How to Clean When Your Brain is a Mess, part II

This is part two of a three-part series.
Part I | Part II | Part III

As we talked about in part one, most people with mental illnesses tend to have massive difficulties in keeping their homes ship-shape. The trouble lies in how our brains are wired (of course), but that doesn’t mean our struggle is futile. Here are some more ideas for tackling the mess in your house:

Credited to flickr user gcg2009. Used with permission.

Pump Up the Volume: Pop your favorite upbeat dance song in the stereo. Most articles which contain the words “How to Clean” in the title emphasize this step because it’s so effective. Music therapy is a flourishing science. In patients undergoing chemotherapy, playing music decreased both their anxiety and frequency of vomiting.

Music also stirs up motivation and affects your emotions. Sadness is triggered by minor keys and happiness by fast tempos, but a depressing song with a peppy beat triggers both. Making an enjoyable playlist can be one of the easiest ways to get pumped for cleaning.

Figure Out Where Your Time Goes: If you do nothing else on this list, track your time for a week. Some people use a logbook and others use a color chart; do whatever makes the most sense to you. Next, figure out where you can squeeze in ten-minute bursts of laundry or dishes. If you thrive on a schedule, assign a day to each room and work for however much time you can devote to it. Then, cut activities you don’t really need. According to my graphs, I spend an appalling amount of time glued to my computer chair, so that has to be first to go–ten minutes at a time.

Credited to flickr user koalazymonkey. Used with permission.

Write a List: If you have frequent access to a computer, Remember the Milk is a fantastic listing tool. You can schedule repeated tasks like, “take out trash every Tuesday”, or “Mom’s birthday every November 5th”. You can even tag them with things like home or errands. We also have a printable weekly calendar available on our Downloads page which may make this step easier.

Warning: I’ve been diagnosed with Obsessive Compulsive Disorder (OCD)–which is uncommon in a manic patient–due to my frequent and sometimes uncontrollable listing. If you also deal with this manifestation of perfectionism, please be aware of how vulnerable you can be when setting routines in this manner. Don’t get too caught up in tweaking your list!

What About Guests? – Aha, here’s a challenge. What happens when you’ve been told that your brother-in-law will be crashing at your place in three hours and your home is a toxic wasteland? (True story.) You weep and gnash your teeth, of course!

Or you can take a look at The Emergency Clean Sweep by My Messie House, which is perfect for this situation. Unfortunately, the site is now defunct, but this is a fantastic outline for tidying up on a basic level. With instructions like, “place the bills next to your computer,” it makes far more sense than stuffing everything in a closet until the visit blows over.

In addition to following these instructions for emergencies, I occasionally challenge myself to get through as much of the list as I can during a set time limit. It isn’t a routine, but I find that when my house is just too overwhelming, I need to hit the reset button.

Thanks for reading! Stick around next time for part III of our cleaning series, where we’ll look at how to tidy the house while in the grip of a mood episode.

How to Clean Your House When Your Brain is a Mess, part I

This is part one of a three-part series.
Part I | Part II | Part III

Also known as, “Hi! I’m Cassandra, and I Live in a Filthy House.”

That isn’t entirely true.  As it stands, my kitchen is clean, which happens roughly three times per year.  But my office is a clutter minefield, and there is an entire room in my house filled with stuff waiting to be put away.  Suffice it to say that I could normally be a contestant on a junior Hoarders.

Credit to flickr user judsond. Used with permission.

All right, show of hands: who else has scrambled to hide the–possibly moldy–dishes when surprise guests drop in?  Parents with mental illnesses, how many Legos have imbedded themselves in your feet in the middle of the night? You’re not alone, and there’s a logical explanation why.

Primarily found in people on the autism spectrum or with Attention-Deficit/Hyperactivity Disorder (ADHD), executive dysfunction is the inability to set and meet goals, self-monitor, and resist wandering off while in the middle of a project. In persons with bipolar I specifically, the wiring in their frontal lobes is so tangled that they suffer these difficulties even during stable periods. It goes without saying that their capacity to execute plans drops sharply during manic states.

It looks like clutter in the mind really does lead to clutter in the house!  Here are a few ways to tackle your piles head on:

Start small!  Most people get excited about starting a routine and try to implement everything at once, like New Year’s resolutions.  Invariably they fail because the habits they need aren’t in place.  In addition, baby steps don’t tend to work well for people with bipolar; they get overwhelmed quickly and have delusions of grandeur about conquering the routine.

Lovely Dishes
Credited to flickr user avrene. Used with permission.

Rather than assigning one room per week at first, try dedicating yourself to one thing at a time. For example, I’ve constantly struggled with my dirty dishes. I tried doing them every three days, then two, then one. Gross? Sure. But it’s what I have to do to ease myself in. Most times I still fail!

Recommended Link: FlyLady – Marla Cilley, also known as the FlyLady, has garnered a lot of praise for sending specific instructions and encouragement via email. She takes a lot of the work out of building a routine for yourself, and one of the biggest proponents of “baby steps” around. If you can handle the volume of emails without being overwhelmed, this site may work for you.

Don’t kick yourself if you make a routine and then stop following it. Just start again tomorrow, or adapt the one you have. Sometimes I’ve made routines that worked well for weeks, and then stopped when I grew bored with them. You have a lot on your plate, so you’ve learned to be flexible. Your cleaning has to be, too. Track where your time goes and then figure out where you can squeeze in a ten minute burst of laundry duty.

Recommended Link: Unf*ck Your Habitat – Billed as an alternative to FlyLady, UFYH lives by the 20 minutes of cleaning/10 minute break method (20/10). They also allow readers to post pictures of their progress. But be careful: the blog mistresses “terrifies” people into cleaning via swear words. On the plus side, the site have a positively reviewed (profanity-filled) app for the iPad and iPhone.

Best of luck whipping your home into shape! But please remember that it’s a process–one we’re not wired for. In part II, we’ll be covering other ways you can build your own time-management scaffolding.

How Privilege Affects Mental Healthcare

Like many people who celebrate Thanksgiving, I’m taking a hard look at what I should be grateful for. When I was young, my family was largely feast or famine. We survived multiple job losses, costly illnesses, and bankruptcies. In my teens, all seven of us lived in a trailer no bigger than 750 sq. ft. And I was always hungry.

Now, I am steeped in obscene amounts of privilege. I am white, and I hold two college degrees. Among other things, this means I have an easier time getting and taking medication. My nursing and Latin classes specifically enable me to understand medical terminology and the effects of medications on my body and brain. I am a very insistent advocate for my health.

I am also married to a partner with a steady, middle-class job, which means my anxiety about ending up homeless or going hungry now is largely irrational. We’ve only been married for five years, but he not only held my hand when I committed myself, but he puts up with my mood episodes today. We could still get divorced, as have so many others with bipolar. But we haven’t yet. We are very awkward when people ask about our married life, because we usually exist in a different bubble than they do.

Insurance Card
Credit to flickr photographer mtsofan. Used with permission.

My partner’s job has insurance. I can—and will—write a post on this benefit alone, because without it, I wouldn’t be writing this today. I’d be dead. My hospitalization four years ago cost $6638.61—and was completely covered. I was flabbergasted. We were newlyweds at the time, and would have been put into debt. Due to growing up having Medicaid or sometimes nothing at all, the feeling is still surreal.

Speaking of jobs, I am lucky enough to be self-employed while writing my book, which means I can have as many panic attacks as I need to have without getting fired.

I’ve been in therapy for years. I’ve also changed psychiatrists five times until I found one I liked. This process of doctor-finding is actually quite common, but we could afford the doctor’s visits, the pills, and the frequent blood draws to check for liver or thyroid damage, which means I was willing to invest in my health. And my nightly cocktail of medication—found through years of trial and error—actually works. There are side effects, of course, but as I understand it, they could be significantly worse.

And finally, I was able to keep my infant despite someone threatening to report me to Child Protective Services during my psychotic break.

Is my mental illness severe? Of course. But I am lucky, to an unrealistic extent. If I wasn’t covered by my partner’s insurance, I would have had go to work immediately after my breakdown to cover costs. If I hadn’t married him when I did, I would be living with my parents, homeless, or dead—and likely one of the latter. There are so many ifs, which terrifies me.

Mental stability—which should be a basic human right—is achieved only by those who can afford it.

Homeless and cold.
Credit to flickr photographer Ed Yourdon. Used with permission.

A disproportionate amount of the homeless are returning veterans, the mentally ill, or both. Would that more shelters could provide a secure environment and treatment for any atypical brain chemistries or traumas that they may have! I would happily part with my tax dollars to ensure that more people with schizophrenia have a chance to sleep in a warm bed rather than under a bridge. Ideally, they’d also have help moving on to more permanent housing and work.

The weeks leading up to Thanksgiving and Christmas warm my heart, but not just because I’m looking forward to spending time with friends and family. The generous outpouring of help around this time is mind-boggling. But I feel I have a responsibility to use my privilege year-round to help others who are less fortunate. First, I’ll keep in mind how much I have.

What struggles have you survived? And what privileges may have helped you through them?

How to Get Your Much-Needed Forty Winks

As everyone knows, hitting the sack is crucial for mental health. Sleep deprivation—a form of German torture in World War II—worsens depression and directly contributes to manic episodes. After a few days of working double-shifts, even neurotypical people start to hallucinate.

It is for these reasons that the recommendation for daily sleep is an eight hour period, give or take. All right, parents of newborns, say it with me: “Hahahaha! Yeah, right!”

Whew. Now that we’ve gotten that out of our systems, let’s discuss how we can get as much sleep as we can so our mental health isn’t compromised.

In short, do what works best for you. A crib in the room, a crib out of the room, or a playpen somewhere nearby—all of these choices are good ones. I know one mother who slept in a recliner for several years. Just make sure to cover your newborn with a light blanket, and introduce heavier ones more cautiously. Before bed, you can gently massage your child, and then feed them as much as they’ll take. If you have a partner, set a time to discuss who covers which blocks of baby care.

When my son, Ryan, was an infant, I co-slept with him to make nighttime breastfeeding easier—despite his having a beautiful, untouched crib in the next room. I was lucky that he enjoyed feeding while reclined, so I didn’t have to leave my bed, and was even able to doze. These snatches of sleep helped me regain my sanity during his first two years.

Studies demonstrate a causal link between bed-sharing and the prevention of sudden infant death syndrome (SIDS). Children who slept with their mothers also appear to have a higher self-esteem, possibly because the infant’s signs of distress were more quickly addressed due to the parent’s proximity.

If you’re interested in trying co-sleeping, please take safety precautions. According to research, most fatalities are due to alcohol, cigarette smoke, soft mattresses, or heavy bedding. Older children may also endanger a newborn that they cannot sense while asleep.

Speaking of older children… Kids thrive in a structured environment, so they will usually go down easier—and sleep better—with an established routine. These three things may help:

  • A place to call their own. If you can afford a permanent shelter, lay them down in the same bed every night. If not, give them a portable comfort object, like a favorite blanket or toy.
  • A set bedtime. Ryan, now a preschooler, goes to bed at 8:30pm.
  • One last hurrah. Books, playing, and baths are all wonderful choices. I sing one or two songs while tucking Ryan in. If you’re shy about singing, don’t be! Your babies will love your voice until they turn thirteen.

I hate to offer this advice, because my inconsistent behavior has made this process extremely difficult for me. Like cooking regular meals, enforcing a bedtime requires me to be on the ball night after night—a topic which will be covered in a future post. But despite the snags, maintaining at least this much structure has been the best action I have taken for Ryan.

When he gets his rest, I get mine—and then my whole family benefits.

What lengths have you gone to get your shut-eye? Any advice for surviving the first year with an infant?

Not to be taken in lieu of a treatment plan crafted with medical professionals.

How to Work Out with a 40-pound Parasite Clinging to Your Leg

Or, to be more politically correct, “How to Exercise with Kids.”

As we’ve discussed in our previous post, exercise is one of the best activities you can do for your body and mind–especially if you have a mood disorder.  But parents often lack the time to tend to themselves. Between shuttling their children off to school, cleaning up potty-training accidents, and managing their own health care, exercise easily slips through the cracks of life.

However, like shredded zucchini hidden in a brownie, you can sneak in a workout while your kids play.  Here are some ideas:

If you have five minutes: Dance with your toddlers or play the game of, “catch me, catch me!” While pushing your kid in a swing, do some quick squats. Throw a ball and try to get to it before your playmates.  You can also get a good grip on their bodies and use them as curling weights.

If you have the strength, lie down on the floor and have your kid attach himself to your legs while you hold onto his arms. Lift your legs slowly, hold for a few seconds, drop quickly—and then repeat. These have never failed to produce shrieks of laughter from my son, Ryan.

If you have ten minutes: Strap weights to your wrists and ankles, or carry two gallons of milk. Pump your arms and lift your knees when you walk around the block or jog in place. After ten minutes, take them off.  Try again for another ten minutes, later.

If you have older kids or teenagers, play soccer or a sport of their choice. Get your heart rate up as much as you can.

If you have thirty minutes: If your kids still nap, try to squeeze in some exercise along with everything else you do during that “free” time. Hustle when you do chores or gardening. In addition to powerwalking between errands or running up and down stairs, you may be able to devote some time to a short yoga or aerobics video.

You can also purchase a jogging stroller, but watch out—these are inordinately expensive. But, as useful as the $20 umbrella strollers are for navigating through airports, they won’t cut it for intense exercises like running.

If you have an hour: Wow, lucky you! If you’re in this position, swimming is a great low-impact exercise, but if you’re looking to really sweat and can afford it, try a dance class or possibly martial arts. I’d highly recommend finding a suitable YMCA—with childcare available. Even if you never plan to use it, knowing that someone can watch your children during your workout in case your other arrangements fall apart is a relief.

Don’t be discouraged if you have physical disabilities! There are many braces, props, and specialized classes available to assist you. Yoga classes are especially accommodating. Swimming is easiest on the joints and can serve as a wonderful substitute for those who cannot lift weights. Team sports such as baseball leagues for the blind and basketball for persons in wheelchairs burn calories while building camaraderie, but there are solo sports like skiing available as well.

Best of luck in pursuing the best workout for you!

Not meant to take the place of a treatment plan created with licensed professionals.

Bipolar? Exercise Will Change Your Life

Many apologies for the missed posts last week! I’ve been tripping into mania, so managing my day to day life has been a struggle lately. Thank you for your patience!

When it comes to actions you can take to improve your quality of life, exercising regularly is largely considered the uncontested champion. As we covered in our post Why Weight Gain is Devastating to the Mentally Ill, a sedentary lifestyle and poor diet are linked to a worsening of bipolar and schizophrenic symptoms and decreased functioning. One of the triggers of depressive episodes is reduced physical activity, which is only the start of a vicious cycle.

A comprehensive review of research from 1966 to 2008 proved that scheduled exercise dramatically improves both the body and mind in persons with bipolar disorder. Not only does exercise flood someone with endorphins, studies indicate that it reduces the “allostatic load“, which is the damage done to your body from chronic stress.

Despite all of these good things, I know how difficult it can be to start exercising—much less follow a routine. But, starting slow is better than not starting at all. If you’re like me and can’t handle—or don’t have the time for—an hour-long workout, then just try walking for twenty minutes per day, ten minutes at a time. Eventually, you can build on your small triumphs. In our next post, we’ll cover how to squeeze in a workout around your kids’ schedules and a little bit about what to do if you have physical disabilities.

Make sure to pack plenty of healthy snacks and water to refresh yourself—and your little ones—during and after your workouts. If you are taking medications, do not become dehydrated! Lithium is especially dangerous to dehydrated persons because the body retains it when losing fluids. This can lead to lithium toxicity, which means the level in your blood has built up faster than it can be excreted by the kidneys. Side effects include dizziness, diarrhea, and vomiting, which worsens fluid loss. If the level is especially concentrated, you may slip into a coma or enter a psychotic state, both of which can damage you neurologically.

As always, please consult a physician before trying any program which involves changes to your levels of physical activity. Please ask your doctor about the effects your medications may have on your body during periods of high exertion, and to what extent you are able to work out in order to avoid symptoms like dizziness. A trained medical professional will recommend exercises tailored to your needs and health.

So start slow and good luck!

What is your favorite way to get moving and grooving?

Good, Good, Good, Good Nutrition!

Anyone who has seen the documentary Super Size Me knows that Morgan Spurlock, who deliberately ate the most unhealthy meals at McDonald’s for a month, plunged into a deep depression by the second week of filming. Our moods are lifted by healthy food and destroyed by processed junk.

While good nutrition is vital for everyone’s health, research shows that it is especially so to those of us with mood disorders. A 2012 review by the University of Washington revealed that poor diet and a sedentary lifestyle may be coupled with “increased severity of symptoms of schizophrenia and bipolar disorder or decreased level of functioning.” 

Unfortunately, psychiatric patients tend to have “many nutrient inadequacies … and occasional excesses,” which translates to both a lack of essential vitamins and minerals and too many fats–in numbers even worse than the neurotypical population. With regard to vitamins, a broad-spectrum pre-natal with folic acid is also a boon if you’re vitamin-deficient.  Omega-3 fatty acids (fish oils) have also shown promise in helping with depression, though the research is controversial.

However, please speak to your doctor before making any changes. Maintaining a healthy diet is made even trickier due to mood episodes. According to the Depression and Bipolar Support Alliance, cutting fat out of your diet entirely can tip you into a manic or depressed state. Sugar is terrible for the bipolar-inclined, as it is linked with severe depression. Likewise, alcohol and caffeine should be avoided like the plague. As a contrast, lean proteins and fresh produce are wonderful, but expensive.  

A rough guideline for anyone with aneurotypical brain chemistry is to look for Zinc (red meat), B-vitamins (fish), and vitamin C (oranges).  Drinking as much water as you can is incredibly useful.  And you’ll need to pay even more attention to diet if you are pregnant, something that almost goes without saying.  

Anyone who plans to make dietary changes is advised to consult a nutritionist—provided they can afford one. I know it’s difficult to stick to changes regarding food or exercise plans, especially if you have to think about making healthy lunches for your children before school. But every little bit helps.

What healthy snack or activity have you found lifts your mood the best? What tends to lower it? Do you have a comfort food, and if so, what is it?

Not meant to take the place of a treatment plan created with licensed professionals.

Why Medicinal Weight Gain is Devastating to the Mentally Ill

“Watch out,” the mental ward’s psychiatrist gently cautioned me. “It’s true that Depakote will stabilize you, but you’ll gain a lot of weight. Plus, anything you pack on will be harder to lose. Are you sure you want this medication?”

“Pish posh,” I said, manic and therefore invincible. “I don’t care about a measly ten pounds.”

At the time, I was seething. Were we, in considering my treatment plan, really going to prioritize my weight over my mental health? In the midst of my psychotic breakdown, I’d just realized that I was insane enough to need serious medical intervention. Was that really the time to caution me about maintaining thinness—especially considering I had given birth two weeks prior? And why were there no other options to treat my condition?

Sixty pounds and a few years later, I care a great deal about my muffin top. So much so that it has started to negatively affect both my health and self-esteem.

I’ve had young children ask if I have a baby in my belly.  I’ve been laughed at and called “fattie!” when dancing.  I’ve even had a certain insensitive business owner look at my four-year-old debit card and declare, “You used to be so skinny!  You know, when you were a teen.”

Ouch.

No one can tell from looking at me what my diet is or what medications I may be taking. Despite that, they feel free to comment on my body. I fully admit that my new curves are not entirely due to my nightly med cocktail. I am largely sedentary and my diet consists of the three major food groups—Grease, Sugar, and Dairy—both issues which I am addressing. But even with that lifestyle, I should not have gained thirty pounds in a year.

Weight gain is a huge factor preventing people from complying with a long-term drug treatment plan. In a 1999 study of the adverse effects of antipsychotics, more than seventy percent of participants reported weight gain as “extremely distressing”—far greater than any other side-effect.

Depakote, a gold standard in the treatnment of bipolar disorder, is one of the worst offenders. Studies have even suggested that women on the drug crave carbohydrates up to ten percent more than men do, and tend to gain more.

This is a three-fold problem:

1.  The mental health industry is a fledgling one, even though its business is currently booming. We just don’t know what a lot of these compounds do to the body yet, especially when blended. And not all drugs work for everyone. I myself am allergic to entire families of medications, including most of the new atypical antipsychotics and serious painkillers.

2.  People stop taking their prescriptions when they feel that the diseases are easier to bear than the side-effects.  In addition, this is often done abruptly, which can be dangerous as it may trigger a severe mood episode.

3.  Despite not being able to tell how healthy someone is by looking at them, many cultures shame fat people.

There is a stigma against having a mental illness. There is a stigma against needing medications to survive. There is a stigma against being fat. But what if you are the first already and have to choose between the second and third?

This is the kind of choice that breaks a person.

What sorts of things have you had to deal with on your meds? If you can bear to part with the numbers, how many pounds have you gained?

What is Cyclothymia?

I once met a man at a writer’s conference whose behavior screamed “hypomanic”. He spoke rapidly, walked fast, made grand gestures, and was prone to heavy drinking and smoking. I often saw him pacing or fidgeting. At any given moment, I expected him to burst out of his skin, unable to contain his elation.

He was also an inspiration to many. The great majority of his conversations consisted of probing questions about who the addressee was, and how were they going to improve themselves—today? What were their dreams, and why weren’t they acting on them already? He oozed charisma, and garnered quite a fan following.

Lucky for him, he had an amazing Team You present at the conference: a group of his friends who had all known each other since their school days. They took shifts watching over him when he inevitably crashed. They explained that their colleague would go, go, go–sometimes for up to a month and a half. Then he’d sleep for about a week, curling into himself in the throes of an awful depression.

When I explained his behavior to my therapist, she said, “That sounds like cyclothymia.”

Cyclothymia is largely considered to be a “weaker” form of bipolar disorder. Episodes of mania and depression are not as severe and do not last as long. Psychotic features aren’t usually present. Some people with the weaker form eventually develop full-blown bipolar. It is suspected that cyclothymia is passed down genetically.

The disorder is difficult to diagnose because it shares so many characteristics with Attention Deficit Hyperactivity Disorder (ADHD), including, “increased energy, distractibility, and impulsive or risk-seeking behavior.” The symptoms also overlap with certain personality disorders. In addition, cyclothymia is frequently comorbid with other disorders, which means that a doctor may have one or more diagnoses to sift through.

Symptoms are usually treated with lithium carbonate and Seroquel, provided the patient desires treatment. Most people with cyclothymia are productive, sometimes to extremes.

Disclaimer: I do not claim to know enough to have diagnosed my friend, nor do I expect or want my therapist to do the same.

The Importance of Team You, Part V

Team You, a term coined by advice writer Captain Awkward, is a group of people who support you in times of emergency. If you are fighting the grips of mania or coping with isolating depression, these allies are invaluable.

This is part one of a five-part series.
Part I | Part II | Part III | Part IV | Part V

Who Shouldn’t Be On Team You

If you’re like me, you’ve found that there are only a few precious people who can uphold the coveted Team You title, and a lot who can’t. Sometimes even close friends and family fit into that description. Even worse, they may insist on “helping” you, when all they do is harm. Cut them off at the knees. Deflect, deflect, deflect.

Phrases include:

  1. “Thank you, but I’ll be able to handle it. Specific, positive example of a Thing recently accomplished.”
  2. “Thanks for the suggestion to try [remedy which contradicts my medications]. I’ll think on that (for ten seconds).”

Then there are the maliciously ignorant. These are the people who loudly declare that conquering depression is just a matter of willpower, and if you’d just get out of bed, you’d be able to see how lazy you’ve been. Avoid these people like the plague they are.

Next is the person who actually wants to help, but always feels uncomfortable doing so and skirts around the fact that you have one or more mental illnesses. They may note, innocuously, that you’re “sick” quite often. Phrases include the ones above, but also: “It seems like you’ve noticed I have a problem today. Do you have any concrete and specific ideas about how to help me?”

Make sure they are as detailed as possible about the extent they’re willing to go, otherwise you’ll find it difficult to take their help—-or they’ll give more than they want to.

Someone who makes you feel guilty for needing their support is almost worse than the maliciously ignorant person. Try not to let them touch you, and if you find one one your Team You, boot them.

Others who shouldn’t be on Team You fall into the category of super passive-aggressives and “extreme” advice givers. Our brains are fragile enough as it is. Don’t let others fill them up with more toxins. If possible, excise these harmful influences from your life.

Thanks for reading our series on finding allies! Did we miss anything?