Tag Archives: bipolar 2

The ‘Poster Patient’ of Bipolar Disorder.

When you’re considered the ‘poster patient’ of Bipolar disorder…

I see all my doctors at regular intervals and I take medication daily. That’s the simple side of things, the easy routine and foundations that you are required to build. Depression and hypomania have accompanied me at different interludes, always waiting backstage for the next show to begin. I see myself as so dysfunctional. So haphazard and incapable of maintaining all the demons in check. I’m writing this post because I see myself as all those things, maintaining complete control of my emotions and rhythm is beyond my control, yet my psychologist insists that I’m a ‘poster patient’ for Bipolar Disorder, my ability to be functional when everything has turned on its head. I was so confused when she originally said this. I know my dysfunction, mismanagement and self-sabotage run deep, hence my confusion to the compliment. She referred to how she used me as an example to other patients about what can be achieved. The facts that she presented were right: I have completed a university degree and I am half way through another, I do have a full time job (I work full time as a secondary teacher), exercise, eat regularly and maintain some semblance of social interactions with friends. It hadn’t hit me that this is what is considered to make me less dysfunctional. My moods don’t generally have repercussions on my life, they are damn high mountains to climb over in order to find solace again, but the hike and lightheadedness of the ‘mood mountain’ doesn’t necessarily interfere with my outer world.

I don’t see these facts as things which make me more managed. I am dysfunctional. My ability to manage my life doesn’t make me any less so. As my depression deepened a few weeks ago, I started to have regular suicidal ideations again. Obviously the recognition that the severity of my depression was getting worse, I acted. I wanted to flip the switch. Anything had to be better than those tendencies, those ideations. I have done a lot of research into the vitamin 5-HTP, simply put it can potentially alter the levels of serotonin in your brain which can result in a hypomanic episode. High is much better than being low. Until you’re high….

Then it’s hell, again.

Without going into specific details of my episode, 5-HTP worked by flipping the switch. The worst part about flipping the switch is when you remember how horrible it is to actually be hypomanic at times. My memory had conveniently let myself forget. My mind has the useful ability to allow me to forget how bad things have been at both ends of my imaginary scale, the thermostat of my mind. It’s a protection mechanism, allowing me to move on and forget the consequences of all my subsequent moods. I took 5-HTP for three days before stopping when my head started to *whoosh*. I find everyone’s interpretation of ‘racing thoughts’ to be different, but then again, each episode I have had resulted in ‘racing thoughts’ which were different from previous occurrences. I see these in the following categories: Actual racing thoughts, when you have too many ideas at once – excitement usually accompanies this variation. Then there is the static or *white noise* head background pressure ‘racing thoughts’ which is usually accompanied by irritation and finally there is *whooshing*, when there isn’t an exact thought but your mind is just doing the simple cycle of the washing machine with your ears blocked, accompanied by a bit of depersonalization. It sounds absolutely nuts. Which it is.

I was never meant to be this broken, popping pills, waiting for the next mountain to climb.

At least I know that I can climb and conquer.

People Are Strange. Wine Is Better.

Lately I’ve become so self-absorbed, I’m not happy, I’m not anything, but maybe that’s just how I’m meant to be. We don’t get born into this life to be happy, I guess we get born to experience, whether it be happiness or sadness or anything in between. I have no reason to be unhappy, I’ve tried enough medication to know that maybe this is just the way I’m meant to be, contained in a simple and sometimes satisfactory existence, I haven’t helped anyone, I can’t even help myself.

I miss hypomania, at least I felt something more. Instead I look calm and collected on the outside, my mind constantly trying to stay afloat among the negativity on the inside. Running away will never make anything better, I need to keep reminding myself this. It seems like humans have reached a point where we keep trying to teach ourselves how we are meant to be or feel, but this doesn’t make it right. It’s not like all the other species in the world go to extreme lengths to achieve happiness from an introspective position. I keep plastering a smile on my face, going through the daily motions of the expected emotions, I keep hoping that this will get better. Maybe it will matter later, maybe it won’t, maybe I will just keep drinking my wine, and hoping sleep comes quicker, daylight always keeping the darker notions at bay.

In the altered words of the monopoly man: “Go directly to Depressiondo not pass go, do not collect $200″. Its ok, I never win at monopoly anyway.

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Alice & Her Attempt At Leaving Wonderland.

It’s been cold in your shadow, my shadow. Never having sunshine on my face, your face. I have always been content to let you shine, to let me shine. I always walked a step behind myself. I was the one with all the strength, a beautiful face without a name for so long, a beautiful smile that hid the pain.

Having an epiphany when two facets of yourself become one, the one the world knows and the quiet self-conscious one inside, the one who stared out of the windows of life, not participating, merely watching and wondering why I couldn’t be both.

(Featured image: Girl walking up hill – by me 🙂 )

My new thoughts consist of pretending that I’m the normal person in the crowd, my boyfriend has found out the truth though, he has seen my scars, he holds me, asking me if I’m alright. The quick answer of “yes” always ready. Last night I told him I was fine, that I was bipolar and that it doesn’t affect me. These are the nice lies that I also tell to myself. He tells me that my scars and disorder hasn’t pushed him away, but I always wonder. It’s nice to know that someone doesn’t see me for my scars. My quick smiles use to hide the sadness in my eyes, but now they are simply smiles. I won’t cut tonight, in my mind that chapter is slowly getting closed.

I don’t need the balance that I found in the blade and the simple ritualistic movements. The never-ending perplexity of non-suicidal self-injury. My happiness and depression making me question what really separates the genius from the madman? New ideas and thought processes are created by people living on the edge instead of the norm. I’m stumped that Bipolar Disorder keeps on getting referred to as a ‘beast of an illness’, it is what it is, you make the most of it, the negatives are only what you make of them. Someone once told me that I’m a ‘beautiful tragedy’, it made me completely disheartened, this happened even before my diagnosis, this was an asterism (a manner of deriding another), these conflicting words made me realise that the only real tragedy was them and their ignorant concept of beauty. At that point in life I was incapable of helping or ‘fixing’ myself, yet people asked me to fix their problems…ironic.

There wasn’t any room left for tears. I’m not that person anymore, thankfully. It’s become silly and trivial, I’m 22 and bored with the useless criticisms from myself and others, life is simply too short. Feeling ‘happiness’ has allowed me to no longer feel like the abandoned shipwreck, finding deep inside a small seed of happiness that I could allow to grow. There seems to be constantly different peaks in my life where at times I feel like I’m running an emergency room without morphine. I’m actually happier than I’ve been in over a year, I’m slowly replacing all my excessive black clothing with the colours that I had squashed to the back of my wardrobe, with the purpose of never finding them or needing them again. People start to get in a cycle where they stop believing in the possibility of being happy because the darkness becomes so consuming and comforting. wonderland_by_lacza-d4x7o6f

The Blame Game: Antidepressants Cause Bipolar Disorder?!

Previously the older anti-depressants were notorious for triggering or precipitating (hypo)manic episodes in Bipolar patients, newer antidepressants such as SSRIs, bupropion and venlafaxine, do not appear as likely to precipitate mania. Both the mood stabilisers lamotrigine (Lamictal) and Topiramate (Topamax) don’t carry a risk of inducing mania.  In the DSM-IV and DSM-V (Diagnostic and Statistical Manual of Mental Disorders) stipulates that diagnosing a person with Bipolar Disorder has to fit these criteria:

Criteria F: The episode is not attributable to the physiological effects of a substance (e.g. a drug of abuse, a medication, other treatment).
Note: A full hypomanic episode that emerges during antidepressant treatment (e.g. medication, electroconvulsive therapy) but persists at a fully syndromal level beyond the physiological effect of that treatment is sufficient evidence of a hypomanic episode diagnosis(My note: most* antidepressants other than Prozac are out of your system in a week). However, caution is indicated so that one or two symptoms (particularly in creased irritability, edginess, or agitation following antidepressant use) are not taken as sufficient for diagnosis of a hypomanic episode, not necessarily indicative of a bipolar diathesis.

Very sneaky phrasing of words.

It has been asserted that antidepressants can act as triggers for (hypo)manic episodes in people who have a higher likelihood of Bipolar Disorder (depression, history & environmental factors etc.). It has been argued that having a (hypo)manic reaction to an antidepressant is not necessarily a symptom of Bipolar Disorder, arguing it’s a manic reaction to the antidepressant. This form of argument can only be assessed by being aware of what antidepressant you’re taking, newer antidepressants have very little chance of inducing mania (rare side effect : <0.1% chance mostly). I had initially blamed the antidepressant for causing my ‘bipolar symptoms’, this has now been changed, I was on Mirtazapine (given to me because of a family history of Bipolar I – this antidepressant had the <0.1% chance of inducing hypomania, agitation, aggression, risk taking, confidence, confusion and insomnia. All of which I experienced long after the antidepressant had left my system).

Symptoms of (hypo)mania need to persist after the life of the antidepressant: A manic reaction to antidepressants is not a symptom of bipolar, it’s a manic reaction to antidepressants. Therefore people who have a diagnosis of Bipolar Disorder who have a manic reaction to anti-depressants, doesn’t consequently mean that it’s Bipolar Disorder.  Symptoms of bipolar (hypo)mania are sometimes about being more irritable, edge and agitated, but these symptoms don’t mean it’s bipolar, they are generally symptoms of the antidepressant or its withdrawal. Sometimes it’s about surviving psychiatry. A test study about the activation of (hypo)mania states that it occurred approximately 0.2% (3/1299 patients) of Remeron-treated patients in US studies. Although the incidence of mania/hypomania was very low during treatment with mirtazapine, it should be used carefully in patients with a history of mania/hypomania.

The following symptoms, anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania, and mania, have been reported in people treated with (older)antidepressants for major depressive disorder. Before being prescribed antidepressants your doctor should be aware of your medical history or family history of psychiatric disorders (e.g., bipolar/manic-depressive disorder), history or family history of suicide attempts. To be diagnosed with Bipolar Disorder the new DSM-V has included the criteria that the person has to not only have the presence of elated or irritable mood but also the association of these symptoms with increased energy/activity.

Personal analysis: I’m not sure if I had suffered from hypomania before, every summer I would work out excessively and sleep little, this was only for the past 2years, but after Remeron (Mirtazapine) everything changed. My research was carried out on the premise of proving my psychiatrist wrong in my diagnosis. I had slowly put together my argument until I had looked up my antidepressant and the time it takes to leave my body. I now have to acknowledge that I no longer have an argument; my hypomania lasted well after the antidepressant had left my system and later returned when my mood stabiliser dose was reduced so that I could change medications. If anyone else has doubts about their diagnosis it is well worth the research into the causation of your (hypo)manic episode, if it was from an antidepressant find out how long your episode lasted and the time is takes for the antidepressant to leave your body.

Blame_by_umbra_rockchick

To make up for this realization is the knowledge that I had an awesome day in Luna Park at Sydney, here is some snaps 🙂

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Lamictal (Lamotrigine): A Review. Part II

I haven’t gained any weight from being on Lamictal, it’s a weight neutral mood stabilizer. My psychiatrist has also informed me that it is the only medication I should be on (other than sleep meds), as it targets both mania/hypomania and depression, he also asserts that Bipolar Disorder sufferers shouldn’t also be put on anti-depressants combined with mood-stabilizers. He offered me the quick fix of Lithium when I was on a downward slope, telling me I’d be a ‘new woman’ within a week. I know Lithium is the top-shelf mood-stabilizer, but I’m also shallow and self-conscious enough that I don’t want to get fat. Lithium for me also has negative associations, I use to think of it only being prescribed to those ‘hardcore’ cases, but then again maybe I am a ‘hardcore’ case. Maybe I’m not bipolar, think I might argue with my psychologist on Thursday.

They have increased my dose on Lamictal, it wasn’t doing enough at the time, especially in contrast to Epilim which fixed me quick, but made me gain weight through excessive carb cravings. Overall I think this is a good medication once you get to the right dosage, I think they will slowly titrate my dose up until I have no lows or extreme highs. If you are self-conscious of weight-gain from bipolar medication: THIS is the drug for you, but be aware that you have to increase your dose slowly, so the effects aren’t instantly noticeable. Now I should just focus on losing the weight the other drugs made me gain…not fun.

I have a great appreciation for the ‘crazy meds’ site, giving funny yet knowledgeable and relatable twists on medication. I’ve been diagnosed as Bipolar 2, yet my reaction was more like Bipolar 1. As follows:

4.2  Bipolar 2

Generally considered to be the best drug on the market for bipolar 2. While there are always conflicting data, your mileage may vary, yadda yadda yadda, with its track record for efficacy and other factors, Lamictal should be the first med considered, but not necessarily the first med used, by many, if not most people diagnosed with bipolar 2.

4.3  Bipolar 1

If you take it like the FDA tells you to – after being stable on another med – the chances are pretty good you’ll stay stable. If you start it while manic1 or only mild-to-moderately depressed and aren’t taking, let alone stable, on another med, expect to be bouncing off the ceiling and have your cycling sped up.

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My reaction was exactly like Bipolar 1’s statement, I was taken too quickly off Epilim which was replaced by Lamictal, I guess I migh’t have been completely stable when I made the transition between the two. I was lowering my dose of Epilim and replacing it with Lamictal. I don’t know what happened really, it felt like a low-level hypomania, but with the increased dose I’m starting to feel less agitated, although i sleep extremely poorly and often have night terrors when I do sleep.

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Lamictal’s Pros and Cons

7.1  Pros

The best medication on the market to deal with bipolar depression without the risks of mania or lowering the seizure threshold associated with antidepressants. Weight neutral. One of the safest meds to use during pregnancy. The side effects suck less than the other meds with FDA approval for maintenance treatment of bipolar disorder.

7.2  Cons

That “without the risk of mania” is only after you’re taking enough. You might get a little too happy the first couple of weeks. Easily affected by drug-drug interactions, in spite of being metabolized in such a way that only a few meds should affect it. Can mess with your skin in all sorts of ways that could cause you to panic and stop taking it when you don’t have to.

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Fornicating On The Altar Of My Own Self-Grandiosity.

“Cause darling I’m a nightmare dressed like a daydream”

Welcome, dear hypothetical reader to the reflections of a childlike adult on the bender for booze and bright lights.

One
Lonely girl
Two
Bottles of wine
Three
Hundred apologies.

I swallow the tablet, the sweetness lingering in my mouth, the knowledge that nothing is helping. Continue reading Fornicating On The Altar Of My Own Self-Grandiosity.

Depression Is The New ‘Black’.

Waking up this morning I’m still so drained from the night, the vivid dreams and disorientation of waking from sleep walking. I routinely get on the scales each morning, the scales determining how I will feel about the day. Today they aren’t bad or good; I’m lying in bed knowing that I should take myself to the gym, not understanding why it has become so important for me to be skinnier. I use to become skinny as an act of revenge (obviously a healthy endeavour), not ever for myself really, but at the moment it’s become a compulsion, but why do I need to be skinny, I ask that to myself, yet each day the same routine and disappointment. I eat enough healthy meals during the day and exercise, yet nothing changes.

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Sometimes I like my scars; they show the pain that I’m going through internally. They show the struggles that my mind puts my body through. There are more scars then I remember, thin straight lines, one after the other. I touch them and I can remember the pain. The self-loathing and madness. Today they represent my pain at the moment; I’m becoming more and more discontent, a nasty edge to my demeanour. I’m withdrawing from my friends, preferring my own company. I decided that they were toxic and I needed to clean up my act, but I think it’s become worse. The discontent runs deep, what am I actually aiming for in life? I’m studying to get a job, a job that will take up nearly all my time, to live a life that seems pointless. Living in a stratified society inhibits the achievement of your dreams. In a very abstract view of life as humans our goal is to live and procreate, that’s the bottom-line, yet I can’t see myself wanting that, I can’t see a life where I will be happy. I have no desire to pass on my genes to another generation.

I know that I’m sick and twisted, but I can’t help but enjoy it. It’s a sick sad world. I can feel my hipbones start to show that little bit more, but it’s still not enough. I’m getting high distinctions for nearly all my assignments in university, but it’s still not enough. I’m eating healthy and exercising regularly, but it’s not enough. The discontentment is too deep, too overwhelming. I will not walk along the cliffs at the beach lest I get the same intrusive thoughts from before, the irresistible need to fall. I was so high for so many weeks, guess it was time for that mood to crumble and be replaced by my mental pit of despair. I drink less, party less hard, sit in the sun and exercise, yet why have I suddenly become so unhappy?

HI, my name is Alice** and I’m my own worst enemy and critic, currently enjoying the trappings of my former life. I took my meds today, I take them every day.

Depression__by_shiyagatte

  • I didn’t immediately post this, I wanted to wait and see if this wasn’t just a bad week, that I could ‘make’ myself better again, it didn’t happen. Depression is the new black; I wonder how much of this acute unhappiness we bring on ourselves and the awareness that we are our own unintentional triggers. I always try and be a positive advocate for mental health, consciously aware of what mental state I have arrived at, but sometimes powerless to lessen its effects. I don’t want to be like this, I want to be in control of my mental state of mind. I’m just going to keep trying.