Friday, April 27, 2012
Bipolar...the Feared Diagnosis...
Up one day, and on top of the world! Down the next, and can barely get out of bed.
Does this sound familiar? Do you deal with erratic highs and lows? Do you have days when you have the energy of three people taking on the world? And do you have days when all you can do is crawl under the covers, hide and cry? If this sounds like you, you might be Bipolar. How do I know? I might be Bipolar too.
How many of us have made fun of the person whose moods seem like a light-switch? They are off one moment staring into space, or irritated and/or angry for no good reason. The next time you see them, they're riding high on the moon, full of optimism and doing two, three or four things at once. I've made fun of such people, when I was younger. When I didn't understand the reason for their weird behavior. Before I understood that these 'tantrums' and 'overboard optimisms' were caused by a physical imbalance. Before I had a name to go with the disorder. And now I know the word for what I once thought was comical. And I understand...because the word just might describe me.
I started counseling a couple of months ago because despite the fact that I felt I was handling my episodes of depression okay, I thought it might be good to have someone to talk to. I'd tried an anti-depressent once in my life (Zoloft) and I hated it. I felt like a zombie, unable to 'feel', unable to 'emote' and I thought the medication just made me numb. Because of that, I quit taking the meds and focused on meditation and exercise and it worked for a while. It worked until I was placed into a job I didn't feel suited for...a job that didn't have anything to do with my multi-thousand dollar education...a job at a desk supervising people I'd rather be friends with.
In this job/position, I couldn't make friends. I had no one to talk to. My boss was, well, my boss. And the subordinates were my subordinates. My one shining light was (and still is) my husband and children, and three close friends who live very far away (Virginia, Georgia and Kansas: You know who you are...). During my counseling sessions, my psychotherapist asked me if I'd ever been diagnosed as bipolar. Given my training as a nurse-practitioner and forensic nurse, I wasn't exactly sure what bipolar was until I went to research it. I took my therapist's question as a gentle push to read and learn more about the disorder. As I read, I thought about my mother's behaviors before she died. She went through highs and lows, erratic spending sprees, she'd tried to commit suicide (two times that I know of), and all of that time I just thought she was a hypochondriac. Maybe she was. But just maybe she was Bipolar.
I've been on Cymbalta the past two months, and the medication has helped to improve my outlook. It's improved my body pain some, only by making me not mind it so much. My muscles and joints still hurt, and I continue to take pain medication, but the pain is still there. The difference is I can deal with it better. My husband says that he can tell a difference in my 'moods' and my attitudes. My mood swings are not so sharp, and I'm more social than I was before. Every now and then, though, I feel my impatience talking with people creep up on me, and I wonder how long this medication will hold out. Will it continue to be effective? Will it stabilize my moods? AM I, as the psychotherapist suggests, Bipolar?
My therapist suggested charting my moods for the day, and I went online and downloaded a "mood" chart. There are several if you Google "Mood Chart" and so if you find yourself having very high "ecstatic" moods and then find yourself feeling so low that only a tow-truck filled with happy elves could pull you out...you just might be Bipolar.
There are two types of Bipolar. Bipolar 1 is a disorder where the person feels 10+ on a scale of good moods and sometimes has delusions of grandeur or other delusions. These people overspend money so much that sometimes they get into trouble with finances and sometimes have legal trouble or very real trouble with coworkers. Their coworker troubles can be so prominent that sometimes the person gets fired or loses their job for other reasons. When a person with Bipolar 1 gets depressed, they may (literally) not get out of bed and spend days in a 'funk' where nothing seems to pull them out.
Bipolar 2 people will notice their "high" moments but they will not be quite so erratic. They'll feel good for a day. Just as good as a 9 or a 10 on a 1-10 scale. On their low days they may say they're at a 1 or a 2. They can still get out of bed, but they may cry alone in a room, into a pillow or in the car. They may struggle from extreme fatigue and feel too tired to do any of the activities they love to do. Then, just like that, they may suddenly feel good again. Ready to go surfing. Ready to go to work, and looking forward to working with people.
If any of this sounds like symptoms you are going through, it may be worth it for you to schedule time with a counselor, and talk about these issues. There may be a name for what you are suffering. A name that I won't make fun of ever again. A name that just might be what I'm suffering from too.
Am I Bipolar?
Bipolar Self Test
Wednesday, April 18, 2012
Arthritis, Fibromyalgia, Exercise...and Weight Loss
I'm almost 50 years old. In my past I used to run 5 miles a day, and regularly participated in 10k races and other running functions. Several years later, and after the birth of two children, I found my joints giving out. Running caused hip and knee pain and no matter how hard I worked with changing my running form or how much I tried to rehabilitate my joints... running hurt. I laid off the running for a while and went into weight lifting, and then tried running again, but still the joint pain returned. Weight gain became a constant battle, and I dealt with the endless cycle of dieting to lose weight, running again and regaining the hip pain, stopping running because of the hip pain and then putting on more weight again. It gradually became clear to me that running was an exercise my body needed to stay away from.
Bicycling was another option I tried, and long ago I used to ride professional style bicycles (helmet, pro-shoes, foot clips) and go to and from work with the wind, rain and other elements challenging me. Again, once I got older, I was less likely to want to go out into the elements which reduced the time I would want to spend on a bike. Uphill climbs bothered my knees. Staying on the seat too long bothered my bum, and no matter how much I positioned my body for better mechanics my back began to ache. Bicycling became a 'fair weather' exercise that I didn't do regularly, and then I gained weight which made it harder to cycle.
In an effort to find something to do for exercise I tried elliptical training, theorizing that the pounding of running was causing the hip pain, and hoping that the elliptical training would be a great replacement. After all, the elliptical took away the force from my hips and knees and transferred it into a more circular action. But even with the elliptical machines (and I tried all kinds) after a while my hips and knees would hurt.
Now understand that I'm a member of the military, with 30 years in military/government service, and so being able to remain physically fit is not only a healthy thing to do but it's required for my profession. My yearly performance rating is based on whether or not I pass or fail the physical requirements test (PRT) and whether or not I pass my body fat weight or calculations. I'm 5'8", or 68", and as a female my max allowable body weight is 170 lbs or 34% body fat. Remaining at, or under, that requirement has been a huge source of frustration for me and I've searched and studied for methods that would help me maintain and/or reduce my weight while allowing me to stay physically fit without pain.
In addition to my exercise frustrations, my body started going through episodes where I constantly felt hip and other joint pain regardless of whether or not I exercised. I developed muscle pain in the morning, and extreme fatigue during the day, even if all I'd done was sit at a desk and work for my clinic in the Department Head role that I currently fill. I decided to see a physician because the level of daily pain I felt, regardless of exercise, severely impacted my quality of life. It became difficult to get out of bed, difficult to sleep, difficult to get through the day because of fatigue and pain. I looked at my nutrition (I'm vegetarian) and my nutrition factors were fine. Finally I decided to go to a physician.
It's important to understand that I'm a Nurse Practitioner/Certified Nurse Midwife. I know all about health, and particularly women's health. Still, I couldn't figure out why I was having so much pain, why my levels of fatigue were so astronomical on some days, and I couldn't figure out what I could do for exercise that wouldn't increase my joint pain.
After working with my physician, and undergoing several tests, I found I had osteoarthritis and a negligible amount of rheumatoid factor (that shouldn't be impacting me yet/no inflammation in my joints) and that all of the rest of my labs were absolutely normal. I'd developed some depression because of work and exercise issues, and because of my pain. My physician still continues to rule out other reasons for the pain but thinks I may have fibromyalgia. I take Ultram and Flexiril for pain when I have to, but when I'm at work I try to stay away from the medications because they make me drowsy.
I researched exercises for both arthritis and fibromyalgia patients and found three that seemed to give the most benefit for these type patients. One was yoga, another was Pilates and the last was swimming. To help with my depression and mood swings, my physician prescribed me Cymbalta to take on a daily basis. This helped with my mood/depression (my husband stating he saw a real difference in my demeanor) but it didn't help my joint and muscle pain. What it did was help me 'not mind' the pain so much. It also helped me with my appetite by reducing my constant desire to eat. I'm not sure why it helped, but it did (just a little).
In addition, I joined the YMCA. There are gyms available on the military base, and there's even a pool, but often I leave work at 6PM (18:00 for you military types) and there is no option for late night or weekend swimming there. The YMCA stays open until almost 10PM (22:00) and there's a sauna and other equipment to use in addition to a 25 yard pool. I started swimming almost regularly over the past month and I've noticed a difference in my muscle structure. I've also noticed an overall decrease in my level of body pain as long as I swim 3 to 4 times a week. In between swimming, I try to incorporate a yoga or Pilates class and these also seem beneficial. My pain isn't completely gone, but my weight is slowly coming down and overall I feel better.
The cost for a family to join the YMCA is $80.00 a month, and though I was worried about the extra financial expense it's been well worth it. I try to spend less on carbonated beverages (soda) to help defray the cost, and I've had the added enjoyment of my son coming with me to swim laps at the pool. I'll often go swim around 7:30-8:00PM (19:30-20:00) and if I have a late night at work I can swim as late as 21:45 or 9:45PM. Both the base gym and the YMCA also offer yoga and Pilates classes and so I can structure core strengthening exercises and stretching into my weekly routine as well.
If you are struggling with weight loss and whole body pain, this workout option may suit you well. If you aren't used to swimming, many YMCA's offers free adult swimming classes once a week. The key to improving your swim is constant practice. I've used You-Tube videos to learn about how to swim better and discovered a variety of swimming 'drills' that work various parts of the body and help improve swim stroke.
In the end, you'll need to find out what works for you and your body but perhaps this method will help you along. I keep a diet of fresh fruits and vegetables and drink plenty of water, and maintain a lean protein intake which consists mainly of tofu, seitan/tofu meat products and a variety of beans. Sometimes I have eggs and/or cheese but it's rare. For my sweet treats I try to get fresh berries or melon at the store and every now and then I do love my oatmeal raisin cookies. And chocolate? Oh yes, I still have the occasional chocolate (dark 75% or more) but I don't crave it as much as I used to.
If this article helped you, or if you have questions, please feel free to refer it to your friends and/or ask me questions. I'll be happy to respond. Until then, keep the faith and keep trying to find what works best for you and your pain and/or fatigue. One of the BEST ways to deal with it is to become involved in your own health care and search for the answers that eventually help you improve your daily life and be happy. :) And most of all: Never give up. Keep moving forward.
Bicycling was another option I tried, and long ago I used to ride professional style bicycles (helmet, pro-shoes, foot clips) and go to and from work with the wind, rain and other elements challenging me. Again, once I got older, I was less likely to want to go out into the elements which reduced the time I would want to spend on a bike. Uphill climbs bothered my knees. Staying on the seat too long bothered my bum, and no matter how much I positioned my body for better mechanics my back began to ache. Bicycling became a 'fair weather' exercise that I didn't do regularly, and then I gained weight which made it harder to cycle.
In an effort to find something to do for exercise I tried elliptical training, theorizing that the pounding of running was causing the hip pain, and hoping that the elliptical training would be a great replacement. After all, the elliptical took away the force from my hips and knees and transferred it into a more circular action. But even with the elliptical machines (and I tried all kinds) after a while my hips and knees would hurt.
Now understand that I'm a member of the military, with 30 years in military/government service, and so being able to remain physically fit is not only a healthy thing to do but it's required for my profession. My yearly performance rating is based on whether or not I pass or fail the physical requirements test (PRT) and whether or not I pass my body fat weight or calculations. I'm 5'8", or 68", and as a female my max allowable body weight is 170 lbs or 34% body fat. Remaining at, or under, that requirement has been a huge source of frustration for me and I've searched and studied for methods that would help me maintain and/or reduce my weight while allowing me to stay physically fit without pain.
In addition to my exercise frustrations, my body started going through episodes where I constantly felt hip and other joint pain regardless of whether or not I exercised. I developed muscle pain in the morning, and extreme fatigue during the day, even if all I'd done was sit at a desk and work for my clinic in the Department Head role that I currently fill. I decided to see a physician because the level of daily pain I felt, regardless of exercise, severely impacted my quality of life. It became difficult to get out of bed, difficult to sleep, difficult to get through the day because of fatigue and pain. I looked at my nutrition (I'm vegetarian) and my nutrition factors were fine. Finally I decided to go to a physician.
It's important to understand that I'm a Nurse Practitioner/Certified Nurse Midwife. I know all about health, and particularly women's health. Still, I couldn't figure out why I was having so much pain, why my levels of fatigue were so astronomical on some days, and I couldn't figure out what I could do for exercise that wouldn't increase my joint pain.
After working with my physician, and undergoing several tests, I found I had osteoarthritis and a negligible amount of rheumatoid factor (that shouldn't be impacting me yet/no inflammation in my joints) and that all of the rest of my labs were absolutely normal. I'd developed some depression because of work and exercise issues, and because of my pain. My physician still continues to rule out other reasons for the pain but thinks I may have fibromyalgia. I take Ultram and Flexiril for pain when I have to, but when I'm at work I try to stay away from the medications because they make me drowsy.
I researched exercises for both arthritis and fibromyalgia patients and found three that seemed to give the most benefit for these type patients. One was yoga, another was Pilates and the last was swimming. To help with my depression and mood swings, my physician prescribed me Cymbalta to take on a daily basis. This helped with my mood/depression (my husband stating he saw a real difference in my demeanor) but it didn't help my joint and muscle pain. What it did was help me 'not mind' the pain so much. It also helped me with my appetite by reducing my constant desire to eat. I'm not sure why it helped, but it did (just a little).
In addition, I joined the YMCA. There are gyms available on the military base, and there's even a pool, but often I leave work at 6PM (18:00 for you military types) and there is no option for late night or weekend swimming there. The YMCA stays open until almost 10PM (22:00) and there's a sauna and other equipment to use in addition to a 25 yard pool. I started swimming almost regularly over the past month and I've noticed a difference in my muscle structure. I've also noticed an overall decrease in my level of body pain as long as I swim 3 to 4 times a week. In between swimming, I try to incorporate a yoga or Pilates class and these also seem beneficial. My pain isn't completely gone, but my weight is slowly coming down and overall I feel better.
The cost for a family to join the YMCA is $80.00 a month, and though I was worried about the extra financial expense it's been well worth it. I try to spend less on carbonated beverages (soda) to help defray the cost, and I've had the added enjoyment of my son coming with me to swim laps at the pool. I'll often go swim around 7:30-8:00PM (19:30-20:00) and if I have a late night at work I can swim as late as 21:45 or 9:45PM. Both the base gym and the YMCA also offer yoga and Pilates classes and so I can structure core strengthening exercises and stretching into my weekly routine as well.
If you are struggling with weight loss and whole body pain, this workout option may suit you well. If you aren't used to swimming, many YMCA's offers free adult swimming classes once a week. The key to improving your swim is constant practice. I've used You-Tube videos to learn about how to swim better and discovered a variety of swimming 'drills' that work various parts of the body and help improve swim stroke.
In the end, you'll need to find out what works for you and your body but perhaps this method will help you along. I keep a diet of fresh fruits and vegetables and drink plenty of water, and maintain a lean protein intake which consists mainly of tofu, seitan/tofu meat products and a variety of beans. Sometimes I have eggs and/or cheese but it's rare. For my sweet treats I try to get fresh berries or melon at the store and every now and then I do love my oatmeal raisin cookies. And chocolate? Oh yes, I still have the occasional chocolate (dark 75% or more) but I don't crave it as much as I used to.
If this article helped you, or if you have questions, please feel free to refer it to your friends and/or ask me questions. I'll be happy to respond. Until then, keep the faith and keep trying to find what works best for you and your pain and/or fatigue. One of the BEST ways to deal with it is to become involved in your own health care and search for the answers that eventually help you improve your daily life and be happy. :) And most of all: Never give up. Keep moving forward.
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