Monday, April 30, 2012

What is Cyclothymia


When I tell people I have cyclothymia, 9.5 times out of 10 they give me a blank stare  - the remaining 0.5 being those in the medical/mental health field or possibly those who have a mood cycling disorder themselves. In fact, as I type, my computer’s spell check keeps putting the squiggly red underline beneath the word, which indicates “this isn’t a word”. It’s that unknown. (Though the fact that it still changes "Pinterest" to “interest” does make me feel slightly better – perhaps my computer just isn’t all that intelligent and adaptable.)

Before I go any further, I feel the need to preface the rest of this blog with this statement: I’m not a mental health professional, I’m not using technical terms other than the very basics, and by no means should anyone read this and try to diagnose themselves with cyclothymia or any other disorder based on my story. This is my description of my condition and what I’ve gone through in my own words, and that is all.  

With that out of the way with, here we go. Cyclothymia is a mood cycling condition that’s “milder” than the better-known Bipolar Disorder. I put milder in quotes because what I go through isn’t always mild. It’s just not as severe as other conditions in the mood cycling continuum. As I mentioned above, Cyclothymia is rare. I’ve found multiple sources that put the prevalence between 0.4% and 1% of the population.*  Because I’m particularly special, I have the rapid cycling form of cyclothymia, which means that my depressed and hypomanic cycles can happen much faster than the those with the “traditional” form of a mood cycling disorder. Technically, a rapid cycling mood disorder is defined by four or more manic, hypomanic or depressive episodes in any 12-month period.  Let me give you an idea of how rapid my cycling is – I can wake up depressed, be hypomanic by noon (particularly if I don’t take my meds on time) and be depressed again by bedtime.  I don’t have specific numbers for the prevalence of rapid cycling, but WebMD lists the prevalence for rapid cycling Bipolar Disorder at 10 to 20% of people with BPD.** If these numbers hold true for Cyclothymia, that means that a maximum of 1/5th (20%) of 1% of the population has rapid cycling cyclothymia. If my math is correct, that’s 0.002% of the population. I guess genetics in the womb foresaw my “I like to be unique” attitude and took it to the extreme.

People often ask me what my mood cycles are like. I describe the hypomanic cycles as such: think about drinking a pot of coffee (or two) all at once, assuming you don’t do this regularly, and then having to sit at your desk, work,  and go about your daily routine. You feel anxious, energetic – though not always in a good way, sometimes irritable, jittery. It’s difficult to focus or concentrate, you feel like your head is swimming, like you could run ten miles (again assuming you don’t normally do this - I don't).  The depressive cycles feel, well, depressive. I tend to lack energy, feel unmotivated and down. Probably the most frustrating feeling of all for me in a depressive cycle is the apathy. I am generally a very passionate person, full of emotion and with a big heart.  To feel like I don't care one way or the other about things is almost frightening for me. It's often the most troubling depressive symptom. 

While I’m discussing the cycles themselves, let me place to rest a huge misunderstanding. Even the most rapid cycling of rapid cycling doesn’t suddenly become manic or depressed mid-sentence (or at least I've never heard of or experienced this).  I hate when I hear people say something like “yeah he was talking to me and was really nice and then all of a sudden he just flipped out. It’s like he’s bipolar.” I’ll tell you something – the “he” in this scenario most likely does not have bipolar disorder or cyclothymia or any other mood disorder. He may be having a really bad day or possibly have some anger management issues or maybe he’s just a jerk, but bipolar, or cyclothymic, he probably is not.  Using the coffee comparison from earlier (I really like coffee), you don’t take a sip and suddenly bounce out of your chair.  You start to feel the effects gradually.  A cup of coffee is probably fine, two might make you a little extra energetic, but by the time you finish the whole pot, you’re probably in a state that you don’t want to be in, or at least one that makes it tough to sit down and concentrate. This is how a hypomanic state comes on. The depressive cycle is similar, though for me personally, I tend to feel most depressive states when I wake up in the morning. I’m not sure if this is common or not.  They’re also a bit tougher to distinguish, because maybe I’m just overly tired and feeling lazy, or maybe I’ve had a bad day/week and I’m down about it like anyone (i.e. someone without depressive issues) would be. I’ve learned slowly to separate these feelings, but it takes a lot of practice and I’m still not 100 percent accurate in my determinations.  

This is a very general overview of the cyclothymia and the way it affects me. No two people feel it exactly the same, and I’m sure others may have completely different experiences. But I realized that while I’ve talked a lot about my condition, my journey, and my desire to increase support, education and awareness for mood disorders, I hadn’t given a good description of what specifically Cyclothymia is. I wrote this as part of a two-part series. Part two goes a bit more in depth into my background of Cyclothymia and how I was diagnosed. As always, I’m happy to answer any questions. If you’d prefer to not leave something in the comments section for personal reasons, you’re always welcome to contact me directly.

Resources for statistics in this blog:
*Sites for Cyclothymia statistics as given in this blog:
MHC

**WebMD source on prevalence of rapid cycling BPD.


Wednesday, April 25, 2012

Who Are You?

The other day I did a guided meditation titled "letting go". I was a bit leery because I thought it was going to be about letting go of something painful or difficult, and I wasn't sure I really wanted to address/relive those things - especially when I've really been feeling much more myself these days (knock on wood). As the meditation progressed, however, I was in for a pleasant surprise...or as pleasantly surprised as one can be by a guided meditation. Instead of teaching me how to let go of things in my life, the meditation was persuading me that it was completely ok to think and feel exactly what I was thinking and feeling.

That sounds pretty cryptic, so let me expand. Being on a regimented medication routine three times a day (Dr.'s orders) and having been in and out of therapy since I was about 18 years old, I'm used the the 'shoulds' and "shouldn'ts", the rules and regulations, and I'm used to closely analyzing myself and my life. I'm used to knowing that when I'm in one of my mood cycles I "need to" do x and "need not" do y. When you're this exposed to these "rules", if you will, it tends to bleed into the rest of your life. You tend to be a bit black and white, right and wrong, good and bad. My condition also predisposes me to this, since I'm often up or down. There's not a ton of room for gray - something I'm working on actively.

This meditation encouraged completely the opposite. The person leading the meditation explained how we should accept how we feel, rather than telling ourselves "I shouldn't feel so tired", "I shouldn't feel this way about this situation/person/etc", "It's ok to want xyz" (ran out of good examples). This probably sounds pretty simple, but to someone that's had to be so strict with certain things in my life, this is pretty amazing stuff.  The fact that it's coming to me at a time that I'm finally starting to feel myself again, to be completely open, to be the smiling/happy/optimistic person that everyone used to know is an added bonus. It helps me open up and accept myself even more.

Obviously, we have to use common sense here. Yes, it's ok to feel what you feel, think what you think and do what you do, but there have to be some limits. If it's immoral, if it's hurting someone else, if it's greatly illegal (I say greatly b/c technically putting your blinkers on in a "no stopping" zone is illegal), then we need to take a second look. But if you're simply creating your own black and white blocks, and walling yourself in because of shoulds and shouldn'ts you created in your mind - and often we don't even remember doing this or know why we did in the first place - maybe it's time to re-examine. Why is this a should/shouldn't? Why do you have to think this way or feel that way? This was truly eye opening to me. It'll take a while, as everything in this whole process is, but I'm realizing that as I let my guard down and don't bind myself by these imaginary, self-created rules, I'm happier and I'm finally finding myself, and it's a wonderful place to be!

Friday, April 20, 2012

Give It A Break

Today's been a little disjointed, to put it kindly. Actually, it's not the day that's been disjoined, it's me.  More specifically, my brain. It's one of those days that I must be cycling a lot. I can't particularly feel it, but I know the signs. I'm having trouble focusing on anything, my creative juices seem to be hiding and I just can't seem to get anything done. In addition, yesterday I completely "spaced" and forgot to write in my journal - the first day I've not written since I added it to my commitments list. Basically, I've just been a little off.

When I realized about the journalling, I first felt really bad about not writing. I was upset with myself for forgetting and wondered "should I write for 20 minutes instead of 10 today to make up for it?". Then I stepped back and re-examined it. It was only one day. I legitimately was busy with work and then personal/social things and plain out forgot. I didn't get lazy and say "eh I can skip one day"; it was purely an accident. I made sure to write first thing today (after my workout and meditation, to be specific) so that I didn't have a repeat of yesterday, but I decided I couldn't let myself be upset about it. This is actually a big step for me. My condition tends create a "black and white" type of mentality, and it's tough for me to see areas of gray - as in "it's not wrong or right, it's just what it is and I have to move forward from it".

Today, I'm having to practice similar self appreciation. I'm feeling very antsy and "all over the place". Perhaps it's just because it's Friday and I'm ready for the weekend. It's equally possible that I've been going through several hypomanic cycles during the day. In all honesty, it's probably a combination. Whatever the reason, this blog is one of the first things I feel accomplished doing all day, and it's almost 4:00 PM. Suffice it to say it's not been my most productive day. None-the-less, I'm trying to give myself a break. I could beat myself up about the fact that I haven't done all that much, but I suspect that would only make me more anxious and jittery. To clarify, I haven't had all that much to do. I'm not shirking responsibilities, I'm just not going out looking for more. I'm waiting on responses from several suppliers about travel for my clients, I've finished several important tasks this week that I'd set out to do and so overall, I feel it's been a pretty good week. So, I am choosing to, somewhat begrudgingly, take it easy on myself and not scolding myself for being a bit "out of it" today.

It's easy, especially in certain states of mind, to feel the need to be over-productive, over-busy, and frustrated when that doesn't happen. In fact, at least for me, this becomes a vicious cycle. The more I reprimand myself about it, the more anxious I become. I then have more trouble getting things done, and the cycle repeats. So I suggest that unless it's something absolutely urgent, it's ok to give it a break. Take some time to re-center your brain and give it some space. There is very little that truly can't wait, and sometimes, you just have to be ok with that. 

Wednesday, April 11, 2012

Commitments List, Part 2

It's been about a month since I made my commitments list. Since I shared my thoughts behind it, my personal list and suggested that it's could be a great activity for anyone. Since I'm very much about being open and up front, I thought I'd provide an update on my progress and my thoughts for continuing the process.

My list started out very small. I didn't want it to be a chore, I simply wanted it to help me keep on track with my doctors orders and with some basics that I thought would help me through the process of growing and focusing on myself. If you read the original blog, you may remember my list looked like this (and if you didn't, here it is):

1. Take morning meds by 9 AM
2. Take afternoon meds approximately 2 PM
3. Take evening meds approximately 9:30 - 10 PM
4. Get 7-8 hours of sleep

Pretty easy stuff, huh? The one that's caused me the most trouble is the 7-8 hours of sleep, simply because I'm not usually a great sleeper and because I have been spending time out with friends (great, but not the most ideal for sleep) and like to get up at a slightly early hour to get my workout in before I start my work day. All in all, though, I feel I've done pretty well. 

The first two weeks I stuck to just those commitments. I wanted to make sure I was truly creating those habits. The next week, I added journaling and meditation, starting with five minutes of meditation a day and slowly increasing by a minute every couple of days. I'm now up to ten minutes a day, and by the end of this week I hope to be at eleven minutes. Like I said, I am intentionally making this a slow process. My journaling commitment now has an extra component as well - I must include three positive things and three things I'm grateful for each day. It probably sounds cliche, but it's helped my outlook as well as my enjoyment of journaling. I try to start off each entry this way in an attempt to 1.) focus on the positive and 2.) avoid making my journal just a regurgitation of my day moment by moment and inevitably focusing on the things that are bothering me. (I wrote a whole blog on my journaling "technique", for anyone who struggles with this activity.)  

So that's my progress. I am still truly enjoying the idea of the commitments list. It's helping me see my progress daily and celebrate the "little victories". Have you made a commitments list? If so, how is it coming along? What have you enjoyed about it, and what troubles have you had with it? What do you hope to include on it in the future?

I'm happy to answer anyones questions about this project. It's something I basically just created (though I'm sure I'm not the first) so there really aren't any wrong or right ways to do it. I'd love to hear your thoughts and your journey with this so far! 

Friday, April 6, 2012

Growing Awareness

About a month ago I wrote about the a-ha moment in which I realized that my condition could empower me to help others instead of being something I "suffer" from (you can read that post here if you're so inclined). Since then, I've worked on making this blog a combination of my experiences and information/suggestions for others going through similar situations. Because I'm not a trained psychology professional, I really have just my personal experiences and those of others I know with mood disorders as fuel for my blogs. Still, I hope that through this I'm able to provide some helpful tips, or at least let others know that what they're going through isn't uncommon and that I'm hear to offer support, or even just lend an ear, if desired. Since I started this mission with the intent of helping others, I thought I'd reach out to you (collectively) for ideas on how best to grow this campaign, and what you feel is most needed and effective.

When I started to focus on mood disorder awareness, I'll admit that I wasn't quite sure of what I wanted to do. In other words, I didn't have much of a plan. To be honest, I still don't entirely.  The reason is several-fold. First and most practically, I own and operate Chimera Travel, and right now this is what pays the bills. I love my business, and I want to still be able to focus on it and give my clients the personalized service they've come accustomed to, so I need to make sure I'm balancing my business with these new efforts. Secondly, I have just haven't done anything like this before, and I want to make sure that my goals and vision align with the steps I'm taking to get there. I want to go about this the right way, and meet the needs that aren't currently being met when it comes to mood disorder awareness, education and support. 

My basic, and very loose, goals are the following:

  • Offer information and suggestions through this blog for those that have mood disorders and even loved ones of those that have them.  By growing the following, I hope to increase my reach with this. 
  • Provide a forum for open discussions on mood disorders and topics that surround them through the Mood Disorders Support System group on Facebook. 
  • Work with, not against or in contrast to, any existing systems or groups that already exist. Mood disorder awareness should not be a competition - that won't help anybody! 
  • Eventually grow the online group into local support/education groups where applicable. This is a particularly loose goal, as I'm not sure if I'd prefer something that's solely for mood disorder 'sufferers', for education of others that might not be aware of/understand mood disorders, or a combination. Thoughts?
  • Some sort of fundraising for awareness, education and research of mood disorders. I've looked and looked for some sort of national organization/association that focuses on mood disorders, and I've been unable to find one. I'd love to eventually partner with something like this, even on a more local level (say a state level), but there really doesn't seem to be much out there that I can find, at least not in the U.S. 
So my questions are: what other/alternative goals do think such a mission could or should have? Do you know of any local/national efforts, groups, organizations or associations that I could maybe work with in the long run? What other information or suggestions might you be able to offer and what would you personally like to see happen that you feel is currently lacking in mood disorder awareness/support/education? 

This blog truly depends on your feedback, so I'd love to hear from you. I'm working on getthing this whole passion and idea more focused, and creating an overall vision and goals, and eventually the steps to get there, is the first stepping stone (after deciding to do this at all).  Thanks, as always, for your thoughts! 

Monday, April 2, 2012

Tearing Down Walls

Have you ever faced an emotional block? It could be family, interpersonal or business, but regardless of the subject, you feel like you get to a certain point with a situation and can't get any further - not because of external boundaries, but because of something internal. You may know why the block is there, but just don't know how to get past it. Other times it's an invisible barrier - you're not sure what's stopping you in your tracks, but it does so none-the-less. It's also possible you know what is bothering you and how to get past it in theory, but you just can't seem to make it happen. Perhaps you have a fear for "no reason" or are worried about something specific but don't understand where the anxiety came from. Regardless of how the block got there and how much you know about it, these emotional walls can be distracting, frustrating, damaging or even emotionally crippling.

Oddly, I'm rather good in helping others discover their emotional blocks and can give pretty decent advice (or so they tell me) on tackling them. With myself, it seems it is a whole different story. Isn't that always the way - easier said than done? I suspect that if we could all view ourselves and experience our emotions from the standpoint of a third party, we'd probably be able to conquer these issues much more easily. Unfortunately, this isn't the case and we have to go about it the more emotionally challenging route.

People have different approaches to breaking down their walls. Some like to attack them with a sledge hammer - all in, confident and positive. Often these people are in limbo for a long time and then appear to have a sort of "breakthrough" and suddenly "get it". It doesn't mean it's easy, it means that they get to a certain stage where they can move forward without much looking back. For others, it's an every day battle of patience. Some days you may feel like you take two steps forward and one step back. You have a great day and then a difficult day, and instead of leaping at the wall with great speed and power, you slowly chip away at it with a screwdriver (or something similar that would do this - I'm not a tools person). Neither approach is better or worse. The key is, whatever way you choose (or feel capable of utilizing), you have to be dedicated to it. If you choose to go full steam ahead, understand that you have to keep facing forward. With that much energy and passion, a fall backwards could be incredibly painful and it could take you a long time to get back up. If you choose to proceed slowly, it requires a lot of stamina. Realize that there will be back and forth, and be resolute to dealing with that, looking at the end result as guidance in your mission.

I have always been the sledgehammer type. Until recently. I realized that my sledgehammer moments were filled with adrenaline and passion, but not exactly breakthroughs. In other words, I had the right heart, but I hadn't actually discovered anything new. I'd decided I was going to conquer my walls but I hadn't emotionally started to move past the block, at least not permanently. So now, I'm trying the chipping away approach. It's a difficult journey and I have great days and awful days. It requires incredible patience, which I'm not traditionally very good at (read: terrible at) but I'm trying to learn. Here are a few things I'm working on, and trying to keep in mind as I go along:

1. I'm going to have set backs and forward progress. It's going to be slow going, and it might not always be moving forward, but if I learn from the setbacks and use that to make progress, I'm accomplishing something important. When I have a bad day, I need to think of the progress I made a day or two ago. If I keep on the right track, the progress will come again and, with effort, those days will outnumber the negative ones.

2. "Insanity is doing the same thing over and over and expecting different results." Change can be painful, but without it, it's difficult to grow. I am learning that getting out of my comfort zone is often the most effective way to move forward. This doesn't always have to be adventurous or monumental. It's often just taking an approach to things that I traditionally would not. In fact, sometimes getting out of my comfort zone is about not doing something. I may want to make a big change, try to fix something suddenly, try to have total control over a situation, and holding back on these is in fact the action that will be most productive.  You may have to get out of your comfort zone again and again until gradually (sometimes very gradually) it becomes less uncomfortable. This is when you can truly see the progress of the slow and steady approach.

3. Make tiny goals. These may be daily or even hourly. My commitments list is part of this. I also plan to start making goals that relate directly to each day (not commitments or must dos, but goals). It could be to wash away a negative thought throughout the day, to send that email asking about an opportunity I've been interested in, to reach out to someone who I feel could provide motivation or guidance. These help make the time pass more quickly (or at least I hope so) during the slower approach because you're accomplishing something every day. Even if you don't see the results right away, you're taking actions to move forward.

4. Similarly, break down your time into small increments. If you're having issues with patience (hand raised!), play this hour by hour. If you're working on a task, or waiting something out, think about in terms of "I can do this until 3 PM". Then "I can do this until 8 pm". Next thing you know it's a day, then two, then a week. It helps break up the time so that your task (or wait) seems less ominous.

5.  Use the past as a perspective. When I think about where I was this time last year, I'm amazed. I feel like it was a lifetime ago. The things I thought I'd never get through then seem like nothing now. Yet now I have another emotional block that I feel I'll "never overcome". Or maybe I'm still working on the same one, but I'm so much farther along. A year seems like an eternity to wait sometimes, but it does give some credence to the phrase "this too shall pass". If I look at the examples of things I've overcome, blocks I've gotten through, it helps me realize that this time next year, or maybe even in a month or two, this particular block could be a thing of the past. (Note: if you suffer from long term anxiety/depression this may not work for you. If you were just as depressed last year, looking back could only make the depression seem endless, so use this tool only if you feel it's appropriate).

6. Don't bandaid it. It's easy to cover up an emotional block and circumvent it rather than break through it.  This happens when people "run away" from something instead of dealing with it, or distract themselves with something else so they don't have to address the block. In the end, though, this only makes it more difficult. Ever see those police shows where the person tries to avoid the police over something minuscule by stealing a car and speeding away from the cops only to cause a horrific accident and still gets caught in the end? By trying to avoid getting in trouble, they ended up making a series of even worse mistakes so that by the time they're captured they have a list of criminal activity that will keep them in jail for years. Same thing here (though hopefully with no jail time!). The more you try to avoid dealing with your emotional walls, the more trouble they could cause you in the long run.

Every emotional block needs to be handled differently, and every person goes about things in their own way. The method for handling these depends on your personality, your history, the block itself and a whole host of other factors. These tips are simply actions that I'm working on to approach my particular emotional blocks and try to take down some walls. It will be a long, slow process. I hope, though, that this time next year, or maybe even in a few months, I can look back and realize that I have progressed, and that I did indeed get through those things I never thought I would. Deep down, I know that somehow I will, and I think that's key. The first step is getting to the root of the issue. Next is determining the approach. From there, it's hard work and (eek!) patience. I look forward to continuing to share this journey, and hopefully providing support and maybe even some inspiration for others working on their own emotional blocks.