Today I started thinking about how great I have it. I may not have everything right now, but I am working on my future. I am excited about moving and being in a new environment. I know God has the right place for me, so I need to continue to trust in HIM. The other day I forgot to take my meds. I totally flipped out and hurried home to take them. I just don't ever want to not take my meds. I believe that meds are so important for "us" bipolar folks. When I stopped taking my meds before, I don't think I really understood what was happening to me. I was hospitalized, but the one thing that the Dr's did not really do for me is sit me down and actually talk to me about my mental illness. I remember my case manager Ziba told me this, YOU have a mental illness. Those words really made me think and it sure hit home. After losing everything I really know what it is like to rebuild a life again. I lost almost everything, but I am working really hard at rebuilding my life. I am stronger now and I know that in time everything will come together.
It is my faith that never left me. Even if I don't attend a church service I know that God is still with me. It is my personal relationship with God that keeps me going. I am not so obsessed over religion anymore. I have met new friends and I have learned to let go to those that were never my friend in the first place. Being Bipolar is not really bad as long as you do your part. I am lucky to have a great team in place and a Psychiatrist that I absolutely love. But I am also the one that has made my recovery so awesome, because I continue to follow through with my treatment and work on bettering my life. I am still struggling with a few things, but I realize now that I have a lot to be thankful for.
One luv,
Cathryn
My journey with Bipolar.
Thursday, September 26, 2013
Monday, September 23, 2013
Losing weight sure ain't easy
I have worked really hard on my weight. It is not really easy when you are on meds that for the most part cause weight gain. I admit my diet lately has not been the greatest. I am working now on getting to 165 and going to hit the gym more frequently. I am now currently a healthy weight of 183. I was 256 so I am losing weight. I feel healthier now and it is easier to perform certain daily tasks. I wear a size 12-14, but I admit my body has changed from all the medications that I started taking Fortunately, I am on medications that really don't cause weight gain. I love the meds I am taking. I am taking Trileptal, Cogentin and Abilify. It took a long time to finally find the right combinations of drugs. I think I can thank my therapist and my psychiatrist on working with me.
Thought this was a great article on trileptal:
Trileptal: Everyone’s Using It!
Suddenly, we all have a colleague who is prescribing Trileptal (oxcarbazepine) for bipolar disorder, and who is claiming to have fabulous success.Rarely has a medication generated so much enthusiasm on so little data. The reason is that Trileptal is blessed with extraordinary intuitive appeal. Approved by the FDA for epilepsy in 2000, it is such a close cousin of Tegretol (carbamazepine) that the molecules look identical except for the addition of a lonely oxygen atom to the middle tricyclic ring of Trileptal. The irresistible reasoning is that since it looks like Tegretol, it must be as effective as Tegretol for bipolar disorder.
And yes, Tegretol has a good track record for bipolar disorder, likely just as effective as lithium and Depakote, but it is rarely used first-line because of poor tolerability (fatigue, nausea, dizziness) and especially because of the risk of life-threatening side effects, such as leukopenia, agranulocytosis, and elevated liver function tests. In terms of pharmacokinetics, Tegretol is a hassle because it induces the synthesis of several P450 enzymes, leading to unpredictable dips in serum levels of concurrent medications.
Trileptal, on the other hand, is free of most of these problems. Fatigue and dizziness may occur, but tend to be milder. It leaves both white blood cells and the liver alone. And although Trileptal does mildly induce P450 3A4, and thus can reduce levels of oral contraceptives and calcium channel blockers, unlike Tegretol, it does not induce its own metabolism, making it easier to dose. Because of its lack of toxicity, Trileptal serum levels are unnecessary; the only laboratory monitoring needed is a couple of serum sodium levels during the first 3 months of treatment, since it causes significant hyponatremia in 2.5% of patients.
It’s nice that Trileptal is so easy to use, but does it work for anything other than epilepsy? The data is very, very scant. Two controlled trials conducted in Germany in the early 1980s showed that Trileptal was as effective as both Haldol and lithium for the treatment of acute mania (1), but the numbers were small and the outcome measures used were unfamiliar to current-day researchers. Oddly, not a single controlled trial of Trileptal has been published since then.
More recently (2), we have a well-done retrospective chart review of 42 patients with refractory bipolar disorder who were placed on Trileptal (average dose 1056 mg QD) either as monotherapy or as an adjunct to their existing regimens. An impressive 57% of patients were rated as “moderately to markedly” improved; interestingly, 100% of the 10 males in the sample improved vs. only 44% of the 32 females. Unfortunately, 52% of these patients discontinued the treatment, either because of side effects or lack of efficacy.
This article originally appeared in The Carlat Psychiatry Report -- an unbiased monthly covering all things psychiatry.
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Thus, while the evidence so far is underwhelming, glowing case reports keep getting published and presented at meetings, giving TCR the sense that a definitive controlled trial must be lurking out there somewhere, hopefully soon to hit the press. Until then, there is little to be lost in trying it on those bipolar patients who are not severely ill and who decline trials of less tolerable alternatives. Most of the frequent prescribers start at 150 mg QHS or BID, and will gradually increase (over a week or two) to about 600 BID. Warn patients about transient dizziness and nausea, inform them that their oral contraceptives and calcium channel blockers may need a dosage increase, and get sodium levels at 4 and 12 weeks. Generally, Trileptal does not cause significant weight gain.
If you prescribe it frequently enough, you too may become one of those Trileptal-boosters who make the rest of us poor schleps feel inadequate. It’s OK, we’re trained to deal with it!
TCR VERDICT: Trileptal: Pretty Harmless; Possibly Effective
References
1. Emrich HM. Studies with oxcarbazepine in acute mania. Int Clin Psychopharmacol. 1990; 5 (Suppl.): 83-88.
2. Ghaemi SN, Berv DA, and Klugman J, et al. Oxcarbazepine treatment of bipolar disorder. J Clin Psychiatry. 2003; 64:943- 9453.
3. Hummel B, Walden J, Stampfer R, et al. Acute antimanic efficacy and safety of oxcarbazepine in an open trial with an on-off-on design. Bipolar Disord. 2002; 4:412-417.
Sunday, September 22, 2013
Being Bipolar And Lacking Confidence
My Self Confidence really was affected when I was diagnosed with Bipolar I. I was placed on many medications that caused me to gain weight and not function very well. I was just plain miserable. When I reached 256 lbs. I remember talking to my therapist and telling her how embarrassed I felt about my weight. I hated going out to the store and worried that people from my past would see me. I used to model and was even featured on the County County Connection buses, so even taking a bus was hard for me. I was an emotional mess inside. Fortunately, I had a great case manager who really worked with me. She was the one that helped me find my current Psychiatrist. I went on several meds, until I found the right meds that worked. And then I joined a gym. I have been a member of 24 Hour Fitness in Concord for quite sometime. I love working out and have gotten to the point where I am happy with my body again. I am still working on losing more weight, but I am not over 200 lbs. anymore. I am at a healthy weight for me and my confidence is improving. I remember going on interviews for jobs and feeling "ugly" and I am sure my lack of confidence was evident in how I did in those interviews. I never got the jobs. I am kinda glad I did not get a job, because I was not ready mentally or physically for a job. I know that in order to really do well I MUST get an education. Enrolling at Heald Business College was the best thing that I could of done for myself. I absolutely love the program that I am doing and know that in time I will graduate from Heald. I just need to stay focused, determined and never give up on myself. I just know that God has really helped me a lot. God never left me and stayed beside me through the rough times. I am indeed blessed.
Saturday, September 21, 2013
What is Bipolar I?
What Is Bipolar I Disorder?
WebMD
Bipolar I disorder (pronounced "bipolar one" and also known as manic-depressive disorder or manic depression) is a form of mental illness. A person affected by bipolar I disorder has had at least one manic episode in his or her life. A manic episode is a period of abnormally elevated mood, accompanied by abnormal behavior that disrupts life.
Most people with bipolar I disorder also suffer from episodes of depression. Often, there is a pattern of cycling between mania and depression. This is where the term "manic depression" comes from. In between episodes of mania and depression, many people with bipolar I disorder can live normal lives.
Who Is at Risk for Bipolar I Disorder?
Virtually anyone can develop bipolar I disorder. About 2.5% of the U.S. population suffers from bipolar disorder -- almost 6 million people.
Most people are in their teens or early 20s when symptoms of bipolar disorder first appear. Nearly everyone with bipolar I disorder develops it before age 50. People with an immediate family member who has bipolar are at higher risk.
What Are the Symptoms of Bipolar I Disorder?
During a manic episode in someone with bipolar disorder, elevated mood can manifest itself as either euphoria (feeling "high") or as irritability.
Abnormal behavior during manic episodes includes:
- Flying suddenly from one idea to the next
- Rapid, "pressured," and loud speech
- Increased energy, with hyperactivity and a decreased need for sleep
- Inflated self-image
- Excessive spending
- Hypersexuality
- Substance abuse
People in manic episodes may spend money far beyond their means, have sex with people they wouldn't otherwise, or pursue grandiose, unrealistic plans. In severe manic episodes, a person loses touch with reality. They may become delusional and behave bizarrely.
Untreated, an episode of mania can last anywhere from a few days to several months. Most commonly, symptoms continue for a few weeks to a few months. Depression may follow shortly after, or not appear for weeks or months.
Many people with bipolar I disorder experience long periods without symptoms in between episodes. A minority has rapid-cycling symptoms of mania and depression, in which they may have distinct periods of mania or depression four or more times within a year. People can also have mixed episodes, in which manic and depressive symptoms occur simultaneously, or may alternate from one pole to the other within the same day.
Depressive episodes in bipolar disorder are similar to "regular" clinical depression, with depressed mood, loss of pleasure, low energy and activity, feelings of guilt or worthlessness, and thoughts of suicide. Depressive symptoms of bipolar disorder can last weeks or months, but rarely longer than one year.
What Are the Treatments for Bipolar I Disorder?
Manic episodes in bipolar I disorder require treatment with drugs, such as mood stabilizers and antipsychotics, and sometimes sedative-hypnotics (e.g., benzodiazepines such as Ativan or Klonopin).
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