More meds and some Med

The past three weeks have been dedicated to getting used to an increased dose of quetiapine (now up to 600mg daily) and the introduction of valproate (500mg as Epilim Chrono). The fluoxetine has stayed the same at 20mg; psychiatrist wanted to double that dose to 40mg but I tried that once before and it triggered hypomania.

So far the valproate doesn’t seem to have kicked-in. Psych says this can take 2-4 weeks and couple of 6-8 weeks before noticing any change in mood. The valproate / increased quetiapine together have had a very sedating effect and at the moment this would seem to be the only side effect so far.

It’s been a real pain trying to get the prescription sorted with GP and pharmacy; the former seems to find it impossible to write a simple repeat prescription and the latter seem inept at getting a stock of quetiapine. Though I’ve noticed the past month that several people on Twitter have also reported problems of pharmacies getting stocks of it.

The school year has now ended and in the end I managed to have only 4 days off sick. I was aiming at having 0 days this academic year, after the several months I had off last year. I see these 4 days as failure, though no-one appears to agree with me.

I’m going away on holiday to the Med; I’ve worked bloody hard for it.

 

tabs for blog2

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10 tips

My advice, from experience:

  1. Allow yourself, wherever possible, to be not well. Some days are like that; in fact many days are like that. But it’s easy to feel guilty handing your day over to something outside your control. If you have a job, it’s even more difficult. But on those not well days, take it easy: watch TV for too long; don’t shower if it’s not essential (and when is it essential?); indulge, mindfully, in your drug of choice later in the day (thanks, I’ll have a kir or white wine).
  1. Get some sleep. Preferably at night. OK, so this is totally outside our control and I really don’t know what the answer for insomnia is. Mine is chronic and seemingly without reason. It used to be worsened by night-time hypomania but I’m medicated now.
  1. Speaking of which, always – always – take your meds. Don’t change the dose without consulting your psychiatrist / doctor. Follow your medication programme closely. And if you’re bipolar then why aren’t you on meds?!
  1. Exercise isn’t the be-all and end-all; sure, a little walk on a sunny day isn’t going to hurt you. I discovered quite recently that too much exercise can trigger hypomania. So before you decide to climb that mountain, take heed to allow plenty of time and be mindful the whole time that you – not your illness – are in charge.
  1. Treat yourself. Indulge in those treats that ease your moods. Could be music – those old favourite tunes – could be chocolate (tell me about it..), could be a glass of wine (go easy, young fellow!). Don’t let it be anything destructive; hypomania rules that part of you so stand up to it, show it who’s boss. In theory at least.
  1. If you must buy loads of crap, buy cheap crap. And no, that Harley is definitely not cheap, even if it is cheaper than a yacht. I bought four USB drives the other day, didn’t need any of them but I can handle a £20 hit and they’ll get used eventually. Maybe not in my lifetime, but eventually.
  1. Do what the Walker Brothers and Edith Piaf told us and have no regrets. Don’t obsess on things. Just learn from things.
  1. Try not to kill yourself; it leaves a hell of a mess and doesn’t achieve much. It also means you’ve lost.. and you’re not a loser are you?
  1. Talk about it. Preferably to someone with ears.
  1. Get a grip. Do what it takes to stay sane. Yes, of course it’s a battle. A daily battle. Focus on the endgame: not the battle but the war. Be who you are.

Exercise and hypomania

Exercise – and this can be in the accepted sense of the word, or merely exertion above the norm (or even at the norm, whatever that is) – is not a good thing whilst hypomanic or in a mixed state.
The body and mind are already under stress and reacting as if they’re being otherwise exerted.
In this state, every molecule of my body, every fragment of nerve, every spark of nerve-ending driving muscles and breath are racing out of control. It takes an enormous amount of concentration – most of it subconscious now – to stop myself becoming more ill; more depressed, more hypomanic, more of both.
Becoming manic. Having only had (as far as I recall, which isn’t much to go on) one manic episode I have no wish to repeat the ordeal.
Because both – mixed – is when it’s worse. I often told my therapist that depressed is effectively my default state; I was probably born like it. Though it took late teens to manifest. And longer for realization that this is what and who I am.
I have no compunction about saying ‘I am bipolar’. It’s been my whole adult life and probably my childhood too. It’s all I’ve known; it’s what I am.
Exercise, above a very gentle stroll for an hour or less, depending on exact mood at any given time (and oh boy, that’s a rollercoaster in itself of course), is not good. Mentally it’s not good – I get more confused, I seem to move and exist in a slower motion. Physically it’s not good – my breathing changes and seems to control me, rather than the other way around as it should be. I get chest pains, muscle pains. Just pains. There’s a pressure in my head I really don’t like. It’s been filled with some kind of squeaky substance, perhaps cotton wool, or candy floss, or polystyrene chips from exaggerated amazon boxes. It overflows to the top of my spine, crowds the medulla oblongata, attempting to push it out of my neck or my throat. Escapes down to my ribcage. Tickles my legs, and not in a nice way.
Did I mention exercise isn’t good sometimes?
I can see, I can accept, that getting out of the house, especially when the sun’s shining, is therapeutic. For depression at a certain level and of a certain type. It can be slightly tiring then, but not exhausting. Tiring is good. It’s the difference between spending a day working in front of a computer and spending a few hours working in the garden. Physical work. Activity.
It’s getting the balance right. Like medication, like life.
I won’t be hiking up small mountains whilst hypomanic again though, trust me.