My doctor’s visit today felt a tad bit like confession.
“So how are you?”
“To tell you the truth, I’ve been feeling a bit fragile. Nothing like last summer when I awoke each morning fighting feelings of wanting to be dead. But I have been more irritable in general.”
“Can you give me an example?”
“The other today I had a meltdown in Toys-R-Us over global warming, consumerism, Chinese child labor, pollution, and the landfill crisis in America. Those are all my hot buttons–topics that really bring me down, and make me feel like the world is doomed no matter what I do. But when I’m feeling more stable, I can think about them and discuss them in proper prospective. Granted, we pulled into the store after 7 p.m. when I was tired and the kids were whiny. But Eric was a little frightened by my explosion after a few Elmos whistled at me in aisle five.”
“Have you had any crying spells?”
“The other day after I hung up the phone with a health-care insurance representative, I started bawling. I realize that those criminals make everyone cry. But what scared me was that I couldn’t stop, even when David came into the room and asked why I was crying.”

“Are you doing anything differently right now than you were?”
“I’ve been training for a triathlon, so I’ve been extremely tired during the day, after my workout. In order to stay awake and write something halfway coherent, I’ve been drinking more caffeine.”
“How much caffeine are you drinking?” (Here’s where it really felt like confession.)
“At least four big mugs…. Usually two in the morning to wake up, and two in the afternoon to wake up. Is that too much?”
“I think four cups borders is what I would call ‘exuberant.'”
“How much can I drink?” (Then again, better to beg forgiveness than to ask permission.)
“It would be best if you could stick to one or two. Maybe one in the morning and one in the afternoon.”
“I’m just so tired. I think my tolerance is growing, because a cup in the morning won’t make a dent anymore.”
“Your tolerance has probably increased, which is why you’ll need to gradually decrease your intake. But if you need it to stay awake, that’s a pretty clear indicator that you are doing too much, and stretching yourself too thin. You shouldn’t have to depend on a stimulant to get through the day. You may be someone who needs more rest than the average person and can’t put as much on her plate for health reason. You need to keep your bipolar disorder and sensitive disposition in mind whenever you take on a project or challenge.”

“I know. Eric told me the same thing, but he doesn’t have as many initials behind his name as you do, so I didn’t listen to him. I originally signed up for the Annapolis Triathlon. But that’s Olympic distance, twice as far as the sprint triathlon I just did. So I’ve decided not to do it.”
“It’s important for a person who has been depressed in the past to have goals, and to challenge herself. The accomplishment can increase self-esteem. However, you need to keep it all in balance. Given your writing responsibilities with Beyond Blue and your obligations to your young children, you certainly have plenty to keep you busy.
“How is your sleep?”
“Not great. I’m restless at night. Possibly because of the caffeine.”
“Caffeine can definitely interfere with sleep hygiene, which is another reason to cut down. It’s a vicious cycle, because the more fatigued you are, the more you want to drink, which will interfere more with your sleep.”
“Anything else you are doing differently that may be making you more fragile?”
“I haven’t been as consistent with the time I take my meds. Sometimes I take them in the morning, and sometimes at night. Could that be a problem?”
“Yes. That can surely affect your mood, because your blood levels are going up and down, and at times you may not have a therapeutic level in your system. It can be hard to remember to take your meds–especially when you are feeling good–but choosing one set time, and sticking to that is very important.”
Summary (important reminder): as a person with bipolar disorder and other sensitivity and anxiety issues, I may not have the extra layer of padding around me to absorb the shocks of daily life that other people do. I can’t drink four big mugs of coffee (plus a Diet Coke or two, and iced tea) for too long without feelings its effect. I can’t be lazy about when I take my meds either. And I have to be extremely diligent about getting my eight hours of sleep or the wheels on my bus can’t go round and round (they fall off).
All those things (caffeine, inconsistent meds, poor sleep) wear out my already extra-thin protective layer, pushing me into psycho world–where I think everyone’s mission statement (whistling Elmos, insurance reps, snack bar dudes, five-year-old boys) involves messing with my head.
In order for me to stay resilient–with fat absorption padding around me–I must adhere to the three-word twelve-step slogan: easy does it (girlfriend).