Yesterday I had an appointment with my psychiatrist in which he called me out for engaging in what are, for me, risky behaviours. I knew this already, or course. I’ve been conscious of feeling more and more driven from within. Part of me is aware that the behaviours I choose as a result are unhelpful, but I tend to reject that knowledge because behaviours are pleasurable or exciting, and because it feels like too much hard work to push against my internal, hypomanic motor. I’ve been distractible, and have allowed that to blossom, rather than pruning it back. I’ve watched myself as if from a distance as I flip between Twitter accounts every few minutes, all too often engaging in conflict with other users. It’s been a week or so since I actually watched a television programme, rather than live-tweeting it or texting or blogging throughout. I’ve been drinking a lot of caffeine, despite knowing that it messes with my mood and sleep. Then there are my recent music choices. When I am hypomanic I really want to listen to fast, busy, rhythmic music, but I also know that I should be listening to music that might stand a chance of bringing me back down to earth (fairly slow tempo classical music, or better yet, relaxation tracks with no noticeable beat or tune).
Yesterday the motor was running hard. I couldn’t make myself wait until it was time to set off for my appointment at the CMHT, because I was so desperate to go shopping. At the point where I left the house, I recognised that there would be insufficient time to shop properly before heading off to my appointment, but I went anyway. I also recognised that currently I really have very, very little money (no more ESA and savings almost gone), yet still I went, and the clothes I was picking up and putting down, putting into my basked and taking out, were far from cheap. I was probably about 85% certain that I could survive the trip without spending what remaining money I have, but I knew of course that in going at all, I was taking a risk. And if I know, why go?
I’ve also been breaking my own rule of only doing one thing in a day, unless I honestly can’t help it. I know perfectly well that running around London by public transport from one activity/commitment to another is bad for me. Yet last Thursday I still said yes to an impromptu invitation to lunch out, even though I was already committed to meeting my son in central London at 10am, taking him to a Sixth Form open evening at 5pm, and going straight from the school to my choir for 7.30pm. I could go on, offer more examples of things I’ve been doing (or thinking) that have been feeding the beast that is hypomania. I could also give you a list of things I’ve not been doing, despite knowing perfectly well that they help; exercising; my yoga classes; meditation; relaxation exercises; craft activities, such as needlework. All things that can help slow me down.
Why don’t I fight back, hit back with some serious CBT techniques, demonstrate to myself, my partner, my doctor that I really do want to get better? For a start, fairly obviously, I like being hypomanic. I like playing with the edges of it to see how far I can go. Although some part of me fully understands the risk of slipping into a dangerous, suicidal dysphoric mania (as I did on holiday this year), somehow the hypomania stops me from truly believing it could ever be that bad (classic bipolar over-optimism, I suppose). There’s also the fact that I feel I have tried most things to regain stability over the past 18 months, and nothing has worked as much as I would like. A few weeks ago, I wrote about whether I needed to adopt a position of radical acceptance about the fact that this episode is going on and on despite the meds, despite the therapy. Now I remember that there’s a flip side to radical acceptance, and that is learned helplessness. Radical acceptance says, “this is the way things are, and I can’t change it, but I can still find value and meaning in my life.” Learned helplessness says, “I’ve tried everything and it’s always the same, so I’ve stopped bothering.” Maybe I thought I was practising the former, but actually I had adopted the latter, along with a pinch of “Why should I try anyway – I deserve to feel good!”
My psychiatrist’s view was that before we add in a 3rd med or take one of my current drugs any higher, I needed to look at my own behaviour and what I have been doing to feed the hypomania (or at least how I have neglected to tackle it). We agreed that my @BipolarBlogger Twitter account is a bad idea for me right now, and so he suggested a four week absence (at which point I nearly cried, like a child having her toy taken away). We also agreed that I would stop the running from place to place and aim to only undertake one commitment/activity per day, and that if I was feeling like a shopping spree, I would a go with a small amount of cash and leave my cards at home with my partner.
What does all this mean? That I am back to exactly where I was this time last year, back when I was working with a psychologist on how to manage my condition. Back to making a timetable that includes daily meditation and exercise, even if only a small amount. Back to slowing myself down by making sure I don’t have my phone or laptop in my hands when I’m watching TV or a film. Back to saying no to caffeine and only a very limited yes to alcohol. I knew all this 12 months ago, yet somehow I’ve failed to take it on board. I’m starting to wonder if I’ll ever learn.