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    Yes, you can work when you’re manic, depressed, anxious and obsessive

    I just wrote a 170 page book in less than two months. It was stupid. That is the only way I can describe my decision to take on the project. Stupid! I guess I forgot what this kind of work pressure does to my moods.  I sent in the final edits today. It’s a good book, but I really do have to be more careful with my choices. The book itself was extremely difficult to write. It’s on how to write and sell ebooks- and the deadline was too quick. This is a combination for disaster.

    I had three hypomanic episodes, lots of depression, a terrible OCD episode that I wrote a lot about and so much anxiety I had trouble sleeping.  But I kept on working.  I have taught myself to keep going despite the mood swings- otherwise I would not get anything done. I try to keep away from major stress, but it’s not always possible.

    I wrote Get it Done When You’re Depressed to help all of us with bipolar disorder learn to work when we are sick.  If I didn’t work while depressed,  I would never get anything done.

    So, if you’re having a tough time, you can learn to work- whether it be housework, taking care of kids, making sales calls or writing a book, you can work.

    I appreciate all of the kind comments and emails I received while I was having so much trouble! I will definitely send everyone a link once the book is available.

    Julie

    Related posts:   Get it Done When You’re Depressed: Put Yourself in a Place You Can Work |  Bipolar Disorder and Work: I’m unsure what to do, but I will do something anyway! |  Solutions to Work Worries |

    2 comments to Yes, you can work when you’re manic, depressed, anxious and obsessive

    • nichol

      surviving brain explosion . . . well, it is possible. everybody- thus far, I AM ACTUALLY WORKING. How can i possibly explain this phenomena? recovery is possible . . . and i have worked thru so much pain and fear and anxiety, but no psychosis like i was dealing with when i tried to work a few years ago . . i’ve had to adjust to new “functioning people’s meds” and i have been able to . . . if i look at things just right, i could probably see that i am one of the luckiest people in this world right now . . . despite several piles of hardened cat puke strewn about the place with giant piles of laundry everywhere puncuated by bits of stained paper and god knows what else; this week the apt. will get cleaned (started anyhow) and dognabbit I AM WORKING! A successful contributor to this society-i think i am A LOT more capable than my brain has realized . . . now is the time to SHINE, uncleaned up cat puke and all . . . love to all
      nichol and cats

    • Hi Julie,

      I have not checked in for a while so have been updating myself with your recent blogs over the past month all today.

      I am sorry to hear you have been struggling at times and had a really tough time. I suppose with this illnes that is power for the course and to be expected, but it sounds as if at times you have been rapid cycling to be honest if you had 2 hypomanic episodes in the 2 months you were writing the 170 pages of your new book, which I look forwrad to reading.

      You also mentioned having been depressed in between too and had some OCD panic feelings and a lot of anxiety. Not sure if the anxiety was during your high or low phases. Was it a mixed episode with agitated anxiety or did you have clear cut lows in between the 2 highs you mentioned?

      I am interested because of 2 aspects that really stand out when I read your blogs, which I love and have given me great hope for the future , and I have learned alot from you. I have recently bought 2 of your books, and have also been reseraching bipolar for about 10 years now quite extensively as my partner has unstable Bipolar 2, dysphoric type of hypomnias, with alot of Raid Cycling.

      I Have researched the medication and the medications in particular, as well as self management and social rhythm regulation, and lifestyle, relationship aspects, so your books have added a valuable source of knowledge and are among some of the absolute best I have come across, alongside Kay Redfiled Jameson’s books.

      The first thing that strikes me , and has before is how you have found Lamictal really works for you, and seem to totally beleive in its effectiveness. MOst do.I must say, this has not been experience, with my partner, and I have observed him very carefully over the 3 year period he has been taking it.

      Although it does without a doubt rapidly ease the depression which is why most people seem to love this drug, those with Bipolar at least, who don’t r rarely all realise they are high, it has caused so much more hypomania, and Mania, particularly long epiosdes, and increased the frequency and duration of Rapid cycling, more highs than lows too than he has ever had before.

      This was only parallelled by the times when he was on Anti Ds in the past, always alongside mood stabilisers may I add, but the Lamotrigine gives no protection against hypomania and mania, however it is marketed. I recall Dr. Preston stressing that to you and the listeners on your radio show. many psychiatrists and doctors do not realise this. It seems that the psychopharmcologists are the only specialist who acknowledge and recognise this fact. Even in most literature it is heralded as thde answer to Rapid cycling, and both manin and depression, which simply is nt the case. Indeed it stops the swing into the lowest of liws, but it certainly does not appear ot manage the highs or prevent them andI feel really needs much more research and studies doen on it, and not just accunts from patients either. Partners would probably give a totally different view on its effectiveness, and unfirtunately much of the statistical dat is gathered from clients who do not report high symptoms. They are also not always spotted by healt In a brief consultation much hypomnic ehaviour is frequently missed and undertreated byhelath professionals in reality. There is a huge body of reserach into this at the moment, therefore how can the dat on lamotrigine be accurate.

      Lamotrigine is purely for the depressive phase of the illness of Bipolar, and particularly good for Unipolar Depression, but not for hypomnia or mania. I have found that those you believe they are really well on it are often infact quite hypomanic uch of the time but won’t admit it is connected , or believe it when it is pointed out or when a loved one shwos concern,or report it. They will tell the psychiatrist they are very well on the Lamotrigine and he just sends them away on it. Thats easier for the doctors if they don’t have to take any furthur action.

      Have you found hypomania happens at all when you recommence it or increase it? Can you be ruthlessly honest with yourself if it were to make you high? Would you notice that happening, or do you just feel really well, so would be reluctant to reduce or stop it ? I am not being critical. am just challenging the Lamotrigine cure all , and wondered what your individual experience of it is. We are really struggling with it, but my partner thinks it is great. I KNOW otherwise. He has been more unpleasanr than ever on it, very hostile and aggressive and done all sort of out of chracater and risky things, and is over working and very goal focussed and work focussed to the exception of all those whom he noirmally cares about, all of which are hypomanic signs.

      I am not being critical. I just wondered do you experience any of the same, as you stated and recognised you are having hypomanias quite abit, yet say the Lamotrigine keeps you vey well. DO you recognise them at the time though or is it in retrospect ? What do you do about it if i happens, particularly whilst working ? carrying on surelky will not help.

      I have just discovered from my partner that he has been taking it again secretly since Last February, without me being aware though I suspected something.

      We have had one of the worst yeras yet, the same as 2006 when he started it. Things only improve once he stops it, and worsen agian with days or a week ofhim starting it again, partly I believe becuase he startsback on 100mg, rather than carefully titrating up slowly. He is on 2000mg of Depakote too, but is low on this on its own for much longer.

      But when off Lamotrigine He becomes more rational, and reasonable, ” Normal “, more caring and afectionate and much more himslef except the depression does over shadow him, atlaest we are not estranged like we are during all hypomnias, when he oushes me away completely and is very aggressive and destructive, but belives he is reasonable. He thinks it is all me causing problems in the redlationship. When he comes out of the high. he recignises it was not me at all, but all caused by his behavioyr and hostile perceptions and agression, and realsies I have only tried to help him.

      But then after a while he slips back into a deeper low again, then the self doubts and anxoety anf crippling negativity and painful agitation settles in. I really feel for him, but we arec never parted by his depression, just his highs,

      I tyhink it is very hard for those with Bipolar to be objective about what has really prevented them from having or mainatianing relationships. The blame always seems to be aimed at the well partner. Tis is not very realistic or an honest evaluation. RElationshops are difficult at the best of times for the average individual if the partners are incmpatible, but are stretched to the limits of endurance if Bipolar, and the expectations are way above what most would be expected to cope with, but I truly believes that with Love, knowledge and understanding a Hppy relationship can be achieved if one partner is Bipolar, as long as one partner is stable, but only if they too are compatible, and have great patience, respect, care, and a high level of knowledge and care. If a partner can not accept the refuced ohysicalmside of a rekationship during the low phase as swell, then they surely do not really love or care enough, as However a sexual relationbship is, I do not feel that a lovong relationship should be defined by it, and many couples have long eriods of celebacy quite happily, but can still be affectionate.

      There is time for great sex when well. I suppose some people can not accept a diminishjed sex life, but that goes hand in hand with depression, so I feel if
      they are committing to the whole person, and depressive illness is part of that, then sacrifices have to be made.

      Ofcourse One party needs to be able to work and bring in some income, so tha is important,lduring long depressions. I still believe Love can find a way to overcome all these obstacles, or chalneges. If Not then ots the wroing relationship. Love Stays in difficulty, but can only be pushed away so much before it gets uo and walks. !

      I can totally understand why my partner wants to take lamotrigine, asthe experience and memory of the depression is so frightening and its return dreaded. Lamotrigine works so quickly as it has a fast acting elevating effect, compared with some of the Anti Ds, and is not reported in drug information as likely to precipitate mania / hypomania, however ,I have read many client and Medical reports that actually state it does trigger hypomania, in just the same way as Anti. Ds, and logically, I can see why it would do, due to its very fast action on depressive symptoms, particualry if true Stabilisers are not optimised.

      DEpakote and Lamotrigine are apparently not a great combination as they both affect the blood or clearance level of the other, whereas Lithium does not adversely interact with Lamotrigine apparently.

      Valproate levels can be reduced by Lamotrigine taken at the same time, and, equally, Lamotrigine levels can be pushed up by Depakote as it slows down the clearance rate of Lamotrigine. Hence individuals are not actually receiving or maintaining the dosage they are taking.

      However ,Depakote is supposedly and more often presrcibed for and beleived to be more effective in Rapid cycling and resistant types of Bipolar 2 , more than Lithium. I am not trully convinced. The problem with Lithium is getting someone to take a high enough therapeutic dosage, and adjunctive treatment may well be needed with something such as Seroquel, lamotrigine, or Geodon, even (lithium and Depakote OR Valproate in combination).

      Lamotrigine is apparently not really a stabiliser like Lithium and Even the anticonvulsant Valproate, becuase Lamotrigine only works on the depressive phase whereas Lithium and valproate work on both mania and depression, although I know Lithium is still the Gold standard of Stabilisers.

      Do you think your Lamotrigine could be in any way contributing to these hypomanias you are wrestling with ?

      What would your plan be if it were contributing, as you believe in it so much. Could it just need adjusting do you think ?

      The second thing that struck me was the fact that you have been so work focussed and said that this really helps the depression. However, you mentioned being hypomanic twice whilst writing the book, but just keep going . Was it the Hypomania actually triggering the ” having to keep writing and going feeling”, pressure to complete it or was it the stress of work which triggered the hypomania. To be honest it sounds as if the hypomania came first and that is why you keep on going.

      Another Comment you made in one of your blogs really rang true. MY partner often says is that all that matters in his futire is maintaining work and finances. However he only feels that way when high, and has repeated it then in different words. Once syaing he would sacrifice everything including me for his material wellbeing.

      This may seem like self preservation, but it is a known goal focussed and finance focussed statement heard again and again by partners when their loved one is high, but does not recognise it, and under hypomania pressure to keep working, Come what may, At whatever Cost.

      Ofcourse when he can’t stop working like this becuase the hypomania won’t let him, It is not deliberate,it just perpetuates the mania more , feeds it. HE eventualy will crash dowm with exhaustion, of b eacuse the Hypomania runs it natural course and ends spontaneoulsy, on eor the other.

      I do not believe that the end of the project coming, or by not working anymore triggers the depression. It just means you have come to the end of the mania. He like you though feels if he does not work he will get depressed and get nothing done. Looking at it objectively as someone who knows the illness very well but does not have it, I believe that the overwork and the new work ideas are brought about by the initial hypomainia, then perpetuates it, and the depression naturally follows, purely and simply this is a cyclical illness, and because the exhaustion of not looking after himself or not being able to when high, eg, not eating properly or not sleeping properly, will eventually bring anyone down.

      A healthy amount of rewarding and stimulating work can really helpmotivate people or help them remain motovated, give people a purpose, a reason to get up etc, but that is all about the benefits of structure and purpose, and feeling part of society, and the normal social interactions that work bring.

      I am not working at the moment, nor do I have any income at all, or savings or benefit, bust a bit kof overdraft left to tide me over fir about 4 more weeks, but am just about up to date with my bills atleast. I am not worried about it at all at the moment, as it gives me time to do other things I would normally not be aboe to do, and I will have to find work in the new year agin, or take on something , anything to keep the wolf from the door untilI get back to proper work. I refuse to worry about it until the bailiff comes knocking.

      Obviously homelessness or hunger and loneliness are the worst aspects of poverty, but as long as we do not reach theselenghts, I think work and financial wealth is overrated. Health is the realmwealth.It just is not worth geeting stressed over work or money. In the past I would, but am going to just take ita day at a time, and pray, and job search, and believe that it will worl out somehow in the new year with faith. I am using my light box for S. A.D and that has made all the difference to how I feel about everything so we shall see.

      I have run myself in to the ground lirerally in the past with work , so I do not do it any more as it cost me my health then. NO More! Health means far more than work or financial and security. IT takes a long time to realise this. I am 45 now. I did not feelliek this even 5 years ago. I think with age come s a different perspective on life. As long as I have a roof over my head and something to eat, and have warmth and companionship in friends and faliyl from time to time, if I have my health I have everything without needing extras.
      However in Bipolar, and in fact in general health, but more so in bipolar perhaps and any chronic delibitating condition, it seems vital to pace the work, and perhaps do less when high, and try to do that little bit more when low if you can, but not to just keep on doing it when yiun obviously start to develop highs . That implies it is not being paced or managed evenly, and then could in turn trigger or feed the mania. It is double edge sword.

      You strike me as someone who has alot of mental insight into yoir symptoms, and I know you use the health cards, however, is that Insight still lost partially even if you start to go mildly high and lose your balance? Deadlines and work pressure whether self imposed or by others can put the average erson under stress and leave us feeling manic in the gerneral sense of the word.

      So I would have thought this is an area of particular attention for someone actually with true manic/ hypomanic mood swings, who can not perhaps push themsleves or allow themself to push themself in the same way as someone without this, who at the very least would still suffer from a feeling of being drained, exhausted or elated or relieved at the end of a project. These kinds of demands take obvious toll on anyone if work is over demanding and not not paced, so I guess It is surely even more important in Bipolar to recognise when this is happening or spot any medication that could be contributing to it or aggravating it however loved they are and beneficial on some levels. Is the lamotrgine helping as much as yoiu beleiv it is ? Does it need reveiwing.

      am sure you won’t like me saying this, but I have followed your blog for a long time, and am concerned.

      I congratulate you on writing your book recently, but it realy seems to have messed up your health whilst doing it, and you are after all advising others on how to stay well, at the same toem looking after yourself, and doing yoir books and radio which I have missed lately.

      THis is meant with the best possible intention. I am a great admirer of all your work and your website and your determined efforts and knowledge about how to stay well and how to learn about and manage Bipolar Disorder, for families, partners, and experiencers. I would hate to see that go arry.

      Recognising you have been high is one thing, all well and good when its over, but catching it and not allowing it to persist is another, as it can be so destructive, and I am sure is the main cuase of relationship difficulties for most of us, not the lows, especially if in an irritable, aggressive dysphoric high.

      I hope you have a restful break, a peaceful, songful christmas, and that youlearn tom love the snow. would love to be snowed in. It can be isolating and I feel for you in that respect, and then the thinking can be too loud in our minds when we are alone. A these times with or without Bilpolar, I would recommend singing as the greatest tonic, uplifting but at the same time relaxing calming, and you never feelalone with a song in your heart. You could perhaps use the Snow Lonely time to write one if your own, have some really nousrishing hot stews, warm baths , and just relax.

      Do not fear this will make you low. It won’t if you vw it in a different way. The snow brings brightness, and lightness, and the sun’s reflection as long as you are cosy and warm inside, or can wrap up warlmy and have a great walk with ahot flask and soem snadiches hat fun ! Love the snow. It will soon pass. WE have cold, high winds and rain in England at the mo, so when the sun comes it is a joy. Can I swap it for some snow ! I Love photography in the smow too. There is much you can do in the snow. Don’t waste time looking out of thewindow. Get out There and ebrace the snow. make that giant snowman you never had time to make before. Dress it up outside your window ! If you do. Send me a Photo please.

      Lots and lots of Love to you. Happy Christmas, and thanks for all your great support and encouragement over the year. I hope you see my comment as a challenge. it is not intended at all critically. Shal send you some more spring pictures soon! Martina.

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