Archive for July, 2011
I’d been messing around with wordpress, trying to make the comments appear below the post, instead of hiding them behind a link, but all I managed to do is block access to them! They should be fixed now. … But now I’ve lost the masthead, damn…
I’ve had long stretches of inactivity, writing this blog. This may make me like many who start blogs: tapering-off writers. Titrating down on the word count until there’s nothing there, a flat silence. I start to forget about the blog altogether. Then a comment will come in and I’ll feel like writing again. So thank you, you who commented — you got me back on track.
I’m obsessed with sleep in all its stages: REM and deep sleep, the sorts of repair work that goes on while you’re sleeping. I wanted to be a sleep researcher when I was in college, but opted out of medical school.
I go to bed anywhere from 11:30 to 3am, but always wake up during the night, ravenous. This feels totally out of my control. I added Celexa to the cocktail hoping that it would flood my synapses with serotonin and kill the hunger, but that hasn’t panned out.
I know sleep and bipolar don’t go so well together, that much is clear. I just want to know how to combat it, like I’ve combatted so many other aspects of the illness.
After showing me my “normal” sleep data, the sleep study nurse practitioner gave me lots of good old sleep hygiene advice, and added a new one: cover all my clocks. This is, I guess, to keep me from thinking about time and focus on how my body is feeling – sleepy? She also told me that if I wake up at 4am – happens a few times per week – I should stay awake for the rest of the day, and no napping! Napping is a depressive’s best friend, I wanted to tell her, but I just nodded. She wants to exhaust me into better sleep, I thought.
Strangely, no lecture about my drinking 5-6 cups of coffee a day.
I’m not covering the clocks – something a little creepy about that one; it seems like an old tradition practiced when someone in the house dies.
I’m in the mood to read more about bipolar depression and hypomania this weekend. I’m considering Getting It Done When You’re Depressed. I’ve read all the Jamison. But I’d like to find more options. The Amazon page is bewildering: I have a hard time separating the fruitless self-help books from the good ones.
Any favorites?
Looking back a few years, to journal entries from December 2007, I see someone with bipolar who doesn’t know he’s got it and who’s floundering, trying to make sense of the emotional turmoil. I had to make lists like, “Things I’m not doing that I should,” and “Things I should be doing to make things better,” and “Things I have not been doing that previously worked.”
I went through months of irritable mania and despairing depressions searching for the reason why things should feel so terrible all the time, and why I should feel like doing nothing all the time. It ate up all my attention – I journaled for thousands of words on this topic, always looking for the answer to the question, “Why?” Why am I feeling the way I do right now, as opposed to just a few days ago when I felt completely differently? Why do the depressions come on so fast and saddle me with unclear reasoning and paralysis? Why are my responses to normal events heightened in a very negative way? What’s the mechanism for this?
I came up with theory after theory. The investigations came up with unsatisfying answers, like loneliness, bad upbringing, leaving grad school, paired with descriptions of the minute-by-minute of my “spirals,” which was the word I used to name my paranoid depressions. “The spiral has me today and I feel like hell,” or, “I’m not in a spiral and thank god for that.” The spiral. I had no better word for it at the time. But the word’s bipolar, and I’m glad I know it now.
I’ve read in many, many places that antidepressants can pitch a person with bipolar into mania. I was willing to risk it. I’d been coming down in mood, sleeping terribly, and waking up hungry at 2am. I asked my doc about getting on an anti-depressant to counter this. My up-moods are controllable, so I wasn’t afraid of what might happen should I get kicked into hypomania.
He was game. He’s a tinkerer, just like me. We like to adjust the medication. I get a burst of hope, and I’m not sure what he gets out of it. It just works out this way.
Hypomania did come: I found myself waking at 3am with an urge to work on something, shop, do something. I thought I was able to go without sleep, that I had too many interests to waste time sleeping. At work I was chatty yet nervous all the time, with sweaty palms. Coffee was consumed at a massive scale.
But the depression went away further. I could laugh more freely and getting out of the apartment (when I wasn’t going to work) became easier.
I reduced the dose. This is Celexa, and I had gone up to 60 milligrams 20 milligrams per jump, so I took it back down to 40. The hypomania eased, though there’s still a little left, and my sleep has been remarkably better.
Tinkering sometimes works, although I think I’m too into it. That hope of finding the right drug this time presses my buttons. Continually looking for that productive, happy, chatty hypomania without the nerves and urges, which I get so rarely – that Teddy Roosevelt vim and vigor.
The other week I went into a lab for a sleep study. A study, specifically, of me. They hooked me up to electrodes – my face, scalp, chest and legs – and put a breathing monitor slightly up my nostrils. I looked like I was on life support.
The room
Despite all this, I fell asleep quickly, mostly thanks to the clonazepam I take nightly.
Then, throughout the night, technicians came into my room and adjusted the wires – it must have been 4 times they woke me up (and who knows how many times they came in and didn’t wake me up). It was strange: they were utterly silent, and in my half-awake, twilight consciousness there was no shock or fear, just an odd feeling, like I’d been kidnapped by gentle aliens. No probes.
I woke up at 5 am, as I normally do. Sometimes earlier, which is what landed me at the study in the first place: waking way too early, hypomanic.
I’d been waking up at 3am a lot, wide awake and ready to go. I often feel a strong desire to shop when this happens, a classic sign of mania. Spend! Acquire! It must flood my synapses with dopamine because it’s so much fun. A funny sense of fun.
I went back to the sleep study center yesterday to get my results. The nurse asked me dozens of questions about my health and sleep habits. Turns out, I do not have sleep apnea or other respiratory problems. I’d been expecting some wild print-outs showing that my brain is out of control. I’d even been hoping for it: evidence in black and white that I do indeed have bipolar II. I long for the day that there’s a blood test or whatever to determine where one stands on the bipolar spectrum. Some reassurance for when I’m badly depressed or paranoid that yes, I do have an illness and these emotions are caused by the disorder.
In the end, I was given a long, detailed and pleasantly professional lecture on sleep hygiene. In other words, we have nothing to help you. They punted back to my shrink. I went home majorly relieved about the sleep apnea (who wants to wear that device while trying sleep?) and pleased that there’s nothing wrong. Maybe I don’t want the print-out after all. I’m happy with normal.
