Admitting you need help...

From www.mcmanweb.com (one of my favorite Bipolar websites)

The toughest challenge on the road to recovery is probably the first - that of admitting you need help. If you’re depressed, the guilt that may be a part of your illness may tell you that you don’t want to burden your loved ones, or that you don’t have a real illness worthy of medical attention. If you're hypomanic, the problem lies in the rest of the world and not you, and in mania you are beyond reason.

Then there’s the old denial factor. Who, after all, wants to admit they’re crazy? Who wants to own up to the stigma and the shame? Typically, it is only when we run out of options (and excuses) that we seek help. The best authorities on this are my own readers:

“What caused me to seek help?” writes Bill. “Almost losing my job and my wife.”

For most people, their default first port of call is their primary care physician. By far more prescriptions for antidepressants are written by this branch of the medical profession than by psychiatrists, often to people who insist on going to specialists and get expert lab work done for every other aspect of their health. Unfortunately, in a routine physical exam there is no time for more than a few cursory questions.

A 2001 UCLA study found that only 19 percent of a sample of depressed or anxious people they surveyed received appropriate treatment from their primary care physician. By contrast, 90 percent of those who saw a mental health specialist got proper care.

Unfortunately, for suicidally-depressed patients and floridly manic or psychotic patients, one's first contact with a psychiatrist is usually via the emergency room and a locked ward. Don’t be frightened by the prospect of being a prisoner. In all US jurisdictions, there are strict limits on involuntary commitment (generally only if you pose a risk to yourself or others), and it’s frightening how fast you’re no longer considered a danger when your insurance runs out after two days.

Those with premium health coverage are often encouraged to remain as inpatients for 30 days before they, too, find themselves miraculously recovered and sent out the door.

Hospital day programs may take up the slack, but again patients receive a clean bill of health the day their insurance runs out. Thereafter, psychiatric and talking therapy treatment is on an outpatient basis - that is until the next life-threatening crisis occurs.

Those who suspect they may have a mental illness are encouraged to make an appointment with a psychiatrist or talking therapist. A psychiatrist is an MD who has completed a three or four-year psychiatric residency. Emphasis is on on-the-job training rather than a formal curriculum. A psychiatrist is qualified to practice medicine and is authorized to prescribe medications, but there is no separate license to practice psychiatry. Psychiatrists, like other medical doctors, are answerable to state licensing boards for ethical violations and bad medical practice, but in practice this tends to be the psychiatrist’s word against the patient’s.

Psychologists are PhDs or PsyDs who have completed six or seven years in a doctoral program, comprising both a formal curriculum and supervised clinical work. They specialize in any of the hundreds of forms of talking therapy and (except in the state of New Mexico and Louisiana after taking additional training) are not licensed to prescribe meds. Psychologists are licensed and disciplined by state boards.

Counselors, therapists, and specialized social workers are generally people with master’s degrees (MA, MS, or MSW) and two or more years of clinical experience. Licensing varies from state to state.

Some psychiatrists also do talking therapy, but even the most meds-oriented psychiatrist needs to be a skilled talker and listener, as his or her knowledge of your illness is only as good as what you tell him or her. Because neither depression nor bipolar disorder leave a readily identifiable biological marker that can be spotted in a lab test, blood sample, or brain scan, a psychiatrist is largely dependent on what you say. Under ideal conditions, an insightful practitioner can elicit all the necessary information from you to make a precise diagnosis and initiate the type of treatment most likely to work for you. But in practice, for patients with bipolar disorder, it takes many years and a succession of doctors to figure out what is wrong. The onus, then, is very much on you to get your story right, which is not always the easiest thing to do while in the throes of a killer depression or out-of-control mania.

I find myself suggesting to readers who have contacted me to put their concerns in writing before their initial or next visit, for, if nothing else, this is a good way to organize your thoughts. Think of those times you felt depressed and write down what it felt like. Did something bring it on - say a relationship breakup - or did it seem to occur out of the blue? Did you feel like you couldn’t go on living? Did you entertain thoughts of suicide? Did you feel like you couldn’t get out of bed? Or, just the opposite, maybe you couldn’t get to sleep. Are you eating more or less? Not feeling your usual self? What’s different? Are you doing a great acting job hiding your distress from your friends and family and colleagues, or do they think you’re acting a bit out of character, too? Are your work and family and personal relationships feeling the strain? Provide details. Are you less patient with people lately? Short-tempered, angry, aggressive? Or perhaps the very opposite, submissive, guilt-ridden, and ready to give up without a fight. How long has this been going on? Have you felt like this at other times in your life?

A good psychiatrist will be asking these questions, but you can save both of you a lot of time and effort if you have your answers ready. Your psychiatrist will also probe for personal and family history, looking for more clues. Now is hardly the time to talk at length about past trauma and abuse, as this may destabilize some patients at their most vulnerable. It is essential, however, to inform your psychiatrist whether you are a survivor of trauma or abuse, as this can have a bearing on your treatment. Later on, in talking therapy, you can try to resolve trauma and abuse issues.

You will also want to write down what it feels like to be normal. If normal for you is feeling constantly depressed, that’s a very good clue. Also try to recall what it’s like feeling happy. Some people may have felt a little too happy in the past, which may be the only way your psychiatrist may suspect you have bipolar disorder.

Many people suspect they have bipolar disorder long before they see a psychiatrist. But even people who merely think they have depression need to focus on all those times they didn't feel their normal selves or felt too much like their normal selves. You might want to go back over those times in your life you would rather forget - such as embarrassing yourself in public or attacking your spouse or walking off your job or getting arrested - or where you were unusually productive - working 20-hour days, cleaning the house in the middle of the night, writing a term paper in three hours - and try to remember what you were feeling during the time and the times that led up to these events. If you felt you were smarter than the rest of the world, describe it. If you were in a raging white heat, fill in the details.

Admitting that there may be something wrong with you is one of the most difficult tasks there is. Add to that fear and ignorance and stigma, and you begin to appreciate why so few people seek help or get a correct diagnosis.

When I ask psychiatrists what they find works best in treating patients, many reply establishing a trusting relationship with the patient. These are the psychiatrists I would hire.

Without this trust, those degrees on the wall aren’t worth the paper they’re printed on. Your end of the bargain is to keep your psychiatrist fully informed and to stay on your meds and other treatments. His or her end of the bargain is to be there for you in a crisis day or night and work with you in getting well and staying well. If your meds aren’t working or you are experiencing bad side effects, you inform your psychiatrist rather than simply quit the drugs on your own. Together, the two of you can work on new doses and/or new meds. If he or she suggests adding a new med to your cocktail, by the same token, you should expect to be informed of the risks and side effects as well as the benefits. If you object to that med, he or she should respect your judgment. And on and on it goes, mutual trust and respect.

Sometimes, though, achieving a good working relationship may involve auditioning more than one psychiatrist. Writes Melissa:

"I went through 10 psychiatrists in one year until I found one able to call down to rock bottom and tell me the footholds up. That was luck. Otherwise I'd be sitting in front of television waiting for the next meal, the sound of doors locking behind me."

Misty, who replaced a psychiatrist she had a bad experience with another who was “who was very good, nice, knowledgeable, and didn't pry into things that weren't his business,” advises, “don't be afraid to fire a bad doc.” Amen to that.

The Death Test...

I guess I'm to live to be 76 yrs old and die of cancer. At least thats what this online test says
Death Test

Sex, Drugs and No Rock and Roll ...

The thing I hate the most about my med cocktail is the effect on the sexual part of my being. I believe it is the Risperdal that is the main culprit.

My mind is willing, but with the mutted BIG "O" it almost makes it a waste of time for me. But just being together with my wife is what counts I guess. I dont worry about the diminished "O" that much because the making love part is better than the actual act itself. The drugs dont effect the sensitivity of touch, smell or the emotion of two people sharing a private moment together behind closed doors.

We've discusses taking a drug holiday before to see what happens. I have no problem doing this myself but my wife needs her drug regiment with her schizophrenia. I'm afraid for her to go off her meds at all due the her recent hospitalization. So we won't go down that road.

So I guess in order to function properly in life we must have to sacrifice other things in our life. I just wish it wasn't sexual pleasure ! But we know that at this point its a problem that we dont need to get too upset about...

Feeling so good that....

I've reached a point now in my treatment that I'm sure everyone in my situation has experienced... Do I really need to be on these drugs ?

I feel so good right now I am questioning the need to be on any drugs at all. Maybe I'm not even Bipolar. Maybe I was just going through a rough time in my life.

But in reality, I know it's the drugs that have gotten me to this point of feeling this good. I've done enough research to know that I would reach this point in my life. I also know it would be pure foolishness to stop my drug regiment.

It's funny that I've reached this point. I don't think there is an article about Bipolar on the internet that I haven't read. I believe I've read 25-50 blogs about Bipolar illness. All of them lead to the same conclusion... Meds do work, and don't stop taking them just because you feel good. I don't want to go back into a mania where I don't sleep or feel bad so I'll guess I'll do the smart thing and keeping swallowing all the pills...

Mail Order Drugs...Risperdal Lamictal, Ativan, Klonopin, Cogentin

Today we received in the mail, my wife's and I prescription drugs for the next 3 months. It cost me $150. That is not bad considering the drugs cost over $750 in real cost. Once again- thank the Lord that I have good health insurance and a drug card.

When I opened the huge mailing bag, it made me sick to see all the drugs and bottles contained within. If I didn't, (and wife wife didn't) really need these drugs to live a functioning life, I would have thrown them all away. It just looked disgusting to see all those pills. I can't believe we have to take all those.
In the bag: Risperdal, Lamictal, Ativan, Klonopin,and Cogentin. All in large bottles, which is stupid as most only had 90 small pills in each. What a waste of plastic.

My wife and I are very med compliant, we take all our drugs are prescribed. The best thing is that they all work. I could probably quit mine and survive and just go back to not sleeping and being in a mania and depressive state. However my wife really needs hers and would once again end up in the hospital pschy ward without them.

I guess its health through pharmacology ! I have no problem with that. Other than the fact it cost me $50 per month for drugs.

To all of you who are on my case for starting smoking again- THANKS. Not only does my wife yell at me about smoking now I have "cyber wives" yelling at me. I hope to try to quit smoking again here in the very near future, maybe in the next week or two. We'll see how it goes.

Don't feel like writing...

I've worked 76 hrs of overtime in approx 2 weeks. I'm tired, my mind is mush. I haven't fallen into a hypomanic state, but rather a depression. I simply am just tired, so maybe its just not depression.

I don't feel like blogging at all right now, so I won't......

Fell off the wagon

Well it happened. I feel off the no smoking wagon. I started smoking again. I'm just like that cartoon commerical with the guy that climbs the line and fall back again.
I'm ready to give it a try again as soon as I'm done working all this overtime at the end of the month.

Working Overtime...

Another Supervisor just went on sick leave for the next two to four weeks. That means I have to work 12-14hr days until he returns. The extra money will be nice, but AAARRRGGG.

This will give my Lamictal a run for its money. Hopefully I won't go into a mania from being too tired.

So far so good...

My endevour to quit smoking is coming along nicesly. The withdraws are still terrible but I think I can make it now. I just have to be careful at work when I'm around those who smoke.

I WANNA CIGARETTEE !!!!!!!!!!!!!....

I WANNA SMOKE ONE- JUST ONE- COME ON- JUST ONE WONT HURT- GIVE ME A SMOKE- I'LL QUIT NEXT WEEK OR MONTH...aaaaaaaaaaaaaaaaaaaaaaaarrrrrrrrrrrrrrggggggggggggghhhhhhhh!

This is whats going on in my mind. Everytime I want to smoke I find something to take away the pain.. .Been drinking alot of cranberry juice to try and flush out my system.
So far I've been hanging in there but it is my days off so I'm not around anyone that smokes. Monday will be the real test.

Quit Smoking...

I quit smoking today for the thousandth time. Hopefully I'll make it this time. I'm just not willing to pay for the increased cost and I better quit before I end up with cancer. Plus I won't have to listen to wife complain about me smoking anymore.
Now she won't have anything to yell at me about-LOL

Thank you...

Today my wife said " thank you for supporting me and being there for me while I was in the hospital and for putting up with the illness".

I tell you this not to say that I'm a great husband, but rather that as being a husband and wife in marriage, that we need to be there for each other during times of trouble.
I didn't give it a minute of thought that I was doing anything out of the ordinary. We took wedding vows to be there for each other "in sickness and in health".
I wonder how many couples get divorced because one person in the marriage becomes "ill"
Yes it hard when one gets sick. Yes it's nice whenever everything is going well. But we must keep to our wedding vows.
Maybe it's been a long time since you last thought about your wedding vows. Maybe it's even time to renews those vows together if only in your heart.

Just a thought.....

Wife is now home.... Seroquel...

My wife is now home from the hospital. She's doing much better. One of the problems she is having is from the toxic effects of being on Risperdal for two years. She walks a little stiff. They call it extrapyramidal symptoms. Sort of like having parkinsons. Her muscles aren't reacting normally. The doctor put her on Congentin to counteract the Risperdal. This is one of the few times I'm having my doubts with her taking drugs. If the congentin doesn't work then we'll have to have a serious discussion about the side effects and what we can do about it.

I wasn't sleeping very well the last week or so. I mentioned it to my pdoc. He gave me some sample doses of Seroquel 200mg. I took one last night to see how well it worked. I already read on the internet that Seroquel works good for a sleep aid even though thats not its main purpose. I took the 200mg tablet at bedtime. Talk about kicking your butt!! I had to get up in the middle of the night to pee and it was all I could do to get there. I was so druggged up I couldn't walk. I had to hang on to wall to get to the bathroom. Once I did wake up the next day, all I could do was sleep. Plus I was sleepy until about 2pm today. It took a strong cup of coffee to help cut the drugged up feeling. The pages I read on the internet said the normal dosage of Seroquel is 50-100mg to start. I guess my pdoc wanted me to really sleep as it worked. I wont take another 200mg again. I'll go to 100mg if I need it again. ONLY if I need it again.!!

Schizophrenia and Bipolar....

It's been a tough week as my wife is in the hospital. I've also had to work 12 hour days, go home get a few hours sleep, then go visit my wife in the hospital. Repeat the process the next day. Her new diagnosis is "schizophrenia with severe depression; an eating disorder(not eating) and OCD (obsessive compulsive disorder)(she obsesses about life's problems). Shes in pretty bad shape and it looks like she may be in the hospital through the weekend at least.

My bipolar disorder is actually holding up rather well. Usually when I don't get enough sleep I slip into a mania phase. So far my sypmtoms are rather stable.I'll be done working all the mandatory overtime on Monday morning. I'm deep down hoping that my wife stays in the hospital through the weekend as I can't be home to support her mentally.

And to top it off tonight, I hit a deer about 100 yards from where I work. It hit me broadside on the drivers side. It busted out the drivers side rear view mirror. No other damage to the side of the car because I drive a Saturn L200. You can hit the side of a car with a hammer and it pops back out with no damage. Dont know what its going to cost to fix the stupid mirror. Todays deer makes the 5th deer I hit with a car. Luckly there is no real damage this time.

It amazing how life can throws things at you. Sometimes you just gotta laugh !!

Day 10 of Paxil Withdraws

Nearly all my dizziness is now gone. Still not sleeping very well but that may be due in part to having to hospitalize my wife. Her relapse made it nessesary to have her go into the hospital for awhile. Sure is lonely at home without her. The visiting hours at the psych ward helps somewhat but it will be nice once she returns home.

My pdoc said he doesn't want me on any antidepressants for now. He wants to take a wait and see approach. He thinks the Lamictal will do the job.I feel pretty good right now. Hopefully it will stay that way since that means once less pill to take per day.

Day 6 of Paxil withdraws...

Day 6 isn't any better than the other days. Right now it's even hard to type as my head is spinning. Dizziness is really bad today. I also just realized how tired I am due to not getting much sleep. I've been having very vivid dreams that have disturbed my sleep. I'm still making it to work everyday. Good thing I have an office where I can go to when the withdraw symptoms get really bad . One of my employees just caught me sitting at my desk with my head in my hands because the room was spinning around. At least he asked if I was alright. I can't really see where the step-down method of cutting the dosage each week has done a thing for me. I figured the withdraws would be over by now, but I don't see any end in sight.I go to our pdoc on Monday. Hopefully he can offer suggestions.

Day #5 withdraws...

Day #5's withdraws are just as bad. No let up on the symptoms at all yet. I'm getting tired of being dizzy.But I miss what Paxil did for me. The getting too fat factor was the reason for getting rid of it. If I'd known ahead of time that the withdraws were going to be so severe I'd never have taken it. But in reality, I miss what it did for me.

Good new today is that my wife got called back to work-seems they laid off 6 people too many. She goes back to work today.

Day 3 withdraws...

Not only am I more dizzy or whoooosing feeling than yesterday, but now I'm having gastrointestional problems if you know what I mean.Also I could only sleep for 3 hrs so now I'm tired on top of it all.

And oh ya, my wife was just permanently layed off from her job today.

When it rains, it pours.... You just gotta laugh sometimes at what life throws at you...either that or go insane...

The terrible withdraws have begun...

This the is second full day without taking any Paxil. I'm extremely dizzy and have a woooooosh feeling in my head.My vision is kind of fuzzy when I move my head. I'm still functioning ok.(I'm at work typing this...90% of the time I'm at work blogging my posts) To make matters worse, my wife who is schizophrenic is going through a really bad time right now mentally. Yes we're a wacko family. I knew my wife was schizo when I married her. Shes only been hospitalized three times in the last 10 years. If it wasn't for her meds I think I'd have to hospitalize her right now. Even with her meds she is teetering on the edge.

It's taking everything out of me right now. With her sick and me having withdraws.... sort of like the saying " I picked the wrong week to quit drinking"
No I dont drink....

We'll make it through all of this somehow. But I not going back on Paxil. We see the pdoc next Monday.

Obsessed with Paxil....

I not obsessed with Paxil but rather getting rid of it. Tommorrow I start my 10mg dosage, down from the original 40mg. (was on 37.5mg CR but since the feds busted GSK and couldn't get CR anymore he put me on regular release 40mg)
So far I have NOT had any withdraw symptoms from the reduction of dosage. This week it'll be 10mg then the following week- ZERO.
We'll see what happens. Withdraw symptoms, if any will be listed in my blog.