Friday, October 4, 2013

Medication Adjustment

Yesterday I had an appointment with my psychiatrist.  I am very lucky to have a doctor who is as caring as she is.  She doesn't just shrug off what I tell her, she listens and asks questions, and is straight forward with me.  I told her about the problems I've been experiencing with sleeping, and about the anxiety I've been having.  She recommended that I increase the dosage of the Seroquel to help me sleep and calm me down a little bit, and start tapering down off the Celexa because it may be causing me to become manic.  Since increasing the Seroquel I slept so much better last night, and I feel a little better today.  I sat by the pool today and being out in the sun and relaxing definitely helped me.  I think this proves the importance of taking the medication and taking with your doctor about how your feeling.  Sometimes a minor adjustment in dosage can be extremely beneficial.   

Thursday, October 3, 2013

Treatment

It's been a long road to find a treatment plan that works for me.  I've been on numerous medications and I've been treated by different doctors.  Before I get into my treatment I want to make it clear what has worked for me doesn't mean it will work for everyone.  We're all different and we respond to things differently.  I just want to provide some insight on my treatment so you can get a better idea of what this road has been like.

The first time I was treated by a doctor was around 2007-2008.  I went to him complaining of being depressed.  But I wasn't completely open and honest.  I didn't tell him about the mood swings I was experiencing.  I just said I'm depressed and that was it.  So his diagnosis was depression and he gave me a prescription for Celexa 40mg.  I took the Celexa for about two months and then I stopped.  I was feeling better so I thought I had this under control.  I wasn't long before the depression was back.  But instead of going back to my doctor I decided to self medicate.  I was taking prescription pain medication to cope with how I felt.  I thought it was helping me.  But is was just making the problem worse.  It's like putting a band-aid on an arterial bleed.  It was just creating more problems for me.  I became dependent on the pain meds, and was filling fraudulent prescriptions to obtain them.  It wasn't long before I was caught and arrested.

After my release three years later I became manic again.  I wasn't sleeping, I was going on spending sprees, I felt like I needed to make up for lost time.  As long as I had money and credit cards I felt great.  This was the longest manic episode I had ever experienced.  It continued for close to a year, but then the money ran out and I had maxed out the credit cards.  The feelings of greatness disappeared, I lost my self esteem, and suddenly I felt like a complete failure.  So back I went to the doctor, but again I just complained about being depressed, and I was given the Celexa again.  My moods were all over the place. Up and down, up and down.  Finally I reached my breaking point.  I was becoming suicidal.  I was beyond depressed, and I had never felt this low before.  My family talked me into going back to the doctor.  And when I told him how I felt, he urged me to voluntarily check into a mental health facility.  So that's what I did.  I saw the psychiatrist while I was there and he then diagnosed me with bipolar disorder and added a mood stabilizer along with the Celexa.  I spent 3 days there and was released.

It took a little bit of trial and error over the last few months to find a drug combination and dose that works.  Currently I'm on Celexa 20mg and Seroquel 200mg.  My psychiatrist just increased the dose of the Seroquel today.  She also wants to lower the dose of my Celexa because she feels it may be contributing to the start of a manic episode.   Like I said it took awhile to find something that worked for me, and to this day it still requires adjustments.  I have to remind myself that there isn't a cure for this and I'm not just going to wake up tomorrow and be better.  But this is manageable, and with the right treatment it is possible to live a productive normal life.  I think staying positive plays a big part in  managing this.  And I can't say enough how important it it's to be open with your doctors.  It can mean the difference between a right diagnosis and a wrong one.

Wednesday, October 2, 2013

Biplor and relationships

Like I said in an earlier post I was once married which ended in divorce.  Do I think being bipolar played a factor in the end of my marriage?  Absolutely.  It definitely put a strain on my marriage and also my friendships.  My wife and I would get into these heated arguments which usually resulted in a screaming match.  Typically this was during a manic episode.  I would become angry if someone didn't agree with me or if they didn't feel the same way I did about my ideas.  To me their objections felt like they were trying to control me.  They weren't able to see how great my ideas were.  I would push people away from me and stop talking to them.  When I was depressed I didn't want to do anything.  I didn't want to go anywhere or be around other people.  I would go to work and come home, that was it.  If my wife questioned why I didn't want to do anything I would become angry.  I never told her how I was actually feeling so she didn't understand what was going on with me.  For 5 years she dealt with my mood swings.  She tried to be supportive, tried to get me to open up and talk to her but I refused.  As time went by our relationship became more strained.  When I started to self-medicate with pain pills I hid it from her.  After I was arrested and charged with drug trafficking she told me that she knew something was going on but she couldn't get me to open to her.  While I was serving my sentence in prison she told me she no longer wanted to be together.  I couldn't blame her.

I was too unstable for her to continue to be with me.   The years of my up and down mood swings, drug addiction, suicide attempt, and bad choices had worn her down.  During the time of our marriage I was completely out of control.  Relationships can be difficult, throw in untreated bipolar disorder and you have one hell of a mess.  The divorce was difficult for me.  I didn't want my marriage to end but I understood why is was ending.  There was no communication between us anymore, she lost trust in me.  I became extremely depressed when I found out she was with someone else.  I stopped eating, I slept all day everyday, and I was angry with myself.  But I still didn't get help.  I just dealt with it.  It wouldn't be until about 3 years after our separation that I finally got treated.

The relationship I'm in now is completely different then the one I had with my ex-wife.  She understands what I'm going through.  Although being bipolar isn't an excuse to just act anyway I want to, having a diagnosis helps to understand whats going on.  We have been through rough times together, most recently another suicide attempt when I ran out of my medication.  But she has supported me through it all.  I've been able to open up to her and tell her how I'm feeling.  Together we battle this.  She has allowed me to realize having a normal life is possible.  Having someone you can talk to in my opinion is the best support you can get.  She can tell when I'm overworking myself or taking on to much.  She's able to help slow me down.  Sometimes the people closest to you see things and notice things that you don't.  That's why I sometimes take her to my doctor appointments, having her there not only for support but also she can tell the doctor things I may have overlooked.  I'm grateful to have her in my life.       

Questions and comments

Feel free to leave any questions or comments.  I'm more then happy to reply

What is normal?

When I first started treatment for bipolar disorder I was skeptical taking medication was going to make me feel better.  Like I said in earlier posts there were times I stopped taking the medication because I felt like I didn't need them.  I learned the hard way that I did need them and abruptly stopping them has dangerous results.  Now I take my medicine as prescribed and I can say that they do help.  I haven't been experimenting the intense highs and lows I previously did.  They way I feel now is a whole new experience.  Is this what normal feels like?  I really don't know because Ive never felt this way before.   There's also this part of me that misses the mania.  Not the psychotic delusional mania but the early beginnings of it.  I would be so positive and full of energy.  I could do anything, and be extremely creative with all kinds of ideas in my head.  Its almost like the medicine has taken that away from me.  Like a part of me is gone and now I'm this new person.  I have to remind myself what could happen if I stop taking the medication.  I take it not only for me but for everyone who is close to me.  Even though I'm the one that's bipolar it affects them as well.  If this is what normal feels like, I guess I'm ok with that.   

Sleep

Problems with sleep have always been an issue for me.  As you can see its 2 a.m. and I'm still awake.  I go through periods where I sleep great.  I fall asleep easily and I get 6-8 hours of sleep.  Then I go through periods where I have difficulty falling asleep or I don't sleep at all.  Typically this is caused by the racing thoughts going through my mind during a manic episode.  The difficulty I'm currently having has been going on for about 3 days now.  It started out with having a hard time falling asleep.  Now I'm just not tired.  It concerns me because I don't want this to be the beginning of a manic episode.  The Seroquel I take has been doing a pretty good job at helping me sleep so I think I may just need my dose increased.  I see my psychiatrist on the 3rd and I'll talk to her about that.  Other then the sleep issue I've been doing pretty good.  I just want to get this under control before it turns into a bigger problem.  

Tuesday, October 1, 2013

An uncomfortable subject...suicide

When I was fifteen a friend of mine took his own life.  I remember the last conversation I had with him.  It was Friday October 2, 1998.  We talked on the phone for a little while and everything seemed normal.  Nothing he said raised any suspicion about what he was going to do.  He ended our conversation with "I'll see you Monday".  But I wouldn't see him Monday.  On Sunday, October 4th I got a phone call telling me that my friend had died.  He committed suicide.  How was this possible?  I had just talked to him, everything was fine.  It didn't make sense to me or to anyone else that was friends with him.  There was no note written.  So we were just left with questions.  Monday morning all of us who were close to him were brought into the school counselors office.  They asked us questions that we had no answers to. Did he seem depressed? Did he talk about death or dying? Was there anything happening at school that we knew about?  Did he mention anything about his life at home?  All I could answer with was no.  I couldn't understand what would cause a kid who was making good grades, had friends, and seemed happy take his own life.  What was so bad?  It wasn't until my own thoughts of suicide years later that I would somewhat understand.

When I was suicidal all I could think about was death.  I would drive down the road fantasizing about my car crashing into a tree or running head on into a pole.  I would think about what would be the best way to die.  I read about suicide online.  Looked up different ways to do it.  I had lost the fear of dying.
But I was also really good at hiding how I felt.  Years of practice allowed me to appear normal to those around me.  Even if someone asked me if I was ok or if something was wrong, I would answer with "I'm fine" or "There's nothing wrong".  Eventually the thoughts of suicide turned into actual plans.  I became so desperate for relief that dying seemed like the best option.  I could find no pleasure in anything that I once enjoyed. The night I overdosed on the Klonopin I was at the lowest I had ever been in my life.  I remember taking the pills without hesitation.  There was almost an excitement about it.  Like I was finally going to have some peace.  I thought about my kids and my mom, but they weren't thoughts about how my death would affect them.  They were thoughts of how better off everyone would be without me.  My depression had pushed me over the edge.  I was a failure and a burden on my family, I didn't deserve to live.  Fortunately I had not taken enough Klonopin to actually die from it.  But it was a wake up call.  I finally realized the severity of my situation, and the impact this had on my loved ones.  It was time for me to start taking this seriously and get help.  

        

Lets talk about bipolar disorder

I hope if your reading this and have bipolar disorder you find some comfort in knowing that your not alone.  If your someone who has not received treatment yet, I hope my writings give you the strength to do so.  I can tell you from my experiences that this is manageable, and it will get better.  I'm not a doctor or a mental health counselor so I'm not going to give advice or tell you what treatments work the best.  Everyone is different, and what has worked for me doesn't mean it will work for you.  I just want to provide some insight and support to those who are suffering from bipolar manic depression.  And if your a friend or family member of someone who has bipolar disorder I hope this provides you with a better understanding of it.

So lets talk about bipolar disorder.  There are all kinds of articles and books covering it.  You can look it up online and read about it.  But what is it really like to have it.  For me bipolar disorder is like being on a roller coaster of emotions.  Incredible highs, and dangerous lows.  When I'm manic I feel unstoppable, like I can do anything, ideas and thoughts race through my head.  I have no patience for anyone who may slow me down.  The person inline ahead of me at the checkout line is going to slow, everyone else on the highway is just in my way.  I'm on a mission.  Whatever idea is in my head at the time is the most important idea in the world.  I have no need for sleep.  At 4 a.m. I'm up writing business plans, creating websites, trying to write a book.  I'm laying in bed staring up at the ceiling analyzing in my head everything Ive done that day or week.  Anyone who doesn't appreciate my ideas is an idiot.  I'm a genius.  Its absolute madness.  This may go on for weeks or months.

My manic episodes are usually followed by depression.  I bring myself to the point of exhaustion.  Going days with little to no sleep finally catches up with me.  My self esteem drops.  I lose confidence in anything that I'm doing.  Hopelessness sets it.  I lose interest in anything that I was previously doing.  My ideas suddenly seem stupid.  Its a downward spiral that in the past has left me contemplating suicide.  Death seems like the perfect escape.  I welcome it.

In my experience with bipolar disorder I have found that not only identifying the early signs of mania and depression, but also their triggers are important.  I have had to learn to slow down.  If my mind starts racing I know that its time to take a break and relax.  Does the medication help? Absolutely.  But I can't just rely on medication and think that everything will be fine.  Honestly I worry about having another episode that could put me in the hospital.  I worry about losing touch with reality again.  Not being able to remember things that Ive done or said is scary.  What if I was to really hurt myself or worse someone else.  That's why managing this is so important to me.  Like I said in earlier the post it took me a long time and some close calls to finally accept that I had a mental illness.  But now I know what it is that causes me to feel the way I do.  So I guess that has brought me a little bit of comfort.     

  



About Me

My name is Robert and I'm 30 years old.  I am a divorced father of two boys and I have bipolar disorder.  For most of my life, as far back as I can remember I have suffered with this condition.  I went years without a diagnosis or treatment.  Just accepting that this was who I was.  I battled the severe ups and downs never finding the courage to seek help.  When I was manic I could do anything.  Ideas flew around in my head, my thoughts raced, I would go days with little to no sleep.  When I was depressed I would shut down.  Cut myself off from the rest of the world.  I had to force myself to get out of bed.  The idea of even going to the store was stressful.  I would put myself into a panic thinking about having to be around people.  And so this went for years.  Then I started to self medicate.  Prescription pain pills was what I became dependent on.  Taking them at first to help me sleep and calm me down when I was manic.  And it worked.  I felt good.  Eventually I was taking these pills all the time.  I'd take them first thing in the morning when I got up, I'd take them when I got to work, I'd take them throughout the day.  In my mind the pills made me normal.  I was a better person by taking them.  But I was wrong, very wrong. 

My marriage was falling apart, my performance at work suffered, my relationships with other people became strained.  I had become so dependent on the pain killers I stopped caring about anyone or anything else.  I was making terrible decisions.  And eventually I would pay a big price for the choices I was making.  In September of 2008 I was arrested on drug trafficking charges.  I spent 3 years in prison and was released in September of 2011.  During that time my wife left me, and we would eventually get divorced.  After my release I thought if I could make it through everything that happened there was nothing I couldn't do.  I was manic again.  There was all these things I felt I needed to do.  I had missed out on 3 years of life so I was entitled to make up for lost time.  I bought a car, I bought clothes, I bought shoes, and jewelry.  I spent money like it was never going to run out.  I enrolled in college, I was working, and I was staying out all night.  I was full of energy soaring high.  But then I crashed.  I lost my self esteem and I lost the energy I had.  I started doubting everything I was doing.  I quit school, I quit my job, and I cut myself off from everyone again.  The depression was taking over.  But I still didn't get help.  Instead I started self medicating again.  Taking pills to numb the feelings I had.  Thoughts of suicide and death were taking over my mind.  And then I ran out of pain pills.  I remember laying in bed my whole body hurting, sick from withdrawals.  I was desperate to stop this horrible agony I was in.  So I went to the emergency room.  They gave me medication to stop the nausea, calmed me down, and sent me on my way.  It was then I decided I needed help. 

The first doctor I saw recommended I get drug abuse treatment.  I lasted one day and didn't go back.  In my mind it was stupid.  I didn't need a twelve step program or narcotics anonymous.  I didn't want to listen to these peoples stories because they didn't understand how I felt.  So my depression worsened.  And eventually I went to another doctor.  His diagnosis, I had depression.  I was put on an antidepressant, which I took for two weeks and stopped because I didn't like the side effects.  I was given another antidepressant, one I was told has less side effects.  I took that one for about a month, and started feeling better.  Much better.  So I did what many people do when they start to feel better, I stopped taking the medicine.  That would prove to have dangerous results.  I was having difficulty sleeping again,  I was thinking about suicide, I was tired of feeling this way.  Tired of the constant ups and downs I was experiencing.  The people close to me were becoming concerned about how I was acting, and encouraged me to go back to the doctor.  My physician felt I was a danger to myself and gave me an ultimatum, either I voluntarily go to a mental health facility or he would involuntarily commit me.  So I agreed to go.  I spent three days there.  The psychiatrist who treated me diagnosed me with having bipolar disorder and put me on antidepressants and anti-psychotics and recommended I see a psychiatrist for further treatment.  Eventually, after pleas from my family I did. 

I sat in the psychiatrists office answered a series of questions, gave her family medical histories, described the feelings I was having, how long this had been going on, and what prior treatments I had.  Her diagnosis confirmed what the mental health facility told me, I had bipolar manic depression with rapid cycling.  Her recommendation was Celexa for depression and Seroquel to stabilize my mood and help me sleep.  And they worked.  My sleep improved, I became more level headed.  I was actually feeling better.  But then due to a miscommunication between myself and the pharmacy I ran out of my medication.  The medical facility I get treated at mails out medications to your home.  I wasn't keeping track of my medications like I should have and ran out before I could get a refill.  For almost two weeks I had gone without the Seroquel and I would learn the hard way how bad it is to just stop taking the medication.  I remember laying in bed thinking how much easier it would be to die.  In my head I was just a burden to everyone else.  I was never going to get better and there was no point in trying to to.  My mind was an absolute mess.  Suicide became all I thought about.  Did I call my doctor and tell her how I was feeling? No.  I told no one.  I thought I could hold out until my refills came in the mail but the overwhelming thoughts of death became debilitating.  I couldn't take it anymore.  I was looking up on the internet ways to kill myself.  It was all I thought about.  I needed some relief from this, I wanted to die. 

I was able to get my hands on a bottle of Klonopin and in my mind it seemed like the perfect way to die.  Just go to sleep and not wake up.  No pain, no suffering, just quiet and peaceful.  My memory of the events after I took the Klonopin is very little.  Most of what I know has been told to me by other people.  Apparently my girlfriend found me lying half on half off the couch.  Bottles and pills everywhere.  I was breathing but not responsive.  The police came, then the paramedics.  I was taken to the hospital and put in a room with an orderly outside to keep an eye on me.  I remember waking up not knowing where I was or what was going on.  I got out of the bed, walked out of the room, and tried to leave the hospital.  I was quickly met by hospital security and brought back to my room.  Then I tired to leave again.  This time I put up a fight.  Security had to tackle me to the ground and I was then put in arm restraints.  But I wasn't done yet.  I was able to undue the restraints using my teeth and make another escape attempt.  Security stopped me again, and this time I was restrained with one arm over my head, one arm to the bed, and my legs restrained as well.  Finally I gave up the fight.  The next memory I have is waking up in a bed at a mental health facility.  I was confused and disorientated, the Klonopin still in my system.  Slowly I started to become more coherent.  I don't remember much about my stay at the mental health facility.  My mom and my girlfriend would come and visit me.  I attended group therapy sessions, saw a psychiatrist, and a mental health counselor.  My diagnosis; Bipolar I manic depression with most recent psychotic episode.  I was placed back on the Celexa and Seroqul.  It was here in the mental health facility that I finally understood how bad off I had become.  It was frightening and eye opening.  I realized that I needed help, I needed to stay on the medication, and I needed to open up and be honest with my doctors.  It was the only way I was going to get better.  I didn't want to die, I actually wanted to live.  My condition improved and the doctor felt that I was well enough to go home.  I left the facility on September 10, 20013.  I'm thankful to be alive.  I'm lucky too.  My battle with bipolar disorder continues, but now I have the ability to manage it.  I finally feel like I can start a new chapter in my life.