No Motivation, Alas

22 Oct 99 - Diary
After more than a week of being out of touch, I am now in reasonable shape to talk. However, emotionally I am in a peculiar state - depressed with no symptoms of depression.

I am worried about the state but I don't know what to do. I'm going to chronicle what I have been feeling and doing.

Except for the inability to do things I feel fine. I am clear headed and without anxiety. I saw my psych two days ago and she said that I am probably a tad below normal. She suggested an antidepressant, St. John's Wort for me to take for about four days. She thought that with my sensitivity to drugs, it would be enough to pull me to normal and once there I would stop taking it.

However I am very resistant to the idea. The idea of taking more medications does not seem ideal to me. In any case the logic of simultaneously taking antimanics (Lithium) and antidepressants (St. John's Wort) seems silly.

I also fear that given my sensitivity, the St. John's Wort will produce a spike of good feeling which will go away as soon as I stop taking it. And then I will be back at square one.

So I told my psych that for the moment I would try behavioral change rather than more meds. In any case I can try the meds later if I need to.

I also have a larger fear. Suppose my current meds (400 mg/day Epilim [Depakote], 600 mg/day Lithium) don't actually stabilize me at normal. Suppose they stop the cycling and stabilize me at this point below normal. Suppose this is as good as it gets. It's a scary thought.

Alternatively, there is an idea that my psych and I have been discussing. Suppose I am actually at normal at the moment? I have lived my entire adult life, since eighteen, on a two week cycle of hypomania and depression. Perhaps I am normal now, but how will I recognize it.

The is a practical problem associated with this. In the past, motivating myself was not something I did, motivation was something I had when I was hypomanic. In a way, I never had to work hard in my life, all I had to do was to wait for my hypomania to kick in and then ride the crest of all the energy. For most of my life this was quite enough.

Now that I don't have my manic push, how am I supposed to move forward. Motivation and discipline are learned things and I never had to learn them before. I am finding it nearly impossible to do the basic things to get my life in order. I know what I should be doing to get my life in order. I just am not doing it.

This is not depression. I am clear thinking and I have none of the other symptoms associated with depression. This is being stuck in one place and not being able to move forward.

How does one learn to be motivated anyway? That and discipline are learned things and learning takes time. I keep on expecting to bounce right back into things because my world is stable, but it is a wrong expectation. I now have to spend time learning how to live a normal life.

I also made an additional mistake. I told the people around me I was stable and we all thought that meant better. But it doesn't, and I've left them with expectations I can't fulfill. Now I have to tell them I was wrong and it is going to take longer.

How many times have I told them that. It is starting to sound a little worn, even to me.

So where am I exactly? I'm feeling quite good. Not anxious, not down, not bad in any sense. But I'm not getting anything done, or not much anyway. My house needs cleaning - I need to get the spider webs out from the corners. My e-mail needs answering and my cupboards are empty of food, as is my fridge. My clothes need ironing and I need to send my car for a tune up. I have been able to wash clothes and dishes and carry out garbage, so I should be happy of some victories.

Work has been odd. I get to work about half hour to one hour late every day, but I am not anxious about this as I usually would be. I've not been dressing up to spec for work, which has been caused by lack of ironed clothes. I tend to avoid dealing with people, but when I do deal with them, I do it properly and without anxiety. And even though I say I am inefficient, in the last seven days I reprogrammed and tested the company's new billing system.

I don't understand how I am able to be efficient and inefficient at the same time. It goes against all my previous experience where I have been either useless or hypereffective.

Personally I think things are going badly because I have not been exerting myself. This is not an effect of being bp. Ha! When is the last time a manic depressive person admitted that.

But I do believe that this is a side effect, or rather an after effect. I have to learn to take responsibility for my life instead of being carried by my emotion. I am sitting in the calm sea and I need to learn how to row.

Unfortunately, I cannot say I need discipline and have it. I have to learn it, in time. And unfortunately for the people around me, it means that I will continue to be unreliable and inefficient for the time being, until I have learned discipline. At the moment, I've been trying to be responsible in my life and making a mess of it.

I'm now delving into my Dale Carnegie and self-help books to get some inspiration, but it is definitely an uphill battle. Nevertheless.

What I'd like to do is go on a vacation for the next two to three months to develop a schedule for myself. I did this once before in my final year of university and it worked.

An Aside
Taking medication when one has no discipline or motivation and when the terror of being bp has receded is really difficult.

I'm beginning to realize why non-compliance rates for taking medication are so high. I often skip taking my medication because I would say to myself that I'll take it in the next five minutes, and remember four hours later.

What I really want to do now is to clear my life of irrelevancies and start over. This is typical of the onset of my hypomania, but I'm not going hypomanic, or at least I am controlling myself really well.

I feel as if I'm so close to a reasonable life but I need to I need to go the extra mile. But without the discipline to do it. Almost there but not quite. It's frustrating and I just want to start over.

I'm trying to visualize my life in the future and I am having a hard time of it. I can do a lot, but I'm scared of my reliability. I haven't gotten any and I am scared to start up anything when I am so unreliable.

I'm also finally willing to admit to myself that I can't do this alone. I'm going to need help over the next few months to keep me on track and going. The problem is that I don't know who I should lean on.

C. should be back within a month or so and is the ideal candidate, but due to other issues, may not be the ideal support.

My parents are very supportive. Too supportive. I don't think that parents should be the long term support for bipolar persons if there is a choice. The parent / child relationship interacts very badly with the help given (and received) and the typical bipolar anxiety and creates a relationship destroying intractable mess.

I've usually backed away from my parents help unless I am desperate. My parents are there to rescue me when things are really bad, not to help me on a daily basis.

However, if parents aren't a possibility and my partner is not here, what choices do I have? I haven't resolved this yet.