I'm mentally ill but driven to excel

I am mostly stable but when I push myself I get sick

Published July 22, 2011 12:20AM (EDT)

Dear Cary,

I'm writing because I respect you and the work you do. I have reached the end of my rope and don't know who else I can turn to for an honest answer. (My friends and family have been wonderful, but I sense that after years of advising and supporting me, they no longer know what to say.)

I am 35, unmarried and I live alone. I have had a rough past, which through years of therapy and dedicated hard work I have come to terms with. Unfortunately, I do bear one significant scar -- I suffer from mental illness. Diagnosis: bipolar with psychosis and PTSD. It runs in my family and is currently managed with a remarkable cocktail that has kept me relatively stable for many years.

The problem is this: I have big dreams for my life. Really big dreams, dreams bigger than healthy people should even have. And I am actively working toward those dreams. I take advantage of the myriad of opportunities I've been afforded, I seem to be naturally lucky, and I am a dogged, diligent worker. However, after any period of stress I become ill. Not necessarily mentally ill -- I've learned to manage my state of mind pretty well. But I become physically ill. Though it is typically reserved for the much younger, I got mono this year. I'm currently recovering from a sinus infection because I'm in an intensive language program. I do directly correlate the two, because I was also here last year and spent several weeks sick with the same thing.

Sometimes the illnesses are normal, like a respiratory infection or sometimes they are bizarre like the two months when daylight was physically painful. Whatever they are they distract me from my goals. They make everything so much harder than it should be.

I began graduate school last year, something I'd been putting off because I didn't know if I'd be able to physically deal with the stress. I got mono, had complications, was working a job and ended the semester with a 4.0 GPA. What this told me was that I should be attending a tougher school with higher expectations. So instead of taking the summer off, I applied to harder schools and enrolled in a language program that packs a year of college level learning into eight weeks.

Cary, I don't know what to do. For years I managed stress with liquor. That was a short-term solution that really didn't solve much. This month marks 10 years of sobriety. Then I managed stress with physical activity, then with therapy, then with art, then with meditation, then with prolonged periods of rest, and currently stress is managed with late-night bingeing on junk food. When I don't push myself really hard I feel like I'm wasting my intellect and the opportunities I've been offered. When I push myself really hard I end up sick and loathing myself for my weakness.

Can you please tell me what to do because I'm so tired of this cycle.


Superwoman Some Days

Dear Superwoman Some Days,

Here's a simple suggestion: Just dial it back 10 percent. Dial everything back 10 percent.


Give it a try. Just take 10 percent of what you're expending and save it. Rest up 10 percent more. Do 10 percent less work. Give your all -- minus 10 percent. Hold back 10 percent in reserve. Use that 10 percent to stay well.

If you're working 40 hours a week, take it down to 36. If you're sleeping seven hours a night, increase it to seven hours and 42 minutes. If you're studying 6 hours a day, decrease it to 5 hours and 24 minutes.

You're never going to stop the cycles. So the thing to do is allow cushions around the corners, around the extremes. Those points where you are completely exhausted and yet you keep pushing on are probably the points where you're breaking down. So if you can avoid those breaking points, you can perhaps live more comfortably.

There's nothing wrong with cyclical change. If you can't stop the cycles, you can at least try to ride them gracefully, with a minimum of injury. So accept the cycles. Accept that you are in motion. No one decision or action is going to change everything. It's flexibility and grace that will get you through.

You can't change the cyclical nature of things. But you can accept what's coming, and you can also change the speed of your own vehicle.

If you want fewer errors and less rattle, you dial back the speed. When playing an instrument, pushing for speed brings more errors. For accuracy, you slow it down. Play the piece 10 percent slower. There is a realm where you can do certain things every once in a while but not consistently. Then there are things you can do pretty much every time. So if you're always pushing, then you're always in that realm of frequent failure. That's where you make errors and get hurt, when you're pushing.

And heck, if there's some chronic illness that keeps popping up, maybe you are in a state of chronic inflammation. I know that sounds weird, but before I got my cancer, I was reading about the connection between certain diseases and states of inflammation. Of course I do not understand the biology of it, but science seems to be saying that there is a connection between the kinds of inflammation that show up as such things as gum disease or joint pain and other more serious diseases such as heart disease and cancer.

So I was ignoring a chronic condition; I was ignoring pain;  I was pushing myself to the limit without regard for my recuperative capacity. I was running myself to the edge over and over. And I finally broke the machine.

I'm healing now. I'm mending. My main job is just staying healthy. So I swim, I play music, I get enough rest. This is of course a subjective interpretation of disease, and I think we all ought to be careful about the limits of subjectivity. There is no substitute for science when it counts. But there is much we can do to stay well. So consider the chronic state of your body, and see if you can change it long-range, so that you are less stressed and more relaxed and more settled. Also, of course, pay attention to what you are eating. This junk-food bingeing cannot be doing you any good. Pay attention to what nutritionists say. Eat well. This will make a difference in how you feel.

It's kind of funny that with all the professionals in your life you would ask me, the cranky neighbor over the fence. My ideas are pretty intuitive, and of course these are only suggestions. But if they sound promising, try them out. As long as you continue to follow the professional advice of your doctors as well, making some commonsense adjustments to your workload can't hurt.

It's a simple idea but has wide application. Just dial it back 10 percent.

Citizens of the Dream

What? You want more advice?


By Cary Tennis

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