Reminders of Mania

[stargazer]

When I had that episode a few years back, I was completely out of my mind. These days, I'm not *completely* out of my mind. But I still have a hard time when confronted with momentary reminders of mania past. It's been happening throughout the day today.

You all know I'm a runner. How much of this has to do with running? I didn't run for six days because I was down with a cold. Yesterday I ran, and to save time I ran to the studio where I work, because I needed to email a file from the work computer to the home computer. Then I ran back home. It was about four miles or so -- not a long distance for me, but my first run in six days.

I was relaxed throughout the day yesterday, feeling cleansed. Today when I awoke, my normal cup of coffee sent me bouncing of the walls. Why?

Then the people currently working on my lifelong project showed up. Although it was a good, productive meeting; my fantasies about the future success of this project skyrocketed, almost to the point where I could not control the rapid flow of thoughts.

I'm trying to bring myself down now, without first opening an email from someone that I have reason to believe will be depressing. If I can calm down within, say, an hour, I'll open the email, and probably be less depressed by it -- because I will have less to lose. If I'm hit with a downer right now, the crash will be too severe.

Does this post make sense to anyone?

 

[David Baxter PhD]

Yes. And I think it evidences increasing insight into what you've experienced over these last few years.

 

[stargazer]

Thanks, David.

Today, by contrast, I have been feeling very lethargic. I also am wondering if coffee itself might be more of a culprit than I'd previously thought. I'm actually ceasing to enjoy my morning cup of coffee, and I wonder if I ought to start the day off with a glass of orange juice. In fact, I went out and bought a jug of orange juice to keep in my room, so as to do so first thing in the morning tomorrow. I also bought some mineral water. If I had those first, maybe coffee a little later on won't be quite so toxic.

I believe I have been unconsciously making my morning cup of coffee stronger and stronger every morning. It's becoming distasteful.

 

[stargazer]

Not sure what's been going on with me since 5pm yesterday, when the workshop let out. I was literally zombified with depression for five hours. Then, after sleeping solidly, I awoke with renewed energy, and in unusually high spirits. I felt a little unfocused, but felt so good I didn't care. The sun was shining and life was beautiful. At a certain point, all systems crashed. I took a one hour nap, awoke, looked at one my music notation files, and suddenly remembered how much of a pest and a bother I had been to all people involved. I became unusually depressed and took another nap of about an hour, in which I actually dreamed I was dying (by falling out of a jet plane.) I was surprised to awaken in my own bed, safe and sound, yet I have been almost paralyzed with depression ever since. Am I having rapid cycling, or is this normal?

 

[David Baxter PhD]

Possibly rapid cycling. Possibly just mental and physical exhaustion.

Try to give yourself time to rectify your sleep deficit over the next few days and see if that helps, since you probably can't see your therapist until after the holidays anyway.

Additionally, look at nutrition issues. Make sure you have a bit of caffeine so you don't go into caffeine withdrawal on top of it.

 

[Mari]

Do you put sugar in your coffee? If my youngest son has even one teaspoon of sugar he starts bouncing off the walls. Exercise is good - his temperment is much more balanced when he is physically active. :emoticon-sign: Mari

 

[stargazer]

Do you put sugar in your coffee? If my youngest son has even one teaspoon of sugar he starts bouncing off the walls.

No, I don't use sugar, or even cream. I just drink it black. In fact, I have no taste for sweets, and don't eat sugar products. However, I recently learned that if you eat a lot of carbohydrates (which I do -- pasta, primarily), it soon turns into sugar in your system.

Exercise is good - his temperment is much more balanced when he is physically active. :emoticon-sign: Mari

I think my lack of having exercised by running over the past three weeks has been detrimental, even though I've purposely been walking briskly to work and back each day (which is about two miles.) Being used to running, walking doesn't quite do it.

I'm definitely going to run today, I hope...

Possibly rapid cycling. Possibly just mental and physical exhaustion.

That's what I've been thinking -- exactly that.

Try to give yourself time to rectify your sleep deficit over the next few days and see if that helps, since you probably can't see your therapist until after the holidays anyway.

I just called her. She was with a client, but I asked her to call me back. I'm still annoyed that they put my sister's address on my new MediCare card by mistake, because I feel as though the people in the clinic in the other County are getting tired of me, as though I have been pestering them, and I really *should* be getting help over here instead. But as soon as I finally became willing to do so, I was slammed not only with bureacratic hassles, but errors on the part of bureaucrats. The combination of that, with my present anger issues, has been somewhat overwhelming.

Also, I'm having abandonment issues. I feel rejected by the people at the workshop, and by the mental health people I'd grown accustomed to in my other County.

Additionally, look at nutrition issues. Make sure you have a bit of caffeine so you don't go into caffeine withdrawal on top of it.

I awoke this morning with a headache that I attributed to partial caffeine withdrawal. Yesterday I had diluted the portion of the cup that remained at my desk, and it wasn't very strong by the time I did so. (Maybe that accounted in part for the lingering tiredness.) This morning I went to Starbucks, where I had an orange juice, a ham & egg sandwich, and a triple Grande mocha. I'm sure that this mocha was of significantly less strength than the monstrose elixir that my morning cup had gradually become.

I probably need more fresh fruits and vegetables and bran. I will say that I've been taking the Prostate Optimizer, and I no longer have those symptoms I described. Hopefully that will hold me over until I can get my medical benefits and have a check-up.

 

[stargazer]

Merry Christmas.

I just awoke from a nap -- it's about 3pm in California. I did hear back from my therapist yesterday, and I was encouraged by our conversation. We discussed what's happened since the workshop, and we keyed into a number of factors. By and large, as David said, I need to allow my body time to re-fuel itself. I allowed myself to become depleted, and it may take a few days.

She also mentioned "incubation," which is the phenomenon by which creative work still takes place in the unconscious, even if pen is not being put to paper. It still takes place when one is cleaning the house, taking a walk, eating a meal, and even sleeping. It takes place as long as the commitment is there.

This is encouraging because it lessens the guilt. I don't have to feel like I'm falling behind, even if I'm not actively writing. Also, I know it's true, because then, after the conversation, when I did begin writing, the ideas flowed very freely and very logically. Already, I seem to have been able to take from the actors' criticisms that which would probably help, and to discard that which was probably useless.

In high spirits, I wrote about two pages. Then, my daughter called, depressed, because she had fallen ill and had missed the opportunity to have an early Christmas with her half-sister's grandparents in the Sierra Nevadas. This depressed me as well, and I told her I would go to Berkeley to take her out to dinner.

On the way, however, I myself fell ill. At the time, I thought it was the flu, but it must have been food poisoning. So I had to call off the dinner, which was sad, and when I got home, I was basically incapacitated for the rest of the night. I didn't get any work done either. I felt brainless and without motivation.

I awoke refreshed, however, and headed down to San Jose to get an Epson Stylus for $40 that I saw advertised on Craigslist, still in the box. The seller met me at the CalTrain station there, so there was no carrying issue. It was just a train down, a train back, and a short walk to the cottage from the station (carrying a printer).

That made me happy, but when I got into my room, I was exhausted again, and fell out for a nap. As I said, I just awoke, and am somewhat spaced. Not sure what to do now, but I suppose I could install the printer, and take it from there.

Hmmm.

 

[Daniel E.]

The seller met me at the CalTrain station there, so there was no carrying issue

...and no issue of being murdered, i.e. the Craigslist nanny murder.

 

[stargazer]

Most people in this area respond to Craigslist ads all the time. I've gotten jobs that way -- you just have to exercise discretion. I know you're trying to be funny -- but seriously, Daniel -- is this funny?

 

[Daniel E.]

you just have to exercise discretion.

Exactly:
http://www.craigslist.org/about/safety.html

 

[stargazer]

Yes, of course. In this case, we emailed back and forth a couple times, then talked to each other on the phone, and I felt pretty comfortable with the whole transaction. Not sure, however, how we got side-tracked from the subject of mania.

 

[Daniel E.]

...She also mentioned "incubation," which is the phenomenon by which creative work still takes place in the unconscious, even if pen is not being put to paper. It still takes place when one is cleaning the house, taking a walk, eating a meal, and even sleeping. It takes place as long as the commitment is there.

This is encouraging because it lessens the guilt. I don't have to feel like I'm falling behind, even if I'm not actively writing. Also, I know it's true, because then, after the conversation, when I did begin writing, the ideas flowed very freely and very logically. Already, I seem to have been able to take from the actors' criticisms that which would probably help, and to discard that which was probably useless...

Relatedly:

Several years ago, while a professor of psychology at Brandeis University, I studied professional artists who occasionally did commissioned work. They seemed to be the perfect population for me to study the effect of contracted-for reward on creativity; they received contracts specifying their monetary "reward" up front for some of their work, but did other work completely self-initiated, with uncertainty about whether they'd ever sell the work. I found that, overall, their commissioned artworks were rated by expert judges as significantly less creative than their non-commissioned—self-initiated—work. The judges didn't know which works were commissioned, and they weren't familiar with any of the artists' work previously. This wasn't true for all of the artists, but it was true for most.

Also while at Brandeis, I did a laboratory experiment with creative writers—people who spent a significant part of their time each week writing fiction, poetry, or drama. I wanted to see if their creativity would be temporarily affected by having them focus on extrinsic motivations for being a writer, such as getting rich and famous, versus intrinsic motivations such as enjoying the process of writing. After getting them to think about one or the other set of motives (or no motives for writing, in a control condition), I had them each write a brief poem that was later judged by experts who were also blind to the experimental conditions. I found that the creativity of the poems was significantly lower in the extrinsic motivation condition than in the other conditions. This supported one of the main findings of my entire research program on creativity: The Intrinsic Motivation Principle of Creativity. People will be most creative when they feel motivated primarily by the interest, enjoyment, satisfaction, and challenge of the work itself, and not by external pressures or inducements.

Time Pressure and Creativity

This point about intrinstic motivation was well expressed by Alan Watts, who compared life to music and dancing:

In music, though, one doesn't make the end of the composition the point of the composition. If that were so, the best conductors would be those who played fastest; and there would be composers who only wrote finales. People go to concerts only to hear one crashing chord - because that's the end. Same way in dancing — you don't aim at a particular spot in the room; that's where you should arrive. The whole point of the dancing is the dance.

By and large, as David said, I need to allow my body time to re-fuel itself. I allowed myself to become depleted, and it may take a few days.

...when I got into my room, I was exhausted again, and fell out for a nap.

A 1998 article recommends extended rest as well:

Abstract
Background: Stabilization of rapid-cycling bipolar disorder is extremely difficult.

Methods: A refractory bipolar I rapid-cycling patient on valproate was treated with long “nights” (extended sleep in darkness) and daytime light therapy.

Results: Rapid cycling immediately stopped on initiation of a 10 hour dark/rest period. This was extended to 14 hours (plus a self-selected 1 hour midday nap) without problems. Depression gradually improved when midday light therapy was added; near-euthymia was attained after light therapy was shifted to the morning.

Conclusions: Nonpharmacological chronobiological treatments may be a means to interrupt rapid cycling.

ScienceDirect - Biological Psychiatry : A rapid-cycling bipolar patient treated with long nights, bedrest, and light

 

[stargazer]

That's all really interesting. Thanks for the quotes from those articles. I want to take some time and think about this. (Also, I'm not sure I'm awake yet. I still haven't bought any coffee -- partly because I'm afraid I'll make too strong a cup -- and I don't think the Starbucks will open for another couple hours.)

 

[stargazer]

I did go back to bed yesterday after posting the brief note above. Then, I didn't get up till nine in the morning. Now, I have some good news and some bad news.

The good news is I think I am back on schedule. Yesterday I finally went running. I ran a little over two miles. I didn't want to run very much further since it was the first day. When it got to be about nine at night, I had no further urge to stay up, so I went to bed. I slept really solidly, and awoke at 4:20am, wide awake. This is how it used to be when I was running regularly, so maybe it's a sign that I am returning to my natural rhythm.

The bad news is that I'm having some kind of strange digestive problem. To describe the symptoms graphically would be a little gross, but I'd have easily gone to the doctor over this in the days when I had insurance. My landlady suggested I go to her personal physician and show him my MediCal and MediCare cards, even though they're technically not good in this County. Maybe if I explain that I have been living here and that the insurance is just caught up in bureaucracy, he'll take me, and MediCare will pay for it later. It's worth a try, anyway. I would try that before going to Emergency, where, for what I'm told, they won't prioritize me any more than they would at a family practice center.

(Yesterday, by the way, I had some thoughts on the articles Daniel posted, but I wanted to collect them and post them on the forum that relates to Creativity and Mental Health Conditions.)

 

[Daniel E.]

My landlady suggested I go to her personal physician and show him my MediCal and MediCare cards, even though they're technically not good in this County. Maybe if I explain that I have been living here and that the insurance is just caught up in bureaucracy, he'll take me, and MediCare will pay for it later

Isn't Medicare national? I'm talking about the traditional Medicare with Part A and Part B.

Until you get it checked out, the important thing, of course, is to stay hydrated. Also, you may get some symptom relief from an OTC medication in the meantime, though sometimes OTC medications are not called for or are even contraindictated.

 

[stargazer]

MediCare is national, and MediCal is State of California only; but unless I'm mistaken, I am not able to use either one outside of my own County. That's what they told me at the Mental Health Clinic both here and in my old County.

I'm thinking that can't be right. I think the State of California Mental Health services are funded by MediCal only, and I can probably use my MediCare card at the doctor without any problem. It's worth a try anyway.

Meanwhile, the digestive thing appears to have run its course. I didn't take any OTC medications, for the reasons you expressed. But there are plenty of other reasons for me to see a doctor. I haven't had a full check-up since I lost my Kaiser insurance in April of 2004.