Archive for ‘bipolar disorder’

March 20, 2013

apparently, ‘picking out’ psych meds is like trying out cereal

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Sometimes while  I watch some mindlessly good television or when I listen to some Rich Eisen podcasts, I take online surveys via those sites that pay you for taking them.  Some of the surveys are rather interesting, and occasionally it’s a way to get to know what products may be in the pipeline for various brands.  The other day, I took a survey that wasn’t about shopping, alcohol or cars; it was about bipolar meds—which I’m happy to answer questions about since I’m familiar with many of them.  So, I began the survey only to realize several things, both about me as a psych patient and about the industry that supplies these medications.

One, it reminded me very early on in the survey that I’ve taken a lot of them (see screen shot 1-sorry about the poor quality of photo). The truth is, while I did not check every single drug they listed on this page, I probably may have taken some of those but just don’t remember them as well.  Also, I’m pretty sure I’ve taken other meds not listed on this page that don’t qualify as bipolar meds per se, but are still mood altering.  It was a horrifying moment to see the glowing list in front of me and having to confront my history. But the fun of this survey had only just started.

A few pages after having to confess my medication history, an interesting question was posed to me (as seen on screen shot 2: this one can be magnified): how likely am I to try the following bipolar meds?  They gave me a short list of the newer p-meds out on the market, and asked me to give my inclination toward them. There was no description of the chemistry of these medications, what class of psychiatric meds they’re in, or really anything else.  Just the names.  Like whether I’d try Quaker Oats brand cereal versus ones by Erewhorn.  While I admit that I had already taken most of them on this list, too, it made me almost cringe in having to wonder what kind of patients those of us with mental illnesses have become.

The survey eventually led to showing of several different commercials and print advertisements, and then asked me stuff like my reaction to the commercial, etc.  And then it asked how likely I am now to ask for that particular drug to my doctor.  It was rather insulting that these companies think I’d be persuaded to ask for a drug because their ads looked pretty.  But furthermore, what is the purpose of having a psychiatrist if we, the patients, just point and ask for these medications, like we’re picking out our favorite easter candy? Well, according to this survey, our doctors really have just been reduced, to put it bluntly, to that of a drug dealer.

From taking this lovely survey, two big conclusions were drawn.  As many people already know, the drug company’s job, while it is to help people through chemistry, is to be a profitable company.  And like any product, they will market them to the public as allowed by law.  But perhaps what’s more important to learn for people taking medications is that the responsibility is largely on us,the customer, to be alert about medications being pitched to us like a new cleaning detergent.  It’s hard to be discerning when we’re so desperate to get through another day or even a minute of agony that comes with mental illness. But we really have no choice but to pay attention to what we’re ‘asking for’ or being given samples of by our doctors.  And we should expect our doctor, the person we paid for in order to get their professional advice, to steer us to make informed decisions when taking new meds.

I wish I had taken a few more screen shots of this survey since it was quite fascinating.  But more than that, it made me worried about the direction that the treatment of mental illness is taking in regard to the approach that tries to make us try medications like we’re choosing our next favorite cereal.

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July 29, 2011

Does too much sleep lead to depression?

I’ve been having a really hard time getting up in the morning. I could stagger from the bed to the couch, but I can easily fall right back asleep for hours. It’s not like I’ve been going to sleep that late. It’s gotten to a point where I can sleep even after 11 a.m., which kills trying to get anything accomplished in the morning. Then I’m having a somewhat similar problem at night where I start falling asleep, sometime after dinnertime.  What am I doing wrong?

Apparently, this ‘condition’ could be called hypersomnia (excessive sleepiness, tiredness), and I came across a new study that reported that hypersomnia among bipolar disorder (BD) patients who are in an inter-episode period may predict future depressive symptoms. According to the article in the Journal of Affective Disorders, Allison Harvey (University of California, Berkeley) and team explain that BD patients “in the inter-episode period spend roughly 50% of their time unwell, and these symptoms predict relapse into mania or depression. Hence, there is a critical need to identify aspects of the illness that contribute to inter-episode dysfunction and to relapse.” (Below this post is a shortened version of the article)

So, what am I to do about this? If I fix my sleep issues, would I be able to avoid a possibly incoming depressive episode? This particular study doesn’t answer that question, but I’m hoping that this is the case. If anything, I can go back to getting to sleep around the same time every night and try my hardest to get up at the same time each morning. If that means curing my hypersomniac tendencies as well as ward off future depression, I’m more than willing to follow that rule.

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Hypersomnia in inter-episode bipolar disorder: Does it have prognostic significance?
Katherine A. Kaplan, June Gruber, Polina Eidelman, Lisa S. Talbot and Allison G. Harvey
Journal of Affective Disorders
, Volume 132, Issue 3, August 2011, Pages 438-444

Background
Hypersomnia in inter-episode bipolar disorder has been minimally researched. The current study sought to document the prevalence of hypersomnia in a sample of inter-episode patients with bipolar disorder and to examine the relationship between hypersomnia and future bipolar depressive symptoms.

Methods
A total of 56 individuals with bipolar disorder (51 type I + 5 type II) who were currently inter-episode, along with 55 non-psychiatric controls, completed a baseline assessment, including semi-structured interviews for psychiatric diagnoses, sleep disorders, and a battery of indices that included assessment of hypersomnia. Approximately 6 months later, participants were recontacted by telephone and mood was re-evaluated.

Results
Three of six indices suggested that approximately 25% of participants with bipolar disorder endorsed symptoms of hypersomnia in the inter-episode period. Within the bipolar group, hypersomnia in the inter-episode period was associated with future depressive symptoms. This finding was independent of baseline depressive symptoms and medication use.

Limitations
Small sample size and concurrent psychopharmacology in the bipolar sample.

Discussion
Though no gold standard measure for hypersomnia currently exists, this research takes a step towards identifying a clinically and empirically useful hypersomnia assessment. This study demonstrates that hypersomnia in the inter-episode period of bipolar disorder relates to future depressive symptoms, and adds to the growing body of evidence on the importance of inter-episode symptoms predicting bipolar relapse.

July 13, 2011

Free bipolar disorder report

Surely we’ve all bought “How to” guides for our respective illnesses from Amazon or other booksellers, but The British Psychological Society is offering a guide about bipolar disorder for free! “Understanding Bipolar Disorder” provides an overview of the current state of knowledge about why some people tend to experience periods of extreme mood and what can help. Much has been written about the biological aspects of bipolar disorders: this report aims to redress the balance by concentrating on the psychological aspects, both in terms of how we understand the problems and also approaches to help and treatment. They hope this report will influence the way in which services are delivered, so that more people have access to psychological treatments and that services will no longer insist that users accept one particular view of their problem.

“Understanding Bipolar Disorder” is available on their web site to anyone.

June 16, 2011

normalcy. well, not so fast

Maybe I need to take back my last hope-filled post about my update on trying to stop me from reaching  full hypomania. I really thought I was making progress in squashing that agitation, but it’s night time, and I am feeling my nerves stirring. Rather than winding down, I feel like I just got wound-up, like that Pristiq doll. It doesn’t feel like the jitters you get from drinking too much coffee. Rather, it’s like a part of my mind is wide awake while what’s left of the logical side of my brain knows that I need to go to bed. It’s such a conundrum because I do want to get some stuff done while I’m up, like putting away clothes, go grocery shopping, etc. But I recognize that doing any of those things will probably just keep me even more awake–and thus leading to less sleep, and then fueling that seed of hypomania that is dying to break out.

I know what I need is sleep. But after that ambien mishap, I’m scared to touch the stuff, even though I am extremely tempted. So, what am I to do? I’ve decided to take Tylenol PM (the recommended dose) and just hope that I can fall asleep sometime soon—and stay asleep through the night.While a full-blown hypomania admittedly feels pretty darn good, I just cannot afford to go through that phase and then crash fast and hard right afterward. And who knows how long that crash might last. I just cannot deal with that right now.

I have to say, though, that more than anything, I’m just really annoyed that I’m having to expose my boyfriend to all of this. I know that he is not aggravated with me. Instead, he is completely supportive and probably the very reason why I haven’t exploded into some mess already. It’s just that I’m still not used to sharing what’s going on within me with another person—in person, not just via the internet. But I guess the reality of a relationship is in moments like this one.

June 13, 2011

a hard day’s night

I took ambien last night in order to get some sleep, but I decided to keep doing stuff around the house even when that ‘sleep threshold’ hits you after about 30 minutes.  After baking some brownies, etc., I realized that I was wide awake at 2am, so I decided to take another one. I eventually went to sleep, but I woke up even before 5am. If I’m ever up around that time, I usually could pique my interest by watching ‘Mike and Mike in the Morning’ or ‘Scarborough Country,” but I couldn’t seem to gather my thoughts in any coherent manner.  I felt pretty much restless, with my mind awake in a way that didn’t feel clear-headed, but rather running around again and again with nowhere to go.  My boyfriend noticed how detached and confused I seemed to be acting, so he and I went and worked out for about an hour. Even after the workout, I could not get myself to calm down. He and I decided that it was probably best for me to not stand around in the house, so we went to several stores and to lunch, but even after several hours of that, the restlessness would not break. The irritability and the agitation just kept seeping out of me.

By the time I got home (the first time), I realized that I was on the brink of not just anxiety but hypomania. Crap, I thought to myself, as I made a fruitless attempt to take a nap. I could feel the fear crawling through my skin, but my mind just spun around so much that I could not even slow it down enough to shed a tear. We were going to spend time hanging around at the house, but we decided that I needed to ‘wear out’ my turbulence, this time by walking around the mall. We walked around for several hours, interspersed by moments of purchasing random stuff.  We eventually came back and made some dinner.

It’s past 10pm, and I’m finally starting to feel somewhat tired albeit still filled with some nervousness. I know that I have to get a good night’s sleep in order to stop the hypomania in its tracks. Otherwise, it could get very ugly quickly. However, I know it’s not the best idea to take ambien tonight, so I’m facing a bit of a dilemma. Should I just stay awake until I fall asleep (whenever that may be), or take ambien and just hope that another disaster like the night before won’t befall my way this time around? My boyfriend and I came to a compromise that taking Tylenol PM wouldn’t be as damaging as taking the mind-altering ambien. So, that’s what I’ve decided to do.  Plus some ice cream and brownies.

November 8, 2010

Mania to diagnose: kids and bipolar

We might not know what a kid’s favorite color is yet, but we could know if s/he’s bipolar.

Slate.com had an article last week titled “Manic Panic: Why are more children being diagnosed with bipolar disorder?” It may seem like a question that’s being asked more recently, but it was in 2007 when the TV program 60 Minutes asked the question: “Bipolar: Dangerous Diagnosis?” (it’s linked to the video).  In this episode, a mother is on trial for killing her daughter with prescription drugs for bipolar disorder. It investigated on the effects of increased diagnoses of this illness in children.

These pieces still left me wondering if we’re now just labeling certain eccentricities as a disorder of some sort (e.g. bipolar disorder) just so the adults can have a ‘rational’ reason for everything. As I think about having been diagnosed as an adult, I cannot imagine what it’s like to be diagnosed with the disorder as a child. How will their self-identity be shaped when they’ve already been given a label that very well may stick with them for a lifetime? How do you grow up when parents and others have decided that you’re mentally ill? Can we really know if someone is mentally ill when his/her brain hasn’t even developed fully?

August 18, 2010

bipolar conundrum

July 16, 2010

in the crowd

Art by Edel Rodriguez

Our plane has taken off from Salt Lake City, and I am now aboard on the last leg of my Santa Barbara vacation. It’s about 3 hours left of being up in the air,where a bunch of strangers are packed like sardines, albeit in a very orderly fashion. It is interesting to wonder who these travelers are that are seated in this flying vehicle. Were they out on business? Did she fly home to see her family? What about that guy sitting across the aisle? Are they on their way to this particular destination? Questions are endless, but in general, most people only acknowledge others with a polite greeting and silence throughout the rest of the flight time. I suppose there are things about ourselves that are visible upon immediate glance, e.g. gender, race, etc. But some things, like one’s mental health, isn’t usually so clear.

I thought about that ad from ‘BringChange2Mind.org where among the crowd would be people wearing shirts labeled with a disorder or as knowing someone with a mental illness (like ‘a friend of…’) If people were to wear shirts like that, how many of us in this airplane would be wearing them?

It’s really easy to think that I would be all alone in wearing a shirt like that, and to speculate that I would not be able to share my experience with mental illness with others because others simply would have no connection to it. However, last week in class, someone mentioned that she’s bipolar, which means that out of a class of fifteen students, at least three students have bipolar disorder. Even in such a small group, I am not alone.

So, as I look around these rows of people sleeping, reading their Kindle or drinking their beverage, I am pretty sure that many of us would actually be able to share stories if we knew a little more about each other.

July 4, 2010

Coming soon: NFL Films on Bipolar Disorder

I was watching television this morning when a commercial featuring Colts quarterback Peyton Manning popped up on screen, telling me that football season is starting soon. Ooh, how exciting, I thought to myself. In case you didn’t know,  I love Peyton Manning, and I really do love NFL football.

So, when I came home from work today, I ran into an interesting blog called “Zen in the art of Living Bipolar” written by a former NFL player, Gregory Montgomery, Jr., who has bipolar disorder. According to his recent post, a ‘Sports Illustrated’ article once mentioned something about his bipolar disorder, but this time, NFL Films plans to delve a bit further into the topic and tell an accurate story about Montgomery and bipolar disorder.

I’m a huge fan of the work that NFL Films produces (e.g. ‘Hard Knocks’ on HBO), so I am definitely intrigued as to what they might come up with to tell this story.

July 3, 2010

“I want to be bipolar”?

According to this commentary by Dr. Diana Chan on BBCnews.com, being bipolar is in fashion.

“Dr Lester Sireling and I have looked into the popularity of bipolar disorder as a self-diagnosis. We believe the phenomena could be due to increased public awareness through the internet, radio and TV, coupled with the willingness of celebrities to talk about their own personal experiences of mental illness.

This appears to have made the disorder less of a stigma, and more acceptable to the public.

A new diagnosis of bipolar disorder might also reflect a person’s aspiration for higher social status and a feeling that by having the condition they too are creative.”

It’s great that bipolar disorder may be more acceptable now, but really, anyone who just wants to be labeled bipolar obviously doesn’t have any idea what it’s like to be bipolar, or have any other mental disorder. Some may associate being bipolar with creativity, but for people with bipolar II, the amount of time spent depressed is 35 times more than time spent hypomanic. And depression does not bode well with any motivation to be creative or trying to live a normal life (showering becomes a chore…you stop being able to get out of your house…everything becomes dull, etc…). And if people think hypomania/mania just leads to more energy, it could also lead to erratic and irrational behavior that’s harmful to self and others.

Besides, it costs so much to treat a mental disorder; wouldn’t people want to spend their money on something else?

June 24, 2010

Diagnosing Bipolar Disorder with a MRI

From Medical News Today:

A single MRI (magnetic resonance imaging) scan may soon help hundreds of thousands of people with bipolar disorder to get a faster, more accurate – and possibly life-saving – diagnosis, a leading researcher reported at the Royal College of Psychiatrists’ International Congress.

Professor Mary Phillips, professor of psychiatry and director of the Clinical and Translational Affective Neurosicence Program at the University of Pittsburgh, told the Congress that missed and delayed diagnosis was a major problem with bipolar disorder.

She said: “Only one in five sufferers are correctly diagnosed at first presentation to a doctor and it can take up to ten years before sufferers receive a correct diagnosis.” A major problem for clinicians is the difficulty of differentiating between unipolar (normal) depression and bipolar disorder. Professor Phillips explained: “The problem is that sufferers [of bipolar disorder] frequently fail to tell their doctors about hypomanic phases because they can be experienced as quite pleasant or judged not to be abnormal at all.”

Yet research carried out at Pittsburgh has shown that BPD may in the near future be more accurately diagnosed with a combination of a Functional MRI, which scans the brain’s ‘software’ or neural pathways, as well as a DTI (Diffusion Tension Imaging) which scans the brain’s white matter.

Professor Philips told the Congress that scans of the brains of people who are suffering depression or bipolar disorder show ‘functionally coupled’ activity in two regions of the brain, the amygdala which processes emotions, and the pre-frontal cortex, important for emotional regulation.

Professor Phillips’ study involved MRI scans comparing brain function in two groups of people, one group with bipolar disorder and the other with depression. It revealed that the two types of depression appear to be easily distinguished “by a very different and distinct pattern of brain activity”.

She said: “If there’s a plan to do just one MRI in the future to try to decide whether someone has bipolar or depression , I’d suggest focussing the right pre-frontal cortex. If there is any abnormality in functioning between the right and pre-frontal cortex and right amygdala, the chances are that the person has bipolar.”

Professor Phillips suggested that the scans may also be used at some point to predict a future onset of bipolar disorder in young people who are not yet affected by the disease.

References:

International Congress of the Royal College of Psychiatrists, Edinburgh, 21-24 June 2010.

Source:
Royal College of Psychiatrists

June 4, 2010

common ties

A few days ago, some of my classmates and I got together for dinner since we didn’t have class that night. We originally meant for the gathering to be a discussion about our class on mental health and aging, but instead, we mostly ended up talking about other things….though we did end up touching on some mental health issues, issues of our own. One of the dinnermates, Zak, also has bipolar disorder, so we ended up talking about different drugs we’ve encountered and some of the bipolar symptoms that we’ve had. It was a really interesting conversation to me, because I’m not sure I’ve ever discussed anything about this part of my life with another person with bipolar disorder. As much as it’s fine to talk about my adventures with other people, I did feel comfortable talking to someone that actually understood what I’m talking about without my having to explain certain things. Of course, it may have helped that we were both drinking some frozen margaritas :).

I hope I get to be a part of another dinner conversation with these three other classmates. It makes me realize that I don’t have to be afraid of people as I often am, because in reality, there’s nothing to be scared of.

April 23, 2010

The Cure

“I’m a 30-year old female; I’m a Japanese immigrant; I’m a patient of ECT; and I’m a blogger,” I said as I started my presentation about my ECT story. I thought the presentation went fine, and I didn’t cry like I thought I might (as I wrote in a previous post). What surprised me about the presentation? The questions I got afterward. Most of the questions had something to do with what I would do if I were suddenly cured. How would my identity change? What would I do with my blog?

I thought that the questions were really interesting, but kind of odd. But they do have me still thinking: Is my identity as a bipolar/ECT patient such a part of me that I wouldn’t know who I am if I were to suddenly be cured? Well, I thought about it, and the best answer I could come up with is to think about how we can call those who have been cured from cancer a ‘cancer survivor.’ It’s because just because something is over, that it’s no longer a part of you in some way. It’s part of my history—what makes me, well, me. And with other illnesses, it’s okay to keep a part of that past with you. Also, I hope that I don’t see myself simply as a bipolar person. I think I’m much more than just my illness.

And what would I do with my blog? Well, I don’t think my interest in mental health would change if I’m cured from mental illness, and I could still write about issues pertaining to mental health—and about living life in general. I’m sure I’ll have something to say, even if it might be about the NFL draft…..

Anyway, it is a good question: What if you were cured all of a sudden? What will happen?

April 19, 2010

excuses, excuses

When someone takes a vacation, s/he sometimes has to play catch-up with work, etc. after s/he is back from that vacation. Well, taking that two-week  ‘med vacation’ is certainly creating some problems for me right now. It has been a couple weeks since I got back on those chemicals, but the amount of work that I chose not to do during that ‘vacation’ is not making it easy for me to have enough time to adjust back, both mentally and physically, to the ‘norm.’ I suppose I could choose to stay up all night to get some work done, but keeping some sort of a sleep cycle is vitally important for those with bipolar disorder. The last thing I need is to become hypomanic (contrary to popular belief, my hypomanic moments do not result in getting work done. I instead end up baking and start to believe that I’m going to be NYT’s Maureen Dowd the next day….).

I told Dr. A that I was behind on assignments, and she immediately offered to write some note to the professors. As much as that would be nice, isn’t it my own fault that I took that vacation? When is it okay to say “I’ve been ill”? When you are mentally ill and have these episodes, you never quite know when it is legitimate for you to be excused from work or get an extension for assignments. With physical illness, it’s, well, physically obvious that you’ve been ill.With mental illness, there’s that additional issue about having to disclose something about your disorder. Even if the professor already knows about your condition, I hesitate to say it again.

I was supposed to turn in a rough draft for a class, but didn’t get it done in time. I finally decided to tell the professor the reason why I didn’t turn it in. I’m glad that he knows the reason why the draft is coming in late, but I feel like my reasoning still isn’t that legitimate.

April 6, 2010

my body. my choice.

I’m trying to get back into writing, but it’s hard. I am stumbling over my thoughts and the words are coming through my fingers as if an engine is stuttering. Oh, well. I did get off my routine for two weeks, and it’s obviously going to take more than just a day to get back to that speed.

I am sitting next to my little jar of pills, but I’m not feeling angry or fearful like I felt just a few days ago. When I started thinking about the pills  the days before, I’d just start crying because I knew I needed to take them, but I somehow felt like I couldn’t. Then, Friday’s therapy’s session with Dr. L came. And somehow, all that animosity over these meds seem to have melted away. Rather, I look at those pills now and be able to say I am taking the pills because it is a choice only between me and myself, that I’m making that choice for myself and no one else. I’m going back to taking my medication not out of fear or anger or because someone is telling to go back on the meds. I realized that I wanted me to be well–and these pills are simply a part of that path to becoming a better me. It’s odd. I thought about that slogan “My body, my choice” that you might hear about being pro-choice. But that’s sort of how I feel. This is my body, and this is my choice.

I think that’s why I posted that photo of myself in the previous post. I could look at myself again and just be okay to be who I am.  In a way, the pills became more than just pills; they represented a struggle within myself.

I’m starting to feel better bit by bit. It does help that one of the meds does work immediately. But more than anything, I think I feel better because I’ve started to learn to accept myself.

I wish I could get back to writing better, because this realization was important to me. But I’ll get there soon.

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