Prodromes of Depression

For me, depression can hit very quickly & usually after a period of hypo mania so the 1st thing for me is to resist not telling my provider about the hypo mania as it feels so GOOD to have an immense amount of energy w/only 3 hrs. of sleep, the real sense of self-esteem (definitely not typical for me), the creativity & just feeling like all is right in my world (again, not typical for me).   Unfortunately, I didn't learn THIS KEY prodromos until 3 yrs. ago.

One (I think more unique) prodromos for me is the desire to start smoking again! I can't even picture myself smoking when stable, so when the Camel cigarette neon light ads in the window of the gas station seem alluring, I know something is up (well, actually DOWN w/my mood situation).

When I plunge into a depression after a hypo mania, I ususally have crying spells, feelings of utter worthlessness, suicidal thoughts & then that fairly unique one of wanting to start smoking again.

I quit smoking when I was about 23 after having a preemie due to smoking & drinking while pregnant (had untreated bipolar 1).  I had such guilt over causing that baby harm that I quit smoking & drinking for her (couldn't do it for myself at that point) until I fell into a really deep depression when we moved from the West Coast to the Midwest about 12 yrs. later.

Sure enough, after some 12 yrs. of not smoking or drinking I started BOTH again.  I quit smoking AGAIN about 13 yrs. ago when I was properly dxed w/bipolar & get on the right meds.  I felt so much better & decided that this was an opportunity to start making good decisions FOR MY LIFE & quit smoking cold turkey about 3 weeks after getting on Lithium.  I also slowed down my drinking to more of "social drinking"--wine w/dinner at a nice restaurant, etc. 

So for me the desire to smoke is a big indicator that depression is descending & I call my meds provider as my depressions turn into suicidal thinking very fast.  Usually I need an adjustment in my medication.  Unfortunately, I didn't realize YET that a period of hypo mania could suddenly make me drop into depression quite quickly  Fortunately, after my last suicidal behavior 3 yrs. ago I started Dialectical Behavior Therapy & indiv. therapy w/the doctor who leads the DBT group.  This has helped me so much.  I've been able to decrease some dosages of some meds & get off a couple completely (was taking Abilify, Lamictal, Trazodone, Klonopin & Provigil--with Wellbutrin added when a suicidal depression was in progress).  I had to stop taking Lithium, though it helped so much w/my mood, due to kidney malfunction while taking it.

When I'm stable I can't even picture myself smoking!

Also, important for me is to watch for "triggers"--situations or thought patterns that can lead to depression such as being around "toxic" people who criticize me frequently or just bring back painful memories or movies that show any kind of child abuse or too much violence or are too sad (or hypo mania--such as too much excitement about a trip, for example, or lack of sleep).

Being on the alert means I have to read movie reviews very carefully & I usually can't watch an R-rated one & sometimes even PG!! I once had to leave a play (tickets cost quite a bit of money) at the intermission as I didn't realize some painful issues were going to be introduced. I try to fill my time w/fun & learning experiences & people who are positive & excited about life.  They energize me.

But I can easily become overwhelmed w/too many activities so I plan my schedule carefully.  I need to get a balance between becoming isolated (very easy for me) & getting too booked up.  Sounds like a lot of work, but I have to take my illness seriously as my mother did die from suicide during a bipolar depression & I've had my share of attempts.  I want my "last" one to be my "last" one!

Thank you for sharing...I am just learning how during this "ahead of" time a person diagnosed with bipolar can be very vunerable and sensitive to criticism.  A loved one might ask you for your opinion..however..I am learning to tread carefully.  They are very proned to take things extremely personally and their feelings can turn to hurt and anger.  If friends and loved ones can work on learning "the prodromos" for the benefit of all...it can save everyone involved (not every time but sometimes)  exaggerated (but very real to them) hurt feelings and tremendous saddness.  "Accidental Toxic Words" is what I like to call them...should of, could of, would of....

Just say....great job and leave it at that....learn your family members symptoms!!

There will be time when they are in a stable place to discuss things of an emotional content.

Of course as far as suicide...never ever take that lightly...discuss immediately...let them know you care and that they are loved and that their life is important...get help (if they won't help or can't help) stick by them with love and care...

all need love... its a basic human need....

and...take care of yourself physically and mentally...you owe it to yourself and you will be better equipped to cope and thrive....and be there when the going gets rough.

yep, it all makes sense, I am there right now and I would rather be sleeping at noon than typing this cause I couldn't sleep at all last nite. But what is the purpose, there are triggers and things happen and there is not one damn thing I can do about it except take my meds and try to ride it out and hopefully make the best of it.  What else can I do?  Nothing and the cycles repeat and repeat and repeat no for 50 years.  Yes, I know the fancy words and smirks and people talking behind your back because you are the nixcest guy in the world and then you just explode over nothing.

As for, just leave me the heck alone.