For me, there has always been a seasonal element to this illness. Last year, on May 1, I suddenly felt truly wonderful and it lasted until the end of October. This year, I've been okay for the last few months--not great--just okay.
Yesterday, I thought everything had changed and the depression was finally over. I awakened feeling really good. Given that the medication I take for depression is a stimulant, once I feel well I have to immediately stop taking it. Unlike other people who are supposed to titrate off medication, I have to abruptly stop because otherwise it will cause a hypomania.
From years of experience I know that once a depression ends, it's usually over. What's amazing--and disturbing about manic depression--is that whenever you feel like you've got it under control, it smacks you in the face.
While I felt fine in the morning and I was able to attend my biweekly photography class at a local community college, by late afternoon I was exhausted. And a few hours later, I was so tired I felt ill. Finally, I went to bed at 7:00 at night and slept until almost 9:00 this morning.
Upon awakening, I could tell that the depression wasn't over, and I needed medication but I wasn't sure how much. Because I take the lowest possible dosage, and because it takes an hour to kick in, I had to take 20 mg and wait an hour to see how it worked before taking 20 mg more. That seemed adequate, and I was able to drop my son off at school and help a friend edit a book. But once again, by 4:30, I was extraordinarily tired and it never lifted.
Compared to other years, this new pattern was just a slight glitch. It was disappointing but certainly tolerable. Years ago, it would have been very disturbing. Even though I try not to ruminate on past experiences, I couldn't help but think how bad I used to feel when my energy ebbed and flowed--and I couldn't be there for my son (the way I would have wanted to), had to cancel commitments, miss a few days of work, disappoint a relative or friend, or change plans.
(I don't know about you, but at some point I realized that I received so much grief if I had to cancel at the last minute, that it was easier not to accept invitations in advance.)
These days, I'm feeling much better and I have far greater flexibility. But I also have great empathy for those people--like me--who work so hard to achieve some level of "normalcy" and stability and yet continually have to adjust to bipolar ebbs and flows. It's just not easy, is it?