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"Normal" BP Mood Chart?


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I just started keeping an actual mood chart on moodtracker.com. I've never done it before and I've been DXed since I was 7 (am now 27).

This is the pattern: mildly depressed for 2 days, baseline for 2-3 days, mildly elevated for 2 days, baseline 2 days, depressed 2 days...!!!

Is it "normal" to have these shifts, even on meds? Is this what BP1 looks like when surpressed, or should it be surpressed more? Do you think I should talk to my pdoc about more or different meds?

PS- I started taking meds when I was 18. Prior to that my rapid cycling was severe I tend to have "crap within crap" as I put it. For example, I'll be in a general mania, but have lessening and worsening of the mania over a period of months, so cycling within a cycle. Same with depression. Right now I'm experiencing true variation on the baseline and I'm not operating within a larger mood disturbance.

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(I agree, BTW, there is no such thing as a 'normal' chart, not even for normal folks, let alone anyone with bipolar)

I like this. 

I don't have extensive experience in dealing with this, so I don't have much of my own to add.  I've long looked over college syllabi and complained "why don't they have a course in normal psychology?"  Normalcy's a rare bird, indeed.  No one will ever have a steady mood chart with blips of 0... 0... 0... day after day.  If I ever meet a person who does, I think I'll kill and stuff them for display in my macabre museum of the strange. 

Missing the point entirely?  Probably.  But hello!  And good luck!  And I'm amazed at you for being so consistent!  11 days straight is beyond me.  I grovel at your feet.

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I don't know that it's really a question of normal.

It seems to me like it's a question of how you function.  If small cycling is what you get and it isn't disturbing you in any way, then yay!

If it bothers you, or it doesn't feel right, or it makes your life suck, then it needs to change. 

The only thing that would indicate a problem to me is the trouble that being either manic or depressed can cause in our brains.  ;)

So, ask a pdoc?

I'll ask mine too, and we can compare.

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I was wondering about that. I've kept a chart for about a month (you can set Moodtracker to call your cellphone and remind you to enter the data in every nigth!) they are up and down a bit...

So, my pdoc's saying that this is what "normal" looks like: little variations in sleep, food and whatever happens during the day will cause variations from baseline to midly depressed to midly elevated (and the ocassional moderately) and baseline for anyone, MI or not.

What you have to watch out for is:

-a definite pattern, eg every x days/weeks/months you are severely depressed and x days/weeks/months after you are in an elevated mood and this repeats consistently

-a fairly steady or rapid increase to moderately or severely depressed/elevated combined with more or less sleep, and this stays the same for a few days (call pdoc at this point!).

Also he says it's useful to watch for correlations between sleep hours and mood and between mood and menstrual cycle, so that you learn to understand their effects...it will help you to know that you'll likely be depressed for a few days of PMS cause then you know it'll  soon pass.

Another trick: MoodTracker also records anxiety/irritability. If your mood is all over the place and you have a ton of anxiety and much irritability and you feel real horrile consider that it may be a mixed state...personaly I would never miss one of those with or without the tracker *shudders remembering last one....

Anyways, hope this helps.

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I've known only a handful of people whose mood never seemeed to change, ever. So much so that mutual friends considered them a bit boring and possibly lacking some mental apparatus. Most people "cycle," if you want to call it that, between good days and bad days, as the non-pathologized tend to call them.

I'm sorry, but I've just grown weary of the implication that how one feels is an indicator of their mental health. That anger, sadness, despair, irritibility, worry, hate, and fear are all abnormal and signs of an illess. Everyone experiences these things. I don't know anyone who doesn't, including the boring friends I mentioned.

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Yes, "good days and bad days" is what I meant by baseline to midly whatever, except in MoodTracker lingo.

I agree with you that emotions and feelings are part of the human condition. But sometimes they are abnormal.

If you feel so sad that you can't get out of bed despite that no one in your family died and you just a week ago got a recomendation (for example), that goes beyond normal. Especially if you switch to feeling terrific, again for no apparent reason and even despite the fact that your life is going very badly indeed at the moment due to your previous inability to get out of bed, not normal either.

Anxiety so bad that you are having panic attacks or irritability such that what you would normally smile at (ie the proverbial spilled milk) makes you throw a huge fit despite your many parenting and anger management classes: way beyond normal.

We won't get into SI or suicidality or delusions or psychosis, except to mention that they are caused by extreme of feelings of anger, despai, worry, hate, fear etc.

Those of us with BP, especially rapid cyclers, tend to question every little mood shift...because we are afraid that they are the begginig of a descent into worse things. Most times they aren't, ergo my (actually my pdocs') warning that for things to be worrisome they must be persistent.

I know from your other postings that you don't feel a BP dx fits in your case. But when you have actually experienced out-of-the-blue drastic shifts in mood accompanied by very real physical symptoms (changes in sleep, energy level, weigth, body aches, panic that feels like freaking heart attacks) you are pretty damn sure they aren't the result of some sudden psychological disturbance inexistent a few short days ago.

True BP goes way beyond normal feelings, Jemini.

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I know that for my years on depakote I was up and down all the time.  The real test for me was specific symptoms that meant mania or depression.  For instance, irritability and anxiety were indicators of hypomania.  If I started spending lots of money at the same time, I knew I had a problem.  Similarly, guilt is a big indicator of depression for me.  So if I start thinking everything is my fault I know I'm slipping into depression.  If I'm guilty and anxious and spending lots of money--oy vey, in case I didn't notice, it's a mixed state.  Of course that's not all the mixed state was; it's just these were indicators that I could track even when I was completely confused.  My therapist used them as diagnostic questions if she noticed I was getting squirrelly.

Although I still have hope for lamictal, so far I haven't ever been on anything that completely squashed out moods.  But are you sure your ups and downs are moods?  Are you just having, say, a good few days at work followed by some not-so-good ones?  In that case you may not be swinging back and forth; you may just be having what they call a life. B)

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freesoul -- Don't tell me what I'm pretty damn sure of.

I'm not a stranger to any of what you're describing. Including, btw, psychosis, suicidality, and delusions. And I know what it's like to become hypervigilant to  my own moods, fearing that I could spiral away. I was first diagnosed bipolar at 18 (when a more rational diagnosis might have been "teenaged drug-addict"). Since then I've refused medical advice, refuted diagnoses, terminated and been terminated by several doctors, been on my fair share of medications and hospitalized several times. Curiously though, even though my more recent doctors have access to the same history, they agree with me that my patterns don't fit bipolar, primarily because I *can* explain every depression, every mania, and even psychosis. Also, even more curiously, my history since I was 18 has not bourne out the dire predictions of the treatment team then, who assured my mother I'd never be able to handle college, working, or adult relationships.

Believe it or not, psychological disturbances can be held in check for quite a long time and come out quite suddenly, just as much as chemical imbalances created by some magical brain fairy with a mean streak. Most recently, my moods have taken a dive in part because I started smoking pot. Which I could either see as a symptom of some illness (self-medicating is a common symptom of just about every psychiatric disorder, quite common with mood disorders), in which case I'm powerless over my own actions and should go running back to the doctor for another cure, or I can see as a bad coping skill I learned in the midst of an emotional wasteland of a childhood, something that is directly causing my moods to destabilize and increase the appearance of a mental illness, and something under no one's control but my own.

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That, I understand completely. If I ran the world (!), mental health workers (including tdocs and pdocs and all the rest) would always try to work with people to understand their psychological issues, poor coping skills, sudden situational problems, etc, and would prescribe drugs explicitly as a short-term aid to even allow people to be able to function. I would not, however, try to eliminate negative feelings or even very disturbing symptoms like hallucinations and delusions, unless the sufferer was disturbed by these to the point of not being able to function or not being able to focus on their issues. Since I've yet to come across any study showing that medications are able to permanently fix any of these issues, and have seen studies showing people are able to recover more quickly without psychiatric meds than with them, I would never allow doctors to claim medications were the first-line of defense, or the cure, or the solution, or any of the other things people have come to see them as.

Bottom line: you can't escape your psychology. You need to deal with your problems in a real way, not with drugs. Drugs can help you do this, but as some studies have also shown, drugs can prevent you from doing this too.

BTW thanks for getting me to the point of my last post. I need to stop smoking pot and get proactive again with my life.

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Jimini, good luck with the pot.  I have so much trouble with the self-medication stuff that I called it quits, joined AA, and now don't take any mood-altering anything except for the prescribed meds.  Oh, and coffee.  I'm still human.

Anyhow, no pot, no booze, and I don't even let myself use my meds as drugs.  I self-medicated for way too many decades to do it anymore.  Hopefully.  But you have my absolute sympathy.  If you can use something recreationally--not that I recommend it--that's fine.  Most people can have a beer or two now and then with no ill effect.  But it sounds like the weed is giving you grief, so I hope you can get a handle on it again. 

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I am dealing with my problems in a real way - I have problems with my head that *don't correspond* to what's going on in my life. I fix those with drugs so that I can deal with what's really going on in my life. Which I am doing, not avoiding, and I resent your implication that I (and most everyone else on this board) are running away from our problems. I suspect most others here resent that implication too.

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noemie -- my response to just reading your first sentence was that I never meant to imply anyone here was avoiding anything. Reading the rest of your post I can really imagine people reading me that way.

Let me say that I thought for most of my life that many of my problems were either unexplainable or only vaguely connected to bad experiences in my past, but still not understandable. Until I figured out what a lot of these were. When you figure out, for instance, that the reason you gradually shut out responsibilies that overwhelm you and get panic attacks over going to your job are actually very much connected to things that happened when you were 7, and you can dissect them and see just what you're doing, it is easier to see that while your job is part of your current situation, and panic attacks, trouble concentrating, and depression as a result of all of this is a real current problem, the pills will only make the problem go away for so long. Eventually those unresolved issues from many years ago will find new ways to interfere with your functioning, and you may need a new prescription if you haven't uncovered them.

I'm not opposed to people taking medication. And for that reason I'm not opposed to doctors prescribing them. I'm opposed to the belief systems that have built up around this, the extreme over-prescribing which MANY doctors are speaking up about, more each year, and the simple idea that our lives are not under our control but are the result of a mysteriously caused illness which we can't hope to address.

I truly am sorry if I'm sounding judgmental of other people, like myself, who have needed psych meds as part of their dealing with mental illness. I don't spell this out often as I tend to be the odd man out with the views opposing the biomedical approach.

Incedentally, I continuously resent the implication that my problems are only treatable with meds, which I've been told directly several times. Ironically one such comment was meant as an attack on my character and weak rebuttal to my logical points, as opposed to any rational assessment of how I am doing psychologically, which is funny in retrospect given where that person's character has gotten her. I haven't felt anyone on this topic trying to diagnose me in this way, and I'm sorry if you think I'm doing that to you.

Edited to add a comment to noemie's edited addition:

I've studied psychology since I was 13. I found the undergrad degree laughably easy and would like to return to school to study psychology and sociology more formally. I can't speak to what you do or don't know based on your profession, but it's possible I know a thing or two myself.

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BTW, not out of disrespect for anyone here, but I'm not going to continue this conversation off-topic.

Mods -- if you think it doesn't belong here, I'd rather posts be deleted than moved, since I already have a topic discussing the downside of meds, and I don't want out-of-context posts being jammed onto that.

noemie -- if you want to debate, see my other topic. I'm eager to have intellectual debates but don't think there's much point to people just ranting angrily at each other. I apologize if I've gotten upset here.

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My bad sentence structure caused a misunderstanding.

"when you...then you..." was meant as in: "when a person...then the person..."; I did not mean you in particular. Nor do I presume to tell you what you should or not be sure of, only what I (and some others )are fairly sure of.

As you say, you are able to explain whatever disturbaces you have. I and some others, can't. I do have psychological issues as well and they are present in whatever my state of mind is at the moment. The other symptoms (or peculiarities, whatever) appear and dissapear out of the blue and in cycles, despite the progress I have made psychologically. Thus I attribute them to a physical dysfunction, aspecially since they have many physical symptoms.

Not that I can't be wrong. People historically have been pretty damn sure that the earth was flat and the sun revolved around it. I have the deepest respect for your opinions and I can see that for many people what you say holds true, but I think that is because MI is sometimes misdiagnosed.

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One of my beefs with psychiatry is that there have been so many detailed theories of psychological development and ways to dig into someone's current experiences and get at the underlying psychology, much of which is no longer available to the average person. The quality of thinking in the field has deteriorated, and insurance coverage has skewed so far towards meds as the primary treatment that many more intelligent and progressive therapists and psychiatrists opt to work outside the insurance system entirely.

The upshot of this is that if there might be clearly understandable reasons for why your symptoms return again and again, which a trained doctor would be able to help you understand and work with, your doctor may never come close to addressing such things, and very likely doesn't have a great deal of training in them.

Unfortunately a lot of my arguments on the boards work against me when it sounds like I'm saying our psychological problems are caused by poor nutrition and lack of exercise (though these things are very important). I don't remotely think it's that simple, but it's as complex as you can get and still have a basis for communicating with people who have had very different psychological realities. I could start going into psychosocial theories of depression, bipolar, and schizophrenia, but I think this truly is the wrong place for such discussion, as it is about psych meds. Or it was. It's getting fuzzier, but anyway I'm not going to get into that stuff here.

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We won't get into SI or suicidality or delusions or psychosis, except to mention that they are caused by extreme of feelings of anger, despair, worry, hate, fear etc.

<{POST_SNAPBACK}>

They are??!!  I honestly wouldn't have thought so.  Delusions and psychosis seem like chemical stuff to me.

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