Monthly Archives: June 2012

Enter – Obamacare

It is everywhere I look right now, Obamacare, and people who are wildly against it thrashing around, tearing the wallpaper off of those digital facebook walls.

As someone who has had a pre-existing condition since before I even knew how insurance worked, someone who has been denied healthcare before, and been yanked around by insurance companies who wont pay for my mental health care I don’t think I can even express how glad I am that something is changing in this country.

Am I certain this is the best route? Honestly I have no idea. I don’t work in politics, and I am not someone who is paid to make attempts at mapping out how the country will react in any given situation so I can’t say what will happen. I don’t claim to know how things will change, but I think that is really the fun of it. We’ll have to wait and see for ourselves.

What I do know is that it has been over a year since I had insurance, and as someone without insurance I have had to avoid treatment at times (for lack of someone who will treat me while uninsured), I have had to limit which medicines and treatment options I can take (without insurance to help pay for those medicines), and I’ve had to go to the emergency room at least once in order to receive immediate care.

And, to be completely frank, I didn’t pay for that emergency room visit… so it is likely there are people out there already paying for my health care.

There is such a weird loop involved for me, because having a mental illness -I have had a lot of trouble working. I could potentially work more if these issues are treated, but my treatment is severely limited without insurance. I could get that insurance, but I would have to work more… and as I said, I would potentially need more treatment to work more.

Which came first, the chicken or the egg?

To be honest, I have been considering applying for disability, but the idea of having to deal with Medicare has me a little terrified. Insurance is something that has always caused me a lot of stress, and somehow needing help with mental health has been less stressful with no insurance at all than with most of the insurance companies I’ve dealt with in the past requiring me to jump through hoops, fax innumerable pages, and sending me statements with numbers of enormous proportions (nearly giving me a heart attack) on accident.

I think these healthcare changes will help people, but I do think they will sift others (like me) into finally applying for disability. If I have to pay for insurance anyway (with the money I can’t seem to make), it only seems logical to me to move forward in that arena instead of floating around a penniless finagler -especially if I’m going to pay in some aspect either way.

Though, I have gotten pretty good at being that penniless finagler.

Whatever happens, some people will be angry, some people will be happy, and some people will be sad. Others, like me, will probably be all of those, but realize that change is imminent so it is better to adapt than to tear down that digital wallpaper.

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Choosing Hurdles

I was over at My Year To Thrive yesterdaya blog written by despitemyself with some pretty rockin’ insights. It seems we have something of a similar background and it really caught my attention that she mentioned always wanting to have joined track in high school to run (specifically) the hurdles. 

Now, I was in track in middle and high school, and my event of choice? Hurdles.  

It struck me a little bit that the most obvious symbolism for living with hurdles in life would probably be (yep) hurdles. I mean, if you think about it… I could have any choice of events to run in a track meet, and I chose the one with the most physical barriers between myself and the finish line.

As someone who has lived with the waxing and waning of OCD traits over a number of years I am someone who feels inclined to do things a certain way. By that, I really just mean my way. And it should come as no surprise that my way probably has more hurdles than any other way.

Why?

despitemyself suggested this action is due to being raised in chaos. My therapist has told me something similar, that people who were raised around a lot of drama often create more for themselves constantly because that is what they’re used to.

And I have, to be completely honest, had moments of boredom (for lack of a better word) where there should have been contentment in my life. For a while I surrounded myself with the most intense people I could find -because there was never a dull moment, and I felt at home there.

Recently someone said, “I think she just likes it that way,” in regard to myself making everything into a problem that needs to be solved. A solved problem presents closure, it presents a challenge to stimulate the brain. I do need both closure and challenges, and to some degree I see that as a positive. I am stronger for it, I think, to have run the gauntlet over and over again and survived.

It is only now, as I look at the price of stress directly in the face that I am able to cut out as much drama as possible. Stress from drama has caused me to have innumerable meltdowns, and I’ve suddenly found myself fleeing from it rather than embracing it.

As someone who needs a problem to solve, can I get it out of my system in other ways? By doing puzzles? By building a bridge out of match sticks? By running a stretch of track littered with hurdles? Can I channel this need for drama into something harmless, or will that defeat the purpose?

The Jane Pauley Stigma Position

I wasn’t really sure if I wanted to talk about this, but honestly the topic has been bothering me ever since reading the article.

Jane Pauley, the previous NBC broadcaster, has been open about dealing with bipolar disorder in her memoir Skywriting: A Life Out of the Blue. That is something I have to give two thumbs up, because all I can really hope for is that people are more open about what they’ve dealt with in terms of mental illness. The more people that talk about it, the less ignorance there is, the less stereotypes ring true, and the more stigma is eradicated.

Right?

That’s what I believe anyway.

Over at the StarTribune website there is a video with a brief interview with Pauley, with a transcript of a small portion here:

You’re starting a campaign against the word ‘stigma?’

“I’d like us to stop using the word. What it describes is real. I think that we inadvertently amplify the power of those old stereotypes when we repeat the word. And for people who have mental health issues it makes us feel bad. Stigma [she said making a cut sign across her throat]. With regard to suicides in the military and not getting help because of the blah, blah, blah, including stigma. So the reference was accurate but we can attack attitudes that are misinformed and out of date. But if we describe what I have as a medical illness, which is hard, we will remove those attitudes but replace them with hope not fear. I’m against the word.

I was completely perplexed reading this, so if you’re as confused as I am I’d reccomend looking at the video. The video interview captures a bit more with the inflections in her voice, but I still sat for several minutes after watching it feeling confused.

In my own life, I have always classified stigma as a sort of fear that was attached to ignorance. Something that suggests repression for no apparent reason, and describes the gap that people place between themselves and those with mental illness because of that fear.

But from the dictionary:

Stigma: a mark of disgrace or infamy; a stain or reproach, as on one’s reputation.

I have long moved past the idea that mental illness scratches a big mark into my forehead to warn people to stay away or somehow tarnishes my reputation, but there is obviously something that leaves people feeling uncomfortable and distant, and I think it is that something that gets pinned with the name stigma. 

Whatever it is, a mark on us of some kind, a gap between the open and the misinformed, or that lack of knowledge itself, Pauley stresses that it is real. Stigma is real, but she stresses that talking about it does more harm than good.

This is the part where I get very confused.

There have been a lot of gaps in American history where one group of people is discounted by another, but I don’t believe Women, African Americans, or homosexuals have made any progress in closing that gap by not talking about the gap. 

So there is a gap. Ok, I agree. But I think there are a lot of people who aren’t even aware that gap exists and really can’t begin to consider the issue until it comes up for them, whether that is talking about it, or being involved in someone’s life who is living with some part of it. That misinformation is beginning to fade, but I think we’ve still got a way to go.

Anyway, I’ve never had my feelings hurt by the word stigma, just by the actions associated with it. Without something to call those actions, I’d probably be more inclined to consider the people behind them assholes instead of just misinformed. That leaves me glad there is a word that describes the unjustified fear and discrimination I’ve been met with, and gives me a name for the wall I’m here to push for breaking down

If you want to read the entire transcript of Jane Pauley’s interview, you can see it here. 

Chipping at Writer’s Block

Boy, I have had a massive amount of writer’s block the last few days. My mind has been darting about a million different ways at once, perhaps I’m still ridding myself of the last hints of trileptal and rispiridone that have contributed to my devoid concentration.

I suppose I can pick up where I left off and let you all know that after stopping the trileptal on friday I have had an immediate backpedaling of most of the symptoms I was having issues with. The psychotic blips, the quick shifting agitation and desperation, and the majority of the intense nausea I had been experiencing completely vanished within 24 hours after my last dosage.

Talk about positive reinforcement, the fact that my symptoms went away so quickly is a huge indicator to me that I made the right decision. I can’t imagine how bad things might have gotten if I continued taking it on Friday, Saturday, and Sunday, but it absolutely would have destroyed my camping trip.

I don’t know what kind of plans my doctor has for what to do next, but I don’t see him for two weeks. I will take that “time off” from experimentation with some very open arms, and I am not entirely convinced that I want to jump right in to anything immediately after that appointment either. The last few months have been like a punch in the face (on the medication route), one right after the other with Lithium toxicity, the Lamictal reaction, and now Trileptal. I’m really considering just taking some time to let my body recover from everything before trying to start another round.

As devastating as it sounded to me when that little bird whispered to me that there may not be a medication that will help me, I’ve had time for that statement to sink in. It doesn’t feel as devastating, but I am also not currently experiencing desperation (which can make all the difference in the world).

I am a problem solver, that is what I genuinely enjoy doing. Problems become puzzles, and I love solving puzzles. If I can fix a broken chair with nothing but a paper clip and a rubber band, I can make this work.

If the medication piece of this puzzle doesn’t work, I will just have to find another piece.

It may not be the most mainstream piece, but when have I ever been involved in mainstream anything? 

Hmm, this optimism is unexpected (even to me) this morning, I’d better find a way to take advantage of this today!

Wrapping Up the Week

This was a bit of a down and out week. My mood chart’s numbers have been lower than they’ve been in months, and I’ve taken an antipsychotic four times within the last week (I take them as needed). That number is ridiculous, considering the last time I took one was a random occurrence, and the time before that being at least a couple months ago.

I feel justified in saying that something isn’t right, and I was already suspicious of the medication I just started (trileptal) before this morning’s 3 am slightly psychotic episode. After that I feel like my hunch has grown into something larger, and I’m not sure what to name it. Perhaps I am having a mega-hunch.

Yes, I have still been taking the trileptal. Funny story, I emailed my doctor as described in Looking into the Trileptal Mineshaft earlier this week, but what I didn’t really mention after that is that he wasn’t there. I received a response from  another doctor (whom I don’t know and doesn’t know me) who said mine was out for the week and it would just be best if I keep taking my current dosage of trileptal until he gets back.

Frankly, this email made me stomp my feet, cry, and gnash my teeth a bit. I disrupted my boyfriend at work with an impulsive phone call because I was so upset about receiving this advice.

What frustrated me the most was that this doctor, who knows nothing about my situation and intense sensitivity to most psychiatric medications, also added non-chelantly in the email that he didn’t think mood stabilizers ever had any negative effect on people’s mood, which is why I should just keep taking the medication I was given.

On my end, that sort of remark easily gets interpreted as,

“honey, you just cray-cray. That’s why you really oughta just keep taking these pills!”

As a consumer, I can see this as a possible side effect printed clearly on the leaflet I was given. Not to mention, I’ve had these sorts of rare side effects before from other medications.

I really wasn’t sure what to do, and I went back and forth about whether or not I would comply at least three times each day since then. It may be easy to say, “just stop taking it,” but as with the Lamictal situation -I am really trying to take this on as seriously as possible. I need to evaluate every move I make with caution and thought, because the decisions I make about taking something or not taking something could literally change my life. 

Isn’t that terrifying? It is a large burden to bear.

I really hoped that seeing my therapist on wednesday would help clarify things for me, but I got a call before my appointment to find out that she too was out of the office.

I don’t know that I’ve ever felt so abandoned by my mental support team before, and it seems as if the planets had to of aligned just right in order for both my psychiatrist and therapist to be out of their respective offices the entire week unexpectedly and at the same time. At that point, all I can say is thank goodness I have a sense of humor or I might’ve taken it a tad personally.

I mentioned earlier in the week that I believed trileptal was causing me to feel desperation, which I found to be quite upsetting and a good reason to stop taking it. Many days later, that desperation has begun to morph into something much larger and darker, suicidality and self-harm ideation have began popping up at unexpected times in unexpected places. Agitation that is accompanied by surges of energy that leave me feeling like my chest is about to explode. Garnishes of intense paranoia that render me feeling entirely powerless. Completely distressing nightmares.

The way in which these symptoms are happening are almost identical to the first time I had an adverse reaction to fluvoxamine (the first medication I was ever given, pre-bipolar diagnosis). The waves of psychosis began getting worse and worse (I don’t experience psychosis much on a regular basis, usually) and the cycling became so fast that things became unintelligible. became unintelligible. And the idea of that happening again scares the bajeezus out of me.

I genuinely wondered if I kept taking trileptal if I would start to follow the same sort of path of when my moods were so destabilized by a medication before. I realize trileptal is supposed to be for mood stabilization (and my past medication sinkhole was with an antidepressant) but my body acts in mysterious ways. The only time I took Klonapin (for anxiety) I had an enormous, un-provoked panic attack. It is as if my body works with these chemicals totally backwards. 

After taking trileptal several days after I would have liked to have stopped, I can very clearly see things heading in that direction. There are all the signs of awfulness there, and there is no way in my mind continuing in this direction is a good idea.

I’ll email my doctor on Monday, but I’m stopping trileptal today. And I’ll fade into the woods tonight, the trees will cocoon me, and perhaps by the time I come home from camping on Sunday some little portion of this will be undone.

A Pain in the Energy Drain

First, I’d like to note that today’s post will be my 200th, which feels somewhat exciting (though it is nothing more than an imaginary milestone). Still, 200 posts feels like a lot, and even though the concept of this blog has sometimes fluctuated in my head I feel a bit proud to have stuck with writing here for 200 posts.

Aside from that, I would really like to address the energy drain. 

There are times when I am walking around, minding my own business, when suddenly it feels like the energy in my body liquifies and gushes out through my sneakers onto the asphalt and evaporates. Suddenly I’m stuck feeling like I am trying to walk through the ocean. My limbs are heavy and not quite as responsive (as if met with resistance), and it is as if every part of my body is sinking.

Maybe someone turned up the gravity intensity knob?

I was pretty happy to hear about the addition of fluctuating energy symptoms being propsed for the new version of the DSM (if you’re just joining us, that is the book that contains all of the criteria for psychiatric diagnoses in the USA), because originally bipolar disorder was just thought to be about mood. 

I’ve been getting increasingly upset about these energy drains, sometimes they last for a few minutes, other times for a couple hours. I can easily recognize that this awkward sluggish feeling is one that I’ve experienced in the throes of depression, but I also know there are times where the energy drain happens without any sort of mood fluctuation.

Are these pockets of physical depressive symptoms occurring on their own? Are they a sign of impending depression? Are they unrelated and simply created when my blood sugar crashes or when the caffeine wears off?

Many questions.

I just started tracking this phenomenon in an attempt to learn more about it. I am charting it on the same graph as my mood (and a handful of other things, pain, anxiety, etc.) so I can watch the full range of energy -both increases and decreases.

What I’ve found so far is that some days, my energy level remains level. Other days, I have fluctuations that don’t coincide with mood changes. And on other days, I see the fluctuations lining up with mood changes. When my mood changes, the energy change has (so far) changed within a 5-60 minute window (before or after) the mood change occurs.

So now I’m just looking at other factors, I am particularly interested in the energy shifts that are happening independent of mood changes. Of course, tracking this means paying attention to many other factors, when I’m eating, if I have caffeine, rigorous physical activity, etc.

I spoke to someone who also has bipolar disorder about it yesterday and they said they also experience energy shifts that appear independent of mood changes. At least, in the draining department.

Honestly, any increase in energy (even without an elevated mood) is something I’ve attributed to hypomania. Would it be safe to conclude that a decrease in energy may be related to depression, even when the mood doesn’t appear changed?

Curious.

I am very interested in knowing if anyone else has these sorts of symptoms (energy fluctuation independent of mood change) or if mood changes are always present in the event of an energy fluctuation.

For me, these symptoms go beyond,

“I’m feeling sort of tired,”

or

“I’d like to sit down and rest a minute,”

The shifts are almost always very extreme, requiring something of a struggle to continue to my destination or prompting laying down with immediate sleep necessary after having been active (normally) only minutes earlier.

Sound familiar? Leave a comment, or shoot an email to host@thebipolarcuriousblog.com

Crafting a Relationship

Today is therapy day, which I am a fan of a solid 99% of the time. That 1% is usually a wandering, crabby, (frankly) pissy sort of day… and with the weather so nice today I don’t think I could be too crabby if my life depended on it!

My therapist is working on an internship, she just finished her degree -which is why her services have been so readily available to me. She is less experienced, which means she is something of a discount therapist (I think they keep those in the bin at Walmart behind the discount dvd bins) but her lack of field experience has not been an issue for our relationship.

For the most part.

And perhaps part of me likes the idea that I am teaching her something while she is teaching me. A swap, if you will, of screwed up information.

The trouble with this set up is that her internship ends in August, which means we only have a handful of (maybe 4?) appointments left. I readily agreed to this plan when I started going to the clinic, but now that I am almost upon the end of this relationship I find myself very sorry to see her go.

My relationships with medical professionals (and therapists) has been spotty at best. My income and insurance situation (i.e. none, right now anyway) has fluctuated wildly in the last 10 years, which has not provided me any stability in the realm of doctors or therapists I’ve seen. I have been on a series of at least 4 or 5 different insurance plans, while phasing in and out of those plans I’ve had nothing. On top of that, I have a pretty significant distrust of mental health providers (and all doctors, really) that has stemmed out of various advice from bad ones, and my own (admittedly) irrational paranoia after being abused by my caretakers in a mental health facility at the age of 17.

It has taken me an exceptionally long time to realize that not everyone is going to attack me for no apparent reason, but I spent years showing up to doctors or therapist offices with vague inclinations that they didn’t know what they were talking about, or that they didn’t have my best interest at heart, or that they really just didn’t get me at all. Of course, I didn’t give them a chance to know me, so I was setting myself up for failure in that department, but my tally of doctor or therapist one night stand sorts of visits is off the charts. For whatever reason. For every reason. Etc.

So this relationship I have currently with my therapist is one for the record books. I don’t recall entirely when I began seeing her (I was in a pretty wicked place at the time, I don’t remember most of last year due to the ultra-intense depressive episode I had) but there was a point where I said,

“you know, I’ve made it past the hump. The point where I’ve always quit therapy, and I am amazed at how different this day feels as opposed to day one.”

I will really be bummed to see her go, mostly because the notion of having to familiarize yet another person with the goings-on of my life sounds absolutely exhausting. I find it agonizing sitting across from someone who has a completely empty concept of me that I have control of pouring things into. I have a knack for getting a little creative with the pouring, if you know what I mean… and I have a hard time not creating a mold for a character instead of me. It isn’t that I want to hide the truth, I just find it too much fun to create fiction.

I am hoping I will find some wisdom about this when I get there today, something about re-creating this kind of relationship with a therapist. I know it is fairly straightforward, but my mind wanders sometimes… and unless one of us is on track, I have trouble getting over that hump.