Category Archives: Bipolar Disorder

Medications and Weight Loss

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How is my new eating plan going, you ask? Please don’t ask right now.

My doc changed then increased my antidepressant med a few weeks ago. I’ve been dealing with sleepiness during the day. I’ve tried taking this drug (generic Effexor) at night instead but to no avail – I still get daytime sleepiness.

I figure it will pass. It almost did – until the doc increased the dosage a few days ago.

Having Bipolar means I’m on an antidepressant and a mood stabilizer, both. They work together to make me feel much better and more “normal.”

It hasn’t been good for my weight loss, though. I gained back what I’d lost and gained about 6 more pounds. Ugh!!

I’ll chalk it up to meds change and not beat myself up about it.

I’ve been eating well, however. I love veggies, fruits, and lean meats. I made brown rice last night with roasted carrots and a small, lean cut of beef. I still find myself hungry much more often than usual. It’s infuriating. I’ve learned to grab grapes for a quick snack or other fruit.

Do you take meds that mess with your weight or that may cause other health issues for you? It’s frustrating, isn’t it?

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I need to go and exercise but am so freaking sleepy I wonder if I can raise my head from this couch pillow. I will push myself . . . see where it gets me. It will either give me energy or I’ll be ready for burial. LOL!

Love y’all!

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Is it Depression or Bipolar?

 

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Thanks to Kitt O’Malley, who posted this before me. And thanks to Michael Pipich for the wonderful information.

Are You Just Depressed or Is It the Onset of Bipolar Disorder?

Michael G. Pipich, MS, LMFT

About two-thirds of people with bipolar disorder are misdiagnosed with other mental health problems before bipolar is discovered.[1] Among those individuals, a significant majority are given a diagnosis of major depression. Most people with a major depressive disorder that is unrelated to bipolar disorder (typically known as non-bipolar depression or unipolar depression) can be treated safely and effectively with a combination of antidepressant medications and psychotherapy. But when people with undetected bipolar are treated this way, a host of mental health problems can occur, making the underlying bipolar condition much worse.

It’s understandable that someone may not immediately be given the bipolar diagnosis if their first mood swing begins in a depression mood zone. This seems particularly true of people who have bipolar II disorder. And sometimes, there may be more than one depressive episode before a manic or hypomanic episode happens in a person with bipolar.

If you’re wondering about whether you may have depression or the beginning of bipolar, there are some keys to keep in mind when seeking treatment.

First of all, when assessing if your depression is a part of bipolar, know that bipolar disorder has distinct genetic foundations. In other words, it runs in families and is passed through family genes. So if you suspect that any family members may have had bipolar disorder, it’s important to inform your doctor or therapist when entering treatment. If the information is available, a thorough family mental health history can really support a proper bipolar diagnosis. Unfortunately, such information isn’t always asked for, so be prepared to volunteer all that you know during an evaluation or treatment session.

Next, your personal history of mood swings should be explored. If you’ve had severe ups and downs during childhood or adolescence, these may be more than the common tumult of growing up. They may instead be early expressions of bipolar disorder. It’s especially important to review periods of hyperactivity, bouts of unexplained rage, self-harm, or suicidal thoughts or actions that could have occurred at any time in life. There certainly may be other explanations for these, such as early life trauma or severe loss and grief experienced during these formative years. But if explosive behaviors or deep depression occurred at different times, especially with little or no provocation, it can point to underlying bipolar disorder.

Usually, most people with bipolar who seek treatment on their own are currently or recently depressed, or are experiencing consequences of untreated bipolar disorder. Any history of mania or hypomania is less obvious, however. And often, bipolar patients will either not understand manic symptoms or will avoid discussion about them. If you have had at least one occurrence in your life of intense euphoria, excitability, unexplained energy and creativity, avoidance of sleep, or impulsive behaviors, inform your treatment professional. But also bear in mind that mania and hypomania may be marked by intense periods of irritability and agitation, know as dysphoria. This is in contrast to the euphoria that most people think about with bipolar mania. Often a dysphoric type of manic or hypomanic episode can be mistaken for the kind of agitation seen in major depression. This can mislead the course of treatment to focus only on depression, while missing the full bipolar condition.

This brings us to the most important part of knowing whether you have depression or bipolar onset. According to the Diagnostic and Statistical Manual of Mental Disorders (5th edition), if a patient is given an antidepressant medication, and it produces manic symptoms, the person is then diagnosed with bipolar disorder.[2] While this is a very clear indication of bipolar, how the mania surfaces in the individual may take different forms. For example, a person in a depression mood zone can improve early in the treatment, and as a result, may not show manic symptoms right away. Any slight improvement may provide a hopeful sign that treatment is working, but when the person starts to get worse because of emerging mania—especially if it’s dysphoric—the unwitting response may be to apply more antidepressant medication. Now we have some real problems.

So, if at some point in your treatment, an antidepressant medication makes you feel more agitated, more irritable, more aggressive, or you start to experience hyperactivity or greater impulsivity, tell your treatment professional right away. This could be the start of a manic episode that is revealing a previously undiagnosed bipolar disorder. Even more importantly, any increase in suicidal thoughts or possible psychotic symptoms, such as hallucinations, should be reported immediately, as these can be life-threatening. Any antidepressants will either likely be eliminated at this point, or possibly paired with a mood stabilizing or antipsychotic drug to keep a lid on mania.

With bipolar finally recognized, bipolar medications can be introduced to decrease manic-type symptoms, while keeping depression in check. Alongside medications, it’s important to have therapy focus on the unique challenges facing people with bipolar disorder. Major depression is frequently considered an acute condition because it often can resolve in time, so medications may be discontinued at some point, along with a shorter overall approach to therapy. But bipolar disorder is a lifelong condition. Even though its symptoms can come and go in episodes, the genetic nature of the condition means the bipolar patient will need continuing care through the lifespan.


[1] Hirschfeld R. M., Lewis, L., & Vornik, L. A. (2003). Perceptions and impact of bipolar disorder: How far have we really come? Results of the National Depressive and Manic-Depressive Association 200 survey of individuals with bipolar disorder. Journal of Clinical Psychiatry64(2), 161–174.

[2] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author, 128-130.


 

Michael G. Pipich, MS, LMFT is a psychotherapist and author of Owning Bipolar: How Patients and Families Can Take Control of Bipolar Disorder, (Citadel Press, Sept 2018). He practices in Denver, Colorado, and can be reached at MichaelPipich.com.

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Bipolar Disorder – My Shadow

 

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A mood disorder is tough to deal with – whether you are the sufferer or the loved one of a sufferer.

It’s like my own shadow but one that often catches up and overcomes me, Bipolar Disorder. And it doesn’t play fair. I go along with my life “normally” for a few weeks until a dark mood sneaks up behind me and bites me in the behind. I’ve had a few episodes of severe mania but now mostly experience the severe depression side when the disorder kicks in.

I dutifully take Zoloft and Abilify to even things out. Thank goodness for those. They allow me to live a life of being stable most of the time. However, when PMS hits or when perimenopause changes my hormone levels, watch out!

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An old friend and I text now and then. She never knew I had been diagnosed with this disorder, and I had hurt her feelings a few years back. I tried to apologize many times  but she kept me at arm’s length in fear of being treated poorly again. I finally told her why I’d been on a roller coaster of emotions back then. I imagined she didn’t want to complicate her life with a friend who had mood issues.

Can’t say I blame my old friend. I don’t like having me around at certain times, either. However, I do the best I can to treat others with respect and understanding (when I have my wits about me).

So, please, if you know someone with this (or other) type of mental challenge, consider being as understanding as possible with him or her. It takes a lot out of a person to ride this coaster.

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Bipolar Mixed Episode . . . The Next Morning

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The hours after a Bipolar Mixed Episode are like watching a scary movie. I keep my hands over my eyes and peek through my fingers. What unintentional damage did I do this time? Who did I reach out to and spill my (very personal) guts to? How many mean and demeaning things did I say to my husband? Did others notice my expression and down-turned eyes when I had to leave the dinner we were attending? If it hits me while I’m in public, I have to find a way out of the people because my mood definitely shows in my face. No playing “just fine” at these times. Many times, I’ll blog. Writing has always been my outlet. Even as a ten year old, I wrote “escape” poetry. I finally took you guys along with me last night during an episode (you lucky people). 😉  Well, today is a new day, and I broke the mood cycle with sleep. Life still isn’t perfect but at least I can deal with things differently today.

Bless you, my readers and subscribers. Have an awesome day ~

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Join Me in a Bipolar Mixed Episode

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It’s been a day of hard issues. Please forgive my disjointed organization of thought. I’m taking you with me on a bout with Bipolar Mixed episode. I have depression paired with anxiety at the moment. I feel anger, rage actually. I want to die. Not to threaten it but to actually do the deed. I don’t because of my two kids and my mother. I love them too much to put them through a loss like that, so I’m stuck in this mental illness with no real way out. Meds work most of the time. Not tonight. I feel lonely – like I am ultimately responsible for myself, and I hate that. It’s scary and a lonely place to be. I’ve always been a sheltered child and then a sheltered woman. One of my problems is that I can’t organized my thoughts to keep a job for longer than a year but also can’t receive government aid (as income). It’s a terrible cycle which causes me much anxiety and depression.  Here is how it starts – the bipolar/mania cycle. As I type, the words on the screen are blurry, and I make a lot of spelling errors. I long for the long seep. The end of all of these roller coaster of emotions. Medications can only do so much for me. I’ve dealt with this for nine years. I’m TIRED of fighting with it. I hope I can sleep tonight. I hope when I wake, it’s a happy new day. But I don’t know. I hang in the abyss of a universe with stars blinking brightly, hurting my eyes. I float too closely to the planets. It’s sometimes hard to breathe in this dark vast space. Other times I get lungs full of fresh air. Hope is all I have. It stays somewhere deep in my core, a tiny flame that doesn’t seem to go out even when high winds or heavy rains cover it. I am inwardly thankful for that flame. It promises  another day that might be a good one. One with sunshine on my face and bird songs in my ears.

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Bipolar Disorder, Be Patient, Dears

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Ever feel like you have a Jekyl and Hyde thing going on? I did but didn’t notice it as a problem until years after it began, and then finding the correct meds and behavioral therapy was like pulling teeth.

I’ve finally found the “cocktail” that works for me. Guess how long it took? TEN YEARS! No kidding. I was first diagnosed with depression, then Major Depressive Disorder, then Bipolar, then back to depression with ADHD. Finally, my new doctor said she wanted to treat me for Bipolar 2. I began Abilify (generic) and have been smooth sailing from that point on. Thanks goodness for perserverence. I just KNEW something had to work at some point.

These days, I am happy (but not too much) LOL. I’m not thinking that suicide is the best answer for me as I did for many years. I’ve also got energy again! Blessed be! It’s been gone for so long. Feels good to want to “do” things again.

The Take Away from this blog post is this: NEVER ever give up on finding what might make you feel like yourself again. It’s trial and error. It’s changing doctors multiple times. It’s being patient enough to keep your head up and your courage up even more.

If you or a loved one might have the following symptoms, please see your doctor and start feeling better! ((hugs to you)). See the Mayo Clinic’s information on Bipolar Disorder here:

http://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/dxc-20307970

The “Highs” (mania). Symptoms of a manic episode may include –

  • Feelings of euphoria, abnormal excitement, or elevated mood

  • Talking very rapidly or excessively

  • Needing less sleep than normal, yet still having plenty of energy

  • Feeling agitated, irritable, hyper, anxious, or easily distracted

  • Engaging in risky behavior such as lavish spending, impulsive sexual encounters, or ill-advised business decisions

The “Lows” (depression). Symptoms of a depressive episode (bipolar depression) may include –

  • No interest in activities you once enjoyed

  • Loss of energy and feeling apathetic

  • Difficulty sleeping—either sleeping too much or not at all

  • Thoughts of suicide, if depression is severe enough