BipolarLawyerCook has a peice up at RealMental that has made me think a lot.
She writes of the difficulty in knowing where you are when you are bipolar. As you live this disorder you are constantly reaching for the level ground you are told you can achieve, but much of the time this feels far off. For me it took 6 years and 30 some medications, plus well over 300 therapy visits to finally understand that level ground does exist. Since that time I had one 2 month period of not being totally well, this current off spell I'm still hoping is med related (I cut my dose in half for a while. Probably this will be a mistake, but we'll see. I'm planning to try to make it until this weekend, then increase as needed. Unless my doctor has something different to say. Usually she lets me do this kind of thing myself though.
Anyway, for me one of the hardest parts is recognizing where I am if I'm not ok and I'm not at rock bottom. Sometimes even rock bottom isn't clear to me; 2 1/2 years ago I kept working even though I was so lithium toxic I was vomiting daily, and I was so manic I was barely functioning, and I thought I was doing great. I was actually on disability for 2 weeks before I realized how badly out of control I was.
During that episode my therapist found a way for me to look at where I am and parameters that go with each level. It makes it easier both for me to understand and communicate what is going on. Even now it is used in conversation when I start to feel off-kilter.
So, made a bit simpler (mainly because I don't feel like going and dragging the full-size poster Dr. Mind made me out of it's hiding place), I use the official road sign monitoring system. Step one is mile markers, meaning I need to notice what I am doing. I cannot put in 12 hour days every day for 3 weeks or I will get sick. If I ignore this I'll overshoot the exit and wind up somewhere I don't want to be. Next, I believe, is a yield sign. Sometimes I need to not do something so I can rest. Next is a blinking stop. That's last week: I must rest, then I can move on. Obviously it's not good to get that far. The more drastic is the full-blown stop. That's time off work, generally increased meds, and bedrest is generally required. The last sign is hospital, added by me mainly because I was still bitter about nearly being placed there earlier in the summer and I was trying to point out I was able to be out just like I'd said. Somehow I have a feeling it was a weak argument, but I needed it regardless. Plus I need to recognize that this may be part of it, and by that point I think I had promised to not fight so hard the next time. Which I didn't, and the next time I actually didn't need the hospital considered very much.
Anyway, this does work well for me. I figured I'd share because this kind of tip seems to help me when I can find it at the right moment.