Making the decision about psychiatric medications and treatments

There are times I wish there was one drug to work for everyone.  I went through years trying to find a combination that worked for me, to be stable (if that is possible), keep the psychosis and mania to a minimum and depression at bay.  Part of the issue I faced in the early years of my diagnosis was being in the military, I moved around a lot.  So, just when I found find a good doctor and felt comfortable with them, it would once again be time to move.  I got to the point where I didn't care much anymore, especially when it came to one of the last doctors I had.  He rarely listened to what I had to say, I was on two medications and I was having awful side effects, I begged him to change them.  He would sit behind his desk and fill out his insurance forms for the visit.  After a few visits and no help I did the only thing that sounded logical to me, I weaned myself off all medications.  I'd had enough.  

Fast forward to a year and I crashed, hard!  It was then I realized that I was not going to be able to do this alone, I had to be on medication in order at least keep some level to stability.  The journey would become harder than I thought, but after three psychiatrists and psychologists, I found not only a medical team I could trust, but also a medication combination that was helpful.  It was not an easy road however; it took several attempts to find out that my system rejected just about every new drug that had come on the market.  In addition, the Anti-Depressants I was taking were actually causing some of my mania.  With that off the list it came down to relying solely on mood-stabilizers, anti-psychotics and anxiety medication, but as we slowly ticked off the list of medications I could not take I became more discouraged.  The main hurdle we faced, in my eyes, was the extent of my diagnosis, Schizo-affective was simply the tip of the iceberg, it also included General Anxiety disorder, PTSD, and Dissociative Disorder.   Thankfully I had a doctor that would not give up.    

In the end we came up with a combination of Lamictal, Neurontin and Klonopin.  The first two keep me stable, for the most part (not drug is going to make this go away completely) and the later helps me not only sleep (my brain refuses to shut down, especially at night), but I can take it during the day if I am having an anxiety attack.  It is important to add that medication alone was not the answer, at least for me, and while we discussed medications he decided to approach the subject of ECT, (Electro-Convulsion therapy).  The idea more than scared me, but I was desperate and I trusted my doctor.  I checked into the hospital, was admitted to the psych ward and for the next 10 days had five treatments, and then I had three treatments as an outpatient.  The experience as not what I expected, my only side effect was bad dry mouth afterwards, and a headache.  

Now being the challenging patient that I am, and while the ECT worked to ease my depression, it brought on mania.  We didn't see it at first, it was subtle, but there was something going on.  12 months later I was back and had a second round after I hit bottom again after losing my cousin to suicide, his death destroyed me and sent me into a severe mixed episode.   Since the last sequence of treatments had help with the depression, this time my doctor knew we had to take a different approach.  It is most common to administer the treatment to one side of the brain; however, for me he decided he had to administer to both sides in order to balance out the depression and mania.  It was like my mind was fighting itself for control and he was making every effort to call a truce.  There was some success with the treatments and balance was restored, but there was a part of me that had hoped that it would make it all go away, I was growing more and more tired of it all. 

I began tracking my symptoms a few years ago; I watch how my mania, depression, anxiety, psychosis and sleep fluctuate from day to day. With the graph I can see what may have been going on that day to cause more a depressive state and what may have caused anxiety.  It’s not fool proof, but it can give a general overview of what may trigger some of the mood swings and then I can make any changes I may need to. 

In the end, yes the ECT did help and the medications continue to keep things in check - for the most part.  Over time I realized that we must live with these illnesses as they are, work with a good medical team, and have a strong support system.  Without all these pieces in place we run the risk of continuing to hide behind our mask and tell the world we are “OK,” when what we really need is help.  

Dispelling the fear of Hypomania

I sit on the rocks overlooking the Tasman Sea as I write this, watching the waves come in, crashing below me.  Some swells reaching several feet, others a mere ripple, all of them though are amazing and powerful in their own way.  Nature directs their path and intensity, in a similar way our minds guide our modds and how the cycle we are in will affect us.  Hypomania, mania and depression - they come and go, each moment in time.

Do a search about Bipolar disorder and you’ll find thousands of results explaining every aspect from depression to mania, medication, depression and the lesser known hypo-mania.  My partner recently read an article about hypo-mania and how it is often a prelude to either a severe depression or more sever mania.  The beginning of the article reads like a warning label, “Hypo-Mania – Danger Alert,” and while the symptoms listed are correct, it should not be written as a warning of impending doom for those who may be just learning about Bipolar Disorder, whether it is the individual or their friends and family.

 

The reality is hypomania, yes can be a pre-cursor to a full blown manic episode or a depressive episode, there is no denying that; however, let’s look at it from another point of view.

·       Learn what hypomania is and how it is different for each person.  A blanket description only tells you what could happen.  You have to discover for yourself, with the help of a partner, friends and your doctor, what triggers your mood and what symptoms are dominant.      

·      Make a list of your symptoms, how they affect you and those around you.  Both the good and bad.

·      Keep track of how long the cycle lasts and what happens as it dissipates.  This is important as it will give you the information you need if you then become depressed or actions become more intense leading to a full blown manic episode.

a.    To monitor my moods I use a daily chart and track my level of depression, anxiety, mania and sleep.  By looking at these numbers I am able to see when I was up or down and can then correlate that with a particular event or see a pattern evolve over a couple weeks, or if the seasons have changed.  The seasons can play a large part in our mood cycles. 

·      The symptoms of hypomania without a doubt can be harmful, but that does not mean you should be protected from life and kept sheltered.

a.    If you have a history of spending money while manic, have a limit set on your credit cards and bank card, so you can only spend a certain amount.  If you are in a relationship and have a joint account, let your partner know how you are feeling.  This can be one of the hardest things to do, as when mania hits it feels good and the last thing we want is someone to take that feeling away. 

b.    Anger and irritability are common.  Try yoga to relax or writing to help clear your mind.

c.    If there is a tendency for promiscuity, have someone you trust be an accountability partner. If you go to a party, don’t go alone and have someone else drive who is aware of you illness and will be your “wing man” for the evening.

d.    Projects are probably one of the most common signs.  I can’t tell you how many I have planned, started and never finished.  On a good note it shows creativity and that we are alive and capable of many things, however, ideas can get away from us and accumulate quickly, leading to being overwhelmed and confused.  Make a list of your ideas and the steps it would take to achieve them and if you would be able to do it, even after the hypomania ends.  As hard as it may be, pick one or two to focus on for a week.  This makes it more manageable.  If after a week you want to try something else, stop one or both of the previous projects before starting the new one. 

It is important to not look at hypomania, or even mania itself and the ideas and projects that can come from them as all bad, they are things that you are obviously passionate about and are important, the problem is we want to do them all at the same time.  Learning to harness the excitement and energy is key.  It is possible, to use hypomania to your advantage as you get to know your symptoms, triggers and how you react to the cycles.   

As with most things, there is the good and bad, what it important here is to look deeper into the information you are seeking, there will be numerous articles all claiming to have the answer and telling you what to expect, take them at face value and see what works for you.  You are the one who matters and needs to educate not only yourself, but those around you as well. 

N - is for Natural Remedies

For years medication was known as the best way to treat mental illness, along with therapy and hospitalization.  A change is happening, however, to a more holistic way of treating these illnesses.  There are reasons people step back from traditional medications, side effects top the list, with many people feeling they are simply taking too many medications and what they can to do to our bodies.  In many cases, the drugs cause irritating side effects, which in turn is treated with more medication to alleviate the symptoms. 

The search for different treatments has been my goal in recent years, with my own mental illness; I have been on too many medications to mention and often they came with debilitating side effects so I would not be able to take them, this lead me on a journey to find another way.  i still take a couple medications and they do help, but there are ways to treat these illnesses without making weekly trips to the pharmacy. 

One of the best I have found is simply being out side in the fresh air and sunshine.  A short 15 minute walk can change your outlook on the day or situations that are ruminating in your mind.  I have discovered over time that when I am not able to be outside my moods tend to cycle more and I become moody.  I am a simple person, I enjoy the woods most of all, surrounding myself with the sounds of birds chirping and trees rustling around me.  During a hike the distractions are only a memory and my mind will once again focus on serenity and peacefulness of what is around me.  In addition, we receive Vitamin D from the sun which is also known to help the mind. 

in addition to spending time outside there are other medical treatments that do not include medication.  ECT (electric Convulsive Therapy) or TMS (transcranial magnetic stimulation) are common ways to treating mental illness.  ECT has received a bad rap over the years after movies and the media have shown it as barbaric, when it is a simple procedure today lasting no more than a few minutes while the patient in under anesthesia.  TMS uses a simple MRI type machine that stimulates the brain with magnetic pulses. 

I think one of the best treatments, next to be outside is journaling.  Writing down feelings and thoughts keeps them from ruminating and clears the mind of disturbing thoughts and ideas. 

There are many other treatments including vitamins and supplements to help stave off the symptoms of many illnesses.  The trick is to find the one that works best for you and you alone.  

FDA EXPANS ANTIPSYCHOTIC DRUG WARNING

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US food and drug administration has issued a warning that older, conventional antipsychotic medications may increase the risk of death in some elderly patients.

The drug companies are being required to include "black box" warnings pertaining to the potential risk in older patients who suffer from dementia-related psychosis. Some newer drugs, such as abilify and Zyprexa already carry such warnings.

Most of these drugs are approved for the treatment of schizophrenia, a disorder that causes unusual thoughts and behavior, including speech and memory problems. With this information, doctors can use them to help treat dementia patients - even though they are not approved for such treatment.

Having taking both of these drugs I know I would never take them again. Abilify made me terribly sick and Zyprexa - that just made me sleepy and more of a zombie. I can certainly see how it can cause problems. Thankfully I was able to stop, only after I left the psychiatrist who had prescribed them after he refused to listen to the problems I was having.

Doctors are right to try new treatments, but side effects and bad reactions need to be monitored closely, especially if using a drug that is not normally used for a particular illness or condition.

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Antidepressants may help Stroke Patients

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Each year more than 700,000 American’s suffer from a stroke, at least 1/3 third of these individuals will face a battle with depression within 2 years. In addition, these individuals may recover at a slower rate, often resulting in death. Researchers say this is due to the possible damage to the part of the brain that affects mod, add to this frustrations of relearning simple everyday tasks and living with impairment related to the stroke. Taking this into consideration, depression may not be such a surprise.

The answer? Antidepressants

In recent research funded by the NIMH, doctors have found that giving the antidepressant, Lexapro to stroke patients from the beginning may deter the onset of depression. According to the studies stoke patients are 4 to 5 time less likely to develop depression as opposed to those taking a placebo.

The study including 176 stroke patients that ranged in age from 50 – 90, these individuals were then divided into 3 groups – one being given Lexapro, the second given a placebo and the third engaged in therapy. The results showed that 9% of patients on Lexapro developed depression, a lower percentage when compared to 22% of those taking placebo and 12% of those who engaged in therapy. As with any discover, however, there is a downside. Side effects of the drug, as well as giving a drug to those who may no need it, may subject them to the added frustration of side effects.

If you are given the option what would you choose? Though the study included on stroke patients in 50 – 90 years old, would this new therapy be as beneficial in younger patients? It would seem to me that the younger the patient, or the more independent a person is, the greater chance of them facing depression; losing their independence, can be devastating.

I thank God for the doctors who continue to look for ways to offer a continued life of independence and comfort. You never know when these discoveries may affect you and your family.

Pacemaker for the Brain

Image via WikipediaIn two of the largest studies at the Cleveland Clinic, results show that a “brain pacemaker” may have the ability to treat depression and Obsessive-Compulsive disorder. Like a heart pacemaker, the devise is implanted in the chest; leads then send electrical impulses to the brain. To date the pacemaker has already been approved to treat disorders such as Parkinson's disease.

The technique known as deep brain stimulation has helped some of the most severely depressed patients, as well as patients with OCD with no serious side effects related to the device.

Currently Medtronic has an application before the U.S. Food and Drug administration for the device to be used for treating OCD. An implantable device, by Cyberonics, was approved by the FDA in 2005 for treatment-resistant depression, by sending signals to the brain through the vagus nerve in the neck.

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Image via WikipediaOnly 2 years ago new pills were being introduced to help people quit smoking, lose weight and beat other tough addictions, such as alcohol and cocaine. The pills would work by blocking the parts of the brain that control the pleasure responses we get when we eat, smoke, use drugs, etc.

However, as tests have gone it may seem that they work too well for some people. There have been reports of some people taking these drugs experiencing severe depression and thoughts of suicide.

The scientists and makers of these drugs say they are say are safe - though not for everyone. The fact that this type of restriction would bring many setbacks and issues - as it would take these new drugs away from those who could use it the most. In addition, the fact that these drugs do block the pleasure center of the brain, in order to curb cravings - they may also play a part in taking away some pleasure of life away in general.

In recent studies, 43 percent of those the drug Rimonaband noted psychiatric issues, with 28 percent reporting the same effects with dummy pills. As with other studies, those with history of depression were more affected by the drugs.

There is the argument that those who quit smoking or are trying to lose weight, will on their own experience mood swings and depression - so all in all it may be difficult to determine what is causing what.

In one report, a Schizo patient was given a drug to help him quit smoking, without worsening his psychological symptoms.

It’s a toss up - do we use the drugs to help, or do we withhold them to save them.

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Club Drug May Ease Depression (Ketamine)

Image via Wikipedia"Special K" a night club drug containing horse tranquilizer and hallucinogens may actually ease depression. Ketamine, a horse tranquilizer, may cause feelings of detachment - it is possible it could pave the way for treatments for those who suffer from depression.

In a recent study, it was found that Ketamine has the ability to restore the orbifrontal cortex, the part of the brain located above the eyes that is overactive in people who are depressed. In addition, this same area is believed to control feelings of guilt, dread, apprehension and reactions to include a racing heart.

While it may seem unconventional, the opportunity to find a new treatment for a disease that affects more than 121 million people around the world and is the leading cause of suicide - is ground breaking.

In the study it was found that the Ketamine improved symptoms within 24 hours - a certain improvement from the month it can take from drugs such as Prozac to take affect. This knowledge offers a target with the ability to design new drugs that will help patients who do not respond to Prozac or other traditional medications.

It does seem a bit strange that a "club drug," would be used to bring relief to those who may use drugs to feel better on their own. Should this actually work, it may make a difference, in addition to giving those who have used it for so long a leg up, thinking......"I've been using that for years, I could have told you that." Can you imagine?

I was never able to take Prozac, I was more like a Zombie. I can't take Wellbutrin - makes me totally manic (not pretty). "Cocktail of choice?" Zoloft and Lamictal. Zoloft has to be monitored and minimal, if not I will become manic. No matter how bad the depression gets, we can't increase the Zoloft. Do I hope there are new medications? You bet!!!

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Ignoring Diabetes to stay thin

Diabetes is a common disease today, though some find it difficult to accept - this idea can have dire consequences.

The practice of skipping insulin shots, or using only partial doses had become widespread and been given a name, "Diabulimic,” categorizing it along with anorexia and bulimia.

The beginning signs of Type 1 diabetes will be sudden and dramatic weight loss. While this is a telltale sign, when insulin is prescribed, there is a tendency for weight gain, not only gaining back the weight originally lost, but additional pounds as well. For this reason many young women are making the choice to use only a minimum amount of insulin, enough to keep them “functioning.” The ease of this habit makes it harder to monitor, as diabetics give themselves shots and can adjust their dosage with no one’s knowledge. As the trend continues, doctors are forced to take notice and reach out to their patients, before they cause permanent damage to their body.

Because this is not an official disorder, Diabulimics are forming groups in cyber world, reaching out to each other, looking for answers, treatment and learning how to make their doctors and the medical world in general away that there is a problem. It seems, as with most illnesses and disorders, there is no real “light shed on it,” until someone dies or makes it famous.

A quote in the articles states, "This behavior is like playing Russian roulette with your health. It's almost like they're turning back the clock to a point in history when we didn't know that the consequences of diabetes were preventable."

Why do you believe in God? Is it your faith that draws you or loneliness

Do you believe in God? Do you believe in angels, miracles or other supernatural beings? It is believed that for some, believing in these things is more mere survival than an understanding or feeling.

Researchers at the University of Chicago say that we, as humans are social creatures, while not essential we look for a connection to people, to share our lives and form relationships. For most people the idea of being alone or isolated can be devastating, no matter the reason.

It is believed through research that when a feeling of loneliness is present, a person will often do one of three things; there may make an attempt to rekindle old friendships, try to create new ones or in some cases will form connections by personalizing gadgets, like computers, cars, pets or religious figures.

In order to test their theories, groups of people were brought together to try to induce the feelings of loneliness in order to monitor how it affects how they perceive pets and/or belief in religious fixtures. Those who feel lonely showed a stronger belief in the supernatural, be it ghosts, angels, miracles, and God.

Overall, this study showed that whether a person feels lonely, or are "induced" to feel lonely, the tendency to lean towards the supernatural was prevalent. In the end, it was seen that these attachments are not necessarily wrong, being connected socially to other people seems to produce the same feelings of belonging as those with a closer connection to pet and/or religious agents.

It just goes to show that we may not actually be alone; wherever we may be it is possible to combat the feelings of loneliness in many ways.

Diabulimics look for their voice to be heard

Diabetes is a common disease today, though some find it difficult to accept - this idea can have dire consequences.

The practice of skipping insulin shots, or using only partial doses had become widespread and been given a name,
"Diabulimic,” categorizing it along with anorexia and bulimia.

The beginning signs of Type 1 diabetes will be sudden and dramatic weight loss. While
this is a telltale sign, when insulin is prescribed, there is a tendency for
weight gain, not only gaining back the weight originally lost, but additional
pounds as well. For this reason many young women are making the choice to use only a minimum amount of insulin, enough to keep them “functioning.” The ease of this habit
makes it harder to monitor, as diabetics give themselves shots and can adjust their
dosage with no one’s knowledge. As the trend continues, doctors are forced to take notice and reach out to their patients, before they cause permanent damage to their body.

Because this is not an official disorder, Diabulimics are forming groups in cyber world, reaching out to each other, looking for answers, treatment and learning how to make their doctors and the medical world in general away that there is a problem. It seems, as with most illnesses and disorders, there is no real “light shed on it,” until someone dies or makes it famous.

A quote in the articles states, "This behavior is like playing Russian roulette with your health. It's almost like they're turning back the clock to a point in history when we didn't know that the consequences of diabetes were preventable."

Stopping Medication - Causes problems

There is a common practice among those who take medication for depression and other mental illnesses – they discontinue they medication because “They feel better,” not realizing it is the medication that is helping to stabilize the chemical imbalances, or stop taking it because of the stigma.

Most often than not it is the stigma that stops medication, having to answer questions as to why they take a certain medication will mean admitting their mental illness, a fear greater than the illness itself.

It has been seen in recent college campus shootings that the gunman had recently stopped taking his Anti-depressant. Most of these medications are used to stabilize mood and when suddenly stopped, the person’s system is put in turmoil and their actions take on a life of their own, so faithfully taking their medication is vital.

So, why do people stop taking it? As I mentioned stigma is a big reason – medication brings the feeling of being an outcast – the mentally ill are not exactly accepted with open arms. Side effects also play a part in stopping medication, when the side effects begin; it no longer seems worth the effort. Another reason, and it is a sign of our times, is many can not afford the medication when insurance money runs out. When you need to make a choice – do you eat or take the medication. Food and shelter will win.

Whether it is stigma, financial or side effects – stopping medication is a dangerous choice. These medications are made to help stabilize mood and help with chemical imbalances stopping and starting these medications will further complicate an illness, often sending the person into a tailspin or suicidal thoughts, mania and/or dangerous activity.

Knowledge and acceptance is vital.

Marijuana Vending Machines - Good Idea?

California was always the place to be, in the 60’s it was “if you’re going to San Francisco.” Then it was roller-skating, pumping iron on the beach…….now in 2008, it is marijuana vending machines. I did a double take too, but it is true. California has once again made a name for itself.

While this will raise eyebrows, the reason for the unconventional vending machines is to help those who use marijuana as medicine for various illnesses or chronic pain. For years the argument has continued – whether or not to legalize marijuana, when given by prescription. The controversy however continues as to if it can be controlled, and what the repercussions would be to legalizing the drug.

For the inventor of the Prescription Vending Machine, or “PVM,”, however, he is helping those in need, those who are in constant pain and are finding no lasting relief from traditional medicine. The concept is simple, the person who desires to purchase the medicinal marijuana, they must be registered in a computer database – which will verify their identity through fingerprint verification and a prepaid card with magnetic strip. After verification, an envelope with the marijuana drops down the slot. The machine is guarded at all times and is said to offer privacy and convenience, especially for those who are unsure of their purchase – but “need” to use it.

No matter the reason for its creation, it is still illegal. California is one the 12 states that accept medicinal marijuana, however it still leave the Feds with the authority to shut down these marijuana dispensing machines.

It is a controversy that can last forever, it may be helpful for those with various medical conditions – yet is abused by others, so who wins?

As I read about this I thought about things I wanted to be 16 so I could drive, once my birthday arrived it was no longer a big deal. Then I wanted to be 21 so I could go to clubs and drink – then I turned 21, and well you can guess what happened – it was no longer a big deal. So, is it possible the same effect occur with other things we see as “illegal?” After all what fun is it if we can get it with no problem and legally.

Treatments for Bipolar Disorder

Image via WikipediaBipolar Disorder has been in the news a lot lately, new drugs, understandings, findings - it seems people can not get enough of it. In some way this can be good, a blessing so to speak; now maybe people will understand and take notice that the stigma does not need to stand any longer.

While that is true, the down side is that those who are putting this disorder in the news are also finding new medications for it, and for some new diagnosis to make sure more people fit the diagnosis. An attempt, maybe by drug companies to collect more money through telling more people they are ill.

So, while the stigma may be finally finding a light, at the same time it is being shot down even further by those who want to give more people medication for disorders/illnesses they do not have, in turn opening up the path for more and more people to use it as an excuse for things they do by their own free will.

Bp seems now to be one of the top 5 most researched disorders at the present time, opening the publics view to a disorder that seems to have a life of its own.

When I first wrote this post back in September of last year, I was first beginning to notice the increasing news reports. Today, there seems to be no end in sight in the fascination with Bipolar - while I find this good, in a way, I wonder if maybe it is simply "jumping on the band wagon." We'll see I guess.

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