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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 434 to 458 of 948. Go back in thread:
Posted by fluffy on August 27, 2003, at 12:26:35
In reply to Redirect: careers, posted by Dr. Bob on August 26, 2003, at 23:12:23
Hi Barb-cat, Katia, McPac, Patricia (and all!)
I just thought I'd share my progress with my little problem of needing med augmentation. I went to my pdoc yesterday. I felt like I was in the "hot-seat" of "who wants to be a basket-case?" BTW, as an aside--does anyone know where the term "basket case came from? did they carry the head-cases of yore with baskets to the asylum? Just curious...
Since the Lamictal alone doesn't seem to do the trick @200mg, I was given two choices: Lithium or Wellbutrin. I sat there for like 30 minutes with him debating the pro's and con's. (thank god he can spend that time with me...he doesn't work by the hour, as he hired by a university, and is a researcher). After much deliberation, I decided on the Li. I think I'd rather experience some lethargy and maybe a case of the shakes than another mixed state. It doesn't seem like my problem is only a depressed episode anyway. I feel like I'm completely cyclothymic at this point. I guess I have co-morbid cyclothymia with BPII.
Like you, McPac, I've felt this whole ordeal has all been very, very confusing. I've had to wrestle with the AD crap, too since I only had major depressions when I was younger. I've had the same questions as you--was my agitation side effects or an underlying problem?? Since being treated with AD's, the underlying problem of BPII has emerged, I guess. And since I can't seem to tolerate SSRI's anymore, I'm taking the safe, mood stabilizer route, now.
So I'm holding my breath and jumping into the Li pool. I'll keep you posted.
Katy
Posted by Ponder on August 27, 2003, at 14:41:45
In reply to basket-case in a wave-pool, posted by fluffy on August 27, 2003, at 12:26:35
Katy,
I found your post interesting as you assessed your history and made an effort to identify your current state (cyclothymic). My history is similar, having been treated for depression quite unsuccessfully despite every class of AD meds since my early 20's.
I read a lot of medical literature and regularly review the symtoms of these various states, not just the symtoms listed in the DSMV, but also articles that describe in greater detail how a patient might experience these states. In retrospect I believe I may have been Bipolar all along. Doctors weren't too good at diagnosing BPAD in those days.Then, a few years ago I had what was clearly a horrendous and protracted mixed states episode that was more suggestive of Bipolar I. It crashed, of course, into incapacitating depression that ultimately resulted in the loss of my career.
I am currently on Lamictal 200 and WB 300-400/day, but also Ativan as needed. Anxiety has always been a strong component of my illness, although I did not realize it when I was working, thinking instead that I was "stressed" about the many tasks that needed doing and that I would be "unstressed" as soon as I got them all done, which was never. Any med to control the anxiety made me too sleepy to work efficiently, so I lived with the anxiety instead.
I did not realize at that time what a strong contributing factor anxiety was to the whole mix of other symptoms.
My bipolar fluctuations continue, but I have not had a bad-as-it's-ever-been depression since that time a 3 years ago. I wonder if the multitude of treatments that I am receiving is actually working, with "bleed-through" mood variations, or if Bipolar II ignited into Bipolar I and later settled down to cyclothymia (well, something a little more intense than cyclothymia, perhaps).
For the life of me, I don't know how a patient is supposed to determine this, and doctors rely on patient reports, so they don't seem to help much in this process if the patient is not pretty good at self-diagnosis and assessment of their own symptoms.
The literature seems to suggest that these different states are distinct pathological entities. In one article, it said that having a mixed-states episode ruled out Bipolar II and indicated Bipolar I. So, I don't know if a person can move from one Dx to another. When I was younger, I had clearer delineation between depression, euthymia, and hypomanic. Now it seems I constantly deal with an amorphous mix of difficulties interspersed with a blessed few days of relative wellness from time to time.
Lamictal/WB may be an overly activating combo. I don't know. I recently had my first full-blown anxiety attack (partly situational, but, you know, I've had plenty of stress in the past and didn't have a panic attack). I backed off the WB a little and added in the Ativan. But I continue to wonder if Lithium would be better, especially since Barbara has had such success with low-dose Li as a part of her combo.Having been through a million med trials and even neurosurgery (VNS) you'd think I would be over the fear of the med-trial process, but instead I seem to be even more reluctant to change anything. This state of clyclothymic-like symptoms is better than full-blown manic-depressive cycles, so I find myself grateful for the improvement and fearful of spending more time feeling sick from side-effects, lack of efficacy, etc. with new drugs.
I will be very interested in your experience with Lamictal and Lithium. You may even decide to add in WB after that if you find yourself needing more energy/motivation. From what I have read on the board, that may be a good combo. Many people seem to have had good success with Lamictal/Lithium. WB seems to be a pretty versatile add-on with little propensity for destabilization.
I hope you'll keep us all posted on your progress. The sharing of these experiences is so valuable to us all.
Posted by katia on August 27, 2003, at 14:58:06
In reply to Re: basket-case in a wave-pool » fluffy, posted by Ponder on August 27, 2003, at 14:41:45
Hi Ponder,
I wonder if DXs can change over time. I imagine if you are medicated from BPI and the result from the med is cyclo. then you are still BPI b/c you're on meds? And would it be BPI in remission/dormat, but not exinct?Good question.
Anyone else have answers?
Katia
Posted by Ron Hill on August 27, 2003, at 15:42:44
In reply to Re: The Cortisol/Sugar Connection » Ron Hill, posted by Barbara Cat on August 17, 2003, at 17:22:30
Barbara,
Thank you very much for taking the time to dig up this cortisol/sugar information for me. Sorry to take ten days to post my thanks.
In the early 80's I became convinced that a low-fat high-complex carbohydrate diet was best for my health and my training. I was wrong! About four or five years ago I came to the conclusion that I am slightly-to-moderately hypoglycemic. So I read "Enter the Zone" by Dr. Barry Sears and the book changed my thinking with regard to diet.
As a result, I try to never eat sugar during the day in order to avoid the blood sugar rollercoaster (eat sugar, insulin released, blood sugar goes too low). I experience the rollercoaster even with complex carbohydrates. Therefore, I always try to eat adequate protein and a small amount of good fat with my fruits and vegetables (and occasional whole grains). However, since I am a junk-food addict at heart, I would periodically binge on treats just before bedtime. My rationale was that the blood sugar rollercoaster associated with my late night snack would be inconsequential because I'd be asleep when my blood sugar dropped. But after reading the information you kindly provided, I have changed my thinking on the subject and I’m attempting to forgo my late night indulging.
Tell me this; what good is it for me to have an addictive personality if I'm not allowed to partake in any of my addictions?
Thanks again, BCat!
-- Ron
---------------------------> Hi Ron,
> Here's a quick and dirty on the subject:
>
> http://vitamintrader.com/articles/1997_04_HypoG.html
>
> There's basically a condition called 'reactive hypoglycemia' which isn't in the mainstream medical lexicon, which only measures fasting glucose and more severe/standard hypoglycemia. "Reactive hypoglycemia" describes a condition that roller coasters up and down the sugar scale all day, causing our already stressed out adrenal systems additional dysfunction. As this article briefly goes into, cortisol which controls blood sugar, should remain low at night. Adrenal glands make cortisol. Adrenal glands become malfunctioning through an overload of stress. There results an inability to smoothly orchestrate cellular insulin/glucose transport causing depression and anxiety among other health issues. Too high a simple sugar condition in the blood causes spikes of cortisol trying to control the sugar/insulin symphony and it just can't because this hormonal system/balance is dysfunctional. Cortisol spikes are like little jolts of adrenaline and high octane caffeine - not good for nighttime sleepies.
>
> Anyhow, the whole subject is fascinating and only one piece of the puzzle that is emerging for me - the Hypothalamus/Pituitary/Adrenal axis implication in many of our woes (I know in my own). There's also a very good little known book called "Lights Out: Sleep, Sugar, and Survival" by T.S. Wiley. Stuff in there that seems no-brainer revolutionary material but we never hear about it or make the connection. I think you'd enjoy it. Happy reading. - Barbara
Posted by fluffy on August 27, 2003, at 16:35:57
In reply to Re: basket-case in a wave-pool » fluffy, posted by Ponder on August 27, 2003, at 14:41:45
Hi Ponder--
Thank you for your almost poetic and thoughtful post (I suppose as your name implies!--ponderous indeed!). I'm so sorry that you lost your career due to your illness. I hope that you are well enough to resume in some capacity. I really don't know how I managed to keep my job. Aside from hallucinations, I had every symptom of a mixed state for days at my job--crying, thinking about suicide, pacing, --you know--excrutiating and devistating. (then a 3 month long depression where I stared into space for hours).
So maybe I am bipolar I. Who knows. I didn't really report everything when I got my diagnosis. But even then, the intern who diagnosed me said I was BPI. It devistated me, as I refused to believe that I was mentally ill, and he revised his diagnosis to BPII since I hadn't been hospitalized. I know I should have been, though. How I survived that episode, I do not know.
I think that a diagnosis can surely change as time goes on. I was diagnosed as first having panic disorder (1st episode), then major depression (2nd episode), then BPII (3rd and most recent full episode). Hopefully, with the aid of medications, a person will not escalate into a new diagnosis. I suppose I should just be happy with being cyclothymic at this point. But I want to test it out a little more and try to get as close to normal as possible. A book that I've been reading ("Bipolar Disorder Survival Guide")states that most BP patients can expect soft cycling, even on medication. I'm going to try to soften my cycling even more, since I'm still having marked impairment with sleep loss, agitation, lethargy, guilt, etc. So I'll definitely let you know how it goes. And thanks for the advice about the Wellbutrin. I had some similar thoughts about maybe adding it if I felt too tired or depressed with the Lithium on board. I just hope I tolerate the Li, and that it works.
Stay well Ponder (and others reading)
I enjoy your thoughts,Katy
Posted by katia on August 27, 2003, at 16:46:54
In reply to Re: Cortisol/Sugar Connection - Thanks BCat! » Barbara Cat, posted by Ron Hill on August 27, 2003, at 15:42:44
Hi Ron and Barb,
I'm actually going in for a metabolic testing. The website is [www.bloodph.com]. Apparently, unless you find out your metabolic type, none of the other kinds of diets/nutrition regimes really work. It's best to just read what he has to say as I'll butcher it.I was going to do this two years ago, but finally decided not to go. I'm ready for this now. I have an appt. next week. Just thought I'd throw in my 2c as you both are on nutritionalish topics.
katia
Posted by Kacy on August 27, 2003, at 16:50:14
In reply to basket-case in a wave-pool, posted by fluffy on August 27, 2003, at 12:26:35
As to your aside:
per American Heritage:
"In the grim slang of the British army during World War I, it referred to a quadruple amputee."per The Phrase Finder http://phrases.shu.ac.uk/meanings/85850.html
"Originally a soldier who had lost his arms "and legs and had to be conveyed in a wicker wheelchair."Just go to The Phrase Finder and type one in and you'll often get the answer.
Posted by BarbaraCat on August 27, 2003, at 18:08:06
In reply to Re: basket-case in a wave-pool » fluffy, posted by Ponder on August 27, 2003, at 14:41:45
Hi Ponder,
Your post could have been written by me, it was so familiar. Your comments on anxiety causing a spiral were so right-on.I never considered myself BP at all thinking, as many do, that 'manic depression' looked like Patty Duke's wild and crazy form of it - very separate depression and loony mania. Only recently I realized that my 'depressions' were very different from what others seemed to experience and were instead very descriptive of bipolar mixed states. I've had the classic polar opposite swings but I never really equated the manic with anything except high spirits or disorganization, and the depressions were, well, vanilla depression. But then the mixed states, always with me tho infrequently through my life, were no longer an every few years event, but were fast becoming a constant way of life.
I think it was Starlight on another thread that suggested that the very intense almost psychotic symptoms in a mixed state are really more indicative of BP-I than BP-II. Mine certainly were psychedelic and nightmarish. I wonder, like you, if my 'basket-caseness' started off as unipolar depression but then devolved into BP. But looking back, the BP signs were there all along, it's just that the depression and mania were more separate and distinct.
My pdoc suggested Wellbutrin a while back when none of the SSRIs were working. I tried it along with Zoloft at one point because of the apathy I got with zoloft, but WB made me feel too wired. Today, I'm feeling kinda dopey and have given into the temptation of bed slug-dom. I feel perfectly OK about it but you've got me thinking about WB. Nah, I think I'll stick to Lam and low dose lithium. We seem to have many similarities and I sure want to frequently compare notes with you. - Barbara
Posted by BarbaraCat on August 27, 2003, at 18:25:53
In reply to basket-case in a wave-pool, posted by fluffy on August 27, 2003, at 12:26:35
Good luck with lithium, Katy!!! I hope and pray it works for you as well as for me. It may take 2-3 weeks, but for me, I noticed a diff in 3 days. A note on the tremors. I got them very mildly at first on lithium and then they subsided. When I started nortriptyline, they REALLY came on like gangbusters. I couldn't even put in my contact lenses and my handwriting went to hell in a 'hand basket' (there's that basket thing again). The tremors subsided somewhat but it was only after stopping the nortriptyline that they went away completely. I was concerned at first that it was the lithium and that I'd have to reconsider taking it, because my fine motor skills were shot to hell (in a hand-basket), but I'm relieved that it wasn't the fault of lithium. I got some frequent peeing spells at first and some other annoying side effects that I can't remember. I think I felt nauseous at first, so I take it with or after a meal. Oh yeah, my hair felt weird at first, wouldn't hold haircoloring, and got very curly which it never was before! I'm now back to thick and wavy and normal. How strange! I kinda liked the curly! I also use extra sea salt as recommended because it gets excreted with increased urine and salt also benefits lithium's nerve conduction.
I'd encourage you to play around with subtherapeutic doses if you can. My pdoc subscribed 900mg for me, but I found it to be too much and too zombie-like, even though I was in the low end of the therapeutic window. I think lithium acts as a synergistic potentiator with other meds so the party line on dosing may not be accurate when you're taking something like lamictal. Again, good luck, Fluffsters! - Barbara
Posted by BarbaraCat on August 27, 2003, at 19:03:57
In reply to Re: Cortisol/Sugar Connection - Thanks BCat! » Barbara Cat, posted by Ron Hill on August 27, 2003, at 15:42:44
Hi Ron,
Yeah, I think most of us were in that low fat, high complex carbs camp and tried diligently to follow it. I never really could. I suscribe more to the 'food as a vehicle for butter and whipped cream' philosophy. And eggs without the yolk? Never! So I was always a rebel when it came to that, even though I feared I was fatally clogging up my arteries. Even though I always ate well and hardly ever any junk food, I always slathered on the butter and oil. I eventually said 'hell with it, it doesn't seem to be hurting Julia Childs' and am glad I followed my intuition and taste buds.My sister-in-law, however, who I'm convinced has body dysmorphic condition, has been anal about fat for around 10 years now. She even uses no-fat 1/2 and 1/2 in her coffee. What a weird concept! Yes, she's thin, but she's starting to look like beef jerky, her face is dry and lined, her hair is dry and she's got some very definite harpy qualities that could use some good Omega 3s. Her son, who has also been the low, no fat recepient of her diet, has got ADD and other learning disabilities. When I last saw her, she peered at me and said 'Barbara, you're almost 6 years older than me. You're supposed to have worse skin than me. How come your skin looks so good?' and I said "Two words: lotsa fat". I've sinced balanced my protein after reading Barry Sears' books and follow a close version of The Zone diet. But I WILL have real whipped cream on my strawberries and that is that!
I really recommend you get "Lights Out" by Wiley as I mentioned previously. I'm re-reading it and wow! does it make sense. They explain the reasoning behind carb/cortisol metabolism from an evolutionary and neurological standpoint that is helping me to understand WHY rather than to just follow a lifestyle and diet because it seems to makes sense.
About addictions: I love Mark Twain's analogy of bad habits and addictions as ballast. He says if we have no bad habits to get rid of it's like being on a sinking ship with no ballast to throw overboard - you're screwed. But I think that eating high carbs late at night will cause the ship to sink anyway due to our fat selves being on board. - Barbara
Posted by BarbaraCat on August 27, 2003, at 21:22:39
In reply to BARB!, Naturopath visit results, please read, posted by McPac on August 26, 2003, at 21:17:11
Deseryl and Trazadone are one and the same. I had to take 150mg to get an AD effect. Most docs stop at 50mg. I don't think it would be the best first line defense, but might be better than something like Buspar to control anxiety. But clonazapam would be my first choice. I can't even remember how many mornings I stumbled into work late because of traz hangover.
Remeron at 45mg is when I started feeling anxiety and unbalance. The NE effect that kicks in that level is pretty harsh. I'd put money on the possibility that this is what's contributing to your irritability. Why Remeron? I was a devoted fan for a while, but eventually dropped it like a hot potato. I clung on to it at 15mg for a few months after starting lithium and still felt icky. Someone on this board said 'just stop taking it, cold turkey'. I did. It was the easiest med to quit and I felt better almost immediately. I'm one of those classic cases who can't take SSRI's or their analogs because of the BP. Maybe there's another med that would work better for you. I just have a bad feeling about Remeron. It sure made me feel jittery once I got to 45mg. Here's a site I found on OCD and meds:
http://www.ocfoundation.org/ocf1050a.htm
You originally asked about BPI vs. BPII. Of course, BPI is more severe, that goes without question. I'm not sure if it's just a matter of degrees of symptoms or not. BPII is characterized by occasional hypomania but primarily depression that doesn't get better with SSRI's. BPI's have psychosis and frequent manias. If there are mixed states involved, BPI's are much more severe and hallucinogenic than BPIIs. There's a definite psychosis present. You might already be familiar with this website, but I think he's got the best BP info around:
http://www.psycheducation.com/depression/frameset.html
If I were you, here's what I'd do. I'd go back to your former dose of lithium, 600mg wasn't it? I'd take clonazepam, low dose, 3x a day for 2-3 weeks to break the anxiety cycle. I personally didn't get addicted to it at all and was able to take it when needed after that 3 week loading. I'd try to find some other med than Remeron. Perhaps you've tried others and this is the best one so far? Maybe it will be OK once you calm the anxiety with clonazapam. Maybe the lithium will calm things down. But I'm tellin' ya, Remeron is a strange one and there's got to be something else out there for you.
About Primal Defense. I'm about at 6 of those teeny little measures a day. I think it's helping cause I'm not feeling so toxic, but I sure wish I could poop a whole lot more. I thought PD was going to help with that. Oh well, irritable bowel syndrome is just one of those things that comes with fibromyalgia. As I get better, my plumbing will improve. PD is helping out in the meantime. My naturopath recommends it and if it's good enough for her, then by golly, it must be good. How about you? - Barbara
Posted by katia on August 27, 2003, at 22:14:14
In reply to Re: BARB!, Naturopath visit results, please read » McPac, posted by BarbaraCat on August 27, 2003, at 21:22:39
Hi Barb,
I'll let you know how it goes for me next week with the metabolic testing. It might be something that could be helpful to you. People have claimed "miracles" from this and it's mainly about diet/nutrition. I left the website earlier. Have a look at it. Also, if you want to follow up on that career topic, just click on the link from Dr. Bob and I'll chat with you there too. It's pretty interchangeable, not so divided as you probably think.
Katia
Posted by McPac on August 27, 2003, at 23:23:25
In reply to Re: BARB!, Naturopath visit results, please read » McPac, posted by BarbaraCat on August 27, 2003, at 21:22:39
Remeron at 45mg is when I started feeling anxiety and unbalance. The NE effect that kicks in that level is pretty harsh. I'd put money on the possibility that this is what's contributing to your irritability.
>>>>>>>>>>> Oh yeah! Up to 30 mg of Rem I can handle---though at 30mg I don't quite get enough mood-lift and it does squat it seems for anxiety (just seems WEAK at that dose).....but at 45 mg, that stupid NE kicks in, I get angry and irritable and somewhat agitated.....45 mg is too activating for me.....maybe that energetic, activating stuff is great for some folks, NOT me it seems!
Why Remeron?>>>>>>>>>>>> Only because it is one of a VERY few non-ssri AD's that has worked for OCD for some folks. At low-doses I love it...that higher dose-NE effect ruins it for me!). I don't get as many side effects at all from Rem (except at 45mg!!)....but it just seems too weak at 30mg...for me anyway.
I was a devoted fan for a while, but eventually dropped it like a hot potato. I clung on to it at 15mg for a few months after starting lithium and still felt icky.
>>>>>>>>>> Rem at 7.5 mg makes a GREAT sleep aid.
Someone on this board said 'just stop taking it, cold turkey'. I did. It was the easiest med to quit and I felt better almost immediately.
>>>>>>>> Yes, it is easier and quicker to quit.
I'm one of those classic cases who can't take SSRI's or their analogs because of the BP.
>>>>>>>>>>>>> Barb, it seems that some meds I CAN handle well at lower-moderate doses (but they're usually not totally effective there) YET those same meds, when I hit certain slightly higher dose levels, cause the anger/irrit/agitation.........it seems to me that the anger/irrit/agit comes out when those meds hit a certain activation level....like Zoloft, at 50 mg I'm okay, but 75 mg starts the anger....Remeron, 30 mg ok, 45 mg, ANGER....same w/ other meds....it's like a certain activation level is reached and then whammo! along w/ that increased activation comes the nasty effects....does that make sense? Seems like there's got to be some psychiatric term for that? (they've got a term for everything else, lol)
Maybe there's another med that would work better for you. I just have a bad feeling about Remeron. It sure made me feel jittery once I got to 45mg. Here's a site I found on OCD and meds:
http://www.ocfoundation.org/ocf1050a.htm
>>>>>>>>>>> The OCFoundation! I used to belong to that....glad to see that site again!
You originally asked about BPI vs. BPII. Of course, BPI is more severe, that goes without question. I'm not sure if it's just a matter of degrees of symptoms or not. BPII is characterized by occasional hypomania but primarily depression that doesn't get better with SSRI's.
>>>>>>>>>>>>>>> Barb, I'm definitely primarily depressed w/ the occassional mini-highs ....... yet the ssri's work GREAT (but I took the ssri's with low-dose lith....don't think I'd do well w/ssri without lith.......so does that sound more like bp2?......never had the psychotic symptoms......the lows get unbelievably low though (w/out meds)....... have had TERRIBLE anxiety mixed together w/ lows before........still sound more bp2?
BPI's have psychosis and frequent manias. If there are mixed states involved, BPI's are much more severe and hallucinogenic than BPIIs. There's a definite psychosis present.
>>>>>>>>>>>>> Can someone be bp1 even if they've NEVER had the psychotic part?
You might already be familiar with this website, but I think he's got the best BP info around:
http://www.psycheducation.com/depression/frameset.html
Thanks!
If I were you, here's what I'd do. I'd go back to your former dose of lithium, 600mg wasn't it?
>>>>>>>>>> Yep, 600 mg lith does the trick! Could probably get by w/ 450 too but I've restarted the 600 already (Barb---does such a low lith dosage...plus my PUNY blood level....does that indicate that I don't have a terribly severe case of bp? maybe a milder case? (although the lows, as I said, ARE severe w/ out meds)
I'd take clonazepam, low dose, 3x a day for 2-3 weeks to break the anxiety cycle. I personally didn't get addicted to it at all and was able to take it when needed after that 3 week loading.
>>>>>>>>>>>>> I think that many folks REALLY need something to keep their anxiety away...keeping that anxiety away often leads to keeping depression and the other crap away...seems like anxiety often leads to depression then on to other terrible symptoms )anxiety>depression>"everything" at once!......kick anxiety's butt and oftentimes avoid the rest! Klonopin is definitely a drug I've got my eye on (took xanax years ago, great! but incredibly hard to get off of...that's why I've tried to stay away from Klonopin so far)
I'd try to find some other med than Remeron. Perhaps you've tried others and this is the best one so far?
>>>>>>>>>>>>> again, non-ssri ocd meds are VERY few.
Maybe it will be OK once you calm the anxiety with clonazapam. Maybe the lithium will calm things down. But I'm tellin' ya, Remeron is a strange one and there's got to be something else out there for you.
>>>>>>>>>>>> I really think I know what I'm going to try next---Celexa.....it's an ssri I know....I'm very confident it will work for the dep/ocd/anxiety for me....again, my ssri problem is that anger/irrit thingy ..... but I think I can handle Celexa....esp. on lith 600 mg/day....I HATE calling any doc and asking for a new med trial...but tomorrow I am.
About Primal Defense. I'm about at 6 of those teeny little measures a day. I think it's helping cause I'm not feeling so toxic, but I sure wish I could poop a whole lot more. I thought PD was going to help with that. Oh well, irritable bowel syndrome is just one of those things that comes with fibromyalgia. As I get better, my plumbing will improve. PD is helping out in the meantime. My naturopath recommends it and if it's good enough for her, then by golly, it must be good. How about you?
>>>>>>>>>>>>> I've never tried it yet Barb....I'd love to believe (and find out) that some NATURAL substance could really, dramatically improve major psych symptoms....don't know if Primal Defense can do much on its own....maybe a piece of the puzzle....seems like cleaning out the inside and taking great care of the inside should help though....I'll no doubt try it in time...take care BC! THANK YOU so much also!!!!
- Barbara
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Posted by fluffy on August 28, 2003, at 11:07:16
In reply to Re: basket-case in a wave-pool » fluffy, posted by BarbaraCat on August 27, 2003, at 18:25:53
Hi Barb--
Thanks for the well-wishing and advice re: Lithium. I start it tonight at 600mg. I'll do that for a week, get my blood tested and go from there. I'd prefer to do the "sub-therapeutic" levels. But I'll see how I tolerate it, if at all. My doc seems pretty set on the therapeutic dose (I don't know what blood levels he's shooting for)
I had one of my "highs" yesterday...my thoughts were jumping all over the damned place. I tried to just settle down and watch TV at about 11:00. But I worked on my house, making changes, rearranging furniture...planning all of the redecorating I want to do. Everytime I get hypomanic, I always want to re-decorate and build furniture. I suppose that's a useful high, but it's getting downright intrusive. I could not sleep b/c my mind was going..."hmmm, I should re-appolster that chair...maybe blue...maybe pink...oh--and that table..it needs new legs....should I get one from Ikea?" and so on and so forth. My face was hurting due to teeth clenching, and smiling too much (I went to a bar last night to celebrate a friend's birthday--I was giddy as hell!) Could NOT calm down. So I took a damned Temazepam and got to sleep. It couldn't be clearer to me that I'm going up and down, see-sawing all over the god-damned place. Only two days ago, I was a dead person, walking around with no thoughts in my head...the only ones I had were so muddled and slow I couldn't grasp them. Falling asleep on the couch early in the evening, staring blankly into space. I'm a classic case.
So in short, I'm f*cking ready to stop this roller coaster ride. I hope, hope, hope the Li works!
Thanks again Barb!
Talk to you later,Katy
Posted by katia on August 28, 2003, at 13:48:03
In reply to Re: basket-case in a wave-pool, posted by fluffy on August 28, 2003, at 11:07:16
Hi Katy,
You really do sound exactly like me. What is this? Ultra-rapid cycling? I thought I was the only one to experience such rapid and abrupt changes from one day to the next - even within the same day.
Question: Were you "high" before you went to the bar?> and did you drink at the bar and feel your high get higher?
That happens to me - kinda like the coffee barometer. When I'm low, drinking makes it worse. When I'm verging on hypomania, I go into it with alcohol.And haven't you been on Lamictal throughout this? How long has it been?
I sometimes wonder if these highs after lows of staring off into the distance or at the ceiling for hours on end, are just a reaction of stored energy. Kind of like bears. They go into hypernation for the winter and then can go and go and go; and they're not BP (or maybe the fuzzy sweeties have been all this time!)
Sometimes when I can't sleep, I think "of course not, I've been sleeping the past year away, I'm ready for some action! i've been dormat for too long".
I too have been having trouble sleeping the past few nights and have had to take Seroquel for sleep. I went to bed last night at 11:30 (forced myself). I thought "wouldn't it be GREAT to just sleep through the night and wake up at 8:00 and do all the things that I need to do before noon?" no such luck. I was lying there until about 1:30 finally drifted off to sleep and woke up periodically and finally totally at 10:30/11. Now it's 11:45 and I'm just having breakfast.
I can't even imagine having a partner/boyfriend beside me during this! So I remain alone forever!?!
I just want to be able to be normal!! Go to bed when it's time, sleep thru' the night and wake up refreshed at dawn with the birds ready to start the day. Doesn't that sound wonderful?????I went to a new yoga studio yesterday and there is an "immersion" class - same class for a month. I'd love to do it, however, it's at 7am! I laughed when the teacher told me that. I said, "that counts me out, the only way I'm making a 7am class is in another lifetime when I have a different personality!".
But why can't I do normal things!!!!!! anyway, I'm getting frustrated too, Katy. Any consolation at all, you're not alone! Misery loves company? Well at least we can provide compassion and understanding for each other!!!!
take care,
Katia>>
> I had one of my "highs" yesterday...my thoughts were jumping all over the damned place. I tried to just settle down and watch TV at about 11:00. But I worked on my house, making changes, rearranging furniture...planning all of the redecorating I want to do. Everytime I get hypomanic, I always want to re-decorate and build furniture. I suppose that's a useful high, but it's getting downright intrusive. I could not sleep b/c my mind was going..."hmmm, I should re-appolster that chair...maybe blue...maybe pink...oh--and that table..it needs new legs....should I get one from Ikea?" and so on and so forth. My face was hurting due to teeth clenching, and smiling too much (I went to a bar last night to celebrate a friend's birthday--I was giddy as hell!) Could NOT calm down. So I took a damned Temazepam and got to sleep. It couldn't be clearer to me that I'm going up and down, see-sawing all over the god-damned place. Only two days ago, I was a dead person, walking around with no thoughts in my head...the only ones I had were so muddled and slow I couldn't grasp them. Falling asleep on the couch early in the evening, staring blankly into space. I'm a classic case.
>
> So in short, I'm f*cking ready to stop this roller coaster ride. I hope, hope, hope the Li works!
>
> Thanks again Barb!
> Talk to you later,
>
> Katy
Posted by fluffy on August 28, 2003, at 14:57:39
In reply to Re: basket-case in a wave-pool » fluffy, posted by katia on August 28, 2003, at 13:48:03
Hey Katia--
I'm glad you have a similar problem (oop--that's not right!, but you know what i mean!). I mean--I'm glad I'm not the only one. I liked your analogy about the hibernating bear...so true! I'm really kinda freaked out about this latest rapid cycling deal. I don't get it. I never cycled like this at all before. Apparently, from what I've read, the rapid cycling stuff doesn't last forever, and may only be a short part of our illness. But what the hell!! And this is ON LAMICTAL! I had a pretty good run with the stuff for several months. My mood chart evened out into an almost flat line. Now--sweet Jesus in heaven above!!!--it's all jagged ups and downs (not ALL the way up or down, but cyclothymic anyway) Maybe the sh*t just isn't working. But I'm not going off of it until I know it's not. Maybe the Lithium will give it a boost. I feel like my stability was just tacked on a wall with a pin. Now it keeps falling off the wall and being tacked up again. Hopefully the Lithium will nail my stability down and give it a firm hold. (but hopefully not like a sledge hammer!!)
As to your question about the bar visit last night. Well-I was pretty freakin' hypo by the time I got there. I was all on edge and speedy. I'd already taken a trip to Ikea to buy a new lamp. But I didn't drink at the bar until towards the end...only one pint of beer. Pretty good considering my track record. But I'm sure it didn't help me sleep. When I got home, I started re-decorating.
How are you doing with your Depakote? From what I know, it's the best drug to zap rapid cycling. So you may get some relief when you're at your proper dose? Tell me how it's going. I"m curious. I really hope you are feeling better. You seem a little better from the posts I've read.
Keep in touch, you fuzzy bear!!
Katy
Posted by katia on August 28, 2003, at 15:34:33
In reply to Re: basket-case in a wave-pool, posted by fluffy on August 28, 2003, at 14:57:39
Hi Katy, (fellow fuzzy bear)
I think IKEA is a stimulant for BP people. I get so hyped up when I'm there and then get into creative decorating frenzies from it too!I can definitely feel something's happening with the Depakote. I'm at 500mg and wondering if I should push it up. I'll call my pdoc. I haven't gained weight so far and my hair's still intact. But I'm still either feeling slightly up or slightly down. I can definitely feel an evening out somewhat. But then again, I'm extremely intolerant and lose my temper easily/react to people in a fiesty way.
So we'll see how it goes. Good job on only having one pint of beer! I just made a pact with my therapist to only drink two at one time and to assess my state after two (if I go for a third). Assess why I want it etc. just bring awareness around it. We'll see how the 2 drinks go. That'd be great if I can moderately drink.BTW, how do you get your mood chart to show lines? And what do you track daily?
take care,
Katia
> Hey Katia--
>
> I'm glad you have a similar problem (oop--that's not right!, but you know what i mean!). I mean--I'm glad I'm not the only one. I liked your analogy about the hibernating bear...so true! I'm really kinda freaked out about this latest rapid cycling deal. I don't get it. I never cycled like this at all before. Apparently, from what I've read, the rapid cycling stuff doesn't last forever, and may only be a short part of our illness. But what the hell!! And this is ON LAMICTAL! I had a pretty good run with the stuff for several months. My mood chart evened out into an almost flat line. Now--sweet Jesus in heaven above!!!--it's all jagged ups and downs (not ALL the way up or down, but cyclothymic anyway) Maybe the sh*t just isn't working. But I'm not going off of it until I know it's not. Maybe the Lithium will give it a boost. I feel like my stability was just tacked on a wall with a pin. Now it keeps falling off the wall and being tacked up again. Hopefully the Lithium will nail my stability down and give it a firm hold. (but hopefully not like a sledge hammer!!)
>
> As to your question about the bar visit last night. Well-I was pretty freakin' hypo by the time I got there. I was all on edge and speedy. I'd already taken a trip to Ikea to buy a new lamp. But I didn't drink at the bar until towards the end...only one pint of beer. Pretty good considering my track record. But I'm sure it didn't help me sleep. When I got home, I started re-decorating.
>
> How are you doing with your Depakote? From what I know, it's the best drug to zap rapid cycling. So you may get some relief when you're at your proper dose? Tell me how it's going. I"m curious. I really hope you are feeling better. You seem a little better from the posts I've read.
>
> Keep in touch, you fuzzy bear!!
>
> Katy
Posted by fluffy on August 28, 2003, at 17:34:02
In reply to Re: basket-case in a wave-pool » fluffy, posted by katia on August 28, 2003, at 15:34:33
Hi again Katia--
I use a mood chart that I printed out from this website: http://www.psycheducation.org/
It's ok, but I wish it addressed appetite and fatigue in another field. But it does the trick pretty well. When I say a "flat line" i mean that i recorded my mood at baseline for weeks. In the "anxiety" or "depression" columns, the line of course moves up or down. (that's how I do it anyway).Good luck with the drink, too. It's probably easier to do it slowly and see how you feel anyway. I didn't stop drinking completely, and I still have a drink here or there.
Glad to hear you are doing better w/ Depakote. And hey--are you sure you're not just a fiesty gal? I think I'm just fiesty and outspoken--I try not to associate it with being ill, and just think of it being "me". It's hard to tell the difference after a big episode and med trial, though.
Lots of luck and care,
katy> Hi Katy, (fellow fuzzy bear)
> I think IKEA is a stimulant for BP people. I get so hyped up when I'm there and then get into creative decorating frenzies from it too!
>
> I can definitely feel something's happening with the Depakote. I'm at 500mg and wondering if I should push it up. I'll call my pdoc. I haven't gained weight so far and my hair's still intact. But I'm still either feeling slightly up or slightly down. I can definitely feel an evening out somewhat. But then again, I'm extremely intolerant and lose my temper easily/react to people in a fiesty way.
> So we'll see how it goes. Good job on only having one pint of beer! I just made a pact with my therapist to only drink two at one time and to assess my state after two (if I go for a third). Assess why I want it etc. just bring awareness around it. We'll see how the 2 drinks go. That'd be great if I can moderately drink.
>
> BTW, how do you get your mood chart to show lines? And what do you track daily?
> take care,
> Katia
> > Hey Katia--
> >
> > I'm glad you have a similar problem (oop--that's not right!, but you know what i mean!). I mean--I'm glad I'm not the only one. I liked your analogy about the hibernating bear...so true! I'm really kinda freaked out about this latest rapid cycling deal. I don't get it. I never cycled like this at all before. Apparently, from what I've read, the rapid cycling stuff doesn't last forever, and may only be a short part of our illness. But what the hell!! And this is ON LAMICTAL! I had a pretty good run with the stuff for several months. My mood chart evened out into an almost flat line. Now--sweet Jesus in heaven above!!!--it's all jagged ups and downs (not ALL the way up or down, but cyclothymic anyway) Maybe the sh*t just isn't working. But I'm not going off of it until I know it's not. Maybe the Lithium will give it a boost. I feel like my stability was just tacked on a wall with a pin. Now it keeps falling off the wall and being tacked up again. Hopefully the Lithium will nail my stability down and give it a firm hold. (but hopefully not like a sledge hammer!!)
> >
> > As to your question about the bar visit last night. Well-I was pretty freakin' hypo by the time I got there. I was all on edge and speedy. I'd already taken a trip to Ikea to buy a new lamp. But I didn't drink at the bar until towards the end...only one pint of beer. Pretty good considering my track record. But I'm sure it didn't help me sleep. When I got home, I started re-decorating.
> >
> > How are you doing with your Depakote? From what I know, it's the best drug to zap rapid cycling. So you may get some relief when you're at your proper dose? Tell me how it's going. I"m curious. I really hope you are feeling better. You seem a little better from the posts I've read.
> >
> > Keep in touch, you fuzzy bear!!
> >
> > Katy
>
>
Posted by Ponder on August 28, 2003, at 17:44:04
In reply to Re: basket-case in a wave-pool » fluffy, posted by katia on August 28, 2003, at 15:34:33
Katia,
I know that mood charts are extremely helpful since bipolars can't remember how they felt or what happened 2 days ago and always seem to think their current mood has been the predominant one for months regardless of how rapidly they are cycling--at least that's how I am.I have had difficulty adhering to the standard chart, but I keep a journal in which I record my weight and how much I sleep each day as well as some notation of my mood or the events of the day and how I reacted. I think that if all I did was track my weight and sleep, it would still give a much better picture of things than I could yield by memory.
My problem with the mood charts is that I find it agonizing to pick which little box to check to record my mood--it's so much more complicated than a 1-5 scale!
That's my two cents worth. I'd be interested in how others go about tracking the efficacy of their meds and their cycling.
I hope this post will not be redirected because mood-charting of some sort is essential to evaluating the efficacy and side effects of medication.
Posted by Ron Hill on August 28, 2003, at 19:20:17
In reply to Re: Cortisol/Sugar Connection - Thanks BCat! » Ron Hill, posted by katia on August 27, 2003, at 16:46:54
Hi Katia,
> I'm actually going in for a metabolic testing. The website is [www.bloodph.com]. Apparently, unless you find out your metabolic type, none of the other kinds of diets/nutrition regimes really work. It's best to just read what he has to say as I'll butcher it.
Let us know what you think of the concept of metabolic typing after you go through the testing. I looked at the web-site and I'm curious about the validity of the concepts.
Thanks for letting me know about this web-site.
-- Ron
Posted by katia on August 29, 2003, at 0:50:53
In reply to Re: Metabolic Typing » katia, posted by Ron Hill on August 28, 2003, at 19:20:17
> Hi Katia,
>
> > I'm actually going in for a metabolic testing. The website is [www.bloodph.com]. Apparently, unless you find out your metabolic type, none of the other kinds of diets/nutrition regimes really work. It's best to just read what he has to say as I'll butcher it.
>
> Let us know what you think of the concept of metabolic typing after you go through the testing. I looked at the web-site and I'm curious about the validity of the concepts.
>
> Thanks for letting me know about this web-site.
>
> -- RonWill let you know!
Katia
Posted by katia on August 29, 2003, at 1:01:02
In reply to Re: basket-case in a wave-pool, posted by fluffy on August 28, 2003, at 17:34:02
Hi Katy,
I've been sobbing for the past hour, not knowing where the h*** this damn Tsunami just came from. This ain't no wave pool unfortunately and I want off this ride!!!!!!!!!!!!!!!!!!
I'm sick to death of being me. I feel like I've been sponged. It's a technique in horseracing where horrible people will stick sponges up the race horses noses so that they will, over the course of the next few days/weeks, develop all these horrible illnesses and noone can see it and noone knows what's going on! (I've been reading Seabiscuit).
I feel like i've been sponged and am suffocating with no outlet or release in sight!!I might be able to attribute this to the two - yes my limit I stuck to it - two glasses of wine over dinner. But it's like a pin on a hot air balloon. It's only releasing what was already there. and I'm sick of being me!
What's all this about anyway - this dreaded life? One where I'm told there are colors, sounds, tastes, but I live cloaked in dust unable to taste and only feel pain.
What is this?! I'm sick of this! I want a normal(ish) life damnit!
Why am I cycling on Depakote? Is my dose not high enough? whereas before I was just racy, now I'm tired and hysterically depressed! So, no it looks like I"m not doing better unfortunately!
katia
Posted by fluffy on August 29, 2003, at 11:02:29
In reply to Hysteria in Tsunami! » fluffy, posted by katia on August 29, 2003, at 1:01:02
Oh miss Katia!!
I'm so, so sorry about your sponging. What a powerful and sorrowful analogy to how you are feeling. Yes--it does feel like the powers that be are playing with us BP peeps doesn't it? I know exactly what you mean, and for what it's worth, I DO feel your pain. Those crying spells and misery--you want to say, "hey--this is silly, I can just snap out of it. i'm just a weakling and I must WANT to be pathetic" (anyway--that's what I think when I'm super down.) Unfortunately, that thought process is a "symptom"--an overly simplified and (if you ask me) a bit cold and unsymathetic and clinical way to explain your feelings.
I don't know what to say except for JUST HANG ON FOR THE RIDE!! You seem like a fighter to me, or else you wouldn't even reach out for help and advice. I know you can get through this. And believe me, if you can weather this icky, yucky, cycling stuff, then you'll be able to handle the icky, yucky med trial stuff.
It may take a couple of weeks for the Depakote to work for you, if it is indeed the drug for you. The dose is maybe not high enough? If you are still not feeling any relief, CALL YOUR PDOC and let him know!! You may respond beautifully to another med or a higher dose of your current med (depakote).
It's been 7 months since I was diagnosed bipolar, and I've had some unsuccessful drug runs. It's VERY DAUNTING, but I can guarantee you that I feel at least 50% better than I did 7 months ago. I'm not out of the woods yet. REMEMBER--It DOES get better!! Please remember that!
I felt like I was diving off of a cliff with my first Li dose last night. I almost had an anxiety attack before I put the pills in my mouth. It was like I was FULLY acknowledging that I have bipolar disorder...I don't know why Lithium is so much more scary than f*cking anti-convulsants! Doctors should just lie to BP people and tell them it's something else to take the stigma and anxiety away from Lithium.
Anyway--Please take lots of care. And don't feel scared to lean on people you love during this time.
Katy
Posted by katia on August 29, 2003, at 13:47:10
In reply to Re: Hysteria in Tsunami!, posted by fluffy on August 29, 2003, at 11:02:29
Hi Katy,
Thanks for your words. I really do appreciate it. When you say "lean on those you love", it makes me sad. I am feeling extremely sensitive and feel rejected by anything any friend does and at the moment it feels as though I don't have any friends. And the ones I do have are probably sick of me leaning on them.
I am going to call my pdoc today and let him know what's going on for me. I am very emotionally reactive to the slightest thing (I think that's what caused the Tsunami last night). And I get exhausted so easily whether I"m having a "good" day or a "bad" day. I cannot handle much social interaction. and then there's the impatient fieryness I talked about. That feels really reactive to me; not so much a trait of my personality (even tho' I am a bit fiery and temperamental - illness or personality???).Maybe I need to up the Depakote. I felt stirrings of something happening, but now not much of anything. I feel a bit drugged and can't wake up before 11am and have trouble falling asleep and staying asleep - but not all the time.
who knows.
Thanks for being there Katy. It trully helps.
Katia
Posted by katia on August 29, 2003, at 14:03:11
In reply to Mood charts to assess meds/condition » katia, posted by Ponder on August 28, 2003, at 17:44:04
HI Ron,
Thanks for your input. I do need to do this, but it's so tedious and hard to do everday. I hate to scruntinize myself so much. It feels like it makes things worse; but i know in the end it make things better by helping assess stuff.
And at the end of the day, you know what my mood chart always says? I'm moody as h***. YEs, we already know that. Is the med working? I think I can get a general idea if I'm evening out or not. Apart from that how have you found mood charts to be helpful?
thanks.
katia>>I have had difficulty adhering to the standard chart, but I keep a journal in which I record my weight and how much I sleep each day as well as some notation of my mood or the events of the day and how I reacted. I think that if all I did was track my weight and sleep, it would still give a much better picture of things than I could yield by memory
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