Daily Archives: March 26, 2015

A Bipolar Care Plan That Works


By Lois Caniglia RN      https://www.facebook.com/pages/Mental-Illness-Living-Lets-Talk/349925245188610 or Twitter @blackboxRN /Inside Black Box RN

It’s been my experience as a nurse and the research I’ve conducted on my disorder that I understand there is no cure for bipolar. Getting a full psychological workup has been an imperative start to towards achieving recovery. After following up with the same psychiatrist all these years, I am adamant about maintaining my continuity of care. I’m not going to expand upon this as I have written about this subject titled, “Why is My Insurance Company Deciding on My Treatment Plan”.

My psychiatrist and therapist have set up a helpful tool box that effectively manages my symptoms. However, I know that I am accountable to provide my doc with symptoms I may still be struggling with or new symptoms that I’v developed. My doctor is only as good as the information I provide him. Not holding back and being honest has been beneficial to my recovery.

Taking my medications as prescribed is another critical aspect in my care plan. I found purchasing a 7 week pill box that is kept in the same place, and an alarm to alert me at the time my medications are due. This is the best intervention for me to stay compliant with my medication regimen. My daughter, who stuffers with mental illness as well, isn’t very good at following up when taking her medications. Her fiancé helps her with reminders of when she should take her next pill. And this works for her quite well. I have set up an auto refill system through my pharmacy’s phone app. Even when there are no refills left for a medication, the pharmacy will automatically contact my psychiatrist for a renewal. Still, I feel more comfortable calling my psychiatrist when a renewal for a medication is due.

It’s in my nature to maintain a daily routine. I find that being determined to stay healthy helps me to plan a routine schedule that keeps me on track. Setting a daily time for meditation, a little yoga, and walking my dogs helps keep me active. Doing activities I enjoy makes my compliance easier to handle. Believe me, this regimen is much easier on paper than in reality. Keeping busy with follow up appointments, errands, and daily responsibilities of keeping house makes all those little pleasures even more challenging. Still, this is a goal worth attempting to achieve everyday. I don’t beat myself up for not staying on task when other events are more pressing than these. Like the ol’ saying said by character, Scarlett O’Hara, “After all, tomorrow is another day.” 

During every followup appointment, my doctor will ask about my sleep schedule. From someone whose been a pro at running on empty- sustained only on 4-5 hours or even less sleep-I know the repercussions of a bipolar and her lack of proper sleep. I acknowledge the experts recommendations that a proper sleep should be 8-10 hours/night. This requirement went right out the window as a nurse. Conversely, a retired RN, has the time to evaluate the quality of sleep and the effectiveness of the prescribed medication provided for sleep. Keeping a sleep schedule helps me monitor my cycles and helps me evaluate if my pill is effectively working. 

Lastly, only I can be the most effective interdisciplinary member with my care plan. I must have said those very same words when education my patients own plan for recovery with every discharge instruction I conveyed. This is no less true with recovering from mental illness. Keeping a care plan provides me a direction and maintaining my continuity of care. By being diligent I am able to outline my observations, take action with what’s needed for implementation, and what information I need to convey to my doctor or therapist. These steps are the skills I have developed to become a more effective caregiver for myself.


Panic Ninjas

I got jumped by a stealthy squad of panic ninjas today.
What was the trigger?
I had lunch with R and that was it.
By the time I went to get my kid, I was in full on hyperventilation pounding heart meltdown mode.
It passed, but it was particularly nasty panic attack.

My mood today has been…subdued. It started fairly level but then came the midday crash into the abyss. I’ve been forcing myself to take every breath and step today. I have no motivation. I am quite honestly, exhausted. I want nothing more than to curl up in bed and sleep.
And I think I can identify the trigger for that. I’ve been doing the semi social thing, going to R’s to watch Arrow and The Flash, or he pops by to spout off on his latest conspiracy theory. Two nights in a row. I’m burned out. If I burn out just staying in watching TV, it’s a damned good thing I don’t have a more exciting life. My head might implode.

My gut has been in painful twisting pretzels today. No idea what that’s about other than the underlying thrum of anxiety I can’t explain.

My nerves feel twitchy and I have the tin foil in the ears feeling going on. Every sound, kid, cat, neighbor,passing traffic…It all feels like it’s being amplified through stack amps for a freaking stadium show. I know this is my mind perceiving the normal noise of life as something much larger than it is, but the affect remains the same.
It’s freaking me out.

Tomorrow is the last day of school for my kid for the next nine days. Spring break. Yay. It wouldn’t be so bad if she didn’t have the attention span of a gnat and need constant entertainment. But she is so easily bored and distracted and spends only a couple of minutes on any activity….It’s going to be a bumpy nine day ride. Get me prepared for the coming three months of summer insanity.

I just feel…off.
I can’t really put my finger on what is causing it other than circuit overload.
And it sounds nuts, who gets stressed out over relaxing with a friend and watching TV?

Tomorrow I am just going to breathe, focus on housework, errands, get it done before she gets home…
Or my mood could be absolute shit and I’ll curl up into a fetal ball in bed.
I never know, my brain doesn’t give me advanced warnings of its shenanigans.

Just give me warm blankets, tv background noise, and let me sleep it off. Whatever this is. For others it’s called life.
For me it feels more like a daily ride on a hamster wheel only the hamster’s on meth and the wheel is demonically possessed.
Chaos be thy name.

Stupid ninja bipolar.

Crosstown Traffic

Have you ever been in a traffic jam that suddenly cleared up for no reason at all? You look around...

The post Crosstown Traffic appeared first on Pretending to be What We Are.

the good, the bad & the freaky linkdump

Thank you for choosing to fly BipolAir; today we will be swallowing the red pill and the blue pill and tailspinning into the proverbial rabbit hole affectionately known as “the internet”. Your pilot today is Salvador Dali and we can’t offer any further info, because he seems to have melted the instrument panel.

Here is an actual photo of an actual plane here in SA. Kulula: the funniest airline in the world.


Let’s pretend that’s what we’re in now.

Without further tenuous connections and clumsy attempts at comedy … THE LINKDUMP!

Sciencey & Socio things:

This fascinating link via bipolar1blog is a great read. It deals largely with psychosis. How come animals don’t get schizophrenia?

” …youth with bipolar disorder were more likely to show limbic hyperactivity and cortical hypoactivity during emotional face processing than youth with unipolar depression.” source

Bipolar Attraction“When you look at people in institutions, you’ll see the people with similar diagnosis sitting together, without even knowing each other’s diagnosis.”


Artish things:

“That woman. That woman. Her broken mind has changed her permanently. Manic depression. Bipolar disorder. Schizophrenia. These are words I will learn later to understand what is “wrong” with her.”

Film review: Infinitely Polar Bear ☆☆☆
“A manic-depressive mess of a father tries to win back his wife by attempting to take full responsibility of their two young, spirited daughters, who don’t make the overwhelming task any easier.”
(Sydney Morning Herald).

A documentary I’d like to see is Walking Man, father-son filmmaking duo of Mark and Eric Norwine (both bipolar), who walked a total of 200 miles across Missouri to get people talking about mental health.

A poem called Manic Depression.

Helpy things:

MoodDiary BETA is yet another mood tracker. You input what you want to track and how often you’d like to be nagged about it; it generates a colour coded calendar of moods and customisable graphs. I was using eMood bipolar tracker, but am now trying this because reasons of extreme, severe and incurable laziness and…ooh look – a butterfly!

ZOMGWTF things:

The Nightmare of Prison for Individuals with Mental Illness – this is certainly not a new issue and not a new discussion, but it still matters enormously.

Dafuq … this one speaks for itself …
Bipolar Chick “Have a taste of pure destructive power by playing that free game on your android phone or tablet! Help the mad Bipolar Chick to go as far as possible without dying.”


On the upside, the stupid fecking game had only been downloaded 50 times when I looked.

This goes against the grain, but it was too surreal (pls note that I am absolutely not using the word funny) not to share. I loathe the Daily Mail and I do not like listing tragedies, but but BUT …
‘Bipolar’ man randomly attacked woman with a medieval mace as she was walking her dog in California – my initial reaction is why is ‘bipolar’ in quote marks, followed by what do less demented and scuzzy news sources say about it? Most sources don’t mention bipolar at all. Man Who Allegedly Beat Woman With Mace Posed With Similar Weapon On Facebook (CBS Sacramento). Of course, the bipolar link still needed investigation, and here it is. KCRA said, Neighbors said he is bipolar, sometimes stops taking his medication and recently lost his mother to pneumonia. Perhaps the quote marks denote hearsay. The other thing that interested me was the fact that he might be charged with mayhem. I didn’t know it was a legal/criminal term. I’m quite surprised nobody uttered “LARP” at this photo (from his fb).


Please will someone with better Google Fu than mine find out what “It’s Your Standard Bipolar Debate Dripping with Pessimism.” means? When I saw mention of the word Tesla, I (naturally!) thought of Nikola Tesla, which made me think electricity, which made me think aha, because bipolar is a legit term in terms of electric things. But nope, they sell cars.

Bipolar things that aren’t bipolar things:



– no links on those due to my laziness.

Things that don’t fit with the other things:

50 or 60 Belgian patients euthanased annually for psychiatric reasons
Manic-depressive patients, in their manic moments, are capable of doing the most improbable things: plundering their bank accounts, staying for weeks in five-star hotels, buying several cars in a single day. At that stage they are not mentally competent, obviously. But in moments of depression, exhausted … they are certainly competent. Then they can say, for example: “I have lived through crazy highs and lows for 30 years; I’ve tried everything to break that infernal cycle, including psychiatric hospitals, but now I’m back on the baseline, and I know I have a few weeks left before I’m sinking into the depths or rising to heights.”

Despite it’s title, We’ve gone too far with trigger warnings is a very good read and makes some very good points.


As an abuse survivor with C-PTSD, the only trigger warnings I need are related to that – and I still might read on, depending on the writer and context. But I want the warning; it can be incredibly distressing to be surprised by a graphic description of … you know how it goes. On my own blog, I tend to use tw for abuse and suicide mostly – and sometimes I use them to take the piss out of myself too. *insert smiley here*



REINSTATE CHILD AND ADOLESCENT MENTAL HEALTH SERVICES IN KINGSTON UPON HULL If your in the UK park of our world, please look at this and sign the petition! Lets help! https://you.38degrees.org.uk/petitions/reinstate-24-7-care-for-camhs-in-kigston-upon-hull

Touching Me, Touching You—at Work

http://www.wsj.com/articles/SB10001424052970203937504574252261140036116 Loved this article about co-workers and is it okay to be a “toucher” I’ll admit…I’m a toucher. I’ve never gotten anyone to give me bad looks or say not to, ever.Where I work high fives are common and okay! I would hate to be at a stiff place, where no one is comforting. I […]

Everybody’s Talkin’ (Except Me Because I Have Nothing To Say Right This Sec)

I am astonished by how astonished I am that I have so many covers of Harry Nilsson’s classic novelty jam, “Coconut” in my library. Right now I’m listening to one by Fred Schneider from the B-52s and it sounds EXACTLY how you think it would.

I wrote like 11 drafts of this post and deleted all but this one because the only thing I needed to say is that I have therapy today and I have nothing to talk about which is really disconcerting because my doctor will let a pause get pregnant and pregnant-er until I spill my guts about anything in the hopes it’ll circle back around to something worth talking about. It’s a really good strategy.

Everything is fine. I think I’m gonna waste the session talking about Harry Nilsson.

Harry Nilsson is one of only 3 blonde dudes I’ve ever wanted to bang. I mean, not now, obviously, ’cause he died in the 90’s, so that’d be hard to swing. But before he had 8 kids? I’d hop on that train, no hesitation.

Harry Nilsson is sometimes referred to as the 5th Beatle, which is kind of unfair because Harry Nilsson is better than the Beatles. John Lennon produced on of his later albums and it’s SO DEPRESSINGLY BAD. John Lennon ruins everything.

I wonder what Harry Nilsson thought about Soundgarden.

If I got to watch Harry Nilsson fistfight Paul Simon, there’s no way any possible outcome would leave me dissatisfied.

Nilsson Sings Newman should be rocketed into space as humanity’s ambassador to all aliens.

I don’t do hard drugs anymore, but I would to ALL the drugs with Harry Nilsson if he called me up and was like, “Laura, I have all the drugs. Let’s do all the drugs together.” Yes, Harry. Let’s.

And then my 50 minutes would be up. I mean, I guess I have some insurance stuff to discuss with my doc, but I’m not insured by Harry Nilsson, so I feel like it’d be really hard to keep me on track.

Sorry about the throwaway post (except I’m not really that sorry, but I feel like I should be). Umm…I guess I should go to therapy. Dig this in my absence:


Tagged: doctor, drugs, Harry Nilsson, music, psychotherapy, Randy Newman

Movie: Mania Days

Coming soon: Katie Holmes and Luke Kirby will play Carla and Marco, a pair of New Yorkers suffering from bipolar disorder, in Paul Dalio's "Mania Days", a new movie screening at this year's South by Southwest Film Festival.

Under The Influence Of Mental Illness

Once again came The Talk. You know the one where someone you know picks up on your mania/anxiety/depression et al. And have the gall to ask, “What’s so bad about life? Why are acting this way? Smile!”
“You’re bouncing off the walls, dial it back a bit.”
“Why are you so nervous? Get over it.”

At the risk of sounding redundant…Mental illness is very much like being drunk or drugged only without your consent.
In a way, you are under the influence. Your misfiring brain sends wrong messages, you interpret these messages, all the while knowing it’s all a distortion. But you can no more talk yourself out of mental illness than one can sober up from a bender by simply saying, “I’m not inebriated.”

I am disgusted by a society that thinks mental illness is somehow a character weakness. Frankly if you look at the influx of anti depressants over the last 20 years and the money made by them…I’d say the mentally ill, serious or situational, are less a minority and becoming more common. So the answer is to disdainfully dismiss millions of people who struggle with an illness of the mind as lazy, weak, histrionic, et al.
It’s like throwing the baby out with the bath water.
Sure, we have problems. NONE of which has to do with being weak, lazy, dramatic, attention seeking, or irrelevant.
And I know I rail against people who don’t get mental illness way too often. But even with my own friends and family, they treat me like some kind of lazy person who simply can’t be bothered to “help herself.”
So it’s not just a large portion of society dismissing the mentally ill. This is personal, this is my life. This is my “support” system. (Trying not to snort derisively.)

There are times, especially during the freak out panxiety attacks, when I would give anything to be able to talk myself out of that space. It’s grueling to believe something even though in the back of your mind you know it’s being distorted. But we can only go with the information we are given and act accordingly. So maybe I am jumpy, paranoid, breathing heavily and look like Jason Vorhees is hot on my heels with a machete.
It’s how I FEEL at the time. The terror is real. Something inside my brain has thrown the panic switch and lights are flashing, sirens are blaring, and fight or flight response is on overdrive.

The black depressions, where there is no joy and every movement feels like climbing a hill and no matter how much you search the recesses of your mind and soul…You can’t find a single speck of light that makes you want to hold on.
To say this is done by choice is ludicrous.
We can do all the therapy exercise, the physical activity, distractions. But it does not change whatever wires are crossed in our minds.
Depression is nature’s roofie. You just kind of go away and by the time it wears off, you’re dazed and confused and there are holes in your memory and disbelief that you actually said or did certain things.

I think the best analogy I have for mental illness and its influence…I used to take 300mg of Seroquel for sleep. And like clockwork, within twenty minutes, it would put me out even if I didn’t want to go out. I was on it two years and the doctor kept saying, you’ll adapt, it won’t hit you so hard once you get used to it. Rubbish. Being on that stuff (and frankly even 25mg ones were just as bad) made me so leaden I couldn’t even coordinate myself enough to get up and go to the bathroom. Or wake to an alarm. Or think coherently the first few hours upon waking. It was not for like of desire or trying. It was being under the influence in pill perfectly legal form.
And while I recognize Seroquel has worked wonders for many and that is awesome…I’ve come to liken mental illness as constantly being under the influence of that zombifying stuff. Difference is, I didn’t choose to swallow this bitter pill.
Nature just slips me roofies everyday.

And Then Life Happens


I understand her genetic illness struggle this writer is suffering. Their is nothing more devastating than to learn that such a traumatic chronic illness has been passed on to your offspring. I can relate to this woman’s heartbreak.

Originally posted on The Bipolar Homestead:

I haven’t posted in a while because I have been in a bit of a funk.  I have been taking my ten year old daughter to see a therapist who recommended some further testing.  She has been diagnosed as bipolar and it breaks my heart.  I don’t want to see her go through all the horrible things I went through.  Such painful emotional extremes piled on top of the difficulties of being a teen.  She seems too young, too delicate.  This is my baby, how could something so horrible be happening inside of her?  How am I, as dysfunctional as I am, going to get her through this?  How do I teach her to deal with these things when I am so recently diagnosed myself?

Things to be thankful for.  Ummmm.   Well, we got an early diagnosis so she won’t be going through this in the dark.  I have a…

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