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Doses and Roses

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When we, people with bipolar disorder, are in a full blown manic phase or a severe depressed phase, the doses of medication we have to take to control those phases are astronomically higher than the doses of the same medicine we take when we are in a normal phase or euthymic.

I have been on as high a dose of Seroquel as 800 mg when I was in a full blown manic phase. If I were to take 800 mg of Seroquel today, I seriously think I would not wake up. My body at this normal phase would not be able to handle that large dose. Our metabolic rate increases a LOT when we are manic, therefore the weight loss and the staying awake all the time. So, our body, in that increased metabolic rate state, can metabolize al LOT more medication than it can in a normal or euthymic state. My lithium dose has been pretty large as well when I was in a full blown manic state, and without bad side effects such as loss of fine motor coordination, tremor, diureresis, even hair loss, and acne.

Many psychiatrists think that if I was on 800 mg of Seroquel when I was in a full blown manic state, that 800 mg is my maintenance dose. But they are WRONG! No one needs the high doses that we take in extreme phases as maintenance doses. Maintenance doses are much smaller. For example, I am currently on 75 mg of Seroquel, less than one tenth of the dose that I took in my severe phase.

I have been on such high doses of Depakote that literally half the hair on my head fell out, among other things, and still the doctor who prescribed it to me wanted to keep increasing the dose!

I’ve actually had arguments with previous psychiatrists about this, when they have tried to keep increasing my dose when I was normal or euthymic. Eventually, I would have to find a new psychiatrist and hope that they realized the dosage issue.

Thank goodness, I now have a doctor who realizes this fully, and was explaining it to me when I stopped him mid sentence and exclaimed “Hallelujah, finally, someone who understands this!!!”

These medications are powerful medications with awful side effects. The thing that is most beneficial is to use the smallest dose necessary to control our symptoms while having the fewest side effects. Of course the key is controlling your symptoms, so the dose has to do that adequately.

Just thought I would write about this because I have struggled a lot with this in the past. Now, I feel lucky to have the doctor I have.

And now my Seroquel is kicking in and I am about to fall into a deep slumber, so good night all!

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How A Machine Learned To Spot Depression

  
Fascinating article from NPR.com about a machine named Ellie who can spot depression and PTSD! Link and article in its entirety, below. 

http://www.npr.org/sections/money/2015/05/20/407978049/how-a-machine-learned-to-spot-depression?utm_source=facebook.com&utm_medium=social&utm_campaign=npr&utm_term=nprnews&utm_content=20150520

“I’m in a booth with a computer program called Ellie. She’s on a screen in front of me.

Ellie was designed to diagnose post-traumatic stress disorder and depression, and when I get into the booth she starts asking me questions — about my family, my feelings, my biggest regrets.
Emotions seem really messy and hard for a machine to understand. But Skip Rizzo, a psychologist who helped design Ellie, thought otherwise.
When I answer Ellie’s questions, she listens. But she doesn’t process the words I’m saying. She analyzes my tone. A camera tracks every detail of my facial expressions.

“Contrary to popular belief, depressed people smile as many times as non-depressed people,” Rizzo says. “But their smiles are less robust and of less duration. It’s almost like polite smiles rather than real, robust, coming from your inner-soul type of a smile.”

Ellie compares my smile to a database of soldiers who have returned from combat. Is my smile genuine? Is it forced?
Ellie also listens for pauses. She watches to see whether I look off to the side or down. If I lean forward, she notices.
All this analysis seems to work: In studies, Ellie could detect signs of PTSD and depression about as well as a large pool of psychologists.
Jody Mitic served with the Canadian forces in Afghanistan. He lost both of his feet to a bomb. And Mitic remembers that Ellie’s robot-ness helped him open up.
“Ellie seemed to just be listening,” Mitic says. “A lot of therapists, you can see it in their eyes, when you start talking about some of the grislier details of stuff that you might have seen or done, they are having a reaction.”
With Ellie, he says, he didn’t have that problem.
Right now, Ellie is strictly for diagnosis. The idea is, once Ellie’s out in the field, she’ll find soldiers who are having a problem and a human will take it from there.

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Never Give Up! Never!

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Here is a comment to one of my posts “I am stuck in a deep depression at this stage, and now that I have read this…if gives me hope. It is keeping the suicide thoughts at bay. Strange how these little things help in a time when you really need it!”

Oh my god, this comment has taught me more about blogging than a million blogging courses could have. If one of my posts could do this, could give someone hope, could possibly stop them from acting out their self harming impulses, than what more could I ask for? Am I not here to give people who are diagnosed with bipolar disorder, as well as other mental illnesses, hope? Am I not here to show them how to be strong, show them that I have been fighting this disease for the last THIRTY years, and surviving, no even thriving? Am I not here to show them that you can be in a suicidal depression, but you don’t have to act on it? Yes I am, yes I am and yes I am.

I was in a suicidal depression, in 1985. I was so severely depressed that there was nothing, absolutely NOTHING left of me. I had severe anhedonia (totally unable to experience any positive emotions), I had gained weight, had acne on my face, the only thoughts/emotions I experienced were confusion, abject sadness, hopelessness, and only negative thoughts. I felt totally helpless to do anything about this because I did not understand what was happening to me. I had an awful feeling in the pit of my stomach. Finally, not being able to stand these feelings and thoughts, I formulated a plan to kill myself. I kept thinking about it for a day or two. The will to live is strong, and even when life is almost unendurable, you hang on. The third day, I heard a song on the radio called “Never Surrender” by Corey Hart. Those words spoke to me. For a week I went back and forth. But every time I heard this song, I felt more sure of myself, I felt more sure that I could live, that I would live. I had a bottle of tranquilizers prescribed for my mom that I had been planning to take. After about a week of thinking about it, I flushed all the pills down the toilet and decided no matter what, I was going to live. No matter what, I was not going to give up. And finally I did get treatment from a psychiatrist. My aunt took me with her to her house, as my mom and step dad were beside themselves, taking care of my seriously mentally ill brother. My aunt kept me in her home, even had her friend who was a psychiatrist come and talk to me, he diagnosed me with depression (later to be changed to bipolar d/o type 1.) He prescribed antidepressants, which I took and became better and better, until I was ready to go home. At the same time, my little brother had also been diagnosed with bipolar d/o. Unfortunately, he did not fare so well and with his demise, all of us, especially my mother, underwent heartbreak and tragedy no words can describe. I don’t know how my mother survived it. She was a strong woman. I would wish that on no one, not ever, not my worst enemy in the world. To lose a gorgeous, loving, intelligent, funny, most beloved brother, it is not something to be borne. I will write his story another time. This post is about never giving up. Which is what I’ve done, even after my brother was gone. And I have lived to get married, lived to see my adored son turn 24, lived to see my niece become a doctor and my nephew get a Master’s degree. I’ve seen my brother and sister come into their own as successful, intelligent, charismatic and beloved siblings. I have spent time with my family and friends, and we have laughed and cried and had loads of fun. I’ve been in plays, I’m in one currently, I’ve moved from Buffalo to Louisville and made so many new friends. And there is still a lot in store, I’m sure.

So you see, never give up! If I had given up in 1985, instead of fighting with all my might, then none of the things I just spoke about would have happened or at least none would have been witnessed by me. My precious son would not have been born, what an awful thought. My son is über compassionate, super intelligent, handsome, very loving, and he will be a lawyer soon, he can accomplish so much, help others, help the earth, help animals, what ever he chooses to do. Just that is a good reason for me to have hung on in 1985.

Never give up. Hang on. Things will get better. It’s always worth it to stay around. No one who has been saved from trying to kill themselves has ever been sorry that they were saved. So you too, save yourself! You will be happy you did. Love and hugs for you my friends.

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Ummmm, Psychcentral.com, Really?

First of all, people, please stay on your medication. If you are having side effects, talk to your doctor about them. Don’t ever just go off your meds. You will survive, live, and prosper on your meds, not off them. However bad the side effects may be from the meds you are on, just know that psychosis, severe depression, and suicide are infinitely worse! So please stay on your meds and carry on a dialogue with your doctor. Ok, now you can read what I write about below.

There is a post on psychcentral.com called “Is Your Depression And Bipolar Medication Harming You?” (link: http://blogs.psychcentral.com/humor/2015/05/is-your-depression-and-bipolar-medication-is-harming-you/?utm_source=dlvr.it&utm_medium=facebook) In that post they say: “There are many valid reasons for not taking medication. There are many valid personal reasons that could be as simple as “I don’t want to take medication period!” All valid, it’s your personal choice to choose to be medicated or to use some other venue to maintain remission or balance without going delirious.  HOW YOU CHOOSE to stay well should be up to you/us.  We should have a say in what we believe our treatment should be… EVEN if that means not taking medication.”

Ummm, this is on psychcentral, where people go to get information about their mental illness. It is categorized under “Mental Health Humor.” Sorry, I don’t find this article in the least bit humorous, and along with the sick looking cartoons, one below, this article should never have been written or posted on psychcentral.com

Mental Health Humor and psychological disorder humor and cartoons by Chato Stewart

Mental Health Humor and psychological disorder humor and cartoons by Chato Stewart

I felt it was just wrong that this was posted there so I left the following comment: “This is ridiculous! To give a person with bipolar disorder the advice to stop taking their medications, even if it is supposed to be humor, is absolutely criminal! A lot of bipolar patients don’t stay on their meds and get so sick that they have to be hospitalized. They go off their meds and have symptoms ranging from depression, mania, suicidal ideation, psychosis and even suicide. It is highly irresponsible to post this on a site such as Psychcentral.com, a site which is supposed to advocate fro the mentally ill and give them good information on mental illnesses. Shame on you.”

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Depression help

I am reblogging this because a reader told me that they were in a suicidal depression but they didn’t do anything because this post gave them Hope! I have goosebumps from reading this and I am so glad that i wrote this post so it could inspire one person to live and breathe!

Bipolar1blog's avatarBipolar1Blog

irisIris, it means heavenly colors.

Being in a severe depression is one of the most excruciatingly psychically (and even physically) painful experiences any one can ever experience. That’s when the bottom falls out from under you, the rug is yanked out from under your feet and in either case, there is a black, terrifying bottomless abyss into which you fall. At first you claw and scratch to get out, but then as the days go by, you give up. You sit down, you stay put. All hope is gone, you have no energy to fight, your inner voice has maliciously turned against you. It tells you you are worthless, garbage, not worth saving. You don’t want to listen but you have no choice, you have no energy left to fight this. You have no hope of getting better. And anyway, are you sick or is the the way you always…

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One of The Best Bipolar Health Blogs of 2015 as chosen by Healthline.com

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Bipolar 1 Blog has been chosen for the “Best Bipolar Health Blogs” for 2015 at Healthline.com.

Who knew this was even a possibility when I started this blog in August of 2014! But I am so happy to be a part of this list. There are some pretty awesome blogs on it, so of course to be included is an honor! Simply put, what I have been doing is being recognized, I hope that means I am making a difference and it definitely means I will continue. Onwards and upwards my friends!

http://www.healthline.com/health-slideshow/best-bipolar-blogs#12

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Just In Case You Wondered, This Is What Depression Is.

Written in 2014. In a brief depressed phase. And yet there is hope, and yet I am alive. You can be in a severe depression such as described below, but you can survive it. You can go through it and come out on the other side and live and thrive. Just know that you can. I did it, I have done it many times, and I will keep on fighting. Fight with me.

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How much should I tell you, how much should I disclose? How much of myself should I give away? How much of the façade should I let crumble? I feel sick, awful, teary, bad… yes depression is on its way…again. The pictures I post on Facebook with smiles on my face, happy, normal looking, that person is gone again. I know it doesn’t make any sense. But this is what bipolar d/o does. One day, you are fine, enjoying life, smiling, thinking about things, and then the next day, you are basically a lifeless statue, expressionless, thought-less, emotionless. All the positives gone. And you feel nothingness and pain. There is a weight on my chest, hard to take a deep breath. My muscles ache, my heart aches. My mind feels dull and empty, no happy, positive thoughts, no ideas, no plans. Tired, so tired. Don’t want to get out of bed in the morning. Don’t want to do anything. Can’t publish this. Don’t want people to know how much of a wreck I am right now. Can’t give it all away. Don’t want everyone to see me deconstructed. Have to keep up some pretense of who I am. Fine, look at me, see this mentally ill person in a depression. See me and count your blessings you were not born with a mental illness.

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What do WE think about? We think about Side Effects.

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I have severe seasonal allergies, I always knew I did. Two days ago, I went to see my allergist (who I’ve been seeing for food allergies 😦 ) and he looked inside my nose (eeeek) and told me he was surprised that I could breathe as there was so much inflammation in my nostrils. So he recommended a steroid shot (100 mg Depo Medrol), some heavy duty anti allergy meds (Montelukast) and a steroid and antihistamine nose spray. And instead of being overjoyed that my allergies are being treated and will soon be gone, I went into panic mode. Steroid injection?! Will it send me straight into depression or, sometimes infinitely worse, mania?? Here are the psychiatric side effects for Depo Medrol: Psychiatric reactions, such as mood changes (including irritability, depression and suicidal thoughts), psychotic reactions (including mania, delusions and hallucinations), anxiety, confusion, memory loss, sleep disturbances.

What about the Montelukast? Here are the psychiatric side effects listed for it: aggression, anxiousness, dream abnormalities and hallucinations, depression, insomnia, irritability, restlessness, suicidal thinking and behavior (including suicide), and tremor. By the way, it’s very interesting that the Montelukast, which is an anti leukotriene, causes psychological side effects. Leukotrienes are molecules produced by leukocytes or white cells (the warriors of our immune system), they cause bronchial smooth muscle contraction, they attract other white cells to the vicinity. These are 3 – 4 times more potent in their effects as histamine. Anyway, the point is that once again there is a connection between our immune system and mental illness. There are many such connections. I will write a post about it soon.

For most people, a steroid shot for allergies is just an inconvenience. For people with mental illness, it is something to be thought about carefully, and even then, it could be an undoer of a life you have oh so carefully, with trembling, tired hands, put together. The same can be said for the leukotriene inhibitors, such as Montelukast.

So, now what do I do? Well I have two options, take them, or not take them. And I will discuss these issues with my psychiatrist and my allergist. In the final analysis though, it’s being injected into me, and I will react to it in whatever way I will, so the decision is mine. Scary, going into the unknown, I’m hoping that all will be well, mood as well as allergies.

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Responsibility

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I have been feeling useless, like a burden, and generally a mess. But I have decided to tackle these things head on. Instead of wallowing in the misery that these thoughts have brought on, I will look at them another way, a more constructive way. Namely by asking myself what can I do to remedy this situation? Do more, be more… How? Well, I might have been feeling depressed or anxious or a little too up and did not accomplish all I should have. So, from now on, I will do more, not go on spending sprees (nothing major, haven’t bought a Maserati yet, haha) so there is not even the least bit of worry about our finances or bills. Yes, spending sprees are a symptom (sometimes) of my bipolar disorder. Actually, I am just very extravagant, my grandfather was and my grandmother used to berate him for it. I think I inherited it from him! (When in doubt, blame it on your progenitors.) But… and yes there is a but… since I am aware of this, I can surely control it. Right? I think, therefore I am! I, very possibly, need to stop using my illness as an excuse and be more functional, carry the responsibility of mine and my family’s life on my own two shoulders. Instead of feeling bad, I am going to be happy that I have had this insight, and now I am able to do something to remedy the negative things and do more of the positives that I was already doing. Yes, tomorrow is another day! Oh gosh, what would we do without our tomorrows (ok, ok  Eckhart, don’t have a fit, I know it’ll be in the now that I will act)? And it is a day to be better than we were yesterday. To be out better selves. To be thankful for what we have in our lives. To be thankful for our loved ones. To not wallow in our misery, but LEARN, learn, learn from our missteps, and live life with responsibility, love and joy, and appreciation for all that is in our lives. Even the negative things, because they are our greatest teachers.

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Depression help

irisIris, it means heavenly colors.

Being in a severe depression is one of the most excruciatingly psychically (and even physically) painful experiences any one can ever experience. That’s when the bottom falls out from under you, the rug is yanked out from under your feet and in either case, there is a black, terrifying bottomless abyss into which you fall. At first you claw and scratch to get out, but then as the days go by, you give up. You sit down, you stay put. All hope is gone, you have no energy to fight, your inner voice has maliciously turned against you. It tells you you are worthless, garbage, not worth saving. You don’t want to listen but you have no choice, you have no energy left to fight this. You have no hope of getting better. And anyway, are you sick or is the the way you always were? Useless, hopeless, ugly, stupid, wrong, just plain wrong. Well this kind of depression, a severe depression definitely needs medication. But might someone in this kind of severe depression, or someone in a less severe depression be helped by another technique? My very good friend once told me of their experience with depression and how they cope with it in a very compassionate and positive way, which is to treat yourself like you are your good friend. So, you wake up, you feel so awful that you don’t feel like getting out of bed. Now you are treating yourself as your own good friend, so you say “Hmm, don’t feel like getting out of bed? That’s ok, just rest if you need to.” Then you check in with yourself and ask :How about now? You feelin’ any better?” Then later “Feel like takin’ a shower? No? That’s ok, maybe later.” And you go on like this, treating yourself as you would a good friend. With compassion, love, caring. No name calling, derision, hate. Remember depression is an illness, you are not doing this to yourself, you are suffering from an illness. What if you broke your arm and started calling yourself names and saying hateful things to yourself? You wouldn’t, you’d go to the emergency room, get a cast and NURSE your arm back to health. This takes me to the second thing I wanted to say, my fellow blogger Gentle Kindness just posted a post (http://gentlementalannie.com/2015/02/13/personal-care-and-depression-be-your-own-nurse/) about depression, in this post she describes depression to a tee and then offers the suggestion that when you are in a depression, you should be your own compassionate nurse! Another brilliant idea. Who wouldn’t benefit from a good friend and a compassionate nurse? Lately, I have been feeling the choking, ugly, bony fingers of depression around my throat. Tasks have once again become more difficult to do. There is dread in my heart and tears that spill easily from my eyes, and my heart feels like it’s breaking for things that would not normally phase me. yes, depression, unfortunately, definitely depression.Well, I am going to try an experiment. Instead of saying what I normally do to myself when I’m feeling depressed “You useless, sick, sad excuse for oxygen consumption.” I am going to treat myself with compassion and love, as a sick person deserves. Well it’s already working to lift my mood a little, it’s infinitely better to hear “It’s ok honey, you are sick, take it easy. You’ll feel better, you always do!” than the above dialogue. Be kind, be compassionate, use loving words and have hope and be resilient. You are hope and resilience. Hugs and positive thoughts for all those suffering from depression or other maladies of the mind or body.