Sunday, April 8, 2007

Triggers

If stress triggers bipolar disorder, then eliminating (or at least reducing) stress should minimize the frequency and severity of bipolar episodes, right? Easier said than done... especially when life seems to be a string of stressful events, the perfect storm of anxiety, fear, and depression with lots of poor decisions thrown into the mix. I wonder if my reactions, responses and decisions in the wake of these major life events would have been different if it weren't for the bipolar component of my personality, but I realize that's a purely academic exercise that doesn't help me in the here and now.

Of course there are those situations that I couldn't control, like being assaulted at gunpoint when I was 19, the tragic death of my brother, losing a job when my employer filed bankruptcy, being diagnosed with a potentially fatal disease (only to learn years later than I had been misdiagnosed). I don't worry so much about the role of bipolar disorder in my reactions to these things... the fact that I'm still alive, and sane, and not abusing drugs or alcohol in their wake is significant.

But then there's the other stuff, like being unable to sustain a long-term relationship or a job no matter how hard I try, or the need to move frequently to start a new life in new surroundings - only to find that wherever I go, I'm always there. There's this obsession with workplace intregrity (see previous post), the exhilirating rush I feel when in the early stages of a new relationship, and the intensely emotional, but equally sporadic, spiritual phases I go through. How much of that is me and how much is mania? Not being able to answer that question makes me confused, fearful, untrusting of myself and very, very sad.

I imagine that everyone has triggers that are unique to them. I'd also guess that the list grows and wans over time but is a constant work in progress. Nonetheless, being aware of the triggers that we are aware of has got to be helpful in identifying when we are headed towards a bipolar episode. Maybe we can avoid the trigger altogether, perhaps we can minimize it's effect on us, or if nothing else, at least we can begin our emotional evacuation strategy to keep us as sheltered as possible from the rages of bipolar disorder.
So here's a first stab at my list of triggers:

For depression:
  • stress at work (usually frustration at incompetence, lack of integrity, or working with people who don't want to do their job)
  • conversations with certain family members who are in denial about some very serious issues
  • job-hunting, interviewing, waiting, being rejected, especially when I know I'm qualified
    stresses of owning my own business (dealing with difficult clients, losing clients, financial uncertainties)
  • settings where everybody seems to be part of a couple or a family and I'm alone
    chronic physical pain, particularly when it's cause is undiagnosed
  • persistent thoughts of past personal failures
  • the death of a loved one
  • the end of a significant relationship, particularly if the break-up is handled poorly
  • being financially unstable
  • the loss of a job
  • unsuccessful shopping trips, especially when I really need something and can't find it
  • gaining weight or not being able to lose what I've gained
  • insomnia
  • unresolved anger, about anything
  • working at a job that I hate
  • having a cluttered home and not having the energy to unclutter it
  • winter (cold, dark and damp days and long nights)
  • disasters (9/11 left me emotionally paralyzed for weeks)
  • setting unrealistic, and often unattainable, goals for myself and getting frustrated with myself when I don't have the energy to follow through

For mania:

  • a new romantic relationship (this is #1)
  • a promotion or major new project at work
  • moving to a new home
  • a new job
  • a new business opportunity or idea
It's obvious to me from this process that I have much less experience with manic episodes, I would consider those that I've had to by hypomanic rather than full-blown mania. I think that part of the reason that it took so long for me to be diagnosed is because until recently, I didn't think any thing was wrong with my hypomanic episodes. To be honest, I actually enjoyed them... so much so that I've spent most of my adult life trying to recreate them.

I've never done non-prescription drugs, but I suspect that the genuine rush I get when I'm cycling upward out of a depression feels very much the same. I can't remember, I may not even know, what it feels like to have a "normal" mood state, so my upswings are probably even more pronounced because they come at the end of a long period of depression. All I know is that when I'm "up", I'm creative, energetic, optimistic, self-confident, productive, playful, joyful, and social. Sleep is no longer as necessary, and in fact, becomes a waste of precious time. When I'm manic, I can get more done in the first few hours of the day than most people get done all day. Who wouldn't want to live like that?

It's only now that I've been diagnosed and researching mania that I'm able to recognize the downside to those manic episodes. I'm beginning to see why the relationships that started out with such ferocious intensity fizzled out just as quickly, why I get so frustrated with co-workers who appear to me to be either incompenent or lazy, why I set such unrealistic goals for myself but still beat myself up when I can't reach them, why I have dozens of unfinished projects hiding away in closets, or why I've spent a small fortune and can't really explain where the money went and certainly don't have much to show for it.

There are so many things I find odd about manic episodes... odd as in fascinating, but also odd as in scary-as-hell. When I'm manic, it seems like the most normal state for me. My actions and reactions feel perfectly normal. It's only when I "crash" that I feel as if I'm waking up from weeks of sleep-walking and I think "my God, what was I thinking?"

I liked life better when I didn't know that those high places weren't good for me. On one hand, I wonder if medication will dull my senses to the point that I lose that creative and productive spark that defined so much of who I am. Yet, on the other hand, I wonder what will happen if medication can't even out those high spots and, like a hot air balloon that's lost it's lead, I float completely out of control. I know that ignorance isn't really bliss, but it would be nice, wouldn't it?

1 comment:

Carl Kelly said...

Thanks for the blog its nice to know other people have very similar experiences.