Bipolar check-in #47

I felt good the first part of the day but now i feel lousy. The pharmacy missed their delivery again. This is the fifth time it's happened. They commit to one day and then don't make it til the next. I usually allow for these screw-ups but this time i am out of the med so i hope it doesn't impact my sleep. It's just medication for low-thyroid so one day probably won't matter. I guess it is time i assert myself with the pharmacy. Asserting myself is a challenge so i will just psych myself up to be firm and direct and calm and get my point across. I'll ask to speak to the pharmacy manager. Not looking forward to it.

I tried to eat healthier again today but i ate things in the wrong order and my protein drink collided in my stomach with my savory veggies and i have pain. Even when i try hard to eat better i still get gut pain. Discouraging.

The heat wave burns out tonight so it's just one more night of discomfort and the humid air like soup.

I've been having lots of trouble getting to sleep, 4:30am last night. I want to stay up late so i don't end up tossing and turning all frustrated for hours but i'm out of things to do and my patience is out too so i guess i will go to bed and if i just lay there, whatever. It's only 1:00am here so i must be outa my mind.

So sorry about the pharmacy troubles, whatever. What a pain. I don't get how they could miss it so many times and sill be in business.

I hope you fall asleep soon!!!!

I admire the fact that you act (reasonably) on your convictions!

Haven't I read you've also done a fair amount of advocacy work for those of us with mental illness? It takes a special person to take on these roles.

I think you do most likely feel much more empowered than someone who is not likely to step out/up and take a chance?

Thank you, @BirdDancer, for any advocacy work you've done.

Here you are!
I'd mentioned you just 2 days ago.

GREAT to have you drop in!
Gonna stay awhile !??

Love and hugs to all

It’s good to see you back

I am also alive and bothering the world

I injured my body a week or so ago (and also had a tummy bug)

Both are improving slowly...

The injury did impact my mood...

The other took up a lot of time

I hope I haven’t posted anything during that time.

Much love to all

I just broke up with my boyfriend. For the best. I was kinda manic and very drugged out when I got together with him anyways. With the lowered dose of tegretol, my rash is all but gone and the itching is still bothering me but it's not as bad. I do feel kinda...frantic? I gotta go find my cat and give him his meds.

Thanks for the update spikes

I was just thinking I hadn’t noticed posts from you (I haven’t been here much lately though)

I’m glad the rash is almost gone

It sounds like you made a wise decision re breaking up with your boyfriend.

I hope it goes ok talking to the pharmacy manager.

I’m sorry about the gut pain.

A heat wave is just starting here. I am not looking forward to it.

I hope you slept some!

I don't have a lot of research on hand to offer. I wish I had more specifics to help. I'll send you links if I can find the stuff I studied when I went through this. However, it is my experience that psyc meds can cause psyc issues. They 'address' one thing and then another pops up. Doctors then prescribe a med to treat the new symptom. All the while the patient believes the new symptoms are a progression of their issues when really their problems sometimes stem from med effects. It is like a big game of whack a mole.

I had it happen to me three times. In the hospital I was put on Depakote. It made me feel even crazier and my heart was beating 160 bpm and my blood pressure was up. The doctor on call put me on Inderal. No discussion. I asked the nurse what it was for and she said 'don't worry dear, it is just used to treat your high blood pressure'. I freaked and yelled 'get my doctor. I don't have high blood pressure'. I told them I would not take Depakote anymore. I felt like it would kill me eventually.

When I was in IOP my therapist asked me in a private session what my biggest worry was. I told her it was relapse. I was very afraid of losing my mind again and hurting my kids. That seemed pretty rational given that I was psychotic and manic 6 weeks before. However, I had no psychosis, mania, depression or anxiety for the 4 weeks I had been in IOP. I was stable. The only medical issue I had was a menstrual issue caused by the risperidone I was on. That afternoon the nurse called me and told me to pick up a script for Geodon. I said why??? She informed me it was to treat the fear I had of relapse. I spoke to the doctor and said I would not be taking both as I was already like a zombie at the lowest dose of Risperidone. She yielded and developed a plan to move me onto Geodon slowly.

I was tapering off Risperidone and I started to have anxiety about something I never worried about before. I had actually never been anxious before to this degree ever. It was strange and new. I told my pdoc about it and he said he would give me something for that. I yelled 'no!' This is not me. What else could cause this. He finally offered that the Risperidone could be causing the problem and I decided to wait until my taper off was complete to see how things went. Poof. Anxiety gone.

All of these meds act as a means to activate or block your neural pathways. They target certain receptors. Our bodies use those receptors for natural functions constantly and each of us is unique. There are 100 trillion neural pathways in the brain alone and many others in the body. When healthy, our bodies and minds are good at managing the traffic load. When we are mentally and emotionally ill, we overload ourselves with certain thoughts and emotions causing electrical(thoughts) and chemical(emotions) blockages or shortages.

The notion any pill or pdoc can step into a web of traffic that huge and fix what is wrong is frankly insane to me. I understand using meds as a stop gap, but somewhere along the way we grew to believe a chemical in a pill is a better traffic controller than our own mind. A pillnwith zero integration or information from our other systems. That would be like asking an Commodore 64 computer with no connectivity to decide how to route all of the traffic on the Internet. Insanity. We lost faith in our power to heal. We stopped addressing root cause. We believe in the magic of a pill instead of resetting and working with our mind and emotions to balance and rewire. We stopped using out highly integrated internal traffic control systems.

Anyway, the more pills you take, and all of these are serious drugs with serious side effects, the more the chances are that your pathways are jammed where they shouldn't be and over active in others. Nobody really even knows what happens when you mix all of these drugs together. There is very limited data and it mostly comes from drug companies who rely upon their drugs being seen as effective. Patients having a response of somewhat better is enough to sell it. Nobody cares what happens years down the line...

You have a lot of great coping skills. You seem to be willing to face and work on some of your emotional trauma. That helps the body relearn to balance chemically and electrically on its own. You are effective sometimes, but you are fighting a chemical army.

I was not. I was only on one med that did truly help me come out of my psychosis at the time. I really needed it. But...I learned all I could and I picked those skills up and dropped meds. I'm not saying that is attainable for everyone. I just feel like if the cocktails actually worked, we would have far fewer members here. There has to be a better way. Balance is out there for everyone I think.

Slowly coming off some of these meds or lowering the doses might help you sort out which symptoms are you and which are your meds. An effort like that needs to occur very slowly and with insight. There are boards out there and resources written by people who did this for themselves. Many of them would tell you they walked through Hell in withdrawal, but the made it through. You're in a Hell of its own now anyway, right?

I'm not sure any of that is what BirdDancer or the others meant. Its just my own take. Do with it what you will.

I hope you feel better soon bpcyclist.

(good post fern)

Respectful regards

@bpcyclist, I am sorry some of what I wrote yesterday confused you. It seems that some of what Fern wrote expressed what I wanted to yesterday, but she did so better.

I am not saying that you are necessarily on too big of a cocktail, or that some people may not need bigger cocktails, but that maybe you might be. I wrote a long, surely slightly disjointed account of when I was on more medications than you. In my account I mentioned how trimming down a bit actually improved my situation. I mentioned that only now, on three fewer medications, do I even know what each does (or does not). Certainly being on fewer medications does not have to mean having a milder course of the disorder.

You wrote that depression is a concern and that your Lithium and/or Depakote may exacerbate it. Then why not talk about that with your doctor? Is it truly necessary to always fight negative medication effects with yet another medication? And with a stimulant, which is downright dangerous for many of us?

I believe most of us must take medications for the rest of our lives. From my long history, I am certain I could not aim to be off of them. However, I did find that I could find more stability on my current mix of four than on my old mix of seven. Some removal(s), some dose adjustments, or an addition/switch, and other therapeutic efforts helped make that possible. It did feel good to clear out some of the chemical excess, for me. It was good for my moods and relief from side effects.

I know you had some flat out horrible, or maybe even traumatic, years of your illness in the past. I did, too. It's understandable to never want to go back there. But please do be sure that the treatments for your disorder don't end up jailing you, in a sense.

I care about you, my online friend. I'm sorry if my delivery of that is sometimes flawed. No need to respond to this, if you'd like to move on from the topic.

Thanks, Wild Coyote! I have done a bit of advocacy work. I'd like to do even more, in the future. As for that letter I wrote to the town's tourism board, it wasn't all critical. I included a nice brief story, as well. And I think my "scathing" was more deep concern for not only the locals, but the businesses, and the tourists. I have very deep roots in that whole area.

feeling okay emotionally

doing nothing though. no motivation

My husband just learned that a close colleague of his suddenly became sick and lost his life in the hospital. He was the youngest person in his department. Probably no older than 30. We don't know the exact cause of death. It is so intensely sad. My hubby is very upset and I am, too. I know they liked each other a lot. We both always commented how lovely his voice was. It makes me also worry about my psychiatrist, who is currently in the hospital with urosepsis.

I start meal replacement shakes tomorrow. I'm nervous they'll taste horrible. It's only 2 weeks then I'm reintroducing healthy food with proper portions. I need to reset my body to proper servings and food choices. I need something filling that isn't caffinated. We shall see if this works. My husband plans to do it later. We'll see.

Hope you feel better today, Fuzzinaotor!!!!

Okay, fern, thanks. I will think about this. You know, I d/c'd all my meds in 2012 and the result was disaster for my brain and symptoms. But maybe we did it wrong or something. Obviously, I am happy for you that it is working so well and a bit envious. Maybe more than a bit. Dunno. Very confused.

Thank you, BirdDancer. I think I understand what you are trying to say to me now.

Slept well and feel pretty good so far bipolar-wise. Otherwise, feeling sort of devastated, to be honest. How am I supposed to know what meds I need and do not need? I am not a pdoc. Some of you know way more about this stuff than I do. I'm just a patient.

After I stopped my meds the last time and had that huge, awful mixed recurrence in the hospital, I promised myself I would never kid myself again and stop them once more. Until yesterday, it never occurred to me that I was on such a weird combination or number of meds that it made me stand out in any way compared to any other person with 'severe' bipolar 1. Plenty of folks in the hopsital were on more than me. But now, I feel like a complete freak, basically. Like some kind of monster or something. So, not sure what to do about any of this. Not putting any of this on any of you, btw, it is all me. I am always grateful for and always open to feedback. Always. Just not really sure what to do about this specific bit of feedback, that's all. But thank you all for sharing with me. i am very appreciative of the input.

Well I wouldnt recommend discontinuation necessarily. However, you might have overlap and conflict of duties going on. A strategic and slow reduction of one thing at a time might help you to sort it out and figure out what is doing what.

For each step down you make you have to give it time because each reduction can cause withdrawal symptoms that are rebounding psych issues caused by the brain's dependence on the med. So for each you need to know what to look for and how long to give it before you know what is a withdrawal effect and what is a true aspect of a disorder. My doc was clueless. I had to come up with my own plan to keep me safe. She was like just stop taking it. I said, what about all of the withdrawal symptoms? She had no clue. The fine people here at PC in combo with lots of research helped me.

Essentially, you'd need to be up for riding out some potentially unpleasant and confusing effects for a while if you taper. For example, one of the major withdrawal symptoms of Geodon, an antipsychotic, is psychosis. What?!??! Crazy, but true. Also, insomnia (a mania symptom) and anxiety (another psych issue). How can you tell the difference? Time. Withdrawal symptoms eventually subside and lessen, true symptoms persist and spiral.

And you probably only want to shift one thing at a time. A sudden drop or changing more than one variable puts you at risk and makes it near impossible to figure out what is going on. Complete trial and error and the degree to which you need meds is very hard to discern unless you go off them in a very controlled, slow, and strategic way. Its kinda like food sensitivity studies and elimination diets. And I mean slow... Some people have to get liquid versions of their meds and go down one drop at a time. Microdosing.

For me, I did have some rebound delusional thoughts firing at first. I was able to recognize them as such and they passed. I also had the insomnia and crazy and scary and violent dreams for a while. I also experienced body issues like headaches for a period of time. This was all due to coming off one med when I was already at the lowest dose possible. I had to break pills in half for weeks and then space them out every other day and then every third day and then down to nothing. I gave each step down time to settle before moving on. My doc checked in at each phase and I continued therapy.

After my taper, life stuff came up. Very yucky, very challenging life stuff. Bad thoughts came, but I accepted them. I worked with them. I got (and am still in the process of almost a year later) down to the root of them. I looked for patterns and now I know more about how my mind and body responds. I see things starting and do the work to rebalance. It is working well for now. If I need meds again, I will not hesitate, but I will approach them as a stop gap and then try the same things or something entirely new to find balance on a low dose or on nothing at all.

You are not a freak or abnormal. When I was in the hospital and I watched people take their meds I was BLOWN AWAY. I am a person who does not take asprin for a headache. I dislike pills of all kinds because my body is super sensitive. When I saw and heard what most people were taking it freaked me out big time.

Almost every person in IOP was on a 3 or four drug cocktail at least. A lot of people here take several things. I think that seems to be the standard of care. It is what three different pdocs instinctive tried to do for me as my symptoms evolved. That doesn't mean it is right or wrong. I think everyone is unique. I think pdocs are doing the best they can. Patients are as well.

How did you go about going off meds back then? What were you on?

You are not a freak! Not a freak. You are the opposite of monster.

I remember once my psychiatrist said to me "BirdDancer, only you and one other patient of mine, take so many medications." After he said that, I felt confused. The first thing I thought was that I must be sicker than maybe all but one of his other patients. And yet, on second thought, the look on his face was not of pity, but I think of possible disappointment in himself. Maybe he thought that HE wasn't using the right strategy to help me with my illness. Yes. I think that was it. Of course, not all psychiatrists may be thinking such a thing. Some just pile and pile and move on to the next patient. Or some may legitimately not know quite what to do. Sometimes they need to be challenged to think a little harder about the big picture. Hopefully, they will. If they won't, and the situation worsens or stagnates, it might be time to get a second opinion.

I'm just a patient, too, but I've learned to question my psychiatrist's decisions, at times. He respects that. With him, we've made great progress over the years, and are still working on more.

A lot of psychiatrists seemed to make wrong choices for my medications. In some of their defenses, it just isn't crystal clear what one patients needs as opposed to another. Trial and error. Working together is better than letting them make all choices alone. A good psychiatrist welcomes and considers feedback. Maybe they sometimes say "No", and that's OK, but only if they often say "Yes" after careful consideration. Careful consideration. That's true caring.

I think good questions for many to ask their psychiatrists are "What does each of my medications do?" and "Could one (or more) of my medications be working in a counterproductive way?" Having a clear idea of these answers can help make us feel more comfortable with our med cocktails, whether they include only one medication or even 10.

Thank you. I was only on 1200 of lithium, 15 of Zyprexa, and 300 of Wellbutirn XR at that time in 2012. My 'new' pdoc decided the way to 'figure out' if I really had bp 1 was to stop all my meds. Since I was in the hospital, she said it was safe. So, we did it. She did not taper much, just over a couple of weeks. Then, a few months later, I had a big recurrence. We started everything again and that was that experiment.