Meeting Notes – March 9, 2011

by Bruce on April 17, 2011

Introductions

We begin the meeting with each person answering the following questions (and passing if they wish).

1. Your first name.
2. Your diagnosis.
3. Your mood on a scale of 1 to 10 (low to high).
4. What do you do to take care of yourself?.

Check-In

At this point we broke up into small groups for a more personal check-in.

Meeting Format

Throughout the meeting, we circulate the question bag (just a paper bag with a big “?” on the side).   Anyone is free to write any question relating to living with a mood disorder. The question is read by the facilitator and members of the group respond from their own experience. The writer of the question remains anonymous, but benefits from the collective experience and wisdom of the group. The discussions are often quite lively and humorous.

(The only topic we don’t discuss are individual medications and health care providers. There is too much variation in individual’s response to a certain medication or certain doctor and what might work for one person might not work for another. We do have general discussions about classes of medications, and people are welcome to ask during the meeting for feedback on a particular medication or doctor and then discuss it with others one-on-one after the meeting.)

Q & A Session:

Q:  When you’re feeling good, is there a temptation to try to make up for lost time – to do all of the things that you couldn’t do when you were depressed?

A:  Yes
A:  When I’m feeling better, I have a tendency to make too many commitments.  When I realize that I’m over-committed I tell myself to slow down.  I need to remember that if I try to do too much, that another bout of depression will follow.  “Stay low, go slow, don’t blow.”
A:  When I’m feeling good it is very hard to rein myself in.  I depend on friends to help me prioritize where to direct my energies.  If you don’t curb yourself, you can end up hurting yourself and others.
A:  Having energy is not necessarily a bad thing.  To me it makes a difference if I’m actually getting things done, or whether I’m just “spinning my wheels”..  If I have a lot of unfinished projects, unfinished business, and I’m not sleeping much, then I know that I’m getting into dangerous territory.

Q:  What have you noticed triggers your bipolar/depression episodes.

A:  Stress.  It can either make me go up or go down.  I end up either laying in bed feeling scared or running around all over the place.
A:  Good things can be triggers, too.  Even “good” stress.  I need to decide how much I take on and make sure that I’m not over-committing.  It’s easy to get caught up.
A:  Isolation is a trigger for me.  Once I start ruminating, it just continues to drill down until I’m really depressed.  Often, if you say you’re depressed, people tell you to get outside and work hard.  It’s true.  If you see people that are working hard all day long, they don’t have time to get depressed.
A:  It depends on whether you’re extroverted or introverted.  If you’re extroverted, you can get triggered by not being around people.  If you’re introverted, you can be triggered by not having enough time alone.
A:  Situations that lead to sleep deprivation.  When I don’t get enough sleep I become a real mess.  Also, if I’m in an unstimulating  environment, without much to do, it can send me up or down.

Q:  Have you ever lost someone in death to suicide?  My friend jumped from his building – he’s still alive but in critical condition.

A:  There was a member of this group that came for nine years – he was a wonderful man, and became a close friend to all of us.  When he took his life it was very difficult for all of us, just devastating.  Each week he’d bring a joke book and tell us a joke at the end of the meeting.  He was always willing to help.  When something like that happens, you just ask yourself, “What could I have done?  Is there something I could have said or done?”
A:  (It was my friend)  I’m also asking myself if there’s something that I could have done.  Also, I feel like I have an inability to express my feelings about it.
A:  Knowing that I can end my life at the time of my choosing has always been a comfort to me.  I think that people all act rationally withing their frame of reference.  I feel like we need to cut people some slack.
A:  I want people to think of me as a safe person to talk to when they’re feeling suicidal.  It’s important that you talk to someone – someone can go from suicidal thinking to carrying it out very quickly.  This group is a safe place to talk about suicide.  Please tell us.
A:  There’s a saying that suicide is a permanent solution to a temporary problem.  People often act on an impulse when it seems like things won’t get any better.  I moved into a new place and met a neighbor who died soon after.  He seemed like a really nice guy.  I met his family when they were cleaning his place out.  They said that he committed suicide.
A:  Suicidal episodes can be very beneficial.  When I’m ready to end my life, it’s like being on the edge, and I realize in that moment that anything is possible.  If I’m ready to surrender myself completely, there really are so many options.  I asked myself, “Which would be better – killing myself or going to live in a country that I’ve never lived in?”  If I hadn’t been to the edge of suicide, I never would have gone there.
A:  I knew two girls, eight and ten years old, who found their father’s body after he’d killed himself.  They’ll never get over it, but I took from that situation the resolve that, “I’ll never do that.”
A:  I’ve felt suicidal for months at a time.  I didn’t want to go ahead and do it.  Instead I told myself, “I’m gonna figure this thing out.”  I do think, though, that when people take their lives, it is a rational act, based on what they’re experiencing.  I don’t want to say that it’s right, just that I can appreciate that it can make sense to someone, depending on what frame of mind they’re in.

Comment:   In general, beware of over-the-counter drugs and their interactions with medications for depression and bi-polar disorder.  Even some cough medicines can trigger the potentially-fatal serotonin syndrome.  Talk to your psychiatrist about ANY medications you’re planning on taking, OTC or prescription.  You can also check for drug interactions at Epocrates.com

Q:  (Just a show of hands)  Does anyone take a medication that a previous doctor prescribed for you (and which you think is fine), but you’re present psychiatrist  doesn’t want you on (totally against)?

A:  Sometimes you have to fight doctors who don’t want you on a particular med.
A:  Get a second opinion, and if that doesn’t help, get a third opinion.

Q:  How can one avoid a manic episode besides medication?  I am talking about when it begins to happen.  I realize that you need to get in touch with your therapist and psychiatrist, but what else can you do?

A:  The last time I began to get hypomanic, I took a pill that my doctor had prescribed.  Then, when I was at my yoga class, I asked the teacher for poses that are grounding, that help you center when you’re feeling fragmented.  I did them and I didn’t have to take a second pill.
A:  There’s an exercise where you touch each finger to your thumb.  First you count up, then you count down.  It helps to change your focus from racing thoughts and helps you quiet yourself.
A:  When I’m getting hypomanic, I just feel like I don’t have as much control over myself.  The first step is to realize what’s happening and remember how I usually get myself in trouble and avoid it.  When I notice that I’m elevated, I try not make any impulse purchases.  I just try to e more careful in general.