How to lift low mood by changing activity/thinking?

Hi everyone,

There's something I've been struggling with for a while and I'd really appreciate you guys' input... Since my mood was finally stabilised through medication over a year ago, I've been suffering with persistent fatigue, which manifests in over-sleeping, lethargy and not feeling 'sharp' cognitively.

I'd presumed this was a medication side effect, as until around three months ago, I was on Quetiapine as well as the Carbamazepine (600mg) I'm still on.

However, since gradually tapering off the Quetiapine, my 'sedation' hasn't improved that much and my psychiatrist has concluded this feeling must be a result of low mood. He's consulted with my CBT therapist to introduce ways to increase my activity levels and work on the unhelpful thinking styles that may be dragging me down.

I'm the first one to admit I'm not happy with my life at the moment, as for the past 2 years I've been pretty much focussing on my bipolar treatment and in order to do this, I've given up a lot e.g. I'm only working part-time, living at home with my mum and sister in a small, boring town and in a relationship that isn't really going anywhere, even though he's a lovely guy. I feel as if I'm just 'plodding through' a life that isn't really 'me'.

Before my last mania in '11, I'd graduated from my Masters, was working full time abroad, was more active, dating, and felt I was generally more dynamic. However, a stressful job plus a lack of social support led to a manic episode and because of inadequate treatment, my depression stuck and my mood was unstable for over 2 years.

As for thinking styles, I tend to have anxious, depressed and very self-critical thoughts and I'm also obsessive. I've always been like this to some extent, but it seems worse now.

Can any of you relate to this situation (not being clinically depressed but experiencing low mood)? If so, how are you working on getting yourself out of it (or how have you previously) and how successful has this been?

Thank you in advance x

I try try and talk to the few people i do know. But if they aren't around. I go for bicycle rides or go out and ride my motorcycle. I find getting out riding relaxiing and up lifting. Of course i work alot to distract my mind also.

Thanks for such a quick reply, thebetterhalf. I really appreciate it. I think a major part of my problem is that full time work has been taken out of the equation (even though my current workplace offered for me to go full time, I felt I had to turn it down so as not to get over-stressed). I've been trying to get out for a daily walk recently, but maybe I should invest in a bike too, lol!

I find talking to people helps, though if I'm too close to them, I just end up turning the conversation to my bipolar-related problems- which I hate doing, but it's so tempting.

Anyway, thanks again x

I think that the only way to deal with negative thinking patterns is to crush the negative thought as soon as you have it. If you linger on it, it can take you over. I use mindfulness, and am aware of the thought but have an inward determination not to be affected by it. Sometimes its very hard.

It sounds like you have problems with low self esteem. I do too. I wrote a list recently of all the things that make me feel better about myself in order to try and improve this. I think that when you're feeling this way, a good thing to do is think of how you might help other people around you. It will make you feel better about yourself and feel less like you're in your own isolated hell... Thinking about oneself repeatedly is so incredibly dull after a while. Its so nice to think about how one might help others, even if its very hard some times due to low mood. Exercise and meditation are great too.

In DBT therapy, we practice a skill called Opposite Action. It's exactly what it sounds like...doing the opposite if what you are feeling. So if you're feeling like hiding away, you're supposed to recognize it and get active, maybe mingle with people. Feeling like avoiding chores? Do some chores. Big task you've put off for awhile? Work on it a while. Set small goals to achieve. It is really difficult to make yourself do the opposite of what you're feeling, but it does help change mood for awhile afterward. Sometimes, a full day can be filled with opposite action. Sounds simplistic, and I suppose it is, but it does help. Good luck!

Thanks so much to both of you for taking the time to reply.

Darkroses- Definitely, my natural response when a negative thought pops up is to ruminate, which I know only feeds the negativity. I think mindfulness sounds a really helpful way to start dealing with this, even if it's difficult.
Low self esteem is certainly one of my main problems, and it's the model we're working with in CBT. Thanks for the advice- helping others more would be a good way to bring me out of this loop of self-obsessed style thinking. I agree it gets tedious, even to me! I hope you're able to find a way out of your low self esteem in time, too.

Caribee4me- That sounds a really useful technique, so thanks for sharing it. It may be simple, but it also sounds very powerful.
One of my major issues, especially when I'm low, is my procrastination, so I'm really working on forcing myself to start my tasks and break them down, rather than just sitting there and thinking about all that I have to do. However, it's hard trying to fight the perfectionist in me that says I have to complete the task in one go, and to a high standard, or there's no point.

I'm going to make the effort to introduce and stick to gradual changes and hopefully the low mood will resolve itself. Thanks again x