Hello Kay. I haven't posted for quite some time here--mostly been busy as a caregiver for my PALS (husband) and once again for my 89-yr-old mother because my sister could no longer help with her. But your thread prompted me to post. I know this is a public forum; however, I am open with my bi-polar diagnosis because I think the only way to end the stigma and shame too often attached is to bring it out into the open. It is like any other medical condition that improves with proper treatment and care.
I relate to your concerns--they are very real. What is working for me is returning to my therapist (every other week now) and seeing my psychiatrist every month now instead of every quarter. He spends a lot more time with me to ensure we stay on top of my medications and to short-circuit any mood shifts. Self awareness is really key, and I find that easiest to do by keeping a mood journal. Any change up or down needs to be addressed right away, before it gets out of hand. A doctor once described it as a trampoline--the higher you go, the lower you go, and vice versa, so the goal is stability.
My therapist is my life coach. She helps me maintain perspective, including the importance of caring for myself. My biggest challenge is the thought of invasive ventilation, because sleep is so important for stability and we don't have the funds for a nightly caregiver. I suppose we'll cross that bridge when we come to it. Which is something I'm learning to do--deal with today first. Plan for possibilities, but not to the extent that they remove you from the present. Life is always a balancing act especially when dealing with ALS OR Bi-polar disorder. Dealing with both makes that balance a little more elusive, but all the more critical.
This forum and the ALS Caregiver Facebook site are truly lifelines, providing both practical information as well as support and encouragement.
My PALS has been my rock for more than 32 years, demonstrating his love through all my highs and lows. He is the light of my life. Now it's my turn to put love into action by caring for him...that means taking care of my illness as well. Kay, please message me any time. You can do this, precisely because of your love for your PALS.