My Nemesis, The Dreads – Part Two

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The Dreads continue to strike each morning around 5:00 a.m.  Fortunately, today I was able to discuss this nemesis in depth with Dr D.  We always cover a lot of ground in our thirty-minute-long sessions, and despite my morning grogginess, I used up every minute to the fullest.  

I worried the day before my appointment as I usually do, despite the fact that Dr. D. is the best and the kindest psychiatrist I’ve ever seen.  To settle my anxiety, I  jotted down a few talking points in my notebook.  Creating talking points always helps me to focus and guarantees my getting something useful out of the session.  

I was about to first place The Dreads down on the list, but then I realized that I needed to start with another topic.  I wanted my doctor to know that I had just spent five days with someone I loved who was verbally abusive to me, and emotionally unpredictable to be around.  Walking on eggshells for five days would be enough to exhaust anyone, and I’ve been utterly drained since the end of that visit.

I suspected that my emotional hangover caused the milder form of The Dreads I’ve experienced recently to become much worse.  Dr. D., who has a gift for therapy and almost became a psychotherapist, was able to shed light on the situation.  I hope to cover what he said in a future blog post as it concerns personality disorders and bipolar disorder as well.

After we spoke about that, the subject turned to The Dreads.  I told Dr. D. I tried to lower the Seroquel and it didn’t work – I didn’t feel it was the right time to take that plunge.  I added that I thought I should wait a few more months to try.  What was interesting to me was that Dr. D. asked why would I choose to make a medication change after what happened last week.  (I thought he had a good point!) He advised that I wait for a calmer time to try again and that I didn’t necessarily have to wait another two months to try, but to take it “day by day”.

I continued explaining The Dreads in gory detail to Dr. D.  I made sure to  differentiate them from their first cousin Depression in that my dread/rumination only lasts until I drag myself out of bed.  The feelings dissipate after a few cups of strong-ass coffee.  Dr. D. understood where I was coming from, and he mentioned an interesting point.  He said (and I’m not paraphrasing too well but I hope this makes sense) that when we are on the verge of waking up, our old consciousness can be stirred up.   Since I’ve been through so much trauma, that concept makes sense to me.  Then he emphasized something I already knew a little about: the importance of regular bedtimes and waking times, but with a different twist…

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I explained how difficult the mornings have been ever since school got out for the girls and that I stopped getting up at a regular time each morning; I also ceased using my Sunbox bright light first thing each morning.

As soon as I said the words “bright light”, Dr. D mentioned reading a recent study with findings that truly surprised me.   The study cited that getting early morning daylight (via natural light or a therapeutic light) & maintaining regular waking times/bedtimes were more helpful in improving depression than regular aerobic exercise.  

Dr. D. said he’d search for that study again to email it to me, and I’ll search for it as well – if I find it I’ll post it here.  He suggested that I consider going outside in the morning with a cup of coffee (programming my coffee pot the night before to get it ready) and hanging out to receive the natural light.  

Since Lucy Puppy is up bright and early at 5:00 a.m., jumping like a pogo stick to go outside, I could use her prodding to get me going.  Craig has been the one to take Lucy out thus far, which has been wonderful , but if I want to stop these damn dreads, I need to excuse him from morning puppy duty!

Wish me luck, kindred bloggers.  I realllllly need it.   The Dreads suck! 

xoxox

Dyane

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Goin’ Back Up after The Dreads Arrive

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This morning I’m writing old-school style, with a pen and a college-ruled notebook.  It’s foreign to write this way, which feels bittersweet.  I’ve become so used to using my laptop for writing that I haven’t used a pen in ages.   I’ve only touched a pen or pencil to jot down birthday card greetings, return addresses on bills (alas, I don’t have those nifty address labels!) and grocery lists.

I’m not handwriting today for its romantic element.  To my intense frustration, I’ve been blocked from using our shared computers, but I don’t feel up to making a fuss over it.  I want this morning to be as calm as possible because I woke up in a big ‘ol funk.  At 5:00 a.m. the precocious Lucy, now a thirteen-week-old bundle of energy, woke me up, raring to go on a puppy ultra-marathon.  My husband Craig also rose early and he made enough noise in leaving our room that I couldn’t get back to sleep.  

While hiding my head in my pillow, a heavy-duty case of what I call The Dreads fell upon me.

The Dreads are a first-cousin of depression and, like The Black Dog, consist of mental and physical fatigue, plus a looming dread of the day to come.  As I sat there in bed I was too wiped out to get up to start the day.  Ironically, when I’ve been hit with The Dreads,  once I’ve gotten out of bed and had my first cup of coffee, The Dreads slowly but surely vanish like a vampire caught in daylight.  That’s the difference between depression and The Dreads – a couple hours. But they still suck.

When I finally crawled out of bed at 7:00 a.m., I remembered I had cut down my Seroquel the night before.  I went from 100mg to 50 mg.  As I hadn’t had The Dreads hit me this intensely for a while, I wondered if there could be any connection between the medication drop and my distressing mental state.   

Of course it could just be a coincidence or my paranoia about how this med reduction affected me, or it could be both things!  But just in case it really is the Seroquel reduction, I’m going to resume my 100mg of Seroquel tonight and remain at that amount for the rest of the summer.

I’ve already found out that ever since my kids got out of school, our days have been too unstructured for my mental well-being.  I think I need a more regular daily schedule in order for me to feel confident about changing my medication dosage.  In any case, I can definitely live with my Seroquel-related grogginess for the next two months.  

My friend Becca Moore, the author and founder of the new website the Bipolar Parenting Project, wrote a great post on routine in her Psych Central Bipolar Parenting column.  Here’s the link:  

http://blogs.psychcentral.com/bipolar-parenting/2014/06/routines-and-structure/

Maybe if I improve other habits that mess up my energy level, such as my sugar-infused diet, that could help with the grogginess.  Also, if I attempt to go to sleep and wake up at regular times like I did when the girls were in school, that would help with kicking The Dreads’ butt and with my grogginess too.

When the girls’ school closed for summer break, I stopped using my Sunbox therapeutic bright light every morning, which I did for a minimum of a half hour.  I didn’t think the light was making a significant difference in terms of keeping the nasty Dreads away, but maybe it has helped me more than I thought.  I’m going to make a point of using my Sunbox on a daily basis once again.  It’s really easy to do this as I can write, surf the net or read in front of it.  And, of course, eat while using it.  (Hopefully not too much double chocolate Talenti gelato!!)

On the brighter side, it helps me to notice that I’ve improved on my “all or nothing thinking” that I’ve done for so long.  In the past, I would have felt that I failed my one-day-long Seroquel taper.  I would have thought horrible things such as “You f*cking loser!” and “You’ll never be able to lower your Seroquel!”  Now, I think differently, and my self-flagellation is thankfully gone.  I’m able to think about all of this more rationally, and I’ll look to the fall as a better time to try again.  That’s pretty cool!

I can’t expect every day to be sunshine and rainbows.  (Can I?)  Well, I know a couple people who actually do feel strongly that way, and I admire them for their attitude, but I’m not there yet.  

In the meantime, I’m going to carry on with my self-care routine the rest of this afternoon. That consists of working out, paying attention to my kids and husband, and trying my best not to eat too much ice cream.  (It’s sooooo good this time of year, though.)

I’ll take Lucy for a stroll on our “Death Road” in which I pray she doesn’t have diarrhea like she did yesterday.  (Oh yes, I practice the fine art of T.M.I.)  I’m so glad The Dreads disappeared because after suffering with bipolar depression, any glimpse of those awful feelings is scary as hell.  

I’ll be around here in Blogville this Friday, and I’ll let you know how my Seroquel increase goes.

Wishing you sunshine, rainbows, gelato ( if you like it) and most importantly, not a whisper of The Dreads EVER! :))

xoxox

Dyane

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Why I Use My “Sunbox” Bright Light Every Day…

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This picture shows my Sunbox DL (Desk Light)in action.  I bought my light from Sunbox over ten years ago.  It cost $250.00 and it has been well worth that (what was for me) hefty price.  I bought it before I was diagnosed with bipolar disorder, a few years after I was diagnosed with major depression.
 
As of today, you can buy a Sunbox DL on sale for $190.00  – it still usually costs $250.00.  (By the way, I don’t work for this company!  I just love their product and customer service.)  I felt such a benefit from using it that I brought it to a work conference four hundred miles away, and I brought it to the maternity hospital when I had my first baby!  I couldn’t care less who gave me a strange look.  I didn’t feel a dramatic change from using it, but I definitely felt it lifted my depression in a subtle way.
 
If you buy a therapeutic light, you may be able to get reimbursement from your health insurance company if you submit a doctor’s letter.  In 2004, Sunbox had a sample letter form on their website.  I could print it out, have my doctor sign it (including my diagnosis of depression) and then submit to the health insurance company.  My HealthNet insurance company rejected my claim, unfortunately, but it was worth a try.  The sample letters no longer appear on Sunbox’s website, but I’d contact their staff to double-check about this reimbursement possibility; their email is sunbox@aol.com and their phone number: 1-800-548-3968 or 1-800-Lite-You.  
Sunbox is the most reputable company I know of and is endorsed by Dr. Norman Rosenthal, a South African author, psychiatrist and scientist. He was the first psychiatrist to describe winter depression or seasonal affective disorder (SAD), and he pioneered the use of light therapy for its treatment.
 
One of the things I love about my light is that it is SUPER-easy to use – I just flick a switch and have a seat in front of it after I crawl out of bed in the morning.  I can read or surf the internet while using my light.  I feel instant gratification as the bright light envelops me.  I use it for about twenty-to-thirty minutes and opinions differ on the optimum amount of time to use the light.
 
The “Bright Light Therapy for Bipolar” article I posted below may seem dated since it’s from 2008, but the findings are impressive.  The study’s control group was very small, but I loved its promising outcome: ” Of the nine women treated, six achieved some degree of response, with several reaching full recovery from depressive symptoms.”
 
There is also a new kid on the light therapy block called the Valkee Bright Light Headset.  Valkee earphones are worn so one can go just about anywhere while simultaneously receiving light-therapy-quality benefits.  These Finland-made earphones are not cheap – they run just under $300.00. For more information check out: https://www.facebook.com/ValkeeCompany)
 
Have a great Sunday, and if you live with bipolar disorder, take a couple minutes to review the study below.
 
take care,
Dyane
 

Bright Light Therapy for Bipolar January 4th, 2008

A new study finds bright light therapy can ease bipolar depression in some patients.  Researchers from the University of Pittsburgh School of Medicine’s Western Psychiatric Institute and Clinic studied nine women with bipolar disorder to examine the effects of light therapy in the morning or at midday on mood symptoms.  “There are limited effective treatments for the depressive phase of bipolar disorder,” said Dorothy Sit, M.D., assistant professor of psychiatry and the study’s first author. “While there are treatments that are effective for mania, the major problem is the depression, which can linger so long that it never really goes away.” The study is published in the journal Bipolar Disorders.  Women with bipolar depression were given light boxes and instructed on how to use them at home. The women used the light boxes daily for two-week stretches of 15, 30 and 45 minutes.  Some patients responded extremely well to the light therapy, and their symptoms of depression disappeared.  The responders to light therapy stayed on the light therapy for an additional three or four months. Four patients received morning light, and five used their light boxes at midday. Participants also continued to take their prescribed medications throughout the study period.  “Three of the women who received morning light initially developed what we call a mixed state, with symptoms of depression and mania that occur all at once – racing thoughts, irritability, sleeplessness, anxiety and low mood,” said Dr. Sit. “But when another group began with midday light therapy, we found a much more stable response.”  Of the nine women treated, six achieved some degree of response, with several reaching full recovery from depressive symptoms.  While most attained their best recovery with midday light, a few responded more fully to a final adjustment to morning light.  “People with bipolar disorder are exquisitely sensitive to morning light, so this profound effect of morning treatment leading to mixed states is very informative and forces us to ask more questions,” said Dr. Sit.  “Did we introduce light too early and disrupt circadian rhythms and sleep patterns?”  People with bipolar disorder are known to be sensitive to changes in outdoor ambient light and to seasonal changes. Researchers are asking whether the risk of suicide in patients with bipolar disorder could be linked to changes in light exposure.“  In our study, 44 percent of patients were full responders, and 22 percent were partial responders,” Dr. Sit and her colleagues write. “Light therapy, therefore, is an attractive and possibly effective augmentation strategy to improve the likelihood of full-treatment response.”Optimal response was observed with midday light therapy for 45 or 60 minutes daily, noted Dr. Sit.  Source: University of Pittsburgh Schools of the Health Sciences