Mood Watch - 41

Since my last post I’ve been through three periods of depression, each of about four to five days’ duration. They’ve followed the same pattern as most of my depressions. That is to say, my energy level will drop, usually for some plausible reason, so at first I just seem tired and in need of rest. I take some time to recharge my batteries, but they don’t recharge. Instead — and quite quickly — my mood drops into such a trough that I can hardly stand to do anything but sleep, and I sleep as much as I possibly can. At such times, not only do I have no interest in my regular work (or anything else), I feel a sense of foreboding about it. It makes me anxious even to check my email. When I go down to campus to teach a class or attend a meeting, I feel no sense of emotional connection. I can’t “read the room” to understand its tone — whether, for instance, I’m making any sense to my students beyond the mere fact that I can speak complete sentences. If I have to type something, I can hardly figure out how to organize my thoughts, and I notice I make a lot of typographical errors (I’m generally a pretty accurate typist).

All in all, the effects are about as debilitating as a bad case of the flu, except that the hallmark is a pervasive sense of misery and shame, as well as the fear that I will never return to normal. Cognitively I know that this is distorted thinking, but at a gut level this is simply hard to believe — it’s striking the extent to which one’s biochemistry informs our impressions of what really makes sense and what doesn’t.

Lastly, although I remember feeling OK, I literally cannot remember what that actually felt like. It seems amazing that I ever enjoyed life or could ever enjoy it again.

In formal diagnostic terms, one would have to exhibit these symptoms for fourteen days to qualify for a major depressive episode. Mine generally last three or four days; occasionally five, but that’s unusual. When I bounce back, it’s abrupt, just a matter of a few hours.

It’s always tempting and sometimes useful to look for correlations with external events which may act as catalysts or triggers. Over the past year a very strong correlation has emerged between business travel and depression. I return from a trip; a depression ensues. My therapist and I have theorized about the possible connection. A couple of explanations have seemed plausible and it’s possible it’s not an either/or question. But at the moment, the front runner is that these trips, in the nature of travel, are tiring and disruptive of my normal routine, and also usually involve giving a public presentation — often two or three in quick succession — so that I have to “gear up” to be animated, energetic, etc. Taken together, it’s no surprise that this would have an effect on my biochemistry.

Since I can’t avoid business travel — it’s pretty much a bedrock component of my professional activity — the issue now becomes whether to just accept the fact that depression will be the likely sequel or, more imaginatively, to find a way to manage the problem. One possible solution would be to make sure I get periods of regular rest during these trips and as far as possible adhere to a normal schedule.

I should have a fair degree of control over my time when attending, say, academic conferences. Invited lectures are a different matter. Having gone to the trouble of flying me in, putting me up in a hotel, and paying me an honorarium, my hosts generally try to get as much mileage out of me as they can. My most recent trip, for instance, involved:

a. dinner with students

b. a 90-minute workshop

c. breakfast with more students the next day

d. a meeting with yet more students at mid-morning

e. lunch with faculty and students

f. another meeting

g. a 90-minute public lecture, including Q&A

h. dinner with faculty

… to which I myself added item g(1): a few afternoon beers with some grad students.

It’s not a question here of being exploited. I liked everyone I met and had a very enjoyable time. Indeed, one could almost posit a connection based on the abrupt transition from a warm, validating atmosphere to, well, the regular workaday world. But if there is something to the thesis of these depressions emerging from my having to remain “on” for extended periods, notwithstanding the wear and tear of travel — then in the future I’m going to have to request what might be called “reasonable accommodation” for the disorder; i.e., a lighter schedule.

Mood Watch - 40

Plainly this blog interests me a lot less than it used to. I maintain my professional blog with a fair degree of regularity — in part because whenever I attend conferences, visit archives, etc., I invariably meet readers who appreciate the blog and tell me so. I feel therefore as if I’m performing a useful service.

With this blog, however, I feel very differently. I’m not sure I’m performing a useful service even to myself. True, on the positive side I have this year encountered at least ten individuals with bipolar disorder or similar conditions. It’s not that hard. A few have contacted me after reading the piece I did a year ago for Inside Higher Ed. But most contacts have occurred after I drop into a conversation the fact that I have bipolar disorder. The opportunity occurs more often than one would think. When I do so, invariably I am approached afterward, rather furtively, by some individual who also has bipolar disorder. Without exception they have kept the condition a closely guarded secret. They’re afraid. They worry what their families will think, their friends, employers, lovers. Often the conversations they strike up with me mark the first time they have spoken openly about the disorder. They are full of questions — what medications I take, what strategies I employ to lead a (more or less) “normal” life, etc.

But mostly they wonder how it is that I have the courage or foolhardiness to treat the condition as if it were an illness like any other. Don’t people look at me funny? Aren’t my colleagues skittish about dealing with me? Have they not written me off as anyone who could produce work of consequence? And in truth, I am morally convinced that some people regard me as the ghost of a once promising historian.

Too bad. I’m convinced that in being open about the disorder I have made the right decision. It enables me to draw upon the support of friends. It helps me to grow in a spiritual sense: I feel more at home with myself; and I can look at my increasingly middle-aged face in the mirror and believe that I possess at least a smidgin of courage and intgrity. But much more importantly, it gives me the chance to talk to people who are similarly circumstanced. Most of them have hidden their disorder to such a degree that, regardless of what statistics may say, they simply cannot believe that there are others like them — still less that this and similar disorders are as common as dirt.

Anyway, as to my mood itself: Overall it has been surprisingly good for the past several months. And I notice that the occasional bad spells correlate strongly to circumstances. Fortunately I’ve enjoyed considerable success in distancing myself psychologically from those circumstances. I’ve truly been amazed by what a difference that has made. In my opinion it has been a greater factor than any of the several medications in my arsenal.

Mood Watch - 39

Things have been good, generally speaking, since the last installment of “Mood Watch.” I’ve been productive around the house (especially yard work) and also in my writing. Last week, for instance, I completed an 11,000-word essay for a forthcoming edited volume. I was able to adhere to my writing schedule and on most days composed 1,500-2,000 words.

The one glitch occurred this past weekend, starting on Friday the 27th and extending through Tuesday of this week. When this stuff happens my first thought always runs to biochemistry, but I’m learning to look more closely at my circumstances and the way in which they may be influencing my mood. In this instance, I concluded it was the latter more than the former.

Mood Watch - 38

Obviously I’ve blown off this blog for nearly three months. I’ve been busy with other things, but mostly I just haven’t felt inclined to write, although I’ve kept up reasonably well with my professional blog.

My mood during this period has, by and large, been quite good. Aside from minor bouts with insomnia or hypersomnia, I haven’t had any trouble. I attribute this to three things: First, I think the Lamictal I’ve been taking for several months is actually doing its job as an anti-depressant. Second, I have a friend who is enthusiastically helping me convert my jungle of a back yard into an orderly, appealing garden — being in pleasant surroundings has done me a lot of good. Third and most importantly, I’ve identified an area of my life that was sapping my energy, creating or exacerbating my depressions, and in general doing me no good at all. I feel no need to be specific, except to say that it has nothing to do with any particular individual. But both my therapist and psychiatrist have urged me to “disinvest” in that environment. I’ve done so and have been startled by how much better I feel.

Mood Watch - 37

Forgive me, Father, for I have sinned. It has been nineteen days since my last Mood Watch. Though actually, come to think of it, nineteen days isn't all that bad.

Hard on the heels of my last trip (to the Chicago area), I took another, this time to Vermont. I went there to be a presenter at a symposium, but I arrived on Friday, March 30, a couple of days before it began. Checked into a lovely bed and breakfast and spent most of the weekend with a friend of mine who showed me around the central part of the state.

Aside from four quick business trips to Boston, I'd never been to New England before, much less Vermont. Everyone I met apologized for the scenery -- it was "stick season": too late for the winter snow and too early for the green of spring and summer and the beauty of the turning leaves in autum. But I thought the state was just lovely: lots of rushing streams, quaint villages and small towns nestled between the shoulders of mountains. All in all, I had a lovely time.

The symposium was fun, too. It has that reputation -- the organizers brings in good speakers, install them at the Northfield Inn, and everyone gets pretty well acquainted, not just over the rich breakfasts but especially in the evenings, when everyone kicks back in the living room/dining room area, cracks open a beer (or six) and talks into the wee hours.

I boarded a flight home on Wednesday afternoon. It figured that after such an enjoyable six days I'd feel a bit of a letdown afterward, but I was surprised -- even shocked -- by how quickly the bottom dropped out of my mood. By the following day I felt so anxious and nearly faint that I had to cancel a class, something I hate to do. Things didn't improve for a full week. Then, as quickly as it hit, the depression lifted. To my mind, that's the very signature of a biochemically based depression.

My therapist, however, doesn't think so. For maybe a year now she's noticed how unhappy I am in my work environment (a lot of my colleagues feel the same way -- my department is undergoing a difficult transition period, for reasons no one quite understands). She thinks the department culture is complicit in the depressions. Initially I was skeptical about this theory, but over time I've become more convinced. Anyway, by the logic of her thesis, this recent depression came about not just because I was leaving a pleasant environment where I felt well regarded, but also because I was returning to one in which I often feel like a stick of furniture.

Be that as it may, now that I'm back to normal I'm sleeping a bit less than usual -- which tends to be my pattern. It isn't too extreme. I generally get at least five hours of uninterrupted sleep each night, and Saturday night I got about nine. But I didn't sleep at all Sunday night. I didn't feel drowsy, so mostly I just rested as best I could. I'll try to push through the day without a nap and go to bed at 9 or 10 p.m. That usually gets me back on a regular sleep schedule.

I had a nice experience the other day. In one of my classes a context emerged in which it was appropriate to say that I had bipolar disorder. The class had 240 students, which meant, statistically, that two or three of them already had bipolar disorder, or would be diagnosed with it at some point in the future. Sure enough, after class one student approached me to say that he too had bipolar disorder and he thanked me for being so up front about it. He keeps his condition private because of the stigma attached to it, but he could readily see that I'm so frank about it, in part, because it's a way to combat the stigma. When 240 students discover that a professor they like and respect is also someone coping with a serious bioaffective condition, it educates them, and the world moves a tiny bit closer to treating people like me the same as they would someone with a physical illness.

Mood Watch - 36

From about March 12 through March 21, I hit kind of a bad patch, but of the sort that illustrates the subtleties of bipolar disorder. The symptoms aren’t always the classic ones. During that period I was “down” most of the time, but the two principal features were hypersomnia and what I’ve heard a psychiatrist characterize as a “reduction in mental coordination.” By that phrase, he meant a marked decrease in one’s ability to do sustained creative work (like research and writing).

But in other respects I was okay. For instance, I continued to enjoy activities that I would ordinarily find pleasant; e.g., watching movies, spending time with friends, and working at the animal shelter.

If I can point to anything tangible that pulled me out of it, it was a trip this past weekend to the Chicago area, where I was one of the presenters at a conference. I found the experience energizing. I’m not sure if it was the conference or the travel: I often find that my mood improves when I’m on the road. But in any event the transition comes at a good time, since Spring Quarter has begun and I’ve got a busy schedule ahead.

Mood Watch - 35

A lot’s been going on of late, and most of it hasn’t been pleasant. But to the extent that I can detach circumstances from biochemistry, I think the biochemical aspect is still running smoothly. Most nights I get enough sleep (but not too much), my energy level is OK (but not too much), and if I feel miserable at times, it’s pretty much the way anyone in my position would feel miserable. The one nice thing in all this has been the way my friends have rallied around me. And anyway, it’s impossible to be miserable all the time. I still have a lot of good moments, too.