Bipolar 2 From Inside and Out

Posts tagged ‘depression’

Promises Made

My husband and I have a pact regarding suicide. No, it’s not a suicide pact of the kind you read about in the newspapers. This is a pact aimed at preventing suicide.

Dan and I both have brain illnesses. He has depression, and I have bipolar disorder. We both take meds for them and are reasonably stable a reasonable amount of the time.

That wasn’t always true, however. At one point or another, we each have considered killing ourselves.

Dan’s episode happened when he lost a job that had started out successfully and well, but devolved into chaos, disappointment, and bad feelings. On the day he was let go, he was so upset that the people where he worked called an ambulance to meet him at our house and take him for a psych evaluation. But Dan has worked in some psych units, so he knew how to answer their questions without setting off any alarms that would cause them to keep him there.

Much later, however, he told me that he really had been suicidal at the time.

My brush with suicide came after my mother died. In the aftermath, Dan did something I thought was dishonest (I won’t go into details), and I catastrophized. I didn’t approve of his action and was alarmed when he said he would do it again in the same circumstances. I felt that if that happened, I would be compelled to drop a dime on him. Then he would be disgraced, lose his job, maybe even be subject to legal consequences. I couldn’t live with the thought of that, so I decided the only thing I could do was fix the situation and then kill myself.

If it seems like those are crappy reasons for suicide, well, they are, but they didn’t seem like it at the time. That’s the insidious nature of suicidal thoughts.

We didn’t just have thoughts, however. We had plans for how to do it. (When we were able to talk about it later, it happened that our plans were almost identical.)

What stopped us? I can’t speak for Dan, but I kept postponing the act until I had settled on a method. Then my meds kicked in and I didn’t feel the need anymore.

Now we have a pact. If either one of us thinks about suicide in the future, we’ve agreed to tell each other, generally by saying, “I’m having bad thoughts.” That’s our code for it. (If we have lesser bad thoughts, we say, “I’m having bad thoughts, but not the really bad ones.”) That’s our pact. We will let each other know if we’re feeling bad enough to consider it so we can get help for ourselves or for each other.

And when we say those words, we know to take them seriously and to talk about what we’re feeling and why. We help each other consider other, less lethal, responses. Fortunately, we have both abided by our pact.

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The Varieties of Grief

Loss and grief affect us all. If you’re lucky enough that they haven’t yet, they’re coming. You won’t know when or why or how, but they’re unavoidable. There’s no way to prepare for them, either. Loss and grief rock your emotional balance and your mental health.

You’ve no doubt heard of Elizabeth Kubler-Ross’s Five Stages of Death and Dying—denial, anger, bargaining, depression, and acceptance. (Some people say there are seven stages, including the usual five plus shock and guilt.) The stages apply to other kinds of grief besides death and dying.

The thing is, not everyone experiences grief in the same way. You may not experience all five (or seven) of the stages or not in the order they’re usually presented. You might skip anger, for example, or begin with depression. It depends on the type of loss you’re experiencing and your psychological makeup. If you suffer from clinical depression, for example, it’s easy to get stuck in that stage of grieving a loss. If you have anger management issues, you might experience that before you get to denial, or you might skip over bargaining.

Nor is there a time limit on grief. The experts say that six months to a year is a “normal” time for grief to last. Obviously, this is not hard and fast. If it takes you two years or more to return to full functioning, that’s how long it takes. No one should push you to “get over it” in what they consider to be an acceptable length of time (but they probably will).

That said, there is a condition called Prolonged Grief Disorder. When grief lasts for years and interferes with your daily life and functioning, you may be suffering from it. If this is the case, you should consider getting professional help.

Grief enters your life in any number of ways, and not always ones you expect. Here are some of the common and less common ones.

Death

Death is what you usually think of when you consider grief and loss. This is usually the death of a loved one, but it can even be caused by the death of a public figure such as John F. Kennedy or someone you look up to and admire even if they’re not a family member or close friend. Even the death of a beloved pet can lead to very real grief that often is not understood by others.

Loss

There are kinds of loss other than death. If you work at your dream job and the company suddenly goes under or you are let go, you can feel grief and go through the same stages of grief as someone who experiences a death. You might be in denial, for example, or experience a period of bargaining or anger. Losing your home to financial reversals or a natural disaster is another example.

Health

If your health deteriorates severely, you can experience grief or a sense of loss over the things you used to be able to do. If you lose a limb, for example, or are paralyzed by disease or accident, you can feel grief over your new situation and again, denial, anger, bargaining, and depression. Even normal aging and the loss of abilities that often accompany it can cause you grief.

Relationships

The death of a relationship can also cause grief. Whether it’s by divorce, estrangement, or abandonment, you suffer because of the loss. You could obsess over the good times you spent together or be troubled by memories of the relationship when you least expect them, such as when you encounter a reminder of the person.

Ambiguous Grief

Ambiguous grief occurs when the outcome of a situation is unknown. A missing child is an obvious example. You don’t know whether they’re still alive or whether they’ve been abducted and killed. You bounce between hope and despair. You may be angry at God for allowing the situation or at the police for not solving the case quickly. If you have a loved one who is homeless and experiencing a serious brain illness, you may not know where they are or if they’re safe. You imagine the worst. You could blame yourself, even if it’s not logical. Bargaining is one typical response, a case of the “if only’s.”

There are support groups for many kinds of grief, such as for the bereaved, crime victims, or those with a family member in hospice. (This could be called anticipatory grief.) Other kinds of grief, such as grief over the loss of a job, home, or friend, usually don’t have any kind of support group. Friends and family members may try to offer support, but that’s not the same as a group with a mental health professional as a facilitator. Being with other people who have also experienced a particular variety of loss or grief can be a profound relief or lead to healing and acceptance. At the least, it’s a safe, nonjudgmental space where you can process your feelings.

Grief is deeply personal. Although there are commonalities to the experience, there is no one blueprint for grief. What you experience is in some ways unique to your situation. Length and depth of grieving can’t be quantified or predicted.

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Sleeping or Not

Sleep is one of the most problematic aspects of bipolar and many other brain illnesses. With bipolar disorder, you tend to sleep too much when you’re depressed and not enough when you’re manic. For adults, the recommended amount of deep, restorative sleep is 7–9 hours. That allows someone to have the proper proportion of REM sleep, which is when you dream and when your brain consolidates memories and experiences.

To this, many of us say, “Hah!”

Right now, I’m torn between the two extremes. I’ve been having mixed episodes, so there are days when I want to stay in bed all day. On other days, I can’t get that restful, uninterrupted sleep. I wake up at around 2:00 a.m. and can’t get back to sleep until at least 6:00. I take a nap in the afternoon, and then can’t get to sleep until around 2:00. Or I’m so exhausted that I go to bed by 8:00 and again wake up at 2:00. Once in a great while I go to bed around 9:00 and wake up in time to see my husband off to work at 5:30. Those are the good days.

It’s true that I’ve had a lot of stress lately. Financial, legal, health, and emotional problems have been piling up for both me and my husband. I read at night after taking my bedtime meds, and I feel sleepy in about half an hour. But when I put down my book and try to sleep, I get racing thoughts about every impending disaster—and there are plenty to choose from. The anti-anxiety med I take does nothing, even if I take a second one (which my doctor allows).

If and when I finally do get to sleep, it’s not restful and restorative. I know that I do enter REM sleep, because I dream. One night recently, every single impending disaster combined into a vision of ultimate dread. It wasn’t just that everything that could go wrong did. They all were over the top, all my fears taken to the extreme with vivid color and sound. Worst of all, I couldn’t talk to my husband about my disturbing dream as I usually do. He was dealing with the same fears and facing the same disasters. It seemed unfair to dump my terrors on him. Although he was involved in the dream, I didn’t want him to think I was blaming him.

Along with the terror dream, I’ve had the normal variety of unpleasant dreams that express frustration or inadequacy—missing a plane, losing a competition—the kind that I can generally shrug off. Now, however, they seem to linger in the back of my brain all day.

There is one thing that helps, but I know I shouldn’t do it. That’s taking a sleeping pill. I don’t currently have a prescription for it, though I did in the past. I stopped taking it when I learned that I slept okay without it. But I still had half a dozen pills and didn’t get rid of them. I thought I might use them if I needed to sleep on a long flight. Instead, I remembered I had them during the current series of crises. And they work. But I have to dole them out carefully. I don’t see my psychiatrist until next month, and he doesn’t prescribe over the phone. I tried to make an appointment to see him earlier, but I don’t have transportation on the days he sees clients.

My best bet at this point is to hope that some of the crises resolve before my appointment and I don’t need the sleeping pill anymore. There’s a chance that some of them will, but then again, they may not resolve in our favor. It looks like more hamster brain for me.

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Meltdown

I haven’t had a meltdown in a good, long while. And I’d prefer to keep it that way. But this week, I had one.

What brought it on? As usual, too many crises all hitting at once. One of every kind—financial, legal, emotional, work, medical, and family. The kind with no obvious solutions.

Individually, I’ve had versions of all these crises before, and gotten through them somehow. I’ve developed any number of coping mechanisms that I can pull out of a hat if I need to. But the hat holds only so much. I can’t keep pulling things out of it if there are no more in there. Hence, the meltdown.

I often turn to my husband when I have a meltdown, but this time I can’t. He’s having a meltdown of his own. It isn’t identical to mine, but they do overlap. Neither one of us has much to offer the other. We do try to support each other to the extent of our abilities. But there’s no denying that we’re both depleted, with not much ability to soothe or strategize.

One thing I could do, and did, was call on a friend so I could let it all out. I’ve known him for years, and he’s seen this happen to me before. And, wonder of wonders, one of the first things he asked was whether I needed advice on my problems or just a listening ear. I chose the listening. What I needed most at that point was to let it all out. And I did.

Once that happened, I was able to pick myself back up and start coming up with solutions. Moving money around. Getting a lawyer. Gathering phone numbers and making calls. Taking notes. Helping my husband calm down when he was having a panic attack and a meltdown of his own.

Another thing I did was reconnect with my therapist. I hadn’t had a session in a few years. She had moved to another practice, I was fairly stable, and our sessions had gotten shorter and shorter because I just didn’t have issues that needed addressing. I had sensibly put the new practice’s number in my phone, just in case. I used it, and within a day heard back from her. I have an appointment scheduled for next week.

I know I’ve done the right things, the things most likely to help resolve the problems, but somehow that doesn’t help yet. I need to get all the assorted crises worked out or at least put on hold before I can return to something resembling stability. Next week will be a rough one, and my phone friend may just get another call. I don’t want to overburden him, but honestly, it’s been years since he’s dealt with me in the middle of a meltdown. I anticipate that Monday will be particularly difficult, with two crises, one major and one relatively minor coming to a head then.

I’m trying to shut down my emotions as much as possible in order to get through all this. I know that’s not ideal, but honestly, I don’t see how I’ll manage without doing that. Of course, that makes the meltdown afterward more likely and potentially more severe. I need to make sure that all my meds are refilled and try to establish a better sleeping schedule, which has been eluding me lately.

Time to make phone calls now, and more later. Wish me luck.

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Ratting Out Max

I knew Max and his wife Sheila for a long time. We went to large gatherings together. We all loved mysteries and fantasy books and swapped them back and forth. Max and I both studied martial arts and compared styles. Whenever I wrote an article for a martial arts magazine, he had me autograph it. When they moved to a big house in the country, I spent time there. We went antiquing. I got to know their children, some of whom are still my friends today.

When I was editing a magazine, both Max and Sheila wrote for me. Max sent me copy in envelopes addressed to Fearless, Crusading Editor and variations thereof. He called me a lot too, about the magazine or just to talk, back in the day before bosses monitored their employees’ phone calls quite so assiduously.

They weren’t just a couple to me. They were individual friends. And they trusted that I wouldn’t go running to the other if they told me personal things. I didn’t tell Sheila that Max had a financial reverse that he hadn’t told her about. I didn’t tell Max that Sheila had a medical issue she wasn’t ready to discuss. I figured such things were theirs to work out. And I didn’t tell Max that Sheila meant to divorce him on a certain date. Again, it seemed to me that it was not my place to be a go-between.

It wasn’t an amicable divorce. Max didn’t want a divorce at all. Sheila was adamant that she did. Max asked me to find articles on how bad divorce was for the kids and talk to Sheila. I never did. I didn’t feel it was my place.

Then one day Max called me. I knew it was going to be a serious, difficult conversation. In it, he expressed suicidal ideation. I tried all the things you’re supposed to do. I asked if he had eaten or slept recently. I encouraged him to do so. I asked if he could listen to the music he loved. I asked if he had talked to his psychiatrist or a religious counselor. I asked if he had a plan.

He did. There was a gun in the house.

And I ratted him out.

I knew the name of his therapist, and I called him. And I called Sheila, and I told her. I didn’t want her to come home from work and find his dead body.

Max forgave me for calling his therapist. He never forgave me for calling Sheila. I saw him in public a few times after that, and he was dismissive and rude. I didn’t try to maintain the connection after that.

I stayed close with Sheila for a while until she gave up on my depressive behavior, fearing that I might be suicidal, too. But that’s another story.

To this day, I miss Max’s presence in my life. I read a book or an article and think, “Max would like that.”

And to this day, I can’t feel regret for ratting him out. I feel I did what I had to for my friend. If the same situation arose today, I would do exactly the same, even though it meant losing my friend. At least he’s still alive.

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Murder and Mental Illness

Murder is associated in the public mind with brain illnesses, particularly schizophrenia, bipolar disorder, and PTSD. David Hogg, anti-gun activist and mass shooting survivor has a lot to say about the topic: “If you believe it’s mental illness, call your reps and ask that they fund mental h[ealth] programs in our schools and communities. I don’t agree it’s mental illness that causes these shootings But we do need more funding for mental health programs to reduce the growing rate of suicide.”

Hogg has said that systemic poverty, race, and hatred are bigger motivators of mass shootings than mental illness. He also notes, “I do think it’s important to note the shooter at my high school had tons of mental health stuff. From my understanding, … there were school psychologists, there were therapists, there were all these different things involved. And I don’t think one more therapist would have made the difference for him. We need to put our politics aside, and get something done.”

The assassination attempt on former President Trump has stirred up the debate again. The assumption that mental illness is the cause of public acts of violence persists. The usual suspects include bullying, psychotropic medication, and social isolation. There have also been a lot of conspiracy theories and blame tossed around. It was Democrats. It was a “false flag” operation. It was staged. It was a foreign plot. The injury was minor. The injury almost took his life. (There may well be more I haven’t heard.)

I fully expect the mental illness hue and cry to start. In fact, it’s already begun. There have been reports that Thomas Crooks sought information on major depressive disorder and was bullied at school. (He was 20 years old when he fired at Trump. Apparently, he committed no violence while at school.) I stress that these are not facts. They have only been reported in the media and tempered by the term “allegedly.”

Personally, I don’t accept such reports at face value. Media reports in the aftermath of a shooting have so often turned out to be unwarranted, misguided, or premature. I prefer to wait for more reliable, less heated reporting that comes from official sources who have actual knowledge of the situation.

I will say that major depressive disorder is a disorder that leads to violence against oneself rather than others. Even if the Crooks did have it (not proven), it seems unlikely that it was a factor in the incident. Depression more often results in suicidal ideation or attempted or completed suicide than in homicide. That he might have been seeking “suicide by cop” is even more unsupported so far and probably unknowable.

It may be true that Crooks had a mental illness, but we don’t know that yet—if we ever will—and there are other possible explanations for his actions, including garden-variety hatred, violent extremism, and political motivation.

What I do think we know is that mental illness will once again be assumed to be the cause by both the public at large and the media. They may even find some psychological “experts” who never met Crooks and never treated him to expound on his diagnosis or motivation in media interviews. That’s usually the course these things follow. Lilliana Mason, a political scientist at Johns Hopkins University, said today, “It sounds like he was relatively isolated and troubled, sad and looking for attention.”

I also firmly believe that this incident will make no difference whatsoever in the debate on gun control. And if mental illness is the cause, it will be acknowledged as a Bad Thing but will not result in any initiative that would provide funding for better care of those with SMI. A massive tut-tut and a hearty shrug are about all I expect.

I’d love to be proved wrong.

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Loneliness Reigns

For some of us, those with bipolar disorder, depression, agoraphobia, and anxiety, it’s like the COVID restrictions were never lifted. We remain at home as if we were still sheltering in place. We’ve lost touch with many of the people in our lives. The thin threads of social media aren’t enough to provide solid connections, though we’ve had practice during the pandemic.

There’s also the “reaching out” problem. We’re perpetually advised to reach out to others when we’re lonely or having difficulties. But of course, reaching out is too much to expect for many. Often, we’re not even able to make a connection when someone reaches in. Whether it’s a matter of not believing that we’re really worth someone else’s time or being submerged in misery, the loneliness of depression or anxiety does not allow us to respond.

Lately, though, there have been a lot of headlines and articles saying that America in general is experiencing an epidemic of loneliness. I don’t know about you, but for me, loneliness is nothing new. Depression does that to a person, even if loneliness is not one of the diagnostic criteria in the DSM.

Of course, the articles point out that the loneliness epidemic coincided with the COVID epidemic. People were sheltering in place, many working from home. We couldn’t get out and see our friends or go to school, church, or family gatherings. We missed weddings, birthdays, reunions, funerals. We missed seeing coworkers and friends. We even missed chatting with the people we encountered in our daily lives—nail technicians, servers, sales clerks, plumbers, and all the other people you don’t even think about missing until you miss them. Even our doctors and therapists took care of us online instead of in person.

But that’s largely over. What’s driving widespread loneliness now? Apparently, it’s a chicken-and-egg dilemma. Does loneliness come first? Do psychiatric illnesses? Recent research “suggests a correlation between loneliness and depressive symptoms, with one potentially leading to the other, although the causal direction remains unclear.”

The Journal of Clinical and Diagnostic Research has published a study that says there are three kinds of loneliness: situational, developmental, and internal. Situational loneliness involves environmental factors such as interpersonal conflicts, accidents, and disasters. Developmental loneliness appears with conditions including physical and psychological disabilities. Internal loneliness is associated with “personality factors, locus of control, mental distress, low self-esteem, guilt feeling, and poor coping strategies with situations.” Two other kinds of loneliness have been reported as well: emotional and social loneliness. It seems to me that those are the two that are behind the “loneliness epidemic” that headlines tout. Among the psychiatric and other disorders they say are associated with loneliness are depression, suicidal ideation, personality disorders as well as bereavement, Alzheimer’s, and physical illnesses.

The research is all well and good, but what’s to be done? The usual remedies don’t work very well. The report cited above recommends developing social skills, recognizing maladaptive social cognition, giving social support, and developing opportunities for social interaction. Not much help there. The last two rely on other people to provide intervention, which is obviously uncontrollable by the person experiencing loneliness. And the first two require therapy of one sort or another.

At any rate, the continued advice of the general public remains, “Cheer up,” “Get out more,” and variations on “Get over it,” as if the loneliness were the sufferer’s fault. Antidepressants may help but they don’t attack the root cause of social isolation. There are still social media, which help me a lot. But I interact with various people and groups, which not everyone is able to do. My husband gets me out of the house at times, usually with the lure of a restaurant meal. And that primarily connects me with the person I’m already most in contact with. He’s my social support. I have a high school reunion coming up, with a number of different events scheduled, but so far I’ve only talked myself into the most casual one.

Am I lonely? At times I am. But my loneliness is not the overwhelming sort that attacks many people. There are some ways to ameliorate the condition, but most of them require getting out of the house, which many lonely people are simply unable to do; having good friends who reach in (assuming that we have the wherewithal to reach back; and the long, slow slog of antidepressants and therapy, which may or may not “cure” the problem. Advertisements are beginning to address the problem of loneliness with advice to reach in and talk to friends and acquaintances who aren’t doing well, those these are minimal compared to all the ads for the latest drugs.

Obviously, there are other aspects of brain illnesses that the experts are working on more vigorously. But I, for one, hope that more research and interventions can be devoted to solving the problem, not just defining it.

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The Overwhelming Problem

screaming (Uma painting)It’s been said that time is nature’s way of keeping one damn thing after another from being every damn thing all at once. I know that taking things one at a time—eating the elephant one bite at a time—is a sound idea.

However, every now and then the damn things gang up on you. The elephant is starting to go bad and you have to eat all you can right away – to use a disgusting metaphor that I will not take any further. (You’re welcome.)

Last month was one of those months. They happen every so often. But if they happen very often, I tend to get overwhelmed. And when I get overwhelmed for too long, my brain breaks. I have a meltdown, or I decompensate, or whatever the proper psychiatric term is. In practical terms, it means that I’m severely depressed and non-functional, for longer than usual. Days. Weeks. Months. Even years.

The things that overwhelm me are quite predictable – financial difficulties, health problems, relationship glitches, and free-floating anxiety of all sorts, either my own or my loved one’s. I know that these are situations that cause difficulty for everyone, but to a person with bipolar disorder, they can seem—or even be—insurmountable. Especially when they cluster and refuse to go away.

Over the years I have become good (or at least better) at recognizing when I am about to be overwhelmed. I know the symptoms—the whirling thoughts, the jumping-out-of-my-skin feeling, the insomnia, the inability to concentrate, and the feeling that doom or disaster is impending.

There is little I can do to stave off these feelings. But I know I have to. I have to keep functioning at some level, higher or lower, to maintain the things that I want to have – productive work, a loving relationship, a nice house, caring friends, and so forth. At the time of my last major breakdown, I came uncomfortably close to losing much of that.

I try my usual remedies for anxiety, of course. I distract myself. I color. I watch mindless TV. I play stupid clicky games on the computer. I turn off my phone. But if the anxiety builds up too much, if the feared disaster is real and really is impending, none of these works. The anxiety shreds my last nerve, and the depression starts to settle in. I isolate. I stay in bed. One task at a time, I stop being able to function.

I have taken one step that has helped, however. An anti-anxiety pill is one of my daily medications—one in the morning and one at night. A few years ago, as the stress was building and approaching overwhelming, I asked my psychiatrist if I could have permission to take one more a day if I needed it.

He agreed.

I have not needed to take the extra pill every day. Sometimes I take one in the mid-afternoon if I start feeling jumpy, twitchy, or panicky. Sometimes I take one at night if I haven’t gotten to sleep within 2 – 3 hours after taking my regular nighttime pills. I know it sounds strange that a depressant helps me stave off depression, but my diagnosis is actually bipolar disorder and anxiety disorder. The med catches me at the point where the one starts to turn into the other.

I’m glad my psychiatrist trusted me not to abuse what I consider a privilege as well as a necessity. By the time I made this request, of course, we had been working together for a number of years and had built up a certain trust. I think there have been only a couple of times when I have had to take two extra pills in a day—one in the afternoon and an additional one at night. And both times, I felt guilty about it and made sure I didn’t make it a habit.

I don’t want to start gobbling pills at the least sign of difficulty. All I want is to be able to eat my elephant in peace and in pieces.

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You May Be Bipolar

If you take three different meds at night and two more in the morning…you may be bipolar.

If your therapist is on your speed dial…you may be bipolar.

If you know the difference between rapid cycling and ultra-rapid cycling…you may be bipolar.

If you have depression clothes and mania clothes…you may be bipolar.

If you’ve stayed in bed for three days and not gone to bed for three days…you may be bipolar.

If your significant other is also your emotional support animal…you may be bipolar.

If all your Facebook friends have psych diagnoses…you may be bipolar.

If your refrigerator door has 40 affirmations on it…you may be bipolar.

If you know who Gabe Howard is…you may be bipolar.

If you have a semicolon tattoo…you may be bipolar.

If you’ve ever watched a show with a bipolar character and said to yourself, “No, that’s not it”…you may be bipolar.

If Carrie Fisher is one of your heroes and you call her “Space Mom”…you may be bipolar.

If you’ve gone through a dozen medications trying to find one that works…you may be bipolar.

If you’ve ever felt depressed and jazzed at the same time…you may be bipolar.

If taking a shower is a major event…you may be bipolar.

If you keep a box of Cocoa Puffs beside your bed…you may be bipolar.

If you’ve had a yearly raise and spent it in a month…you may be bipolar.

If all these statements apply to you…you’re DEFINITELY bipolar.

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Structure in My Bipolar Days

I used to be a fly-by-the-seat-of-my-pants kind of gal. Work provided the only structure to my days, back when I was able to work in an office. It wasn’t always the same structure, depending on the job, of course. I have worked various shifts over the course of my checkered career—first, second, and third. I adjusted to them fairly well (except when I was working third shift and going to grad school in the mornings).

That all changed when I quit my last office job. I remember feeling so free. I basked in the ability to do freelance work whenever, run errands whenever, go to sleep and wake up whenever. Of course, I was hypomanic at the time, which I should have recognized because of the golden glow that seemed to envelop my days. Naturally, the crash came, along with the absence of freelance work to do. Then, when I fell into a deep depression, anything resembling a schedule fell apart. I didn’t have a specific time for going to bed or waking up, for eating, reading, errands including bill paying, and even showering. Without that structure, I had trouble finding a reason to get out of bed.

Now I’m stable on medication and therapy, and my days have fallen into more of a pattern. I still work at home, but for a company that gives me ghostwriting work. It has a built-in rhythm to it. Most of my assignments are 30,000 words long and due in 21 days. They want us writers to average 1,500 words a day. I divide that up into 750 words in the morning and 750 in the afternoon. I work weekends at this pace, too.

Fortunately, I find 1,500 words a day eminently doable. My daily schedule consists of mornings spent breakfasting, paying bills, keeping track of appointments, or making necessary phone calls (which is my usual role in running the household).

Then, mid-morning, my husband calls on his break from work. Part of the reason is to make sure I’m okay, but most of the time I’m fine and we simply talk, often about what I’ve scheduled for the rest of the week. (I keep track of his appointments and phone calls too. Sometimes I feel like I have a second job as Dan’s secretary.) After we talk, I begin my first stint of writing for the day, my first 750. I’m generally done in time to have lunch around 12:00. Dan calls again in the early afternoon, and I begin my second 750 afterward. When he gets home, we spend time together and have dinner around 7:00.

Those are my daily schedules, which I don’t really need a planner for. When it comes to weekly schedules, I do use a computer app. Our “weekend” is Sunday and Monday because of Dan’s work, but I work on my writing anyway. My calendar is filled with bills to pay by a certain date, appointments we each have to go to (which I remind Dan about), and notes indicating when my 30,000 words are due. I also make note of which weeks are for recycling. (The day before trash day, there’s frantic cleaning.) I have this and another blog that I post in on Sundays. I have a weekly internal schedule for that, too. I start writing them on Tuesdays, have them at least mostly finished on Fridays, tweak and tag them on Saturdays, and publish on Sunday mornings at 10:00.

Having these systems in place keeps me on an even keel which, after all, is my goal as a person with bipolar disorder. My days are predictable, but not boring because I don’t find writing boring, even if it’s on someone else’s topic. Does it seem too regimented? All I know is, it works for me.

This past week, I went on vacation, so for one week, my schedule was largely out the window. I looked forward to staying up late, sleeping late, having meals whenever we felt like it, spending time reading or shopping or sightseeing or watching movies whenever we wanted. Because, as much as I like my structure, I need a break from it at times. Sometimes I take a few days off between book assignments to work on other projects like organizing my jewelry armoire or my desk.

It’s a balancing act, really. Enough structure to keep me focused, but not so much that it becomes a rut. Dan’s phone calls help. Having time in the mornings and evenings before and after I write helps. And my most important routine, of course—taking my meds in the morning and at night. That’s a part of my day’s structure I never want to neglect.

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Mental Health

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