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What is Cyclothymia?

I once met a man at a writer’s conference whose behavior screamed “hypomanic”. He spoke rapidly, walked fast, made grand gestures, and was prone to heavy drinking and smoking. I often saw him pacing or fidgeting. At any given moment, I expected him to burst out of his skin, unable to contain his elation.

He was also an inspiration to many. The great majority of his conversations consisted of probing questions about who the addressee was, and how were they going to improve themselves—today? What were their dreams, and why weren’t they acting on them already? He oozed charisma, and garnered quite a fan following.

Lucky for him, he had an amazing Team You present at the conference: a group of his friends who had all known each other since their school days. They took shifts watching over him when he inevitably crashed. They explained that their colleague would go, go, go–sometimes for up to a month and a half. Then he’d sleep for about a week, curling into himself in the throes of an awful depression.

When I explained his behavior to my therapist, she said, “That sounds like cyclothymia.”

Cyclothymia is largely considered to be a “weaker” form of bipolar disorder. Episodes of mania and depression are not as severe and do not last as long. Psychotic features aren’t usually present. Some people with the weaker form eventually develop full-blown bipolar. It is suspected that cyclothymia is passed down genetically.

The disorder is difficult to diagnose because it shares so many characteristics with Attention Deficit Hyperactivity Disorder (ADHD), including, “increased energy, distractibility, and impulsive or risk-seeking behavior.” The symptoms also overlap with certain personality disorders. In addition, cyclothymia is frequently comorbid with other disorders, which means that a doctor may have one or more diagnoses to sift through.

Symptoms are usually treated with lithium carbonate and Seroquel, provided the patient desires treatment. Most people with cyclothymia are productive, sometimes to extremes.

Disclaimer: I do not claim to know enough to have diagnosed my friend, nor do I expect or want my therapist to do the same.

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The Importance of Team You, Part V

Team You, a term coined by advice writer Captain Awkward, is a group of people who support you in times of emergency. If you are fighting the grips of mania or coping with isolating depression, these allies are invaluable.

This is part one of a five-part series.
Part I | Part II | Part III | Part IV | Part V

Who Shouldn’t Be On Team You

If you’re like me, you’ve found that there are only a few precious people who can uphold the coveted Team You title, and a lot who can’t. Sometimes even close friends and family fit into that description. Even worse, they may insist on “helping” you, when all they do is harm. Cut them off at the knees. Deflect, deflect, deflect.

Phrases include:

  1. “Thank you, but I’ll be able to handle it. Specific, positive example of a Thing recently accomplished.”
  2. “Thanks for the suggestion to try [remedy which contradicts my medications]. I’ll think on that (for ten seconds).”

Then there are the maliciously ignorant. These are the people who loudly declare that conquering depression is just a matter of willpower, and if you’d just get out of bed, you’d be able to see how lazy you’ve been. Avoid these people like the plague they are.

Next is the person who actually wants to help, but always feels uncomfortable doing so and skirts around the fact that you have one or more mental illnesses. They may note, innocuously, that you’re “sick” quite often. Phrases include the ones above, but also: “It seems like you’ve noticed I have a problem today. Do you have any concrete and specific ideas about how to help me?”

Make sure they are as detailed as possible about the extent they’re willing to go, otherwise you’ll find it difficult to take their help—-or they’ll give more than they want to.

Someone who makes you feel guilty for needing their support is almost worse than the maliciously ignorant person. Try not to let them touch you, and if you find one one your Team You, boot them.

Others who shouldn’t be on Team You fall into the category of super passive-aggressives and “extreme” advice givers. Our brains are fragile enough as it is. Don’t let others fill them up with more toxins. If possible, excise these harmful influences from your life.

Thanks for reading our series on finding allies! Did we miss anything?

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The Importance of Team You, Part IV

Team You, a term coined by advice writer Captain Awkward, is a group of people who support you in times of emergency. If you are fighting the grips of mania or coping with isolating depression, these allies are invaluable.

This is part one of a five-part series.
Part I | Part II | Part III | Part IV | Part V

How to Avoid Burning Out Your Team

As everyone with bipolar disorder knows, living with a mental illness is exhausting. And although the people around us may not feel the exact effects that we do, dealing with someone who can’t stop talking or can’t get out bed is exhausting, too. Like many people with this disorder, I have lost friends due to either:

      1. relying on them too much
      2. driving them away with an overbearing manner during my manias
      3. losing touch with them during my depressions

The last two are subjects for different days, but please keep them in mind. The first is crucial to avoiding friend burn out. If our friends are to be our supporters and allies, we must support them, too. This means we can’t overwhelm them with bragging or obsessions or negative complaints, especially during periods of mania.

We also have to listen to their successes and problems in return. Every relationship is based around give and take. Strive for a healthy balance. Make sure to ask your friends to tell you when they need a break—and try not to be offended. This is exhausting for everyone, remember? I promise that it’s not personal.

Ideally, you’d have several friends’ brains to pick. If you don’t, please try to be patient. Journal your thoughts and feelings so that you don’t dump them on the few friends who have stuck around.

It might not seem fair to have to manage your effect of your mental illness on your friends. You’re right. It’s not. But, unfortunately, learning your limits and your friends’ is part of the whole. The more self-aware you are about your disorder, the better you’ll be able to control it—or react when an episode gets the best of you.

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The Importance of Team You, Part III

Team You, a term coined by advice writer Captain Awkward, is a group of people who support you in times of emergency. If you are fighting the grips of mania or coping with isolating depression, these allies are invaluable.

This is part one of a five-part series.
Part I | Part II | Part III | Part IV | Part V

When to Explain Your Disorder to Your New Friends

This section head is actually misleading. You can go full bore and spill everything on your first date—er, meeting—or you can wait until your friendships have been cemented a little. Either approach can work, though I’ve found that the latter is smoother for all involved.

Parent friends are tricky because at first you’re meeting for your kids, and only sometimes each other. Make sure to get to know them as a person first, and vice versa. Once your conversations turn to the personal, now you get to decide how to tell them. If you’re already pretty open about your condition, this is old hat. But if you’re not, you get to try and gauge their reaction and tailor your explanation. Fun!

When it comes to a parent friend, I look for the following signs by the third play date:

        1. Is this a trustworthy friend I feel comfortable with? Are they comfortable with me?
        2. What is their experience with bipolar disorder or even post-partum depression? Are they at ease talking about those topics?
        3. Are you living in a community that is insular, like a small town? People in larger cities tend to be a *little* more accepting of mental illnesses, and news in small towns gets around. Try to gauge if your friend is circumspect.

Once you decide that it’s time, there are several ways to tell them. You could take the conversational approach: “Sorry for losing touch with you. I deal with periodic depressions due to bipolar disorder, so I was pretty much out of it.” Or the formal approach: “I want to let you know that I have this disorder, and what it might mean when I’m manic/depressed.”

Your friend might have an “oh!” moment, where they quickly re-categorize everything they know about you. They might need some time off to process everything. They may even run. Let them do what they’re going to do. If they back off completely, let them go—they wouldn’t have made a good Team You member anyway.

The next process involves time. Time, time, and more time. Make friends with your friends. Get to know them. Rely on them, and try to be a person they can rely on, too. Write thank you notes. Apologize when you need to and celebrate your successes—together.

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The Importance of Team You, Part II

Team You, a term coined by advice writer Captain Awkward, is a group of people who support you in times of emergency. If you are fighting the grips of mania or coping with isolating depression, these allies are invaluable.

This is part one of a five-part series.
Part I | Part II | Part III | Part IV | Part V

How to Find Team You

Unfortunately, collecting a solid Team You takes time. If you’re a parent, then hopefully you have parent friends—ideally ones who you are comfortable explaining your struggle to. If you suffered from severe post-partum depression like I did, then that may not be the case.

One channel to find parent friends is story times at libraries, or, if you’re bold, a public park. If you can afford it, take a parenting class and take notes on both the subject and your classmates. Toddler groups are excellent places to search for potential allies, too.

Outside of the parent friend channels, MeetUp.com is an amazing resource to find like-minded people, provided you have steady access to a computer. You can attend parent groups, cooking groups, maybe even underwater basket weaving groups! Bipolar support groups can also be found at local libraries.

It also goes without saying that a quality therapist and psychiatrist treatment team is priceless—if you can afford them. There are sliding-scale counselors available. The Mental Health Mountie has compiled an incredible list at Captain Awkward of such providers in America and Canada.

Soon, if you’re lucky, you may run into a different problem: having too many friends.

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The Importance of Team You, Part I

This is part one of a five-part series.
Part I | Part II | Part III | Part IV | Part V

What is Team You?

One of the best concepts I’ve taken from the lovely Captain Awkward is that of Team You.  The term has never been clearly defined, but there is enough on their website to form a thorough idea of what it means.

Most times I’ve seen the term used, it’s due to an emergency (eg. “He left you? Time to call Team You”). But a person with bipolar disorder or not only has to deal with emergencies like relationship troubles or deaths in the family, but also mood episodes ranging from isolating depression to mania to full-blown psychosis.

That’s where Team You comes in. Who are they? Supportive, unbiased people in your life like counselors, psychiatrists, parents, reliable sitters, religious figures, and/or one or more friends (who may or may not have kids of their own).

In short, this is a group of people—online or off, professional or otherwise—who:
• Are willing to listen to you vent and then ask, “Have you talked with your therapist about this?”
• Preferably have knowledge or experience with mood disorders
• Can possibly identify when you’re sliding into an episode
• May be able to stage an intervention
• Don’t mind getting lunch with you on a bad day
• Generally give you solid advice
BONUS: May be able to watch your kids on occasion, especially during emergencies

A good Team You is not only effective at supporting your efforts at damage control, they also tend to keep you on an even keel during periods of stability. I am lucky enough to have a few friends with whom I can be completely honest about my ups and downs–and who can be honest with me about them, too!

People on Team You want you to be happy, healthy, and sane. They’re your supporters, your allies, and your friends. Sounds nice, right? Well, stick around; we’ll next be covering how to find Team You, how to avoid burning out your Team, and who shouldn’t be on it.

What qualities do you think people on Team You should have? Do you have people like that in your life?

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A Breath of Fresh Air: Deep Breathing Techniques

“Ryan!” I said to my three-year-old. “Take two breaths.”

My son, who had been spasming on the floor in the throes of a tantrum, scrambled to a standing position. He formed a little ‘o’ with his mouth, inhaled twice, and then looked up at me.

“Are you feeling better?” I asked gently.

“Yes,” he said, wiping his tears away with his pudgy wrists. “I just calmed down.”

Deep breathing techniques are as old as dirt, but I always marvel at how quickly they work for my son and me. I first learned of them from my therapist, who treated me for severe anxiety during and after my pregnancy. According to the article “Taming the Fight or Flight Response” by JoAnn Revak, anxiety is driven by a hypersensitivity to perceived threats. It is frequently caused by chemical imbalances, which is why comorbidity with other mental illnessses and traumas is so high.

One of the ways to dispel excess energy drummed up by the flight or fight response is to perform breathing exercises. The one I use and have taught my son goes like this:

1. Close your eyes, if you feel safe enough to do so.
2. Inhale deeply through your nose, preferably into your abdomen, while counting to three.
3. Hold for three-to-five seconds.
4. Release air through your mouth over a period of at least three seconds.

This rarely fails to relax me. What do you do to calm down?

Not meant to be taken as medical advice to replace that of your physician or therapist.

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A Beautiful Mind

This website is a cool little stop in the wide, wide Web for people who want to find out generic facts on bipolar disorder like treatments, diagnoses, and other things.

One of their features is a list of “famous people with bipolar.” Interestingly, the site has a separate list of celebrities the authors can only guess at having the disorder, given that some of these people are dead and a lot of living ones don’t tend to speak publicly about their mental illnesses (likely due to the bad PR they’d receive).

They’ve split the list into these categories for easier reading:

  • Musicians and Artists
  • Entertainers: TV and Movies
  • Writers, Authors, and Poets
  • World of Sports and Miscellaneous
  • Politics and Business

Curious, I did a quick count of the participants, separating by field of work.

Number of people in subjective, people-centered fields like politics and the arts?
199.

Number of people in the sciences and maths?
7.

Hooray for the specific genius of the mind!

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Hypomania: A Closer Look

Out of all the states a bipolar person flows through, hypomania is the most coveted–and the most difficult to give up. I’ve often thought of it as a zen state, but rather than letting everything go via meditation or practice, I magically gain the ability to keep track of everything I think I need to in my overcrowded brain.

In 2010, I wrote this anecdote as a journal entry, during a time when I was struggling to adjust to new dosages of my medications. I don’t think I could describe the sensations of hypomania any better today:

When I’m in a hypomanic state, my senses are on fire. Colors are brighter and smells are stronger. I’m a bit more sexual, more confident, more outgoing. Everything—everything!—is alive with passion and potential and emotion. I feel sharp and witty whether I truly am or not.

Stability, on the other hand, is bland. As if someone turned down the saturation in my life, all that’s left are shades of gray.

It’s easier to discern truth from fiction (and stupid ideas from smart ones) when I keep having water thrown in my face, but the process washes away quite a bit of the life I knew and enjoyed previously.

Normalcy is bittersweet.

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What is Hypomania?

People in a hypomanic episode usually have feelings of euphoria, irritability, increased sexuality, and competitiveness–but less than someone with full-blown mania. In Latin, “hypo” means below, so the definition of hypomanic as, “appears less intense than manic” follows logically.

Whereas inability to focus permeates mania, my experience with hypomania has been completely different. Increased focus and feelings of contentment means that I am incredibly productive while hypomanic, and I don’t doubt that this drive and ability applies to other people in such a state as well. Hypomania is a very pleasurable episode to be in; I have often felt as if I am coasting along in my day, accomplishing anything I set out to do with my super-human energy. It is part of the reason bipolar people often grieve for the hypomanic episode while depressed or normal. Similarly, medication compliance is difficult while this a state of ecstasy.

A hypomania diagnosis is also the main difference between Bipolar I and Bipolar II. People with the former suffer from full-blown manic episodes complete with psychotic features like hallucinations and delusions of godhood, whereas Bipolar II people deal with depression and hypomania only.

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