 Depression has been my unwanted companion for many years. I work hard to make sure it doesn’t take over my life. I’ve noticed that free days where nothing is schedule are a problem for me. Because of this- I try to schedule myself out a week in advance. This doesn’t always work. Would you believe there are people who aren’t this crazy about scheduling and say,”Let’s see what happens?”
I know what works for me. Scheduling and being with people. This is especially true on Friday and Saturday night. Do I wish I were different and more ‘fluid’with my scheduling? Of course! But I’m depressed a lot- and this is what helps. Julie  I once watched a reality show on becoming a Dallas Cowboys Cheerleader when I was at the gym. I had a political interview show on my IPOD,but this was far more intriguing ! First of all,it was a pretty weak premise for a show –as watching cheerleader tryouts probably brings back a lot of bad memories for those of us who were not fond of high school! But there was something very interesting on the show.
The women had to climb up a really high pole and jump off onto a trapeze bar. Yes,that was one of the tasks. There was one candidate who was very scared of heights. She cried the whole way up the pole. But I had to admire her. She got up there,stood up and jumped off. It was pretty safe as she had on a harness,but I could see it was one of the hardest things she had ever done. I admired that. I haven’t forgotten her bravery. I have a lot of social anxiety around certain situations. I’ve found that some give me severe OCD anxiety symptoms if I let them go too far. It’s hard to keep going in these situations –you either do something dumb like running away- or saying something embarrassing,or drinking too much or just being silent! Next time you can think of the cheerleader –if she can do it. We can do it! Julie I just received an interesting question from Heather about OCD bipolar disorder symptoms. She wrote that she didn’t know that OCD was so common in bipolar disorder. (It is!) Then she asked about her obsessive thoughts: Julie I don’t understand my own obsessive thoughts or where they came from. I am always thinking about paper cutting my eyeball or slicing my achilles tendon. These thoughts make the relative body parts actually hurt! I have no idea why or when these thoughts pop into my head but I can’t get rid of them! Sometimes I wrap my ankles in ace bandages for the psychological ‘protection’ from the unseen knife. Or last time I was in the hospital having the thoughts about my eyeball,they gave me an ice pack to carry around and cover my eye. It was embarrassing but hey,all of us in there have problems. Do you have any suggestions or even an explanation? Hi Heather, That is what happens to me when I have mild psychosis. I see myself get killed,maimed,poked,cut etc. All of the good stuff! I didn’t know what it was until I learned more about the illness. I have a lot less psychosis now. Mine is definitely stress related. Did this happen after you went off the Abilify? That is the main question. It can definitely be OCD as it’s a repetitive thought. I deal with this in a few ways- meds of course- then trigger management. Is there anything that triggers these episodes? Could be a stress reaction in general. And then ,the hardest to treat is if it’s simply a part of the illness and has nothing to do with any outside influence. I suggest behavior modification help. For example,when I get obsessed= and it is awful –I talk to myself and say,”You have bipolar disorder. This is a part of bipolar disorder. Treat the bipolar disorder first. This is not real.”I do this every time an uncomfortable thought comes up. You have some questions to answer: 1. Did I have the same symptoms when I was on an anti psychotic?
2. Are these obsessions triggered by events or certain situations?
3. Is it OCD or psychosis?
4. How can I talk to myself to deal with what is going on while I get help. Those of us on this site know that what you are going through is real. I wish you luck in figuring out exactly what is going on so that you can find relief! Julie Hi Julie, I am going to court tomorrow,and I have been a mess,shaky,anxious,and frustrated at everybody around me. I feel like everything someone says is just irritating and worthless to me. I don’t’want to around anybody,but I know that is not healthy for me. I have been getting worse all week leading up to this stressful situation. I am worried that I am going to have a full blown depression episode. I cannot concentrate and am having trouble sleeping. Hi Colby, Isn’t it amazing what stress can do to our bodies and minds…I would be stressed too. It hits us harder- that’s for sure. It’s amazing that you are aware of your anger and frustration- this means you can keep it from ruining relationships and getting you into trouble. I was majorly irritated yesterday and even yelled at a friend- I felt terrible and then realized that is not the real me and I have to manage myself better. I suggest that you have a mantra to say the rest of the day. I am angry because I am stressed and anxious and I have bipolar disorder. I will NOT take this out on other people. They are not the problem. I will NOT ruin relationships. I have made it through many tough things and I will make it through this. I know when the court session is over I will feel differently. I can do this and I will. Now,what do I need to do right now to feel better? I talk to myself like this constantly- even with the stress is overwhelming. The truth is that you can’t get out of the court situation,so you might as well use it as a learning experience to see how well you can manage the anger. If I can keep myself from punching a wall- you can too!!!  Julie 
Men and women are different- so it makes sense they would get depressed differently as well. Here is an interesting article on men and economic change. Male depression is expected to become a factor for more Americans in the coming years because of growing social and economic pressures. http://www.thirdage.com/news/depression-expected-hit-more-american-men_3-1-2011 I can’t stress it enough that depression is treatable. Especially with the right medications. If you are a guy with depression,you have different pressures than women. Find a male therapist if that will work better- talk to other guys who are depressed and read books by men who have managed the illness. Julie  I just received an interesting question:Julie,why do some people with bipolar disorder cry and cry when they are deoressed while others don’t cry at all? I am not sure why people cry. Melissa.
I am not an expert on this,so I asked my coauthor Dr. John Preston for his explanation. Hi Julie, Crying likely serves several purposes. The first is crying as a distress signal. Babies do this,and the result is that loving parents are alerted to their discomfort and feed them or rock them. Likewise,crying is a social signal that may elicit support for others. Additionally,crying has been found to result in significant emotional relief. There are basically two types of crying:one is an aborted crying spell;here the person tried not to cry…they hold back tears and this is often accompanied by a flood of inner negative thoughts (e.g. “What’s wrong with me…I’m crying like a baby”…and other negative attitudes towards the self that generate shame). The other version is where the person given themselves permission to cry. Rather than being self-condemning,they accept that crying is a natural and understandable human reaction to loss,disappointment,or significant stress. This type of crying spell often leads to emotional relief. Neurobiologist William Frey has shown that emotional tears contain the stress hormone ACTH. The lowering of ACTH levels has a direct impact on the stress hormone cortisol. Cortisol levels are often significantly elevated in depression and have been found to increase depressive symptoms. If you decrease ACTH levels,cortisol levels also decrease. Thus crying is a way to reduce the levels of this hormone and lessen depressive feelings. John PS:This is an excerpt from our book Get it Done When You’re Depressed. 
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Depression has been my unwanted companion for many years. I work hard to make sure it doesn’t take over my life. I’ve noticed that free days where nothing is schedule are a problem for me. Because of this- I try to schedule myself out a week in advance. This doesn’t always work. Would you believe there are people who aren’t this crazy about scheduling and say,”Let’s see what happens?”
