was a work horse…at least in six week spurts.
Sorry, no advice to give on this subject. Perhaps you could give me some.
I recommend reading this article: Bipolar and the Americans With Disabilities Act
My daughter just turned fourteen. I adore her. I mean ADORE her. She’s bright, creative, hilarious, beautiful, and talented. And most importantly, she’s my daughter. In some ways I relate better with her than I do my wife. She’s silly and prone to flights of fancy, just like her daddy. My wife couldn’t have a flight of fancy if you nailed twelve foot wings to her shoulders, which is good because she grounds me when I need it.
So my daughter’s been having some trouble at school. Like attention issues. My wife and I decided to have her evaluated for Attention Deficit Disorder in hopes that we might find some way to help her. She was evaluated by the school counselor, her teachers, psychiatrist, and a psychologist.
We learned some interesting things. Her verbal skills IQ is through the roof. This wasn’t surprising. She scored high for depression and anxiety. Again, not surprising. She’s struggled with this for a number of years. She scored high for ADD inattentive. So our hunch was correct. But here’s the gotcha. The psychologist and the psychiatrist said that she is probably an emerging bipolar. I’ve seen her cycle between mania and depression many times. So it really wasn’t a surprise, I just didn’t expect it to come out in this evaluation.
I don’t know how to feel about this. I sure wish I had known far earlier about my bipolar. It would have prevented a lot of pain, suffering, and embarrassment. But I love her bursts of silliness and exuberance. I get it. I live it. That part feels good…at first. So far, it’s been harmless. The depression and anxiety is the bummer part of this. I don’t want her to suffer with that. I don’t want her to continue to suffer from insomnia. And I don’t want her impulsiveness to eventually cause her embarrassment.
Once you get the label of bipolar, it sticks forever. It means a lifetime of therapy and drugs. The doctor hasn’t put her on drugs, yet. She’s on some sort of super mental health supplement. And she takes melatonin for sleep. It seems to be helping. But for how long? How bad will her disorder get as she becomes an adult?
And the worst part is the risk of suicide. I know she thinks about it. She doesn’t think of actually doing anything about it, but I know she imagines the scenario.
There was always a good chance that one of my children would inherit this.
