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Posts Tagged ‘mood swings’

Many of us with bipolar disorder take drugs to lessen the intensity of our mood swings, whether that is depression, hypomania or mania. We take them in spite of the side effects such as foggy thinking, memory problems, weight gain and sleeplessness or sleepiness, just to name a few. Many of us have convinced our doctor or psychiatrist to change our meds as a result of the side affects. Some of us have decided to tolerate some side effects because the meds are doing the job of leveling out our moods to normal or close to normal and, after trying many others, these are the only ones that have worked. We tolerate it because the toll the mood swings have on us is far worse than the side effects.

But what if a medication actually causes the behavior we are trying to prevent? Recently the Food and Drug Administration issued a warning about Abilify. I read a bulletin from Drugs.com stating that on 5/3/2016, the FDA (Food and Drug Administration) has issued a warning that Abilify, an antipsychotic drug used to treat bipolar disorder, schizophrenia and tourettes, has been found to have side effects which cause a lack of impulse control in some individuals. It results in compulsive behaviors such as spending or shopping, gambling, eating and sexual activity. Although they are rare, the FDA is still requiring that these side effects be listed on Abilify’s label.   Once the medication is stopped, the symptoms disappear.

By no means should anyone stop their medication without discussing it and working out a plan with a doctor.

These side effects are the very things that we are taking our meds to avoid. We want to steer clear of those manic and hypomanic type of behaviors. Findings like this it just reemphasizes the importance of being self aware. It is important to keep a running record of our meds, their dosages, any changes positive or negative and the start and stop dates. If something doesn’t seem to be working right, we can go to the doctor’s office armed with this important data. S/he will see that we have been doing our homework and, with the detailed records, s/he will be better able to help us. I certainly can’t keep all of that data in my head. I must write things down or I forget half of what I want to bring to my doctor’s attention during my appointment. I keep the record for not only my psychiatric meds but those prescribed by my family doctor as well. It serves me well.

You can find the FDA report online—I checked it out. https://www.fda.gov/Drugs/DrugSafety/ucm498662.htm

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Today is very special. It’s our anniversary. My husband and I have been married for 44 years. He stuck by my side through the best and worst of times. He’s a gem.

During the worst of times, when my bipolar was out of control, I didn’t feel I deserved him. I felt I was ruining his life. I wished I could die so he’d be rid of me and wouldn’t have to put up with my roller coaster moods anymore. During the worst depressions I would often think of ending my life. I figured that he would hurt for a while but then he’d realize that he was free from living through my hell with me. I tried to shield him from my moods but he could read me.

There were four occasions where I actually planned how to commit suicide and was ready to go through with it. I had promised my husband, that should that day come, I would tell him. I kept my word on each occurrence and he took me to the hospital for help. The last time was the charm—the doctor in that hospital put me on a combination of meds that nearly eliminated the cycling moods. The hypomanias have been eliminated completely. The depressions are now very few and shallow. They are pretty easy to control and keep from escalating. It’s been two years now and I’m still doing very well.

My husband fought this battle right beside me. He never gave up even when I wanted to. Communication was the key in our getting through it. He kept me talking and sharing what I was feeling and going through even when I didn’t want to but wanted to shut down. Those talks gave me the strength to dig deeper for tools to overcome and push through.

I know there are a lot of people out there with bipolar who feel alone, unlovable and that you will never know what it feels like to be well again. That is the greatest lie this disorder can tell us. It is the depression talking. It’s also the frustration talking. If you have a family member or close friend who you can talk to, share what you experience with him or her but initially do it when you are in a semi-controlled state if you can. You’ll be less emotional and make more sense. Our loved ones can’t help us if they don’t understand. The only way they can get a sense of what bipolar or depression is like is if we share and give them the information so they can learn. Direct them to websites that educate about bipolar. Let him or her come to an appointment with your psychiatrist for therapist so s/he can ask questions and learn. We need all the help we can get otherwise it’s a long and lonely journey.

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I’ve now enjoyed 10 months of stability. I finally know what “normal” feels like aside from the side effects of the drugs I’m taking. When I’m feeling good I often think that perhaps I don’t have bipolar at all. I blame myself for making bad choices to cause the mood swings. In reality, that thinking is hogwash. I had mood swings even when I made wonderfully good choices.   At times like now, when I’m feeling very well, I sometimes think that it would be an awesome thing if researchers actually came up with a test for bipolar and other disorders. Perhaps I’d find out I don’t have bipolar at all! My mind will run with that thought in spite of the mood chart I’ve kept for the past 6 years that documents rapid cycling mood swings. I’m told this kind of thinking is a normal occurrence among those of us with bipolar.

I’m sure that many of you have experienced wishing that a definitive test would be discovered to correctly diagnose us.

The Test is in the Works

A blood test is being worked on that would identify a biomarker in psychiatric patients.   This test could pave the way for improved treatment. Imagine what a great tool this could be for diagnosis and treatment. Xianjin Zhou, PHD, assistant professor in the Department of Psychiatry at the University of California, San Diego School of Medicine along with several colleagues is doing this study. You can read more about it here: http://www.psychiatryadvisor.com/mood-disorders/new-biomarker-earlier-detection-mental-illness-women/article/422105/

I would like to see that test perfected and approved for use soon for others who need a diagnosis or to confirm or disprove one already made.

I will continue to keep myself grounded when my mind takes the “I don’t have bipolar” trips. I know from my mood chart and my journal notes that my psychiatrist got the diagnosis right.

 

 

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After fighting a deep depression for 1½ months, I finally came out and settled in at “normal”.   After a few days I should have been very pleased but I was frustrated. I felt bored. Totally and hopelessly bored and I didn’t know why or what to do with myself.

I had an appointment with my therapist. We talked about my sleep problems, I’d been getting only a couple of hours per night for a few weeks and by afternoon I would feel starved for sleep. We determined it was either my new meds causing it or a rebound effect from coming off the old meds if they helped me sleep.   It could also be a combination of both.

Finally, I told her how bored I felt. She asked me what I have been doing and I told her it was just the same routine stuff—nothing had changed. She said, “Oh, but it has.   How are you feeling?” “Normal.”, I said. And then she blew me away. She said that “normal” has left me with nothing to work hard at. When I’ve been at anything but normal, which is usually most of the time, I’ve had to work hard to continue to live a normal productive life.   It can be incredibly hard work but now I had nothing to work hard at, just routine chores or errands. She was right! It made perfect sense.

I’ve achieved 12 days of “normal”! And I feel free and content. Boredom fled when I realized the reason for it. This is bliss and I have to believe it will stay this way. I know in reality the odds are stacked that I’ll slide up or down again. But negative thinking brings me down. The work now is to stay positive, believe for the best outcome and live in the moment. That’s not very hard work at all.

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There is a great debate, and yes, even shouting, about the issue of medications vs. no medications for treating mental illnesses. And I am addressing bipolar in particular since that is what I am most familiar with.

I have an acquaintance who has tried the no medications s route by using the holistic methods touted by many and yet she is still suffering.   Early in my treatment, I convinced my doctor that I wanted to go med free because I had reached a point of stability and I was afraid of these powerful drugs and what they can do to our bodies over time. Of course, the rapid cycles started again in spite of having great coping skills and I went back to my psychiatrist for help. The drugs are what had helped slowed my cycles down enough to cope well, and those particular drugs never quite worked the same as before I had stopped them. I had messed up with my meds.

That led to an interesting conversation with my psychiatrist and a great revelation to me.  It was one that I had difficulty accepting.  My argument was the meds cause weight gain, increase the risk of diabetes, cardiac problems and a host of other problems besides the side effects associated with them.  I told him that I’ve already begun to have problems, pre-diabetes for one, and would most likely die younger never reaching truly old age.

My psychiatrist’s response was that I was suffering without my meds.  My cycles sped back up to ultra rapid cycling making coping and life difficult.  There is a high risk of suicide with my deepest depressions; it’s in my gene pool which is a great concern.  He stated that it’s a matter of choice as to whether I want a better quality of life or life with suffering, both of which have an impact not just on me, but on my family too—one positive and one negative. He led me to the conclusion that sometimes we have to give up quantity for quality, and quality is a better choice in this case.

I chose quality and haven’t looked back.  I’ll do all I can to live as healthy a life as possible and I’ll enjoy my family and friends while relieving them of any worry about my overall well being.  Life has been far better for all of us this way.

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Two weeks ago, after spending 5 days following my psychiatrist’s directions to do absolutely nothing but relax, sleep and rest, my depression continued to rage and grow worse.  It’s never been that deep, dark and severely painful for so long.   It was now becoming dangerous.  I was exhausted and my coping skills were breaking down.  I wanted life to end and started noting what we had in the house to do so.  That’s when I knew I had to do something fast.  Something my husband and I had learned two years ago during a depression nearly as bad.

 The Benefits of a Safety Plan and a Pact

After the experience in 2012, my husband and I knew that, because of my being bipolar, a depression of this magnitude could happen again.  We remembered the anxiety he felt when he had to leave the house and I was alone. I remembered the fear of losing control as well as the fear of being hospitalized.  We had been exhausted and afraid because we didn’t have anything to guide us along.

 We put together a plan, a safety net:

  1. I chose a hospital that has a satellite recovery center (treats psychiatric disorders as well as alcoholics and addicts).      I checked it out on the Internet and printed out the web page with their address and phone number.  I also made a second choice and printed it out just in case the first one is full.
  2. I made a pact with my husband and psychiatrist that I would inform my husband when suicidal thoughts start becoming intense and could become impulses.
  3. I made list of phone numbers that my husband would have to call (my psychiatrist’s office, my supervisor where I volunteer).
  4. I tacked my little packet to my bulletin board so it could be easily found.

 Time to Go

Two and a half weeks ago, I kept my promise and told my husband that my skills were disintegrating and the suicidal thoughts were becoming dangerously close to impulses.  I didn’t want to go to the recovery center, but I knew we needed the assurance that I’d be safe.  My husband can’t, and shouldn’t have to, stand guard over me every minute of the day.  When would he sleep?   All it would take is one weak moment in that horrible suicidal depression to do irreversible damage.

I packed a couple of sets of clothes and we headed off to the hospital without anxiety.  We had all the information we needed at our fingertips to get to our destination.  My husband had the phone numbers he needed when he got back home.

Since it was necessary for me to go, I made up my mind that I was going to learn as much as I could for however long I had to stay instead of lamenting over the situation.  I would treat it as an education about bipolar disorder and myself.  Everyone experiences it differently.  This was an opportunity to pick the doctors’ brains.  Luckily, I had 2 psychiatrists who loved to educate patients who asked questions and wanted to learn.  And since I was learning from the doctors, I now have more information to empower me to ride the waves of bipolar.

Just Another Coping Skill – the last resort

I discovered that my Safety Plan was a coping skill of last resort, but a coping skill nonetheless.  It guided us through the emotional confusion when choices for my safety had to be made.  I was in a safe place of my choice with professionals who truly cared.  I received the treatment I needed to help relieve the depression.  My husband’s mind was put at ease.  The Safety Plan worked beautifully.  

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So much has happened since I posted  over a year ago (November 2009) and I’ve finally learned how to live with my condition and live fully.  I am happier than I have been in my entire life.  It happened when I finally realized I had to take full responsibility for my treatment and learning to choose my reactions to my mood swings.  It was a wild ride and a lot of work but I couldn’t be happier with the results.  I am so much better for having gone through what follows.

It’s been a long journey and some of it wasn’t pretty.  There were many changes in medications and combinations of them.  Some did seem to help me through a whirlwind, weeklong family visit in mid-March-2010.  But soon after, my mood took a turn swinging up and down through various stages of depression.  It was awful.  My doctor tweaked my meds again and I became more depressed.  By June 3, 2010 I had sunk to the dregs of depression and by June 7th there was no light in my soul–I wanted to die.

I saw my psychiatrist on June 9th, 2010 and he sent me to a good hospital with a good mental health unit.  After a week, they decided they couldn’t help me.  They dropped all my medications, put me on Wellbutrin and sent me to another hospital’s mental health unit with the hope that giving me a series of ECT treatments would help.

I was in the second hospital for a week and had 3 ECTs.  I was released and over the following week I had 3 more.  It appeared they were helping but I couldn’t remember anything short term.  I remembered nothing of the week in the 1st hospital (still don’t), and little of my stay in the 2nd hospital.  All my memories after that was filled with blanks.  I had to keep lists for everything, for chores to do, to remind myself when I had to go shopping, everything.  I’d forget conversations with my husband shortly after having them.  It took many months to before my brain recovered and I could slowly begin to remember events from the days and eventually weeks before.

Three days after my last ECT, I hit bottom with a death wish again.  The next day I swung up into hypomania & mixed moods for three days, then down to normal for 5 days, then depression for over a week, then hypomania for three days, then depression.

I became angry that over the course of 2 1/2 years I had been through trials with all kinds of meds and combinations thereof, finally ending with ECTs which fried my brain, left me feeling stupid and made simple problem solving impossible.  Originally,  I had been told that my doctor and I would eventually find the right combination of meds to level me out.  During the one time that meds had leveled me out for a couple of weeks, what they actually did was remove my ability to feel–I couldn’t feel anything–no happiness, no sadness-NoTHING, except occasional anger.

By the end of June or the beginning of July 2010, I finally decided I would have to take control of my fate. I told my psychiatrist which meds I refused to take and which meds had to be reduced to lower doses.  I told him I had to feel the mood swings to some degree so I could learn to cope with them and learn to react to them in a healthy manner.  He protested–I persisted.  He was worried and I thought he might drop me as a patient, but to his credit, he stood by me.  We truly became a team.  Slowly we kept reducing the doses of the last few meds I was taking as I learned to live well with the mood swings.

It was tremendously hard work.  I had to deliberately keep my mind focused in the moment, in the NOW, all day, everyday so I could function well and the hypomania or depressions would eventually just become background “noise”.  As I grew more skilled in this, I developed more tools to help myself.  My doctor & I have finally reduced the doses of 3 meds to a minimal amount and I may drop one of them entirely very soon.  I have been living and functioning well, living a full and normal life.  My moods still swing approximately every 2 weeks.  I still feel the depression hit bottom sometimes BUT it is just background “noise”.  Depressions no longer disable me or slow me  down.  Deep depression might slow me just a little bit if it lasts more than 3 days but no one seems to notice. I am aware of where the moods are but they no longer control me.  Rather, I control my reactions and choose to live well.  It has become engrained in me now so I don’t have to consciously think about the cycles and my choices constantly.

My doctor is amazed and happy for me.  He didn’t think my method would work.  He’s read theories written by other professionals stating that living well with bipolar by learning how to choose one’s response to mood swings could possibly be done, but my psychiatrist didn’t believe them.  But my mood chart, our talks and the records/chart he’s kept on my progress are proof of my success and he is both surprised and happy for me.

Along my journey for control and a better life, I have discovered there are others like me.  I found one blog in particular which intrigued me on http://www.psychcentral.com written by Tom Wootton.  He has written three books about his experiences and what he has learned.  He now gives workshops with a team of professionals about what he calls the Bipolar Advantage or getting Bipolar in Order (instead of disorder–get it?)  You can find him at http://www.bipolaradvantage.com.  Reading his books has given me more to think about and discover about myself.  Through his books I gained a few more tools, which helped me realize that I could achieve even greater control than I already had.

I have finally reached a place where I truly believe I have a bright future ahead.  Mr. Wootton, my doctor and I are all realistic knowing that sometimes life can throw awful events in our paths which could possibly cause a setback.  But having learned so much and the fact that I have the tools to get back on track gives me confidence that I won’t lose heart and will recover quickly.

I hope someday to be meds free–and I also know that it might never happen but I’m happy anyway because my hard work has paid off.  And the fact that I’ve found others like me makes me feel my method and my struggle has been validated.

I know my method may not be the right fit for everyone, but I hope that what I have shared can at least instill some hope in people with bipolar or depression that there are some things that they can do to help themselves in addition to taking their meds.  What the doctors haven’t told us is that the meds are not a cure–they just cover up the symptoms to keep them in check so we won’t become overwhelmed.  Right now, there is no cure.  But there is HOPE for a better future and we all the potential to have more control than we have been led to believe.

My advice is, stay on your meds and talk with your doctor–get him to team up with you to help you learn what you yourself can do to work towards your wellness.  We are not all made from the same mold so each of us has to discover what tools work for us for ourselves.  We may not all achieve the same results but I do know each of us has the capacity to make life at least a little better.  It starts with baby steps and the desire to succeed at living.

I wish you peace, success and sunny days.

Godspeed,    J

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