Posts tagged ‘medication’

Anosognosia

I received this link in my email today because I subscribe to the About.com bipolar newsletter. (I highly recommend it)
http://bipolar.about.com/cs/brainchemistry/f/faq_anosognosia.htm?nl=1
This brief article explains one reason why bipolar individuals may not accept that they have a disease, and may discontinue meds as a result of disbelief. It may not be simple denial!

October 14, 2008 at 3:26 am Leave a comment

Being active — but not too much

I’ve discovered something new about my bipolar and what can trigger episodes. In the past I was able to function at a higher level — I could withstand the last-minute frenzy of deadlines, intense classes and studying, caring for small children all day by myself, jet lag and other hazards of travel, and similar stressors. In a word, I could be more active. I did have episodes back then, but they were much less severe and didn’t seriously impair my daily life. And it took a more intense, sustained period of stress to trigger them.

I did not know I had bipolar disorder until I was 33. Like many others, I have stopped and started my medications along the way. I also did not take seriously the suggestions from my psychiatrist on how to adapt my lifestyle. As a result, my condition has worsened.

In the last 6 years, since the serious episode of ’01-’02, my activity level declined (partly due to medication) to such a degree that sometimes I slept several hours a day. I didn’t have a job or any social contacts where I live, I only had my family and some friends I visited in Dallas. I tried working several times but was not able to maintain it. Each time, I became very stressed and compulsive in my work, developed physical complaints such as pain over my entire body, then rapidly deteriorated emotionally, sometimes requiring hospitalization.

Even my home-based job as a freelance writer led me down that path. Earlier this year I began writing web content, and for awhile everything seemed peachy-keen. What I didn’t realize was that I was already entering a manic phase, which leads inevitably to mixed mania/depression and then deep depression. Once triggered, the cycle usually plays itself out, although some effects can be mitigated with medication and lifestyle. I am just now, in August, finishing the cycle which began in the latter part of January.

Now I know I must walk a very fine line. Too little activity, with its concomitant isolation, is bad for me and will cause depression. Too much activity, with its concomitant stress, is bad for me and will induce mania.

This is when I am very, very glad that God cares about me and will help me along this path. I firmly believe that the spiritual nature of human beings must not be neglected in emotional disorders (or any disorders). I encourage anyone with bipolar disorder to turn to the God of their understanding for assistance. Also, examine your life closely, not to condemn yourself, but to see cause and effect. In this way you will determine your own triggers and, hopefully, ways to avoid them.

August 23, 2008 at 6:08 am Leave a comment

The Great Medication Dilemma

A common issue for bipolar individuals is medication — to take or not to take? Lithium, anti-convulsants such as Depakote, and atypical anti-psychotics like Abilify can each prove very effective in preventing and managing the cycles of mania and depression. Most of us don’t miss the depressed times, but let’s be honest, those “up” moods can be really fun and productive! Plus, research suggests a relationship between creative genius and the shifting moods and insights experienced during bipolar episodes. Given these facts, plus the side effects medications can have, it’s not surprising that many of us stop taking our meds periodically.

I can say from personal experience that, although understandable, the decision to stop taking prescribed meds is one I always regret. There are two main reasons: one, stopping the meds usually precipitates an episode, and two, stopping cold turkey results in withdrawal symptoms, sometimes severe.

Four years ago I came to the (misguided) conclusion that, while I clearly had recurrent bouts of depression, I was not actually bipolar. So without talking to my doctor, I discontinued my anti-convulsant and anti-psychotic. I still took the anti-depressant, though, which made the situation even worse since anti-depressants can trigger mania.

For a long time — more than six months — I thought I was okay and that I truly was not bipolar. My behavior gradually became more erratic, however, and over time it was evident, to those around me at least, that I was escalating through hypomania into mania. I had the classic symptoms of expansive and grandiose mood (plus a LOT of irritability), excessive involvement in pleasurable activities, risk-taking, lack of sleep, and so forth. When I took off one day to cross five states for a romantic tryst, my mother did venture to ask, “Are you manic?”

My response was “Well, if I were, I probably wouldn’t realize it anyway!” But shortly thereafter I did realize something was terribly wrong, because I moved into a mixed state of mania and depression combined. Along with the above symptoms I had intense jealousy and fear, bouts of crying, feelings of hopelessness and self-loathing, and other signs of depression. I was very frightened, so I finally asked my pdoc (psychiatrist) for a mood stabilizer. He put me on Topamax — I had been taking Depakote before then — and unfortunately I had significant side effects including neuralgia and hyperasthesia (even the slightest touch or other stimulus to my skin and mucous membranes was extremely painful).

Finally I was on Depakote again, but by then I was well into the depressed phase. Because I was unmedicated in the earlier part of the episode, the depression was long and severe. I self-injured and thought frequently of suicide. I went so far as to make a plan, and was saved from carrying it out just in the nick of time.

I have to admit that there have been occasions since then when I missed up to several days of a medication, especially if I ran out because I forgot to refill it. However, as much as I hate taking the drugs, I know that I don’t want the experience I had before. I might not survive it the next time. And I’m not quite done with this Earth yet!

June 17, 2008 at 1:34 am Leave a comment


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