Thursday, April 26, 2012

All About Me!

Unfortunately, 15 years ago I received a diagnosis of bipolar, which happened to be the type of bipolar which is the most difficult to treat. In 1998, three years after initial symptoms developed, the diagnosis of bipolar I, mixed state, ultra rapid cycling, with psychotic features was made.

Having mixed state bipolar is different from being diagnosed with “bipolar” or “major depression.” The reason is a mixed state involves being in a polar opposite symptomatic state. With bipolar and depression, a person is either happy or sad. Being in a mixed state, equates to being happy and depressed at the same time.

So what symptoms for me emerge during a mixed state? When destabilized life becomes a living hell and I would not wish the symptoms on a worst enemy. There obviously are different characteristics of mania and depression. Depression for me is straightforward, I want to sleep all the time, unmotivated, can get very suicidal, and want to be left alone. During a mixed state, I become depressed and manic at the same time! Literally, I can be crying, depressed, and bouncing off the wall manic. My bipolar is not a euphoric mania but a dysphoric mania; I become highly paranoid, agitated, and aggressive. In the past, I have experienced psychotic episodes, and when my mania is severe I have a heightening of senses, I see colors brightly, almost in 3-D, noises are very loud, and there is increased creativity.

Personally, mania emerges in different ways with different types of symptom combinations for each individual. For example while one of the characteristics of bipolar can be going on shopping sprees, this behavior has never happened with me. My bipolar needs to be monitored closely or severe destabilization can occur when symptoms are not monitored. For me, when I am hypomanic, I get hyperfocused on project-oriented tasks that I see as very important to others or myself. This blog is an example of this, it has become an important mission for me to research topics and to help and bond others with mental illnesses together. This blog has also been therapeutic because I am getting everything out in the open in a positive honest venue.

While on one side of the line I am manic, I usually stay closer to the hypomania side and closer to stable (cross your fingers and knock on wood).  When I am in the hypomania stage, it is usually not as severe and can be controlled with medication adjustments. Unless in full-blown mania, hospitalization can be avoided. In the past, I have been hospitalized in a psychiatric unit at least 18 times, two of which were in an eating disorder clinic called Renfrew. I once tried to estimate how much of my life was spent in a hospital, and it added up to approximately 3 years!

Because I have tried to commit suicide 4 times in the past, it is important to monitor my suicidal thoughts. To continue my path of stability it is also important that my psychiatrist, therapist, family, and friends keep a close eye on my symptoms because I do walk a fine line between mania, hypomania, and depression. Sometimes I need an outsider’s perspective since it is easier for folks to observe and notice symptoms that I do not notice.

During hypomania, I get very talkative, whether with my friends, family, or even random folks in public! Along with racing thoughts and jumping from topic to topic, pressured speech and an increase in activity and energy levels. That is why I have been able to write successfully with this blog….I cross my fingers everyday that I do not crash and become depressed and withdrawn and continue on this positive path that I have started.

Even though I received my bipolar diagnosis over 12 years ago, I still ask myself sometimes why me? This disease is highly genetic yet all other members of my family are completely healthy. My husband is bipolar as well, and we have gone back and forth about starting a family. Statistically if one parent has bipolar disorder the odds of a child, being diagnosed with it is 10%. When two parents have bipolar the odds jump to 55-65%!

One of the many questions I have struggled with for years “who am I apart from my bipolar?”Originally, for years I felt treated like Bipolar Betty by friends, family, and not Betty with bipolar. It was frustrating because I did not want to be defined as my mental illness.

Another initial question I asked my psychiatrist was “will I have to take medications the rest of my life?” The answer was ‘yes”. While he did state in the future he might be able to wean me off some of the medications, the fact I have treatment resistant bipolar makes it highly unlikely, and if anything, more medications continue to be added to the medications that I am already taking.

I know I have come a long way with acceptance but sometimes when I am taking my eight psychotropic medications in the morning and evening it gets to me. How can it not? Right?
So let me tell you about my medication regimen. This ironically makes me depressed!

Due to treatment resistance, I have consulted with three of the best psychiatrists in the country who specialize in bipolar disorder, specifically pharmacology. Different doctors have different theories and approaches. It has been so frustrating and many tears shed because I have felt so helpless. I feel sometimes I am knocked down time after time. Luckily, I am a fighter, but after 15 years, it gets harder and harder to bounce back, which doesn’t help with depression.

Currently for my bipolar and other psychiatric issues I take eight medications. These medications include Clozaril, Pristiq, Wellbutrin, Lamictal, Liothyronine, Zaleplon, Clonazapam, and Adderall. These medications facilitate in keeping various symptoms of my bipolar, ADHD, and OCD in check.

The Clozaril and Lamictal are mood stabilizers, which help keep my moods from going up and down, and rapid cycling.

The Pristiq and Wellbutrin are both anti-depressants and assist with preventing depression. It is important to note that unless an individual with bipolar disorder is stable, use of an anti-depressant is risky. Especially the class of anti-depressants known as Selective Serotonin Reuptake Inhibitors (SSRIs).

The Zaleplon is a sleep medication that aids helping me stay asleep, as well as the Clonazapam, which is an anti-anxiety medication, but it helps me sleep as well.

For my ADHD I use Adderall, which can be risky to use for a person with bipolar. This medication if not watched closely, could cause rapid cycling and severe mania. My psychiatrist is constantly monitoring my moods because multiple times in the past after only a week of use I ended up in the hospital destabilized. This medication really helps me focus, and wake up especially since some of the medications cause drowsiness throughout the day.

Lastly, I take Liothyronine which is a thyroid medication I do not have a thyroid problem, so I need to make sure my thyroid stays just below hyperthyroid, but the goal of the thyroid medication is to  aid the other medications to work more effectively, with the thinking those with hypothyroid tend to be more depressed.

Of all the medications, the Clozaril is the harshest. If I do not take this medication around 6pm, I will sleep in late. Over the past two years, my dose has been decreased from 400mg to 150mg and I still sleep 12-14 hours a day. It also requires monthly blood work to make sure that my white blood cell count is normal. This is due to the fact Clozaril can cause deadly reactions.

I once made a list of all psychotropic medications I have been tried on. Of about 50+ medications, I had been tried on all but approximately eight! Some medications I have tried were rough. When I was given Zoloft, I was ready to attack, I was so angry and aggressive it was horrible. Abilify made me feel like I was about to have a seizure. Since Lithium is a salt it made me feel like a marshmallow, I gained 60 pounds, and it was horrible.

I would be lying if I do not get depressed when I am putting my medications into my weekly pill container and when I swallow these medications daily. In addition to my eight psychotropic’s I take seven others for other health issues including asthma, allergies, acid reflux, seizure disorder, and chronic pain, which includes morphine and a muscle relaxer. Because of my chronic pain, my depression is intensified.

So there you have it a brief synopsis of my psychiatric issues! While this blog is about my diagnosis of bipolar disorder, please check back for specific blogs on my other issues, such as my eating disorder, ADHD, and OCD.

Thanks for Reading,

Love Bipolar Betty


Daniel Bader said...

Hi Betty,

Thank you for this quite articulate post. I also have mixed states, though it sounds like they are less severe. That combination of depression and energy is really hard to deal with. I'm glad you mentioned the lights! I also experience light very strangely, especially when I'm in mixed states.

I had a bad experience with Zoloft, too. It made me hypomanic. SSRIs and I just don't mix.

I really like your blog, which I found on Facebook. Thank you for sharing :)

A Piece of My Mind said...

Thanks so much for your comment...please continue to look for other blog topics!! Refer folks too who might be Mixed folks need to stay together!:)