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Posts posted by Squirlygrl

  1. Pending a doctor visit:


    1. The first order of business is the driving!  You do not want to hurt anyone. It can happen. If you must, give someone your keys.

    2. No caffeine, no alcohol.

    3. I'm glad the money isn't an issue yet. That doesn't mean you shouldn't plan ahead.  Leave your debit/credit cards and checkbook at home, and except for bills, only pay cash.

    4. I talk a lot, and social contact gets me going. I have said things that I regret. You may want to get more quiet time.  You can write your thoughts down if they are making you uncomfortable.

    5. That said, there are places where, and people with whom, I am relatively safe. If I've been reckless somewhere, it's off limits.

    6. Stay away from anyone with whom you might have an inappropriate erotic relationship. I saw a person ruin her life this way. If it's meant to be, the person will still be there when this passes.

    7. Moderately intense exercise will buy me some time.  Past a certain point, for me, it becomes part of the problem.


    Three more thoughts. Please don't respond, just consider:  (1) 900 mg gives some people a substantial lithium level, and others not; yours should be checked; (2) Does the person who is prescribing your Keppra (which of course you MUST NOT touch on your own) know about your mood? and (3) while it may be good riddance to that psychiatrist, it usually takes a substantial problem to get them to fire you; consider whether something happened there that you'd like to do differently with a new prescriber).


    Good luck, and sleep well.  A cheap fan does wonders for me.

  2. I found Abilify agitating. I react to antidepressants.  I also do poorly on other antipsychotics; I've either been sedated or had movement issues.  Which leaves me with --


    Lamictal, which I think has helped me with the depressing effects of a large dose of Depakote.  However, Lamictal did absolutely nothing for me until I reached a blood level above the minimum lab range.


    The following article does a nice job of flagging the "we thought Lamictal was great, but we didn't consider all of the studies" problem. http://www.psychiatrictimes.com/bipolar-disorder/content/article/10168/1567592 (2010).  It concludes that Lamictal is still worth considering as one of a number of options.


    Also, I feel miserable on benzodiazepines or quetiapine for sleep.  I've been using zaleplon very occasionally instead, and it's worked well.

  3. When I joined I had a thing for Foamy the Squirrel, and particularly the episode in which his fellow squirrel Pillz-E rants about getting his coffee ("So I Said to My Doctor").  Also, it was self-deprecatory/own the insult, etc.  The same way as "crazy".  It's been a long time, and I don't know that I'd love Foamy's later evolution.  I should probably change it  But I still want some coffee.

  4. I am so sorry.  I have been zapped out of the blue a few times, under stress, but when I was not otherwise having a mood.  One, which was largely tactile, lasted a day or go, and was macabre.  In general, though, mine were not as intense and cleared up with outpatient Zyprexa.  I haven't had any in a while.


    I hope that you feel calm and safe soon.

  5. Yes. Big time.


    I have fought a lot of meds.  When they produced, say, twice-a-day naps, or dyskinesias, I think that was warranted.  When, as now, I am raging against the last little bit of Tegretol, I think I should probably just get over it.


    My son has seen the pills and said "I wish you didn't have to do that." And I have been able to say, "Yes, but aren't things good now?"


    And that's the bottom line. :cool:

  6. That's an interesting article.  You'll note that he's talking about "mild bipolar symptoms" becoming subsyndromal.  For the rest of us, he's talking about self-management plus meds, which I heartily endorse.


    Please hear me. Residency is not stress-free.  Sleep deprivation is a nightmare.


    "The worst that could happen is hospitalization" is a little breezy.  The worst that could happen is that your behavior could cost you your medical license, or God forbid, take someone's life.  If you are hospitalized, you move pretty quickly from a world in which you have overcome youthful instability into a world in which no doctor in the country will take away your mood stabilizers, for fear of malpractice.  If you hate medication and don't want a lifetime label, that's the world you want to avoid. 


    Believe me, it's not fun to be in a world in which you'd have to lie about your medical history to get the independence want. I personally did not enjoy Seroquel and am not even on antipsychotics anymore, and I understand your concern about the effects of long-term use of drugs, and I hope your consideration of the research has been extensive and has included consultation with someone experienced.  (At a minimum, Goodwin and Jamison are smart, and I believe they address the difficulty of finding medication-naive brains to study.)


    I'm glad that you have willpower. I have willpower too.  I graduated with multiple honors from a very good professional school and practiced in selective jobs for ten years.  I am really lucky that I didn't come apart until I was well into a second career, or something that was only a crushing failure could have been much worse.


    I also had willpower when, with medical advice, I discontinued a drug cold turkey and ended up in a locked ward hiding under the furniture and drinking the soap.  Your mileage may vary, I hope.

  7. I also think it's worse in the aftermath of a crisis.  Some of that is their caution, and I think that some of it is natural post-episode burnout.  I I can be depressed then and not know it.


    I personally have a rough time on some dopamine drugs (I'm looking at you, Haldol) but not all (I liked loxapine, but had motor issues and had to stop). That may be a factor.


    It took me a very long time to feel under control and vital at the same time.

  8. I had resting tremor from lithium and a super-annoying but variable intentional tremor with Depakote, which got much worse under stress.  Both were worse with coffee.  The Depakote one is dose-dependent, and it doesn't interfere with my life anymore, which is good because I play the piano.  (I tried to learn to pick the banjo back in the lithium days, and that was a little too much).


    If anyone notices, I shrug it off and say "oh, that's just benign."  I would absolutely try propranolol if needed and think it can be used PRN.

  9. I have been in relatively unstructured psychodynamic therapy for 2 1/2 years, at the insistence of others. I had been vehemently opposed to the method, I hated it when I started, and it still sometimes feels invasive (or, alternately, silly).  But I have also been very stable and happy or 2 years (it took a while to recover from my last hospitalization).


    I needed to be there:

    to try to accept and repair the damage I'd inflicted;

    to set new standards for my own behavior;

    to reflect on the causes of past episodes;

    to deal with meds, which I have fought against pretty hard;

    to stop missing the intensity, and to find it in real life rather than craziness;

    to regain a sense of autonomy, even if my mood does start to change;

    and generally not to feel sad or angry or confused or entitled or invincible. 


    I'd had many years of treatment resistance, and the coping skills I'd developed during that time were ugly, and are mostly gone. I've had cognitive/behavioral improvements as a result, but it isn't CBT, which I've never tried and can't speak to.  If I hadn't been in so much trouble for so long, a shorter and less intrusive therapy might have worked, but I'd gotten really messed up.


    I'd still love to be too good for this. But the team isn't ready for that yet, and while I am much improved, my judgment and self-control could be better.


    I agree that therapy has to show results.  Whatever the method, if you're not seeing any progress in a few months (you don't have to be perfect), it's time to move on.  If you don't like or respect the person, move sooner. 


    By the way, any kind of weekly contact is vital for me, both as a motivator and as a reality check for me and for the doctor.  Before I did this, I saw my prescribing doctor for an hour a week.  He didn't fix me, but I kept showing up, which stopped me from doing some awful things.  He's made mistakes and I've hated him sometimes, but he may well have saved my life and the things I love in it.


    Well, there's a novel for you.  Sorry to run on.  Hope some of that is useful.

  10. Forgive the delayed response.  I think it can get quite a bit better.


    Lithium (now Depakote) helped me not wake my husband at midnight to cry at him.  Therapy helped a lot, a lot -- I did not trust him because I was pretty sure I deserved to be discarded.  Don't tell anyone, but I actually tried to return my engagement ring once (while keeping my wedding ring).  Not recommended.  He looked at me like I had grown another head.


    While you are working on the weight thing (empathy! I've had weight issues, med gain, etc.) I found it helpful to seek out role models who were not small but seemed confident, well put together, and happy.  I was pretty judgmental of these people once, but I am a lot happier in a more inclusive world with more people to admire.  I find it very difficult to discuss these things, but it might be helpful to bring it up with your husband.  When mine said "it's good you're losing weight BUT I do not expect you to look 18" it made me very reassured.


    Happy DBT and welcome to Lamictal.  I hope it continues to be good for you.

  11. Hi there,


    First, my MRI was not so bad, mostly loud. It is nice to have a little rear-view mirror so you can look out the back of the tube.  I also had a lumbar puncture, not bad. I was at the point where I was hoping it was something physical.


    While no one ever said SZA to me, I have had hallucinations in the absence of a mood episode (I have also had the visionary mixed-state thing).  I think they were  from med changes (add Lamictal, d/c AP) or just from emotional triggers. (Oddly, the genuine crises have not been a problem, but strange little memories were, before my meds got settled).  I am sorry for what you are going through -- it is much more intrusive.


    Zyprexa helped me greatly.  I think I need 7.5 or 10 mg for at least 3 days.  Haldol helped too, but not as much, and it made me too sleepy as a maintenance med.  I do know that Abilify made me much worse, but not strictly hallucinatory.


    This is worth a phone call. You should not have to put up with it.

  12. So, so helpful for me.  I gained 15 lbs because of the med (I was hungry), then I gave up and gained another 15. I think I can lose some of that if I just accept that cheese is not a food group.  (Even so, it's not outrageous; I am still right on the line.) 


    No hair loss, no depression (I also take Lamictal).  Blood checks are no big thing.  Supposed to be great for cycling/mixed states, and for me it's true; I had been only partially responsive to lithium and APs, for years.


    crtclms is right; it's an experiment, not a tattoo. I remember staring down that first lithium pill like it was a little snake in the palm of my hand.  Just work closely with your doctor.


    Good luck!

  13. At least partly, I strongly suspect.  But I have a ray of hope (or wishful thinking):


    The wackiness in my family (undiagnosed) comes in different flavors.  It goes back several generations.  However, children are affected by being raised by people with issues. (This is why adoption studies are so great, when you can find them).  Not everyone in my family with a challenging parent has matching (or compensatory) issues.


    So what I plan to tell the children is:


    1.  You may well be more vulnerable than the average person, because of how you are bulit and/or because you had to deal with me.

    2.  You can practice good mental hygiene.

    3.  You can intervene early if things start to go wrong.

    4.  Even if you do have issues, not every case is the most severe or difficult to treat.

    5.  You can have a good life, because I do now.  In fact, you can have a better life, because I did not do 2 and 3.


    I hope this works.  Good luck!

  14. I have too.  All of this is good advice. 


    Also, your wife is your ally.  Think of what might happen if you told her "I am feeling really upset with myself for not being able to take care of things better.  I can do it, but sometimes it's going to be really hard?" 


    I don't know the two of you, but I personally would have had an easier time of staying out of the whole "want to hurt myself" cycle if I had been able to be more verbal about those feelings.  You don't necessarily have to go into specifics.


    Just a thought.  Best wishes to the two of you, you have a lot to carry.

  15. I drifted away as I got better, had different problems, thought I needed to change focus, thought it would be tempting fate to post about it. 


    One problem with the whole MI thing is that, through a combination of denial and stigma/discretion, many of the success stories are driven underground.  How was I supposed to learn by example if only the most flamboyant successes were talking?

  16. Well, fuck. I am so sorry. And angry. And I don't even know the half of it.

    Now, it is triage time. You are right that you need some safety net for meds and a reality check. Maybe that is all for now. I look back and wonder whether my wheel-spinning therapy was not significantly worse than useless, especially the parts I spent saying "can't you look past the depression and see what else is wrong with me?"

    I don't think that all of the standard emotional outlets are enough, but they are a safety valve, and they might carry you a long way toward a place in which you were covered for more thorough help.

    If I had it to do over again, I would not medicate every potential second diagnosis as such, but I would also insist on a therapist who acknowledged every symptom and worked on the assumption that it would end up very well controlled, at a minimum, and possibly even healed. Much easier said then done. That is why, in your copious spare time, you might cast a wide net for less-qualified cheap or pro bono counseling of some sort, to act as moral support until you get in a better insurance situation, which I hope will be possible.

    I actually think you are kind of a rock star for bearing up under that professional strain. I am glad for your loving BF of 10 years; I hope he is helping you with it.

    I feel bad for being AWOL on this. We had a family situation. I know you have tons of support here, but I wanted to say "thinking of you."

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