Bipolar 2 From Inside and Out

Posts tagged ‘my experiences’

Overeating and Bipolar Disorder

When you think about co-occurring disorders associated with bipolar disorder, you generally think of drug or alcohol abuse. But there’s another one you should consider: eating disorders.

For example, binge eating is a problem that many people with bipolar experience. Both conditions typically begin at a fairly young age. Both are experienced in cyclical patterns. And both are associated with changes in energy levels and eating patterns.

There’s scientific evidence that the two conditions are related. For example, research has shown that 30% of people with bipolar disorder also have problems with binge eating, Binge Eating Disorder (BED), or bulimia, and more than 9% of people with BED also have bipolar disorder.

The two disorders are intertwined, affecting each other. Someone experiencing a manic episode may be likely to overeat or binge, probably because of impaired impulse control. Depression, on the other hand, may lead to decreased appetite and low energy that makes it difficult to prepare food.

That’s not always true, though. The revved-up feeling of mania can lead someone to skip meals. Depression can lead a person to eat more “comfort foods,” which are often laden with carbs and sugar, as a coping mechanism, however maladaptive. These foods may increase serotonin and so make the person feel better temporarily. Either way, the over/undereating can cause stress while shopping or preparing food, or result in dissatisfaction with body image.

Medication for bipolar disorder can also have an effect on eating behaviors. We all know that certain drugs cause weight gain as a side effect. Antipsychotics, for instance, may contribute to increased eating because of changes in the brain’s reward system and a decreased ability to tell when you are full. And weight gain may lead to cycles of bingeing and purging.

Research has also shown that people with co-occurring bipolar and an eating disorder also may have PTSD, indicating a possible link between the conditions. It’s thought that people who have experienced trauma may use eating as a control mechanism.

At any rate, the combination of the two disorders is complex, and it’s likely that a person with both conditions may need help from a team or a holistic approach to treatment, both psychological and medical. It’s been suggested that topiramate (Topamax) or lamotrigine (Lamictal) can be considered, as these mood stabilizers don’t appear to result in weight gain.

Personally, I had a combination of the comfort food eating/skipping meals cycle. When I was in college, my weight fluctuated from roughly normal to too thin. Since then, thinness has not been a problem, possibly because of the medication I take. I certainly have a desire for comfort foods like mashed potatoes, pasta, and large amounts of cheese. One of my crazier comfort foods has been ridged potato chips with cream cheese, topped with M&Ms. My husband knows that when I want those particular ingredients, I’m sliding into depression. Lately, I’ve been swinging between comfort foods and skipping meals. On the other hand, I’ve lost 18 pounds since the spring. (My doctor asked me how I did it and I replied, “Eating less” rather than “skipping meals.” He thought I meant portion control, which I do try to do.) My bipolar disorder, while mostly stable, is still a cause of (less extreme) mood swings. My eating habits are likely just that—habits that I need to break. And I need to increase my activity, which should be easier once I get my knees replaced.

At any rate, I’ll try to keep an eye on my consumption and ask my husband to help me when it comes to eating better. Now that the holidays are almost over, it’s time to get back on track. Losing another 18 pounds sure wouldn’t do me any harm.

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Hello, Post-Traumatic Growth

I’ve had my share of trauma in my life. There was trauma in my childhood starting with relentless bullying, including children throwing rocks at me. I still remember crying into my mitten, my tears mixing with the blood. There was trauma in my young adulthood from self-harm to the gaslighting and implosion of my first serious relationship. There’s been trauma of various kinds since I’ve become an adult, when many of my traumas became lumped into the effects of my newly diagnosed bipolar disorder. When my psychiatrist said that I needed ECT, that was traumatic, too.

But I’ve recovered from all those traumas. (At least I think I have.) In fact, I may have experienced what’s called post-traumatic growth (PTG).

Post-traumatic growth is when you come out the other side of a trauma and experience positive changes in five spheres of your life. These are often listed as: appreciation of your life, relationships, personal strength, new possibilities, and spiritual change. PTG is usually discussed in connection with PTSD, sexual violence, and near-death experiences. By those measures, I guess what I experienced was really resilience, the ability to bounce back from hardship. Only one therapist has ever suggested that I had PTSD from the emotional abuse I suffered and, at the time, I dismissed it as unlikely. Now I wonder.

I do appreciate my life more now. My relationships are stronger and more stable. My personal strength is vastly improved. I have responded when new possibilities entered my life. My spirituality has evolved. I feel like a new person, a stronger feminist, a better person, better able to make and develop new relationships.

This is not to denigrate the experiences of anyone who has experienced PTSD, a near-death experience, or sexual violence. I understand that my experiences are nowhere near those traumas. But I’m not here to compare traumas. I’m here to talk about the aftermath.

Some people may experience PTG in the immediate aftermath of a life-altering experience, but I think that’s rare. It can take years or never happen at all. Therapy is likely to be a part of achieving PTG.

There are circumstances where PTG is assumed to be instantaneous, or nearly so. Cancer is a life-changing diagnosis that can take you through the five stages of grief. But, in the case of breast cancer, some people are expected to demonstrate PTG almost immediately. Barbara Ehrenreich has written about her own breast cancer diagnosis. She pointed out the number of people who, quite soon after their diagnosis say that it was the best thing that ever happened to them or that “cancer is a gift.” Ehrenreich noted all the pink ribbons and cheerful positivity that ensued. It was as if people with that diagnosis were not allowed to feel frightened, angry, or bitter.

But for most people, it takes time. The five stages of grief don’t occur according to anyone’s timeline. It’s personal. No one can tell a sufferer what they should feel or when they should feel it. In fact, those diagnosed aren’t even supposed to think of themselves as suffering from cancer. They call themselves survivors rather than victims. Acceptable reactions are strictly limited. How different is that from when people with psychiatric diagnoses are told to simply get over it?

Both resilience and post-traumatic growth are good things. I wonder if they’re related—if people who have resilience are more likely to experience PTG, or if people who demonstrate PTG then become more resilient. And I don’t know if we’ll ever find an answer to that.

But whether either explanation proves to be true, I’m just thankful they both exist. And I feel deeply for those who fight trauma without either one. They need help in any way they can get it, but likely through professional help. I know that whether I am resilient or have PTG, professionals have helped me. And so have non-experts who have supported me on my journey. I thank them all and wish the same for others.

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Mania, Overthinking, and Costa Rica

I’ve had a bad spell of overthinking lately. It’s related to a bad hypomanic episode that I had lately. I had it in my head that my husband and I needed to move to Costa Rica. Of that I was sure. (Why Costa Rica? Of that I wasn’t sure.) What I couldn’t decide was whether we needed to go to Costa Rica for a week or two to scope out arrangements before we took the proverbial plunge.

At first, I had been exploring whether there was any real estate for rent at a reasonable price in or near the town of Grecia, which I had somehow fixated on. (Why Grecia? Again, not a clue. That’s about the last thing I’d need to decide and arrange for if we were to move.) I was researching the cost of living, the health care system, and the cuisine. I was practicing in my head the Spanish that remained from my high school days, supplemented by “essential phrases” that were listed online. I looked up what papers were needed and how long you could stay on a temporary visa. I checked on whether we could bring our cat.

It kept me awake at night. After I take my nighttime meds, I usually read for about a half hour before I shut down my brain and try to sleep at night. But I had no such luck. The arrangements, the language, and the travel all occupied my thoughts. I would give up on sleeping, try reading for another half hour. Then the cycle would start all over. For the first time in a long time, I need sleeping pills—the 10 mg. ones. Even then, sleep didn’t come easy.

My husband pointed out that maybe it would be better if we went to Costa Rica for a week or two to see how we liked it before we made the move. Instantly, my mania switched in a different direction. I began working with a travel consultant on what cities or attractions (in addition to Grecia) we might like to see. Anticipating a chunk of money coming in (another manic fantasy), I researched flights, even selecting flight times and layovers as well as costs. I selected dates, then revised them based on seasonal prices. Again, I couldn’t sleep for running over the arrangements in my head.

At last the mania and the planning eased off. The fantasy funding fell through, as I should have realized it would. Along with it, my mania retreated and my overthinking stopped—at least for the time being. My overthinking backed off too, at least on the subject of Costa Rica. Now, what I have to overthink is my writing assignments, which seem to have multiplied while I wasn’t looking. I’ll make money, but not enough to get me to Costa Rica.

At any rate, I’m happy to say that I’m back to where I was before the mania and the overthinking—back to sleeping without sleeping pills, anyway. Now all I have to overthink, besides the writing, is our upcoming trip to Florida, which provides plenty of fodder. I’ve prearranged everything I can think of, but I’m sure there’s something that I’ve forgotten or that is completely out of my control. And I hate that feeling. It leads to other things that are out of control, like thinking and mania.

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Completing Therapy

In a sense, there’s no such thing as completing therapy, and in another sense, it’s necessary. Right now, I’m trying to balance between the two poles of that spectrum.

I know that, barring any unlikely miracle cures (which I don’t anticipate), my bipolar disorder is something I’ll be dealing with for the rest of my life. On the other hand, I have on occasion achieved periods of stability in which therapy was no longer a necessity.

Sometimes it’s been my therapist who has encouraged me to leave treatment because they didn’t feel that I had symptoms severe enough to require further therapy at that time. I was, if not cured, stable enough to function well without weekly or biweekly boosts of psychological or psychiatric tune-ups. (Once, when I left therapy this way, Dr. L. told me solemnly, “I hope you don’t think I’m rejecting you.” I didn’t, but I thought it was nice of him to bring up the subject.)

Once I quit therapy because it was supremely unhelpful. It was couples therapy, and it wasn’t achieving its goals. The therapist sided with my husband and shredded me. After a few sessions, I refused to go back.

Sometimes, my therapy has quit me. I had a very good relationship with Dr. R., my psychiatrist, who retired and moved across the country. I knew I still needed the services of a psychiatrist as well as a therapist, so I began the long search for another practitioner who could help me, had an opening, and would take my insurance. It’s a process much like interviewing candidates for a job. You need to find a good fit (i.e., one who won’t shred you). At the time I mostly needed someone who could supervise my meds, as I was seeing a therapist for my ongoing psychological issues.

I stayed with that therapist for years. It began to become clear that perhaps I should leave therapy when I needed therapy less often—once every other week instead of every week, then once every three weeks, and eventually every month. Even when we still had sessions, they ran short because I didn’t have immediate issues that needed to be addressed. And her advice consisted of “Look how far you’ve come” and “Keep doing what you’re doing.” When she moved to a new practice, I had one or two more sessions, then ended therapy. I kept her number, though. You never know.

Right now, I am considering leaving therapy with my psychiatrist for purely practical reasons. Dr. G. only sees people on Thursdays and Saturdays till early afternoon. At the moment, my husband works both those days and hours and we have only one working car. I see Dr. G. four times a year for med check, but it’s becoming increasingly problematic for Dan to get time off work to take me to appointments. I suppose I could take a Lyft, but it’s another expense I can’t afford. Perhaps I should look around for another provider closer to me with better hours. If I can find one that doesn’t have a years-long waiting list, I mean. (I’m told that I need to get a referral from my PCP to get one in-network.) Or someone else in Dr. G.’s practice who would be willing to take me on. (I have to go to the office and fill out a form to accomplish that.) Either way, no guarantees.

There have been times in my life when I felt stable enough to go without a therapist or psychiatrist. Right now, though, I’m having issues with anxiety, hypomania, and insomnia, so I need someone at the very least to prescribe or tweak my dosages.

Most of all, though, I hate the process of finding a new psychiatrist—interviewing them to see if we’re a good fit, telling them the Reader’s Digest version of my screwed-up life, getting my records transferred, and the rest of the tap dance involved.

Wish me luck.

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Finding Intimacy

What do you think of when you hear the word “intimacy”? Sex, right?

That’s a part of intimacy, but it appears nowhere in the American Psychological Association’s definition. There, it says, intimacy is “an interpersonal state of extreme emotional closeness such that each party’s personal space can be entered by any of the other parties without causing discomfort to that person. Intimacy characterizes close, familiar, and usually affectionate or loving personal relationships and requires the parties to have a detailed knowledge or deep understanding of each other.”

Let’s take a look at that definition. “Extreme emotional closeness” is pretty understandable. But note the word “extreme.” It implies that intimacy is more than ordinary closeness. We have friends whom we are close to, but not intimately close to. They may be friends we can talk to about our troubles, share our stories with, be close to, but still not share that extreme emotional closeness. You’re not necessarily intimate with a best friend, though of course it’s possible.

The next part of the definition is more troubling to some. That part about “personal space” being entered by “any of the other parties.” It implies that there can be intimacy among more than two parties. To some people, that sounds like cheating or polyamory. But that’s when intimacy implies only sex.

Personally, I have a number of intimate friends, both male and female. That’s not to say that I’m promiscuous, bisexual, polygamous, or polyandrous. What I mean is that, as the APA definition states, we “have a detailed knowledge or deep understanding of each other.”

What does it take to get that detailed knowledge and deep understanding?

What are the qualities that foster intimacy?

Time. I’d say that, for non-sexual intimacy anyway, time is required. I can’t say how long that is exactly, but I do know that it isn’t instantaneous. You may feel an instant connection with someone you meet, but that’s not intimacy. I felt an instant connection with someone I helped through a public breakdown, but our intimacy had to grow over the years. Now I do count him as an intimate friend.

Sharing. You don’t have to share everything, but some sharing is essential. It may be seemingly superficial things like a love of country songs or a television show, but that’s only part of it. The intimacy kind of sharing involves actual sharing of thoughts, ideas, and experiences. You don’t have to agree on everything, though there are usually some non-negotiables. But for intimacy, you shouldn’t be afraid or embarrassed to share the truths about and inside you.

Laughter. Nothing bonds two (or more) people like laughter. Intimacy can be enhanced by laughing at the same things. A good belly laugh, the kind where you can’t stop and can’t breathe, is what I’m talking about. Or the snickers that you both have to suppress because you know you’re in a place where you can’t express it until you’re alone.

Help. For true intimacy, this is probably the most important quality of all. Someone you feel intimacy with is someone you can turn to when you’re at your lowest. Someone who understands or even if they don’t, will hold you closely in their heart or spirit. Physical help or financial help is good, but it isn’t required.

For those of us with SMI, it can be hard to feel intimacy. We may even fear intimacy because we’ve been betrayed by someone we’ve felt intimacy for. It’s difficult—or sometimes impossible—to get past that, but if you can, and you can open yourself to that extreme emotional closeness once again, intimacy with someone new is possible. Looking for someone to share intimacy with may not work. Sometimes intimacy has to find you.

Be open to it if it does.

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Overthinking Night and Day

Like many people with SMI, my superpower is overthinking. In fact, even as I write this, it’s 2:30 a.m. I can’t sleep because I have hamster brain, a phenomenon I’m sure will be familiar to most of you.

I’ve got plenty to overthink about. I’m starting a new writing assignment and am confronted with a big, messy outline that I didn’t write and have to make into a coherent book. We don’t have the money to get a plumber, only the downstairs toilet works, and there’s only a trickle in the showers. Between the two of us, over the next six weeks, we have a total of six assorted doctor appointments coming up, for everything from nail fungus to heart meds to psych meds to test results to steroid shots. There’s the trip we have booked in January to see Dan’s 96-year-old mother. There’s our senior cat whose health is holding for now, but who knows? Pick any one. Or two. Or more.

If only overthinking were productive. Wouldn’t it be great if all that thinking led to creative problem-solving? But no. The problems remain and continue rolling over and over.

Overthinking is tied to anxiety, at least in my case. I do have an anxiety disorder, so my overthinking is something prodigious. And, as exemplified by the hamster brain analogy, it’s cyclical. Anxiety causes overthinking causes anxiety and so on and on. The more out-of-control your problems are, the more out-of-control your thoughts become.

Overthinking is also a symptom of other mental disorders, such as PTSD, OCD, and depression. Another perhaps related phenomenon is intrusive thoughts, the ones that seem to appear spontaneously in your mind for no apparent reason. Perfectionism can be involved, too, if you obsess about doing everything just right. Catastrophizing and all-or-nothing thinking can also contribute to overthinking.

But those are facts. And overthinking has little to do with facts. Take that upcoming trip, for example. The flights are booked, the accommodations are arranged, the rental car is reserved. All three are already paid for. All this was taken care of months ago. But I still overthink. I check the airline reservations to make sure they haven’t changed (they did at least once, with a layover in a different city). I hope we can get an accessible condo. I worry about paying for gas and food. I feel panicky about getting to the next gate during layovers. I have done everything I can think of to make sure the trip runs smoothly, but still…

It’s exhausting, so it’s ironic that I can’t sleep.

How to stop overthinking? Mindfulness and meditation are often recommended, but those don’t work for me. I just can’t shut off the over-thoughts long enough to accomplish them. Distractions are another recommendation, and I try that, but they only provide temporary relief. Reframing negative thoughts is yet another suggestion, but I don’t know how to reframe having to go downstairs to pee in the middle of the night. Self-acceptance or self-compassion, forgiveness, and gratitude—nothing seems to work.

I do take antianxiety meds, and I do have permission to take an extra one if I have more than usual anxiety. I have a prescription for a sleeping aid, but I don’t like to take it very often. More often I just say the hell with it and get up, read or write or watch TV. My sleep-wake schedule is off for days, along with my meals, but if I can just stop the thoughts for a while, I’ll take it.

For me, overthinking happens mostly at night, but it doesn’t have to. There’s plenty of fodder for overthinking during my waking hours. Perhaps I just don’t notice it as much because during the daytime I’m usually doing something that distracts me from my thoughts. Today I was overthinking how to get an accessible room at the condo where we’re staying in January. I made phone calls and stayed on hold, but I got put off until four weeks before the trip. That started me overthinking about what to do if we can’t get an accessible room. I’d have to get one of those shower substitute wipes they use for people who are bedridden. Then I started looking those up online. Maybe I should order some, just in case. Or, I thought, I could wash up in the sink every day. Or some combination of the above. It’s ridiculous how long I spent contemplating the possibilities. All I really have to do is request an accessible unit when I show up, and they’ll tell me whether one is available that day. But do you think I’ll be able to wait until we show up? No, I’ll keep overthinking it. And get the wipes just in case.

Because that’s just what I do.

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When Couples Therapy Works

Couples counseling is never easy. It’s hard enough to have one person discussing their problems with a therapist, much less two. Two opinions. Two versions of reality. Two sets of problems. Two emotional whirlpools. Two perspectives. Two of everything.

And one therapist. One person trying to understand the dynamics. One person listening to two stories. One person trying to help two individuals and to help a couple.

It’s a wonder it ever works.

But it can. It does. Not always, but sometimes.

My husband and I have been to couples counseling three different times. Two of them helped. One didn’t.

One was a long-term round of therapy when we were much younger, trying to work out some of the typical problems that young couples face. We weren’t fighting, but we didn’t know how to live and work together well.

Our therapist was an older lady, very dignified and comforting. A good listener, she gave us as long as we needed to talk before she did. It was a productive relationship and helped a lot.

The second time didn’t go so well. It was short-term therapy, under the auspices of an Employee Assistance Program, so we had six weeks to work things out.

Except it didn’t work. The therapist took sides, and sided with my husband. She ignored my bipolar disorder (or depression, as it was diagnosed at the time) and suddenly, he was the sane one and I was damaged. She expected me to accommodate him. After every session, I felt shredded. I didn’t make it through the six weeks. At some point before that, I refused to go.

The third time was after we had a major blow-up, one that threatened to ruin us. My therapist recommended a counselor who could work with both of us. We had opposing views that were incompatible. There was bitterness and anger on both sides. The therapist gave us a safe space to say what we needed to, question each other’s perceptions, and work out a way to go on from there. Mostly, she listened. After only a few sessions, we achieved a detente and were calm enough to continue without outside help.

Three examples—uniquely ours and not representative of anyone else’s experience. Three dynamics. Three outcomes.

What made them different? Two were safe spaces for both of us, and one wasn’t, for me at least. One was long-term and might have been even longer if the therapist hadn’t retired. One was short-term and even shorter because I couldn’t continue with the process. One was positively episodic, three sessions only.

Of course, I don’t know what couples therapy is like from the therapist’s side. From my own perspective, it seemed that the process only worked when there was space—space in time, as long or as short as needed, neither cut off artificially or drawn out more than necessary. And when there was someone who listened to both of us. Comfortable physical spaces, too, not impersonal offices but welcoming rooms that looked like someone could relax in them.

Two people with multiple problems. Two processes that worked for both of us and one that didn’t.

I can’t pontificate about the process. All I can say is that couples therapy can work, and does work, and did work for us—at least two times out of three. What made the difference? I think it was the ability of the therapists to step back, listen to both of us, and not tell us what to do. They talked too, of course. They recommended books for us to read. They suggested new ways to think about things and talk about them. They absorbed the bad feelings in the air and didn’t deny them. But in their presence, it was possible to think, to listen, and to talk. To disagree, to argue, to come back together. To heal and discover. To grow.

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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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Where Does the Money Go?

Though it embarrasses me to write this, it’s true that when I’m hypomanic, I overspend. That’s one of the ways I can tell that I’m actually hypomanic, when I go on spending sprees. Online shopping is my downfall.

I buy things for myself. I’m still in search of the perfect bra, and I like to have a good supply of underwear. I buy exotic jewelry—amber, picture jasper, zoisite—this despite the fact that I almost never leave the house. I end up wearing the jewelry to my doctor’s appointments. And I know it doesn’t really go with my t-shirt collection.

I buy books. Lots of books. I have an e-reader with almost 2,000 books on it. I know I’ll never read all of them, but I can’t resist something really interesting or by a favorite author.

I buy presents. I see things online that I think my husband might like, buy them, and squirrel them away until his birthday or our anniversary or Christmas. Half the time I don’t even know what he’ll do with them. My latest purchase for him was an articulated copper trilobite. I figure he has a curio cabinet and, if he can’t figure out anything else to do with it, he could put it there.

I buy presents for friends, too. Recently I bought carved stone guitar picks, for no reason, for two of my dear friends who play the guitar. And I sent a friend one of his favorite treats for his birthday.

Has this gotten me into financial trouble? I’d have to say yes. We’ve had some financial reverses recently, but truthfully, we could have absorbed them better if we still had the money I spent. There’s no room left on our credit cards. At the end of the month, things get tight and we have to watch every penny until our Social Security comes in.

Of course, my husband has his own fits of reckless spending. He buys presents, too, mostly for me or his mother. And he buys lots of garden supplies, everything from individual plants to truckloads of mulch. He also indulges in fossilized wood, spheres of polished stone, antiques, and the like. He can’t resist the discount shelves at the grocery store and brings home expensive (but bargain!) delicacies like canned banana leaves and pumpkin pasta sauce. We both like to eat out.

So, how do I try to keep these hypomanic spending jags down? I do try.

First of all, I take my meds faithfully. They include a mood leveler, which I hope will cut down on the hypomania.

Second, I listen to my husband. He often notices when I’m teetering on the edge of hypomania and tells me so.

Third, I try to spend the least amount possible when I do spend money. I buy books when they are discounted to $3 or less. (When we ran out of money at the end of last month, I didn’t even look at the ads for bargain books, just deleted them.) I buy underwear only when it is on a closeout sale. I use gift cards when I have them.

I also try to set limits. I try not to buy things that cost more than $25. (Sometimes I don’t make it.) I watch for sales, free shipping, and 2-for-1 offers. When I consider a larger expense, I talk it over with my husband. (Sometimes he enables me, however.)

Then too, I’m the one who pays the bills and monitors the credit cards and bank account. Sometimes I miscalculate, but I almost always know how much is in the bank and what bills are due and when. There are times when I tell my husband how much we can spend on groceries for the week (not that he always sticks to what I tell him).

Of course, the consequences of my hypomanic spending increase my anxiety, to the point where I’m almost immobilized. (That’s where I am right now.) I’m not sleeping well, or some nights at all. But I am trying to find ways to bring in more money to supplement our Social Security and my husband’s job. But my work is unpredictable and so are my earnings. There are steady months, but right now my assignments are in a slump.

Oh, well. I guess overspending is better than hypersexuality.

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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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Mental Health

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