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.

More About the Bipolar Low

When I am in a protracted low, anything more than two weeks for me, I feel like the worst loser on the face of the earth.  Generally, even on the first "down" day, I cannot even think creatively.  I can’t imagine singing or doing much of anything productive.  Just getting up, making unimaginative meals, and taking care of my family’s basic needs are all I can handle.  I sleep ten hours at night and nap during the day.  When I have made advanced plans to do creative or demanding things and they happen to fall on a very low day, I have some tricks that work to get me through them, but they have consequences. 

One thing I can take is a banned substance, though completely safe for me, called ephedra.  It used to be sold over-the-counter as a diet aid, but too many people abused it by combining with caffeine, taking ten times the suggested dose, or combining with allergy or asthma medications with sometimes-disastrous results.  There were deaths and the easy availability made it that much easier for certain folks to buy in bulk and turn it into meth, ephedra being a main ingredient of that dangerous drug.  I have to order it from Canada in the lowest dose I can find, 8 mg.  It really works and doesn’t adversely affect sleep patterns like caffeine does, but I won’t take it for more than two days in a row and sometimes, rarely, it makes me feel creepy.  That’s the only way to describe it.  Maybe it’s because of product inconsistency.  Supplements are a completely unregulated industry and I love/hate that.  There’s just no way to tell for sure what is in any supplement, but government intrusion would only make our vitamins and herbs outrageously expensive.

 I try to avoid using caffeine because of the aforementioned sleep issues, but I do occasionally find myself drinking one cup in the morning frequently enough to get addicted. Coffee just tastes good and is so much easier to take than a pill on a cold morning.  Then, I have to deal with headaches when my high-energy phase comes on and I have to go cold-turkey.  Advil helps, though, and there's no way I can drink coffee when I'm "up."  I really should take the ephedra more often.  My bottle of pills usually expires long before I’ve finished them.  The thing is, my lifestyle is rather laid back as a home schooling mom and I can get away with giving in to my lows quite often.  I can usually cancel all plans except appointments, classes, and lessons and retreat into my own little mom cave with books and chocolate. 

These are my only real vacations anyway.  I am only home schooling one youngster these days, and she is easy, so she brings her books to me in bed and we work from there when I am low.  Between naps and my own books.  Our family vacations tend to be of the adventurous and exhausting sort, always fun, and I truly have to recover from them when I get home.  Lots of camping and bike racing.  Or visiting relatives and surfing.  Someday we will take restful vacations, but for now I often crave a week of low energy/low activity  just to recharge from the previous manic phase or from completing big projects that wipe me out physically and emotionally.   I am usually caught up on housework, shopping, and paperwork by then and can really enjoy being slightly depressed.  For about a week, that is.

After that first week, I begin to feel guilty.  Then, if there is a third week of depression, true self-loathing sets in and certain physical problems start to manifest due to too much sitting and lying around.  I think, when I'm in a manic state, that all I have to do is force myself to go on a short walk or even walk in place while watching T.V. or something every day when I go low, but it just doesn’t happen.  Unless, that is, I have made plans with someone and have some sort of obligation to live up to.  Then I force myself to go and feel better in the long run, though depleted.

With that in mind, I have committed to showing up three times a week as a ride leader for a local high school mountain bike team.  Mark, my husband, and I co-coached our own team for most of ten years and he is still involved with the league.  I wondered what it would be like for me to be obligated to this level of activity in a very low phase, but so far I have only stayed home and missed practices when I have been ill and low all at the same time.  The few times I have made myself go when I really didn’t want to, it was so rewarding that it motivated me to do so again the next time.  It has been good, now that I am feeling so much better and three-week lows are rare, to push myself this way.  I am finally losing some frustrating extra weight, too, which helps when I race at our local cross country bike series.  I do not race when I'm low, though.  Just can’t do it, even with stimulants.

This was supposed to be about things that help me and I have neglected to mention the very most important thing of all: prayer.  There was a study once, double blind, with very sick hospital patients as test subjects.  Half of them were prayed-for and half were not.  None of them knew they were being studied.  The praying people were from many different belief systems and, you guessed it, those who were being prayed-for often had much better outcomes by far than those who were not.*  Also, "those with belief in prayer saw different results than those with less belief."** No power of positive thinking at work here.  Something supernatural, I believe.  I’ll write more about that later, probably, but I will say that I am a praying person and I believe the God who made me loves me tremendously and answers all my petitions and wordless longings.  It’s just that sometimes the answers are “no” and “wait” as well as “yes.”   I’ll never really know on this earth how much of my healing has been from God.  Often my answers are pieces of information that He knows I’m disciplined enough to try.

I will talk about prescription medications next time.  And hormone supplementation.  And nutrition, maybe.

*There are studies that show no effect, but some good ones that do.  http://onlinesurgicaltechniciancourses.com/2010/25-intriguing-scientific-studies-about-faith-prayer-and-healing/
** http://online.liebertpub.com/doi/abs/10.1089/1075553041323803

Memories

The first time I remember feeling something, that I later recognized as a sign of bipolar disorder, was  walking down the hall in junior high feeling like I was in a bubble or a cloud.  I remember observing how odd it felt, to be there but not really be there.  I also remember running around our house until I couldn’t run anymore, on a very different day.  It just felt good, but I didn’t ever exercise into injury or exhaustion.  So it never occurred to me that anything was wrong.

I have been around full blown bipolar people.  A friend of my husband’s was well-known as an extreme exercise fanatic and surfer back in the eighties.  He would be seen sometimes running at night from golf course to golf course in Carmel and Pebble Beach, probably covering 20-30 miles at a time, and then would disappear for weeks.  He was also a famous philanderer, though his live-in girlfriend was one of the most loyal and attractive girls I’ve known, and he often spent money irrationally and used various dangerous drugs despite his otherwise healthy diet.  This Adonis-of-a-man killed himself by jumping off a bridge, thinking he would fly, after using what turned out to be a "bad batch" of cocaine.  It was shocking, but looking  back, his outcome was tragically common to many undiagnosed bipolar sufferers who self-medicate illegally and unwisely. 

Bipolar 2 people don’t experience extreme highs and lows.  We get tired, self-critical, discouraged, and unmotivated, but not often suicidal.  I would call it garden variety depression.  On the flip side, we over-plan, overdo, have trouble focusing, and overspend, but we do not usually gamble away the house or run credit cards to their limits or exercise dangerously.  We self-medicate, but with melatonin and caffeine, maybe marijuana and alcohol (I do not recommend the last two for obvious reasons), but not usually the harder stuff.  Psychotropics are largely ineffective, which is probably a good thing because the side effects are not usually worth the benefits and the good effects don’t seem to last.  That has been my experience.

Bipolar 2 sufferers tend to blend into the general population and are often unaware of the nature or even the name of their problem.  If the highs outweigh the lows, we are considered very upbeat and agreeable, if somewhat annoying, characters.  We don’t socialize much when we are down.  We hide out, read books, do just the bare minimum to get by until we are back to “normal.”  But what is normal, really?  Many artists, most of the best writers and creative people of all kinds, have some sort of mood disorder.   It goes hand in hand with inspiration, that indefinable quality that makes any artistic expression timeless and wonderful.  In song-writing, this quality has been referred to as "window-to-the-soul."  The “muse” does not often visit the even-tempered.  I am a song-writer, a singer, a  musician, a fledgling novel writer, a baker; I love to create something out of nothing and I feel dead when I can’t. 

My next post will deal with specific things that have helped me.  I don’t benefit in any way financially from any of the things I’ll mention, btw.  That’s not what this blog is about.

Manic Me

I’ll probably always post on this blog when I am in some sort of manic state.  That would be right now.  I’m trying not to over-plan, over-commit, or overdo.  I showed up to help a friend coach some high school kids a few days ago and I talked way too much.  Had to send an apology email and promise not to do that again.  But since I am “up,” there is no self-loathing.  That will come later.

Prioritizing is an important skill in a manic state.  Distractions are hard to resist, like a toddler with a succession of shiny balls hanging around him and a favorite toy across the room.  The toy gets neglected, and when that toy is one of my kids, it is not good.  When the toy/activity is music or baking or bike riding, who cares?  The distractions are usually household chores or cleaning that corner of the kitchen that no one even sees. . . .  I usually finish the main task, but the time frame is unusual and full of detours.

Most people think that manic me is the real me.  I used to think so, too, until a radio doctor described bipolar disorder one day and I realized that he was describing me.  Dr. Edell said that there are so many varieties of this condition, it was almost impossible to gather all the symptoms into one neat package.  There’s the mostly up, sometimes low hyperactive; the medium-to-low depressive and everything in between, including the full-blown bipolars who tend toward suicide at one end and crazy-spending/exercising on the manic side.  I suddenly realized that I was not lazy, not an occasionally horrible procrastinator, and not unaccountably anti-social most of the time.  It was such a relief.  And the beginning of my journey to find what was available that would help.

More about that later.

Bipolar 2

I think about this blog from time to time and wonder if I'll ever get back to writing. I had all the best intentions to make this my minimum writing exercise every week and maybe encourage a few folks. I then became discouraged with writing in general and decided that my very first blog post was more likely true and that I really didn't have that much of value to say. That may or may not be true.

I have recently been filled with a desire to help others in a way that is not easily found, on a subject that is not often talked about. Since a very famous actress announced last year that she is a Bipolar-2 sufferer, I have been thinking about what I might do to help those who have been diagnosed, suffer in silence or self-medicate dangerously as a result of this commonly misdiagnosed (or undiagnosed) mental illness. I have not kept this a secret from my closest friends and I have sometimes suffered from the stigma of this condition. I have been my own best guinea pig. I have tried so many supplements and a few medications, very few of which helped, but I have learned some very important things, which i intend to start writing about.

I'll start with the most important discovery of all. One can read the entire, fascinating story about this micro-nutrient supplement that has revolutionized my life and the lives of thousands of others here: http://truehope.com/default.aspx I hate health fraud with a vengeance and I don't believe this non-profit company falls under that all-too-common category of bogus health aids. I will write next about other things that continue to help me. Anyone out there?

Parenting quote from The Middle

I have a new favorite T.V. show. It's called The Middle, on ABC, and I finally got around to watching it today. I don't really watch sitcoms anymore and I almost never laugh out loud watching any show these days, but I laughed, OUT LOUD, all through this show. I recorded it because I love Patricia Heaton, though I rarely watched Everybody Loves Raymond when she played the wife. Just not a big sitcom fan.

Maybe it was especially timely considering what I came home to this afternoon. My husband (remember the reference to perpetual motion in my first post? No? Well, he is it) decided to clean the "room" that our 20-year-old lives in. Mark had a short list of things I really needed done, like a sink faucet that randomly sprays me in the face, but this is what he did instead. And he found stuff. Incriminating stuff. I tried to keep my eyes from rolling, I really did, but there were four piles of Nick's clothing in the garage to wash because, though they were technically clean, they stank. Many missing household items were retrieved (thermometer, serving dishes, our socks) and Febreeze was applied liberally.

We will probably not see our rebellious son for a few days. His bedroom is a pre-fab piney shack in the back yard and he goes to work while we will be at church. But it will be an interesting exchange the next time I stay up late to hang with him. Really late, like midnight. I had nothing to do with the ninja room cleaning; I get to be the good guy these days. But because we are living in the same house with two twenty-somethings and two teenagers (the teens are practically angels), The Middle was more than relate-able. It was downright cathartic.

Favorite quote: "Parenting is like being a cop in a bad neighborhood sometimes." If your children are not yet sixteen or seventeen, you will not think that is very funny. But watch the show on Hulu while it is still free! And laugh your head off or just get ready for things to come.

Oh boy, Nick just drove up. His new (first) car sounds like a lawn mower on steroids. Here we go. . . .