Keeping Track of Sick Days: An Alternative to Mood Charts

I have rapid-cycling bipolar disorder. My moods change throughout the day. I can wake up depressed and go to bed hypomanic. I can feel normal for part of the day, and then anxious for a couple of hours.

I haven't kept a mood chart in years. Every time I try to keep one, I freeze up, because I don't know what to fill out. Should I count that hour of craziness as hypomania? How about that episode of unusual tearfulness - was that depression?

So this month I have tried something different. I only write down my sick days. And by sick, I mean sick enough that I would have stayed home from school/work and/or went to see the doctor. A runny nose or a few sneezes doesn't qualify as sick. That's just normal life.

And guess what? Writing down sick days is really turning out to be helpful! It helps to put a depressed day in perspective. It also will help me to know whether my amount of sick time is normal or not for me.

So I started keeping track at the beginning of May. This is a good month. This is what my sick days list looks like:

5/3/11 - Depression

5/10/11 - Anxiety, took phenibut, then felt good. Not a full sick day, since I solved the problem.

5/21/11 - Depressed, took: Ginseng, Piracetam, 2 Choline & Inositols, Aniracetam (started to feel more normal, but not completely better), Coffee... around 11pm, getting back to normal

5/22/11 - Half sick day, depressed in morning, took 2 Choline & Inositols, and Aniracetam, felt better.

As you can see, I also wrote down if I did anything for the sickness. I was also somewhat hypomanic on 5/24 and 5/25, but not to the point that it interfered with my life, so I didn't write it down. On 5/24, I simply found myself stating “What a wonderful day it is today!” and I then thought, “I don't really have any reason for thinking that...” so I was really positive, but it didn't mess me up. I was also a bit more talkative than usual on 5/25, but again, nothing bad came of it, and I was able to control myself fine.

But looking back over the month, this tells me a lot. I went for about a week with no symptoms, and if you ignore the anxiety episode (which could have been triggered by a specific event), I went for over 2 weeks with no depression. I did have mild PMS a few days, but it wasn't strong enough to qualify as a sick day - I was still able to function as normal.

I'm going to try to keep writing down my sick days. It really is giving me insight!   

Early Symptoms of Depression and Mania Mood Episodes

This is a table from a study entitled "Prodromal symptoms in manic depressive psychosis" by Smith & Tarrier, 1992. (Abstract)

A prodrome is an early symptom that a disease or attack is about to occur - in this case, an early symptom of a mood episode.

I saved this table because I sure can relate to it!  Note how some of the symptoms are physical - like feeling tired - while others are changes in thought patterns - like feeling guilty or spending money more freely.  The fact that some symptoms represent themselves as thoughts makes it really hard! 

I think this table gave me a lot of insight.   For more insight, check out "Loving Someone with Bipolar Disorder" by Julie Fast. Although this book is for a family member to read, it is really worth reading if you have bipolar disorder yourself.  She talks about the thought patterns that are symptoms as well.  Plus she has lots of ideas for possible triggers.

Natural Light Keeping the Blues Away! (January Update on my Mood)

This blog needs an update.  I've gotten sidetracked lately.

About a month ago, I started using a new light by my desk to help improve my mood.  It seems to be working.  I had some bouts of depression before getting the light, but since using it every day, my depression has stayed away almost entirely.

Of course, this is a subjective experience that could be attributed to other things, but the results seem good to me.  I'm still having some of the same stressors, still not getting much outdoor light, and yet my mood is improved.

I am using a Verilux Original Natural Spectrum Deluxe Clamp Lamp.  It's not a special mood light, but I believe the bulb it uses is the same one that is in some of the mood lights.  I use it throughout the day. It sits above my head but off to the side some, and is attached to my computer desk. This way I just do my normal computer work and get the light at the same time.

To sum up, this is what I've been doing to try to keep my mood stable:

- Lithium Orotate, 20 mg a day total (half in the morning, half in the evening)
- Zinc 25mg, taken in the morning

At lunch time, I take chromium to help with my blood sugar levels, plus a multivitamin and vitamin C. These may be helping my mood too.

I used to try to walk every day but I haven't been doing that lately because of foot pain.

I have had an excellent January mood wise. My mood has been pretty stable and I've been productive, except for about 3 days out of this week because I had some cold virus making me dizzy :(

I am also taking Manganese 10mg but this is to prevent tinnitus and I don't think it has any effect on mood - but who knows :)  I guess the good mood could be from that instead, although I started taking that in mid-December, and shortly thereafter my mood was down. So I don't think that's helping my mood unless it just takes a long time to start working.

Whatever I'm doing, it's working!  I have been thinking very positively lately, but not noticeable hypomanic. My thinking seems correct.

I am up in the middle of the night but I think that's because of having a cold virus. I've been getting tired in the evening and sleeping in the evening, then waking up in the middle of the night for awhile, and then going back to sleep.

I also should mention that I am taking piracetam and phenibut occasionally. The piracetam to help with brain function. The phenibut to help with sleep.

The Piracetam helps with many mental functions, but the most measurable one is how fast I can recall the answers when I watch Jeopardy!  I definitely get more answers correct when I take it.

A Bipolar Day

Today I had one of those days which make me realize that I still have Bipolar disorder.

A passing comment and thought triggered what felt like was going to be a meltdown. For some reason my emotions went haywire and I felt anxious and not cohesive.

I told me husband and he helped me decide to take some medicine (phenibut- half dose, and B-12) and it succesfully brought me back to normality.

Or, at least mostly normal.

The important part is that I was able to recover from what seemed like a meltdown and continue my day as I wanted.

That is something that I did not know how to do in the past. And although medicine is not always the answer, sometimes it is just the right thing.

Is Bipolar Disorder an Overreaction?

There are a lot of triggers in life, and some of them are so small that I don't like to acknowledge them as triggers. My rational mind doesn't want to say that "this small thing" is a trigger.  Because my rational mind knows that the small thing is no big deal, but my emotional mind doesn't always agree.  It's as if my emotional mind overreacts to little things.  I'll deny that it's effecting my emotional state, because rationally I know that it shouldn't, but I think I need to accept that what happens isn't always rational.

I'm going to start a list of my triggers, and I am going to teach myself to notice and accept them.  I think I need to learn that triggers are just part of this mental illness. They aren't indicative of a bigger problem in my life. But if I can recognize the triggers, then it will help me to understand why my mood changes so suddenly sometimes. I can't avoid all triggers, but I can plan for them, and hopefully minimize their effect.

Have you evaluated what triggers your mood episodes?  Do you accept that some triggers are not rational?

In a lot of ways, bipolar disorder is about overreaction.  If I had one way to describe what lithium helps me with, is that it minimizes my overreaction response.