Daily Archives: November 25, 2014

So, the Gabapentin isn’t working that well

I’m on 300mg (I know, low dose, but my pdoc is being conservative because I’ve had reactions to anticonvulsant mood stabilizers in the past, like Stevens Johnson Syndrome with Lamictal) of Gabapentin and it isn’t doing anything. I think its making me worse.

I wake up feeling like shit. I don’t want to get out of bed or do anything. But I force myself to get out, take my meds, and most often go back to bed. Then I give it a bit of time and get out for real. Well, it’s been cold and the barns been closed, so no riding, so I’ve been in bed with my laptop watching Grey’s Anatomy and knitting.

I’ve knit a LOT. I’m making hats for Community Cares, a local food bank and thrift shop. I’m on my 5th. I’m making 3 in 3 different sizes. Child, small adult/older child and adult.

Today my roommate texted me from the barn (she runs the farm I ride at and will hopefully own it eventually) and said she was having a meltdown. She had a panic attack. It takes me 20 min to get there, but there’s no snow, and I got caught in construction, but not that bad. I got there and found her.

She said she has a doctor’s appointment December 10th to get back on meds. I’m glad she has the appointment. I have one the same day, with my pdoc. I talked to her while she mucked stalls (I’m not allowed, by her or my doctor, to muck stalls because of my shoulder) and she gave me a hug and started crying, asking what she’d do without me. I felt appreciated, but was sad she was crying. She’s usually so positive, but everyone breaks down once in a while. We’ve fought, not talked, etc, in the past, but always got over it.

She’s a wonderful person to have in my life. She’s a horse woman through and through and has dedicated her life to it, which I admire. There isn’t a lot of money in the horse industry unless you’re running an “A Circuit” barn with 100 students and 20 lesson horses, and everyone goes to shows. She gives to people. I take the extremely low lease price of Sully off her rent every month, and she gives me lessons (normally $30) for free when I want them. At shows, she doesn’t charge for schooling or anything. I just have to pay my own fees for classes. Most instructors charge $60-150 for schooling at shows. (Schooling = warming up before your class)

She gave me Sully. He’s her horse, and she does use him in lessons, but he’s mostly mine. I have a half lease with them. After the lease with Ayla broke up, she offered me this wonderful horse when I didn’t know what I was going to do. Sully is the best. I got my confidence back on him. She does things for everyone at the barn, organizes Girls Nights Out, birthday parties for the younger kids, birthday dinners for the older people, she takes the best care of the horses as she possibly can and does it out of love.

She supports me and I support her. She’s frank and honest, won’t hide anything. She is in a lot of pain all the time from past injuries, but works 12 hour days. She’s amazing. It’s like nothing can stop her.

We went and got hotdogs and coffee (well, tea for her, a Crispy Crunch latte for me) and talked in my car.. She offered gas money, but I refused. We went back to the barn. We talked some more, horse talk, and she said if I wanted I could go. I gave her another big hug (I’m known as the barn hugger, and I have “Free Hugs” tattooed on my knuckles in light brown) and let her know I’m there for her.

My asshole neighbours kept us up all night smoking pot and partying. I called my landlord again, who talked to them (and well, guess what they’re doing right now! Smoking pot!) and they complained that our boots are making the carpet outside the apartments dirty and I always leave the back door open… and they don’t?

I started a workbook, kinda CBT, to keep track of my moods and symptoms. I find I forget about phone apps and computer stuff. This is more accurate. I worked on it for a while, and set a bunch of goals for today – some very simple (shower), some harder (leave the house) but I did them all. I’ll bring it to pdoc appointments with me.

I’m improving.

My mom’s birthday was Saturday and she was out of town going nuts Christmas shopping. You should see the 16 outfits she got for Hunter, my nephew, her grandson. 16 outfits! All different sizes, all brand name, and she got them on sale, got really good deals. So adorable. There’s an Adidas track suit in there for 18 months (Hunter is 3 months as of the 21st, but is wearing 6 months to a year, he’s a big baby) and all sorts of adorable little outfits. She also got Dr Seuss stuff, lots of books, even a special edition (my brother and SIL painted the room Dr Seuss themed, it’s amazing).

She also spent $90 at the Lindt store. I know what I’m going to be enjoying after Christmas! She works so hard to make Christmas special for everyone, and it always is. My mom is special. For her birthday, I got her a stuffed moose, some moose stationary that magnets to the fridge, I knit her a big scarf/shawlette with a matching hat, and another hat. She loved it all. I wish I could have done more, but she understands my financial situation and tells me not to get her anything. I made her a card, too. When I have some money I’m going to send a bouqet of cookies to her office.

So things are getting better. That’s a bonus.

Here’s a pic of Sully and I, me riding him bareback (which means no saddle, but I use a bareback pad because he has high withers and that HURTS) goofing off.

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A picture after our ride my roommate took, of us looking out of the arena.

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Goofing off at a walk. I can do that at a trot and canter, too. I get Sully into a canter, and drop the reins and put my arms out. It feels amazing.

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Us Cantering.

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I wish I had this pic in high resolution. The light is just right.

My roommate says I need to ride with a saddle more often. I have thighs of steel from riding bareback so much!

 

 

 

Crazy is seeping back in

Ah, shark week…A lovely time of month where the crazy is on ten the week before, then dies down for a day or two while I curl up fetalized in pain with pain. The Marquis de sade has nothing on a woman’s body when it comes to inflicting pain and misery.
Ya know, bipolar and a once monthly bout of dysphoria, which my doctors, sages they are, call mild. Joy, joy, happy happy.
I’m still in pain but the pain induced lethargy is dissipating slowly. I am coming back to life. And so is the crazy.
Anxiety so rampant I feel like I have bugs crawling on my skin and am itchy with hive spots.
Paranoia I can’t explain. (X hasn’t called in a few days, how did I offend them now? That lady at the gas station gave me a dirty look, what is her problem? What was that noise outside, is someone trying to break in?)

Let us not forget the Fangsgiving family thing, AKA ninth circle of hell Thursday. I called my mom today and mentioned something about not having money for something…And she told me to get a better job. Meanwhile, my brother in law has not had a job in 17 years and she and my sister support his x Box and weed habits.
Yeah, mommy is working up her venom so Thursday should be a bloody blast. The venom is generally aimed at me. Can’t wait. and by that I mean, I’d rather have open heart surgery while conscious.
C’mon, universe, shark week and a family get together in the same week? Whose Cheerios did I piss in???

I have done fuck all for days now aside from taking care of my kid. Pain demotivates. Makes apathy metastasize. The world won’t implode ‘cos my laundry needing to be folded rivals Mt. Vesuvius. And anyone who has a problem with it can bite me. (Hey, she’s my mother, venom is in my bloodstream.)

I am hoping once the sharky horrormones die down, I will be in a decent place mentally.
The anxiety may settle after (IF) I survive the family shindig.

I want desperately to start writing again but my thoughts are so scattered, so cluttered, I would only churn out drivel. Desire and inspiration rarely coincide when it comes to my writing. Forcing it makes it worse. It’s a creative bondage, of sorts. You want to break the chains, get free, let it flow…But the strength isn’t there to overcome the binds.
I love writing but I would have much rather have artistic or musical ability.
Writing is going the way of the dinosaur and vinyl.
People will always want artwork and music.

Oh,well. For all my griping…I’ve had two days to curl under a warm cover with various kitties sleeping on me. That’s one of life’s best treats. Hard to be unhappy when a purring cat is near making biscuits on you.

I still think happiness is a mental disorder.

Contentment…Now that is true sanity. Being at peace with the place you are at any given moment in time.
Or maybe that’s the delusion I feed myself because with cyclothymia, not even the bad moods stick around long. Therefore even if I reached this “happy” place…It’d be gone in a blink.

Content…I can abide because even in madness there is always one small thing to cling to that gives contentment. My kid saying, “I love you, sooo sooo much.” Good song. Good show. Purring kitties. Yummy food…The little things so many take for granted, waiting for the big exciting moments in life.
Placing so little importance on things that are constants in life while striving for a place you might never know…
That seems delusional to me.


Postpartum Management of Bipolar Disorder

International Society Bipolar Disorder

This morning I participated in a webinar sponsored by The International Society for Bipolar Disorders entitled, Postpartum Management of Bipolar Disorder: Challenges and Opportunities, led by Dr. Verinder Sharma. Bipolar disorder is commonly misdiagnosed as major depressive disorder, just as postpartum bipolar disorder is misdiagnosed as postpartum depressive disorder. Misdiagnosis of bipolar disorder has serious consequences. Reproductive events such as the birth of a child can trigger manic, hypomanic and mixed symptoms.

Studies vary as to the effect of pregnancy on bipolar disorder. For some women, pregnancy is associated with an improvement in symptoms. Childbirth and the postpartum period is a potent trigger of episodes of bipolar disorder. Psychiatric hospitalizations exponential rise during the one month postpartum period. Risk factors include being unmarried, perinatal death, and C-section. Both biological and psychosocial factors play a role. Later in life, menopause is associated with increased rapid cycling and more clinical visits for depressive symptoms.

The paradigm shift that is required is assessment by primary care providers throughout the lifecycle, including at the onset of menses (adolescence), pregnancy, post-partum, menopause, and other life stages.

Among women with prior psychiatric diagnoses, those with bipolar disorder are at highest risk in the postpartum period. 75% of cases of postpartum psychosis had onset within three days postpartum. 5% had an onset before delivery. Serious episodes of mania and psychosis commonly occur immediately after delivery. Care providers must identify these symptoms early on and pay attention to early signs and symptoms of an episode.

Different psychiatric diagnoses have greater or lesser risk postpartum. The highest relative risk is in bipolar disorder when compared to major depressive disorder and schizophrenia. Research studies clearly indicate that childbirth is a potent trigger of episodes of bipolar disorder. Schizophrenia is associated with the lowest relative risk for a postpartum onset.

For bipolar disorder type 1, postpartum symptoms of mania, hypomania, and mixed states are quite common. Once again, childbirth is a key and specific trigger for mania. For bipolar disorder type 2, in 20% of pregnancies there were mood episodes, with more depression and no psychosis. Co-morbidities include anxiety and major depressive disorder. Mania and psychosis had an earlier onset postpartum than depression. There is a higher risk of postpartum recurrences for bipolar disorder type 1 than bipolar disorder type 2.

Risk factors for increased postpartum relapse include: prenatal mood symptoms, younger age, unplanned pregnancy, primiparity (psychosis, mania, recurrent depression), history of prior postpartum mood episodes, family history of mood disorders or postpartum psychosis, lack of maintenance medication pre or post delivery, and prior psychiatric hospitalization.

Care providers must screen for symptoms of hypomania and mania because bipolar disorder is commonly misdiagnosed as major depressive disorder in postpartum. Treatment of bipolar disorder with antidepressants can trigger manic symptoms. 54% with of women diagnosed with postpartum depression had bipolar disorder, not major depressive disorder. 46% of women with postpartum bipolar disorder have co-morbid anxiety disorders (64% of which had OCD).

Postpartum hypomania common, with multiple studies showing 10-20% occurrence (Sharma 2009). There is an eight-fold increase in hypomania from pregnancy to postpartum. Childbirth is potent and unique trigger to bipolar disorder. (This point Sharma made repeatedly.) Often women were not diagnosed. There is not adequate awareness among clinicians. Clinicians are not asking the right questions, so they are not picking up symptoms of hypomania such as decreased sleep and racing thoughts.

The BRIDGE study of 2011 & 2012 found younger age of illness onset, high number of prior episodes, seasonality of mood episodes, hypo(mania) in 1st degree relatives, episodes of short duration, postpartum onset, psychotic symptoms, atypical features, and mixed depression. The conversion rate was 6.52% from major depressive disorder to bipolar disorder (11-18 fold higher) – the highest rate of conversion at any time during a woman’s life.

What is called for is screening and detection, universal screening during pregnancy and the postpartum period, at the first onset of depressive symptoms in the postpartum period, at early psychiatric contact (4 weeks postpartum). Treatment during pregnancy must be comprehensive, collaborative, and individualized. Follow-up must be both scheduled and as needed. Psycho-education is key. Clinicians must provide their patients with information about the disorder, the benefits of treatment, treatment options, expected results, the role of sleep deprivation as a trigger, and the effects of smoking, alcohol and drug use on fetal development.

Psychosis must be treated inpatient. Psychosis is a psychiatric emergency. The safety of the mother and her infant are paramount. Hospitalization provides a reduced level of stimulation to the mother.

Dr. Sharma’s conclusions: We can easily identify women at risk. The risk period is short. For bipolar type 1, the first is key. For bipolar type 2, the first two to three weeks.

http://www.isbd.org/education/webinar-series/upcoming-webinar-schedule


Filed under: Bipolar Disorder, Bipolar Parenting, Depression, Mental Health, Mood Cycling Tagged: bipolar disorder, postpartum bipolar disorder

Deep/ression:Recession

As I say I don’t want to kill myself, I just wouldn’t mind dying.”
-Stephen Fry

Depression is a right bastard innit? One day you can think rationally, the next you’re off swirling down the whirling plughole vortex of doom, into the Marianas Trench of Despair (fuck the slough of despond, really) and then priorities shift. Everything becomes very black and white indeed.

Do you want a coffee?
No I want to DIEEEEEEEEEEE!
What do you think of this shirt?
Like it matters … life is fucked. FUCKED!

Speaking of coffee + depression click that, it made me go yesssssss!

It is a very, very antisocial state to be in. And the interminable catch 22 of company that you need, but don’t want … et fucking cetera, baby.

Chocolate tastes like shit.

The mind in bipolar disorder, whether manic or depressed, is never quiet. source

Even when you do all the right things, you cannot take one tiny sodding step out of the tench. If all your dreams came true during a serious depression, it wouldn’t change a thing. You would still want to die.

Sometimes I thought about killing myself. The idea of it circled my head, shining and lovely like a tinsel halo. How beautiful it would be if everything could just stop. If I could stop. If I didn’t have to feel like this. Yes, I thought about it and thought about it, but I was too exhausted to do anything about it. That should have been funny, right?
Alexis Hall, Glitterland

I wrote this a day or two ago. Right now I’m either happier or hypomanic. Right now I can’t tell the difference.

A Disordered Mind

I look around and all I see is clutter.  Unlikely pairings: A glass with dried remnants of good red wine atop a crumby plate that also holds a cast-off case from a long disused (broken) cell phone.  Plastic sacks of clean laundry, some of them from last winter, not yet put away.

Useful, that: the weather is already wintry here, so no need to hunt for the winter clothes.  They’re already in reach.

A microwaveable hot pack draped over a still-unopened bedbug-proof pillow case.  I am phobic about bedbugs, but I have yet to put the protective casings on my bedding, even though I travel frequently to places where there might be bugs.  I’ve had the casings for three years and counting.

It oppresses me.  Why do I let things get this way?  Every time I move into a new place, which is often, I vow that I will turn over a new leaf and keep it clean and tidy.

But I never stay long.  My disordered mind gets to feeling restless, or else some duty calls me away, and I start over…again.

After packing up to leave for new digs, I marvel at the expanse, however small, of clean, dust-free floor and counters.  Why could I not just maintain this mind-soothing order?   Such a balm to the senses, to be able to look around and distinguish individual objects rather than piles, piles, piles of things thrown down, left, tossed away, to be taken care of later, a “later” that never arrives.

I think I was born this way.  My child-room was the same way.  I guarded it fiercely from that hated intruder, my mother.  If she got into my room she threw out my treasures indiscriminately.  I might come home from school to find my room spotless, sterile, bereft of projects in progress that I might have abandoned months ago, but still….I might have finished them, someday, but now they are gone and the potential in my mind’s eye is also gone.

And she dumped out my socks drawer, along with the family of field mice that had taken up residence there.  My pets.

There was never a time when I did not hate my mother.

Perhaps it has to do with the constant acid rain of her curses, name-calling, denigration falling on my infant head.  Maybe the piles of junk started out as a bulwark against her obsession with neatness.  Up your ass with a piece of glass, “Mom.”

I survey the utter chaos in my dwelling of today, every single surface piled with stuff that either needs to be put in some logical orderly place or simply thrown out.  I am not a hoarder.  I just feel paralyzed, looking at all the stuff, and it seems to be looking back at me imploring me to do something about it.  Or at least just to take out the trash…start there.

Sometimes I get the urge to just go out and lock the door and buy a tent.  You can’t stuff much in a tent, can you?

Then there is the mail.  I am paralyzed by the sheer bulk of what appears in both my physical and my email boxes.

I have three or four email accounts that I never even look at.  There is probably something of import, certainly, positively, and possibly some three or four items that might even have some significant impact on my life (license renewal notices, things like that).  But I cannot face the task of cleaning out 999,000+ messages from my Yahoo account.

Then there is my mind.  I have packed a lot of stuff into this finite space, within this bone box.  Yes, of course I have heard the rhetoric about how we only use “x” tiny percentage of our available brain space….and I think that’s bullshit.  The rest of our brain is hard at work backstage, doing stuff that keeps the rest of us running, more or less.  Mine seems to be less, or maybe (more likely) too much.

Sometimes I think that if I could just break out of this 60+ year habit of surrounding myself with chaos, that my mind would work better, that my brain would feel more organized and content.

In fact, I am sure of it.

On the other hand, I think my abnormal unusual mind might have built a fortress around itself, beginning as a very young person, with piles of junk, to protect itself from my mother’s compulsive cleaning and straightening of everything in her environment.

Not to say that my disorderly mind was caused by my mother’s OCD.  No, I believe I was born with this mind, and to tell you the truth, when I am not suffering from the pain it causes me, I enjoy the lightness that allows my brain to fly to places where a more tethered mind could never go.  It is an artist’s brain, and I like it, when it lets go of tormenting me.

I used to make some astonishing art.  I recently saw a set of slides of my art from the ’70’s that must have been a portfolio for getting into one of the three art schools I attended.  I was bowled over by the beauty and quality of my own work.

What happened to that?  Where did it go?  I can pick up a pen or some colored pencils, even now, and make a piece of art that would look good on any gallery wall.  Yet I don’t have the urge, the drive, to do it.  It’s lying in the pile of unused talents and vocations, over there in the middle of the floor, where I have to walk around it to avoid tripping.

My music has gone to hell because of the inflammation in my hands.  I can still sing, but I am afraid to, because I might lose that too, and so I actually do lose it because I don’t use it.  Or to tell you the truth, I forget to sing.  How strange.

I forget to listen to music, except for Pandora, because I just, I just….forget.  So except when I am finally doing the dishes and really need something to distract my mind so I can keep on task (oh God….how strange….), my environment is silent except for the background noises, the furnace, the honk and wail of the railroad trains (how I hate these shrieking interruptions in my silence), the mumbling roar of the river after a big rain.

My shrink is sure I have ADD.  He pushes stimulants.  I try them.  They make me feel creepy, and they don’t help.

I know I don’t have ADD.  I have something far deeper.  I have a Disorganized, Dis-Ordered Mind.  I don’t think there’s a cure for that.

Don’t.

Don’t tell me about DBT, CBT, LMNOP.  I’ve done those.  They are interesting, and they help me to understand that Joe Shmoe might just be having a bad day that I was not the cause of.

But they don’t fix my disordered, disorderly brain.

 


All I Want For Christmas Is…….

  The thing I want for X-mas is damn near impossible or so it seems, and that is for everyone in this world that is currently fighting some misguided ideological and monetary war to just stop long enough for people to talk and find commonalities rather than differences, to learn about the other side’s reasoning/ideology, […]

Heading towards the Temple of Gloom!

I’m having a bit of trouble with the slump in the middle: the area between high and low that ordinary people would call ‘normal’. As a bipolar survivor (and I view every day I ‘survive’ a minor miracle of its … Continue reading

Apollo Beach? Or Just Sit Like A Slug?

It’s rainy today, and I’m tempted to just stay in and binge on Netflix. But, there’s also this place I heard of, Apollo Beach, where the manatees just chill. I’ve never seen a manatee in real life so I’m very tempted to hop in the car and drive over there with my camera. The thing is, it’s over an hour’s drive. And driving in Florida SUCKS!! The stoplights take forever and drivers are rude, rude, RUDE!! Not sure if I can rouse myself, I’m going to think about it for a little bit. In the meantime, I’m going to say Hi to my friend Orange Is The New Black. Hopefully I’ll get bored and the boredom will propel me to ACTION! Have a happy day, people.


Filed under: Bipolar, Bipolar and Stuck, Bipolar Disorder, Psychology Shmyshmology Tagged: Apollo Beach, Bipolar, Hope, Mental Illness, Psychology, Reader

Stigmama

Stigmama is a wonderful resource, created by the lovely Dr. Karraa Walker, PhD,  where women and mothers can share their stories and experiences with mental illness. The sharing of our truths can serve as a creative outlet, comfort, and a tool in which we can start to shift the status quo of stigma and discrimination.

I am thrilled and pretty honoured to say that I am now one of the writers for Stigmama and my first contribution was published today. Come and see out my piece; titled Enough! While you are there (if you haven’t already) take the time to check out Stigmama and the wonderfully talented writers and contributers that are featured.

stigmama


Annoyed, Pissed, So Fucking Angry

I haven’t been in the best of moods lately as you know. Today I thought for a moment it might have actually lifted. I managed to keep busy and not dwell on sitting alone by myself for yet another day. I wasn’t ready to kill someone either.

Needless to say my mood fooled me again. About 20 minutes before my husband came home I get recklessly angry. You know where you could easily hurt someone if you didn’t concentrate completely on keeping control of your anger. This is my mania coming through. It’s a step down from depression to be perfectly honest. At least with depression I am only dangerous to me.

My stomach hurts from keeping poison words in and not letting myself hurt the people I love with the words that can escape my lips.

I would kill for a punching bag right now. Definitely an investment to make once we get into the house for now I will just develop an ulcer while I just hope no one says anything to incredibly foolish to me.