Hypomania and NREM sleep

I think during hyperactivity or hypomanic phase NREM sleep increases. This is marked by patient not experiencing any dreams during the night. During such a phase a patient often can experience his Thalamus cutting his sense off as he goes ito sleep. For example, he might notice the decrease in surounding ambient noise/volume and him falling into sleep. NREM sleep has a word in sanskrit “Sushupti”

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Anxiety and Bipolar Disorder

Over the years I have accepted Bipolar Disorder as I experienced its highs and lows. Experiencing these stages makes one realize its existence and hence accept it.  Anxiety is one state that I am still perplexed about. For the life of me, I can’t understand why we get to experience this added negativity! It doesn’t fit the depressed or the elated state which are usually well discussed. One can be either depressed and anxious or manic and anxious.

Depressed and anxious: During depression one may have to leave school/college or resign and stay at home. I was a penultimate year student when this illness stuck me. Various states of Bipolarity are only revealed with time. Seeing my hyperactive and at times delusional behavior, the doctors initially thought that I was suffering from Paranoid Schizophrenia! I had to leave college because the medicines made me sleep the entire day. I could only wake up when my Mom bought me food on bed and fed me. As soon as the food was over, I used to tell mom to turn off the lights, close the door and leave so that I could sleep more. I don’t remember too much about the first 2-3 years but I do remember being dragged to the bathroom for a shower on Sundays.

Life changing from ‘normal’ teenage to this state still baffles me! At times, I still feel this can’t be happening to me. A couple of years later, I found myself going out, to sit with my friends in the evening. I found that people my age had already graduated and were looking for jobs. They no longer came out to sit in groups. I was now sitting with their younger brothers who were still studying. All the teenagers gathered in the evening to do the usual small talk. Slowly anxiety started gripping me.

I had never dropped a year in college and knew that scoring depended only on a little bit of hard work. But now I found that I could not concentrate and remember anything. I wondered how I would complete my college. For working class Indians, being a college graduate is the bare necessity. Not having a college degree is equivalent to being illiterate. One can’t even think of a decent job without it. At times I told my sister that I had to commit suicide because there was no way out.

After observing my suicidal ideation, my doctor gave an address to mom asking her to take me there. It was a place called The National Job Development Centre. I had never heard of the place and had no idea what it was about. We got a letter from the doctor that we were supposed to give to a lady and she would guide us further. This was in the mid-nineties. Today, I found out that they even have a website now! (www.adaptssi.org) The institute then was mainly for physically handicapped with courses like Book-binding, Screen-printing, Tailoring etc. I met a social worker there who told us that I should try to do repetitive physical work like Gardening. I cannot imagine telling anyone how horrible that would feel for someone aspiring to get a Physics degree! Hearing her made me feel weak in my knees. I started shivering inside and asked my mom to leave soon. I was trembling at the bus top waiting for the bus home. I begged mom to take the costlier rickshaw (small taxi) instead of the bus so that we could reach home early. At that time I could not explain others how I felt. I learnt it because I felt that if I can express myself better, maybe the doctor can cure me better. After all, he has no blood reports to see.

Back home I was more depressed than before with more crying spells. I suppose my anti-depressants were then increased considerably because soon I started exercising and feeling better in general. Next academic year (1996-97) I joined college to complete my graduation. Things happened quickly and without any realization. A rule of thumb in bipolar medication is slow and steady. Any marked mood change can be an area of concern. It can also be a sign of medication induced manic state.

While back in college, it soon became evident to me that things were not like earlier. I felt that I could not memorize the way I used to. Now, to memorize, I had to write the answers again and again and still couldn’t feel confidant. At the back of mind, I felt that I could not afford to drop any more years! Also, since I had already dropped three, I had to score well! This added to my anxiety. The result was increase in medication and drowsiness. In one way or another anxiety had become a part of depression. I guess anxiety comes from dealing with one’s weak self and hence feeling insecure about one’s future. No matter how are why it comes, it is one of the most uneasy state of bipolar disorder. It compounds the problem by many fold and patients often press for anything that could give them relief. Often medication give during anxiety attack have increased problems faced by bipolar patients later on in life.

Manic and anxious: In Bipolar Disorder, we don’t realize when we move from being confidant to over-confidant to repulsively cocky. I still don’t understand my moods changing like that while I am still under medication and visiting the Psychiatrist at least once a month! I could accept such changes if I don’t take my medication and don’t seek help. In hyperactivity a part of me loves the new found confidence and vehemently opposes anyone who tries to bring some ‘sense’ to me! But I slowly realize that I am losing control over the way I think and react! Thoughts become faster and action becomes quicker. Slowly anxiety starts to grip in because we are in self-denial. A part of me starts to realize that something is wrong and something needs to be done but as soon as the thought arise, I shun myself thinking that the present is much better than the past. One feels anxious each time one find oneself reacting in an uncontrolled way. Time and again, one observers an uncontrolled chain of thoughts, racing in the mind. The thought ends in anxiety and palpitation seeing the total loss of control and the repetitiveness of the problem. Unlike, in depression, Anxiety in the manic state is more intense, shorter and coming in bursts. In depression, anxiety tends to exists in a small amount all the time. It usually starts when you wake up. The first few minutes are blissful because you don’t feel it then. The next few minutes are the worse because you can feel it gripping you as if it was waiting for you to wake up. 18 years into this illness and I feel I still am desperate to learn to deal with anxiety. It would be so helpful to know how others deal with it.

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Continuing friendship

I suffer from Bipolar disorder and I am currently coming out of a “depressive episode”. Whenever life starts becoming normal, we tend to start where we left at. When the depression starts, we stop talking, and when we become normal, we try reaching back to our friends. Unable to stay in touch with the closest’s of friends, puts a strain in the relationship. We cannot communicate to our friends why we stopped talking one day and why now, have we decided to talk. When the depression starts to subside, we try to get back in touch with our old friends, but most, if not all, appear cold. Some may perceive that we had been ignoring them but that is so untrue! Also, it is hard for them to understand the change in our personality. For example, we would stop laughing at the jokes that we usually laughed at earlier. We try to mask this by faking a smile but soon people start to see the real dull person and move away. People would naturally be closer to someone who would laugh more often.

People can’t be criticized for moving away because they never know the complete truth. They only see us change without reason. Even when the people know that we are Bipolar, a years gap changes everyone and we are left behind. This means that we are bound to loose out on friends. The separation during depression always drives friends away, especially since we never tell them why. In Bipolar disorder this condition repeats every few years. Slowly more and more friends break away and it makes us more and more lonely!

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Being Mentally Ill in India

There is no better or worse place to be mentally ill; everyone suffers the same. But with a little awareness, acceptance, and support a lot of suffering can be decreased. We don’t need more medication, just an acknowledgement that it is tougher for us than usual would help us survive. This blog is about my experience, as someone from India, with a mental illness. Its about the problems I face/have faced. They might be same as yours or they might be unique to India. I am not sure, I am here to find out.

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