How can a bipolar person stop worrying and learn to love the bomb?

August 31, 2008 11:57 AM

Bipolar filter: is it normal to feel like everything's about to go wrong, and either way, how to move past it, sort yourself out, live in the present and get on with your life?

I know I have a lot of good qualities (creativity, smarts, a passion for a thousand different things, humour) and bad traits (disorganisation, poor impulse control, overspending) and things I want to change (diet/weight, living habits, lack of confidence, things I want to learn and do). And I've had a difficult year - moving out of a very shitty flat, difficulty with my illness, problems with my old job then when moving to my next one having that offer withdrawn because of a poor reference, unemployment, breaking a foot and putting weight on because of it.

But it feels like things are turning round. I live in a nice flat with a housemate I get on with. I started a new job three months ago which challenges me, gives me responsibility and pays better than the old one. I'm coming up to a year with my boyfriend, who is a wonderful man that's supported me above and beyond the call of duty as well as making the fun stuff much much more fun. It feels like I'm changing into a different person - an adult - rather than 'lurching from one crisis to the next'.

The problem is I feel infused with paranoia and worry. I'm on probation at work, and end up evaluating each day as 'good' or 'bad', feeling like I make hideous mistakes, or that I'm not learning fast enough. The people I work with are different to my former colleagues in that they're party people (lots of drinking, dancing, drugs) which a) I can't participate in because of meds b) clubbing really really bores me, and I like reading and making things and taking pictures and thinking about things, but to many this seems dull or 'look at me I'm so quirky'. It's quite a gossipy workplace, and I worry that I won't be seen as good enough when my six months are up. I constantly think, whenever there's a meeting, that it's about me and how hiring me was a mistake. For the first month, it was 'what if I got a bad reference and they'll have to dismiss me'.

I worry that my housemate (she's also the landlady) will want me to move out, because I'm not clean and tidy enough. Note that this and the work thing above may be based on my not doing something I should, but instead of Actually Doing Something I get kind of paralysed by worry.

I'm trying hard to be less of a hoarder and overspending, but I seem to spite myself and give in to bad habits too much. The overspending was because I feel too anxious in the present, or as though I'm not 'finished' yet, but in the future X Y and Z might happen and it will all be better and I'll have item A B or C for it.

And while I've kicked self-harm, I seem to get something in my head when I worry and panic that tells me I should cut or, on one occasion, that I should jump on the tube tracks when a second earlier all I was doing was looking for mice and thinking about what to have for tea. 'Hearing voices' sounds dreadfully melodramatic and I'm pretty sure it's part of my brain rather than me thinking it's outside of it, like whispering in my ear, but I don't like it. I take 40mg of Citalopram and 750mg sodium valproate each day, on which I'm quite stable but I had a couple of weeks recently where I didn't take them due to a mess-up with my prescription, and I wonder if the increased worry is something to do with that. (Yes I - and the PPC that send me my prescription card - are idiots.)

I'm sorry, this got rambly. Basically, I want to change things and enjoy things and do the best I can and not do the messing up purely because I worry. How?

posted by mippy to health & fitness (8 comments total)

Are you seeing a therapist and/or a psychiatrist regularly? Because it sounds like you've got some bipolar stuff going on there (and the disruption in your meds might be the reason for this) and also some situational anxiety.

You really need that ongoing professional support as part of your overall plan to address this situation.
posted by Sidhedevil at 12:29 PM on August 31, 2008

1 Yes, not taking your meds for a couple of weeks will mess with your head. Many of these meds build up gradually and go down gradually so after a couple weeks, so you have lost the benefit of whatever they were doing to help you (reduce depression, paranoia and/or anxiety). Furthermore, once you start taking them again, it will take time to get up to full strength.

2 Talk with your doctor about your meds - they may need to be adjusted.

3. Are you working with a therapist as well as a doctor? You have enough serious issues that you need professional help (and not just drugs) to negotiate your way through it.

4. The feeling of having separate "entities" inside of your head (not coming from outside, but feeling like it is "not you") can be an element of depression. But if they are giving you ideas of self-harm, you need to really tell your doctor and therapist about this. Depression can be fatal!
posted by metahawk at 12:32 PM on August 31, 2008

I was seeing a psychotherapist on the NHS who recommended group therapy. I can't do this, for work reasons, until January, if at all, as it takes place during office hours. The psychotherapist seemed to feel that everything was down to family relationships which I don't agree with - I have some sadness about some things which happened in my past, but I feel now I've left them behind and they are less relevant. I think CBT might be useful but the waiting list in my city is 12 months or more.
posted by mippy at 12:40 PM on August 31, 2008

If you've had a break in your prescriptions this would definitely alleviate any problems you might have. Your problems, on a much milder level, sound like normal stressors -- you have different interests than your coworkers, you're a bit insecure about yourself and your work. Even the occasional urge to self-destruct is normal occasionally (just ignore that "voice" completely...the more you pay attention to it, the more it can intrude). I occasionally had the "I should just walk in front of that bus" thought, and it was generally when I was a bit depressed in my job and felt overwhelmed. It was a momentary thought and then it passes. Just let it pass.

Stay on your meds (if your doctor doesn't know about the prescription messup, call them and ask them what to expect/what to do) and see how you feel in another week. Long term, you might want to look into getting a social network so it matters less what your coworkers do. Even finding one good friend who shares your interests and can spend some quality time with you will make all the difference in the world.

BTW: every so often, particularly when things are difficult, I have the "OMG everything is going to go wrong" feeling and I'm fairly "normal" aside from my ADD. If you're going through a difficult time your feelings are totally normal. Try not to freak out about the fact that you are worrying about things. Worrying about worrying only makes things worrier. Odds are very, very good that you're fine. Just keep breathing, keep taking your meds, follow up with someone if the depression gets worse or the self-destructive 'voices' get louder, and keep your head up.
posted by Deathalicious at 12:42 PM on August 31, 2008

On postview: have you confirmed with your boss/superior that taking some hours off for this class (and then making them up later somehow) is out of the question? Group therapy can be useful. I am not really familiar with how the NHS works...do you have options with therapists? If so, ditch the one who wants to fixate on your family relationships. Even if they are a cause of your issues, if you don't want to focus on that you're not going to get better by having to listen them say "You need to deal with your mom issues!" each time you meet.

It sounds like you're young and that you're just starting out in the working world...correct me if this isn't the case. A lot of these worries will go away as you become more confident about yourself as a worker.
posted by Deathalicious at 12:50 PM on August 31, 2008

Get on the waiting list. You might have to wait a long time, but if you're not on the list you'll have to wait even longer.

My response was going to be therapy, too. I was initially sceptical of therapy for the same reasons you give - I have some sadness about some things which happened in my past, but I feel now I've left them behind and they are less relevant - but exploring this has been really helpful. It's OK to be sceptical about therapy and question the relevance of these things. What I found was that although I'd dealt with most of the crap that was going on when I was a kid, the roles that I tend to take in situations are often shaped by roles I found myself in as a child. Sometimes these roles are helpful and sometimes they're not, but learning to recognise what's happening and make a conscious choice about things has made so much difference.

The paralysed by worry thing is something that affected me too and seems pretty common among the bipolar folks I know. For me it's about being overwhelmed by things and finding it easier to ignore them. For me being able to identify the underlying causes of the worry, to recognise the feelings of dread and catch myself before I go into pretend-it's-not-there mode has been helpful. So I can break up the horribly worrying thing into not-quite-as-worrying pieces, which I can try to deal with one at a time.

You fairly clearly have some issues that aren't being dealt with by medication. A friend of mine often says that the disease keeps you from dealing with anything and then when you finally start fighting the disease, you suddenly have to start dealing with all the things that the disease wouldn't let you deal with. It's normal to feel anxious after you get your symptoms under control.

Definitely give therapy another try. And keep taking your meds.
posted by xchmp at 1:07 PM on August 31, 2008

Oh - and also, if you do want to try CBT, until you can get some time with an actual therapist, you might find MoodGym helpful. It's an online cognitive behaviour therapy course for depression.
posted by xchmp at 1:11 PM on August 31, 2008 [2 favorites]

Deathalicious - I do have a couple of close friends in London who I see when both of us can make it, and other friends who I might not talk about this kind of stuff with but with whom I can meet up and have fun. My old job was shift-work, so there was a kind of esprit-de-corps there from working long hours, but as things turned sour there I lost touch with people. I get on with people at work, but having not been there long enough to be part of the social network there it does feel a bit odd. Half the office seem to have flown to Ibiza this week!

I can't take time away from work until I've passed my probation - I made tentative enquiries around it. It would mean a very slight paycut, not enough to be painful but enough to need to be a little more careful with disposable income. I think the benefits outweigh this.
posted by mippy at 2:19 PM on August 31, 2008