I suck. And I’ll start updating more, too.

August 1 2008 I had been discharged from my longest hospitalization.

form1

October 7th, 2013 I was hospitalized until October 24th because the stress of life, the universe and everything kicked in and I broke down. Of course, no beds on my Dr’s unit, so he loopholed me through PERT – Psychiatric Emergency Resource Team. They had an emergency room physician come in and put me on a Form 1. 72 hour involuntary hold. Dr N, my pdoc, was not impressed. He took me off it when I was transferred to Unit B, the ward he works on. I was a danger to myself. What crap.

I had a panic attack when they handed me the Form 42 (copy of the Form 1). PERT is just seclusion rooms. Luckily, I wasn’t locked in. They nurse gave me some Ativan and a heated blanket. I slept. BF showed up. He brought McDonalds. My friends took my car back to the apartment. The next day I was transferred to Unit B, where my pdoc works. I had a private room. It was BF’s birthday. He saw me anyways. I owed him big for that!  They tried to give me Ritalin at 10pm, night meds. I refused it. They charted I was “refusing meds”.  My pdoc laughed the next day, thankfully, saying it was good I knew to refuse Ritalin at 10pm! He then told them to NEVER give it to me after 4pm.

Pdoc was good to me. Saw me daily. I had a pass for Canadian Thanksgiving. It sucked, my dad was drunk and being an ass. It was a short pass, thankfully, I had BF with me. “Oh, back so soon.” Oh, yes. BF went for his MRI results: No change in the tumor since his diagnosis a year ago!! MRI’s are yearly, now. At the best cancer centre in Canada, only 45 min away from us. He had a seizure last night. His neurologist is still working on the meds. Less bad, shorter seizures, but still minor seizures. No unconsciousness, no disorientation, but still.

So, we had a lot of groups. I met a couple cool people. I had a day pass, I went to the barn, went riding.

sparkle

That’s me on Sparkle. She’s a five year old, gigantic Thoroughbred filly. Her registered name is “Sparkle Tangerine”. I did some walk, trot, canter and a small jump. She was very good. Look how tiny I am on her!  I was exhausted when I got back.

I did all the groups. I got so sick of the religious crap from a lot of patients. There wasn’t a lot of super craziness like I’ve seen. No restraints used, no chemical restraints used. A few “code whites” (unmanageable or violent patient) called. I was going to go long term, but the beds weren’t available. Dr N saw staying on the ward was getting hard on me, and we agreed on discharge for the 24th. I start outpatient therapy next Tuesday for anxiety, stress. CBT, that sort of thing. One on one. The only cost is parking.

I now take Geodon (aka Zedox), Lexapro (Cipralex), Ritalin, Topamax, Clonazepam, mostly at lower doses, managing. and my normal meds for my health. I was diagnosed with endometriosis yesterday. BLAH. I start birth control (I’ve had a tubal ligation!!) after my period to try to ease the pain. If not, we do more drastic things. It’s not the worst thing in the world. The ultrasound could have shown a million WORSE things. (Endo is not detected on most ultrasounds) I’ve decided on rotator cuff surgery. Dr N was great to me in the hospital. I thanked him before I left, for his patients. The rec therapists were great. One I’ve known since 2002. We even had a ball pit!

That’s my life for now.

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Mania slowly eats your brain (seriously)

Mania, the horrible mistress of bipolar disorder. We sometimes take it for granted in it’s early stages, hypomania, but in a full blown out manic episode, everything can go to hell. Many people accidentally kill themselves in manic episodes. But did you know, that during an episode, you’re killing your brain?

“Episodes of mania and depression may cause damage to learning and memory systems”(1)

Long term patients showed more cognitive impairment than those younger, or newly diagnosed. Bipolar disorder and time are not your friends. After 5-7 years, the newly diagnosed showed some cognitive impairment.

It can be blamed on medications, but that’s untrue. They can cause cognitive slowing but they aren’t a culprit. Some medications even repair parts of the brain, and are considered to have neuroprotective properties.

The brain breaks down as the disease goes on, and it isn’t able to process information the way it used to. (Remember, bipolar is a kindling disease, if left untreated, it just gets worse and worse, and the damage increases per episode)

“People with bipolar disorder suffer from an accelerated shrinking of the brain”(2)

Gray matter in the brain is lost during an episode, in the areas of the brain that control memory, face recognition and co-ordination.

“Evidence has been overwhelming that bipolar disorder is a disease of the brain, like Parkinson’s or MS”(3)

Those with bipolar disorder have enlarged ventricles in the brain and extra white matter, for example. Impaired awareness (50% of those with bipolar disorder are aware of their disease, diagnosed or not) is because of decreased activity in the pre-frontal area. This is similar to a stroke victim.

Results of MRI’s from the mentally interesting and people without mental illness show that those without mental illness had more gray matter in their brains.(4) Gray matter is consisted of nerve cells. An essential amino acid, called NAA, was monitored in bipolar patients and the amount decreased as the illness progressed, which indicates damage to neurons. These findings are comparable in Alzheimer’s.

In conclusion, if you’ve been diagnosed with bipolar disorder and want to make the best of your life, take your medications, live a healthy lifestyle, don’t drink or do drugs and learn some insight to get proper treatment before an episode happens.

And just remember this: What goes up, must come down.

  1. http://www.healthyplace.com/bipolar-disorder/articles/brain-damage-from-bipolar-disorder/

  2. http://www.sciencedaily.com/releases/2007/07/070720103036.htm

  3. http://www.pendulum.org/disease.htm

  4. http://www.ehow.com/about_5245785_effects-bipolar-disorder-brain.html

Fun Facts About Bipolar Disorder

I hate being bipolar. It’s awesome!

Well, we know that people with bipolar disorder are definitely mentally interesting (I much prefer that to mentally ill) but here are some fun facts I’ve pulled together. I’m writing this for a bit of a laugh, why so serious?

Lithium can make concrete harder and can power small batteries. (Also, when I broke my jaw at age 18, I poured my lithium capsules into cranberry juice as that was the only way to take it, my jaw was wired shut, and it turned the cranberry juice green!) Also, lithium is extremely toxic to humans in it’s normal form. When it is converted to a salt (lithium carbonate) it is safer. (Same with table salt!) Nobody knows exactly why lithium carbonate stabilizes the mood.

Bipolar disorder is often misdiagnosed. In women, they are more likely to be diagnosed with depression (unipolar) and men are more likely to be diagnosed with schizophrenia. I’ve actually been diagnosed with both at different times, but eventually, they just said, “you have bipolar disorder type 1 and schizotypal personality disorder”.

Nobody knows what the hell schizotypal personality disorder is. I went to a walk-in clinic because I had a UTI and the doctor asked why I was taking all these psychiatric medications. I told him my diagnosis and he said “oh, schizo-TYPICAL personality disorder” and I then argued with him for a good ten minutes, because schizo-TYPICAL personality disorder doesn’t exist. It’s schizo-TYPAL. I eventually got my damn antibiotics and he wrote down on my file that I’m schizo-TYPICAL. Is that a good thing or a bad thing?

Us bipolar folks are said to be the hardest to treat. Why, thanks! I guess it’s because we’re all over the goddamn map. Over half of those with a bipolar diagnosis have attempted suicide, and 1/5 do so successfully.

Manic episodes can be brought on by irregular sleeping patterns. Too much sleep? You can end up manic. Not enough? Same thing. I once worked at a restaurant, doing 8-12 hour shifts during a manic episode. I didn’t sleep for 3 days, got some sleep on my day off, and then resumed. I was full blown manic and I don’t remember the details, as with most of my episodes, but I ended up on lots more medication.

Rapid-cycle bipolar disorder means that you have more than 4 episodes a year. Only one manic episode is needed to diagnose somebody as having bipolar disorder. Ultradian (episodes lasting hours to a couple of days; may be phased out in the DSM-5) cycling is extremely controversial and is often mistaken for a mixed episode. (And mixed episodes can also been mistaken for ultradian cycling)

The higher you swing, the harder you fall. (True!)

The hippocampus, which means “sea horse monster” is bigger on the left side of a bipolar brain.

Mania is not always fun. It can be downright devastating. A lot of people with bipolar stop taking their meds when they get hypomanic, thinking that they’re normal and don’t need them, and WHAM, get him with mania. Some things manic people like to do: Spend every cent in the bank, have sex with anyone that has proper ‘equipment’, abuse substances (self medicate), drive recklessly and don’t think of consequences.

Many people with bipolar disorder are more creative than the rest of the population, in such things as art, writing, and more. Some people refuse treatment because they don’t want to give up their gift.

Bipolar disorder doesn’t discriminate on race, religion, sex, gender or age.

 And finally:

We are dazzling, passionate, and adventurous lovers.

Scary Side Effects Part 3 – Antidepressant Induced Mania?

In the 1980’s, bipolar disorder was called manic depression and was a feared word. It was changed to bipolar (two poles) later in the 1980’s and diagnosed more and more. But often, the patient will present with depression symptoms, and get prescribed an antidepressant, which can cause horrible hypomanic, mixed, and even full blown manic episodes. This can be because we go to the doctor when we feel down, not up. After years and years of being bipolar, I know when to see a doctor for mania. (Also called “insight”)

 Mania can feel great, but it can also be dangerous. Impulsivity, people giving away all their money. Then comes the inevitable crash. Many bipolar suicides are accidental during a mixed or manic state. Some may say that antidepressant induced mania is just a side effect, it isn’t indicative of bipolar disorder. There are a lot of controversies about it.

 Some people put on antidepressants are bipolar, but it can have the same effect on somebody who isn’t bipolar. Their moods start cycling(1) and they start showing clinical features and meeting the diagnostic criteria of bipolar disorder. Is this a lasting effect? It can be. The criteria for bipolar disorder is one manic episode, although most have several.

 The findings of this study confirm that treatment-induced mania is a clinical phenomenon that belongs within the bipolar spectrum rather than a coincidental treatment complication, and that it should be placed under ‘bipolar disorders’ in future classification systems.” (1)

Statistics

Thirty-five percent of the patients had a manic episode rated as likely to have been antidepressant-induced. No variable was a predictor of vulnerability to antidepressant-induced mania. Cycle acceleration was likely to be associated with antidepressant treatment in 26% of the patients assessed. Younger age at first treatment was a predictor of vulnerability to antidepressant-induced cycle acceleration. Forty-six percent of patients with antidepressant-induced mania, but only 14% of those without, also showed antidepressant-induced cycle acceleration at some point in their illness. (2)

 Antidepressants can be devastating to someone with bipolar disorder. It can send the patient into a mixed or manic state. Some people are able to tolerate antidepressants such as tricyclics, MAOI’s, or Wellbutrin, but SSRI’s and SNRI’s have a tendency to push you over the edge. However, this may not be true at all!

 

Myth or Mania? Controversy

Sometimes the myth is just an incorrect use of language. Many people have detected a temporal association between the use of tricyclic antidepressants and mania in patients with bipolar disorder, but no mechanism is indicated. There is an assumption the association could extend to all antidepressants despite chemical and pharmacological transformations.(3) 

This association between mania and SSRI’s hasn’t been found. Studies find that the switch rate is no different than that of normal bipolar disorder when the patient is on an SSRI or SNRI.

 Revisiting the Controversy

Mania is likely to be antidepressant-induced and not attributable to the expected course of illness in one-third of treatment-refractory bipolar patients, and rapid cycling is induced in one-fourth. Antidepressant-induced mania may be a marker for increased vulnerability to antidepressant-induced cycle acceleration. Antidepressant-induced cycle acceleration (but not antidepressant- induced mania) is associated with younger age at first treatment and may be more likely to occur in women and in bipolar II patients.”(4)

 

Conclusion

Antidepessants can make a bipolar patient exhibit signs of mania. When the antidepressant is stopped, the mania generally goes away. Antidepressants are often prescribed for those that are bipolar, for the symptoms during depression. (I take Luvox for Pure-O OCD). However, a mood stabilizer with an antidepressant effect such as Lamictal or Lithium would be more effective than adding on antidepressants.

 

There are controversies, so keep that in mind. Also, with any medication and diagnosis: YMMV (your mileage may vary)

 

 

  1. http://psychcentral.com/news/2011/10/13/antidepressant-induced-mania-similar-to-bipolar-disorder/30300.html

  2. http://www.ncbi.nlm.nih.gov/pubmed/7625459

  3. http://thelastpsychiatrist.com/2005/07/do_antidepressants_induce_mani.html

  4. http://ajp.psychiatryonline.org/article.aspx?articleID=171161

I’m Not Crazy Just Bipolar

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The title of this book caught my eye and was the reason I bought and downloaded it. There is a stigma to “crazy” and “bipolar”, and this book explains the high’s and the low’s in the first person, with incredible detail.

Her descriptive writing portrays how she feels at the time the words were written, and it is very relateable if you’ve gone through this yourself. She, like many others, never thought there was anything wrong with her, until she saw it after getting arrested, on video.

She begins the book with an interesting prologue describing how she got diagnosed with bipolar disorder. She was a college student, 6 weeks away from graduating, and the school psychologist caught her in the midst of a manic episode and sent her to the psychiatrist. Her parents were called and they were told to hospitalize her. She refused to be hospitalized and finished her semester, on medication.

She did use drugs for many years, heavy marijuana use and alcohol didn’t help her illness. She eventually turned to cocaine and later crack cocaine, given to her by a boyfriend, and lost everything because of it. She sobered up after that.

She has a good use of dark humour but doesn’t have much insight into her mental illness until much later in her life. When she’s manic, the writing is frantic and a bit disorganized, and when she is depressed, you can definitely tell.

She makes poor life decisions, like meeting a man in Las Vegas after quitting her job and flying there, to find out he’s married. She goes into a depressive episode when her friend and uncle die, then she loses her job, friends, and money.

Her psychiatrist isn’t working out for her, so she goes off of all her medications and sees a chiropractor that insists vitamins, exercise and hypnosis will get her out of the depressive episode. They don’ work and she sets up an elaborate suicide plan, which fails, and she gets into a car accident and wakes up in a psych ward, where she undergoes ECT and there is no improvement because the doctor’s didn’t do it correctly.

During another suicide attempt she is interrupted and stops, thinking it is God telling her not to kill herself. She also lies on train tracks and gets up at the last second. She ends up in a better hospital, which is also a rehab facility, and gets more ECT, done correctly this time, helping with her depression. Her ECT experience is relateable to me, as well.

She is promiscuous and meets a telemarketer that sold her a cell phone. He smokes crack, and they break up. She would frequent a nude beach and it made her feel better about her body, but she also had sex with many men.

She turns her life around, giving good advice for one with bipolar disorder to take. Such as, no alcohol and drugs, sleep properly, exercise, take your meds as your doctor prescribes them, listen to others around you.

I enjoyed this book. It was a quick read and I related a lot.It shows the rollercoaster hell of bipolar disorder and how destructive mania (which many people think is just an elevated mood) can be.