Tag: medications

Relapsing [Without Being a Moron About It]

 A Bumpy Road: Dealing with Relapse

There may not ever be a last episode, but there are ways to fend off and mitigate the next one.

By Jodi Helmer

Doctors never talked to Elly L. about RELAPSE.

Although she was hospitalized during a manic episode and diagnosed with bipolar disorder, doctors never mentioned that it could happen again. Instead, Elly was stabilized, handed a prescription for mood stabilizers and discharged. She had no idea that she’d be battling mania and depression for the rest of her life.

“I was told that as long as I took my medications, I’d be okay,” recalls Elly, a mental health coach in Toronto, Ontario.

Elly experienced at least eight relapses between her diagnosis in 1978 and 1991. Each time, she was hospitalized, often placed in restraints and taken to the psychiatric ward in a police car or ambulance. Upon discharge, Elly always promised herself it would be her last hospital admission-but she had no idea how to stave off future relapses.

In bipolar disorder, relapse is defined as the return of depression or a manic or hypomanic episode after a period of wellness. According to a 1999 study published in the American Journal of Psychiatry, 73 percent of those diagnosed with bipolar disorder experienced at least one relapse over a five-year period; of those who relapsed, two-thirds had multiple relapses.

“You can never say that someone with bipolar disorder has had their last episode; relapse is part of the illness,” explains Alan C. Swann, MD, professor and vice chair for research in the Department of Psychiatry and Behavioral Sciences at The University of Texas Medical School at Houston and director of research for the University of Texas Harris County Psychiatric Center. “Relapse is self-perpetuating; once it happens, the more likely it is to happen again.”

Searching for Answers

It’s possible to do all of the right things- follow a proper medication regimen, eat well, exercise, minimize stress and get enough sleep-and still experience relapse. Unfortunately, there is no clear understanding of why this happens.
“There may be changes in the cellular level that cause cycling but their cause is unknown,” says Joseph R. Calabrese, MD, director of the Mood Disorders Program at the Case Western Reserve University School of Medicine in Cleveland, Ohio.

While the neurological causes of relapse are unknown, a few things are certain: Those who are diagnosed with bipolar II are more likely to relapse than those with bipolar I. Their episodes of depression, mania or hypomania are often shorter than the episodes experienced by those with bipolar I but tend to return more often, according to Calabrese. It’s also far more common to relapse into depression than into mania or hypomania. Calabrese estimates that in bipolar II, there is a 40-to-1 ratio of depression to mania; the ratio of depression to mania drops to 3-to-1 in bipolar I.

“The key to recovery is a low tolerance for relapse,” says Calabrese.

In fact, Dr. Roger S. McIntyre, MD, associate professor of psychiatry and pharmacology at the University of Toronto and head of the Mood Disorders Psychopharmacology Unit at the University Health Network, believes that even the mildest symptoms of depression and mania should be treated as potentially hazardous.

“The takeaway message is that we need to seek complete elimination of symptoms as our treatment objective,” he says…

Click here to read the full article, “A Bumpy Road: Dealing with Relapse”

“bp Magazine” is a wonderful “shot in the arm.”  I would suggest that you get a subscription, and for a friend as well.

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Join NAMI today!

When you become a member of NAMI, you become part of America’s largest grassroots organization dedicated to improving the lives of persons living with serious mental illness. And now you can join online.

http://www.nami.org/template.cfm?section=About_NAMI

Intensely Loved, but Definitely Broken, [Reality]

bryondeck-2For everyone who loves Jesus, but yet has had an experience of terrible loss, sickness or the death of a loved one…this post is meant for you.

I am evangelical, a former pastor, and a Bible college instructor. I also have bipolar depression, and a bit of paranoia and delusional thinking. I have been hospitalized in mental hospitals seven times in 10 years.  But, I love Jesus more than anything. And I’ve been told by many who repeatedly insist that He loves me as well.

I have experienced the darkest and most crippling depressions.  There are some weeks (months?) I could not get out of bed, shower or even eat.  For this Bipolar, I must take Lithium, Zoloft, and Lamictal.  These meds hold me in place. I’m being treated for a seizure disorder, and have had surgery to remove a tumor in my brain. I now walk with a cane.

“He comforts us in all our troubles so that we can comfort others. When they are troubled, we will be able to give them the same comfort God has given us.”

1 Corinthians 1:3

This blog is geared for the mentally ill believer, the terminally ill, habitual sinners and all who are confused and dismayed by their own brokenness. But you don’t need a diagnosis to read this blog.

It seems like failures—

  • the mentally feeble,
  • lame,
  • chronically ill
  • blind, and deaf
  • sinners, great and small
  • and mentally ill have not always been welcome in the Church. I think that is about to change.

I’m honestly convinced that it has been the churches’ loss. How is the Church ever going to learn to love the unlovely without us to ‘train’ them? We the disabled are sprinkled into each fellowship to tutor them through our illnesses.

The church need not look to new ‘fund raising ideas’ or to pave the parking lot, it just needs to reach out to the broken– one at a time.  I think God will bless every church who will do this. This is the work and passion of Jesus. This is what Jesus’ church looks like. “For the Son of Man came to seek and to save the lost.” (Luke 19:10.)

The Church needs us, whether it realizes it or not.  It is as broken people that we model our fallenness as the paradigm to intimacy with Jesus.  We often are the first to know that it has never been about our giftedness, but our intimacy. 

We are a witness, a tangled but tangible reminder, of how God’s grace gives His power to the weak and despised (2 Cor. 2).

“For I have come to call not those who think they are righteous, but those who know they are sinners.” 

Matthew 9:13

“Then Jesus said, “Come to me, all of you who are weary and carry heavy burdens, and I will give you rest. 29 Take my yoke upon you. Let me teach you, because I am humble and gentle at heart, and you will find rest for your souls. 30 For my yoke is easy to bear, and the burden I give you is light.”

Mathew 11:28-30

I simply can not say anything more. Just please love us.

“The power of the Church is not a parade of flawless people, but of a flawless Christ who embraces our flaws. The Church is not made up of whole people, rather of the broken people who find wholeness in a Christ who was broken for us.”

–Mike Yaconelli

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All scripture quotations are from the New Living Translation.

Becoming Manic: What You Can Do

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Top tips for coping

These are a list of things that people who have difficulties when they become high or manic have found helpful:

  • Try to get some sleep. Going without sleep has been shown to cause manic states and make them last longer.
  • Eat well. Don’t go without food or eat high energy food. Eat slowly.
  • Use relaxation techniques.  Quiet prayer works well right now.
  • Stay in bed even though you feel compelled to do lots of things.
  • Don’t act on your ideas. In a few days time you may see things completely differently.  Emailing friends now is dangerous. (I know).
  • Don’t buy anything expensive. Some people have found it helpful to give their credit cards/check book to friends.  (I tried to buy a 7 foot potted tree in London, UK once, because it was lonely.)
  • Use medication, herbal remedies, or other things that slow you down and/or help you sleep.  Think “speed bumps”.
  • Take relaxing (rather than high energy) exercise e.g. walking, swimming.  This is a must-do.
  • Make a plan for each day and keep to it. Don’t plan to do too much.
  • Try to do things slowly rather than quickly. Talk and walk consciously slower than you feel driven to.
  • Challenge any grandiose ideas you might have about yourself.  You must do this!
  • Reduce any pressures or stresses on you.
  • Cut out stimulants e.g. coffee, sugar, chocolate, fizzy drinks, alcohol. Some anti-depressants (e.g. the SSRIs like Prozac) can have stimulant-like effects – discuss this with your doctor and consider stopping them.

It may be helpful for you to make a plan about what to do before you get really elevated. You know yourself best, so build as many things into the plan that you feel will help you not do things you may later regret. It may be helpful to draw up a plan, and a list of ‘warning signs’, with a trusted friend or mental health professional at a time when you are not ‘high’, but that can be put into place as you or others notice your warning signs.

Some people believe that ‘getting manic’ is a response to not thinking about or facing things that might be quite frightening or depressing. It might be helpful to ‘get connected’ to such things, by talking and thinking about your life and some of the root causes of some unhappiness in your life. You could do this with a trusted friend or mental health professional.

 

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Give Us This Day, Our Daily Meds

My particular issue is with Bipolar 1, with psychotic features.  I have social anxiety which factors in as well as weird delusions.  The anxiety and delusions are pretty much one and the same.  They are often the things that will touch other people, while the rest is less obtrusive and can be hidden.

I have a tendency to hatch ‘mini-conspiracies’ almost daily.  They can be really paranoid as I think the worse about people, and life as it enfolds around me.  Facebook with its social networking helps, but it has also intensified my issues.  I am very much a recluse, and only get out and about twice a week. There are some who can see through my issues and really help. They are worth more then gold to me.

Depression, which is part of the Bipolar, has been more of a factor just in the last few months.  Suicide, that dark word, will deepen if the depression goes too long without lifting. It is an awful and brutal thing. My last bout was just two months ago and I quit functioning. I really did pray for death. Debilitated, I laid in bed powerless to do anything but sleep, and hide. I didn’t take a shower or bath for almost a month. Just the thought of being pelted by water seemed too violent.

Being a believer gives me a reason to live.  The Holy Spirit is so patient with me.  His companionship is far more helpful than any anti-depressant.  He doesn’t require that I become symptom free to fellowship with Him.  Instead, He weaves with the materials He has, and my discipleship is really no different than other Christian believers. This gives me a constant hope.

Overall, in spite of a very tumultuous, and ‘see-saw life’, I find that life with Jesus (discipleship) is truly grand.  He understands me, and is guiding me.  He is the Shepherd who is good, and I am His sheep who needs kindness and forgiveness always. He bruises no reed, nor does He quench the smoking candle (Matthew 12:20.)

One more thing.  Having a mental illness has, I believe, made me more compassionate and tender toward others.  When I meet a difficult person, I will be the last one to give up on him.  Others will bail out, but I stick.  I guess this can be a bad trait, but I can’t help it.  I love people, esp. those who hurt.

Here’s a list of my daily meds.  I hope this helps someone navigate the wild seas of psychiatry safely.

AM– lithium, 600 mg/Zoloft 200mg/Seroquel 400 mg/Provigil 200mg

NOON-Seroquel 200 mg

PM-lithium 600 mg/Seroquel 400 mg/Lunesta 2 mg

The lithium works mostly on mania, but does help depressive states.  The Zoloft is an anti-depressant (similar to Paxil)  The Provigil is for alertness, I have had issues with daytime sleepiness, esp. since my brain tumor.  Finally the Lunesta is a sleeping pill. This may seem a lot, but it has taken 2-3 years to get it figured out.  If I can help explain any of this, please let me know.  I aim to please!

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