Friday, September 19, 2008

An Expert on Me

In the last few weeks, a number of people have told me how good it is that I'm able to figure out what's wrong when I feel ill and correct it. At this stage in my life, it would be great to say, "Thank you. I'm so intuitive. It’s easy for me."

But that would be a downright fabrication. The truth is that the reason I'm able to do this is because I kept a detailed mood chart for six years, in which I noted what medication I took and in what dosages, how it made me feel, how I felt in general, how much sleep I got each night, what I ate, how much exercise I did, and detailed records of all my psychiatric visits as well as those with alternative practitioners.

In fact, I have been keeping a daily journal--albeit not as detailed--for almost 20 years. I began it when I started working as a freelance writer and had to bill clients for my time. There have been years where I have kept more or less detailed notes.

But, if you want me to tell you how I felt when I was taking Lamictal, Depakote, or Wellbutrin (or 22 other medications), I can do that.

It is this discipline, which enables me to remain well today. What I decided years ago--when my medication was making me sicker and sicker and my psychiatrists were incompetent--was that I needed to become an "expert on me." And so I have.

What I find very interesting is that while I've said numerous times that keeping mood charts is a critical wellness activity, I sense that few people are doing it. And I'm not really sure why.

If your psychiatrist said, "In order for you to become well, you need to keep a mood chart," would you do it?

It's certainly something to think about. Because if he/she did say it, and if you wouldn't take the time to do it, what does that say about your commitment to wellness?

In my case, I have done everything humanly possible to become well...and so I finally have. Years ago, when I was so depressed that I didn't see how I could survived, I searched the WEB for someone who suffered from bipolar depression and was well. I wanted to know what they were doing that I wasn’t. If I had found that person, I would have religiously tried what they recommended to see if it worked for me.

I now realize I have become the person I was seeking. It’s a great feeling of accomplishment!

18 comments:

KJ said...

I think you are a rare person of character. There are few people whether bipolar or not who demonstrate the dicipline and commitment you seem to have demonstrated through your wellness process. It is much easier for people well or ill to be a victim of their circumstance rather than an overcomer. It is a good lesson for me and for us all that real wellness, actually real success comes after much (maybe years) of hard work and commitment. You deserve all good that comes to you because you have worked and fought for it.

Robin J Foote said...

I agree. About a month ago I started a mood chart after being diagnosed just 8 weeks ago with Bipolar II.

Since starting records I have come to understand my symptoms leading up to a mood change and the effect of medication and sleep.

A question; Does anyone suffer reverses in mood changes or bad moods after high salt intake? I have noticed that some of my depressions and mixed moods are often after I have an elevated salt intake. I keep it down nowdays, but sometimes its accidental.

jipps76 said...

Susan,

I have a couple of questions regarding your mood charts. First, have developed a specific format that you follow or is it in journal format, so to speak? Also, do you set aside a specific time each day to accomplish this or do you write at various points during the day when something pertinent needs documenting?

I have kept a mood chart on and off over the last year or so. If I wait until the evening when the dust settles from that particular day, I fear that I lose the exact feelings and emotions of significant moments. Conversely, sometimes I just don't have the time to write several times per day.

Thank you for your time and attention to these questions.

Josh

Andrea said...

Good for you! I completely agree with you. I absolutely believe it was my years of journaling that lead to my having a correct diagnosis (and I went to three independant doctors, and they all came up with the same diagnosis, before I agreed to treatment). There would have been no way of recognizing the patterns without it. I'm blessed to have had so little trouble with my medication, and doubly blessed to have settled on the doctor who pushed nutrition and exercise to prevent having to take more medication than is necessary.

I think EVERYONE with bipolar, or any other mental illness, should journal! Nothing but good can come of it.

Wellness Writer said...

Dear KJ,
As always, your kind words make me feel so good. What's interesting is that I never thought of myself as unique in this way. I assumed that everyone else who was ill was doing what I was.

I figured that if people were experiencing the same level of pain and suffering, they would do anything to feel better.

I realized that if my doctors couldn't help me, and I wanted to survive--preferably flourish--I would have to "cure" myself.

I am so grateful I was able to do so.

Susan

Wellness Writer said...

Dear Robin,
I don't know about the salt. It's not something I have experienced. But hopefully, someone else can speak to this.

I commend you for being so proactive with this illness. If attitude counts--and I firmly believe it does--then I would imagine you'll be able to control this.

Susan

Wellness Writer said...

Josh,
If you look at my archive, I've written a series on mood charts. But, the quick answer to your question is this: For 20 years I've used the two-page per day Day-Timer system. I used part of it for business and part of it for my illness.

I noted things all day long. If I felt hypomanic for part of the day and had a lower energy level for part of it, I noted it. It could be as simple as writing: 10-12 Hypomania. 12-4 Mood leveled out.

Since I was freelancing and had my own office, confidentiality wasn't a problem. If I worked for a company or organization, I'd probably have had to do this with a second Day-Timer, which I could keep in a locked briefcase or a locked desk drawer.

If I noticed that interacting with certain clients or colleagues made me feel worse, I'd try to figure out why.

My own feeling is that you have do it all day long because feelings are fleeting. The object for me was to refine my skills of observation so I could see "cause and effect" patterns.

In fact, the entire exercise is to enable you to determine patterns of behavior so that you can change them. Or to figure out what wellness activities work. And it's also a technique for monitoring your behavior.

For example, I learned that the on the days when I didn't exercise, I felt worse than the days when I did. On the days when I couldn't come home and decompress, I felt more stressed than the days when I could spend some time by myself.

On the days when I was hypomanic, I wrote down what I may have said that might have disturbed a client or colleague so I could clarify it or apologize and move on.

Finally, since I have worked as a freelance writer for the entire time period, I have always had time to jot down notes.

If you truly don't--and only you can be the judge--then I'm not sure how you can handle this.

Susan

Wellness Writer said...

Dear Andrea,
Welcome to my blog. Good for you too! We're in total agreement on this. Actually, I believe that anyone with an illness should keep mood charts because I've read that stress causes more than 70 percent of doctor visits.

Susan

Nancie said...

Dear Susan,

You are truly very disciplined in keeping the mood chart and journal and they have worked so well for you!

I started keeping a mood chart and journal during my recent relapse of clinical depression a few months ago. I have found them to be very helpful as I slowly begin to see when my mood changes and what may have caused them. The mood chart became a very powerful feedback tool to my Doctor and she was able to advise me regarding medication adjustments plus other self-help technique. In some ways, my Doctor makes me a co-therapist by teaching me what to observe in my mood chart and what I can do when I see changes there and how to prevent symptoms worsening. Now I begin to feel more in control of my illness and no longer a victim!

I really hope more people with mood disorders will understand the importance and advantages of keeping a mood chart. Thanks for sharing with us! Thanks for visiting my blog. Take care and have a happy and healthy weekend too.

Nancie

Wellness Writer said...

Dear Nancie,
Isn't it amazing how effective a tool it can be and how little effort it takes to enable you to assume control of your illness? It's also a sign to your doctor that you truly want to be a co-healer rather than a victim. I just wish others understood this.

Susan

JayPeeFreely said...

Well, I think you manage pretty well. I only hope I'll be able to do the same in what is my hopeful new home...1 month from now.

(Final straw snapped for me.)

Arrangements for stuff - portfolio, clothes, cash, and a bus are in my future. I'm done with the Midwest.

Wellness Writer said...

Dear JayPeeFreely,
Thanks. I wish you the very best!

Susan

Immi said...

I was told 3 things when I was diagnosed with bipolar: I had to take meds, I had to do life management stuff, and I had to do a mood chart. I wanted to be well so badly that I started all of them. The combination has helped so much that I've stuck with them. I've insisted on coming up with my own mood chart when the ones available didn't work well for me, and changing the meds when they were more problematic than helpful. I'm not convinced I have to be on meds forever, but I am convinced that I have to be on life management and mood charting forever. I believe it's hugely important to take responsibility for one's own wellness or lack thereof, so I'm tickled to find your blog. Thanks!

Wellness Writer said...

Dear Immi,
I'm "tickeled" (love the word; haven't used it in a long time) you found my blog as well. Welcome. Actually, the advice was good except for the drugs, wasn't it?

Too bad more doctors don't recommend mood charts and life management skills rather than focusing solely on medication--which has proven to be so ineffective for so many.

Susan

Mariposa said...

Hi Susan!

I was just talking to IT Guy yesterday about knowing ourselves as the main key to getting by whatever mood swings we go through (take note I try to use milder words... ;p) I also said, we go through this bec of some imbalance in our system, yet, not most doctors try to address these imbalance and other root causes, but rather they go ahead and address what is clear in the surface...address the behavior that readily manifests. So that when I am so down, they so something about it...and when I am so, they are to pull me down a bit...but not all would tell me, watch it...you are causing yourself or about to go there. I am lucky I have people around me (friends and doctors) who taught me how to get to know myself more...and so I can be in control...so far, things are within norm. :)

People say I'm doing a pretty good job...but like you, ha, I'm charting my moods and behavior as well...and I write journals a lot...it helps me see things clearly.

Thanks for all the support and encouragement... :)

Mary said...

Even though I don't suffer from bipolar, I try and keep a mood chart whenever possible. This way when I see my therapist I can tell her how I felt before seeing her. I admire your discipline and hard work way to go..take care..Mary

Wellness Writer said...

Dear Mariposa,
Thanks for all your insight on this. I couldn't agree more. And thanks for being such a bright light!

Fondly,
Susan

Wellness Writer said...

Dear Mary,
I've always believed that mood charts would work for a large number of issues, and it's great that you're keeping one to discuss with your therapist.

Good job!

Susan