How to Work Out with a 40-pound Parasite Clinging to Your Leg

Or, to be more politically correct, “How to Exercise with Kids.”

As we’ve discussed in our previous post, exercise is one of the best activities you can do for your body and mind–especially if you have a mood disorder.  But parents often lack the time to tend to themselves. Between shuttling their children off to school, cleaning up potty-training accidents, and managing their own health care, exercise easily slips through the cracks of life.

However, like shredded zucchini hidden in a brownie, you can sneak in a workout while your kids play.  Here are some ideas:

If you have five minutes: Dance with your toddlers or play the game of, “catch me, catch me!” While pushing your kid in a swing, do some quick squats. Throw a ball and try to get to it before your playmates.  You can also get a good grip on their bodies and use them as curling weights.

If you have the strength, lie down on the floor and have your kid attach himself to your legs while you hold onto his arms. Lift your legs slowly, hold for a few seconds, drop quickly—and then repeat. These have never failed to produce shrieks of laughter from my son, Ryan.

If you have ten minutes: Strap weights to your wrists and ankles, or carry two gallons of milk. Pump your arms and lift your knees when you walk around the block or jog in place. After ten minutes, take them off.  Try again for another ten minutes, later.

If you have older kids or teenagers, play soccer or a sport of their choice. Get your heart rate up as much as you can.

If you have thirty minutes: If your kids still nap, try to squeeze in some exercise along with everything else you do during that “free” time. Hustle when you do chores or gardening. In addition to powerwalking between errands or running up and down stairs, you may be able to devote some time to a short yoga or aerobics video.

You can also purchase a jogging stroller, but watch out—these are inordinately expensive. But, as useful as the $20 umbrella strollers are for navigating through airports, they won’t cut it for intense exercises like running.

If you have an hour: Wow, lucky you! If you’re in this position, swimming is a great low-impact exercise, but if you’re looking to really sweat and can afford it, try a dance class or possibly martial arts. I’d highly recommend finding a suitable YMCA—with childcare available. Even if you never plan to use it, knowing that someone can watch your children during your workout in case your other arrangements fall apart is a relief.

Don’t be discouraged if you have physical disabilities! There are many braces, props, and specialized classes available to assist you. Yoga classes are especially accommodating. Swimming is easiest on the joints and can serve as a wonderful substitute for those who cannot lift weights. Team sports such as baseball leagues for the blind and basketball for persons in wheelchairs burn calories while building camaraderie, but there are solo sports like skiing available as well.

Best of luck in pursuing the best workout for you!

Not meant to take the place of a treatment plan created with licensed professionals.

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Bipolar? Exercise Will Change Your Life

Many apologies for the missed posts last week! I’ve been tripping into mania, so managing my day to day life has been a struggle lately. Thank you for your patience!

When it comes to actions you can take to improve your quality of life, exercising regularly is largely considered the uncontested champion. As we covered in our post Why Weight Gain is Devastating to the Mentally Ill, a sedentary lifestyle and poor diet are linked to a worsening of bipolar and schizophrenic symptoms and decreased functioning. One of the triggers of depressive episodes is reduced physical activity, which is only the start of a vicious cycle.

A comprehensive review of research from 1966 to 2008 proved that scheduled exercise dramatically improves both the body and mind in persons with bipolar disorder. Not only does exercise flood someone with endorphins, studies indicate that it reduces the “allostatic load“, which is the damage done to your body from chronic stress.

Despite all of these good things, I know how difficult it can be to start exercising—much less follow a routine. But, starting slow is better than not starting at all. If you’re like me and can’t handle—or don’t have the time for—an hour-long workout, then just try walking for twenty minutes per day, ten minutes at a time. Eventually, you can build on your small triumphs. In our next post, we’ll cover how to squeeze in a workout around your kids’ schedules and a little bit about what to do if you have physical disabilities.

Make sure to pack plenty of healthy snacks and water to refresh yourself—and your little ones—during and after your workouts. If you are taking medications, do not become dehydrated! Lithium is especially dangerous to dehydrated persons because the body retains it when losing fluids. This can lead to lithium toxicity, which means the level in your blood has built up faster than it can be excreted by the kidneys. Side effects include dizziness, diarrhea, and vomiting, which worsens fluid loss. If the level is especially concentrated, you may slip into a coma or enter a psychotic state, both of which can damage you neurologically.

As always, please consult a physician before trying any program which involves changes to your levels of physical activity. Please ask your doctor about the effects your medications may have on your body during periods of high exertion, and to what extent you are able to work out in order to avoid symptoms like dizziness. A trained medical professional will recommend exercises tailored to your needs and health.

So start slow and good luck!

What is your favorite way to get moving and grooving?

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Why Medicinal Weight Gain is Devastating to the Mentally Ill

“Watch out,” the mental ward’s psychiatrist gently cautioned me. “It’s true that Depakote will stabilize you, but you’ll gain a lot of weight. Plus, anything you pack on will be harder to lose. Are you sure you want this medication?”

“Pish posh,” I said, manic and therefore invincible. “I don’t care about a measly ten pounds.”

At the time, I was seething. Were we, in considering my treatment plan, really going to prioritize my weight over my mental health? In the midst of my psychotic breakdown, I’d just realized that I was insane enough to need serious medical intervention. Was that really the time to caution me about maintaining thinness—especially considering I had given birth two weeks prior? And why were there no other options to treat my condition?

Sixty pounds and a few years later, I care a great deal about my muffin top. So much so that it has started to negatively affect both my health and self-esteem.

I’ve had young children ask if I have a baby in my belly.  I’ve been laughed at and called “fattie!” when dancing.  I’ve even had a certain insensitive business owner look at my four-year-old debit card and declare, “You used to be so skinny!  You know, when you were a teen.”

Ouch.

No one can tell from looking at me what my diet is or what medications I may be taking. Despite that, they feel free to comment on my body. I fully admit that my new curves are not entirely due to my nightly med cocktail. I am largely sedentary and my diet consists of the three major food groups—Grease, Sugar, and Dairy—both issues which I am addressing. But even with that lifestyle, I should not have gained thirty pounds in a year.

Weight gain is a huge factor preventing people from complying with a long-term drug treatment plan. In a 1999 study of the adverse effects of antipsychotics, more than seventy percent of participants reported weight gain as “extremely distressing”—far greater than any other side-effect.

Depakote, a gold standard in the treatnment of bipolar disorder, is one of the worst offenders. Studies have even suggested that women on the drug crave carbohydrates up to ten percent more than men do, and tend to gain more.

This is a three-fold problem:

1.  The mental health industry is a fledgling one, even though its business is currently booming. We just don’t know what a lot of these compounds do to the body yet, especially when blended. And not all drugs work for everyone. I myself am allergic to entire families of medications, including most of the new atypical antipsychotics and serious painkillers.

2.  People stop taking their prescriptions when they feel that the diseases are easier to bear than the side-effects.  In addition, this is often done abruptly, which can be dangerous as it may trigger a severe mood episode.

3.  Despite not being able to tell how healthy someone is by looking at them, many cultures shame fat people.

There is a stigma against having a mental illness. There is a stigma against needing medications to survive. There is a stigma against being fat. But what if you are the first already and have to choose between the second and third?

This is the kind of choice that breaks a person.

What sorts of things have you had to deal with on your meds? If you can bear to part with the numbers, how many pounds have you gained?

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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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