What’s Does TMS (Transcranial Magnetic Stimulation) Feel Like?

Overall, the TMS treatments through Queensland Health have been far more bearable than past ECT treatments.  After a drama with making sure I was on the same medication each day, I became stable enough to start TMS treatment.  I think the magnetic resistance level I started out at was “65.”  I’m not sure what this means, but it felt as though someone was hammering a thumb tack into the left side of hairline pretty quickly for about 5 seconds straight followed for a rest of about 45 seconds.  I do not feel it as intensely as I did before and actually find TMS to be the best part of my day.  The pain has become a good pain, and the 45 minutes of treatment distracts me from my otherwise dismal existence.  I imagine it is what getting a tattoo removed might feel like, but I don’t have any tattoos so don’t quote me on that.

I can tell that my mood is improving over the past 7 days (it was a 0, it’s now a 4 out of 10).  My energy levels have increased from about a 2 to a 5 out of 10.  After a week of treatment, I can feel some motivation again and look somewhat towards the future (ie, I can see myself planning ahead for the next 2 hours).  This was non-existent a few days ago.  My belief at this point is that TMS is working, but there are a lot of environmental consistencies that I need to see in my personal life to be able to say that the change is going to last and that TMS is the answer.  My guess right now is that it is part of the answer.  It seems to be giving me the lift I need to sort out the other shit in my life that has me going off the rails.

What has helped most in this entire process has been having well-intentioned (although painful) family members around that are TRYING to do their best.  I’m learning to let A LOT of things slide about their imperfect involvement and them not really getting it.  I’m learning to communicate what I can since communication is difficult during my depressed days and to try to ignore what I can.  I have a few people texting me daily just checking in on me.

I bought a 52-week journal that prompts you to jot down things that you accomplished for the week or or grateful for.  My accomplishments list for this week were bleak since it’s hard to be like a super-cheerleader when your biggest accomplishment was a shower, but hopefully either I will be around in 52 weeks to see how far I have come or someone that finds this book will know how much I have truly been suffering.  Either way, I see that as a way to leave a bit of a legacy to help others or myself make sense of this pain that I find so hard to escape from.

Writing this blog helps when I’m well enough to string a sentence together, but it’s hard knowing that very few (if any) people read it.  Much of the time, I’m not well enough to write.  I know millions of people with mental health stuff have blogs, and I try to make mine less about me and more about what I see in the system, what seems to be working and how things could be improved.  Maybe one day they will have a way to capture and catalog all these bloggers lived experiences to have some hard data that will change the possibilities in mental health treatment.  Maybe it’s a body of research I could even do as I improve.  Optimism folks.  That’s the word on the street that I hear works the most.  *My gag reflex sometimes reacts when someone says, “Just think positively,” but there is a glimmer of truth in that idea.  I think it triggers me because I do think positively then a wave of bipolar and treatment-resistant depression pushes me over again.  It is hard to pick yourself up over and over knowing that you will be mercilessly and cruelly pushed over and with little notice again.  But anyway, I’m learning those signs that the bad waves are coming and trying to stay optimistic that they will not come for too long or strong.  xo

Tagged with: , , , , , , , , , , , , , , , , ,
Posted in bipolar, ECT, Mood, TMS

rTMS (Transcranial Magnetic Stimulation) in Australian Public Health

rTMS Therapy has finally made it to Queensland to a Public Health Centre near me, and I thought I would share my experiences.  First off, Repetitive Transcranial Magnetic Stimulation doesn’t seem to be a whole lot like my past experience with ECT (Electro-Convulsive Therapy) because it seems like a less of a mad-doctor in a freaky lab sort of treatment.  I was referred by my psychiatrist, and the waiting period was about 2-4 weeks.  Generally, I’m pretty “stable” with my bipolar 2 (ie, I am compliant with my meds and generally cope with life somewhat).  However, my depression worsened from about a 5 on a scale of 10 to about a 0 during the waiting period in which I was to have my first rTMS.  I have probably never had such suicidal ideation, near attempts and overall life-threatening depression as I have in the past 2 weeks.  Please don’t worry about me or search my IP address to have me involuntarily committed.  I’m just telling you that I’m skating on that line of severe illness.  I wasn’t really able to talk a few days ago, so at least I can get out of bed and walk to my computer today somehow put sentences together so hopefully I’m improving.

Back to TMS – so the day of my intake involved a well-intentioned nurse with a glimmer of meanness asking me my ENTIRE life’s psychiatric and psychological history.  I was in a public health centre, and I’m generally pretty vanilla and go to private doctors so I was not prepared for this.  The rooms were very sterile with long corridors that led into rooms with 2 doors (one for clinician access and one for “consumer” access).  Nothing was on the walls but neutral paint, and there were no windows anywhere in the building.  It was eerie and cold.  I would have a hard time working in that environment.  I was placed in an interview room that had a mirrored wall, but when I asked she said that I was not being watched or recorded (yeah, like I believe that).  Anyway, after undressing me with her inappropriate and insulting questions for two hours, I was told to come back next week to be measured and was told I would be seen and questioned by a staff psychologist for about an hour.

When I returned the next week for my psychologist’s visit, she re-asked some of the protective and strengths-based questions (ie, what do you do to stay safe if you have having suicidal thoughts).  She and the nurse asked me to consent and sign (again) to rTMS.  They judged me to be doing poorly compared to my bright presentation the prior week.  It was true.  Between my appointments, my depression spiraled into a place of darkness and despair I have not ever known.  I overdid my drugs and drink (something I do not ever tamper with).  They told me that they were concerned about me and that the chemicals I ingested might interfere with my readings.

Nonetheless, they guided me into “the treatment room” that was similar to a dentist’s office.  I’ll try to get a pic for next time.  It had the same setup without any sinks and a large TV on the wall with my choice of two DVD’s (one of which was “Pimp My Ride).” Yipee.  I sat on a hard chair while they measured my head like they were taking my measurements for a cheap bridesmaid dress.  They pressed HARD onto my head with a permanent marker to mark the spot where they would use something that looked like a chiropractor’s “clicky tool” to magnetically charge my brain.  They held this contraption up to my head and gave me a dose of “45” and it made my fingers on my lap move like when the GP bangs your knee to check your impulses.  It felt a bit like when you get a bit of an electric shock from licking a battery or something.

The next day I was to start a course of 20 treatments held 5 days a week during 45-minute sessions without any consideration of how that timing would affect my job.  How the f*&$ do you tell your employer that you have to be away for 2 hours a day for a whole month to have “a treatment” done?  I work part-time.  I wish they could have been more flexible in providing me a time that would not cause my employers to need to know since they sell this as something you can do and still maintain your job.  Just FYI – the only local private hospital in my city that does TMS requires that you spend a month in treatment, 9AM – 2:30 PM, 5 days per week with each day sitting in 3 hours worth of open “groups” (that are actually education sessions on things like CBT (cognitive behavioural therapy) ACT (acceptance-commitment therapy, etc.)  People like me that have a background in this sort of thing would be as bored as batshit but would be obligated to give it the good ole college try because it’s a requirement of admission and because of hopes that anything might make this dreadful depression leave.

Anyway, on the morning of my first rTMS treatment at the Public Health Centre, I arrived barely able to talk and extremely depressed.  I had taken a couple of Seroquel the night before due to extreme emotional pain, and they said that because it’s not in my normal regimen of meds that they could not start TMS.  For TMS to work, they said, I would not be able to change any of my meds or drinking habits for the course of the treatment.  Given the instability of my mental health currently where I think I’m having a lot of mixed states, they graciously said that I could delay my TMS if I could stay on the same meds for a week or 2.  We’ll see how I go.  Please wish me luck and kindness.

Tagged with: , , , , , , , , , , , , , , , , , , , , , ,
Posted in bipolar, ECT, TMS

Sodium Valproate = Relief

After being on Lithium a couple of years with bad side effects and decreasing effectiveness, I changed to sodium valproate (aka Depakote, Valproate) about 8 weeks ago.  I found some useful info on this site about side effects and such that might help if you are considering switching or using this drug.  The main side effects I noticed were weight gain and severe sleepiness for the first 6 weeks or so, but those side effects are lessening now.  I’m glad I stuck with the drug because the new side effects felt overwhelming and as though I was attempting to jump on a trampoline made out of putty.

The longer-term side effects I am most concerned about are liver damage, changes in blood platelet levels and harm to an unborn fetus if I were to accidentally get pregnant.  I think I gained around 11-12 lbs (5 kilos) in a month and increased my sleep to about 2-4 hours per 24-hour period.  My weight has decreased about 4 lbs (1.5 kilos) over the past month, but I get help with this from a drug called Vyvanse.  My understanding is that it is approved for adult ADHD but has been gaining traction to treat Binge Eating Disorder (BED).  That’s what I take it for, and it has been working pretty well for me for about 8 months.  For example, my binging has decreased from about 10 times weekly to 1-2 times monthly!  There is a discount coupon for Vyvanse your doctor can hook you up with, so look into that, too. The benefit-risk ratio, that is, the amount of relief and stability sodium valproate gives me versus the side effects’ severity, is worth the current risks.

I didn’t realise some of the ways in which lithium was messing me up until I ceased using it and changing to sodium valproate.  I did this gradually with my psychiatrist’s care.  I could tell within a week after ending lithium completely that my brain felt more flexible and less rigid.  I was able to think more complexly and vibrantly again.  My nausea and diarrhea were gone.  I felt less confused and like I was no longer swimming in glue all the time.  It’s important to note that lithium toxicity is dangerous, and I had my lithium levels regularly checked and closely monitored.  These were side effects I had taking a safe dose.  The dose I needed to *somewhat* stabilize my mood was narrow and would often give me unwanted side effects.

So, what has this meant for me in practically and in real life since I’ve been settled into taking sodium valproate?  I have been able to attend work without needing to hide in an office, call the suicide line and cry to them for an hour before returning to my desk and pretending that I am a perfectly stable human being to my colleagues.  It has meant that I am mostly not needing a nap during the day.  It has meant that I can practice mindfulness (I love the Headspace App).  It has meant that I feel consistent enough in myself that I can make plans for the next day, or sometimes even a week ahead of time, and follow through with my commitments.  It means that I have consistent energy to do my mood charts almost every day, take showers, do exercise, prepare healthy food and have healthy boundaries with others.   It’s created better self-awareness.  Most importantly, it means that I have started the healing process as a parent and partner around some of the damage caused the last couple years due to my severe bipolar II, suicidality, and time doing ECT as a hospital inpatient.

To those out there reading (and I thank you heaps and heaps!), please find the right informal and formal supports, medical team and things that nourish your soul.  I NEVER thought I would be able to have a day without pain, much less a whole two months.  I’ll share some of the random resources that have really helped me in an upcoming post.  I hope they can help you, too.  Please share this if it has helped you or could help someone you know. xo

Tagged with: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,
Posted in Binge Eating, bipolar, Meds, Mood

Trauma work, bipolar and thoughts of suicide or homicide

The complexity of living with bipolar II and having a career where there I am exposed to others’ trauma is a lively tightrope walk that involves honest self-reflection, exceptional supervision and surrender.  I know some things, but I am not an expert.  If I could re-do my career, I would go into some sort of moderately-intellectually intensive but bright work like designing murals or studying and designing how human structural environments influence behavior.  I may still do that, but for now I am staying with what I know and trying to maintain employment so I can pay bills.  I choose to be a realist in that way, but I realize that I need a burnout career, and I’m exploring my options before my final burnout comes.

I kind of accidentally fell into trauma-related work because an interesting opportunity presented itself when I was fairly fresh out of university.  This pre-dated my bipolar II diagnosis, and I still do not totally know how this web of personal and professional knowledge and experience that I hold is interconnected.  It’s fucking cool though, and I love to analyse the hell out of it.  So here I go:  *Please note that I might swear a bit, use generalizations, summaries and change details to protect the confidentiality of myself and others.  Please take what I say with a grain of salt.  I do not profess that it’s gospel.  I write my posts in my pj’s, after all.  I’m not perfect, but neither are you so please only bring thoughtful and kind commentary into my world if you choose to critique my writing.*

I have a shared client who has expressed thoughts of homicide towards a past partner.  Please be reassured that I’ve done my duty of care and safety planning things.  As I was discussing this case with a colleague, I realized that I had a more optimistic and strengths-based view of why someone might disclose homicidal ideation knowing that the person they are disclosing to will likely act on the information they are given.  I thought this client was awesome to trust my colleague enough to disclose his/her thoughts of homicide.  Because I’ve felt the security and relief of disclosing suicidal thoughts to professionals and loved ones who take it seriously but do not freak out, I realized that this client was likely disclosing as a protective measure for him/herself and the person they were thinking about killing.  Now, I’ve also come across inexperienced dipshits who think the world is going to end and feel like a cage is the only way to contain a person with suicidal or homicidal thoughts, but I digress.

My point is this – when trauma is lopped upon to trauma (and even if it’s not) sometimes the main form of relief from pain is expressing what you are most afraid of AT THE CORE.  I believe this is fairly obvious, but because homicidal thinking seems so far-fetched, taboo and so hard to empathize with, I encourage others to think of it in similar ways to suicidal ideation.  It’s hard to know what feeling suicidal feels like if you’ve never felt it, but for me suicidal thoughts come when I feel I need to escape because the pain is overwhelming.  When I’m suicidal I don’t generally really want to die or feel like death, but I need someone to take the plug out of my tyres so I can decompress a bit.  Contrastly, when I am “on death’s door depressed” (for me a 0 which could legitimately result in a loss of life because I am needing hospitalization and unable to care for myself, I am not generally thinking about suicide).  Suicide would be too hard in that instance, and I already feel nearly dead.  I don’t have any research on this, but from my range of personal experience, if a person is talking about homicide or suicide, they are not generally at the point they are going to act on it.  They more likely need to talk about it to someone who is not going to freak the fuck out (pardon my French).

My normal mood range is a 6 (feeling awesome) to 0 (thoughts or feelings of death).  I can’t imagine going much higher than a 7.  I only have a few moments in my life that would rate that high, such as the moment I saw my child for the first time.  I want to make an important distinction about how my mood at 0 (thoughts of feelings of death) is quite different from thoughts of suicide.  These two things are separate and quite different from each other.  That is, I can be experiencing a 3 (feeling depressed) and have thoughts of suicide but be at a 0 (where I feel close to death) but not contemplating suicide, mostly because I am so miserably low and feeling such intense pain that coherent thoughts do not exist for me.

This time a week ago, I was at a 0.  I am now at a 5.  That’s how quickly bipolar II can flip for me.  Some people might believe that I am unsuitable or unfit for my work just yet because I was literally unable to feed myself a relatively short time ago.  There’s no doubt I need to maintain very close contact with my doctor, be a maniac about self-care right now and ease back into my normal life.  However, going to work, contributing my dynamic perspectives on trauma, risk assessment, safety and mental health gives me a way to keep my voice alive and to speak up for those that might be finding it hard to find the most socially acceptable ways to speak up for themselves right now.  I have had months off after having a major 0-level mood dip, and I believe it did more harm than good.  These days, I prefer to try when I can to jump back into normal life because it doesn’t feel like as big of a canyon stepping over from illness to wellness.  It’s how I’ve found I can maintain my dignity and identity when bipolar tries to break me.

Tagged with: , , , , , , , , , , ,
Posted in bipolar, Mood, work

Trauma Work and Bipolar

Let’s be honest, many of us go into social services, social work, psychology, sociology, etc., to make sense of our own past.  It took me over 10 years to acknowledge this and attempt to make peace with it.  I’m not making a value judgement towards others about this but stating my personal experience.  Please note that some content may trigger readers sensitive to hearing about sexual assault, child abuse and/or domestic violence. 

My bipolar II diagnosis has been long in coming.  I’m not sure if it has taken decades or years, but I have known from the time I was about 6 that I “pouted” a lot because my cousins regularly complained about this.  I never saw my behavior as “pouting.”  To me, it was INTENSE feelings of injustice, forced submission and not being heard.  I was a quiet child with delayed speech.  The pediatrician said it was because I had an older , louder high-IQ’d sibling doing all the speaking for me.  Maybe I was never able to find my own voice because I was under this high-evolved sibling.

I felt I experienced abuse as a child, but it is not stereotypical abuse or abuse where the Department of Child Safety would ring alarms.  I was a highly sensitive child.  I was ALWAYS the best behaved in my glass and sat firmly on the green traffic light in school when other boys and girls were occasionally moved to yellow or red.  I wept for days *literally* because another child tricked me into doing a task that put me on a yellow traffic light.  Talks were enough to improve my behavior, and I listened and respected intently to my parents words.  Nonetheless, I was belted (aka “spanked”) by my father and an uncle.

I did not necessarily view my mom as a super-woman at the time, but she was.  Her superwoman status came about, in my mind, when I realised that she spend most of her married life in total submission to my dad as a way to maintain peace.  My mom, previously a career woman who never cared about canning vegetables, making jams, home-sewing dresses had been transformed into this role out of economic and patriarchal pressure from my dad.  She cared about education, and she slaved to private school expectations and fees for dozens of years to guarantee we would be able to fly and be independent women one day.

This brings me to my bipolar II a bit.  I graduated from a university that only gains an “ooh or ahh!” from local, in-state residents when they hear that I attended there.  In short, I was a big fish in a small pond.  I completed a dynamic degree that could land me a top job in-state, but it’s only a pre-requisite for a mediocre job in more competetive job markets and overseas.  And overseas is where I sit.

I have worked in a trauma-related field for about 10 years now, and I love aspects of my job.  I’m great at the analysis, I love the continual learning, I like seeing people grow and expand their worldviews, and I love the writing aspect within the work.  However, I am exposed to gruesome, toe-nail curling, innocence-destroying, pain-provoking and shameful acts of some of the most horrible types of things humans can do to others.  When I first started this work, I had to talk about it non-stop.  It was the same feeling as though I watched a horror-thriller late the night before and had to freak out anyone that would listen with the shock and awe.  As I’ve matured in my career, that shit has just stuck to me.  It’s like glue that has webbed it’s way inside of every crevice of my skin into the hollows of my bones.  It sucks my life.  My marrow has dissolves with its presence.  .

So, about 5 years ago, my formal #bipolar diagnosis came in the midst of a particularly hard time at work.  I was hospitalized and underwent ECT.  My doctor has been careful to try and tease out my bipolar symptoms from my repeated exposure to trauma, but bless his heart, I don’t know how possible that is.  How do you treat a mental illness like mine when I hear about threats of gang rape to a pregnant client who is so scared she defecated on herself as a common part of my job?  I’m off of work this week because I had two stories that WERE MINE.  They were nearly identical to my lived experience of abuse when I was a young person, and I was unable to be professional me.  Usually stories do not infiltrate me like these did.  I felt tears rolling down my face, and my voice drew quiet as I told a woman, “I am so so sorry.  There’s nothing you did to deserve this.”  I could utter out the words like a mouse, but I did not have strength because I am not sure I could say those same things to myself.

I saw my doctor after needing EXTREME sleep (like 18 hours straight, 2 days in a row), and he said that he does not think I am having a depressive episode.  He said that the effects from trauma (and my work’s inability to increase funding to help me manage my ongoing, unreasonably heavy and stressful workload), were a central issue issue.  I have not been coping many hours of the day, and I’m surprised I can write this now since I have been mostly unable to get out of bed, raise my arms, eat or bathe, but I feel good about saying what I have outloud.

My next challenge is figuring out what to do about this.  In some ways, I love my work.  I’m experienced and my skill set is extremely specialized.  I receive pretty good pay, and my working conditions are generally flexible.  Moving to another career would mean a MAJOR drop in pay, and I would be hard-pressed to find a job that stimulates my intellectual side as much as this job does.  I have an unhealthy co-dependent job on my type of work.  Even with better boundaries, lowered working hours and a supportive team environment, I am missing a LOT of days of work.  That adds more pressure.  I think, “I could do my job from home some days.”  The hard part is getting up within a tight timeline, getting showered and dressed, putting on that smile showing “I’m an amazing fluffy cloud of inspiration and team togetherness,” and keeping my energy up the entire day, day after day.

I face so many barriers changing jobs including:

  • needing to upskill or go back to school (in lord knows what?)
  • remarketing myself or getting into temp-perm work for a career change
  • not being able to do “9-5″s very well because of my illness
  • depression from unemployment is highly likely to happen for me
  • being socially isolated while finding jobs
  • oh, and a biggie, not being able to afford anything while finding a job
  • not being eligible for social assistance to find a job because my partner makes too much (I still need to look into that)
  • being bored out of my mind doing work that is not challenging enough for me
  • being underpaid because I have transferable skills

If you have an advice or want to join the conversation, please do!  xo

Tagged with: , , , , , , , , ,
Posted in bipolar, work

Mood charting, boring but do it

Of the dozens of mood charts I have tried worldwide, online and on-paper, I most recommend this one by the Black Dog Institute in Australia.  I’m yet to find a mood tracking app that has the needed characteristics of this old-fashioned paper one.  If I had the skills to build my own app, I’d use this the Black Dog one as a guide.  In the hight or lows of a mood disorder like mine, bipolar II, I find it EXTREMELY hard to be consistent in charting my mood.  My psychiatrist is awesome at tracking my mood and can show me graphs over the past 5 years where my mood has ebbed and flowed.  Mood fluctuations seem to be less from known triggers in my external environment than to my internal biology and processing.

What I’ve found is that even though he has nailed down themes and patterns, I have a responsibility to bring in conversation topics since he is also trained to do the work of a therapist.  When I don’t mood chart, I only bring in the things that feel most intense on that day or that week.  When I can mood chart inconsistently, I only seem to mood chart when my moods are feeling average (for me, that’s about a 4 or 5, which he wants to improve).  I miss the most telling details of mood tracking.

The magic comes when I can mood chart reliably, day-after-day, with consistency.  Since being on my new mood stabilizer, sodium valproate, I have unlocked some mysteries about myself.  Most notably, I am stable.  Things don’t throw me unless they legit and REALLY intense to the point that anyone would find them unnerving.  For example, my mood used to spiral by the nothingness of feeling a change in temperature, an out of stock grocery item or a sideways glance of a stranger that might not even be directed at me.  My world was getting so small because any and every slight affected my mood so I worked to control everything.  Likewise, I became inspired to stay awake ’til 4 AM just because I read a cool tweet or had a meaningful conversation.  How do you remain steadfast on mood charting if you cannot lift your head one day and you are able to stay up 20 hours straight the next?  I don’t know the answer to that beyond having someone watch you do it or for them to do it for you.  That never did work for me, either.

What I’m excited to share with you is that I’m at a stable enough place now that I feel I can go to therapy and make some headway in the nuanced areas and relationships that might throw even a stable person off their balance.  I can do the real work of therapy now, not just patchwork to keep me alive until my next session.  That’s exciting.  I’m already able to do more on my own, like process knowledge from some of my favorite podcasts including All In The Mind and Strangers. I am naturally cautiously optimistic about all this due to my history of drug-resistant depression and the cyclical nature of bipolar II, but this feels a bit different because I have some confidence back in my tank.  I was about as low on self-esteem as I could get before, but knowing I have weathered ANOTHER cycle of ABSOLUTE SHIT makes me determined to make it a bit less impactful the next time.  I hope my story does the same for you.  xo

Tagged with: , , , , , , , ,
Posted in Basics, bipolar, bipolar II, Mood

Missing Work Due to Mental Illness

How can someone with mental illness become well-versed in their rights and possible accommodation options so that they don’t fear job loss every time they have a mental health time off?

Check out this site specifically about how your mental health rights SHOULD work in Australia: humanrights.gov.au

I think it’s a great tool in knowing what you could be doing and what your employers should be doing to help you out.  This information is built upon basic human rights, but I realise it is an ideal and is not what currently happens to folks like is living with mental illness.  I’d love to hear what others have to say and what other resources you recommend, especially for the state of Queensland.

Tagged with: , , , , , ,
Posted in Medical, Overall Health, work

Planning for Depression

One common suggestion for people with bipolar is to document how you would like things to proceed when you are unwell.  This is my plan.  Feel free to adapt it for your use.

Wellness Strategy (ongoing pretty much daily – this are the minimum actions I have to do to keep me well)

  • Eat a balanced diet and watch weight
  • Exercise and move as much as possible
  • Practice mindfulness and listen to podcasts
  • Drink water and avoid soft drinks
  • Take meds religiously
  • Track moods
  • Go to my psychiatrist at least fortnightly
  • Nurture my support system
  • Do not let work become higher than #3 on my priority list
  • Do essential self-care (shower, brush and floss, shave, iron, do hair)
  • Freeze healthy meals or have meal replacement shakes handy
  • Keep sleep schedule as normal as possible (9 PM – 6 AM)

Depression Strategy (when I rate a 3 out of 10 or less).  Do the above when possible plus:

  • Attend doctors visits more often, if needed
  • Get help with tracking mood
  • Ask friends/family to check on me
  • Have good work excuses ready
  • Ask for help on self-care items and try to eat healthy, easy food
  • Avoid bingeing

Super-low Depression Strategy (for when I rate a 1 or lower).

  • Make sure there is someone there to bring me healthy food
  • Have someone around that can be with me to try to keep my sleep schedule normal
  • Have someone around that will help me get out of bed and walk short distances
  • Arrange with psychiatrist to do transcranial magnetic stimulation (1st try of this, ECT done and didn’t work in the past)
  • If I’m an inpatient, have someone call me once or twice a day and visit me once a week
  • Have someone that can tell work that I’ve been ill and make arrangements for my role to be covered for 2-6 weeks.  Talk to work about this to plan (if/when appropriate/safe)

Hypomania or Mixed State:

  • Avoid going on social media.  Use crisis lines, blogging or journalling instead.
  • Listen or watch positive TV, music or podcasts
  • Avoid negative people
  • Call into work or adjust work schedule for the week.  Re-arrange client appointments.
  • Focus on repetitive cleaning or doing creative projects that are towards bigger projects that have already been started instead of starting something new.
  • Exercise more.


Tagged with: , , , , , , , , , , ,
Posted in Actions, Basics, bipolar, Health