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bipolar medication
Control
When we are in one of our phases, we people with bipolar d/o, we do lose control of our minds. The degree to which we lose control is dependent upon the severity of the phase as well as the type of phase (manic or depressive.) Losing control is something I intensely fear. Losing control of my mind, losing control of my life (having to be hospitalized) losing control of my thoughts, my actions… I am a robot controlled by my illness when I’m in a severe mood phase. The real me disappears from hours to days. I can say things (F words, hateful, angry things) and do things (throw something at someone, go on a trip out of the blue) and I can definitely think things that may or may not have any basis in reality. Quite frightening. It may be a result of this that I need to be in control of things in my life. If something is out of my control, it causes me untold anxiety. However, I am also realizing that I cannot control everything. I cannot control situations. I cannot control people. They, like myself, come with their own specific set of issues and their own specific ways of reacting to things. I am also realizing that I need to respect that and not constantly demand that others be at my beck and call all the time (well I really don’t, but you know what I mean.) I have to let go of the strong urge to be in control and let things be. I have to let go of the fear of not being in control. And that fear is huge, the anxiety, sometimes, overwhelming! The more the fear and anxiety get ahold of me, the more controlling I become, and the more fearful and anxious my mind gets. It’s a vicious, vicious circle… I have to realize that the only thing I can be in control of is myself (most of the times) and the one thing that is of paramount importance is to stay on the optimal dose of my meds so that I can be in control of my self.
Wide Arc Mood Swings
Emotions are a double edged sword for people with bipolar d/o. Our intense emotions allow us to feel deeply, be empathetic, be creative. But these intense emotions can also break us. Things like Empty Nest Syndrome are very difficult to deal with, as our emotions get get very intense and painful and difficult to handle for ourselves. Any kind of emotional upheaval is more difficult when you have a mood disorder. We people who have bipolar 1, 11, or major depressive or anxiety disorders have a more difficult time coping with it. We feel so much more deeply, we really do, I’m not making that up. Whether we are happy or sad, we feel off the charts. Our mood swings are more extreme and have a wider arc than someone who doesn’t have a mood disorder.
Here’s a figure I made. It’s not exact, just illustrative, the normal mood range is a little past the lines labelled “Normal Depression” and “Normal Euphoria.” The Bipolar mood swings however can go beyond even the “Out of Touch with Reality Depression” and “Out of Touch with Reality Mania“!!! That is some depth and intensity of emotion, that is why when people are in a severe depression, they kill themselves, because the depth, the intensity, the very quantity of their sadness is too painful, too intense to bear.
Just something I wanted to share with people who don’t know what it feels like to have a mood disorder.
Mood stabilizers like Lithium Carbonate, Depakote, Abilify keep us in mostly the normal mood range. They are literally heaven sent for us, people with mood d/o’s. I don’t know if I’d be here without my Lithium Carbonate, I don’t think I would actually. Even with it, I still have been going through some extreme mood situations, but they are somewhat attenuated and more easily reversed than if i wasn’t on Lithium. So even though I have Bipolar Disorder Type 1 (the official name) I feel lucky that I also have Lithium Carbonate. Also, my mood lability was also due, in large part, to Zoloft, which I haven’t taken in 3.5 months, and this will also help stabilize my mood. Yaay! Coming off Zoloft has been anything but easy. But that’s a subject for another post.
Best wishes and hugs to you my dear friends.
Maybe, maybe not…
Don’t really have anything to say. Tired. Very low energy. Low mood. Beginning of a depressed phase? Don’t know. It’ll become apparent soon enough. If It’s hard to wake up in the morning, if it’s hard to get anything done, if I don’t even want to get anything done, if I have lost interest in activities that were pleasurable, such as taking pictures, or singing, then yes it looks like the beginning of a depressed phase. These things have been happening to me in the past few days, but only the past few days so it’s still too early to tell. It may just be a blah period and not the beginning of a real depression. At least Zumba is still FUN! If that stops being fun, then I am in serious trouble…
Also if I do go into a depression, there is one big problem this time: No Zoloft. My psychiatrist will not let me take Zoloft or any SSRIs (Selective Serotonin Reuptake Inhibitors), because he says that they make people with bipolar disorder cycle more, and apparently research supports his claim. But this is pretty scary for me, because until now, whenever I felt a depression coming on, I would start taking Zoloft and it abated. This time I don’t have that option, that safety net. If I truly do go into a depression, I don’t know what I am going to do. And just this fact is causing me a lot of anxiety and stress.
The drugs he has recommended I go on all have given me very bad side effects in the past. For example Abilify literally gave me Parkinson’s like symptoms, with very stiff muscles, a shuffling gait and muscle tremors. When I took Welbutryn in the past, I thought i was going to burst because of an insane level of anxiety. Latuda gave me blinding headaches and Saphris also gave me a lot of anxiety and severe headaches. Provigil, which is a stimulant is also one that he has suggested, but I will not take it as it can push people with bipolar d/o into full blown mania. I don’t understand how he even suggested that, given the fact that this is a side effect! So there we have it. The one medication I can take without side effects is now forbidden to me and all the ones I am allowed to take are ones I cannot take because of awful side effects. The fear, anxiety and stress of what’s going to happen if I do go into a depression are quite enough to send me into a depression 😦
Going to NYC for Thanksgiving. A lot of close and extended family will be there. Hoping I will be fine. I was so looking forward to this trip to NYC with my husband, my son, my stepdad, my brother, my sister, my cousin, her children and many, many others. And now I don’t know. Oh well, all I can do is hope for the best.
Also wondering if it is time to find another psychiatrist. But what if what this one says is true… then it would be unwise to find someone new… going around in circles and have no idea what to do. Even deleted a whole post I’d written because I thought it was garbage… simply going around in circles. Not so bad that it is definitely a depression, but definitely some symptoms, and maybe on my way to a depression.
Oh yes, bipolar strikes again, as usual with its impeccable timing, and all it does is make my life a living hell. Tired, so tired of this. Of fighting depression, of fighting mania, wtf bipolar d/o, leave me the hell alone.
Lithium, the miracle drug for people with mood disorders!!!
Lithium is a naturally occurring element. It is the same element that is used in batteries. But it is a Godsend for people with bipolar d/o. It stabilizes our moods. It stops the swings altogether or at least stops them from being too extreme. In areas where the concentration of lithium in drinking water is high, the incidence of mood disorders is lower!!! It is a calming mineral that helps with mania and, to a lesser degree, with depression. The general dose is 900 mg per day. I was on 300 mg because of the few side effects I had (fine muscle tremors, frequent urination, hair loss, acne, weight gain, GI problems.) But that was not enough to control my mood swings, so I went up to 600 mg/day, and that was better, but my swings were still not controlled. Now I am on 900 mg per day. Even though my right hand shakes a LOT, more of my hair is falling out, and I may get acne now and then, however to be stable mood wise is very, VERY important to me. So I am taking hair skin and nails vitamins, using benzoyl peroxide and living with fine muscle tremors. I am confident that the 900 mg dose of lithium is going to keep me in the normal phase, without swings that are too extreme in either the depressive or manic direction.
Lithium possesses unique anti-suicidal properties that set it apart from other agents. With respect to cognition, studies suggest that lithium may reduce cognitive decline in patients. It is seen to have a protective effect on people’s brains. The neuronal cell death that is seen in people with bipolar disorder is decreased when they are on Li+. As neurons die, venticles in the brain increase, this is also seen to lessen in patients who take Li+!!! It even has been hypothesized that Li+ causes neuronal cell growth, thereby reversing the damage that bipolar d/o inflicts upon its victims. So I am very happy, thrilled in fact, to know that the Li+ I take is not only preventing this disease from having an effect on me, but it is also protecting and regenerating my neurons. :)))))
The molecular mechanism of lithium (Li+) seems to be related to its similarity to sodium (Na++). It is taken up by neurons through the same pump that pumps in Na+ (Yes there are pumps that pump ions, such as calcium (Ca++) potassium (K+), in and pumps that pump ions out of all cells, including neurons. Pretty amazing hunh?)
Evidence from both in vitro and in vivo studies has demonstrated that lithium exerts multiple effects on neurotransmitter/receptor-mediated signaling, ion transport, signal transduction cascades, hormonal and circadian regulation, and profoundly alters gene expression patterns.
Li+ reduces excitatory (dopamine and glutamate) but increases inhibitory (GABA) neurotransmission; however, these broad effects are underpinned by complex neurotransmitter systems that strive to achieve homeostasis by way of compensatory changes. For example, at an intracellular and molecular level, lithium targets second-messenger systems that further modulate neurotransmission. For instance, the effects of lithium on the adenyl cyclase and phospho-inositide pathways, as well as protein kinase C, may serve to dampen excessive excitatory neurotransmission. All this means is that Li+ affects molecules that are called second messengers (the neurotransmitter being the first messenger) and that normally transmit the signal, well Li+ stops the excitatory signals. Makes sense, as it a cracker jack mania buster!
Li+ also has inhibitory actions on inositol monophosphatase, inositol polyphosphate 1-phosphatase, glycogen synthase kinase-3, fructose 1,6-bisphosphatase, bisphosphate nucleotidase, and phosphoglucomutase enzymes. Some of these enzymes are involved in increasing activity of neurons in response to neurotransmitters, such as dopamine, serotonin, epinephrine, norepinephrine, and GABA. So again, Li+ stops excitatory signals from being passed from one neuron to another, thereby decreasing neuronal activity. This is good, because in mania your brain is working like gangbusters! And it needs to be slowed down. So Li+ does that.
If your doctor has prescribed Lithium for you, please take it. It is a wonderful medication, which will save your neurons, your brain, your relationships, and maybe even your life.
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