The Power of Medication and Self-Management

I would like to share with you the worst couple of weeks I have had in years and their impact on my mental state.

It started about the second week of December when I interviewed at a local store for a part-time job. Everything seemed awesome. My store manager was a direct, no bullshit kind of guy who had overcome some mental health issues of his own. The job hours were perfectly suited to what I was looking towards. It would have had me in and outside on a regular basis, so no stagnation in four walls constantly. Rather easy going environment so long as you got your work done. Seemed great! Super stoked and happy about the prospect.

I’m offered a job. I go through my self-management practices that I learned in Cognitive Behavioral Therapy. Being Bipolar, I know from previous experiences that I would often escalate when offered a new job. I would rocket up, be super excited, happy to get going, and then either get myself fired for saying inappropriate things thanks to hypomania removing the filter between my mouth and brain or crash into a mind numbing depression and be unable to function for a few days.

I purposefully avoid thinking about it for about the first 12 hours after I find out. Every time it comes to mind, I push it back out with something else that requires a lot of thought. Reading about economics and finance are my general haven for that. You don’t have to do anything that boring; but having a difficult subject to try and focus on can help derail the thought processes.

Make it through the job offer with no hints of an escalation! Success!

On Monday, December 21st, I go in for my orientation at about 9 A.M. At about 8 or 9 P.M. that night, I start feeling very off. By about two in the morning, my body is violently rejecting anything I had put into it that day. I am forced to call off of work my first scheduled day because my body is expelling everything from it, from both ends, with the force of a geyser.

I’m hoping this turns out to be a 24 hour bug. NOPE! I’m repeating this process for a good 48 hours until I am finally able to eat and actually keep things in my stomach. Though my stomach seems to be settled, my intestines weren’t quite finished with me. I tried to go into work that day. I was there for an hour going through training before I realized, “If I bend over or try to pick up something heavy, I’m going to shit myself.”

I get sent home because I can’t do my job. This goes on for about 5 more days. Maximum dosages of anti-diarrhea medicine don’t touch what’s going on in my intestines.

So, let’s rewind for a minute.

The day of my work orientation, I’m driving home and my engine makes three hard fires and then starts driving like a tank. I’m like, okay, I have a misfire. I get in to a mechanic some days later to find out that one of my cylinders has no compression and is scored severely. Diagnosis of trashed engine. $4500 that I don’t have for a remanufactured engine and installation or shop for a different used car. Only reason I’m not going to be driving a $500 beater is my folks were willing to help me with it.

On Day 2 of this ordeal, I get a call from Social Security. “We never received paperwork for reexamining your Disability case. You are going to lose your benefits if we don’t hear from you.” I immediately call and find out they sent me paperwork in JULY that I don’t remember ever seeing. The social worker I’m dealing with gives me until January 12th to file a new set of paperwork. (Seriously, be nice to these people. They are there to help you, even when they are giving you news you don’t want to hear.)

At this point; I’m stressed out about being sick, figuring I’ll lose my job for missing so much work in my probationary period, figuring out what I’m going to do about a vehicle with no credit and the couple hundred bucks I have, and the potential for losing Social Security and medical insurance.

I’m proactive about communicating with my work to show that I want to be there, that I want to work. My Store Manager decides he doesn’t want to fire me if I have a legitimate medical excuse (good guy, boss) even though I should be let go. Unfortunately, I can’t get in to get cleared to return to work, per company policy, until January 4th. I get cleared, I go in January 6th.

I’m like awesome, came out of this with my job intact! I go in, work on January 6th. January 7th, I report for work. I ended up losing the job anyways. Fun stuff.

The only response I could muster was laughter…for about five straight minutes. It was one of the deepest belly laughs I’ve had in years. Why?

No unwell cycle. Because of medication, the practices I learned through Cognitive Behavioral Therapy, and the things I’ve come up with for myself – no unwell cycle. Some depression, sure. But my brain isn’t screaming at me to kill myself nor is it running unchecked into mania. Ten years ago, the circumstances like this would have rocketed my brain into a severe unwell cycle and screwed me up for months; just like I’m sure it would for many of my readers out there.

Bipolar Disorder can be a daunting, intimidating illness. It is especially scary for people who are newly diagnosed or do not know much about their mental illness. The more you learn, the smaller the teeth on the monster become. It will always have some teeth. There is a possibility that I could have triggered and had an unwell cycle because of this no matter what I did. No one should be complacent in the management of the Disorder and making sure they keep it controlled. I identified that I was entering a turbulent time and responded with my contingency plans for dealing with my brain during them.

Knowledge, planning, and tools from the mental health industry are why I’m not out of my fucking mind right now. Anyone can learn to do these things. It’s a lot of work and it’s not easy. I don’t always get it right and neither will you. Derailing just one unwell cycle can greatly reduce the overall chaos in the life of a Bipolar person and their loved ones.

In other news, I’ll be using the time I have between applying for new jobs to begin working on my third e-book in earnest. The next to come will deal with my observations and suggestions in creating more harmonious Bipolar relationships (friends, family, love), identifying toxic situations and when it is time to let go, common mistakes I see people make regularly, strategies for dealing with different situations, and more! Like all my work, it will be written to be equally useful for mentally ill people and the people that love them.

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15 Responses to The Power of Medication and Self-Management

  1. Victoria H. says:

    You are an inspiration Dennis!

    • Dennis says:

      Thank you, Victoria!

      Please note that I changed your display name to remove your last name. You want to avoid using your full name when posting on or discussing matters of mental health so that search engines don’t tie your name to your posts. You don’t want this stuff to turn up if someone decides to Google you.

  2. SRC says:

    Wow, you make me feel humble. I don’t have BiPolar but tend to get very down and hit the Valium so I don’t have to think at all about things I can’t change or escape. I used to have a set of go to tactics that would head off the bad stuff but after 5 years of almost constant chaos(not just my own) , these don’t work anymore. Can you please tell me where to find any notes you have made about your strategies, if you have made them?
    And well done for not losing the plot…I would have been straight into the pills

    • Dennis says:

      Thank you for the kind words, SRC.

      I’ve mentioned bits and pieces of things here and there; but I had intended to fully address my own methodology in a coming ebook. Unfortunately, changing the way I perceived the world and what it brought me was a very long-term result of a process that I’m not entirely sure of. I just reached a point where I decided that I’m not going to allow the world to dictate how I feel. I would dictate how I feel. There was definitely some anger and disappointment in me about it at all; but it was very fleeting because I forced myself to not dwell on it, thought of other things, looked for a way to turn it into something not negative, and even did a fair amount of meditation.

      I feel like the mental space I’ve developed from regular meditation and forcing myself to not think and dwell is what played the biggest role in changing that perspective. We’re always so busy, always so worried about what’s coming down the pipe. Life can just be an unending avalanche of stress unless we force ourselves into a place of quiet.

      I imagine that would be much harder for people with anxiety disorders (if you have one). And I also realize how that likely sounds to people. “Oh, it’s just that simple! Don’t worry about it! Thanks, fucker!” But it’s not simple. It’s something I forced myself to do and worked on for a long time until it became a regular habit. Being able to separate myself from not only life stresses, but the stresses of doing what I do in my advocacy work is pretty essential for my own stability. If I didn’t develop it, I couldn’t do what I do through my website, email, and social media.

      What kind of anything do you do to relax and take your mind out of a stressful space for awhile?

      • SRC says:

        Sometimes, favourite happy movies and visiting my grand children will work but more and more I notice these things do not. One of my sons has no diagnosis but is prone to bad mood swings, whilst the other has Aspereger’s and has lost what little drive he had since leaving school a year ago..sits on a game console all day and eats everything he’s not supposed to and now has hypertension at 19. They both live with me. My man works away and can be prone to behaving like a single man on occasion so I am constantly on alert. The Valium does nothing but knock me out for a few hours. I used to travel by car and that would always work but his new job does not pay enough so I am stuck home. Just getting my self diagnosed CFS under control so I hope to get a job so I don’t sit home constantly thinking. I CAN make myself not think about all this or I would not sleep bu for me, that does not seem to be addressing the issues or I would be feeling better. Totally no idea what to do.

        • Dennis says:

          Hm. It sounds like your depression is pretty severe from that description. Your “self diagnosed CFS” could very much be a part of the Depression. Assuming you mean Chronic Fatigue Syndrome; everything that occurs in CFS also occurs in severe Depression. And from your words here, your escape mechanisms, and how you’re describing your feelings; they are all consistent with severe depression as well.

          Are you able to get in to see a doctor for an eval, diagnosis, and to start treatment? If you do have severe depression, it may be worth applying to social services about. I’m not sure if you’re in the states or not; but I was found disabled due to Major Depression primarily. That would not only give you some income, but insurance, and open up an avenue to disability-related work rehabilitation programs that states offer. That would give you a platform to try and change your situation from.

          How does your autistic son function? Is he able to socialize appropriately but just doesn’t choose to? If there are depression problems in your genetics, it would be very easy for school ending to cause him to withdrew into his own shell and stay there; because it’s a safe place and life is a chaotic, disorderly mess.

          • SRC says:

            In Australia, disability services has had the previous extra help cut to almost nothing and getting on the Disability Support Pension is next to impossible. I have been diagnosed with depression in the past so they will not accept that unless I am way worse and can prove it. My Aspie son is also on anti depressants because leaving school was a big shock to his routine. I have to say he has grown out of most of his traits like no eye contact with strangers etc. I want so badly to see him either study further as he is extremely intelligent or even get a part time job, just so he has a social life again. I feel much of my depression atm is through being unable to help or deal with the 3 men who live with me. I found a drug called Low Dose Naltrexone which has given back most of my physical ability and I exercise at least 3 times a week now, so it’s not all bad. Maybe too much time on my hands so I plan to study this term.
            If only I could get these men to step up a little.

          • Dennis says:

            That is an unfortunate situation really. It’s great to hear that you’re getting regular exercise. That can help quite a bit.

            In regards to your HFA son, you’ll probably need to push him out the door to get him moving through the depression. As you know, depression robs us of motivation and drive. So that may need to be forced. Shit all you can do about your husband really, unfortunately. As for your other son’s mood swings, again that’s really only something he can address.

            You can’t help someone that doesn’t want to help themselves. That’s a main mantra that I find myself repeating to myself on a regular basis.

            Too much free time to think is usually a bad thing when it comes to depression. I think studying will probably help though, because it will take your mind off your three guys in a very distinct way for a little while.

          • SRC says:

            Thanks for your kind remarks, nice to have validation. I am in awe of how you address your condition and refuse to let it rule you…gives me hope

  3. SuperCookie says:

    Hi Dennis,

    I was in a relationship for five months with a great guy who was diagnosed with bipolar disorder and severe anxiety about a year ago. It was intense and he pursued our relationship relentlessly. Three dated in he said “I love you and have never felt this happy” which worried me. He was upfront and honest with me from the beginning and I did everything I could to learn about his disorder. He did everything by the book to manage his illness: religiously took his medication, ate healthy, avoided drugs and alcohol, exercised regularly saw his psychiatrist and until recently did the same with a therapist. He communicated with me when he was unwell or needed space and I did my best to respect that. I helped him talk through many of his depressive episodes, which lasted usually about 2-3 days at most.

    My (I guess now) ex dealt with punches and blows in life quite well. He is self aware and is getting a good grasp on his illness. We struggled with my own issues of not communicating enough my frustrations with our relationship (it’s freaking hard!!) but I did my best to work through my them because I love him.. We live on the east coast and decided to weather the recent blizzard that hit our area in his tiny studio. We had a good time except for a few moments of friction. I went home and he all of a sudden became lethargic and slept most of the day. He went to work the rest of the week exhausted and I noticed his communication with me was becoming more distant and less affectionate.

    Yesterday he called me up to break up with me. He said he didn’t feel like he was good enough for me. That he didn’t love or care about himself so he can’t be in a relationship right now because he couldn’t offer that to me or anyone else. He said no one can help him but himself. He acknowledged that he did still love me and cared about me but he was protecting me from him and his demons. He also acknowledged that I was the first woman he’s been in a relationship where he ever felt respected, loved and valued. He assured me I did nothing wrong and it’s just the chaos in his head that he can’t doesn’t know how to deal with. He said he wanted to work on our relationship but couldn’t because he didn’t know how. In my highly emotional state, I told him I can’t handle picking my stuff up from him and that I never wanted to see him again. I also asked if he would regret this and he replied “no” with an eerily robotic tone.

    Dennis, I am reeling from this. I thought everything was going well and that he was managing his bipolar at an impressive level. Through how he lived his life, I saw him working hard on being better. I thought his medication was being effective although he hadn’t seen a therapist since last October. I love him and care about him so much. What should I do? Do I hope and wait that he comes out of his depression to realize he still misses me? Do I contact him? How is it possible that someone who works so hard to be better destroy what he acknowledges to be a good thing? Especially someone who is on medication?. I let his family know so they could check up on him.

    I’m sorry for the long narrative. I’ve read your blog and it has offered me some comfort. It’s also helped me stop being so hard on myself. I look forward to your reply!

    • Dennis says:

      Hello there. Here’s the thing, and you really should communicate this to your guy. Just because you’re putting the psych medication in your body doesn’t mean it’s doing what it is supposed to be doing. From your description, it sounds like a very stereotypical manic cycle. The intense love within a few dates, the relentless energy and all, and then a crash into morbid depression. It sounds like his mood stabilizer may not have been strong enough. We also can grow a tolerance to psych medications as well. So it may just be that he needed a tweak that he missed.

      I realize his actions are incredibly hurtful and destructive to you, but from the sounds of things he very likely has been in an unwell cycle since you two started dating. You should really reach out to him and let him know this information. Instead of “I don’t want to see you again,” just inform him that it would be better if the two of you just held off on anything emotional while he’s dealing with this instability. The two of you can decide what to do when his mind is in a better place.

      And that will also give you time to figure out if you can deal with Disorder in the long-term. A Bipolar person can do everything completely correctly and still have a major unwell cycle like this crop up, just from a lack of knowledge of a certain tidbit of information. It sounds like he has a very good attitude towards his mental illness and works very hard to stay balanced. It sounds like he just wasn’t aware of this and it hit him unexpectedly. It happens, unfortunately.

  4. SuperCookie says:

    Resending my response because I’d rather use this display name. 🙂

    Thanks again, Dennis.


    Thank you so much for your response, Dennis. This has offered me so much insight and clarity about what is going on with my ex. I will try to communicate to him what you said about his medication in a way that he won’t feel nagged.

    The same night he broke up with me, my family asked me to fly down to be with my dad after he was rushed to a hospital. My ex knows that my father has terminal cancer and has reached out to ask how he as doing and if I was okay. He also offered to stop by my apartment when I get back to return my things in person (rather than throwing out or mailing to me). He responded to an email I sent him listing out all the positive things he saw in me but he was starting to realize he could not see himself making me happy because he can barely do that for himself.

    Is it possible that he has that capacity to care, even when depressed? Have I misunderstood depression as the inability to function or think clearly? Can someone depressed be kind and genuine in an email? I’m so confused.

    • Dennis says:

      I went ahead and deleted your other post. You’re very welcome for the reply!

      I’m very sorry to hear about your father. That is a tough thing to need to deal with on top of everything else.

      Depression, and Bipolar Disorder for that matter, has a wide range that it functions in. Yes, it is very possible for a person to care, be kind, and genuine while depressed. It’s also possible for the person to be borderline nonfunctional. It really just depends on how severe the person’s depression is. There are a lot of functional, depressed people out there. I’m one of them.

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