BIPOLAR AND RELATED DISORDERS~ EVERYTHING YOU NEED TO KNOW (Part I)

I believe in knowing as much as you can about what you have been diagnosed with. If you don’t you are putting all of the control and life changing decisions into someone else’s hands. I’m not okay with that. I learned too late that just because a person has “Doctor” in front of their name it doesn’t necessarily mean they’re automatically right.

All of the information presented here is taken from College Curriculum that everyone needs to take to work in the Mental Health field. All of it is from 2017 so it’s up to date.

BIPOLAR DISORDER: Shifts in mood, energy and ability to function. Ranges from severe Mania to severe Depression.

CAUSES

1. Biological: question of decreased gray matter in the brain.
2. Neurotransmitter Imbalance
3. Genetic
4. Life events may trigger a mood disorder in someone with a genetic pre-disposition.

RISK FACTORS

1. First degree relative with Bipolar Disorder.
2. Substance or alcohol abuse.
3. Major life changes such as death of a loved one or other traumatic experience.
4. Increased risk if person has existing mental illness.

COMPLICATIONS

1. Substance/Alcohol use 60 to 70 % of people with Bipolar Disorder meet the diagnostic criteria for a lifetime history of substance abuse/dependence.
2. Suicide/Suicide attempts
3. Financial problems
4. Isolation

ETIOLOGY: Early onset is more severe and harder to treat. Young people have more mood switches, mixed episodes, are sick more often and have a higher risk of suicide attempts. Theories of development are focused on biological, psychological and environmental factors.

PHYSICAL: There can be physical symptoms that occur with Bipolar Disorder. The more common ones are dehydration, poor nutrition, weight loss, asthma, bronchitis, hypothyroidism, migraines and gastric ulcers.

BIPOLAR DISORDER I

For a person to be diagnosed with Bipolar Disorder I they have to have had at least one week long manic episode that results in excessive activity, energy and alternates with depression or a mixed state of agitation and depression.

MANIA

There are many aspects to Mania some of them include an extreme drive and energy, inflated sense of self-importance or grandiosity*, reduced need for sleep, excessive talking combined with pressured speech*, a personal feeling of racing thoughts or flight of ideas*, easily distracted by environmental events, unusual obsession with or over focus on goals and risky behavior.

RISKY BEHAVIOR includes indiscriminate spending or spending sprees, reckless sexual encounters or promiscuity, and taking financial risks like gambling or investments.

There are two types of Mania, Euphoric and Dysphoric.

EUPHORIC MANIA: Starts out as a wonderful feeling then turns dark as euphoria moves toward confusion and loss of control.

DYSPHORIC MANIA: This is a mixed state or agitated depression. There are depressive symptoms along with mania.

The “clinical findings” or outcome of medical research and diagnostics for Bipolar I are the following:

1. Euphoria of manic episode causes patient to have little insight as to what they’re doing.
2. Person can also be irritable.
3. Spring and Summer seem to be peak periods.
4. Person may believe they have special abilities outside the normal range of talents or training.
5. Inflated self-esteem may reach delusional proportions.
6. Goal driven energy that leads to poor judgement.
7. Talking excessively.
8. Answers questions at length when it isn’t necessary.
9. Talks when no one else is listening or interrupts when others are talking.
10. Shifts from one topic to the next.

Mania onset is fast in Bipolar I and can last a few days to months. It’s usually briefer than Depression and ends as abruptly as it begins.

Manic Episodes are usually followed by Depressive Episodes.

HYPOMANIA: Patients will have elevated mood and other classic symptoms but are usually not delusional or have hallucinations. Hypomania usually lasts no longer than 4 days.

DEPRESSIVE EPISODES

Five or more symptoms need to be present during a two week period and represent a change in previous functioning.

Symptoms: Feelings of worthlessness, indecisive, guilt, difficulty thinking/concentrating, thoughts of death/suicide, Somatic symptoms, change in appetite/weight, sleep, motor skills, agitation, and loss of energy.

Assessment: Relies on clinical picture, history and response to medications. Structured interviews are helpful to gather relevant history and a medical evaluation is critical. Traditional psychological testing isn’t useful until the patient has been stabilized.

*grandiosity- Exaggerated unrealistic sense of importance

*pressured speech- Disturbed speech pattern where logical speech is replaced by loud rapid and confusing language.

*flight of ideas- Over productive speech with rapid shifting from one topic to another.

I’m going to stop here for now. As I was researching Bipolar Disorder and had the actual exams and study guides that Doctors, Therapists, Nurses, and other people working in the Mental Health field had I found myself becoming angry.

You could put a check mark next to almost every single symptom/criteria needed for a diagnosis of Bipolar Disorder for me.

It started at a young age and by the age of 21 I had already been court ordered to see two Psychiatrists, two Therapists and a Drug and Alcohol Counselor. Not one of them ever did a real assessment. All they saw in front of them was a young girl with low self-esteem who drank too much and maybe had anxiety. They would give me a 6 month supply of an antidepressant and send me on my way. Unfortunately some of what they gave me made things worse.

Over the years I would be court ordered to see more Psychiatrists and Therapists who still didn’t ask why I was drinking or what I was trying to escape or numb with alcohol. I told all of them that my family has an unusually high amount of mental illness from Bipolar Disorder, Borderline Personality Disorder and Schizophrenia. This included my Mom, Grandmother, and two of my Mom’s siblings. Her brother and sister were both diagnosed with Paranoid Schizophrenia. My Uncle hallucinated quite a bit but he was harmless, my Aunt on the other hand was manipulative and cruel.

The fact that I had to wait 25 years for a diagnosis is ridiculous and now has made me basically untreatable. I was given the wrong medications for years, I self medicated with alcohol for 20 years, manic and depressive episodes put me in situations that resulted in memories my brain won’t allow me to remember so I stutter and shake instead when I’m upset. My brain was nice enough to leave me with memories I wish it hadn’t that it likes to play on a loop when I’m having a really bad day which is often. I now here my own voice constantly whispering “They were right. No one will ever want you. You’ll never be pretty enough, smart enough, thin enough, good enough. No matter how hard you try you will always be that 250 pound fat drunken slob who slept with any guy to try to prove she was worth something.” I won’t get into the other things I hear.

It doesn’t help that the Generic Brand of Topamax changed their formula and I’m the one that has to suffer for it. It’s been pretty horrible I have to say. I have not thought of hurting myself in years. A few weeks on this new formula and that changed dramatically so I had no choice but to taper off of it for now until I can research a replacement. You would think my Doctor would do that but I don’t let him because they will go with whatever company has been by to push their new drug and I’m not a guinea pig anymore.

DEAR DAD, YOU ASKED WHERE YOUR LITTLE GIRL WENT….

Dad, you asked me the other day “where your little girl went the one that was always happy”. I told you she’s been gone a long time. You didn’t want to believe me so I had to explain it to you. I know it hurt you to hear it and you stopped listening. That’s part of the problem. I know you feel guilty because you noticed things that were odd and discussed it with mom. The both of you talked about taking me to a Doctor when I was very young. You both decided against it. It isn’t your fault. There isn’t any blame it just is.

I have to live with Mom’s last words to me. “I’m sorry I fucked up your life so much”. Those were her last words to me before she died. I wish they had been “I love you”.

When I think of everything I put the two of you through I feel sick. The phone calls in the middle of the night from the Hospital or Police, never knowing which one it would be. I’m ashamed. Remembering Mom’s face as I got my stomach pumped or wrists stitched up again but at the time I was only thinking of my pain. It’s still all consuming.

When I was younger I learned to hide. Family functions were difficult for me so I would be in my room reading. Eventually when people noticed I forced a smile and some polite conversation for as long as I could. I was the “Great Pretender” until I started drinking.

Alcohol  made me happy most of the time. The times it didn’t were usually triggered by an event or comment. It didn’t take much to push my buttons and the people I surrounded myself with at the time knew this. It took too long to get away from them and by the time I did the damage had been done. Alcohol still made me happy but also weary of people like them. I also always felt I had to prove something. I had to prove I was worthy, pretty, wanted, belonged, and not a mistake. I knew only I could change how I felt about myself but for some reason my brain still won’t let me accept it. I’m not sure it ever will.

Dad, your daughter is still here. I love you. I live with you and make sure you take care of yourself. I make sure you are eating and eating the correct food for dialysis. I’m the one who is here when you need someone just like when I quit drinking and you watched movies with me. I’m the kid who loves animals and helps you with your birds. No one else would help you give 150 injections into the necks of your pigeons so they don’t get sick. I do it because you have always been there for me and I love you. You are cranky and stubborn and sometimes I need a break but I’m sure you feel the same about me. I offered you a kidney but you wouldn’t take it. Now I don’t have one to give and might be looking for one myself. We both know who didn’t step up to the plate on either occasion. She’s my sister and I love her but I don’t have to like her. I know that upsets you too.

I’m doing the best I can right now. I tried to explain how sick I am physically and how it interferes with my medications but I’m tired of explaining myself and apologizing. So this is the last one. I’m sorry and I love you more than anything. (How we used to be 1991)

SOMETIMES, I LAUGH

I know I have not been much of a joy to be around lately. (Okay the last few years) But yesterday I laughed more than I have in a long time. I made my dad laugh for the first time in a long time. (I ruined it by tearing up once I realized I hadn’t heard him laugh in so long)

I was on the phone with my sister. I had texted to her the other night to watch the movie Keanu. I was talking about the scene in the car where the guy is sincerely convincing a group of African American “Gangsta” drug dealers (how the movie describes them not me) that George Michael is African American and the song with “Father Figure” in it is about how he didn’t have a dad when he was growing up. He didn’t have a strong male role model. He had a “business” partner that was trying to hold him back and steal from him called “Ridgeley”. When George found out no one ever heard or saw him again.

By the end of the car scene they are all singing along to George Michael’s songs. One even gets a George Michael tattoo. I laughed so hard I had a coughing fit. My sister and I were hysterical with laughter just talking about it on the phone. I told her I had forgotten just how talented he was. She was still laughing because she was thinking the same. She was surprised I had listened to his music.

I wasn’t surprised she thought that. She never really took the time to find out my interests. I listen to ALL KINDS OF MUSIC. I know the lyrics to almost every “Oldies” song. I also used to listen to Ice-T when he was in Body Count nonstop. I go from Kenny Rogers to Slayer. Rod Stewart to Rob Zombie. Patsy Cline to Slipknot. Bob Seger  to Motley Crue. Manfred Mann’s Earth Band to Judas Priest. I have forgotten more concerts than most people have been to. Not only is alcohol in my genetic makeup but so is music. I have my mom and brother to thank for that. Whether they were happy or sad they each expressed themselves through music. It’s something I have always done too.

So next I’m on the computer. I’m reading information when my dad comes in from outside. He starts to talk about being tired and not as strong as he used to be. He was complaining about having to carry ten, 50 pound bags from his truck down to the backyard. You have to go down a first set of stairs made of a railroad ties then crushed rock. There’s about 5. Then there’s a bigger step down to the rest of the stairs made the same way. There’s about ten more of these.  (he’s 73, on dialysis, has mesh holding his stomach together from an aortic aneurysm, has had a quadruple bypass, and in general isn’t well). I admit I was only half listening because he says the same thing every time.

I’m not sure why I said what I did. I was actually a little serious I think. I stopped for a second to look at him and said ” I think I need to get back out there and find a boyfriend who can help with heavy lifting and stuff”. I must have looked sincere. My dad started laughing harder than I’ve seen him laugh in a long time. He said “thanks for sacrificing yourself on my behalf and offering to “get a boyfriend” for me”. He could barely talk he was laughing so hard. At first I didn’t know if I should be offended. Then I just started laughing too. It was pretty ridiculous of me to say.

I love my dad and I would do anything for him. It felt good to laugh with him and my sister yesterday. There’s nothing wrong when a few slivers of light pierce through the darkness.

P.S.~ The steps continue behind the building which has some of his birds in it and also serves as his “Clock Shop”.

 

 

Am I Sick?

Today I feel so sick I couldn’t lift my head until about an hour ago when I started vomiting. Sometimes I don’t know if I’m really sick or not. With everything going on it’s hard to pin point a cause.

The other day I ate GF Oatmeal and Cherios which are supposed to be gluten free. I have not felt good since. I also went back to 2% milk instead of lactose free because it’s too expensive. My feet and calves have been swollen and I’ve had a small fever and headache with a stiff neck. I can’t move. It’s like walking through wet cement. I hate throwing up. It reminds me of my drinking days.

My mother was sick all the time. It got to the point where no one showed any kindness or sympathy. I’m at that point now. How I regret my treatment of her. Now I know what it’s like. Laying on the couch afraid to move my head because I know what will happen. My dad coming in and yelling at me for being on the couch all day until I roll over and vomit. Then I have to clean it up even though my head is pounding. My sister shut her phone off as usual. The puppy peed in my bed last night. I’ve pretty much had it. The screen is hurting my eyes. If it continues I’ll go to the ER maybe. I’m just too tired.

Did You Know Essential Oils Cure Bipolar Disorder?

I like to browse Pinterest. I look at recipes, art, Bipolar information, pretty much everything. When I see numerous articles about essential oils and diets that “cure” Bipolar Disorder I get pissed off. If it was that easy so many of us wouldn’t be struggling.

Let’s discuss my good pals the FDA. They really have no control over any of this. They don’t have the manpower and there isn’t any money in it for them so the only time they get involved is if a class action lawsuit is brought against the company or someone is seriously injured or dies.

It’s the same with how they regulate generic medications. Basically they don’t. That’s why most of them do not work the same as the name brand and the companies still use gluten as a binder even though they say they don’t.

I have to pay more for name brand medications and get a note from my Dr. saying I have to get the name brand because of an allergy. My insurance still fights me tooth and nail on this. They have refused to pay for some of them and that leaves me paying out of pocket.

To mislead the public into thinking natural remedies can cure Mental Illness disgusts me. Lavender oil, Oregano oil, whatever, isn’t going to do a thing for me.

I know there is a movement against medication. That is their right. I have the right to disagree. I have researched this illness up, down, and sideways. I have tried so many medications and ECT. Believe me if I thought there was another alternative I would gladly accept it. There isn’t.

I have family members who like to go off their meds. You know where it gets them? One goes back to heroin. One hears voices and hallucinates and ultimately gets committed. It’s the same thing every time. It effects everyone around them. The one with the heroin also self harms. It is difficult for me to hear when this happens. She’s my niece and I love her. She refuses to talk to me. We have not spoken in years. I called her out on her drug use when she stole my mother’s pain pills when she was dying. Everyone said “No she wouldn’t do that”. I went into her purse and got her compact. The pills were hidden underneath the mirror. I’ve been around addicts most of my life and I’m an alcoholic. I know how the game is played. She never forgave me. Maybe I should have handled things differently but it was a stressful time. I did the best I could.

So my opinion is stay on your meds. If they are not working talk to your doctor and change them. Sometimes it takes years to find the right combination or there could be an underlying problem where you are not absorbing them. Keep asking questions. Keep trying. That’s all I can say.

Lies, Honesty, Self-Preservation

This post will be brutally honest. It might be too honest for some so I’m warning you now.

I am Pro Choice and always have been. When I was young I always pictured myself married with a house and children. That was not to be.

I didn’t know the path my life was to take. One of self destruction. I couldn’t have known.

Some of you know that I started drinking heavily at the age of 17 to self-medicate an illness I didn’t know I had. I continued to do so for 20 years.

What no one really talks about with Bipolar Disorder and Addiction is the promiscuity that sometimes goes with it. The need to prove that you are human, that you exist, that you’re alive, that someone wants you. Even if it’s for a night. Also a need to feel like you’re not garbage. This is a Catch 22. You wind up feeling like garbage anyway.

I never had a boyfriend, I just had people I drank with that I slept with or guys I met in bars to prove my self worth. I can say there were a few I thought I loved but was so overwhelmingly hurt by them it made me worse.

At the age of 19 I became pregnant. I was pressured by my family to terminate the pregnancy. Considering I wasn’t sure who the father was and I was drinking at the time it was for the best. The father would have been an alcoholic or drug addict. I was selfish and not willing to stop drinking. I would’ve been on public assistance in an apartment with just me and a baby. This would not have been a good idea at the time.

The experience itself was demeaning, horrific, and one I’ll never forget. Someone had superglued all the locks to the clinic doors, I had things thrown at me on the way in and of course religious things shouted at me as I entered the building. I do not regret what I did at the time. I wasn’t ready and I was ill.

I regret lying to myself later in life whenever the subject of children would come up. Somewhere in the back of my mind I knew I couldn’t handle it. I was resentful of my sister for being able to have children and be a good mother.

At first it was the drinking, then it was my inability to find someone to be with. I didn’t want to admit the damage that had been done by men in my past. I am easily startled by loud boisterous men. Most men frighten me. Part of my Conversion Disorder is linked to this I think.

So the years went by and my body changed. I stopped getting my period 2 years ago at 40. I no longer have a choice. Part of this makes me sad. But I can honestly say that I as much as I love my nephews and other children I don’t think I could I raise one on my own. It would be unfair to the child and the people around me who would have to help.

This doesn’t mean I don’t feel an ache sometimes, I do. I also feel at times it’s a form of punishment for years ago. I have to deal with that. There is so much inside me I would like to forget but can’t. There is a never ending sadness. I can only deal with it a little at a time. Some days are worse than others. I do try. Some days I’m just too tired. I can only hope the next day will be better.

Put Me Back

I had one of my surgeries today. My sister took me to the Hospital, dropped me off, and left. I waited for 2 hours alone in my gurney. There was no one to talk to, no one who cared. As I was waking up I remember crying and telling them to just let me go. To put me back wherever I was. It didn’t matter. The Doctor said my sister was coming. I remember crying harder and laughing at the same time. I told him she didn’t love and care less. She got there just as they were putting me in the wheelchair to wheel me out of the hospital. She was supposed to be there earlier. I knew she wouldn’t be there on time. Everyone including the staff knows I have a problem with anesthesia ever since I had ECT. But I was still left alone to deal with my emotional breakdown.

I’ve had enough. I will not do for others that can’t lift a finger for me not even in a crisis. No more begging for their love, bribing for their love, I’m a human being. I’m not a monster, I never intentionally hurt anyone but myself. If you tell me I need to change than you will change. Into thin air. I’ve cried my last tears for people who cry none for me, who don’t even acknowledge my pain. I’m sorry mom. I was expected to keep everyone together after you died. How can I do that when I can’t keep myself together?

I Love Doctors Like I Love Colonoscopies

Yesterday I went to see my Psychiatrist for my usual 3 month visit. I had some issues to address with him about my file and the diagnostic codes. As soon as I asked I caused a panic.

I couldn’t get a word in. Finally I got as loud as I could and said ” I just want to know what I am, what I have, what is told to the review board!”. He stopped to look at me and said ” It doesn’t really matter if you are Bipolar I or II it matters how well you function and if I think you can handle the stress of working and you can’t”. I told him it does matter because Bipolar II is still seen as Bipolar Light or Soft by Disability and even other people that have Bipolar Disorder.

His response was that I don’t fit the Bipolar I criteria because I haven’t had a manic episode that involved hospitalization due to full blown mania with hallucinations, voices, etc. I have never read that to be the criteria. Only that you have to have had at least one manic episode lasting more than 48-72 hours.

He also said it was Medicare doing the coding and that he was putting in all the info on me. I find this hard to believe when I downloaded copies of my records and it wasn’t there.

I have some decisions to make. He once again asked me how I was doing on the Brintellex when we stopped it 3 visits ago. It might be time for a change and someone with fresh eyes.

The Ass Maker

I have a habit of telling someone how I really see them or how I feel about them. It makes people uncomfortable to hear the honest, heartfelt, good observations about themselves. I’m not blowing smoke up any asses, I don’t need to. There are people who find this annoying and for that I say too bad.

If a lyricist has written a song that makes me feel something whether it’s sadness, anger, lust, or enlightenment, I want them to know. If later they think I’m a nut job for my observations then it’s a shame. And I then feel shame for voicing my joy and appreciation for an art form I use to speak for me at some of the most important times in my life .

Sometimes when I’m angry and I can’t release that anger because there is a tremor in my vocal chords and a stutter in my brain I put a song on that equals that emotion.

I get cut off on the freeway- Pantera “Walk”

I think about my mom’s death and me- Blue October “Hate Me”

I’m happy sexy- Aerosmith “Chip Away the Stone”

The drinking love song- Aerosmith “What it Takes”

The drunk belt it out songs- Motley Crue “Home Sweet Home” and Aerosmith “You See Me Crying”

I could do a great “Ace of Spades” when I drank too but not now.

Since I was little music was such a huge influence on me. It had nothing to do with fame or fortune. These people got to sing and have other people HEAR WHAT THEY WERE SAYING.

When I spoke no one ever really heard what I was saying. They didn’t hear:

Help me

I don’t want to be here anymore

No one loves me

I let them hit me because it means they must care at least a little bit

I don’t remember last night

I’m sorry I just don’t want to feel

Now they try to hear me but don’t have the patience for the way I think and speak. They walk away.

When I tried to communicate with a person or 2 that I mistakenly thought would understand me I was laughed at, blocked, and saw the report where I was called “annoying”.

This 42 year old woman has been through things in her lifetime that would make most men squeal like a bitch. But I took it all.

I am now sober and where once I would beg to be pretty I now know that I am.

I still have a lot of work to do.

I won’t apologize for telling someone I appreciate what they do. Thank you again Mr. Tyler.

I’m not The Ass Maker anymore I’m Dana like it or not. P.S. I’m the one with reddish hair the other person is my hair dresser who listens to me and let’s me take my time and think before I speak. In exchange she get’s to do what she wants to my hair except cutting it short.

My Psychiatrist is About To Be Tested!

I have an appointment with my Psychiatrist on 11/11/15. Things are going to be different this time. I’m going to make a list of everything I need to ask him and everything he needs to do. I’ll try to get my sister to help me. lol If she answers her phone. If the things on my list are not done or addressed than I will find another Doctor.

The problem I’m having is when I look on the Medicare website where you can download your records, I see what he’s putting in my file and what he’s charging Medicare.

Medicare is over charged by 99% of doctors. There are fewer and fewer doctors taking Medicare in my State because they feel they don’t get compensated enough and it’s a pain in the ass. So the one’s that do pad the bill. I’m not going to say anything about that. If I do it will get around to other doctor’s in the system and they will not take me as a patient.

The fact that he copies and pastes every visit I DO have a problem with. This was what almost cost me my Disability. If I hadn’t had a lawyer to point it out to the judge I would’ve lost. I thought he stopped doing it. He hasn’t.

Every visit says the same thing Bipolar II.

This is wrong. I am Bipolar I, I also have Conversion Disorder, General Anxiety, Social Phobia, and someone added Catatonia which I have no idea what that is even about. None of these appear in my file.

So when I go up for review and the board looks at my file all they will see is the incorrect diagnosis of Bipolar II.

I have to figure out a way to explain this without stuttering and getting upset. I don’t want to offend him. He really isn’t a bad Doctor he just hates paperwork and the record keeping part. He’s told me so himself. But lately he’s been off his game as a Doctor also. Asking how I’m doing on a medication that I discontinued 2 visits ago and is on the screen in front of him. Or it should be. Something is different with him. If I get the same feeling on the 11th than it’s time to go.

The problem is where? We all know a good Psychiatrist is hard to find let alone one that takes your insurance.

I wish my Hematologist could be my Psychiatrist and all my other Doctors rolled into one. He’s the only one I like. The only one to encourage me to advocate for myself and learn about what I’m diagnosed with. He also encourages questions. NONE of my other doctors do that. He’s rare. Maybe he’ll adopt me.

The point is make sure your doctor is putting the correct info in your file and explains things to you. If they don’t like you asking questions then there is something wrong and try to find someone else. Good luck we need it.