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