Making Meaning

I read an article recently about finding meaning in your life when you have bipolar disorder. It has resonated with me as I have been feeling lately, even on my good days, that my life has become somewhat small and meaningless.

What I mean is that I used to have so many facets in my life; my work, my studies, my friends, my creative endeavours, through which I found meaning in my life, and many of those have all but disappeared due to my bipolar disorder or subsequent treatment, shrinking my life and limiting the areas in which I might find meaning.

I'm currently only working part-time which leaves me with days when I have vast expanses of unoccupied time to fill. I understand that it's necessary for me to be working part-time at the moment; my stamina is still not what it has been and I tire easily, but some days I face an empty afternoon and genuinely wonder at how on earth I'm going to fill it. There's always TV or fooling around on the internet, but these things don't really add to any grand sense of meaning in my life, they feel like activities to mark time.

I used to occupy more of my time with friends. My illness isolated me and has left me at times feeling friendless. I know this to not be the case but it's difficult to maintain friendships when I'm sick and barely able to leave the house or afterwards, in recovery, when I'm taking such painstaking care of myself and trying not to exhaust myself. People drift away and it can feel like they've turned away instead. At the moment I'm trying to reconnect with some of those drifted friends but where previously I could pack a full day with socialising I now know I need to pace myself and do one activity per day, so it's a slow process of reconnecting with the outside world.

I think one of the greatest losses is in my creative life. I used to write plays. While I was never prodigious or disciplined in writing regularly, it was something I always had a hand in. I'm unsure whether there's a dulling down of my senses from the medication or if it's just that my brain is still too preoccupied with its own illness to contemplate anything else, but I have no inclination to write a play now and feel like I may never again. While there should be no need for a creative outlet when there is no creative outpouring, it was something I used to define my personality. But now, if I'm not creative play-writing Katie, I wonder who am I?

There are of course still areas in which I find meaning. I adore being Auntie Katie to my three wonderful nephews and I find that my role in their lives is a rich one, I hope for them as well as me. I hold a treasured place in my family, something being sick has actually made me more aware of with the care and affection that has been afforded to me in this time.

And there's also this blog. It's a solitary exercise to write this and I often feel like it's purely an exercise in self indulgence but then the feedback I get makes me feel like it is worthwhile.

This week I am beginning a course of Acceptance and Commitment Therapy with a new therapist. I suppose this also has me thinking about the meaning in my life as part of ACT is committing to values in your life, so I'll need to define them. I'm hoping this will be a guided process and in weeks to come I'll be able to tell you more about the values I am realising in my life. In the meantime, thank you for reading and by doing so contributing meaning to my small but hopefully expanding life.

Happy Winter Solstice!

My prayers were answered and it was a remarkably short stay at The Melbourne Clinic, thanks to a medication adjustment.

I was taken off the Abilify and started on 10mg of Saphris and 75mg of Effexor. Within a day I started to feel brighter and as the days went on I noticed I was less tired, my anxiety lessened and within the week I could honestly say that I no longer felt depressed, hence my discharge. It's remarkable as well what a difference the absence of side effects makes. They were only ever slight with the low dose of Abilify but there was a constant underlying sense of restlessness I experienced. So far, side effect free on the new meds, apart from the mild drowsiness after the evening dose of Saphris.

Taking the Effexor is a bit controversial for somebody such as myself with a bipolar diagnosis. Antidepressants, particularly those of the SNRI branch, which Effexor is, can cause mania and that was the real worry with putting me on it. I was concerned too that my sudden mood shift was one that was going to head into the stratosphere, but so far my mood seems stable at a positive place.

The other thing that was a huge help from my hospital stay came from a group session run on Acceptance and Commitment Therapy. The session was specifically on thoughts so I was interested in attending due to the hostile nature of the thoughts that had recently been clogging my head. In Acceptance and Commitment Therapy we are taught that we are always going to experience negative or painful emotions, thoughts and physical sensations and rather than trying to avoid or fight these we can learn to accept them and cope with them and commit to living by a set of values.

In the session I attended we were informed that around 80% of our thoughts are involuntary and they tend to predominantly be negative. Avoiding or fighting these thoughts exerts a great deal of energy and is mostly ineffective. Instead we must accept that we are having negative thoughts. The thing to understand though is that our thoughts are not necessarily important. They are not commands we must obey or the truth or threats. If we can recognise that our thoughts are not necessarily important then we can examine them to find out instead if they are useful or helpful. Then, if the thought is not useful but still present there are a number of ways to accept the thought while minimising the impact of it.

I'll give you an example, say you have a recurring thought like 'people hate me', you think this over and over and immediately your amygdala lights up and sends cortisol into your body and your heart starts beating faster and you begin to feel really bad. Rather than continuing thinking 'people hate me' (which is an unhelpful thought) or trying to avoid thinking it, which tends to make the thought come back stronger, you can try thinking 'I'm noticing that I'm thinking people hate me'. The thought is being accepted, but diffused by the language surrounding it and the impact of it is lessened.

This all might sound like psychology mumbo-jumbo but as somebody who has the thought 'people hate me' about ten times a day, I've actually found it really effective. And it doesn't just work for that thought, oh no, it works for 'I've failed at life' and 'my life is a mess' and all other manner of thoughts. Try it some time! You might like it!

Well, anyway, the conclusion is, I'm feeling pretty darn good right now. I'm inside and warm on this cold day, the shortest one we'll have this year. Even though this means we're at midwinter, I like to think positively that the days are only going to get longer from now on. And may they mostly be happy ones!

Waiting on a call

Things further unfurled.

My anxiety and restlessness kept me up at night. My concentration deteriorated. While I was away in Sydney this long weekend I started to hear a voice. It gave me compelling reasons to die sooner rather than later. The reasons started making sense. I'm waiting on a call now to say that there's a bed for me at The Melbourne Clinic.

I'm hopeful it's a short stay. I'm hopeful it will just be a simple medication change or even a short round of ECT and I'll bounce right back. I'm hopeful, and that has to count for something, right?

I'm sorry then if it's a while between posts. I'll write when I can.

Ill at ease

I had a few bad days and then things righted themselves and I got back to being me and went off and did fun things like watch new episodes of Arrested Development and book flights to Sydney to see Angels in America. But I was still worried about those bad days I'd had. So in consultation with my psychiatrist I decided to up my dose of Abilify from the piddly 10mg I was on to 15mg.

A few days later and without consultation with my psychiatrist and I have dropped it back down to 10 and if I didn't think it was a completely reckless thing to do I would stop taking it altogether.

For the few days I was on the 15mg I have never felt so ill at ease. I couldn't get comfortable. Even in my favourite track pants. Even in bed. I just felt physically uncomfortable and emotionally unsettled. It doesn't sound like much but after 3 days I was so exhausted I wanted to cry. I was desperate to know if what I was experiencing was common or likely to pass and so I did what any sensible person with the internet does and I googled side effects of Abilify.

Holy fuck! The horror stories out there about Abilify are intense. One of them claims that Abilify actually shrinks your brain! I don't know whether these posts are written by people who have now forgone all medication and swear by goji berries to keep their mental health intact or if they are people like me, desperately trying to find a medication regime that works.

All I know is that Abilify is my only anti-depressant and the plan had been that if I became depressed again we'd up my dosage as the first line of defense. Now that I know I wouldn't be able to tolerate that I'm without a lifeboat. This makes me think that I might need to try switching to a different anti-depressant, one that I'll tolerate better, not just at super low doses.

Knowing this has left me feeling, along with the residual pharmacological effects, ill at ease. I hate trialing new medication as there are never any fun side effects to withstand as you let your body adjust. I don't want to go through that wobbly stage again where nothing feels right and I can't work or see my friends. I just want things to be settled. Of course I could stay on the 10mg of Abilify and hope I'm never graced by bad times again but that just seems irresponsible.

So watch this space for news of new medication. I'm really hoping that on a pharmacy shelf somewhere out there is the right drug for me.