Thursday, May 30, 2013

Questions and Answers - Mental Health Edition

In this post I'll be answering questions that were sent in to me about my mental health. I 

Q: I view that there is a logical part of your brain and an emotional part. At your lowest points does the logical part of your brain ever completely shut down? In other words do you ever fully believe what the emotional part of your brain is telling you – that things are hopeless - or, do you still have functioning logic that tells you that your brain is sick and that at some point you will feel normal again?
A: I completely agree with you. When I'm depressed, I lose my capability to reason. I have had people tell me (quite forcefully) that things are going to get better, but I continued to believe that they were only tricking me into staying alive. In the past I have been so overwhelmed by bad feelings that I lose my ability to process time. I'll explain: I feel like each minute lasts forever and that there is no foreseeable end. I can't be rational about the possibility of getting better or feeling normal again.

Q: Do your mood/mental cycles follow any pattern in time or are they random?   Do you track your moods/mental condition?
A: I've kept a detailed mood chart the last several months and there doesn't seem to be a clear pattern. Every day I rate my mood from -10 to +10, mark if I have had anxiety or mixed moods that day (feelings of depression and mania simultaneously), note my bedtime, wake-up time, and naps, and then mark whether I had work, saw friends, or went to therapy.

The one TMI thing is that I tend to have suicidal thoughts around my period. I know that sounds gross, but I think reproductive health plays a significant role in emotional health. According to the DSM , 80% of women deal with some kind of PMS, but a much smaller percentage deal with such extreme feelings. I'm on a special birth control pill to help me deal with this. 

Q: Is there a correlation between your “real” situation and your mental state?  If things are going really good for you does it lessen the chance that you will go into a deep depression? If things are going bad in your life can it trigger you into a downward spiral?
A: The line is blurry, but overall I can say that bad things bring me down. If things are going well, my mood can still be negative. If things are going poorly, however, it is very rare that I am still in a good mood. At this point in time, I am still learning how to deal with stress in a healthy, effective way. So when things get stressful, I sometimes have meltdowns. On the bright side, I am recovering much more quickly than I used to. My bad moods aren't lasting as long and they aren't as severe as they used to be.

Q: Can you quantify in any way how much yoga helps you?   Do the effects last longer than the yoga session?
A: Yoga provides me with 75 to 90 minutes during which I am free from my labels and responsibilities. Being active helps me feel more positive when I leave the studio, and I feel like I have accomplished something. The effects last generally through the rest of the day, unless I went to yoga to avoid homework that will still be waiting for me when I get home. Additionally, the breathing techniques I learned at yoga help me to be mindful and to control my anxiety.

Q: Does food affect you in any way? Seasons? Weather?  Exercise (besides yoga)?
A: I haven't noticed a substantial effect from food, but caffeine is a different story. I try to avoid it as much as I can, because I already have a fairly delicate sleep cycle. Caffeine just messes me up! For seasons, I notice that I feel worse in the spring, but that is because in my past I have struggled with my eating disorder in the springtime (panicking about bathing suits and shorts). Spring also seems to be the busiest season, and with the busyness comes stress. Additionally, holidays are very stressful for me and I tend to have more bad moods/feelings of emptiness. I don't notice much of an effect from weather, and at this point, I am not exercising besides yoga. Exercise has been a trigger for me, because I get obsessive, but I hope to play club volleyball in college.

Q: What do the drugs you take do for you?   Do they remove the highs and lows? Do they just reduce the depth of the lows?
A: I am on several medications that do a variety of great things. I am on Lexapro, an antidepressant, to control the lows, Risperdal, a mood-stabilizer, to limit the depth of the highs and lows (but particularly the lows for me), and Lithium, another mood stabilizer, to limit the highs and prevent mania. As I mentioned before, the birth control pill I am on also helps me by allowing me to have fewer periods that aren't as "intense."
Fun fact about Lithium: Unlike many other mood medications that require you to wait and see (6-8 weeks!) if you are at an appropriate dosage, Lithium can be monitored through blood tests after only being in your system for three days. I love this! It makes finding the balance so much easier.

Q: Do you have days where you are really happy all day or for several days in a row? If so, how often does this occur and how long does it last?
A: This is a new thing for me! In April I experienced my five consecutive days of elevated mood that were not mania in a long time. It happened again this month, so that means I'm on the right track! 

Q: In hind sight how far back do you trace your mental illness?   How old were you?
A: My eating disorder "appeared" when I was thirteen and in the 8th grade, and my depression became severe when I was 15 and starting 10th grade. I didn't think I could be bipolar until the summer before I turned 16. I often wonder if some of the memories from my childhood were warning signs. I have a distinct memory of getting so hyper while playing dolls with my best friend Claudia that I thought I was going to be physically sick. I remember her getting upset with me because I just could not calm down. She even told me I was scaring her. Was this a sign of future mania? I don't know. I also have a memory in fourth grade of getting home from school, going to my room, turning off all the lights, and lying in my bed because it "was time for me to die." Warning sign of future depression? Maybe.

Q: Given the magnitude of the problems that you have to deal with do you have trouble relating to the typical problems of your peers?
A: This one is tricky. I had these problems long before I was bipolar, and it's part of the reason I chose not to take part in prom or graduation. Most of my friends are in their twenties, and I am very comfortable with them. That is not to say I don't have friends my age or younger that I treasure; my comfort level is just different. I am much more concerned about being judged for my problems by my friends my age. I hope this answers the question.

Q: If you had a friend or acquaintance that felt they were sinking into depression what advice would you give them in 5 bullet points or less?
1) Tell someone. Your mom, dad, grandmother, friend, teacher, doctor. It's better that they know when it's just starting than to be ambushed when it's a full-blown problem and you need to go to the hospital. 
2) Keep track of your moods or feelings. It can be an Excel spreadsheet, a journal, or a stack of Post-It notes.
3) Don't be afraid to get professional help. Therapy and medication are not enemies, just small things that can help you be the best person you can be.

Okay, these are my answers. I hope they are satisfactory! If you ever have any other questions, feel free to contact me.