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Bipolar and confident? Must be at risk!


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More a soliloquy than an ask for help...but, comments on my thoughts of course welcome. :wtf:

I have BPAD...Type 1 as you'd say on the tinternet, but here it doesn't seem to be differentiated like that openly - It's Just BPAD. I've been in hospital about 3 times over the last 2.5 years - I take responsibilty for that, it was mainly due to me stopping the meds. Not a good plan at all, eh? My reasons like many in position are many and varied. Anyway, back then I was on 2 mood stabilisers and an anti-psychotic (they changed over time), plus diazepam prn for the The Fear, when that came to visit.

Well, something clicked about 6 months ago, after recovering from a major crash after a short high..I don't even want to talk about that in detail, still painful to even think about. I now take my Lithium (1200mg) almost without fail every night and the occasional 10mg of Olanzapine, or short course when I think it's needed, if I've been up till 4am a few nights in a row, but sill up at 7-8am.

Basically I'm taking a more active role in my illness. I've learned a lot about it, and it's context within me as a person and my life. I recognise that this is a process too, and things are liable to change. I'm ready for that and open to it.

I've not felt more in control and good ole fasioned 'well' for a good few years. My mental health team seems to disagree and have put me on...well, a 'higher care programme', or some such shit. :)

I'll paraphrase a typical, if somewhat exagerated, conversation.

'You really need to be on 2 mood stabilisers plus an antipsychotic, Mr Ringworm'

'Why?'

'Because you show occasional signs of elevated mood which could lead to an episode. We don't believe that the litium carbontate provides adequate coverage. Plus, you have problems engaging with the service'

'I have over-confident and occasionally grandiose, amoung others, personailty traits. You draw a line in the sand with that one with regards to 'elevation'. I know all my early warning signs thank to CBT & my partner is hyper-twitchy about it given my past. I now take my lithium without fail and after last time won't stop. I avoid the service because of bullshit like the topic of this conversation. Nothing personal, I'm sure you understand :cussing: '

'What about your bloods? You're always late by weeks.'

'So I hate getting my bloods done, but I do get 'em done..and I watch out for signs of toxicity. A second mood stabilsor and a regular AP won't change that. Y'know, so far I'm getting the impression that the needs of the service are out-wieghing my REAL needs in terms of potential treatment.'

"You've stopped taking your meds before..."

"Yeah, partially at least, 'cos you bastards were over-medicating me! Ever been on 1200mg litium, 1000mg of depakote + olzapine or quetiapine blah and a benzo? No you haven't, you have no idea what it feels like. Try listening this time, mmmkay - I.was.emotionally.numb. Felt nothing for anything much...that isn't 'well''

----

Of course, this being the Kafkaesque bullshit that it is at times, I have not actually been given infomation as to what exactly this new bullshit 'higher care programme' they are doing TO ME ;) is, beyond a fluff ridden waffle by my CPN over the phone, the friday before a monday appontment, when i was told about it...cheeky bastards, like I have no plans eh?.. For a so-called Collborative Care thing...I don't feel very 'collaborated with'

I hate it when they make desisions about my healthcare behind my back! It makes me rant in the tinterweb :cussing:

:ehem: Please excuse the rant...just had type that one out.

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You're welcome. I have all this joy to come, as BUPA will no longer cover me and I've just been referred to the local Mental Health team. Despite the fact that I'm yo-yoing like crazy and getting actively suicidal, I expect it will take up to 6 months to get an appointment.

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Well, you've eleoquently described your situation. I guess the best course is to go and see what they propose and consider their reasons. Perhaps your partner could attend both to provide observations on your behaviour and to also be aware of the concerns.

Congratulations on the progress you've made. It's a continuous process of evaluation and adjustment, I think.

a.m.

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You're welcome. I have all this joy to come, as BUPA will no longer cover me and I've just been referred to the local Mental Health team. Despite the fact that I'm yo-yoing like crazy and getting actively suicidal, I expect it will take up to 6 months to get an appointment.

Thanks :wtf:

I've no place to compare the two approaches from. I've never gone private...but I never need much excuse to type when bored though ;)

If you have been sectioned, or are showing 'worrying signs' as you write about, they won't fuck about too much in terms of making ya wait if you speak up, at least where I am in a major city. For all my complaints here, they have been there for me when I needed them on the whole - even if I didn't realise it at the time. The problem I have is the reverse, gettin' 'em off my back now I am stable to a degree where me and my family is content with it. Do I still yo-yo a bit? Hell yeah...but, well, I've taken ownership of it. Better than being dead inside, anyway. They will listen, I won't let 'em not do so :)

I suggest you clarify in yourself what you want from your treatment from the NHS, in a collaborative way with your team if possible - I believe a lot of that is the way you approach it. Tell them what you want and stay with it, just take the bits you feel appropriate to you as an individual with BPAD and throw back the bullshit...Empowerment and all that. It's all too easy to just swollow down whats handed to ya when you're not sure what's around the corner, or you've had episodes of questionable reality...i think so, anyway. But, fuck that....we know inside what's best for us on the whole, even if it does get mixed up at times.

After that...ride your 'message' till the wheels on that metaphorical tricycle fall right off. It's your treatment, you fight for it.

Well, you've eleoquently described your situation. I guess the best course is to go and see what they propose and consider their reasons. Perhaps your partner could attend both to provide observations on your behaviour and to also be aware of the concerns.

Congratulations on the progress you've made. It's a continuous process of evaluation and adjustment, I think.

a.m.

Yeah, I am trying...and thanks :cussing:

Monday, The Partner is taking the time off work, even if it is just to say 'he's not mad', its helps to have a 'normal' with ya, i find, when saying that....grrr..bastards.

..typing out helps for me, helps me clarify thoughts and well.....as you may be able to tell :cussing:

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Cheers, mate! That was very helpful. If I don't get any sense from the bastards I might just have to see if I can afford to see my old shrink at my own expense - at least I can see him when I want, not when it suits the poxy NHS.

You're right about telling them as much as they need to know to solve the issues I want dealt with. I probably hold back too much now, and I doubt I'd tell the NHS lot my fucking name in case they get the bloody social workers all over me and the family.

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BPAD, yeah. i don't get why we need to have yet another variation on the name when it means *exactly the same thing* as the preexisting term, but okay. hospital says i have bpad, others translate that more narrowly, and... i don't care. i just take my lithium every night, like you say, and usually remember the rest of my meds, too. for the past few months, i could even pass as non-bipolar. it's pretty cool.

care teams seem to be obsessed with one thing: stability. they have great difficulty differentiating between, or often even caring about, a healthy stable mood and a depressed or numb stability. all stable is good, right? bullshit. normal humans have variation in mood and activity level. no less bipolars. we just have to watch out for going on solitary sprints through the extremes of human emotion. and so few psychiatrists seem to acknowledge that a little movement in overall confidence and affect does not, without exception, lead to the latter.

it can be tricky to watch your own mood. in theory, we should know ourselves better than anyone else, but i sometimes have problems with denial or just overall missing things because it's so different inside oneself from periodically popping in as an outside observer. i hope the presence of your partner at your next meeting gives your care team more confidence in the veracity of your judgment, and that from now on they will limit their interference to when it's needed.

they fear us, a lot of the time. they either fear the crazy, which shows both that they're in the wrong field and are very very human, or they fear getting into deep shit if we harm ourselves. overmedicated zombies theoretically don't harm themselves, leaving them free of blame. that we're people who'd like to live as such can get lost in all the fearfulness.

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BPAD, yeah. i don't get why we need to have yet another variation on the name when it means *exactly the same thing* as the preexisting term, but okay. hospital says i have bpad, others translate that more narrowly, and... i don't care. i just take my lithium every night, like you say, and usually remember the rest of my meds, too. for the past few months, i could even pass as non-bipolar. it's pretty cool.

care teams seem to be obsessed with one thing: stability. they have great difficulty differentiating between, or often even caring about, a healthy stable mood and a depressed or numb stability. all stable is good, right? bullshit. normal humans have variation in mood and activity level. no less bipolars. we just have to watch out for going on solitary sprints through the extremes of human emotion. and so few psychiatrists seem to acknowledge that a little movement in overall confidence and affect does not, without exception, lead to the latter.

it can be tricky to watch your own mood. in theory, we should know ourselves better than anyone else, but i sometimes have problems with denial or just overall missing things because it's so different inside oneself from periodically popping in as an outside observer. i hope the presence of your partner at your next meeting gives your care team more confidence in the veracity of your judgment, and that from now on they will limit their interference to when it's needed.

they fear us, a lot of the time. they either fear the crazy, which shows both that they're in the wrong field and are very very human, or they fear getting into deep shit if we harm ourselves. overmedicated zombies theoretically don't harm themselves, leaving them free of blame. that we're people who'd like to live as such can get lost in all the fearfulness.

Great post.

I'm tired of all that bullshit... For a long time I swung a long way too far in my rejection of it all, the bullshit, fear and the over-medicating, all wrapped up in this ball of frustration that 'this can't be what they mean by stable, but they're all telling me it is without cracking a smile, the fucking freaks! Look at 'em! This can't be it...It can't...I've been 'normal' and this isn't it.... "Fuck you! I'm right you're wrong!"' - so I'd stop taking the meds and going to the appointments..only for a month or so later my head to explode with..well, y'know. I bet I'm not the only one where this has played a part in their 'non-compliance' < words do not describe how much I hate that fucking.term...grrr...

I'm tired of that cycle. I was never a pure reciever in medication terms anyway, but these days I stick to what I know to be true, from a self perspective, and stick with it till its broken down with good old fashioned sense and fact by those who KNOW me. Not fear mongering, or liability concerns from some prick testing out his corporate sponsored dissertation with the latsest atypical antipsychotic on my fuckin' psyche.

I'm pretty sure that come my appointment it will come to even their minds that I ain't crazy at the moment. They can play all the games they want with my treatment plan, cos I ain't a shiftin on meds without hard evidence that theres a problem with the combo I've finially found to work.

I have all that, the real stuff, in the VERY sane woman I live with...she doesn't take any of my bullshit at all and just reads the signs on this stuff. I don't need to even speak and she knows I'm starting to rise (its in the eyes so she says)..She's cool and real about it.

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...windows to the soul and all that :)

Anyway....I've had my appointment. I must admit after the ranting from me in this thread I'm almost a little embarrased to type the follow up. Nah...

It was actually a very usefull appointment. Turns out that I've been on this 'Enhanced Care Plan', as its correctly known, for a while. I was just never told thats what it was as the process to get you on it can take time...oh, yeah, they got some feedback on that one! Fancy not telling your hyper-aware-to-the-point-of-'raaah', even at the best of times, Bipolians that changes are made to their fucking care plan? Asking for trouble that is... I want to know about all the shit to do with my care, its my fucking brain afterall. They, as they said, never really thought about it that way...being wrapped in the system and all and thanks for the feedback, they'll bring it up next meeting and try to address it for their other patients.

Seems I may be able to manipulate it to my advantage, this ECP. There are some residual issues I wanna sort out such as being able to plan and organise...I think I may have burned out a few of those synapses on the ride. I was always crap in that regard, now after a few manias in as many years I'm really really crap.

I got some sleepers for the nights I'm not elevating in a hypo way but just need a little help to calm down enough to sleep. They said I lonked well and am obviuosly sane...as I get, anyway ;) No mention of drugging me into submission.

Doctors or any other healthcare profs' reading this, talk to your damn patients. It's to your advantage and ours.

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Good to see that you were able to be assertive. I spent this morning in a 16-25 year old service users meeting for our mental health system, and I gave it to them straight about how the services let us down around here, I'm not for putting up with any crap!

We are crazy, hear us roar! (ROAR)

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Good to see that you were able to be assertive. I spent this morning in a 16-25 year old service users meeting for our mental health system, and I gave it to them straight about how the services let us down around here, I'm not for putting up with any crap!

We are crazy, hear us roar! (ROAR)

'We're here...We're weird...GET USED TO IT!! RAAAAAAAH!!!!!" ;)

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  • 2 weeks later...

i live in the US and go to a community mental health clinic. i think that overall, they allow me a great deal of latitude in dealing with my mental health and are very open to my ideas. however, they also know better than i do when i'm going nuts and will put down the foot when that happens.

i think your team is just trying to keep you out of the hospital. in your medical system, the gov has to pay for it, so they'd rather be overaggressive in outpatient than too lax and then have you in the hospital. you could keep a journal and mood charts and show them, so they can see your stability, and explain that maybe you could come off of a med or two in a little while and see how your mood charts and journals reflect the changes. doctors love to document stuff. give them the documentation they love and you should get a little more cooperation. hopefully. fucking bastards! ;)

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Okay, so I'm wrong now. Doc thinks I'm hypomanic now... "take your lithium!" he says.

...I really should be better at this.

So it could be possible. Anything is possible, really.

I agree with Loon - a mood diary would really help both you and your pdoc. It's hard to keep one up - I stopped mid february but I'm going to try again. PM me if you want to see my excel version -- I combined the aspects of many different charts for one I like - I can show you how to alter it, too. ;)

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