Not at my best...

It's been awhile since I've been on medication. I'm pretty par with the average consumer that I loathe the side effects of anti-depressants and I'm probably better than average at finding other ways to cope. Notice I didn't say healthier ways, just other - although as I've grown older I've tried to avoid self medicating with substances or food. sigh... key word - TRIED. Sometimes I'm pretty good at avoidance.... sometimes what I'm avoiding isn't necessarily what I should be avoiding.

I'm pretty much free falling at present - enough that I think I may have no other choice but to go to my doc and ask for meds. Again. This in and of itself, is not making me feel better.

I know that my current depression is mostly due to my reactions to some very specific current events, some of them personal and some of them the world at large. I tend to soak up the free floating anxiety that our current economy and pre-election hysteria send out to the ether; like many with depression, I feel everything personally and intensely. I just spent a full week in a training to become a WA State Certified Peer Counselor and came home pretty shook up. (Imagine a week of intensive group therapy.) Then I had someone I thought of as a friend tell me she is "done," (with me? I assume) - leading me to ruminate on how she got to "done" without me even guessing that there was a problem. ( I will think this to death. It will be my fault. Can't maintain even the most rudimentary adult relationships - just like your mother - bladdda, bladda, blah.)

The level at which I am NOT coping right now is pretty clear. Binge eating is being narrowly avoided, or not avoided depending on your point of view... I'm bingeing but on pretty low calorie fare so it hasn't left me feeling a complete failure... only a minor one. I'm avoiding social contact. I'm a complete bitch to my poor husband, because he's around me enough to catch the brunt of my misery. I haven't started drinking for relief. I cry myself to sleep after an hour or two of mindless mental activity to wear me out... or I have to take something to sleep - tylenol PM or Xanax (down to my last 6 pills and hoarding them. Don't really want to go the doc.)

Is it enough for me to say that I need help, even while I'm avoiding getting it?

Older. with Bipolar.

No sour grapes for David Zagorsky—the acronym GRAPES means something quite the opposite for this vibrant 63-year-old living in seaside Del Mar, California.

Zagorsky participated several times in a cognitive program that taught him to incorporate these words into his daily life: 'Gentle, Relaxation, Accomplishment, Pleasure, Exercise, and Social.' GRAPES, he says, are great motivation. "Just do a little of each. For example, walking to the local convenience store accomplishes both the exercise and social components."

Sometimes you'll need to dig deeper, Zagorsky admits. "When you're really down, challenge yourself, and say, 'I'm going to get up at a certain time and move on with my day. I've just got to do it.' You give in to this illness, and you're done." He knows that maturity means being able to handle what is often a full plate. "Go to work on behalf of other people to escape your own misery."

The determined and reflective Zagorsky, diagnosed with bipolar I at age 24, is a dedicated facilitator at the peer-to-peer Depression and Bipolar Support Alliance (DBSA), San Diego chapter. He relies upon his "three-legged stool"—medical management, a skilled therapist whom he trusts, and his family and friends. These friends include his DBSA group, which meets each Monday "because illness does not know vacation and it's not a walk-in-the-park illness, but one that is chronic and cyclical," he says. "You never know when it's going to sneak up on you again, so be aware of 'gradations,' those subtle changes."

Read the rest of the article by Stephanie Stevens here.

Anger Management

Mood specialists are careful to distinguish between occasional hot flashes of anger and the long-simmering irritability and rage—angry outbursts lasting over several days, during both manic episodes and agitated states of depression—that is symptomatic of bipolar disorder. During a manic episode, experts say, mood changes can swing from irritability to euphoria to depression—all within a 25-minute period of time.

“Instantaneous anger that lasts a few minutes and occurs twice a week is not bipolar, it’s being angry,” says David L. Dunner, MD, FACPsych, director of the Center for Anxiety and Depression in Mercer Island, Washington. “Irritability can be present during highs and lows, but irritability without elated mood makes me suspect the illness may not be bipolar.”

In other words, everybody gets angry. Just because you have a head-turning temper tantrum doesn’t mean you have bipolar disorder. Anger is a common response to both physiological illnesses like cancer and heart disease and mental illnesses such as intermittent explosive disorder, major depressive disorder and substance-induced mood disorder.

“As bipolar disorder receives more media attention, it’s easy for any type of abhorrent behavior to be attributed to it when in fact, this has to do with one’s temperament,” says Ronald A. Remick, MD, a consultant psychiatrist at St. Paul’s Hospital in Vancouver, British Columbia.
“Bipolar patients are not angry, hostile, irritable people with short fuses,” he emphasizes. “If people with bipolar illness have anger issues, they have anger issues.”

It is, however, a side of bipolar disorder that has long passed under the radar screen. Many people with bipolar say that uncontrolled anger has destroyed their marriages, families and personal relationships, ruined their careers and left them emotionally isolated...

ANGER MANAGEMENT 101

Here are some suggestions from both doctors and patients to help you get a handle on your anger.

• Ask yourself these questions when you feel yourself on the verge of anger: Is this really what I want to do? Do I want to have this conversation or explosion now? Maybe I should wait until I feel better. Answering “no” could buy you a few precious seconds to consider your next move,” says Roy Perlis, MD, MSc, medical director of the Bipolar Clinical and Research Program at Massachusetts General Hospital in Boston.
• The same goes for email. Don’t let loose too soon. Print is forever.
• If you’re prone to anger outbursts you know it by now. “For some people, this feels like a panic attack, a rush of adrenalin, heart pounding, skin flushed,” says Perlis. Have a plan in place about how you intend to RRespond—and keep to it.
• Remove yourself immediately from the situation. That’s appropriate especially if you’re a parent with a child or even a pet owner. At work, excuse yourself and go to the restroom.
• Explore relaxation techniques for managing anxiety, like visualization, listening to music, or maybe doing a task that distracts you.
• Exercise daily.
  
• Communicate with your doctor, advises Sharon Lyons. And be creative, like Jeff McDonald, who shouts the odd-sounding name of Providence Bruins hockey goalie, Finnish player, “Tuukka Rask!” Why? “It makes me laugh,” he says.

Excerpt from Stuck on the rage road in the Fall 2008 issue of bp Magazine

(I'm out of town until Oct. 18th... am attending WA State Peer Counseling Training... sort of mental health camp:)