Hormones and medications

When my hormones started ramping-up about six years ago, typical of peri-menopause and exacerbating my bipolar symptoms, my family did a casual-but-firm intervention, but I was already prepared to see a psychiatrist for the first time.  Before that, I was doing well using melatonin to sleep longer, and coffee or ephedra for energy.  After the hormonal change, my highs averaged around two to five days instead of my usual five to fourteen and my lows stretched to nearly six weeks sometimes.  And they were very low.  Not-getting-out-of-bed-for-days low.

I chose the best doc I could find in my small city, an integrated psychiatrist who would be on board with my natural approach, chiefly with the TrueHope supplement I take every day.  He was not completely well-versed on bipolar 2, and wanted to try talk therapy which I knew would not be effective, but we began with lithium.  It turned me into a zombie.  Next, I tried Abilify, which is usually prescribed along with other psychotropics, but it wasn’t effective either.  The doctor was also encouraging me to try things like SamE and fish oil and some other things, but their effects were even more negligible. I tried Zoloft at some point and experienced the same effects as Abilify.  Who needs to be low all the time?  I was looking for the opposite effect.

We did find two winners, though.  Geodon (ziprasidone), a very new drug at the time, seemed to mitigate the mood swings better than anything I'd previously tried.  I’m still not positive that its results were more than the placebo effect because I did not take it long enough.  It was prohibitively expensive, and will be until there is a generic available. (There might be one by now.) When the first side effects made themselves known, I could no longer justify the big hit to our family medical account.  I think they were mainly sexual side effects, not good for the marriage, but very common to psychotropic drugs. 

If I ever to go back to a doctor, I think I would try Geodon again and then see what else was new if that didn't work.  There is something advertised on TV right now for bipolar depression, *Latuda, which I really should try.  I would also experiment with different doses of thyroid medication, if I could find a doctor who would help me, which one article I read claimed was a last-resort cure for some bipolar 2's. That's pretty drastic, though, and I feel pretty good with the strategies I've come up with right now.  And I could go into full menopause at any moment and have to start over with new medications, anyway.

One medication I tried with the first doctor, which has helped me more than any other drug so far, was Ambien, generic Zolpidem.  Thankfully, I did not have any of the crazy side effects that are common with this sleep medication, and melatonin no longer worked for me.  Alteril worked better, but not consistently.   I only take Ambien when I am super-manic and will naturally sleep only about two hours.  It gives me another three to four hours, and there is almost no drowsiness the following morning.  Ambien has truly changed my life, almost as much as the TrueHope supplement designed for mood disorders, EMPower Plus.

Because of difficulties with insurance for an out-of-plan provider, I left this doctor and tried another plain old psychiatrist I found on my insurance list of preferred doctors, but I think he was a drug addict.  He definitely showed signs of drug-seeking, and he moved his office out of town, so that was that. 

My sister was having some nervous troubles of her own and started taking estrogen for them.  When she described what they were doing for her, it suddenly occurred to me that maybe they would help me, too.  After all, the exacerbation of my symptoms coincided with hormonal changes.  Long story short: The low-dose estrogen patches, now 90-day rings, have helped me tremendously.  I take a vacation from the .5 mg of estrogen every so often, and I notice more emotional outbursts and worse sleep patterns, so I get right back on.  There is a very small chance that I could be at higher risk for estrogen-feeding breast cancer, but healthy women in my family who get it are almost always in their seventies and took very high doses of estrogen before they knew better.  We lost my mom to lobular breast cancer, so I must be very sure I need estrogen by going off it about once/year.

 The last thing I discovered was another supplement recommended by the excellent TrueHope phone counselor, called phosphatidyl choline.  I take it when I feel like my manic episode is over-the-top and I would otherwise drive everyone crazy, and it calms me nicely.  Natural, no side effects.  They also suggested I try evening primrose oil for depression, but I haven't done that consistently yet. 

So, am I perfectly balanced now?  No, not at all.  I still drink coffee instead of taking an ephedra every other day, like I should when I am depressed, and the energy it gives only lasts a few hours.  And there is a big crash afterward.  I still give in to the depression when I have nothing I absolutely have to do.  Though I am not experiencing the protracted lows of the past two years lately, with sometimes only a few days of manic-ness to catch up in between, I am still hard to be around when I am really flying high and I still over-commit and even over-spend sometimes.  Things are changing as I approach full menopause, but I have no guarantee that my symptoms will completely disappear, though that is the experience of the majority of bipolar 2 sufferers, according to both of my doctors.  Please, God!

* http://www.latuda.com/bpd/what-is-bipolar-depression.html?utm_medium=SEM&utm_source=Google&utm_campaign=Consumer_Bipolar&utm_term=SEM&utm_content=LAT_PDSEARCH_C_B&gclid=Cj0KEQjwrPqnBRD56dGe1o_WlZsBEiQAb5ugt4pKzBcOXJCCnfAjJ1ki8BvicXDHibxKIlUfIdt5O28aAqIS8P8HAQ

Manic Monday

I'm baaa-aaack!  Sorry for neglecting this blog, blah blah blah . . . now back to business.

One of my least-favorite sayings, actually a Yiddish curse I think, is: "May you live in interesting times!"  Such has been my journey these past few years.  Interesting, difficult, but not without many lessons learned and a few wonderful epiphanies granted.  James wrote, "Count it all joy when you meet trials of various kinds, for you know that the testing of your faith produces steadfastness." (James 1:3 & 4)  And isn't that what we who suffer from mood disorders desire the most?  Steadfastness, calm, peace, even-keeled emotions . . . I almost said normalcy, but that is not right.  For me, being a bipolar 2 is my normal.  It's how God made me, and for a purpose.  But being a person who is a lot easier to be around is a goal. (And a promise!)  No one likes to be disliked.

Changes since I wrote last: Ephedra is now legal to buy and sell in the U.S. again.  It never should have been banned.  But I don't expect to see it as an ingredient in Red Bull or in over-the-counter weight loss medications anytime soon.  Even though it is much better and safer than huge doses of caffeine for those who need a boost.  I still use it very infrequently.

My two youngest, girls, are now eighteen and twenty-two and live at home.  I could write a whole separate blog about that, but since they will remember very little of what they say and do right now in the future when they can stand me again, there is no need to dwell on these things overmuch.  I have that perspective after talking to my older two, who actually like to talk to me and don't lecture me endlessly, if they ever did.  I don't remember.  

My husband and I are once again coaching high school mountain biking.  We tried to get out, but it pulled us right back in.  We have one of the best teams ever, and since right now is the midst of our busiest time of the year, it is nice to stop and reflect on how that is affecting my ongoing mood disorder challenges and what I have learned in the interim.

I need to let the chickens out and eat something right now, but I'll get right back to blogging in the next few days.  Follow me for more!  I will finally write about the legal meds I have tried and what I mean to do next.  About my time with two awful psychiatrists and the challenges of insurance for mental health.  And two very sad stories resulting from self-medicating and the lack of support available for those who are mentally ill and addicted.  Ciao for now.