Bipolar Fibromyalgia?

According to psychiatrist, Dr. Jim Phelps of PsychEducation.com, there may be an important but unexplored connection between bipolar disorder and fibromyalgia. Having been diagnosed with both, I'm aware of the overlapping symptoms, so a possible connection doesn't come as a big surprise. Nor should I be surprised that more research hasn't been done on this, particularly given that for years, fibromyalgia wasn't even recognized as a "real" disorder. Since fibromyalgia affects women to a much higher degree, it's one of many ailments that has long been considered a figment of our weak and easily excitable minds.

In his recent article, Fibromyalgia and Bipolar Disorder, Dr. Phelps, patients with fibromyalgia are twice as likely to have major depression as are patients with rheumatoid arthritis. Even more startling is the finding that patients with fibromyalgia are 153 times more likely than those with rheumatoid arthritis to have bipolar disorder!

In response to a post at BipolarWorld.net asking about the connection, Dr. Phelps replied that:

I've never seen a word in the literature about this, but I've sure seen it in practice -- over and over. So, to answer their question: yes, I see the two show up together. In fact, in virtually all the "fibromyalgia" patients I've seen, there is mood stuff too. Of course, I wouldn't be likely to see FM patients who had no mood symptoms at all! But my rheumatologist friend says he sees the overlap too. But the important point to me is that the mood symptoms are much more likely, in my view, to have "bipolar" characteristics (as opposed to unipolar): profound sleep disturbance, cyclic recurrence, irritability and decreased concentration even when little "depression" is present. Perhaps most salient: the FM symptoms seem to directly cycle with sleep, almost as though in these women -- as they are nearly all women -- the pain symptoms are just another "bipolar" symptom. i.e. the pain *cycles* along with the rest of what we might typically regard as mood symptoms. Think about it: what if "chronic fatigue syndrome", which also co-occurs with FM and bipolar, was in some people just the depressed phase of "bipolar", with it's characteristic profound lethargy and fatigue, without obvious depression? As most patients know, the "mood dial" and the "energy dial" don't always turn the same way at the same time; they're relatively independent, at least in some people. Finally, why is that there is such a predominance of women with FM? This is an obvious and crucial question. I used to think it was because sexual abuse is so unfortunately common in women. But I've seen women with no such history, nor any clear reason to suspect some "repressed memory" either. I'm working on a "hormones and mood" website where I'll try to present current research that relates to this topic.

This is fascinating. Any thoughts on this?

Things you can do to support someone who is depressed

One of my most frequently visited posts so far was about things NOT to say to someone who is depressed. Since there seem to be a lot of people who want to help, I've come up with a brief list of some simple ways well-meaning friends and family can help. I know there are lots of other ideas, but I'm drawing a blank at the moment. If you can think of others, please post a comment!

1. Come over to visit - bring lunch or dinner. Many times going grocery shopping is a real chore, and even if there's food in the house, on some days it just requires too much energy to cook, especially if you're not hungry. When you're making a pot of spaghetti, or soup, or a delicious casserole, double the recipe and share.


2. Invite them to a movie - offer to drive. Sometimes people who are depressed find it hard to make choices. If you know them well enough, make it easy. Pick a movie and a time. All they have to do is get dressed and be ready to go.


3. Offer to keep the children for a few hours. If there are children, particularly young children, offer to take them out for a few hours, to the park, to a movie, to Chunk E. Cheese, or over to your house for pizza. Even a few hours of quiet time alone, having to be responsible for no one else, can be a welcome relief. And many parents are just too embarrassed or ashamed to ask for a break from their children.


4. Call to check in on a regular basis. Sometimes it helps just to hear a friendly voice. Even if the person doesn't feel like talking for long, just knowing that someone cared enough to call to see how they're doing can make a world of difference.


5. Bring a movie and popcorn. Sometimes people who are depressed don't want to talk, but they do crave company. Avoid the awkwardness of feeling the need to have a conversation by just sitting together and watching a movie.


6. Offer to attend to their errands while attending to yours. If you live nearby, and it's convenient for you, tell your friend that you're going to the grocery store, the drug store, Wal-Mart or the dry cleaners and ask if you can take care of anything for you while you're out. If they think you're going anyway, it may not be as difficult for them to accept your offer.

A new outlook on work

I am so far off the fast lane of corporate America that I don't think I could find the on-ramp again if I wanted to. I'm in the process of ending one business and starting a new one (more to come on this soon), but I know that I'm still going to have to *work* for a while until the new business is established. After all, a girl's gotta eat and have a roof over her head, right?

The process of job-hunting is so different now than it was years ago. I still hate it, but in some ways it's a bit less stressful. Not because jobs are more plentiful, because they aren't. The employment market has changed, and not entirely for the better. Age and experience isn't valued as much as it once was, and I'm often interviewing with people who are much younger and much less experienced than I am.

The biggest change is me. I'm at the point in my life where I no longer define myself by my career. I am not what I do from 8 to 5 each week day. I prefer to define myself by my interests, my passions, my relationshisp, my volunteer work. I am no longer a corporate professional. I'm a writer, a knitter, a teacher/trainer, a mentor, a budding photographer, a mother-best friend to my daughter, a daughter, a niece and a friend.

Today I saw a beautiful poem that says it much better than I can. I hope I'm not violating any copyright laws by posting this in it's entirety. It was written by Beverly Rollwagon, from "She Just Wants" by Nodin Press and I found it in the October 2007 issue of Skirt magazine, published by the Richmond Times-Dispatch.

Employed

Beverly Rollwagon

She just wants to be employed
for eight hours a day. She is not

interested in a career; she wants a job

with a paycheck and free parking. She

does not want to carry a briefcase filled

with important papers to read after

dinner; she does not want to return

phone calls. When she gets home, she

wants to kick off her shoes and waltz

around her kitchen singing, "I am a piece

of work."

Organizing: Leaving it to the pros (Part 2)

Having professional organizers reorganizing my office last weekend was somewhat like a marathon therapy session. I had no idea that in addition to analyzing the space, we'd also be analyzing my work habits, work style, decorating preferences and a host of other issues. Thankfully, the women I hired were both as skilled at handling me as they were in handling my office clutter. They asked very probing questions, but always in a gentle and non-judgmental way.

At first I thought their goal was not to make any decisions, but to ask the right questions for me to think through the options and make clear decisions that were right for me. But the more I think about this, I'm beginning to believe that they were the organizer's equivalent of "a good wife" - someone who can get her husband to do exactly what she wants him to do, while making him think it was his idea! Here's an example of how our day went:

ORG: Syd, I notice that you put this big burned-up candle back in the stack of things to go back into your office. Did you mean to do that?

ME: Yes.

ORG: Do you mind if I ask why? Does it have some sort of sentimental value?

ME: Not really. A guy I used to work with when I was temping at a salvage yard found it in a wrecked car and gave it to me because it had a really strong scent, which I needed because the guy I shared an office with had REALLY bad breath!

ORG: That's nice... not that you had to share an office with a guy with bad breath. I mean the fact that a co-worker was kind enough to help you out with that... And it appears that you've certainly gotten a lot of use out of it. But why are you keeping it?

ME: Because I'm planning to melt it down, put a new wick in it, and recycle it because I really like the smell.

ORG: Oh! That's wonderful. I didn't realize that in addition to writing, knitting, photography, and playing the piano that you're also into candlemaking. How long have you been doing that?

ME: Well... I haven't started yet.

ORG: Really? Hmmm..... So don't you need special supplies for the wax?

ME: Yes.

ORG: Where are they? I didn't notice them in your office when we took everything out.

ME: Oh, I haven't bought them yet, but I was looking at them in Michael's Crafts just this morning, in fact.

ORG: Are they expensive?

ME: Well... kind of.

ORG: Wow. Sounds like you're really serious about this.

ME: I think it would be fun.

ORG: So, which of your existing craft projects are you planning to give up in order to pursue candlemaking?

ME: I beg your pardon?

ORG: You just finished saying that you love how streamlined your crafts storage area is. So, in order for us to keep it that way, we're going to have to take some things out in order to make room for your new candlemaking supplies. Don't worry, it's not a problem at all. We told you that this was a work in progress and that we'd probably have to do some tweaking... So, what's your pleasure?

ME: (silence)

ORG: Syd, where are you going?

ME: To throw my candle in the trash.

Organizing: Leaving it to the pros (Part 1)

This past weekend I hired a pair of personal organizers to completely overhaul my home office. This is something I've attempted to do myself many times (with limited success) and up until last week, I considered it an extravagance that I couldn't really afford. In retrospect, it was a vital business expense that I couldn't afford NOT to invest in.

I've been self-employed for the past 6 years in a small primary data collection business which has been slowly fading away. I'm in the process of starting an exciting new business (more on this soon) and my office was, quite frankly, a mess! I could bore you with all of the psychological reasons why that was, but since it isn't any more, I won't focus on the past.

I think I watch too much HGTV, because I went into this project thinking that with 2 people working, it was probably a 5-6 hour project and it would be comparable to having a housekeeper come and do a thorough clean of the place. I couldn't have been more wrong. It was about a lot more than cleaning and moving things around and it was also about a lot more than just my physical office space.

It was a process that explored my work space, my temperament, my creativity, my professional and personal goals, my work habits, my buying habits, my sensory perception, and my stress management techniques.

Thirteen hours later (over Saturday and Sunday), I found myself not only with a beautiful new home office, but a lifestyle change too. It's become extremely important to me to keep my space looking the way it does now and the process showed me exactly how to do that through a serious of conscious choices, literally on a day-to-day basis. It takes a long time to create bad habits and they don't go away over night. But now that I have positive habits to replace them with, and I can see and feel the benefits, I'm committed to this change. In fact, I'm so motivated by the changes in my work space that I've cleared all of my work off my plate in the evenings this week and through the weekend, if necessary, so I can devote that time to applying the same approach to the rest of my home.

I'm making extensive notes about the entire experience while it's still fresh in my mind. When I'm done, I'll post more about what we did and what I learned.

(to be continued...)

It's never too late

I just read an incredibly honest and moving post at a great bipolar blog that I found recently, called The Bipolar CEO. This particular post is an open letter to the blogger's ex-girlfriend (from many, many years ago). I am truly impressed by the honesty and courage this letter exemplifies and I hope that the woman to whom it was written will see it. I couldn't begin to do the letter justice, so if you're interested, you can read it in it's entirety here.

Making the mood

I tried an experiment this week and I've decided that it's worked even better than I could have hoped. I've been writing lately about trying to be more conscious of my moods, or more specifically, what I'm thinking about, which in turn has a direct correlation with my mood.

I've noticed that while I enjoy silence sometimes, living alone with long periods of silence can be troublesome, particularly when I'm struggling with insomnia in the late hours of the night or the early hours of the morning. I don't particularly care for the radio stations in my area and I hate the commercials. I am, however, a political news junkie, so I'd resorted to using cable news as a radio of sorts.

Until my experiment this week, I didn't realize how much that was NOT helping my mood. Because I really care about this stuff (national politics), I'd find myself getting frustrated, and sometimes angry... with the coverage, with interviews, with the sad state of national and international affairs. I was well-informed on the issues, but no less stressed or tired.

So this week, I decided to take advantage of my expensive digital cable subscription. I found a smooth jazz channel that I love. So other than about an hour of cable news a night, the rest of the time (including most of last weekend), I had the tv on, listening to the most incredible jazz music. Not only has my mood increased substantially, but I find that I'm more energetic and more productive. I've discovered that it's impossible for me to feel sad, angry or stressed when I'm listening to music I truly enjoy. In fact, there have been times that I've even found myself dancing - yes, dancing around my home, by myself and having a great time doing it!

Susan wrote a great post earlier this week about a book she's reading called "BrainSwitch out of Depression: Breaking the Cycle of Despair" by A.B. Curtis who is a licensed cognitive behavioral therapist. I was so intrigued by Susan's brief overview of the thesis of the book that I ordered it yesterday. Reading her post about this book was validation that I'm on the right track with my music experiment because if I understand it correctly, Dr. Curtis believes that through hard work and practice, we can train our brains to respond differently to stressful situations. For me this is great news because it means that I don't have to be a prisoner to my moods and that my mother may have been right when she used to lecture me about dressing for success. She used to say that if you look successful, you'll start to act like you're successful, and if you act like you're successful, eventually you will be! I think the same theory applies to winning the battle against depression.

Endings are beginnings

It's easy to get caught up in the sadness of endings. There's just something about the word "ending" that seems so... final. But by it's very nature, when something ends, it signals the beginning of something else. Whether it's a relationship, a job, or any other significant change in our lives, we can choose to focus on what we're losing, or we can choose instead to focus on the new opportunities that this change represents.

When I change jobs, I like to focus on the fact that I have a clean and hopefully clutter-free workspace that I can organize the way that works best for me. I reflect on the things that weren't working for me at the last job and develop a strategy to avoid falling into the same traps this time. And, I look forward to learning new things, meeting new people and creatively identifying ways to add value in my new work setting.

When a relationship ends, I like to remind myself of all of the things I stopped doing because my partner didn't enjoy them, or I just didn't have the time. For example, I'm looking forward now to dancing more, exploring new places to shoot pictures, re-energizing my knitting ministry, and jump-starting my writing career. I am not saying that endings don't hurt. As I wrote in Cry Me A River, it's going to hurt until it doesn't hurt any more. It still hurts, but a lot less than it did.

The world is round and the place which may seem like the end may also be the beginning. -- Ivy Baker Priest (former U.S. Treasurer)

More on finding closure

I've spent weeks feeling sad, depressed and angry because the man that I'd been involved with disappeared without a trace. I've been upset because in choosing to walk away from the relationship without an explanation (a very cowardly choice, if I may say so), he was not giving me what I needed most - closure. Then at some point over the weekend it suddenly hit me... why on earth am I looking to someone else to give ME closure. At this point, what could he possibly say that would make the way he handled our break-up any more decent or thoughtful? Absolutely nothing. In fact, by not acting in a mature and respectful way, he said much more than words ever could. The emotional closure I needed was there all the time, it just wasn't coming from him. It came from me.

Once I finally stopped to ask myself exactly who I was crying over, I realized that I wasn't crying for the loss of a relationship that was, I was crying over a relationship that I wanted. I wasn't crying over the man I was dating, I was crying over the potential I saw in him. The man I was grieving over does not exist, he would never have ended a relationship this way. A man that could walk away without the decency of a good-bye is not the man for me anyway. So as much as it hurt, he did me a favor... and once I realized that, a sense of closure wasn't far behind.

Despite the fact that the relationship didn't turn out the way I'd hoped it would, I am still thankful for the time we had together. Because he was unlike any man I've ever dated before, and because he was the first man I've dated since coming to terms with my depression/bipolar disorder/whatever it is that I have, I had the opportunity to put into practice a lot of what I've been thinking about and working on for quite some time now. Realizing how I often sabatoged my personal relationships in the past, I worked hard to be consciously aware so that I could make better choices this time. And I did. I'm not perfect, but I did it right this time. That proved to me that I've finally learned the lessons that I needed to learn from my prior failed relationships and that I'm emotionally ready to move on.

I believe that he came into my life to make me stronger emotionally and he has. He's also raised the bar in terms of the kind of man that I'll date moving forward and the firmness with which I'll set boundaries. And I am so thankful for that.

He has helped me learned more than he could have imagined, and perhaps more than he'd planned. To sum it all up:

1. I can only own my own issues. I can't be responsible for anybody elses issues but my own. No matter how much I want to help, just as I need to learn my own lessons, the other person has to learn theirs too. And when it comes to issues, we all have them and there are more than enough to go around. It's critical that when issues arise, I clearly identify those that are mine, deal with them as best I can, and leave the others to their rightful owner(s).


2. Accept things as they are, not as I'd like them to be. I've always had a tendency to fall in love with a person's (or a job's) potential. I dream big dreams and pride myself on being able to look beyond the current state of affairs and see the possibilities. That may be sound advice for young couples right out of school, but when we're talking about grown men in their 40's or 50's, chances are pretty good that they've already become the men that they're going to be. Of course people can and do change at all ages, but they have to really want to, and not everybody does. So, "what you see is what you get" needs to be my new dating mantra and I need to assume that he's already being all he can be.


3. Find clarity through contrast. This exercise from The Law of Attraction is an important part of learning the lesson. What better way to figure out what I really want than identifying what I don't want? Rather than thinking of the time spent in this relationship as time wasted, I think of it as a learning experience on a lot of different levels. In this case, thinking about what worked this time, and what didn't, can only help me become clearer about what I'm ultimately looking for in a relationship. And the clearer I am about my desires, the more likely I am to manifest them in my life.


4. Always take the high road. There have been so many times during the last several weeks when it would have been easy to lash out in anger or pain for the way we broke up. But, I'm proud of the way I conducted myself throughout the course of our relationship and there's no reason to change now. Obviously he can't see, or does not appreciate, all that I had to offer... if he did, he wouldn't have walked away from our relationship or from our friendship the way he did. But I don't believe it will always be that way. At some point, it could be weeks, months or years from now, he will look back on the time we spent together. And when he does, I want him to remember that I handled the end of our relationship with as much class and grace as I handled every other aspect of it. That, to me, will be my greatest "revenge".

Finding closure

I've been grieving over the loss of a relationship for the past 6 weeks or so. I could have chosen to fight the constantly fluctuating, complicated and confusing mix of emotions, denying that once again I opened the door to my heart, only to have it slammed shut. I could have chosen to be embarrassed by my tears, my loss of appetite or my inability to do much more than curl up on the sofa and watch movies for hours on end. I could have chosen to deny how much I've been hurt by the situation. But I didn't choose any of those things. This time I chose to face the pain, to struggle through it, to ride the wave.

I've been through the first 4 stages of grief: shock, denial, anger, depression - several times. I wrote a while ago that I was going to hurt until I don't hurt anymore. Well, it still hurts, but not as much as it did at first. So even though I'm not completely over it yet, at least I'm heading in the right direction.

In thinking about this break-up, it hurts for many reasons, but the thing that hurts the most is that there was no closure. We just hit a wall... no explanation, no discussion, no nothing. To this day, we have yet to have a conversation about what happened or why. I've let him know that the door is open when he's ready to talk, but I draw the line at begging him to talk to me, even if it is only to explain why he walked away. I have some pretty good ideas, but I may never know for certain.

What I do know is that as much as I believe that our "relationship" I deserved a graceful ending, for now, the key word is "ending." Rather than continuing to focus on what hasn't been said, I need to accept that his silence has spoken volumes. I've run out of psycho-babble excuses for why he hasn't been able to verbalize his feelings (or lack thereof). I think I may buy a t-shirt that says "If something goes without saying... let it!"

The bottom line is that I've worked so hard to grow - emotionally and spiritually. I've done the hard work, and it hasn't been easy. And now that I have, I know that I deserve better than what I've gotten. I'm not perfect, but I'm a kind, thoughtful and loving person, and even if I haven't earned his love and trust, I deserve his respect. Apparently he doesn't agree, and that's his right. Just as it's my right to say that it's time for me to let go.

If you've been reading this blog for a while, you know that I'm not one for passing up an opportunity for personal growth, and this break-up has certainly provided that. I'll post about some of the things I've learned next time.

(to be continued...)