A Rare Form Of Dwarfism May Protect Against Bipolar Disorder

While researchers are on the hunt for exactly which genes are causing illnesses, research is also being done to search out genes that can protect against them.

An article in The Boston Globe’s science section recently reported that researchers have discovered that a rare, genetic form of of dwarfism called Ellis-van Creveld (a form found relatively commonly among the Old Order Amish of Pennsylvania) may actually cause a genetic mutation that prevents bipolar disorder.

Though researchers don’t want to reproduce the exact mutations, they believe it may be possible to explore new forms of treatment through this discovery.

This has been a very short summary, if you are interested in reading more check out the full article in The Boston Globe here!

One Good (Manic) Turn Deserves Another

The last thing my (ex) therapist said to me (jokingly) was,

“…and I never got to see you manic!”

In my depressed state I shrugged and replied,

“it is rare these days… euphoric mania, anyway. It hardly ever happens anymore, frankly I can’t even remember the last time it did.”

Little did I know, within a week I’d be hunkered over my chest of drawers urgently rearranging my shirts because, well, is it better for them to be grouped by print or by sleeve length?? And, no, no, no, the underwear needs to be arranged in descending order of favoritism and then by color!

As much as I would like to say I saw this swing coming, I would be lying to you. Generally I would say I have a tendency to become manic in October, however I find that when I say that ahead of time it never actually occurs.

This time around I think I would like to blame the aggressive head cold that has been going around for my lack of catching the warning signs. Normally euphoric mania comes on largely in a physical way for me first, but I can’t say I felt any kind of awesomeness, electric humming, or skin-crawliness that I normally experience until much later on. This time around (because of the cold) I felt sinus pressure, ringing ears, a sore throat that lingered on much longer than I anticipated, and initially much more lethargy than I normally would when mania strikes. By the time I started to realize things were getting out of control it was a bit too late to divert it.

Of course, in hindsight I can say, “ahhhhhh, ok,” to the series of odd and rather impulsive actions that led up to my frantic laundry situation and subsequent hours of laying in bed awake, chest pounding, having rapid conversations in my own head. One would think I might have had a clue when the series of somewhat depressing situations I’ve found myself in lately became increasingly hysterically funny to me, or when I stopped each of five consecutive movies I was trying to watch halfway through because I no longer felt interested (and then the only movie that did hold my attention was The Silence of the Lambs), or when I cut all of the instances of the number “2” out of a cosmo magazine to see which one was “the best,” or when I spontaneously maxed out my credit card buying tickets to see The Who. I was even having trouble writing, many of my sentences were coming out backwards.

Contrary to popular belief, these are not things I normally do. I’m the kind of girl that usually just likes to wad her shirts up in a ball and shove them in the drawer, or look at the prices and fluid ounces of every bottle of shampoo in the store to make sure I am getting the absolute best deal before buying one. I know I usually claim I don’t do the “spending” thing with mania, but apparently this was an exception. (Boy, I hope I’m not inadvertently picking that habit up!)

To be fair, I think normally these are things my boyfriend would probably notice, however he was out of town for work all last week.

The episode seems to have peaked Saturday night and then turned to the dark side, leaving me experiencing four swings of “crazy girlfriend” type, hostile-agitated-mixed chunks appearing between mildly euphoric moments throughout the day.

I’ve been having trouble getting my thoughts together long enough to complete anything I’ve been trying to write, but I have a few ideas that I hope to get down soon. Thankfully I have been lucky not to experience any psychosis in the last week (knock on wood), however the sort of hostile, “I hate you” mood swings I’ve been having haven’t exactly been a walk in the park either.

I have my intake appointment with my new psychiatric clinic on Friday (hooray!) and though they are usually somewhat grueling, I will be happy to have someone around to help me untangle the big ball of emotional spaghetti in my brain again.

Lithium Nausea; Curbed By Tater Tots?

After four years of taking Lithium I have finally discovered a substance that nullifies lithium nausea.

This is big news, are you ready for this?

Potatoes! Or, more specifically, tater tots!

As I said, I’ve been taking lithium for four years now and though most of the initial nausea, tremors, and grossness has faded, I have always had trouble with the window between the time right after taking the lithium before I fall asleep. This has been especially bad if I can’t sleep (for whatever reason) and the longer I lay there, the more awful I feel… consequently making it even harder to sleep.

While I’ve tried just taking the lithium with food, I don’t like to eat a “meal” within two hours of going to bed because I have bad acid reflux and wind up with nasty heartburn. When I’ve tried staying up two hours after taking the lithium, I reach a point where my stomach empties (good for going to bed) but then the nausea hits me. In my experience, empty tummy = return of the nausea.

I discovered the method I’ve been using the last month or so when I began having really bad stomach problems (as a result of medication side effects). It only really works if I eat dinner at least three hours before I plan on going to bed (two hours before I take the lithium and tots so my stomach is empty, one hour before I expect to actually get in bed).

This has been my recent experimental tot-to-lithium nausea nullification ritual;

1. I bake up 6-8 tots (depending on my hunger level) and start them so they will be out of the oven an hour before I plan to get in bed. Keep in mind that involves subtracting oven pre-heat time and baking time (about 25 minutes total for my oven but each oven is a little different) from the time I want them done, so I start the oven up about an hour and a half before bed. Also, it is good to note that cooking 6-8 tots takes less time than, say, half the bag, so usually the full time printed is not necessary -I tend to knock off 3-5 minutes of the cooking time, but as I said, each oven varies.

2. Once cooled, I eat the tots (with a little salt), take the lithium, and enjoy a nice episode of whatever is on.

3. By the time I crawl in bed an hour later I have been surprisingly nausea free and slightly comforted by the tots. For whatever reason, this has made falling asleep significantly easier, and I have had less nausea upon waking up later than I did when I was taking the lithium before bed on an empty stomach.

The potato seems to have enough carbohydrates and starch to keep me feeling full even though it is only a few little tots, but not full enough that I feel bloated or have had to deal with acid reflux. I have not, however, been using any kind of condiments because this has generally just triggered heartburn once I am in bed.

I don’t expect this is a phenomenon specifically caused by tots, if you are a whole-food or organic eater it might be worth trying a few cubes of boiled or roasted potato instead. I just use the tots because they involve significantly less prep, and I find the thought of taking “potato pills” with my regular ones somewhat amusing!

I realize this is probably one of the weirdest things I’ve ever stumbled upon, but honestly it has really helped me so I thought I would share. Though I can’t guarantee this will work for you, a little experimentation could definitely be worth your while! Tot-on!

Back to the Basics

Things seem to have reverted back into a state of normalcy for me. Of course, when I say normalcy, I mean my normalcy. This change definitely has it’s plusses and minuses (less physical pain and vision problems, a return to a flip-flopping of psychotic mixed and depressive states, and the typical health care team issues I tend to run into every six months or so) but I wanted to address this return “back to the basics” that has occurred over the last two weeks before writing about anything else that has been on my mind.

My current psychiatric medications have returned to a regimen of  lithium only. 

I’m sure it was pretty clear that the seroquel I tried the last few months brought on some serious health problems, but it wasn’t until the issues with blurred vision, dizziness, nausea, and light and motion sensitivity that I began to suspect the wellbutrin I’d began in the last two months might be contributing to the problem. After having my eyes, ears, and stomach checked out I began a systematic stop and start of the medications I was taking at the time to see if any changed occurred. I pulled the plug on the 150 mg of wellbutrin I was still taking (after decreasing a week earlier and seeing some improvement and speaking with my psychiatrist) and about ten days later (Saturday) I was able to sit through watching a movie for the first time in five weeks without thinking I was going to vomit.

Not having been able to watch tv or movies for that long was pretty agonizing, movies are one of the few things I generally still feel passionately about and being without that sense of comfort was very jarring.

I was a little surprised (but glad I didn’t have to go see a neurologist about this) because the warnings for wellbutrin list “eye pain and vision problems” but that isn’t very specific. What really tipped me off was that I found out that wellbutrin can trigger problems with vertigo, and though I have experienced plenty of vertigo in the past and what I was dealing with this time was different, there were aspects of my symptoms that felt similar. At any rate, this issue is improving… and I wont be taking anymore wellbutrin in the foreseeable future.

The swings are back in action. 

While the seroquel seemed to keep me from swinging around the mood spectrum, it also kept me in the depressive end where I was sinking very quickly into a dangerous place. Now that I’ve stopped it, I’m back to my typical, sporadic swings lasting anywhere from thirty minutes to days or weeks at at time.

“From your perspective, which is worse?” I asked my boyfriend. “When I am depressed all day every day, or when I seem ok one second and then fly off the handle the next?”

He paused for a moment before replying, “I can’t really call one ‘worse’. They’re both equally devastating.”

I feel like I ask myself the same question a lot, because remaining in a single state (like depression) can sometimes feel better, more stable to me than rapid cycling because I can often do a better job of predicting my future mood; depressed. At the same time, everything shuts down and my mood rarely stays “somewhat depressed”, usually moving toward “earth-shatteringly depressed”.

If I’m rapid cycling, I can usually experience one or two hours a day where I feel relatively ok, and if I’m really lucky, maybe one day in a week where I feel relatively stable. Sometimes, just the fact that these moments are possible makes rapid cycling feel somewhat better to me.

I find the negatives of rapid cycling to be much worse though. It grinds on my relationships, I have no way to make any kind of predictions about how I will be feeling from one moment to the next, and switching into mixed episodes (which has become more and more common for me) becomes extremely dangerous.

Annnd health care team problems… as per usual.

I feel confident today in saying my concerns about my healthcare team the last week have had nothing to do with delusions.

Usually when I have problems with healthcare, it has been because of insurance coverage, or co-pays, or my old doctors not taking new insurance, or whatever element of the system seems broken at the time. This time, my concerns are a little different.

October has always been a fishy month to me, and I don’t consider myself superstitious but usually when something weird goes down or people are acting very strange, it is in October.

Anyway, first my general doctor started acting very strange and making me incredibly uncomfortable. He’s began giving me these long “pep talks” about how I need to look inside myself and find happiness, naturally this is one of the biggest turn-offs you can come across when you have a mood disorder. This has happened twice now, and though I understood when it happened the first time (I had a breakdown in his office) the second time it was completely unwarranted and generally had nothing to do with anything we spoke about in my appointment (regarding stomach pain). This man has always been a good doctor to me, very smart and professional for several years, and I know he is coming from a place where he is intending to help me, but for the most part while I was stuck in that little cold room with him trying to make extended eye contact it felt like if either of us is insane, it is definitely him.

Next it was my GI specialist. I needed a prescription refill order and she failed to return any of my calls, messages, or emails for three days. When she finally did send the order, she sent the wrong order to the pharmacy and never called me back. After calling the office again (to make another appointment) all of the notes from our last appointment have mysteriously vanished and there is no record of it. Needless to say, this (even more than the above problem) makes me extremely nervous. I realize she is a busy woman, but I feel like my experiences last week are definitely bordering on (if not already) unprofessionalism. I ran out of medication saturday, I still haven’t heard from her or her office.

Finally, my therapist quit unexpectedly two weeks ago. He had scheduled a follow up appointment with me last week, but the receptionist called me that day and said he never showed up. By the time this happened I couldn’t help but laugh.

I don’t have much of a plan of action for the first two doctors (maybe they’ll get their sheezy together?) but as far as therapy is concerned, I’m ready to switch clinics. The one I have been going to the last three years I’ve had a lot of problems with, and the people who work there are very inexperienced. Instead I’ve began pursuing a community clinic specializing in patients on medicaid with more significant mental health problems (me!), at this point I’m just hoping to get in before next month when things become extremely (more) stressful.

Tonight I have an appointment with my psychiatrist and I am keeping my fingers crossed he hasn’t completely fallen off the deep end too.

Got Chocolate?

I’ve always heard that eating chocolate produces those good-feeling endorphins that can turn a frown upside down, and though I would say I find chocolate to give me a general sense of comfort (at times, I’m not a big chocolate lover normally) it wasn’t until last week that I really experienced that “chocolate high”.

Because of the diet restrictions I’ve had over the last month, I went three weeks without eating chocolate of any kind. Because of the dairy problems I’ve had I was advised to steer clear of milk chocolate, however, as I mentioned, I’m not a big chocolate buff. I tend to prefer the salty snacks to the sweet ones, so avoiding chocolate was relatively easy.

The thing I was really missing was milk. Last week I decided to remedy this by purchasing a lactose-free protein drink that was chocolate flavor -to trick my brain into thinking I was drinking chocolate milk.

Well within minutes of my first sip of this chocolate “milk” I found myself smiling and laughing for the first time in weeks. It appears that after living off of nothing but potatoes and pasta, a chocolate high can pack a powerful punch!

It never ceases to amaze me how something as simple as a chocolate protein drink could help improve my mood.

This morning’s chocolate “milk” drink is dedicated to the anniversary of this blog -which just happens to be today! Hooray!

Now With Even More Damage Control!

My ability to write right now is severely limited, but I’ll come back to that in a minute.

First I want to note that my stomach pain and problems seem to be stable-ish at the moment. Granted, I am not eating anything acidic, dairy, beef, or caffeine (so pretty much carbs, carbs, some peas, and more carbs) but my stomach seems to be coming around. I’m hoping that over the next few weeks I can introduce some small bits of more exciting food to it (condiments! flavors!) and see what will happen, but as it is now it appears that stopping the Seroquel has also put an end to my stomach’s apparent suicidality.

There are several symptoms I have been experiencing however that have not improved.

Though the reduction of wellbutrin from 300 mg to 150 mg earlier this week did reduce the amount of blurry vision and inability to focus I was having, it did not seem to touch the dizziness, nausea, eye pain, and (what I have now pinpointed to be) sensitivity to light and sound. The sensitivity to light has become severe enough that I can’t use the TV, computer, or even my iphone without turning the brightness all the way down, wearing sunglasses, and then only using it for a few minutes at a time before stopping again. Failing to do this results in intense dizziness, eye pain, and increasing nausea.

Having to wear sunglasses indoors makes me feel like a doofus. Strangers keep accusing me of trying to look cool, which (believe me) is pretty much the opposite of how I feel right now.

Even now I am writing a paragraph of this post at a time, hanging out in the kitchen for several minutes, and then coming back to write more. Needless to say, unless things change drastically soon my posts will probably be fairly few and far between for a while.

Since both my regular doctor, my GI specialist, and I thought these symptoms were also associated with the Seroquel (which I have been off for two weeks now with no improvement, and actual worsening the last few days) there are several theories floating around.

One theory (from my GI specialist) is that I might have some kind of bowel disease. I will probably be subjected to the pleasure of receiving a colonoscopy in the next two weeks to check for that.

After seeing the ear doctor (to check up on the theory of some kind of inner ear problem and finding nothing) his theory was that it might have to do with an eye problem.

After seeing the eye doctor (who found no evidence of any abnormalities) his theory is that it is a neurological problem -or- a side effect of one of the other medications I’m taking.

Going back to my GI doctor she agreed seeing a neurologist is also a good idea, since I have a history of weird headaches and headache symptoms and this could potentially be all of the symptoms of a migraine without the actual headache part. Apparently that can happen, albeit rarely.

In the meantime, my theory is that it has to do with one of the drugs I’m taking, so I am systematically phasing all drugs out and then back in individually to rule them out as culprits for this issue. The ones I have left to scrutinize are lithium (which I’m not particularly worried about because I’ve been taking it several years now), the wellbutrin, and ranitidine (an acid reflux medication). Both the wellbutrin and ranitidine have potential side effects involving dizziness, vision problems, and vertigo, and these weird symptoms came on right around the time I increased the wellbutrin and started the ranitidine.

Though the side effect thing really gets my goat, if these symptoms are a side effect I think I would be grateful at this point. Really the alternative would involve something potentially being seriously wrong with my brain or bowels which (let’s face it) doesn’t sound like a good time.

Plus I think it is the responsible thing to do to really scrutinize my medications at this point because I have a long history of getting weird side effects and it is much easier (and financially viable) to stop taking something for a week or two (with my doctor’s consent) than to move forward with brain scans and swallowing radioactive bullets and whatnot. Obviously, I will do those things if I need to, but why go there if it isn’t actually necessary?

In conclusion; things are better and worse. Thankfully I’ve switched back to depression this week because I couldn’t go to all of these appointments half deranged (let alone fully deranged). As usual, I am trying to do the best I can… and though “best” in this situation involves a lot of panic attacks and crying, I at least have sunglasses to hide my tears behind.

Complication Damage Control

After last Friday’s realization (regarding the delusional state I’d been overtaken by) I contacted my psychiatrist. He prescribed me the ODT (orally dissolving tablet) version of Rispiridone as I haven’t been able to stomach lactose recently and lactose is an inactive ingredient in several (if not most) psychiatric drugs.

The lactose acts as a base for the medication to be applied to in most tablets, but usually isn’t used in extended release tablets, capsules, and orally dissolving tablets. I figured this out after a delirious game I played last week called, “why are certain drugs making me vomit?” The result? The vomity drugs were the ones that contained lactose as an inactive ingredient. I was not surprised, since I haven’t been able to tolerate lactose in food for over a month now.

Had this not been an issue, I would have just taken my typical emergency dosage of rispiridone right away… but at the (very slow) rate my stomach has been healing I have been doing everything in my power not to upset it and in conjunction, not further upset my mental state.

By the time my psychiatrist and I got this plan sorted out it was already late afternoon on Friday and I had spent most of the day with my hands clenched on either side of my head. I don’t know if I was hoping to squeeze out the delirium or if I was simply trying to make lemonade out of lemons, but I figured if I could wait until I got the prescription filled everything would be relatively ok.

Of course, that was assuming any of the pharmacies in a five mile radius of my apartment had the ODT version of rispiridone. Not one did. I called them all, and yelled at the technicians who worked at most of them. The best they could do was have it by monday and I didn’t know if I could make it.

I also didn’t know what the alternative would be. Would I have to go to the emergency room again? I’ve already been to the emergency room four times in the last six months, and I was even more concerned that doing that would result in being given more medication I would have no control over, having more bad reactions (triggering uncontrollable vomiting), and starting over (again) in terms of trying to give my stomach a leg up.

I trudged through the weekend by being about 10% mentally present in everything that took place and trapped in my own head, full of a horrible amount of noise, the other 90%.

The noise. Every time I mentioned it I imagined myself with the snarled, green face of the Grinch who stole Christmas.

I have tinitus (ringing in the ears) anyway, but since starting up wellbutrin again the ringing has become exponentially worse. When I feel alright I can kind of ignore it by pushing it to the back of my mind, but when I don’t feel alright and all of that stuff near the back of my mind gets giant neon signs shaped like arrows pointing at it, the ringing joins hands with the other noise (negative thought chatter, obsessive thought loops, and internal radio station playing the first ten seconds of five different songs in a loop in my brain) that takes place when I become agitated and though bad enough on its own, it easily combines with ambient noise to form a wall of noise I can’t get beyond.

When I get trapped like that by the noise, that’s when things get truly dicey. I become very desperate and impulsive, and when I’m already in a suicidal state I fall into red-alert really quickly.

The first thing I did yesterday was contact my psychiatrist and negotiate reducing the wellbutrin dose in hopes of helping the ringing. Today I can say that this change has helped, so I am really feeling relieved in terms of that already.

I have also still been having a significant amount of nausea, dizziness, and blurry vision that did not improve after stopping the seroquel. I am hopeful that this might be linked to the wellbutrin and by lowering the dosage I can get a reduction in these symptoms.

After procuring and taking the ODT rispiridone last night I must say that it was probably the most awful thing (well, medication) I’ve ever tasted and even this morning it made my taste-buds act funny.

Despite that fact I woke up after a night free of nightmares (something that hasn’t happened in several weeks) and even though I hear a little, high-pitched whine, my mind feels considerably less cluttered. I generally consider the typical tablet form of rispiridone to provide relief in the form of a foggy stupidity, but I feel much more alert today than I expected. I can’t say for sure that this is only due to the rispiridone because I am also taking half as much wellbutrin as I was two days ago, but either way I am very glad to get some relief.

The bad side? Welllllllll… my hands did start twitching uncontrollably after imbibing the rispiridone last night, so I need to spend a little more time talking to my healthcare team before I could consider attempting to take it in an every-day fashion (and not as needed as I have been) but just the fact that I have something I can take in an emergency at this point makes me feel significantly less stressed.

These mixed episodes with psychosis have usually come on in waves for me, so even though I feel good about making it through one I am not going to try to fool myself into thinking this is the end of that super fun delusion time. I’m just hoping that if I can continue to be gentle with my stomach and not rock the boat, the waves that come next might be a bit less severe.