Monthly Archives: January 2014

The Confused Mood

Have you ever had one of those moods where you couldn’t tell exactly how you were feeling? The sort of mood where you felt neither up or down but weird, or up and down at the same time?

This morning I’m heading into my third day in a mixed episode. It really stumped me for the first day because when I have mixed episodes they tend to be dysphoric (aggressive, angry, wild, agitated moods). The state I’ve been in the last couple days isn’t anything like that, which is something of an anomaly for me.

This mood is more detached, more like having a place where good and bad feelings are all sitting in a hot tub together having peace talks. I can feel everything at once, but there is also an absence of feeling… like they are simply too busy talking to be taking up space in my brain.

It has come with a sort of detachment I usually only reserve for mania, a tingly-floaty feeling in my body where I feel like I’m trapped in a bubble. Everything feels far away and fuzzy and like it just quite doesn’t have anything to do with me.

The biggest issue I’ve seen is one with memory. It has pretty much just shut off, and I find myself confused, digging through my purse looking for something that isn’t there or asking people to repeat themselves because everything just went in one ear and out the other.

The change in mood has come at a change in dosage in my ramping up of Tegretol so I am pretty sure they are entwined (especially since this mood is so rare for me). As it is a euphoric mixed episode I don’t particularly feel the need to panic though, I am just going to keep close tabs on things and alert my psychiatrist if it moves into the realm of full mania. After all, I’ve already given him the anxious false alarm twice about Tegretol, alerting him to side effects he claims have nothing to do with the drug.

I guess there is one other issue I have with this mixed state, and it is that feeling so detached has left me feeling difficulty connecting with others. Corey’s homecoming from his trip Wednesday was a little weird because of it, but once I explained the situation he seemed to shrug it off.

I don’t know how much longer this will last, but I am trying to take as close of a look at this state as possible. Everything about the symptoms feel elusive, and if I look at any of them directly they seem to disappear. It isn’t often that I “feel crazy” but trying to figure out what has been going on in my head the last couple days would definitely do it!

Let’s Talk: The Language of Mental Illness

Shout out to my Canadian friends, we’re all in this together!

climbing the crazy tree

“Bad enough to be ill, but to feel compelled to deny the very thing that, in its worst and most active state, defines you is agony indeed.”

― Sally Brampton, Shoot The Damn Dog: A Memoir Of Depression

So today is Bell’s Let’s Talk Day (There’s also the Time to Talk Day based in the UK on February 6th, not sure why we didn’t all join forces). I firmly believe that talking about mental health is a critical to improving the well-being of individuals and society as a whole. We have gotten a lot better about talking to mental illness and becoming more accepting of those with mental illness, but there’s still an echo of the belief that individuals with more common disorders such as depression and anxiety are “making it up”/”making a problem for themselves” or that they just need to “cheer up” and “stop worrying.” So we have all…

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SSDI Prep – My Medications

I’ve been working my way down the list of objectives given to me by my attorney for my SSDI hearing. Here’s where we’re at:

1. Keep a diary
2. Make a list of things you used to do but can no longer do
3. Make a list of medications
4. Write out a description of your job duties of your former jobs
5. Meet with your lawyer

Next up is to prepare a list of my medications.

Keeping track of my medications has been fairly difficult. My diagnosis is bipolar type 1, but recently my psychiatrist has moved me into the category of “treatment resistant” bipolar disorder since I have tried numerous medications that haven’t had any (positive) effect on my symptoms.

Basically what this means is that I have been trying every new medication my psychiatrist throws my way, usually every couple months. I’m constantly ramping up on a dosage or ramping down, so even trying to predict what I’ll be taking in three weeks (at my hearing) is sketchy at best.

I’ve talked a bit about this before, but the way I go about handling all of the information that comes with trying so many new medications is that I have a spreadsheet where I list:

  • the medication I tried
  • when I began taking it and when I stopped taking it
  • the maximum dosage achieved
  • the side effects that ultimately caused me to stop taking it

I keep a separate section for medications I am currently taking, with similar information.

I also keep a list of hospitalizations at the bottom of the spreadsheet for a very important reason.

Let’s say I am going to the emergency room, or entering an inpatient hospitalization, or even going to see a new psychiatrist – this sheet has my entire medication history on it. All I have to do is hand it to the nurse or doctor when I arrive instead of trying to prod a brain that is thoroughly out of whack for this information. And, hey, if you want to have your prescribing doctor’s information on the sheet, that never hurts either.

I keep all this information in a spreadsheet on a cloud (through gmail) so I can access it from any computer with internet in an emergency. So far, it has really helped me.

Ok, so side note, I am preparing my medication list to include all of the medications I’ve tried so that I can demonstrate (if it comes up) that my symptoms have been treatment resistant at my hearing. Again, it is always better to have more information than not, so I want to consider my entire history, as well as my current medications.

If you are compiling a list of your medications, it is perfectly reasonable to start with your current ones. Open up the medicine cabinet, grab your bottles, and start your list.

You want to list all medications, so consider things like herbal supplements you might take (I take fish oil), over the counter daily medications (I take pepcid AC daily for an abundance of stomach acid), or things like prescription face creams (which I use for acne). You also want to consider medications you take as needed. 

These things may not seem important, but they might be addressing issues that are side effects of the psychiatric medications you’re taking. I have stomach issues and acne from taking lithium, so I use two medications to address those side effects.

My current medication list looks like this:

  1. 1200 mg Lithium Carbonate (once daily)
  2. 20 mg Latuda (once daily)
  3. 50 mg Tegretol (once daily)
  4. 5 mg Risperidone (as needed)
  5. 10 mg Ambien (as needed)
  6. .01% Tretinoin Gel (once daily)
  7. 20 mg Pepcid AC (twice daily)
  8. 1000 mg Fish Oil (once daily)

From what I understand, this is all that is required for the social security hearing. I know from experience, however, that if asked to recall information about my previous medications I will have a bit of trouble, which is why I want to be ready with the full history list.

If you are interested in making a list of your full medication history, there are a few things you can do to help in the process.

  • You can ask your prescribing doctor to give you a list of what they’ve prescribed. Most doctors I’ve met are happy to share this information.
  • Look at old medication bottles. I have a bit of an OCD thing where I can’t throw mine away, so I have every psychiatric medication bottle I’ve been prescribed since 2003. This was extremely helpful in piecing together which medications I took and when.
  • Look through a blog or journal. You may have written something about trying a new medication, or stopping an old one.
  • Ask a family member or friend if they remember any details.

Having a history of your medications can be helpful, but it isn’t absolutely imperative. After all, you could always begin your list with what you’re taking currently, and if things change, update it. Realistically, I only really care about having a history list so I don’t wind up taking the same medication twice, when I’ve already had a bad reaction to it in the past.

Here’s a chopped down version of my list:

  • Latuda 40 mg (12/10/13-) – back and neck muscle agitation, mood destabilization
  • Geodon 120 mg (10/28/12-8/2/13) – developed muscle spasm in jaw, intense dizziness, fainting, no appetite
  • Lorazepam 1 mg (10/1/12-10/25/12) – worsened mood (hostility)
  • Trileptal 150 mg (6/12/12-6/21/12) – worsened mood swings
  • Zyprexa 5 mg (4/3/11-6/6/11) – 40lb weight gain in two months
  • Zoloft 100 mg (4/7/11-4/13/11) – triggered mania
  • Abilify 5 mg (4/13/11-4/20/11) – extreme nausea and dizziness
  • Clonazepam (4/3/11) – severe mood swings, panic attacks
  • Seroquel (4/2/11-4/3/11) – extreme dizziness, trouble focusing, intense drowsiness
  • Prednisone (2/04/11-2/6/11) – severe mood swings with uncontrolled crying spells, unprovoked panic attacks
  • Lamictal 25 mg (2/23/11-2/26/11) – rash, discontinued
  • Wellbutrin 150 mg – (no memory)
  • Neurontin 300 mg – (no memory)
  • Fluvoxamine 150 mg (12/02-2/03) – worsened depression, mania, psychosis, and homicidal/suicidal ideation
 There we have it!

Straight From the Horses Mouth

Most of my blog posts are concocted days, if not weeks in advance. I write about four times more than I actually post, to weed out… well, you know. Crap. Yesterday, for example, I wrote four posts in preparation for today. All I had to do was wake up, pick one, and post it.

There are moments every once in a while though where I need to be able to write about my current situation (not complain, mind you) without feeling guilty about it or feel like I’m some kind of raving lunatic. The truth is that I’ve got a lot going on, and trying to put the pieces of the puzzle together has left me more confused than informed.

I spent the better half of yesterday and this morning delusional. This isn’t new, as Corey just walked out the door about half an hour ago (the delusions just usually take a bit longer to catch on). I’m about to be alone for the next five days (I say “alone” but I mean primarily “with friends” so not actually alone alone) and there was a moment last week in therapy where my therapist predicted this broken record of a situation.

“Your lizard brain is going to be screaming ‘he’s leaving me, he’s leaving me!’ …but he isn’t.”

I’ve been rather forthcoming on this blog about how backwards my brain seems to work when my boyfriend is away. I do seem to suddenly believe he has left me, that I am all alone and will be forever, and that he doesn’t give a shit about little old me.

In the last 48 hours, this has caused me to cry uncontrollably, send him angry text messages, yell at him, cry some more, and try (probably unsuccessfully) to explain that my brain is giving me both fact and fiction at once, and it is anybody’s guess as to which will win out at any given time.

It isn’t that I’m jealous, or even suspicious of him. It is more like once he is out of my sight, I believe whole heartedly that he is dead and I will never see him again.

Of course, were this some kind of zombie apocalypse movie, I’m sure he might be… but Texas on a Friday probably isn’t a big deal.

At this moment I feel surprisingly optimistic. I mean, maybe it is over? Maybe I’ve cried all the tears I have, and I wont cry any more.

On top of that, it could also be that Tegretol could be to blame for this cry-fest, not Corey’s departure. All I can do is keep taking it and see if the crying continues or if it (hopefully) stops.

The delusions themselves seem very… quick-ish. Coming on rapidly in waves of 30 minutes to an hour apiece, and then apparently evaporating as quickly as they arrived (nice, I’d say). My head does feel like a magic eight ball somebody has been shaking all morning though, so I think I will need a little time before I can step back and see the big picture again.

In any case, I am prepared to watch chick flicks, eat pizza, go shopping for cheeses, eat donuts, belch loudly, and dance around in my pajamas for the next five days. If you need me, that’s where I’ll be.

Mental Health Bloggers Widen Their Support Systems on WordPress.com

The WordPress.com Blog

When we start a blog instead of simply keeping a private diary, it’s because we want to connect with others. When you start to blog, you join a community.

It comes as no surprise that many bloggers are drawn to online communities as a place to work through challenges — to heal and process, find others with similar experiences, and seek (or offer) support. There are lots of supportive communities around WordPress.com: women dealing with breast cancer, people managing diabetes, parents of children with unique needs, and many, many more. Throughout January, we’ll be zooming in on how bloggers use WordPress.com to support their health and wellness.

Today, on the heels of the Blog for Mental Health 2014 kick-off, we’re focusing on mental health. Read on for a look at the many ways WordPress.com bloggers use their sites to improve their own lives, and the lives of others who have…

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SSDI Prep – Finding a Witness

Continuing with the ongoing story of what is going on week to week leading up to my Social Security Disability hearing in a month or so, I received a letter in the mail from my attorney that says I have a telephone meeting scheduled with the attorney the day before my hearing to go over everything, and oh, yes… by the way… we need you to find a witness who can come to your trial. Thanks!

First, I find myself flabbergasted that this hasn’t come up before now. I mean, the hearing is in a month! And, you know, generally everyone I know works, which means having to take time off to come to my hearing.

Then there is the obvious question, who should be my SSDI hearing witness?

While I’ve already done a little research on this topic (when my friend was applying for SSDI and asked me to be his witness) I know that someone who has seen my disability in action is the best candidate. That said, I have also read several articles that suggest that this witness have something more to say than what I have to say about myself.

I know I am not the first (or last) person to find myself in this conundrum.

If we were going solely off of someone who could tell you something new about me, I expect being able to show the judge my disability through the eyes of my boyfriend might suffice. At the same time, wouldn’t it be more fitting or be more helpful to have my witness be someone I’ve worked with, who has seen my bipolar symptoms in the workplace?

I thought about that for a while, but I think in all reality the answer is no. While in the workplace I worked hard to veil my bipolar symptoms and anxiety wherever I could, generally limiting my panic attacks and outbursts to a stall in the women’s bathroom.

At my last job, I couldn’t even recognize myself that I was exceptionally paranoid and delusional until much later, and when I spoke to representatives in HR and had meetings with them and my department head, they all took me very seriously and believed everything I told them (for the most part).

For these reasons, I don’t think my ex co-workers or boss could even pick out the elements I was presenting that were off, (short of shouting absurd comments that didn’t make sense at meetings). Most of them don’t know that I have a mental health diagnosis, and thought I left the company because of physical illness.

Though Corey (my boyfriend) hasn’t worked with me in a while (we’ve done a few small projects together) he has been privy to everything that has gone down in the last year (and more). I have not hidden my symptoms from him, and he is someone I consider to be a particularly intelligent person, someone able to draw their own conclusions rather easily.

Having considered these things, I am about 95% certain I am going to rely on Corey to be my witness, after all, he is (as requested in my letter)

“a friend or family member who is familiar with your medical condition and daily activities available to speak on your behalf.”

My only fear in this situation is that he might hold back on the truth, but he really isn’t the sort of person who fears many things… I expect it will be fine.

And, just as a final note, my psychiatrist has agreed to speak to my attorney and give him his files. I had to pay about $85 for this service, but I have been seeing this psychiatrist for a few years now and he has a ton of information on me that will really be helpful at the hearing. I’m excited that these things that have caused me so much anxiety are slowly falling into place!

The Latuda Conclusion

Well, I went to see my psychiatrist yesterday and the verdict is that the Latuda is doing more harm than good.

I want to take a second to say that the results in my own little Latuda experiment are probably not typical, as I have a rather severe treatment-resistant form of bipolar type 1. I know of several people who are currently taking Latuda and have had wonderful luck with it (which is why I was itching to try it), unfortunately it just didn’t turn out that way for me. 

The final verdict is that the drug has been making my mood de-stabilize (yes, the exact opposite of what we want). I agree with this analysis from my doctor as last week I had no less than three mood swings per day, and in a series of three to four days experienced a stable mood, severe depression, self-harm and suicidality, an agitated mixed state, an aggressive mixed state, a euphoric mixed state (something I don’t think I’ve ever experienced before but it was quite interesting), and straight up euphoria.

Somehow I managed to cover the whole spectrum in a couple of days, and though I am typically a rapid cycler the manner in which things progressed erratically from depression to mania was so fast and so weird it was a clear tipoff to my doctor that this medication isn’t for me.

Honestly, I was skeptical at first. Maybe I’m just not taking enough, I thought. But then, laying out the side effects I’ve also been having, it seems appropriate to give up on this one.

Headaches, for one, always starting around 1 pm and lasting until bedtime. Not overwhelmingly bad ones, in fact they are the only headaches I’ve had in the last few years I’ve been able to treat with tylenol (which was nice). Still, any extra pain is generally a nuisance.

Weight gain, to the tune of 8 lbs in the last 5 weeks. This, however, does worry me. I went and lost 40 lbs I put on because of taking Zyprexa a couple years ago, and the idea of gaining it right back again is a little heartbreaking. The way this worked with Latuda is a feeling of hunger and cravings in the evening, basically the worse my mood was the bigger the cravings. On top of that, I saw an enormous change in my self-control (normally I’m pretty strict with myself) and on more than one occasion I found myself continuing to eat food despite being full as a method of self-harm. 

No thanks. That’s definitely something I can live without.

The one positive? I was sleeping like a baby. Within thirty minutes of taking latuda in the evening I was asleep, and managed to sleep almost twelve hours each night with no problems. I will be sorry to miss that feature, but the other factors really didn’t make it worthwhile to keep trying.

So that’ll be medication #13 or #14 (or is it #15?) coming off the list. My doctor is having me cut the Latuda dosage in half, and wants me to start taking Tegretol (carbamazepine). I had been putting this drug off for a while because from what I’ve heard it can be hard on the stomach and I have some pretty gnarly stomach issues already.

The one thing I’m worried about is that he wants me to start the new medication right when Corey is about to go out of town, and I always like having someone around in the beginning in case I have a bad reaction or my mood explodes in a flurry of unwanted activity. In any case, I’ll make it work… I always do!