Tag Archives: medication

Three Months of Freedom. I’m Back.

It’s been three months without thinking about Bipolar Disorder. Three months ago my psychiatrist started to think that I could potentially be Borderline Personality Disorder comorbid with Bipolar Disorder, it’s taken me two months to even acknowledge this. Borderline Personality Disorder can often co-occur with Bipolar disorder, having numerous overlapping symptoms. My psychiatrist sees the disorders linked in some people, existing on a mood spectrum where they interconnect. I’m against this analysis, I was mad, I’m still a bit mad. I slowly began to take myself off my medication. I cancelled all my other upcoming appointments, in my mind it was a big f*** off to mental health. I was good, I was on university holidays, no stress, nothing to trigger mood instabilities, and it was nice. University went back 4weeks ago, so I took myself back to the doctors, my psychologist, in contrast to my psychiatrist she doesn’t believe I’m BPD, but reaffirmed her belief that I need to monitor my moods and stay on top of my emotions. My psychologist forced the importance of Bipolar Disorder awareness back into the forefront of my mind. I’m still medication free, but the reality of mental illness is scary.

For anyone else who is or potentially has both Bipolar Disorder & Borderline Personality Disorder.

Development/Nature of the Illness:

Borderline personality disorder is a type of “personality disorder” which essentially means that it is a developmental condition – something that has evolved through the entire development of a person’s emotional/behavioural infrastructure.

Bipolar disorder is an illness that presents acutely or sub acutely (less than acute) sometime in a person’s life and is not, at least as we define it now, a condition that is part of a person’s core personality structure.

Course/Presentation of Symptoms:

Borderline symptoms are present as a person’s baseline– their difficulties with mood regulation and impulsivity, their ups and downs, are part of their life all the time. They are always up and down.

Bipolar symptoms present in episodes that must be a change from the person’s baseline – that is part of the diagnostic definition. Their episodes of depression or mania are a change from who they are when they are feeling well.

So the most annoying part of all of this: HOW CAN I BE BOTH! Uh… Having to exist on a spectrum with both, I don’t exhibit all symptoms of either.

Would love to hear from other people’s experiences.

Hope everyone has been well and happy. Love Alice.

*image by ahermin

Euphoric or Dysphoric? Ramblings… I’m Probably Nuts.

Looking at this post in the daylight I can definitely tell it’s been hypomaniacally induced. Sorry to anyone who read this post earlier, to those reading it now – it could’ve been worse.

*CRINGES* What an awful week. It’s been is an emotional riot, my emotions lashing out, stress setting them free (or the anti-depressant which has been added to my cocktail…), the dissent is definitely making itself at home.

I’m pretty sure I experienced a hypomanic episode for all of one day, I think. Wanting to rearrange all my furniture at 9pm at night and starting to sand back other furniture for my DIY projects is usually a giveaway for me. It’s like I have to do something, but not any of the things I’m meant to be doing (sorry university work, you will still be there in the morning). After recognising this and my annoying/over the top behaviour which my partner told me was annoying, not to mention talking too fast and having snowball like ideas – they are always great ideas, anyway – point being I quickly took all my medication because I didn’t want to sleep (doubling the sleep meds) and proceeded to knock myself out. Waking up the next morning I felt extremely normal, except the following days I became so discontent that I’m just not happy with anything, it’s usually furniture (I swear I can be obsessive compulsive sometimes). I’m still discontent, I don’t want to go home and deal with my head being even more unhappy. I’m currently in my university’s 24hr library at 1am, who needs sleep anyway?!

I actually had a point to this post which wasn’t meant to be drowning in my current whinging and whining state. POINT: I liked to believe that to experience hypomanic symptoms you were meant to have the episode for 4+ days, they failed to mention that these mood extremities could take place daily and leave as quickly as they came without being classified as an ‘episode’. Some people only experiencing (hypo)mania once, others (apparently) have daily mood swings regardless of their diagnosis into our ‘categories’, each individuals pattern is distinctive. My only hypomanic episode was one which lasted around a week, I’m now realising that other times I have experienced the same symptoms for shorter durations – “hypomanic episodes tending to last a few hours or a few days”. I’m under the firm belief that I don’t have rapid cycling; instead I have fluctuating moods based on stress levels.

John Preston, PsyD, Psychology: “During euphoric hypomanic episodes, people have a heightened sense of well-being and are very productive and gregarious. During dysphoric episodes, people are agitated, pessimistic, and restless.

Even people who always take their medication and are careful with their health can still have mood swings from time to time. That’s why it’s important to catch changes in your mood, energy levels, and sleeping patterns before they develop into something serious.” – What arseholes.

People with bipolar disorder are seven to eight times more likely to experience an unwanted, extended period of extreme mood shift — failure of their usual coping mechanisms — in response to a stressful life event,” says Dr. Bennett.

Ramble: Appetite suppressants have been linked to manic episodes…great, no quick fix skinny pills for me then.

Interesting abstract from a site I found:

“Anxiety, mood and energy, all waving up and down, sometimes with each other, sometimes one going off without the others:  a total mess, right?

People with such instability have big changes in their mood, or energy, or creativity over time. Here the green curve represents mood, the red curve represents energy, and the black curve represents “intellect” (speed of thought, creativity, ability to connect ideas).

KraepelinWavesAs you can see, if they all go up together — and far enough “up” — this would be what is commonly called a manic or hypomanic episode, as shown at point A on the graph. If they all come down together, far enough, that would be an episode of “major depression”, as shown at point B. But now we can see how “agitated depression” could be part of a bipolar problem, when the energy curve is up while the others are down, as at point D.

Point C represents an unusual combination usually recognized only on inpatient psychiatry units, when a person is agitated yet hardly moves, so-called “manic stupor”. But imagine what a milder version of this would look like: the person would know she needed to get moving, indeed she would be thinking of many things she needed to be doing, and she might really want (in a very powerful way) to be doing them, and yet her body would refuse to go along. She would be lying there on the couch, miserable yet not really depressed, wondering what was wrong with her and why she couldn’t get herself going.

Point B represents another very important combination we psychiatrists see commonly: the energy wave is up, but the mood wave is down (in this case, the timing is such that the intellect wave is up too, but not as high as the energy — yet there are many combinations, as you’ll see in a moment). This could be called “dysphoric mania”: energized, as in a usual manic phase, but mood is very negative.”

**********

Okay, new point:

  • Bipolar Disorder is clearly handled with medication first, bipolar-specific psychotherapies coming second.
  • Self-harm: Isn’t always about the excessive depressive/self-hate/suicidal times, sometimes it’s an attempt to ‘treat’ severe agitation or as a punishment. The behaviour often disappearing quickly when the agitation is reigned in.
  • It’s getting sadder, the more I have to face my own reality, I can’t deny Bipolar Disorder anymore, it’s becoming too blatant and overbearing
  • Caffeine can cause hypomania ‘like’ symptoms…yay…
  • Current evaluation: I get super excited for particular activities (DIY/buying furniture etc), start doing a bunch of things, only to run out of steam, spending way too much money, asking myself why am I doing this?! I have much more important other things that need to be completed – needless to say, I’m here typing instead of doing all the important things, looking up journal articles about Bipolar Disorder to seek comfort in knowledge.

♩ ♪ ♫ ♬ ♭ “Everything that kills me makes me feel alive…Everything that drowns me makes me wanna fly” ♩ ♪ ♫ ♬ ♭

Medication: 400mg Lamictal, 25mg Quetiapine & 3mg Haloperidol. Mostly taken consistently.
*image by angrymikko

 

Dear Sleep: You Suck. Love Alice. (Happiness And Other Stuff, You’re Still Cool)

Are you coffee or vodka? Maybe you’re both. Happiness, hormones and sleep. 

Swallowing my sleep chemical cocktail, wishing it was wine. The booze was better than this tablet induced hangover. My elusive sleep plagued by parasomnia.

1 tablet
Nothing.

2 tablets
Nothing.

3 tablets
Nothing.

4 tablets
Sleep.

On the bright-side I’ve taken a proactive approach towards a healthier lifestyle…minus the drugs, but other than that I’ve been exercising and eating right. Fighting the bulge of medication, 1kg at a time. Life is better, the positives out weighing any negatives. I know I complain a lot about medication, but truth be told I’m too scared to go off them, afraid that it might ruin my nice new balance I have going. I’m vain enough that I care about my weight, my BMI normal, but that is never enough, I’m a perfectionist, I want my mind and body to reflect my current happiness. Sometimes it’s a hopeless intangible pursuit, other times anything can be possible. I’m writing less, no longer driven by the need to put my emotional turmoil of feelings into words, no longer motivated by depression. Depression makes good writing. Whinging is unbecoming, but it is also the recognition of dissatisfaction. Maybe I am just on the upwards spin of the bipolar spectrum, but all the same: I just don’t care; life can be good without it having to be on any emotional spectrum.

In the context of Bipolar Disorder there are high comorbidities associated between perfectionism/ anxiety and their relationship with bipolarity. Bipolar Disorder has a high co-occurrence with eating disorders, eating disorders often linked with a need for perfection. I’m not sure if people diagnosed with Bipolar Disorder have a higher likelihood of being perfectionists (would love to hear people’s personal experiences), the perfectionism of Bipolar Disorder is often motivated through anxiety, anxiety causing the person to see the inadequacies of their life. More often than not, binge eating is common among people with Bipolar Disorder, I will admit I have binge eaten, often in the search for a quick endorphin fix which will starve off negative emotions for a short time. The quick “fix” of endorphins can be seen through, sex, drugs and over eating/exercising, becoming a quest for endorphins. We try to manufacture our own happiness, these addictions often a response to depressive emotions. Through endorphins we experience contentment and euphoria. Realising that you can’t be a seeker for the bigger endorphin rushes, endorphins should become a more natural balance to encourage long term contentment.

endorphin_by_lepusplus-d80chg6Apparently people who are deficient in endorphins should eat protein with each meal, but I’m not sure how scientific that belief is. However, dopamine is released by foods with high protein, dopamine being a positive mood enhancing hormone. Looking at the more natural ways to deal with anxiety/depression – sunlight (serotonin),  exercise (endorphins), protein (dopamine), Phenylethamine (chocolate) and Ghrelin (for relief of stress – released when we are hungry, although this needs to be balanced by normal food intake, over-eating doesn’t maintain good levels). All these hormones can only be long term effective if you fix the root cause of your unhappiness, over doing it with any one hormone will not be beneficial in the long run. Moderating and persistence is key.

This was meant to be a post that focused more on sleep, as usual I get side tracked, and I also intended the post to be short…whoops.

Image by ElusiveDreams07 titled ‘Sleep Paralysis’

Image by Lepusplus titled ‘Endorpin’

Setting The Fox to Guard The Hen House. The Blind Leading The Blind. Psychiatry’s Grand Confession.

I don’t understand how I’m so late to this uptake.

Psychiatric drugs are now a commodity, consumers passively learning to live with and in many instances enjoy. Discovered by accident and lacking an explanation in relation to why they worked. Initially it appeared that psychiatry had found magical pills which ‘fixed’ depression. Doctors attributed the success of psychiatric drugs to chemical imbalances in their patient’s brains which were fixed as a result. Friedman told Times readers, “just because an S.S.R.I. antidepressant increases serotonin in the brain and improves mood, that does not mean that serotonin deficiency is the cause of the disease”.

I now see my psychiatrist as my state-licenced drug dealer. Specialising in ‘mood-altering’ drugs just like street dealers. “Irving Kirsch’s meta‑analysis of antidepressant trials revealed as being just as efficacious as the SSRIs was … heroin”. The chemical imbalance theory is a sham; used merely to reassure people.  No test result can demonstrate that your brain has a chemical imbalance. The pharmaceutical companies appear to have no idea how exactly their psychiatric drugs work, with no confirmable tests that there is a chemical imbalance.

I have always said that psychiatry and psychology were areas of grey, I misunderstood that our complete diagnosis was based on theories and not concrete scientific data. We are medicated based on our symptoms and the current DSM.  I feel violated by the advertisements, a victim of marketing programs, nicely hiding their lack of knowledge about why their treatments work. I’ve been actively sold repeatedly by the psychiatry industry on the concept that bipolar disorder was a chemical imbalance.

Ronald Pies’ article in Psychiatric Times “Psychiatry’s New Brain-Mind and the Legend of the Chemical Imbalance” acknowledges that the chemical imbalance theory is falsified, merely promoted by pharmaceutical companies even though the psychiatry community were aware that this theory was incorrect. Many patients are given the rationale that the illness is based off a chemical imbalance. The concept of chemical imbalance is definitely last-century thinking, low serotonin levels aren’t likely to cause depression as a study has shown that a normal person depleted on serotonin doesn’t become depressed, maybe an abnormality in the serotonin system instead.

Psychiatry has failed to debunk the chemical imbalance hypothesis which misled public opinion. We have been collectively labelled bipolar, restricted to categorisations and a diagnosed ‘box’ of people with a variety of different aetiologies, believing us to be all the same. It’s becoming an over-common diagnosis; the frequency of both legal and illicit drugs playing a vital role in facilitating mania and the diagnostic criteria for a bipolar diagnosis which has expanded with each new DSM.

I’m going to begin the road to un-diagnose myself, believing that I suffered from Iatrogenesis in relation to drug-induced hypomania. My hypomania was a reaction from anti-depressants, I am aware of the counter argument that I was still hypomanic after the medication had completely left my system, but I still believe there is a point to be argued. I’m going to conduct a new search for holistic well-being and medication free approaches.

FEB 2015 update: A holistic approach has currently failed,  send reinforcements.

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.

________________________

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.

________________________

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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Let It Burn. The Idealistic And Miserable Ravings Of A Self-Professed ‘Mad*’ Woman.

I was covered in blood, by myself, vodka in hand, head not stopping its endless stream. I was sitting in near darkness, candle burning, blade in one hand and drink in the other. I was better than that, I should’ve been better, I will be better. I need to be sober. Need to stop debasing myself, my own self-ruin. I was trapped in the cage that is my mind, banging against the bars as the innately primal instinctual creature, asking myself all the unanswerable questions. Wondering if it’s all worth it. Continue reading Let It Burn. The Idealistic And Miserable Ravings Of A Self-Professed ‘Mad*’ Woman.

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.

543b6ddca859ca0f2c214a7975e0ae7d

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.