Daily Archives: October 11, 2014

Saw my psychiatrist

Had a decent appointment. Apparently Piportil works as a mood stabilizer as well. My pdoc upped the clonazepam to 2mg at night, switched me off dexedrine and put me on ritalin instead, and upped the Piportil dose to 75mg every 2 weeks. I see him next Nov 10.

Here’s the fun part.

Piportil doesn’t come in 75mg vials. It was either get two shots (one 50mg, one 25mg) or waste some of the 100mg. My GP is in charge of the Piportil, and he said he’d rather waste some of the 100mg, because its less needles.

So.. my pharmacy.

They got the 100mg in too late on Friday. Then there was a kerfuffle about my insurance card which I gave them on the 5th when I renewed a prescription. I left at 1pm. Dr B’s office was closed for Canadian Thanksgiving weekend.

Fawk.

The pharmacy called a walk in clinic and explained the dosage and whatnot, and I waited there for an hour, got my shot (3/4 of a 100mg vial, or 1.5mL, easier to measure in mL).

But I BLEW UP at my pharmacy. I was PISSED. I later apologized, but FUCK, seriously, get it RIGHT. And they’re “the best” according to my docs. I’d hate to see the worst!

Oh well, its over now.

The new 75mg dosage, up from 50mg, really knocked me out for a bit. I got home and cuddled under many blankets (Piportil makes me more sensitive to the cold) and then after the lovely sedation (quiet mind, just relaxed) wore off, I had to bring my roommate to the ER because she got kicked by a horse.

The doc there was an ASSHOLE. I felt terrible for her.

I slept well last night.

I fell off my horse today just goofing around. It was pretty funny. I wish I had it on video.

That’s about it.

Happy Thanksgiving to all the other Canadians out there!

NIMH · Atonement

In his blog post entitled AtonementThomas Insel, MD, Director of the National Institute of Mental Health (NIMH), calls for humility:

So this year on Mental Illness Awareness Week, my call is for humility. We need to be aware that mental disorders are immensely complex—too complex for scientists, clinicians, patients, or families to solve alone. Prevention, recovery, and cure—the NIMH vision—need a collective effort. Beyond the day—or week—of atonement, we need a massive campaign to transform diagnosis and treatment.

http://www.nimh.nih.gov/about/director/2014/atonement.shtml

Below I directly quote his very moving and thoughtful piece in its entirety.

Thank you, Dr. Insel.


Director’s Blog: NIMH · Atonement
By Thomas Insel on October 8, 2014

One of my first meetings when I arrived at NIMH 12 years ago was with board members of the National Alliance on Mental Illness (NAMI). I asked them how NIMH could be helpful. One board member’s request was especially memorable. “Declare a day of atonement,” she suggested. When I saw this same board member last month at the annual NAMI meeting, we both recalled that 2002 meeting with a touch of regret. I wished I had had a better response to her request. And, as she said to me last month, “I wished I had asked for a week.”

As it turns out, Mental Illness Awareness Week this year began with Yom Kippur, the Jewish Day of Atonement. Which begs the question: what do we (in the mental health community) need to atone for? There are so many answers. For some, it may be the culture of blame and shame perpetuated for years by clinicians who explained all mental illness as being caused by trauma and evil parents. For others, it may be the singular reliance on medication and modifying behavior rather than holistic care and the provision of skills. Others will name the paternalistic structure of mental health care, which can undermine rather than empower individuals and their families. The list goes on. Maybe it would take a week, not just a day, to capture the many complaints.

My own favorite atonement issue for Mental Illness Awareness Week this year is the lack of humility in our field. Mental disorders are among the most complex problems in medicine, with challenges at every level from neurons to neighborhoods. Yet, we know so little about mechanisms at each level. Too often, we have been guided more by religion than science. That is, so much of mental health care is based on faith and intuition, not science and evidence. On the plus side, we put a premium on listening and compassion. We help people to change through understanding. But not enough of our care has been standardized to a high level of quality, as expected in the rest of medicine.

On the research side, it’s easy to lose humility. The pace of discovery in genomics and neuroscience is ever more rapid—this week’s Nobel Prize in Physiology or Medicine is a good example of how neuroscience is revealing the fundamentals of brain activity—in this case describing the brain’s “GPS” network. Advances in systems neuroscience, from dissecting circuits to human brain imaging, are unequivocally stunning. But, and this is a humbling caveat, we simply have not been able to translate this revolution in neuroscience to diagnostics or therapeutics for people with mental disorders.

Why the disconnect? Translation takes time. Translation requires replication, regulation, and ultimately reimbursement. Fundamentally, translation is really difficult. For instance, we have thousands of neuroimaging studies but none that has delivered a clinically useful biomarker. For NIMH this is a humbling realization—we still lack biomarkers to identify who should get which treatment. We still lack effective treatments for many aspects of mental illness.

So this year on Mental Illness Awareness Week, my call is for humility. We need to be aware that mental disorders are immensely complex—too complex for scientists, clinicians, patients, or families to solve alone. Prevention, recovery, and cure—the NIMH vision—need a collective effort. Beyond the day—or week—of atonement, we need a massive campaign to transform diagnosis and treatment.

http://www.nimh.nih.gov/about/director/2014/atonement.shtml


Filed under: Atonement, Mental Health, NAMI, NIMH Tagged: #MIAW, Mental Illness Awareness Week, NIMH

Writings from Bipolar Bandit’s Father Part 2: Privileged to be a Bipolar Dad

dad and meThis post is long overdue. As the Dad of a daughter with bipolar disorder,  I experienced many heartaches, sleepless nights and long road trips to bail her out of many crisis situations. I would do it all again. I will do it again and I am thankful that this daughter chose to stand and fight and is now fighting for others.

Bipolar disorder is a terrible illness. It took away our daughter’s teenage years, yet she managed to not only graduate from high school, she stayed with it to get her college degree. and taught school for over 10 years before the illness finally took her out of the workforce altogether. She fought that eventuality with everything she had. She had debilitating dystonia, long bouts of depression, multiple hospitalizations and much more before finally realizing she just could not longer work.

Her mother and I are very proud of how she continues to battle back, stays alive, stays on her medication and has finally found her own soul mate.  So here are some of the joys of being a Bipolar Dad:

  • Cards out of the blue saying “I love you Dad”
  • Special gifts that express thoughtfulness and love – Don’t Quit, Eagle, and more
  • Special hugs and knowing smiles
  • Our own special language – eye luv ewe too
  • The moon
  • Sharing with family
  • First of our daughters to graduate high school and college
  • Some very special and dedicated friends that became a part of us
  • Unbelievably dependable in times of stress for the family
  • Helping to heal damaged relationships
  • Smart as a whip – she could be a doctor in different circumstances
  • A great editor
  • Caring, devoted to her family and friends
  • An advocate beyond belief – helping others deal with this terrible illness

I truly could go on forever and will come back and add more things as I think of them, but this should give anyone who reads this an appreciation for my belief that being the Dad of a Bipolar is a blessing and not a curse. I am thankful that my wife and I stayed with her through all the trials and tribulations and we are now very proud to be the parents of a wonderful daughter.


Clang Associations etc

It’s not purely a mood disorder …

Linking words together based on similar sounds rather than coherent meaning is a symptom of psychosis in people with bipolar disorder.
clang associations in bipolar disorder

It is thought that people begin to speak but become distracted by both the meaning and sound of the words they are using. This means that they repeatedly lose the thread of what they are saying, and shift off the topic to follow the new connections they are making between words.
what is clanging

New ideas and thoughts come so fast that even speaking as rapidly as possible, a patient may be able to express only a small percentage of them.
Disorders of Thought Are Severe Mood Disorders: the Selective Attention Defect in Mania Challenges the Kraepelinian Dichotomy—A Review

Also: 10 totally tongue twisting word disorders

Word salad. (Schizophasia) A jumble of words that are not apparently linked and may be hard to understand. Philosopher Noam Chomsky is well known for his studies in language and cognitive science; his famous grammatically correct example of word salad is “Colorless green ideas sleep furiously.”
Disorganization. Jumping from one idea to another without transition.
Neologism. Making up words that have no meaning to anyone but the speaker.
Echolalia. Repeating others’ words or phrases.
Flight of ideas: (in psychiatry) a continuous stream of talk in which the patient switches rapidly from one topic to another and each subject is incoherent and unrelated to the preceding one or is stimulated by some environmental circumstance. The condition is frequently a symptom of acute manic states and schizophrenia.
Mosby’s Medical Dictionary, 8th edition. © 2009, Elsevier.

There will be better days…if you say so

Today was ass trash. It took me two hours to get the cobwebs off my brain enough to even get dressed and out the door. I “bathed” with wet wipes because I still couldn’t work up to the shower thing.

Got to the shop to find R in some sort of fury over a tv that had a secondary problem and was pissing him off. So for the first two hours, I listened to him talk to himself and rant and rave at the tv. Fine, I watched some stuff on youtube and cringed every time his voice rose. I don’t do conflict. My parents yelled at each other, and us, a lot, and to this day, even if not directed at me, raised angry voices make my inner panic kick in.
Unpleasant and nerve racking is an understatement.
Torture came when he hit a mood up moment and forced me to sit through secondhand Toto and Dave Brubaker tunes. I don’t do 80’s wuss rock and I sure as hell don’t do jazz. I am fair enough to say, interesting for that genre, they have talent…Not my cup of tea.
So I figure give and take and play a few songs I like. Only to be told the stuff I like has no talent, no musical ability,loud,obnoxious, yada yada.
This type of hypocrisy drives me infuckingsane. If I can open my mind and say something good even if it’s not something I am into…then why does everyone around me get to tear down what I like? Sure, it sucks to you, but maybe like me, you could just shut the fuck up and say something non committal (Doesn’t move me).
Hate people who don’t play fair on the playground, which means I pretty much hate everyone around me.

It only got worse from there. I was sent to fetch things. His card was declined at 3 places. Which started a very loud tirade and a lot of cringing on my part. I get being pissed off and screaming and throwing things when pissed. In fact, I used to do all of that prior to mood stabilizers and he claims that was why he ditched me.
So…tantrums when angry are ok.
Mental illness that induces such behavior…character flaw.
Got it.

So he hogged the computer playing angry birds while on the phone to the credit card company which put me, and my mounting anxiety and paranoia, in a holding pattern because he wanted me to order parts. Have to have net to get the part numbers, they only take phone orders. So by the time the credit card drama was solved…The parts place, on the east coast, was closed.
More yelling ensued.
It’s almost humorous when this happens with him. He has no clue that his occasional bad days are pretty much how 99% of my days go. But rather than being frustrated and flustered like him when he has a bad day and throws fits, I am overreactive and negative.
For some reason, it doesn’t matter how magnificent people are in every other way, hypocrisy is just a quality that makes me hate every living being on the planet. Having a set of rules for yourself but a different set for others…
Ass trash.

I finally escaped, by that time feeling the proverbial paranoia induced target painted on me. Anxiety bloomed into borderline panic.
I get home to a glowing report of how my kid pretty much behaved like Jesus and walked on water in my absence.
Disheartening, to say the least, but it is her M.O.
(And no, Becca, you don’t have to feel bad because this is about my kid, not you.)
So I am feeling down and nervous and needy and tell my kid I want to snuggle buggle (outside the potential lice danger zone) and she gives me a kiss, says she loves me and bounces off.
Yet every other moment (including this morning upon waking) she is a glom monster who won’t give me elbow room or let me go pee without following and talking to me through the door.
When I am having a needy bitch moment…

Meh.
R always says, there will be better days.
I’ve been waiting for that to happen for three years.
LIES!
My biggest enemy right now is my slipping mental state. I am feeling both distant but needy which is a confusing place to be. Hug me,I am sad, wait, don’t get near me, everything I touch turns to shit.

Grrr.

Then there’s this war with my insane mother and father. All because my kid has lice and for some reason, it means I don’t care about her.

Sometimes, I yearn for a tornado to hit this place. Maybe it will relocate us for free,far far from this fucking place near my idiotic if well meaning family.

Ok, dramatic but running joke for years when you live in a trailer and people spazz out during storms and tornado watches. “Hey,that’s my relocation plan to get out of here, don’t knock it.”

Another month or so, I won’t even have my warped humor anymore.

The depression’s at the door and it’s gonna huff and puff its way in even if I built my mind out of bricks. But that’s ok, I will just keep steeping myself in denial so I don’t disappoint my shrink because at this juncture, I can’t take another one of her jaunts down borderline lane. Borderline isn’t cyclical or seasonal and for her to even confuse a few traits against a bloody bucket full of bipolar symptoms makes me so mad, I fear I just might be truthful and of course, disagreeing with a shrink just seals them thinking you’re an unreasonable nutbar.

My life has started to spiral slowly downward. My mind is giving me cycling mood/mixed episode whiplash.
And I’m worried my illness will offend my doctor.
All the while wondering if this lice thing is ever going to be eradicated and where I am gonna get all the money I gotta have…

Throw in the change in weather and…

I am braindead woman walking.


I Loved It! ~ Patients Rights Advocacy

Loved shadowing an MHA Hearing Advocate earlier today. Look forward to learning more. Great opportunity for me to make use of my experience having been psychiatrically hospitalized for bipolar disorder (albeit voluntarily), while dusting off old knowledge and skills from my education and the careers of my early adulthood. After all, I have a BA in Legal Studies and experience as a legal assistant, an MA in Psychology and counseling skills gained as a Marriage and Family Therapist, and advocacy skills. Those careers date back to my twenties. I’m 51 now. In between, I spent a decade working in commercial real estate.

Californians with mental illnesses who are receiving treatment in mental health facilities, including those persons subject to involuntary commitment, are guaranteed numerous rights under State and federal laws, including the right to be free from abuse and neglect, the right to privacy, dignity, and humane care, and the right to basic procedural protections in the commitment process.

~ http://www.dsh.ca.gov/Publications/Patients_Rights/


Filed under: Hearing Advocate, Mental Health, Mental Health Advocacy, MHA Tagged: #MIAW, Involuntary Hospitalizaton, Patients Rights

Not Hating Myself

I often filled with self loathing. You’re fat, you’re ugly, you’re stupid. I could go on.

Right now I don’t hate myself I realize I have some talent. I can cook. I can paint some and am learning more. I’m not ugly though I really hate this missing tooth. It makes me feel like a backwoods yokel. It will be replaced though.

I am not beating myself up. It’s really surprising when I am feeling down. I’ve even managed to be intimate with my husband. That rarely happens due to the self-hatred.

I would say the Latuda and therapy are definitely making my life better. The depression isn’t as hard. (so far) I’m starting to think more positively and even though some crappy things have been happening, I’m dealing with it.

I’m still writing my blog every day and I’m still getting out of the house.

So once again fuck you depression. You are not gonna beat me down this time.

Oh and Misha Collins wanna help me set up a charity for mental health research. You do a lot of good work ;) like you would read this, hahahaha.

I am thinking about setting up a charity for bipolar research not sure where to start, but this is a goal I plan to have.


So….who are you?

One of the major side effects of ECT is short term memory loss. And, boy, did it affect me.

I underwent ECT thrice weekly for ten sessions in the locked ward. Which, incidentally, reminds me. Recently I was considering my time in hospital and found it remarkable that when you are first involuntarily frog marched to a locked ward it is a major crush to the soul. You’re all “let me out of here! I’m being held against my will!” you pound your fists on the air lock doors and almost inevitably get told that you are going to be given something to “calm down”, which actually sounds quite pleasant until you are stabbed with a hypodermic needle. Then a few weeks later, after you have settled in, you’re all “welcome to my crib. Bitch.” Institutionalization at its finest. Clearly a topic for another time.

Anyway, back to my terrible memory.

While I was in treatment people often tried to make me feel better about my increasing forgetfulness by relating comical instances of their own forgetfulness or stating that they have a terrible memory too. While I appreciated their kindness, they really didn’t understand the extent of my memory problems.

I forgot where I was, why I was there. Which room was mine. What foods I wasn’t supposed to eat (a major problem as the nurses wouldn’t always be informed of my diet, and I would cheerfully tuck into the cheese toasty they brought me after treatment…) how old my son was, the fact that my grandmother had died, major family events, what my PhD was on.

Even worse, I started to forget the names of objects, words for things and feelings. On my homecoming found that I sent my doctoral supervisor, like ten million emails, all basically saying the same thing. I had to restart the book I was reading every few days as I would forget. Perhaps, most weirdly of all, I started to like foods that I used to dislike. Like honey (or bee vomit, as I used to call it.) Thats right. I had forgotten my food preferences.

I knew things were bad, but i don’t think i realized how bad until one day (over a month after the completion of my ECT) when there was a knock on the door. My registrar (who, incidentally was the splitting image of Gok from “How to look good Naked”. A resemblance so uncanny I had to wonder what the hell was going on when I first met him.) and a middle aged woman. They said hello and sat down and then there was this awkward silence, while I waited for the woman to introduce herself.

20141013-155355.jpg

Eventually I cleared my throat, and since she looked too professional to be a student, said “So…are you a doctor?”

She and Gok looked vaguely surprised and then she asked if I remembered her.

It turned out that she had been my treating psychiatrist for some time. I had absolutely no recollection of her. Of course then I had to complete a number of ridiculous memory tests which I miserably failed, because, sheesh, who does know who the current prime minister is?!

I was then informed that, while most people’s memory improves fairly rapidly after ECT, I most likely had a rare side effect of severe memory loss due to taking Lithium during ECT…WHICH YOU ARE TOTALLY NOT SUPPOSED TO DO. Thank you, State Psychiatric Facility.

Luckily for me, with some rehabilitation (aka crossword puzzles and my Book of Things to Remember) my memory eventually returned to normal. There are still a few things that I don’t remember about my hospitalization….

But I think some things are best forgotten.