Bipolar Disorder

For many of us, prescription drugs are a fact of life and with the day to day medication routine it is easy to get a little blasé forgetting that these little pills do have the potential to cause big problems. Thus, medication safety is an important topic. Here are ten tips for medication safety, from avoiding pharmacy errors to checking for possible drug interactions.

Photo by Adam Ciesielski.

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The popular martial arts actor Jean-Claude Van Damme says he believes he was manic-depressive in his teenage years. Fame came with the movie Bloodsport when he was 28, but just a few years later he was using cocaine and his life went on a downward spiral.

But when he became suicidal, he chose life. Read about this turning point and Van Damme's attitude toward his illness: Jean-Claude Van Damme and Bipolar Disorder.

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I said that to my son about half an hour ago. I knew it was time to go downstairs, get a glass of milk, then come back up, set my pills for the night out, and take them. Every night a computer alarm pops up at 11 pm saying "Take meds," and I'd already snoozed that alarm 3 times, which is fairly common for me. Sometimes I snooze it for an hour or more. But I always take them, sooner or later.

I went and got the milk. I pulled out the container holding my night medications and set them out. Twelve pills to take. Four very small, three small, three medium, two very large. It takes the entire glass of milk to get them down.

In the 3-part article 5 Bad Reasons Not to Take Medications, I discussed five very common reason why people with bipolar or other disorders refuse to take or stop taking their meds. "I'm just sick of taking pills" isn't there, though. Take a look that the reasons I listed. Can you think of others? Do you have anything to add?

As for me, I know that whether I'm sick of the pills or not, I need them. I'll keep taking them.

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My doctor prescribed an oral antifungal drug, Clotrimazole Troche, for me after diagnosing me with thrush. I'm a little concerned about this, because there can be some moderate interactions between antifungal drugs and some of the psychiatric medications I take.

Fungal infections include athlete's foot, vaginal yeast infections, and jock itch. These are generally treated with over-the-counter topical applications like creams, sprays and powders. While there is less likelihood of drug interactions with antifungals used externally, it's still important to know what signs to look for while you're using one of them, and especially so if you're taking an oral drug.

I know what I should be looking for so will be monitoring myself carefully during the ten days I'm taking the clotrimazole lozenges.

Read Antifungal Drugs and Psychiatric Medications

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Whether it's something as mild as seeing a koala on your dresser (a hallucination) or as serious as being sure your spouse is trying to kill you (a paranoid delusion), psychosis is always a serious problem. Here is a roundup of information on all aspects of psychosis - definitions, in-depth descriptions, the mental disorders where psychotic symptoms may appear, and a listing of related details, all in one place.

Psychosis - A Comprehensive Resource

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A Boy and a Bear, written by Lori Lite and illustrated by M. Hartigan, is a book that will entertain children while effortlessly teaching them how to calm down using a breathing technique. If your bipolar child needs to learn how to calm himself or herself, this book is for you. Highly recommended!

A Boy and a Bear: The Children's Relaxation Book.

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Guest author Debra got the nickname Queenie from her six younger siblings because they said she was bossy. Maybe having to keep six kids toeing the line is why Queenie went into the Army, but no matter what the reason, this woman with a whole raft of mental disorders ranging from bipolar I to PTSD managed to stay on active duty for 18 years. Her home life, though, was chaotic and dangerous, and having to fight her doctors to get correct diagnoses all along the way made it that much harder.

"Queenie's Quest" is an inspirational story of struggle, determination and triumph in the face of tough obstacles. Can you apply her tenacity to your own obstacle course?

Read Queenie's Quest

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Michael Janflone's book Long Sleeved Summers is a gripping look at the stresses and temptations he faced as a young pharmacist that led him into drug addiction. Here, interviewed by Andy Behrman, author of Electroboy: A Memoir of Mania, Janflone gives insights into his struggles, and along the way he discusses his opinions about the number of prescriptions written in the U.S. as well as his belief that a culture of overmedicating that has grown up here - and why.

The interview may make you look more sympathetically at your local pharmacists - and also make you more careful about checking your prescriptions when they are handed to you.

Read Michael Janflone Interview

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Back in 2010 I posted a blog called Bipolar Disorder, Meds and Blood Sugar. In it I talked about my situation, having gained a total of 80 pounds from various psych meds and developing diabetes as a result. A HIGH percentage of people taking psychiatric drugs gain weight from them, and losing weight gain be more difficult than for the average person because we still need to take those drugs. Many aren't even told about the risk of weight gain - and good luck getting insurance to pay for professional weight-loss counseling unless you are morbidly obese.

The difficulties are substantial, so when that blog got this comment from someone named Richard, it made me want to throw rocks at the writer:

Okay, you got your anti-psychotic meds, and then you began to "feel" better. You went back to your eatin' everything in the fridge, local burger shack, and every snack imaginable in Safeway is now on your coffee table. You have the exercise enthusiasm of a tortoise, and you wonder why you gained weight? Sure, blame the pills instead of taking responsibility for your gluttony and your fear of exercise. Yeah, I'm heartless, because I just don't believe all this bullshit about blaming every pill for every ill.

You may well need the medicines, but you need to get off your fat asses and eat healthy, and do some hard work. Take responsibility for your fatness, you bunch of lard-asses.

GRRRR! Read More...

I've had vivid dreams all my life - long, clear, and so detailed I could write them out as bizarre stories. These are rarely nightmares, but I have those, too, on occasion. My nightmares most commonly revolve around the fear of falling. For example, more than once I've dreamed I was in an elevator with a central pillar, and suddenly the floor turned to rubber and detached from the edges. The only real safety is to hang onto the pillar, but I'm never alone, so several of us are going for that pillar, while others clutch the edges of the heavy rubber sheet as it bends down into the shaft.

Read More...

Adjunctive therapy is, put simply, the addition of one treatment to another for the same condition. The goal may be to increase the effectiveness of the first treatment, to reduce the side effects of the first treatment, or to supplement the first treatment. Adjunctive therapy is very common with medications, but there are other forms as well - for example, chemotherapy after cancer surgery.

For more examples and additional information, see Adjunctive Therapy.

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Suppose you ask me, "What one memory comes to mind when I say 'shopping mall'?" I'm probably going to say, "I hate shopping at malls, because my feet get so tired." That's a wrong answer - it's general rather than being a single memory as was asked for. A specific answer would have been, "I remember when the Younkers store burned at Merle Hay Mall in Des Moines."

A simpler example: for the cue word "joyful," someone who answers, "I was joyful when my son was born," is recalling a single memory, while the person answering, "I'm always joyful at our family reunions," has retrieved the general memories of many occasions.

Research has found that people who have depression tend to call up memories in general more often than specifically. This phenomenon, called "overgeneral memory" or OGM, appears to be interrelated with clinical and bipolar depression, and may even lead to new treatments for depression.

Read about Blurred Memory Function and Depression

Image: Chad Baker / Getty Images

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Carrie Burr has Bipolar I disorder, and her history with the mental illness included two extensive hospitalizations. Yet she and her husband were able to adopt two children from foster care and raise them with love, courage and joy. I can attest to this: Carrie is my cousin.

In this series of articles from 2000, Carrie tells the honest truth about her bipolar disorder, the process of deciding to adopt, and the adoption process itself - including what she needed to do and say regarding her mental illness.

Adoption With Bipolar Disorder

• Part 1: I really want a child, but...
• Part 2: Look before you leap
• Part 3: My story, my children (2 pages)

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Mania and hypomania are the keys to Bipolar I, Bipolar II and Cyclothymia. The first thing people think of for treating mania is the traditional group of mood stabilizers - Lithium and the anticonvulsant drugs such as Depakote (valproate), Lamictal (lamotrigine) and Tegretol (carbamazepine). But there are other medications that can help control mania and hypomania. These include some drugs classed as antipsychotics, calcium channel blockers, and benzodiazepines.

Explore the traditional mood stabilizers along with the drugs that are known for treating other symptoms and conditions, but not well-known as treatments for mania / hypomania:

Medications for Mania and Hypomania

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A store manager who had received performance awards was fired, he says, when he asked for time off to adjust to a new bipolar disorder medication. Last week a US District Court judge ruled that the firing violated the Americans With Disabilities Act and ordered the employer to pay Sean Reilly back wages plus $50,000 for emotional pain and suffering.

The suit was brought by the Equal Employment Opportunity Commission (EEOC) on Reilly's behalf.

Have you ever been fired from a job because you had bipolar disorder? Not because it was affecting your performance, but simply because you have it? Tell your story on one of these pages:

• How has mental illness stigma affected you? or
• How does having bipolar disorder affect you at work?

Read about your rights under the Americans With Disabilities Act (ADA)

Source: Fastenberg, Dan. Employer Can't Fire Workers With Bipolar Disorder, Court Rules. AOL Jobs, 3 April 2012.

My goal at About.com Bipolar Disorder is always to provide the support and knowledge that patients, friends and family need to help manage bipolar illness in the best way possible. There's information on medications and their side effects, recognizing and understanding symptoms, treatment options, and disability in the United States; there are coping tips, illustrative stories, health information and much, much more.

But sometimes it's important to say don't. Don't do things that could hurt you, things that could be dangerous. Don't let certain things happen to you when you can prevent them and make your life easier. Don't do harm to your bipolar friend or loved one.

In 10 Things Not to Do If You, A Family Member or Friend Has Bipolar Disorder, you'll learn things you're doing or things you've let happen that can be making life more difficult or actually doing harm to someone with bipolar.

My "10 Things Not to Do" is part of a group effort by About.com Health Guides to help our readers improve their mental and physical health. You are very likely to be interested in one of the other conditions in the list compiled by Social Anxiety Disorder Guide Arlin Cuncic. After you check out my 10 Things, take a look at Arlin's and those of 30 other health experts: 10 Things to Stop Doing: Stop and Improve Your Health. I guarantee at least one of the topics will make a difference to you.

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I've been lucky - nobody, at least to my face, has ever said, "Everybody has bad days" or "You're sick because you don't pray enough" to me. I did have trouble with a boss who basically told me to get over it, but my family and friends have been very understanding. I only wish my experience was more common!

Sadly, for thousands of people with bipolar disorder, family and friends are less than understanding. If you're reading this because someone you know has been diagnosed with bipolar, or are looking for some way to get the people you know to understand better, these articles are for you. Don't make the difficult life of your friend or loved one even harder. Learn what not to say to someone who has bipolar disorder:

• Don't Challenge My Bipolar Diagnosis
• Don't Tell Me How to Get Over Bipolar Disorder

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"There is no reason to take a pill for a mental disorder," says the website Psychology Debunked. "Mental disorders are NOT medical/physical disorders like cancer and diabetes." And "Every major psychological theory is anti-Christian at its core."

Unfortunately, there are all too many people who actually believe this kind of crap. Fortunately, one of our members is able to debunk IT.

In her compassionate essay, Ileana, who has a degree in Christian Religious Education, makes it clear that Christianity and Psychology Can Go Hand in Hand.

Jason Russell was virtually unknown when he made a 30-minute documentary called Kony 2012 and uploaded it on Vimeo and YouTube. The video, which talks about atrocities committed by African warlord Joseph Kony, highlights a group called Invisible Children that Russell co-founded in 2005, dedicated to raising awareness about Kony's brutal activities.

The video exploded into popularity, generating both heavy praise and sharp criticism, and about two weeks into the furor, Russell was found screaming incoherently and pounding his fists on the pavement in his shorts. According to his family, he has been diagnosed with brief reactive psychosis.

This illness is actually now called Brief Psychotic Disorder, perhaps because it can occur without being in reaction to an event, so the word "reactive" wasn't accurate. In Russell's case, said his wife Danica, the "great mental, emotional and physical shock his body has gone through in these last two weeks" was likely a strong factor.

Here's the lowdown on Brief Psychotic Disorder.

More on Joseph Kony: United States Continues Its Efforts Against Kony

_{Source:
Associated Press. "Wife: Kony 2012 director suffers from psychosis." 28 March 2012.}

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If you have anxiety along with your bipolar disorder, your doctor might prescribe Klonopin, the generic version clonazepam, or another brand of the same drug, Rivotril, to help with the anxiety symptoms.

Anxiety is common in people who have bipolar disorder. Indeed, one study found fully half the bipolar patients participating also had a comorbid anxiety disorder. Thus it isn't unusual for clonazepam to be prescribed to someone who has bipolar.

While the most common side effects like dizziness and sleepiness are usually manageable, there are others, less common or rare, that can be serious. Anyone taking this drug, or who has a family member taking it, should be aware of the possible side effects.

Clonazepam Side Effects (Klonopin, Rivotril).

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Mary Kay Letourneau was 35 when she began an affair with one of her school students, 13 year old Vili Fualaau. The case highlighted Mary Kay's bipolar disorder, child rape laws and sentencing, and emerged over the years as one of the most bizarre "love stories" of the last two decades. Although the furor had mostly died down, the recent airings of the film "All-American Girl" on cable have brought Mary Kay's story to the attention of a new generation.

Here is the true story, from the beginning, of Mary Kay Letourneau's involvement with Vili Fualaau, with links to my commentary on the case and other material. Was her bipolar disorder to blame, or was she?

Mary Kay Letourneau: Criminal, Or Victim of Bipolar Disorder?

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Celebrated actress Vivien Leigh, who won an Oscar for her performance as Scarlett O'Hara in the blockbuster of 1939, Gone With the Wind, was diagnosed with manic depression in the mid-1940s. Eventually, her fairy-tale marriage to actor Laurence Olivier, with whom she is shown, became severely strained, and her mental and physical ill-health also damaged her career as well. For a mini-biography and a look at how bipolar disorder affected her life, read:

Vivien Leigh and Manic Depression

_{Photo: Getty Images}

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A lot of people don't realize that having bipolar disorder can affect physical health, too. It goes farther than the increased energy of mania and hypomania, and the fatigue and body aches of depression. Even before diagnosis, there are health issues for people with bipolar.

This article, the first in a series, looks at a pair of destructive habits common to bipolar people both before and after diagnosis, and discusses the problem of physicians who look at bipolar first and physical health symptoms second.

Don't Give Up On Your Health

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Reader Ashley asked, "Does anyone just completely fake a smile while going through a depressive episode just so no one knows how bad you really are?" It's a great question. I can't say I remember doing this, but I did learn a lesson about smiling long ago - it changes your voice. If I was in a tense mood at the office when the phone rang, I'd force a smile before picking up the receiver and saying, "Word Processing, this is Marcia, how can I help you?" My co-workers knew I was doing this and used to crack up, but it worked. My voice sounded pleasant every time.

In fact, a forced smile can do more than just make your voice pleasant - it actually can help your mood. It's been studied!

What about it? Do you fake a smile as Ashley asked? Does it help? If you're wondering why and how to smile - What's In a Smile? gives you the scientific research and offers some ideas to help you get smiling.

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Lesson 4 of the series Bipolar for Beginners introduced you to the depression side of bipolar disorder. In Lesson 5 we take a closer look at the symptoms that, whether mild, moderate or severe, can affect every aspect of your daily life.

Depression is more than an emotional low. It also can have physical effects, change the way you think and behave, and alter the way you view yourself and others. And for most people with bipolar disorder, depression is more common than mania or hypomania. Whether you have bipolar and are seeking more information, or you need to educate yourself to help and understand someone you know, this lesson is critical to increase your knowledge.

Understand: Lesson 5: Bipolar Depression in Depth

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