Talking to Your Psychiatrist – How To Guide

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I get really bad doctor anxiety and have trouble saying what I want to say at appointments. I find writing things down as I think of them days in advance helps. Here are some pointers on making appointments with your psychiatrist effective for both of you.

Be honest. This is important. Don’t lie to your psychiatrist. Don’t exaggerate. Don’t hide symptoms. Don’t be embarrassed. He’s probably heard it all before.

If you think a medication is or isn’t working, tell you psychiatrist this and why. It’s important to be informed on your medications. It’s important not to control your medications, because the psychiatrist is the one with the MD and training, but if something isn’t working, you have the right to say so.

Psychiatrists don’t often offer therapy much anymore*, but they do need to know about your life and general health. A psychiatrist is trained in diagnosing mental illness and treating it with psychotropic drugs, or a referral for therapy or other care, like a medical doctor would diagnose a physical illness and treat it with the appropriate care or medication.

Don’t focus so much on your diagnosis, focus on your symptoms(1). The diagnosis is generally used in communication with insurance companies and too many people get caught up in the diagnosis hype. Treating symptoms is most important. Right now, the DSM has just changed over to the DSM 5(2), and things are confusing. It can take a while to reach a diagnosis, so focus on eliminating the symptoms and getting better.

Be reasonable with your psychiatrist. There is no magic pill (I’ve been told this by so many doctors) and you have to work at it, too. Mood trackers, therapy, keep track of medications, go to all appointments. Don’t stop a medication unless you’re having a side effect that could kill you. Some medications require blood tests – get them done. Work with your psychiatrist.

A psychiatrist is a doctor and is going to have good and bad days. There are good and bad psychiatrists out there, trust me, I’ve had a couple of bad ones. Fortunately, right now, I like my psychiatrist. It’s not always easy to change doctors, especially if you’re in a country like Canada (where I am) and there’s a doctor shortage. A psychiatrist should always remain professional and never be rude to you.

*A psychiatrist is a doctor trained in psychiatry with an M.D. A psychologist is more often referred to as a therapist and you spend more time working on issues with them. Very few psychiatrists offer 50 minute appointments with a couch, a notepad and psychotherapy anymore, unfortunately.

 

Signs of a good psychiatrist:

  •  They listen to your concerns and don’t ask the same questions over and over.  They will ask relevant questions, about your mood, your current situation, and current meds.

I had a psychiatrist that asked me, every appointment, if I had quit smoking “dope” yet. I had never smoked “dope” in the entire time I saw him.

  •  They respect your concerns, needs and what you say.
  •  They stop medications if they don’t work, or if the side effects get bad.  I had a psychiatrist bitch at me when I had to stop lithium due to diabetes insipidus. He said I “complained too much”. Same one that accused me of smoking dope. I had two doctors telling me I couldn’t take lithium, and that psychiatrist was being a jackass, he had never heard of the condition. Fortunately, he retired. (Note: I only stayed with him because of how hard it is to find a doctor in this area)
  • A good psychiatrist respects your wishes with medications and doesn’t intimidate you about them. You should be able to be open about medications – you live with the side effects of them and you also pay for them one way or another.
  •  No psychiatrist should tell you you’re going to fail or never get better. If they feel that way, they should refer you.
  •  They should schedule appointments appropriately. Some people need to be seen every few months, some need to be seen more often.
  •  They should have open time to see a patient in crisis. Sometimes they can’t get you in that afternoon, but they should be able to get you in fast.
  • Keeping you waiting for hours in the waiting room is not good. They should also return phone calls in good time. It’s disrespectful and unprofessional not to.
  • You should feel comfortable and not threatened with the doctor.(3)

(1) Talking to a Psychiatrist
(2) DSM5 HomePage
(3) Makings of a Good Psychiatrist on Shrink Wrap

Medications Part 2 – Anticonvulsants

Some anticonvulsants are found to have a mood stabilizing effect. These medications are a first or second line treatment in bipolar disorder, with lithium being one of the first. More modern anticonvulsants often have less side effects. For example, Epival (Depakote in the USA) is great for rapid cycling, when lithium is only partially effective.

The three most commonly used are Depakote, Lamictal and Tegretol, or Trileptal (a newer version of Tegretol). If those fail, other meds like Topamax or Gabapentin can help. Gabapentin also works great for anxiety. Dilantin, one of the oldest seizure medications, is used, but not very often anymore. These are the main medications I’m going to cover in this article, and I’ll add some personal experience to them as well.

Why anticonvulsants?
There is a link between bipolar disorder and seizure disorders, but these medications are made to control seizures. Why do they also control mood?

They calm nerves in the brain, making them less excitable1. This evens out the chemical imbalance. They do take a bit to work and have unpleasant side effects at times. Most antivonculsants need to be “titrated up”(2) With medications like Lamictal, this can be very frustrating. Lamictal is approved to treat bipolar depression, as well, but it comes with the potential, 1/3000 odds of getting Steven-Johnson’s Syndrome3, which, for a quick explanation, is a flesh eating rash that is potentially fatal.

I titrated up slowly on Lamictal in the hospital and one day I broke out in a rash. They confirmed it was Steven-Johnson’s Syndrome and took me off the Lamictal immediately and gave me another mood stabilizer, because even if you’ve never had a seizure before, rapid discontinuation of an anticonvulsant can cause seizures, in very rare cases.

Some anticonvulsants need blood work done, but not necessarily to establish a therapeutic level, like with lithium. Depakote needs blood levels done to check on the liver, as it can be hard on the liver.

Depakote
Depakote is usually the first tried, at least with me, anticonvulsant. It is approved for bipolar disorder and helps with rapid cycling more than lithium, or other anticonvulsants. It is also a first-line treatment with seizure disorders. It has some unpleasant side effects4, it should not be taken while pregnant or breastfeeding, it can cause birth defects. Hair loss, liver toxicity, pancreatitis are other side effects, while rare, they do happen, so this medication must be monitored by a doctor. It can also, ironically, make you suicidal.

My experience with Depakote, the first time, well, it made me suicidal, and I attempted suicide. This landed me in the ER chugging charcoal and my psychiatrist refused to see me after that. They just sent me home and told my parents to hide the pills. I was 17. It knocked me out for the first couple of weeks, but I’m on it now, and I don’t have nearly as many problems. Minor side effects are stomach upset, hair loss, both of which I’ve never had problems with. I currently take 1000mg of Depakote a day in my “cocktail” (Depakote, Luvox, Xanax, Abilify and Benadryl). I’d recommend this drug, it is quite helpful.

Tegretol
Tegretol is similar to Depakote. It used to be an off-label prescription, but has been approved for bipolar disorder under a new name. It is good for mixed states and manic states, and is often used if lithium and Depakote fail6. Unfortunately, it can cause other medications (like antipsychotics, antidepressants, birth control, and more) to become less effective. It can also affect white blood cell count. Trileptal is similar, but newer, and has less side effects. It doesn’t require regular blood levels but it can lower sodium levels in the bloodstream. I haven’t taken Trileptal, but Tegretol made me halucinate. It did come in tasty chew tablets, though.

Lamictal
Lamictal is approved to treat bipolar depression and also works as a mood stabilizer. It isn’t an antidepressant, but it has antidepressant effects. It is considered one of the most long term treatments for bipolar disorder7. There aren’t a lot of side effects, but the ones you get can be bad. There is a potential to develop Steven-Johnson’s Syndrome (I did, because I’m damned like that)3. You need to very slowly titrate2 up or you can end up with SJS or another type of rash that isn’t as dangerous. It works best for Bipolar II.

It starts working when you’re in the 200mg-400mg dosage range8. It can begin working very quickly at low doses for depression. It is often considered the best medication for people with bipolar disorder, but does have it’s side effects. There is a risk of mania, because of the antidepressant qualities. There is the risk of “the rash3”, and a lot of anxiety while titrating up. It can impair cognitive functioning a bit and cause drowsiness. If the benefits outweigh the side effects, this is a good drug.

Topamax
Topamax is an anticonvulsant used for seizures and migraine prevention. It is also used for bipolar disorder off-label. It just went generic, so my insurance covers it, and I tried it for about two months, but the nickname “dope-a-max” comes to mind. Titrating up sucked, I was tired all the time. It has one good side effect: weight loss, but it can cause foods to taste differently. Like pop, Coca-cola just tasted off. It comes in pill or sprinkle form.

It has major side effects at times and can effect congitive functioning, kidney stones/damage, glaucoma, extreme sensitivity to heat and making the blood to acidic9. It is a last-line treatment for bipolar disorder.

Gabapentin (Neurontin)
This is another anticonvulsant drug and also helps with neuropathic pain. It is not effective on it’s own for bipolar disorder, but it pretty handy with anxiety. It can cause suicidal thoughts or actions and has a hellish discontinuation syndrome.

“Neurontin has not been shown to be effective in treating acute mania or depression. In other words, if you’re currently experiencing mania or depression, Neurontin will not be effective in stopping the acute mood episode.10”

There are minor side effects, and it can be added on as a treatment for bipolar disorder, but lithium, depakote and lamictal are better first-line treatments.

 

  1. http://abcnews.go.com/Health/BipolarTreatment/story?id=4396044

  2. Titration is starting at a low dose and adding to it until the therapuetic level is reached.

  3. http://bipolar.about.com/od/lamictal/a/Stevens-Johnson-Syndrome-Symptoms.htm

  4. http://www.depakoteer.com/

  5. http://epilepsy.emedtv.com/tegretol/tegretol-for-bipolar-disorder.html

  6. http://blogs.psychcentral.com/bipolar/2008/08/bipolar-disorder-medication-spotlight-tegretol-carbamazepine/

  7. http://lifeloveandbipolar.com/lamictal-for-bipolar-disorder

  8. http://www.crazymeds.us/pmwiki/pmwiki.php/Meds/Lamictal

  9. http://bipolar.about.com/od/topamax/a/profile_topamax.htm

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.

Medications Part 1 – Lithium

Lithium was a great med for me. I took 900mg of it per day and it stabilized my moods, I was happier, but I gained weight. I went to my GP to see if he could find a reason for my weight gain, and he figured I had type 2 diabetes.

Well, the good news was I didn’t have type 2 diabetes. I have a rare condition, instead, called diabetes insipidus. Type 1 and Type 2 diabetes effect the pancreas and the way the body handles sugar. Diabetes insipidus is when the kidneys aren’t filtering, and it is also known as “water diabetes”.

Basically, I was thirsty all the time and peeing a LOT. I thought this was a side effect from my medication cocktail. Meds dry you out, so I’d drink a lot of water, juice, etc, and well, urinate a lot as well. Seems like a good explanation.

My doctor immediately pulled me off Lithium, no tapering down or anything and it was time to start looking for a new drug. I take Depakote now, but it’s not the same. And coming off Lithium cold turkey did wonders for my moods. NOT.

I didn’t lose any weight coming off of the Lithium. The diabetes insipidus didn’t go away in three months like they said it would. I have a physical tomorrow and am getting referred to a kidney doctor, and a new psychiatrist, as mine is retiring in 10 days. (Thanks for the short notice, asshole!)

Okay, so back to lithium. It is the only true mood stabilizer. Lithium affects the flow of sodium through nerve and muscle cells in the body(1). Sodium effects mania. Oh, I also craved salt like nothing else when I was on lith. I practically needed a salt lick. (Lithium is a salt by chemical structure)

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With lithium, there is a therepeutic dose, found by blood tests, which should be done once a week for the first month or so, then every other week, then every month, every three months, etc. It ranges from 0.4-1.2mmol/L in the blood. Anything lower than 0.4 means lithium isn’t effective, and if you go too high, the lithium doesn’t work either, and you can get toxic from the lithium.

Lithium toxicity has some very unfun symptoms as the following: nausea, vomiting, diarrhea, drowsiness, muscle weakness, tremor, lack of coordination, blurred vision, or ringing in your ears.

Lithium effects the kidneys and thyroid. Both can be countered with other medications, but if it gets really bad, it’s time to discontinue.

Side effects that put up a red flag to STOP taking lithium (with a doctor’s discretion!) are: extreme thirst/urination, weakness, restlessness, eye pain, blurry vision, restless movements in the eyes, tongue, jaw or neck, pain, cold feeling, discoloration in the fingers or toes, feeling light-headed, fainting, bradycardia, hallucinations, seizures, fevers.

Common side effects are a minor tremor in the hands. Everyone noticed my tremor. They thought I was nervous or in shock. It made soldering in electrical engineering very hard. Sometimes there is weakness or lack of coordination, nausea, and itching. I sometimes got nauseous, but the tremor (and kidney problems) were the main side effects I ended up with. My level was ~0.8, which is a good level.

Lithium doesn’t play well with NSAID’s, it can increase the amount of lith in your body by 150% and send you into toxicity. Doctor’s rarely listened to that when I informed them I was on lith. My pharmacy would catch the interaction, call the doctor, and give me something else. Pain in the ass!

Lithium prevents mania, but studies have shown that it is very effective when combined with an anti-depressant for treating depression.

“Upon ingestion, lithium becomes widely distributed in the central nervous system and interacts with a number of neurotransmitters and receptors, decreasing norepinephrine release and increasing serotonin synthesis.”(2)

If you read my article on glutamate here’s another fun fact:

“The University of Wisconsin researchers found that lithium exerts a dual effect on receptors for the neurotransmitter glutamate – acting to keep the amount of glutamate active between cells at a stable, healthy level, neither too much nor too little.”

I’m full of fun facts tonight:

“For the last 60 years, lithium has been the preferred treatment for bipolar disorder, but little research has been carried out to discover how it impacts the brain and the body clock. New research from the University of Manchester has found that lithium strengthens the body clock’s rhythms, which could lead to new treatments with fewer side effects.”(3)

Lithium has been used for 60 years, one of the oldest psychiatric medications. It is incredibly effective in many people, if they can tolerate the side effects. I loved it, but I need my kidneys.

1. http://www.drugs.com/lithium.html
2. http://bipolar.about.com/od/lithium/a/010312_lithium1.htm
3. http://psychcentral.com/news/2012/03/14/regulating-body-clock-may-be-key-to-treating-bipolar-disorder/35966.html

Bipolar Disorder The Latest Epidemic Book Review

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This book looked interesting when I saw it in the Kobobooks store. So I downloaded it and started reading. There were very vivid descriptions of abuse she sufferedas a child, including when her mother hit her so hard with a 2×4 she broke her back, leaving her ermanently disabled after the age of 30 and multiple surgeries that were unsuccessful.

But then.. she starts talking about God and Jesus Your Savior. It starts off small, and then it gets bigger and bigger, until almost every sentence is talking about how Jesus and God will cure what ails us. We should still take our medication (she is pro-medication and pro-therapy, at least, but against ECT) but we need to accept Jesus in our hearts.

Normally I would just close the book and delete it, but for this review I thought I’d keep going because the book is such a clusterfuck. She is abused at home, by her mother, in gruesome ways, and her father turns a blind eye. She is considered the “toad” of the family while her sister is the Princess. She takes out her anger by bullying kids at school.

She has a lot of misinformation on bipolar disorder, treatments, ECT and more in the book. Her belief is that the bipolar disorder was caused by the abuse as a child, but she also has a diagnosis of PTSD and borderline personality disorder, which, to me, seems like the abuse as a child would fit those two diagnoses better. I’m not trying to diagnose her. She also says that schizophrenia is “that one with multiple personalities” which is very untrue, schizophrenia is a thiought disorder, while multiple personalities is now known as Dissociative Identity Disorder and is much different from schizophrenia.

She has a lot of borderline personality disorder traits. She takes risks and abuses her own son. She got pregnant while drinking and doing drugs, so she had an abortion as not to bring a handicapped child into the world.

One big pet peeve in this book for me is that she’ll end a sentence with “it’s often seen in bipolar disorder”. She does this frequently through the book, mentioning symptoms and adding “often seen in bipolar disorder”. Her descriptions of mania and depression are vague and look copied and pasted from a website that hasn’t looked at the DSM. ANother pet peeve is that she says “bipolar disorder is like very bad manic depression.” Manic depression is the old term for bipolar disorder, it isn’t used anymore and isn’t in the DSM. Bipolar is it’s new name.

She has lost chunks of time in her childhood, and doesn’t remember being raped, though her friends and family do. She marries twice, both times in abusive relationships, with her being abused and the abuser. She has one son who turns out all right, but there was a huge custody battle for him.

Because of her broken back she is bound to stay in bed and watches religious videos and Podcasts every day. She goes into detail about her many surgeries, but is very vague about her “suicde attempts” which are basically her taking a handful of pills with a bottle of vodka, and then calling a friend, the police get called, she gets hospitalized for 72 hours.

She says that mental illness is an illness, which it is, but she also says that you can’t blame your actions on your illness. That’s one thing that irks me, when people blame everything on a mental illness. She says to turn to god for sinning, and that suicide is a sin. She also recommends that people see multiple doctors until they get the answer they want.

She knows very little about medications, saying that they contain serotonin and she has too much serotonin in her blood, therefore she can’t take them. This is untrue, because if there was serotonin in our blood, a blood test could have diagnosed many mental disorders years ago. She uses bad analogies and has a very frustrating sense of humour. (Serotonin is in the brain as a neurotransmitter)

This book is more of a self-help book, or “Abuse for Dummies” because she writes so simply. There isn’t much about the bipolar disorder in it. She does have some good advice on dealing with past abuse, and how to handle it after it’s over. I don’t see this book as a memoir, though. It was quite a boring read, and I wouldn’t recommend it to somebody that knows little about mental illness due to her ignorance of a lot of the disorders and treatments.

She warns about allergic reactions to medications, which is rare. She constantly mentions it, though, basing it only on her own experience. She later says that the only way one can get better is to take god into their hearts, to pray, to attend church, to be spiritual. She also uses marijuana to control her bipolar disorder and rages. Her cure for mania? Look it up in the bible.

There is a section on the different episodes of bipolar disorder, but a lot of it has been repeteated again and again throughout the book, with her giving a little bit of input on her personal experiences. I was expecting this to be a memoir, rather than a (bad) information book. It is getting to be a really frustrating read.

She assumes that bipolar disorder stems from abuse, that the abuse causes the chemical imbalance. She also assumes that doctor’s give too many medications, but she encourages researching medications and being knowledgeable about them while they are being discussed at a doctor’s appointment. Another frustrating aspect is her misinformation on ECT, something she refuses to try.

All in all, this book sucks. There are a few things I agree with, that bipolar disorder is overdiagnosed, that medications are good, therapy is good and abuse in childhood can bring major prolems in the future. The book is just very disorganized and not a memoir at all. Not what I was expecting. I don’t recommend it. I couldn’t even finish it.

ECT and Me

I said I wouldn’t post personal experiences, really, on this website. Just research and opinion. But here’s my story of undergoing electroconvulsive therapy in the summer of 2008. I had 1 bilateral (both sides) and 5 unilateral (one side) ECT treatments.

ECT is often known as “shock therapy” and the mind goes to “One Flew Over the Cuckoo’s Nest”, Sylvia Plath and other scary sounding stories. In truth, it’s a safe procedure. This is how it’s done:

The patient is put under with a short acting general anesthetic via IV. Muscle relaxants are put in through the IV as well, and a blood pressure cuff is attached to one arm, so they can see fingers twitching to see if you’re having a (tonic-clonic) seizure or not. They may also record brain waves (EEG) to tell the duration of the seizure.

Dosage, duration of the seizure, type of anesthetic and muscle relaxant are determined by the psychiatrist in charge of the patient receiving ECT, as well as the anesthesiologist. Bilateral means they shoot electricity through both frontal lobes. Unilateral means they only go through one, which reduces memory loss.

The hospital I was at, St Joe’s in Hamilton had assessed me thoroughly before deciding to go ahead with ECT. It was 100% consensual and part of the reason I had been sent to that hospital. Nobody forced me into it, I signed a lot of papers and I had several counselling sessions. I was inpatient at the time and released shortly after. I met with my social worker and psychiatrist, who agreed with going ahead with ECT. He then had me meet with the ECT psychiatrist who gave his opinion of me to the pychologists and my psychiatrist at the hospital.

It was a go. I suffer from sinus tachycardia, so I underwent an EKG, echcardiogram and Holter monitor to make sure my heart was health and could stand up to the anesthesia and seizure. The seizure only happens in the brain and sometimes the fingers, the body isn’t jerking around, like the movies like to portray.

It was a surprisingly easy procedure. The nurses were not allowed to give me any medications that stop seizures (such as anticonvulsants like Depakote, or my regular Valium) at night. I was not allowed to eat or drink after midnight, and around 5am the ECT nurse came and gathered the patients going for ECT and we would pile into the St Joe’s van and go to the main hospital at the bottom of the hill.

We were to undress and leave only underpants on, no bra, and put a hospital gown on, open in the back. We were assigned a gurney numbering who was up first. It was done early in the morning because they used the Recovery Room for post-surgeries, and at that time, it was least busy. We were on the tenth floor, and went far down for the Recovery Room, in order. I was usually third out of six or seven people.

It is nerve wracking and very scary. I declined a sedative from the nurse, and a small-bore (little needle) IV was placed in my arm and a saline drip started. They covered me in hot blankets and we took the elevators down to the Recovery Room and waited. The noises were scary, you could hear the machine screech. I always wished I was first, so I didn’t have to listen to it. Some people, mostly smokers, had to have some suctioning done in their mouth from things coming up. You could hear the gurgling.

We wore oxygen masks, and when the ECT doctor, anesthesiologist and nurse came to the bed it was switched to an AmbuBag being pumped by a nurse. The ECT doc was always friendy and the anesthesiologist put me out quickly and painlessly (some people report intense pain after being given the anesthesia, before they go under, but this has never happened to me and I’ve been under general anesthesia 8 times in my life) I don’t remember waking up.

The whole thing takes about 5-10 minutes. I remember eating a muffin, being given tylenol for the headache. Some people said they had headaches so bad they needed morphine, but 2 Extra Strength Tylenol did it for me. I remember bumming a smoke from the ECT nurse while we waited for the van to take us back up the hill. I also remember a breakfast burrito, which has turned me off from them since.

I don’t remember a lot of detail in that month I was being given ECT, it is very fuzzy. I had written down all of my computer passwords and important information, but I didn’t lose any memories. The worst was when a rec therapist made me go put a scrapbook together one day. She did get in shit because patients were supposed to, and allowed to, rest all day after ECT. I would come back on the ward, take my medications and go to bed for the day. I had 6 treatments over 3 weeks.

Would I do it again? Most definitely, it brought me out of a crippling depression nothing else would touch. It has made my high’s lower and my low’s higher. I have’t had a full-blown manic or depressive episode since then. I still have mood episodes and I take medication, but not nearly as much as before, and it works better.

It is a serious procedure, because of the use of general anesthetic, but I’d rather get zapped again than go to the dentist. At least you’re unconscious for ECT! One woman in my room went from catatonic to being very active, talkative and started eating again after a few sessions. I saw it help people, and I saw the benefits in it myself. The ECT doc told me that ECT is about 85% effective in treatment resistant mood disorders.

Madness: A Bipolar Life Book Review

Madness: A Bipolar Life

I first read Madness in 2009 after putting it off for a while. I saw the book when I went into Chapter’s, in my favouite section, Biography, and I would pick it up, read the back, and put it down. I enjoyed Marya Hornbacher’s first book, Wasted (a journey through her eating disorder) and thought it would be similar in content, and therefore a waste. I was very wrong. I read the prologue and was shocked at the detail. It could be very triggering to those that self injure (SI) but it caught me, and brought me into the book.

She wasn’t telling somebody else’s story. She was telling a first person account of her time with madness. I could relate to her (because I’ve been diagnosed with bipolar disorder, type 1, rapid cycling) and see myself in some of her passages. Her struggle to find the right medications, to get a correct diagnosis chimed in my brain, I’ve been through that. Others have been through that too, her experience, though not terribly common, has been experienced by many others in the grips of bipolar disorder.

Her writing style is quite simple, it isn’t a hard book to read, it’s quite easy, which makes it more appealing, especially if you have a short attention span. She makes you want to go on, to read more, to know “what next?” She brings you through her intense mania’s and wallowing depressions and at times, you can feel the sorrow and the joy, the irritability and the rage.

With her own experience she shows someone what not to do. She shows how her drinking affected her already prominent bipolar disorder, even before it was diagnosed. She shows how it affects relationships, functioning, finances and everything to do with every day life. She pulls through, managing to keep writing through her dramatic mood episodes and make a living for herself. She ends the book not cured, but in a way she shrugs off as, “everything’s okay”.

This book I would recommend to someone who is suffering from any style of bipolar disorder, to family members, friends, spouses. She uses humour and descriptive writing to show her personal story. This book covers practically everything about bipolar disorder in a first hand experience. Even ECT is brought up in this book, a controversial treatment (electroconvulsive therapy, something I underwent in 2008, it changed my life, formerly called “shock therapy”) is described in as much detail as possible and shows the positives and negatives to it.

I wish I had picked up this book the first time I saw it. It has incredible insight into one of the most serious forms of mental illness and shows you that you can get through it. I give this book 5 stars.