Some Snippets

Two weeks after my last 25 mg of trazodone, and I finally feel like I am sleeping normally again without it. I am falling asleep quickly, and staying asleep, and I feel much more rested and alert. I'm still taking Benadryl...but that's normal for me this time of year. I have allergies, and as August and ragweed season approach, there is no way I can leave off the Benadryl right now. Once we have a killing frost I will stop taking it.

It sounds like the Journal Workshop class will be happening this fall. Now I just have to keep my momentum going until October...I've almost finished my notes for the first of the four sessions. Keep your fingers crossed for me!

Gianna at Beyond Meds posted the abstract for a very intriguing looking paper the other day, all about how iatrogenic illnesses may be caused by mitochondrial damage, and how the psych meds many of us take may be the greatest culprits. My initial response to reading it was that I'm not at all surprised, and it would be arrogant in the extreme for medical science to assume it knows everything about the ways in which our bodies function. And if it's true, well, no wonder psych meds have so many horrible side effects and can do so many awful things to people. Case in point right here...

Also of note, Philip Dawdy over at Furious Seasons is celebrating his one-year anniversary off meds. Congratulations, Philip!

Writing Prompt: What is one thing that you are thankful that you learned to do? For me, it would be sewing. My mother taught me how to sew when I was about five. By the time I was twelve, I was making some of my own clothing, and when I moved into my first apartment, I made all the drapes and home dec. stuff for it. Now I work on art quilts, things which have very little in common with the little pin cushions and doll clothes I first learned to sew. But I will never forget that it was my mother who first opened this door for me.

Knowing When to Slow Down

Part of being well and staying well is knowing how to pace yourself. Sometimes we load too much on our plates and then we get stressed out and don't do any of the things we're trying to do to our satisfaction.

My sleep is still disturbed after my trazodone withdrawal, and I'm trying not to take anything to help because I feel like then I'm just trading one chemical for another. As a result, I'm a little more tired than usual, and a little less alert.

I think I need to slow down and be kinder to my body and mind.

I am not doing well with coming up with anything to say today. In addition to it being summer and having the kids home all day and needing attention, I have a couple of other projects going--coming up with the curriculum notes for my journal class this fall, and working on a book about bipolar disorder and wellness strategies. I think I need to post a bit more sporadically...so I will try to get something up a few times a week, but I think I need to slow down a little...I'm running out of steam, I don't want to push myself so hard that I end up dropping the blog entirely. I'll still be visiting your blogs, but I don't think I can keep up the pace I've set so far!

Writing Prompt: How do you know when you are trying to do too much? What signals does you body give you? What signals does your mind give you? Do you listen?

My Bipolar Survival Toolbox

When I made the decision not to take mood stabilizers, antidepressants, or antipsychotics, I realized that I was going to have to pay much better attention to what I was doing to my body and what I was putting in it, so I developed a regimen that I try to stick to (try being the operative word, here). I do pretty well with this except for the constant battle with my thyroid. I have hypothyroidism, and as soon as my thyroid levels start to crap out again, all bets are off.

My Bipolar Survival Toolbox includes the following:

1. Sleep hygiene. Very important. I need to get my eight hours; I sometimes feel myself revving after only a couple of bad nights, so even though I'm trying to get off of trazodone as a regular thing, I can see keeping it around to take occasionally...at least until I figure out some other things that work.

2. Excellent nutrition. Lots of whole grains, fruits, and veggies (I'm a vegetarian, so there isn't any meat in the equation), no pop or candy or junk food, very little processed food. Limit alcohol (I very rarely have even one drink these days, but I do have rather a weakness for Bailey's Irish Cream!). Limit caffeine...right now I have two cups of tea in the morning, and that's about it. (Us Brits just have to have our tea!)

3. Hydration. Drink a minimum of 64 oz water a day (not including tea!).

4. Stress management (yoga/meditation). I do yoga at least four times a week...er...I aspire to do yoga at least four times a week. Doesn't always work out that way. I do biofeedback/meditation with the help of the Healing Rhythms software by the folks at Wild Divine. I also have a prescription for Ativan which I take (very rarely--that's a slippery slope, that is) when stress starts getting to me. I do my best not to put myself in situations which I know are triggering for me, and that means avoiding certain in-laws and out-laws completely.

5. Supplements. I take flax oil (omega 3 goodies), a multi-vitamin (no iron...iron make me ill), B-complex, and calcium (last ditch pre-menopausal attempt to avoid osteoporosis).

6. Journaling. I journal every morning, just to get a feel for where I'm at. I find this more effective than mood-charting, which I tried for a while, but found that I was getting too focused on every little fluctuation and blowing things way out of proportion.

7. Medical support if necessary. I have a psychiatrist I see every few months, just to check in. He prescribes trazodone to help me sleep, and Ativan to help me deal with stress. He thinks I'm an episode waiting to happen, but after three years of this regimen, I'm more stable than I have ever been. I figure as long as I'm on his patient list, if I get in trouble and decide I do need chemical intervention, I won't have to wait months to see someone.

8. People who watch out for me. Between my husband, my mom, and my best friend, I've got three people who know what symptoms to watch for and who are committed to telling me if they think I'm starting to go off the rails. (Whether or not I listen remains to be seen!)

9. Exercise. If I'm getting depressed, it's the last thing I want to do, but it really does help. Even if it's just going along with the Chief when he walks the dogs at night.

A lot of this stuff was a major lifestyle adjustment for me, and I still consider myself a work in progress. I don't stick to it perfectly by any stretch. I have days when I don't feel like hitting the yoga mat, PMS days when I am compelled by hormonal forces beyond my control to chow down half a bag of chips or a bag of Ghiardelli chocolate (you know, the stuff with the soft caramel inside...*drools on keyboard*...), days when I feel like eating healthy is just too damn much work, and days when I feel resentful because other people don't have to watch themselves so carefully.

It has been a long, slow battle back to clarity, creativity, and health, and I still don't think I'm working at the level I did before medication. But this regimen has done a lot for me in the three years I've been working with it. I've lost 40 pounds (20 more to go!), I've started doing my quilt art again, and more recently, I've started writing again.

Unfortunately (some would say) I've also regained my off-beat sense of humor...which my nearly-teen-aged son is finding quite disconcerting. And occasionally embarrassing. But we won't go into that here...

Trazodone Taper

Well, the thyroid test came back and it's definitely not low...it's actually the highest it's been since this thyroid fiasco started five years ago. So my days of butt-dragging-no-energy aren't due to the thyroid.

I don't think it's depression, either, because it hasn't been the usual inexorable descent into hell. It's just been the odd day here and there.

So my next likely culprit is trazodone, an antidepressant which I was prescribed for insomnia during the Big Mania. At my worst, I was taking 300 mg a night to sleep. More recently I've been using 100 mg, but I'd upped it to 200 mg a night over the holidays, which always cause me much Anxiety and Hand-Wringing, and, not surprisingly, Insomnia. And I hadn't gone back down after things settled down. So now it's time to taper down the trazodone and see what happens.

Hopefully I will be able to sleep without it. Hopefully I will sleep deeply enough without it that I won't be constantly awakened by the Chief's snoring. And the various dogs' comings and goings.

Before we had kids (and before I needed medication to sleep) the Chief (whose normal bedtime is a couple of hours after mine) used to complain that I was the only person he knew who slept so lightly that the sound of him removing his socks would wake me. To which I would reply that he was the only person I knew who removed his socks with the assistance of a crowbar, a mallet, and a bagpipe ensemble.

Perhaps it's time to think about separate bedrooms...on opposite sides of the house.

Sleep...or Lack Thereof

What a night. Took trazodone. Couldn't fall asleep. Dog decided to lie sideways between us. Other Dog couldn't decide if he wanted to be on the bed or off the bed, with much scratching and tag-jingling in between. Funky noises outside. Too hot. Finally fell asleep. Woke up. Took more trazodone. Finally fell asleep again. Lather, rinse, repeat.

Sleep never used to be a problem for me. Before my bipolar diagnosis, I rarely had sleep issues, and when I did, I would just take Benadryl or whatever allergy med I was on, and that would usually take care of it.

I never lay awake stressing about whether or not I would get to sleep.

Now I do.

I'm not sure if it's the whole bipolar indoctrination about how lack of sleep can push you into hypo/mania, or if the medications I took have somehow damaged my ability to fall asleep naturally, or if taking trazodone most nights for the past five years has made me psychologically dependent on some kind of sleep aid, but whatever it is, I can't seem to fall asleep by myself.

Unless, of course, I'm lying on the couch, tired out.

But as soon as I get into bed to really, seriously sleep, if I haven't taken my trazodone, forget it. Doesn't matter how tired I am.

So I'm wondering if maybe it's time to try and get off the trazodone.
I'm wondering if it is part of what makes it difficult for me to write.
I am wondering if I am sacrificing clarity for sleep.
I am wondering how safe it is, really, for me to take this stuff every day.
I am wondering what else it's doing to my brain besides helping me fall asleep.
I am wondering if I really want to be on this medication for the rest of my life.
I am wondering if my body even knows how to fall asleep anymore without chemical intervention.

And I'm wondering if losing a couple of nights' sleep is really enough to push me into hypo/mania like my first psych doc warned me that it would.