A Cardigan and the Resulting Mood Disturbance

I fear that the effects of coming off my medications in preparation for pregnancy have started to manifest themselves. If I’m honest, the truth is that I haven’t really been doing the things I’m supposed to do to keep myself mentally healthy. I felt so much like my old self all my new ways of coping with stress and the structuring my days didn’t seem to be needed.

I was wrong.

The catalyst was a stupid cardigan. Since I’m a larger size than I used to be I’m having daily struggles to find something to wear to work. (This is mainly because I refuse to buy another larger size. I vow I will NOT stay this size.) I had an outfit in mind because I knew the pants would fit, but I couldn’t find the cardigan that went with it and it set me off. I spiraled. I’ll spare you the inner dialogue that had me screaming and crying but everything went from a missing cardigan to “I’m so fat and ugly” to “Life is so overwhelming, nothing ever goes right, I fucking hate everything.”  All the while, Hubs is trying to reign me in. He’s telling me how weight is a fixable problem and that I need to get myself to work and not let this instance ruin a whole day.

If you know me, mornings just aren’t my thing. Never have been, and I doubt they ever will be. Needless to say the cardigan went missing when I was already running behind. To top it off Baby Boy could feel my anxiety and it made him anxious in turn. He got clingy and needed extra holding. It’s for him that I feel the worst. He witnessed yet again in his short little lifespan his mother losing control. He even tried to comfort me by gently rubbing my face and arm while I held him. Obviously he had no idea what was wrong but he knew something was wrong with his mommy and it was upsetting him. By the time we eventually made it to daycare he was quiet and sullen. He clung to my neck when I took him in. The daycare lady asked me if he had a good morning, at which I couldn’t hold my tears in and said “No, we’ve all had a very rough morning.”

I didn’t want to, but I pried myself away from Baby Boy and went to work, practically crying the whole way. I legitimately felt that today would be have been a good day for a mental health day since I was stressed to the max before even leaving the house. I was a half hour late when I made it in. I really was in no mood to talk to anyone, but as soon as I got in people were knocking on my door. Then my assistant got sick and had to go home, so the option of leaving early after meeting deadlines was no longer available. Finally before lunch I made it down to see my very good friend on the first floor. (For now on I’ll just refer to her as Care Bear.) She knew right away that I was upset and let me cry in her office and tell her about my morning and how terrible I felt as a mother. As we were talking our dean came in and saw me crying, a side of me he’s never seen. Instead of letting me feel embarrassed, he laid on the encouragement. He doesn’t know anything about my mood disorder but he made a point of enthusiastically telling me that I’m a good mother and an outstanding colleague at work.  So between the dean and Care Bear I got a thorough pep talk and genuinely felt better.

No one may notice from the outside that I struggled with my moods today. I’m grateful the storm has passed, but I’m left with a sense of deep shame. I’m not ashamed that I had a hard morning and or that after 18 months I still haven’t figured out how to get in a good routine with my son. What shames me is that I let my mood negatively affect my family, especially my son. I feel like I took away his right to peace in our home. He shouldn’t be the one to comfort me in times of distress. I should be the one comforting him.

Baby Steps

I saw my psychiatrist yesterday and he has officially deemed to be “stable.” The lithium orotate was exactly what I needed to smooth out my moods. He and I are satisfied enough with the results that I have received his blessing to start tapering off the Latuda so that we can prepare for pregnancy. There isn’t a lot known about the lithium orotate and pregnancy but his opinion is that I shouldn’t be taking it during pregnancy because even though it is a supplement it still contains elemental lithium. Before he sends me to see a maternal fetal specialist he is going to have a panel done to see if the lithium orotate is showing up in my blood. He said if my lithium levels were about 0.2 then we know that it probably isn’t safe to take. He also explained that in Europe, lithium doesn’t have the same taboo during pregnancy than it does here in the US. I’m really hoping that I can continue to take this so that I remain stable. My mood disturbances take a heavy toll on our family life and I’d rather not add that on top of a pregnancy. My personal hunch is that since I had a happy first pregnancy that I’ll have a second happy pregnancy, but I am also a pragmatist and know fully well that circumstances have changed since my first go around. Nevertheless, I am happy that we are now on our way to making a second child a reality.

My Many Colored Days

many colored days

Dr. Seuss’s My Many Colored Days is read often at bedtime in our home. It’s usually read on days when I feel low, when I have an angry outburst, or even when Baby Boy is having a fussy day. It’s my way of helping my son understand why mommy is not always herself, and that sometimes Baby Boy won’t always feel himself either.  I have a lot of guilt that my son has a reactive and sometimes unstable mother. I grew up in a home with a highly explosive step father, and I always vowed my children would never experience the same. Well, as my mother says, “Never say never; you just don’t know what life will bring.” I have far more angry outbursts than I care to admit. My temperament is highly reactive, and sometimes little things set me off more than they should or I react with inappropriate elation.

Something that strikes me about this book is how much the alternating moods and colors so accurately represent the bipolar spectrum. You have your grey days (“nothing moves today”), purple days (“I’m sad. I groan. I drag my tail. I walk alone.”) and brown days (“I feel slow and low, low down.”) that fit so closely with  how our depressive days feel. And then you also have depictions of both hypomanic and manic days. The yellow days  so accurately represent the goal-driven days of hypomania can bring where you feel more productive and get lots done – “I am a busy, buzzy bee.” Or the pink days that so accurately reflect the euphoria hypomania can bring: “When my days are happy pink, it’s great to jump and just not think.” Full blown mania is represented in orange when “all of a sudden I’m a circus seal! or red days when “how good it feels to be a horse and kick my heals.” There is also the dark hypomania represented in black, “Mad. And loud. I howl. I growl at every cloud.” And thankfully you have peaceful stable days listed which are green and you’re “deep deep in the sea. Cool and quiet fish.”  You even have your mixed episodes represented and “Wham! I don’t know who or what I am!”

And the reason I read this book so much? It’s the final two pages that read, “But it all turns out all right, you see. And I go back to being…me.”

Sleep

When I was first doing research on bipolar disorder I read an article where the author believed that one day it will be reclassified as a terrible sleep disorder since there is a huge correlation between sleep and the course of the disease. Personally, I don’t believe this, but it is nonetheless an interesting argument. What I do know is that sleep is a trigger for me. If my sleep is disrupted, especially several nights in a row, then I’m very likely to have a mood disturbance. And if I am having a mood disturbance, especially if it’s in the depressive state, then likely a good night’s sleep will have me feeling back to my normal self. I also have nights, like last night and this morning, where I have trouble getting to sleep but then still be able to function perfectly normal the next day. I’ve been thinking about my sleep in both a present-day and a long-term perspective, and wondering if it should have clued me in on a mood disorder much sooner.

Starting in high school my sleep patterns were erratic. Most days after getting home I would crash and sleep for a couple hours. Then I would get up and do all my homework (I was an honors student so there was always plenty of it). When I was finally done I would hit the sack again around midnight or one o’clock. Some nights I would simply have insomnia and sleep would escape me. This particular problem lasted until I became pregnant. For most of my 20’s I functioned best with 9-10 hours of sleep but was up until odd hours of the night. I thought I was just a “night owl.” It was irritating but didn’t feel alarming.

In stark contrast with today, I find that most nights I’m incapable of staying up all night. Being a mother changed all that. When we first brought Baby Boy home I could somehow function with very little sleep. At the time, I did note that it was odd, but was enamored with my baby and just grateful to be functioning. And then it got worse. As the weeks and months wore on the baby just wouldn’t sleep and it caught up to me. I couldn’t regulate my emotions and Hubs said I acted like a a patient who’d been sleep deprived for experimental reasons. Little did we know this was a huge red flag.

This is one reason every night I pray that Baby Boy sleeps straight through the morning. He’s a toddler now, and has been sleeping through the night for a while, but he still frequently wakes in the middle of the night. If he’s sick, then it’s a virtual guarantee he’ll wake up. Sleep is the thing I worry most about when I think about having another baby. In the hospital with Baby Boy, we all three slept upright in the hospital bed, much to the nurses’s disapproval. (With the c-section scar it was just too difficult to lean over the bed to get him in and out of the cradle.) But then when I got him home I was inexplicably terrified to sleep with him. Finally Hubs said that co-sleeping was the right thing to do for us. Both he and my mother tried to convince me that I wouldn’t accidentally kill him in my sleep. If I didn’t co-sleep I was going to end up with a nervous breakdown. I relented and it was the single best decision we made in those early days.

Since co-sleeping was the only thing that allowed me to get sleep, we plan on doing this right away with baby #2. We’ll also start sleep training from day one. Obviously a newborn can’t literally sleep through the night since they need multiple feedings, but you can lay the ground work. You can make a clear distinction between night and day so that they can learn that nighttime is meant for sleeping. I don’t know how other bipolar moms handle this, but for us these are the most logical steps to take.

In the meantime, I do my best to get regular patterns of sleep. I’m not super consistent, but on weekdays the alarm goes off at 5:30 and I try to be in bed by 9 every day of the week. I’m aware that one is supposed to get up at the same time everyday, even on the weekends, but I’m still holding on to that extra hour or two on Saturdays and Sundays. For now, it feels the best way to survive the baby years.

Baby Fever

In a perfect world, I think I’d have five or six kids. I love being a mother that much.  I know most people think that’s too many. There are also those who still believe that that for a bipolar mom, even one is too many. Ever since Baby Boy was born, though, Hubs and I knew that we defintely wanted more children. Despite my feelings, I’ve practiced caution and have been adamant about waiting  until things were right to bring another child into this world. In the scheme of things my bipolar diagnosis is still relatively new. My psychiatrist knows I’d like to have a medication-free pregnancy since the guilt and worry would eat me up. I have a new hope, though.

After learning I was allergic to several medications that could treat my condition, he suggested I try a supplement called lithium orotate before we give up and go with the tried and true prescription lithium carbonate. I really don’t want to take lithium carbonate because of the side effects. Since taking the supplement I have become much more stable. It worked a whole lot better than I expected for something over the counter. Most importantly it’s restored my hope – hope that I can lead a life much less encumbered by bipolar disorder; hope that I can go back to being myself and actually attain all that I had envisioned for myself. While on it, motherhood has become more like how I expected it to be. I find that I can be present with my son, that most days I’m not plagued with emotions that prevent me from functioning like a normal person. Needless to say, I’ve become a believer.

This is all to say that now that my hope is restored baby fever has firmly taken root within me. The timing feels right now and much to Hubs’s delight I have let him know I’m ready. I feel such a difference within myself I feel comfortable enough to ask my psychiatrist if we can stop the Latuda (lurasidone) at my next appointment (about two weeks away). I’ve spoken to Hubs about it, and while he too has the same reservations about pregnancy and medications that I do, he has no worries about me taking the supplement. I’m hoping that it can be taken during pregnancy and will also allow me to breastfeed safely. I know there is so much to consider and so many challenges, but I look at my son and I feel such joy and such contentment. Nothing about bringing him into this world has been easy, but ALL of it has been worth it. I feel my truest self as a mother and firmly believe becoming one has been the single best thing I’ve done with my life.

Video

A Song for Today

Last night Baby Boy and I had a rough evening while Hubs worked on our A/C unit. Baby Boy wouldn’t eat dinner, he fussed and fussed, he continues to refuse a sippy cup and will only drink his milk in a bottle. Etcetera, etcetera, etcetera… It all made me feel like I was going to explode and then of course after I put him down for bed I felt guilty for being so short tempered and cried on Hubs when he finally came in for the evening. And then I woke up still low today. I had to drag myself out of the bed. I cried on the way to daycare. I was late to work. A million thoughts are running through my mind telling me I’m deficient; that I’m simply not good enough. All this when I just thought I was in the clear. It’s been a month since my last mood disturbance so I let myself think I was “better.” I pray this is just a blip in the radar. Maybe I just need a really good night’s sleep, after all, it’s been three nights in a row that my sleep has been disrupted.

But until I feel myself again, I have to put on “the mask.” I’m a supervisor, and supervisors aren’t allowed to be this way in front of their staff. My direct reports don’t know I have a mood disorder so they probably think I’m crazy, never knowing what to expect…

I’ll leave you with a song. It came up on my playlist this morning on the ride into the office. The feelings it conveys perfectly reflects my state this morning.

Exercise

I really didn’t want to. I pulled another 9 hour day at work yesterday, and our A/C was (and still is) on the fritz. The last thing I wanted to do was spend a half hour sweating. But on Sunday while looking at our calendars, I vowed I wouldn’t let another week pass without exercising. I told myself, “It’s just a walk. 15 minutes out and then you can come right back. Plus the baby needs to get outside.” I even told my husband I needed him to tell me to just do it, to which her wryly said, “Get out there and just do it.”

So, I changed my clothes, filled up our water bottles with ice water and put my son in his stroller trike. I set the timer on my phone, turned on the tunes, and headed out. The nice thing about our neighborhood is that there are any number of ways you can mix up your route. I decided, “Let’s walk to the park, baby boy.” We did not take a leisurely pace. I was hot and sweaty and completely winded. I hated it, but found that I was able to push myself harder than I had in a long while.

For the final home stretch back to the house, I ran. It seemed like the distance didn’t get shorter until it did. My body hurt and I wanted to stop, but I couldn’t let my son see me give up even if he is just a year old and wouldn’t have any memory of our jaunt. When we got back in the house I was so wiped I thought I might collapse. It had been so long since I had done any challenging physical activity. As I cooled off though, I realized my mood had altered. I felt confident, I felt proud of myself for going 30 minutes instead of just 15, and, most importantly, I didn’t feel so damn tired. I actually had the energy to get through the rest of the night.

I thought, “This is why exercise is stressed so much at therapy.” Before I had the baby, I would take a long lunch once a week to head to barre class offered on campus where I work. I would also use the rowing machine at home a couple times a week. I have lots of excuses why I stopped. I’m sure most are the same ones other people use.

I’ve been blessed with a naturally petite frame, but I have a deep fear of becoming obese. It’s in the genetics. There are just too many in my family that are overweight, and I see how much it affects their quality of life, especially the women. We also have incidences of diabetes, hypertension, lots of cancers, as well as mental illness. All of these are very good reasons to do my best to take care of myself physically.

Even though I loved being pregnant, I frequently broke down in tears at my ever growing size. I was scared I would put on too much weight, and never get it back off. My doctor assured me at every appointment though that I was doing very well and not gaining too much too fast. Once I had the baby I wore my postpartum binder religiously, and breastfed to lose the baby fat. By the time I went back to work 11 weeks later, I was back down to my pre-pregnancy weight, 120 lbs. I was delighted.

And then I got sick. I spent lots of time in the doctors offices trying to find out what was wrong. I saw the weight come off even more than I planned. I got down to 109 lbs and a size 2. I was worried what it all meant, but I was also secretly ecstatic. Eventually, all they could say was that I got sick due to anxiety, after all I was a new mom with lots of new worries.

Fast forward a few months and a bipolar diagnosis, I stopped being physically ill all the time and instead dealt with trying to regain stability and find the right medicine combination. Much of the time I alternated from feeling insanely irritable to extremely depressed, and started eating for comfort. I ate like I could eat anything without consequence. Over the last couple months my weight shot up over 130 lbs and could barely fit into a size 4, my normal size. Which brings me to where I am now.

I need to get active again, not just so my clothes will fit right again, but also for my mental health. There’s a clear correlation, for me, that as I gain weight I feel depressed and lack confidence. I have accepted that a size 2 is unreasonable since it was the size I was while very sick. I’m a mother now, and the aim is to have the functional fitness to care for my family. I also need the mood balancing properties that exercise and activity brings.

I’m starting slow with my changes since I want lasting changes and not just a temporary quick fix. The goal these first four weeks is to walk with my son for 15-30 minutes 3 times a week. I’m also trying to cut out soda – regular and diet – and eat more wholesome foods instead of junk food. I hope to gain more energy for my day-to-day activities and to continue on my path of stability. I’m one month stable today, and so now that I’m here it’s time to focus on flourishing.