Running on High Octane

8 Feb 2000 – Diary
Four days into the new schedule and things seem to be working fine. Getting up at 4:30 am has been surprisingly easy, but adjusting my schedule to go to bed at 8:30 pm has been a bit difficult. Feels terribly early.

I’m definitely hypomanic or somewhere on that side of things. Everything has been too easy, too effortless.

I’ve been getting at work at 6:00 am and I have been very focused and productive. My desk has stopped looking quite like it is quilted in paper and some of my projects are again on stream, or getting there. I have the discipline to leave at 2:00 pm regardless and go swimming and I have been able to push myself at the pool (although I am out of condition). I haven’t got back to working on the web site much yet, but then again I need to fix the rest of stuff in my life too. And I’ve started back cooking and doing all the little house and car things that I am supposed to do.

Which brings up that nagging little question once again. Was I faking it in January?

Before I found out I was bipolar I used to blame myself for the things that didn’t get done and work all the harder for it. In a way I compensated well enough so that it took years before the effects of being bipolar severely affected my ongoing life. But I also took ownership and responsibility for my life.

After I found out I was bipolar I decided that it was a medical problem. I liked that idea, it made me innocent of any wrongdoings. After all, it wasn’t my fault if I didn’t go to work or skipped meeting someone or lapsed on work I was supposed to be doing. As part of my coping strategy, I stopped trying to compensate as much as I used to and my anxiety level and general frustration fell dramatically. But because I stopped taking as much responsibility as I used to when things went wrong, I also stopped being as effective in gathering the pieces and moving on. In some ways, I became less effective in managing my life after I was diagnosed as being bipolar.

The reality is becoming more complicated. I am innocent of being bipolar – that is beyond my control. And there will be days when I am helpless to do anything, to get on with my life. But my life is my life and I am responsible for that. If I think that the lack of responsibility for being bipolar means a lack of responsibility for my life, I will never really succeed. I dare not afford to think that I am ever helpless, even when I am depressed.

To be responsible means doing everything I can to keep my life moving along. When things are failing and when I am picking up the pieces I have to try as hard as I can. And then try a little harder than that. And just keep on trying.

Whenever I go swimming and I am tired, I tell myself “just two more laps – you can do that.” And I do.

10 Dec 99 – Diary
This is the sixth day of this experiment. I had a little difficulty in waking up. It seems to me that only a short while ago I could get by with six hours sleep like last night. But apparently I need my eight hours sleep every night now. I get headaches with less sleep.

Of course the headaches could be caused by taking St. John’s Wort (an antidepressant) only. I’ve been quite tense over the last few days, which is a sign of hypomania for me. I worry that I may be propelling myself into a true manic episode, but so far I’ve been missing some of the other signs – I haven’t been particularly irritable, I haven’t been obsessing on a hundred persnickety things to do (well, not too much), my jaw muscles are not permanently clenched, and I can still relax and accept that I am not superman and I won’t get everything I want done today.

Of course I’ve had lots of experience in managing my hypomanic moods and I may be actively keeping my hypomanic mood from going manic. This worries me because I could be in a potentially unstable situation and I could go manic still.

However, I am not changing the status of my medications. I am betting on my time tested ability to gauge my hypomania accurately. And I always walk around with 200 mg Tegretol in my pocket. Tegretol works extremely effectively as an antimanic on me and will calm me within half hour. Just in case I need it.

Meanwhile, the last six days have been just about perfect. If I could live my life like this I would be very happy indeed. I feel as if I am in control of my daily schedule instead of events in control of me.

I am being productive in work – I’m no longer working in crisis management mode where every task seems insurmountable and every decision is a weight on my back. In fact some of the problems in the long term tasks are unsnarling themselves, which means they were never big problems to start with.

I have started back cooking, which I enjoy immensely. Funny how there was no time to cook when I was depressed and not going to work.

The only thing I would fix now is sex. I never realised until recently that sex is far less good when I am hypomanic. A rather large part of good sex is the ability to relax and enjoy the sensations of what your lover is doing to you. But apparently when I am hypomanic I cannot relax enough to, well, just lay back and enjoy it.

And to add insult to injury, I don’t relax after sex. No luxuriously lazy descent into slumber with limbs sprawled carelessly. I’m still tense and my shoulder muscles still tight when I fall asleep.

It’s a tough call. Good food or good sex. Can’t have both. At least not yet.

11 Dec 99 – Diary
Since Monday I’ve been getting that wonderful feeling that life is good. Slightly euphoric if you will, but not unhealthily so (it’s a little sad that I have to measure and monitor even my good moods). After being cooped up in my house and the office for a month and never looking outside, I am enjoying being outside in the sunlight and the wind as I get around. It helps that the weather has been hot, clear, and breezy. Perfect beach weather.

This morning as I was driving to work I watched the morning sun spread green-gold across the park, luminous and rich. I caught my breath in an appreciation keen and subtle, like a light winter breeze against my cheekbones. There was an internal thrill that translates to me only as joy.

I don’t know if this is how normal people perceive the world, but I hope that I can always see the world this way. It has been happening all week and I have been enjoying the most mundane sights and tastes, touches and sounds. In my world of schedules and duties, it adds texture and richness.

I have constrained what I can do dramatically in order to remain stable, and I am chafing at the restrictions. However, the heightened appreciation of the senses makes the restrictions less onerous.

At a philosophical level I worry. I could get lost in the appreciation and creation of small things. But I want to feel that I contribute more to our world. There is a beauty in what I sense now, and a trap.

PS – Notice how different the writing is here compared to previously.

12 Feb 2000 – Diary
I’m starting to get a few little signals that perhaps that my week of good fortune are over and that I might be just sliding from the peak of my hypomanic period.

For the last day or two it has been harder to get off the bed. Going swimming seems to be more of a task, although when I get into the pool I work out just fine. I feel a bit hungrier more often now than at the beginning of the week although I still have proper control. When I am doing some tasks my mind has a tendency to wander, although I catch myself and finish up efficiently.

Still, I seem to be losing my edge. My quandary is what to do next. There are a few possibilities – none of which I am keen on.

I could assume that an increased dose will prevent me from cycling downwards into depression. It might. But I worry that if this is true I will need an ever increasing dose to stave off depression. I know that Tegretol becomes less effective the longer I take it – perhaps St. John’s Wort might be similar.

Alternatively I could assume that an increased dose will simply negate the depression. In effect my body will continue in my typical manic / depression cycle, but the St. John’s Wort will simply prevent me from feeling depressed when my body says I should be depressed.

Of course I will have to constantly vary the dosage of St. John’s Wort to match the manic / depression cycles. I would take less medication when I should be high, more when I should be depressed. The usual signs for mania and depression would allow me to chart my cycles and adjust the medication.

I shudder when I think about the amount of effort it would take daily to monitor myself. And how much I would worry over whether I am reading my signals right and adjusting my dosage correctly.

I also wonder happens if I miscalculate. Miscalculating and dropping into depression would set me back a month or two. Miscalculating and going fully manic – well I am not sure what could happen, but I really don’t want to find out.

I could go back on my mood stabiliser (Epilim / Depakote). However, the last time I took it, it got me stuck in mild depression. I am not keen on this option yet.

Decision for now. I will remain at the same dosage, be particularly vigilant for signs of either depression or mania, and be quite rigid in ensuring that scheduled tasks get done, whether I feel like getting them done or not. If I start to slide into depression I will increase my dosage of St. John’s Wort (all the while being careful of becoming manic). If I reach double the dose I am on now and I am still becoming depressed, I will reconsider taking a mood stabiliser. And head down to my psych as soon as I can.

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