Dr. Russell observed that these patients were adept at identifying their mood triggers. These needed to be picked up much earlier, they reported, than what their doctors recommended. Once depression or hypomania picked up a full head of steam, it was already way too late. Instead, these patients were microscopically attuned to such things as subtle changes in sleep, mood, thoughts, and energy levels.
By quickly responding, successful patients could nip an episode in the bud. Sometimes it was as simple as getting a good night’s sleep or stopping to smell the roses.
At around the same time, I received in the mail a manuscript copy of “The Bipolar Workbook: Tools for Controlling Your Moodswings” by Monica Basco PhD of the University of Texas, Dallas, now a very successful book. "See It Coming," said the heading of the first section.
Dr. Basco is a leading proponent of cognitive behavioral therapy. In her book, she gave the example of a person with a great idea who stays up all night following up on it. The problem is not the great idea, Dr Basco notes. The problem was staying up all night. Now, thanks to a lack of sleep, there is all hell to pay.
Dr. Basco points out that emotions change our thinking, which affects behavior. We need to learn to take stock, spot patterns, and recognize triggers.
In other words, we need to be exceptionally mindful about how we conduct our lives, even if we are on meds.
Meanwhile, I was engaging in a series of conversations with John Gartner, PhD of Johns Hopkins, author of “The Hypomanic Edge.” Hypomania can be a very scary proposition for many, but for a lot of us, Dr Gartner pointed out, it can also be a very positive personality trait. I long held the belief that psychiatrists tended to err on the side of overmedicating us. Now a clinician was validating my suspicion.
I had been on the same (recommended minimum) dose of a mood stabilizer since 1999. My business was picking up traction, I was receiving recognition for my writing, I had broken out of my social isolation, and I was into my second year of my second marriage. Moreover, I rested secure in the knowledge that my behavior, after all these years, was fairly predictable. As long as I remained on my meds and stuck to my various lifestyle and coping regimens, I was never going to embarrass myself in public.
