Hypomanic and Depressed at the Same Time

I read an article today and now my world makes so much more sense. In a Depression Bipolar Support Alliance (DBSA) “Ask the Doc” article, Dr. Mark Bauer, MD states that:

“[T]he most common mood state in bipolar disorder is a mixture of hypomanic/manic and depressed symptoms. In fact, the classic picture of bipolar disorder having a course alternating between the poles of high and low moods is an over-simplification.”

He goes on to explain mania and hypomania more clearly, basically describing them as hyperactivation – feeling “sped up” and driven. This can feel good (e.g. grandiosity), bad (e.g. irritability), and everywhere in between. In other words, mood and activation level are two different things.

Ergo, we can think of bipolar disorder as

“a condition of recurring depressive periods punctuated by periods of hyperactivation – and sometimes these periods of hyperactivation alternate with slowed down, depressed periods, but at other times they overlap.”

That. Is. My. Life. It’s very rare for me to experience a period of time with no depressive symptoms; at best my symptoms become few and mild enough that I don’t meet the criteria for clinical depression for a couple days to a few weeks. But periods of hyperactivation… just look through my blog and you’ll see my posts about “I’m going to do this new thing that will change the world,” staying up all night composing, “now I’m getting better and I’m mad at Fox all the time,” and most recently “Let’s Play Skyrim!”

I usually feel better during my periods of hyperactivation because 1) I have energy to do things and 2) I’m hyper-focused on something that’s meaningful to me, at least while the hyperactivation lasts. Sometimes I don’t feel so good because I want to Do All The Things!!! but I can’t focus on one thing to do, so my mind is a jumbled mess. I’ve also tried to be a part of too many different groups at once, which invariably results in me feeling overwhelmed, backing out, feeling guilty, and my depression symptoms becoming more severe. As far as I can tell, all of my periods of hyperactivation have occurred at times when I also met the criteria for mild depression. (Possibly also moderate depression.) In other words, I’ve never had a discrete hypomanic or manic episode.

I try not to put too much importance on labels; what’s really important is that the needs of the person with a mental health issue are being met. But having a label creates a container for my experience; I can understand it and talk to other people about it and know I’m not the only one who’s had that experience. Finding labels that accurately describe my experiences helps me feel safe. I obviously can’t diagnose myself, but the label “bipolar disorder” seems to become more accurate the more I learn about the experiences it’s intended to describe.

I know I’ve been “depressed” lately because I’ve been feeling sad and/or grumpy, isolating, having trouble eating full meals, apologizing for my existence, and thinking “I want to die” when I’m tired. I feel like it’s only a matter of time before my world starts unraveling (again): I worry about Fox’s safety, our rats’ health, my own health, the house burning down, etc. Calling these experiences “depression” helps me separate a bit from them, accept them, and engage in self-care.

A Line Through Time

One of the worst things about my mood disorder is feeling disconnected from my past self/selves. I feel like I’ve lost something and I want it back, but I’m not even sure what it is. Most of my work with Wakana has focused on reclaiming aspects of my Self and my life experiences that I’d repressed, abandoned, or otherwise been ashamed of. It can be very painful It is excruciatingly painful, but with every step I feel closer to being whole.

Last night I decided to make a timeline of my relationships. I started with meeting Banji over 15 years ago and continued through college, my first full-time job, grad school, meeting Fox, Banji moving away, getting married, all the way to this year. I realized there was at least one major transition – including but not limited to beginning, losing, and ending relationships – in every calendar year since I graduated from college about 10 years ago.

There is a concentration of intense transitions from 2011 through 2013. As Banji was preparing to move away, I essentially proposed to Fox – despite only knowing him for a handful of months. Spring 2011 was the last time I facilitated music therapy sessions for actual clients. Banji moved over the summer. I applied for an internship and thought it was a sure thing, so I waited months to learn whether I’d been accepted… only to be rejected twice. By the end of that year I’d moved in with a friend from college.

I don’t have much written down about 2012. I spent a lot of time trying to find the right medication and psychiatrist, and ended up taking some meds that probably did more harm than good. I adopted a pair of rats early in the year, one of whom died about a month or two later, and I had to euthanize the other by the end of the year.

Banji moved much closer to home (but still 5 hours away) around the beginning of 2013. I followed suit by moving back in with Mom; I’ve barely seen or talked to my former roommate since. Mom got knee replacement surgery, my uncle died, I had to drop the classes I’d waited 2 years to take because they were triggering my worst symptoms, Fox moved in with me that summer, and we got married in the fall. Looking back on it in that context, I think I must have been crazy!

Some of the above transitions were out of my control, but others (like moving) I imposed on myself. I honestly don’t regret them; they were necessary for me to reach the point where I am now. But they definitely added to my stress and were not entirely beneficial to my mental health. I couldn’t do most of the things I was used to doing; I stopped doing things that had been meaningful to me. I made at least one decision that I do regret now. In hindsight I think my worst problem may have been the guilt and shame I felt because of the problems I was facing – particularly as they affected my pursuit of a career.

Things have been improving since last summer, when Fox and I started marriage counseling and finally gained access to the medication we need (thanks to the Affordable Care Act, aka “Obamacare”). Fox has been working full time for several months now. I did well through a challenging semester on a sub-therapeutic dose of my medication. Now I’m on a therapeutic dose. We’re regularly using the skills we learned in marriage counseling (which our therapist terminated 2 months ago). Our relationship brings us both a lot of comfort and joy.

Of equal importance is that Banji and I have worked through at least some of the issues impacting our relationship; we’ve become closer as a result. We’ve adapted to the current physical distance between us. Whenever we meet in person, we blend continuing fun traditions from the past with planning for the life we intend to build together. We’re not where we want to be – living within a 10-minute drive of each other – but we’re hopeful.

I haven’t been putting off applying for internships because I’m afraid of rejection. I’m not even sure it’s accurate to say I’m afraid of success. Starting an internship would be Another Huge Transition: new relationships, new routines, new responsibilities, even a new role/identity. The dynamic between Fox and me would change – hopefully for the better, but it would still be a change.

This is something I actually have some control over; I am exercising my control. I am not procrastinating and I do not have anything to be ashamed of. I am choosing to postpone another huge world-shattering transition because I’ve learned that it’s harmful to have too many of them in such a short period of time. There’s a lot of pressure to start my internship as soon as possible, and a lot of benefits that could come from doing so. But there are also benefits to waiting, at least for few more months.

I need some time to breathe.

The Way of the Voice

Working on my Let’s Play has the potential to help me become more intentional in how I use my voice. Creating an episode is a process that I’d estimate is about 1/4 recording and 3/4 editing, the latter of which involves a significant amount of time listening (and re-listening) to my commentary. It gives me the opportunity to hear my voice as someone else might: without the lower frequencies I’m used to hearing and containing unintentional fluctuations that can be interpreted in a variety of ways.

When I said I like the way my voice sounds in my last post, I meant that the absence of the lower frequencies doesn’t bother me. I’ve also learned to speak with a deeper, more adult-sounding voice – well, most of the time. My voice as it’s recorded for the commentary usually sounds like a me I want others to perceive. I consider that to be a rather awesome accomplishment.

As I’ve been listening to my commentary, I’ve come to notice unintentional fluctuations in the volume, energy, pitch, and rhythm of my voice. It tends to get softer and its rhythm more erratic at points that are unscripted, so my focus is diverted to figuring out what I want to say and how to word it. Sometimes the volume – at least as it’s measured by my audio editing software – will be the same, but my voice will sound… smaller, perhaps more child-like. The pitch can be all over the place and too often rises at the end of statements, which drives me crazy because it sounds like I’m constantly asking questions.

I don’t know if others would interpret these fluctuations the same way, but to me they all come together to make it sound like I’m uncertain about what I’m saying, perhaps seeking validation or approval. If I do this in my real-life interactions, people might think I’m incompetent or lack confidence or I’m asking them for help; this might contribute to others (including Wakana) “taking over” and telling me what to do. That’s not how I want to be treated, but it’s how I’m unintentionally asking people to treat me. I need to figure out how I want people to treat me (like an equal? like a competent adult?) and learn to present myself that way.

I’ve tried to mitigate this, with some interesting effects. In one episode I noticed that my request to “please subscribe” sounded like a plea, as though I were desperate for followers. In a later episode I intentionally tried to drag the pitch of my voice downward, in hopes of at least providing some variety. When I listened to the recording I thought I sounded like a bitchy teenager, complete with huffing and rolling my eyes. I immediately deleted both of these atrocities out of their respective episodes. (Thank goodness we can do that!)

I recognize that 1) I’m probably being more critical of myself than others would be of me, 2) I might be looking at myself through depression and/or anxiety goggles, and 3) different people might not even notice these fluctuations, or might interpret them in different ways. Ideally I can ask others for feedback – actually, Wakana would be the perfect person to ask; as a music therapist whose voice is her primary instrument, she is the one most likely to notice the fluctuations in my voice. Perhaps she can teach me to be more intentional in how I use them to communicate.

With and without Wakana’s assistance, I can use my Let’s Play commentary as an opportunity to listen to my voice in a variety of situations:

  • when I’m intentionally trying to convey certain emotions as part of role-playing my character
  • when I’m sharing my thoughts about strategy, the plot, gameplay mechanics, etc. – basically, talking about stuff with a focus on the content of what I’m saying
  • when I’m directly addressing the viewer, e.g. “thanks for watching”

I can also experiment with making my voice sound different and listen to the results. Does intentionally lowering the pitch at the end of sentences help me sound more confident? What happens when I try to put more energy into my voice? When I’m role-playing, do the inflections in my voice accurately express the emotion I’m trying to portray?

Of course, I can’t act my way through life: trying to convince others I’m more capable and worthy than I actually felt is what got me into this mess in the first place. I need to continue the work I’ve been doing with Wakana, which essentially comes down to learning that I have the right to exist and I’m worthy/”good enough” just the way I am. As I do that, the ways I present myself will change, and so will the ways people treat me, and that will help further improve my self-esteem.

Or, maybe the changes in how I present myself aren’t quite keeping up with my changes in self-perception. In other words, I feel more worthy and confident than I convey to others. So, I choose to intentionally improve my ability to communicate my confidence and worthiness, so others will see it and respond accordingly… which will help further improve my self-esteem.

The Curse of the Dragonborn

“Let’s play Skyrim” – by which I mean: “Let’s repeat the same sequence 7 times before we’re satisfied with the footage we recorded, then discover that the video and audio have become unsynchronized, so we have to do it again!” (I’m actually not exaggerating.) Then let’s do a great job editing the footage together and record some kick-ass post-commentary (which tends to also require several takes, and editing).

I’ve been working on this Let’s Play for a little over a week now; I’ve felt just about everything one could possibly feel about it:

I’m frustrated with how time-consuming and repetitive the process is. I’m angry at myself for how much time I’m putting into it, and feeling guilty about the things I’m not doing as a result. I’m thoroughly obsessed with it and gain a lot of satisfaction from thinking about it – but I would also like to occasionally not think about it. I’m devastated when I turn my back on it to spend time with Fox, but we’re both too exhausted to do anything. I feel better when we talk about Skyrim.

I’m proud of the work I’ve done so far and I want to share it. I’m concerned no one will watch it. I’m unsure whether I’ll be able to keep it up – and whether doing so is healthy. I feel very powerful when I play well. I feel very anxious when I’m unsure about a decision while recording. I want to show off my fantastic skills and wow viewers with my insightful commentary. I even like the way my voice sounds. I want to know what others think of it – mostly.

I think I should delete everything and start over. I think I should delete everything and stop playing Skyrim. I think I would be very sad if I deleted or otherwise lost my completed episodes, which are quite good – especially after putting so much time and energy into them.

I think it’s a fun hobby and good long-term project, assuming I can take breaks from it without abandoning it entirely. I want to join the Let’s Play community. I’m happy that so far I’ve prioritized opportunities to socialize in person and going to my therapy session over playing Skyrim. I’d much rather play Skyrim than do chores, apply for jobs and internships, run errands, exercise, do other leisure activities, etc. I really need to move forward with my life. I’m being creative, really!

My pet rats are adorable, make everything better, and are completely dependent on me. They are a million times more important than Skyrim.

… they also sleep a lot.

Now Let’s Actually Play Skyrim…

My computer problems seem to be resolved. I did a clean install of my operating system, let it update itself, and I’ve been slowly replacing programs. Fox asked me to back up his level 50-something character, so we have all our save files from The Elder Scrolls V: Skyrim. Today I played with my level 39 character – who has more gold than she’ll ever need, owns multiple houses, and makes the best gear in the game. (Better gear will become available as her smithing skill improves.) It provided a nice break from all the reality I’ve been dealing with lately.

I played for a while, decided to take a break, and was pleased to discover that my computer did not crash when I closed the game. Since I’ve been so obsessed with the idea of doing a Let’s Play, I decided to give it a try. Like anything else, videos that combine gameplay footage and audio commentary don’t happen because a gamer wants them to. They happen because the LPer gathers the necessary software and equipment, presses “record,” and does their best to make whatever happens entertaining. It takes a lot of courage and self-acceptance.

I started a new game just so I could practice recording. There are some things I need to work out in the introduction, but it goes smoothly enough. Perhaps unsurprisingly, the comments I made during character creation bore little resemblance to the lines I’ve been compulsively practicing.

I want to share my thought process while choosing my character’s race, but actually making the selection in character creation takes me about 2 seconds because I’ve already made my decision. Do I let the video become static while I talk, or do I make my selection quickly? If I do the latter, should I try to talk about the race I chose while tweaking the character’s appearance? It seems like character creation is set up so it can happen quite quickly, without breaking up the action that is going on at the beginning of the game. I’m torn between going along with that and taking some time to share my strategy.

Perhaps I should record post-commentary: instead of talking while I’m creating my character, I can record my comments while watching the video later. That will leave me free to focus on character creation while recording the gameplay footage, then focus on sharing my strategy while recording my commentary. Yay not multitasking!

The point is, I’m finally trying things and learning what does or doesn’t work, instead of just obsessing over them. I even made a short trial episode! Perhaps as I practice taking a more “hands on” approach to the Let’s Play, I’ll feel more confident about working to improve my skills, complete quests, and level up in reality.

Let’s Play Skyrim

Welcome to a repeat of my post from April 2014! I like to think I’ve come a long way since then: I’m hopeful regarding my future. I feel a strong positive connection with Fox (my husband) and other loved ones, especially when we express our mutual affection. I have been playing video games, but for reasonable periods of time and without allowing them to interfere with living my real life. (It’s been several months since the last time I played Skyrim.)

On Tuesday my prescriber told me that I’m doing great, switched my prescription to one dose per day, and said to come back in 3 months. I’ve started addressing my social anxiety with help from my music therapist, Wakana. The last couple days have been a fun reunion with dear college friends. Honestly, the only not-so-awesome thing going on for me right now is the problem with my computer… and even that seems close to being resolved.

I’m doing this re-post because I’ve started obsessively practicing lines for the first couple episodes if I ever do a Let’s Play of The Elder Scrolls V: Skyrim. It’s kind of annoying because I’ve already said the same things many times, and yet I still feel compelled to repeat them over and over. It’s better than having a panic attack because a bee bounced off my windshield while I was driving, imagining wasps attacking me, or being afraid to look in the mirror at night because I was traumatized by a movie I watched as a pre-teen, though.

My anxieties – social anxiety, general feelings that something horrible will happen, and my bee/wasp/hornet phobia – have been flaring up like crazy lately. It kind of makes sense that my defense would be to concentrate on a fantasy world, where I can load from a recent save if I don’t like what happens. The lines I’ve been practicing focus almost exclusively on character creation, the one part of the game over which the player has nearly total control.

There are a lot of parallels between my current situation and the context for the original version of this post (below). I was feeling good about my life, being active and social, trying new things, and acting like a responsible adult then, too. My anxiety was flaring up then, too – driving my mind to grab onto whatever it could as a security blanket:

I had an epic day of being awesome on Thursday, so I was exhausted on Friday. I spent what part of the day I wasn’t sleeping practicing Zentangles and hanging out with friends. Saturday was similarly low-key. After drawing my Zentangle for the day, I was itching to play a video game: something beautiful and epic and new…

So I started a game of The Elder Scrolls V: Skyrim on PC. Next thing I knew, the sun was rising. I took a nap and basically spent all of Sunday playing thoroughly immersed in that fictional world. I’m enjoying the game and want to experience the story, but to be honest there are aspects of it I find rather stressful. Melee combat, for one – especially since the default difficulty was too high for me and I kept dying. I’ve been doing much better since I dialed it down a notch, but I still prefer to avoid melee combat when possible.

The other thing I find stressful is that, whether a character is attacking me physically or not, they’re talking at me. The physical attackers hurl insults that can hurt more than their blades (except that they’re obviously wrong, because I end up killing them.) Other characters I pass might say something mean, ask me for something, or randomly tell me their life story.

Some of the other characters in Skyrim say very mean things to the player character, especially if you’re playing one of the less popular races. […] I’m still concerned that hearing negative talk consistently for hours at a time can be harmful… at least for me.

[…]

Anyways, as much as I want to just play the game and have fun with it – learning things as I come across them and making decisions spontaneously – my mind wants to plan out a Let’s Play. The most basic definition of a Let’s Play is a video that combines actual gameplay footage with simultaneous audio commentary by the player; it can be a walkthrough, a challenge run, friends goofing off (whether playing competitively or collaboratively), even a talk about a topic that has nothing to do with video games. Fox’s favorite Let’s Player (LPer) is HCBailley.

I love the idea of Let’s Plays and have wanted to do one for a few years now. I had a couple false starts, but on some level I’m convinced it’s only a matter of time before I get one going that I can be consistent with (and get all the YouTube followers!). It’s an opportunity to do some video editing – which I enjoy for the process at least as much as the product – and share my thoughts about the game. I want to share the story, be witty and entertaining, and give a feminist critique.

I’m trying to convince my mind to put the Let’s Play idea on the back burner for now. Let me learn to be consistent with things that are important to my real life before I start a project that requires me to play a long and involved video game on a regular schedule (and in manageable doses). […]

The thing is, if I think about the game when I’m not actively playing it, there isn’t much to say. I have my character. I’d like to improve my smithing and melee combat abilities. I’m really glad I can mute the voices and determine when subtitles appear. I’m not entirely sure it was wise to drop all of my gold on a house this early in the game, but it’s a place to keep the dragon bones and scales I’ve been collecting. It also enabled me to adopt a child; interacting with her causes me to feel warm and fuzzy inside. I could think about which quest to start next, but they’re all in a nice convenient log for me so I can just decide next time I play.

The above don’t give my mind much to grab onto, and it doesn’t like that. Moving forward with my real-life career goals, dealing with real-life people (especially strangers in positions of authority), and even just being fully present in the moment are all things that provoke my anxiety. My mind needs something to grab onto, something to think about so incessantly there isn’t room for thoughts about the real world in general and my own life in particular.

It was hoping the Let’s Play would provide such a security blanket; it wants to lure me into thinking about my ideal character build instead of actually developing skills I need in real life. It wants me to direct my creative energy into witty commentary about the game instead of into composing original music, creating original art, or writing anything worth reading. It wants me to feel good about earning virtual money to make a virtual home pleasant and cozy… instead of finding a real job, earning real money, decluttering my real home, and raising a real family.

Oh, Mara, I thought I’d gotten past this. I should have known! How could reading a few chapters of a book once truly change the way I think about and perceive myself? How could it counteract a lifetime of internalized messages reinforced by my perception of my experiences?

[…]

I thought I was doing better but then… I don’t know! Did I push myself too hard and need some downtime to recover? Did I relapse? Am I making any progress, or am I just walking in circles completely lost? I hate being unable to trust my own perception of reality.

Priorities and Letting Go

I’m having some serious problems with my computer. I think I got a virus or other malware that made harmful changes to my operating system until it wouldn’t load correctly. Long story short, my efforts to repair it seem to have made a bigger mess. I’ve backed up all my essential files and made sure I can reinstall important programs (e.g. the software I use to compose music). The next step is to format my hard drives, then reinstall my operating system. If all goes well, it will be like having a new computer.

Which means I’ll lose all the progress I’d made in The Sims 3 and other favorite games. If I ever want to play The Sims 3 again, I’ll need to reinstall the base game, several expansions, tons of additional content, and all the updates. It will take several hours – possibly days. Then my only choice will be to start a new game, completely from scratch…

Or I can just walk away…

I’ll be honest, I’m not happy about this. I’d prefer for my computer to run smoothly and never have problems. But I’ve had this computer for over 5 years. The hardware is still in good shape, but the software is getting clunky. There are programs I don’t use (one of which interferes with The Sims 3 and other games), I’m way overdue to defragment my hard drive, and my files are kind of disorganized. I had a ton of bad, blurry, or redundant photos taking up space, things I meant to sort or delete and never did, a plethora of downloads… It’s a mess.

I actually welcome the opportunity to start anew, with a clean uncluttered desktop. I can be intentional regarding what I install, how I organize my files, etc. I can build a tool that will help me accomplish my dreams instead of distracting me from them (as much?).

With all the things I’ve been angry and anxious about lately, I’m grateful for my ability to be at peace with this. It’s not a medical, emotional, or financial crisis. I’m not going to lose important files I worked hard to create. And it’s provided some good opportunities. I spent the last few days going through old pictures and reminiscing. I watched the video from my wedding and found the sermon & vows to have even more meaning than they did on that day. I’ve learned a lot about how to protect oneself from malware and other unwanted software. I’ve started focusing more on my priorities: wellness, family, my career, making the world a better place.

Now I just need to let go. To trust that I have everything that’s important, I can live without (or replace) the files that will be erased, and I’m making the right decision for me based on what I know now. If I regret something later, I will have the resources and support I need to work through and release that regret. It’s okay, I’m okay. The world is so much more than this.