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Posts Tagged ‘Bipolar’

Not Dead Yet

The good thing about writing this type of blog is that I get to use my personal experience with mental health issues to shed some light on the reality of what’s in the news or in the lab. The bad thing about writing this type of blog is that sometimes my mental health issues get in the way of writing anything at all.

The Lucky Rebel is still alive, but it had some touchy moments in the past year or two. Sixteen times I sat down to write. Two drafts were discarded, and fourteen were saved to the WordPress app on my Android phone. All fourteen were lost when I switched phones this past April. I had a meltdown over the cell phone carrier’s inability to help me coordinate a simple transaction, and in all the confusion, I forgot to upload all those lovely thoughts and musings before the old phone was deactivated.

The problem is, this past year has been an entire series of little bitty meltdowns. Individually, they were a blip on the radar. Together, they snowballed into a complete lack of desire to get off the couch or write anything at all. That new, seriously comfortable office chair might have been a complete waste of money if I wasn’t sure that eventually I’d bounce back. I always do, and I’m getting more familiar with the ups and downs so I can remember that the downs won’t last forever.

Lately, the upward bounce is taking its sweet time, though, which has me a little worried. It’s ironic – the couch is much less comfortable than the chair. But my laptop is nicer than my desktop computer, so I talked myself into staying on the couch. And with that, my inner compass laid down on the couch with the TV remote in hand and decided to stay there.

Don’t get me wrong – I’m still functioning. I’m still working. I can’t say my heart is in it all the time, but I keep up with the work. I’m working more slowly, but I’m working. (Trust me, I’m not billing by the hour anymore.)

Part of the problem is my medication. My psychiatrist prescribed a small dosage of Seroquel several years ago, and I began to sleep so much better. But when my son died suddenly in an accident, I asked him to increase it, and he did. Oh, that felt like the biggest blessing to me. If there was ever a time I needed something to help me sleep instead of freak out all night, it was then. I’m so glad I was already taking it. But then the doctor took off without a word, and I was given a new psychiatrist, who promptly proceeded to double my dosage – not just increase it, double it. Big mistake. The XR part was a great idea – that way, I only had to worry about taking one pill a day – but the increased dosage was completely counterproductive. I now sleep way too much, and I’m starting to feel lethargic when I’m awake. I have to get her to give me a lower dosage when she gets back from vacation.

Come to think of it, I remember that I started to take the new pills the day before I switched phones – I especially remember that I was too much of a zombie to engage in productive problem-solving, and it ended up costing me the rebate that teased me into trading up to a better phone in the first place. Nobody should be asked to make a major decision in that condition, but the rebate had a deadline, so I had myself convinced that I had to go for it. A rough adjustment to any new psych medication is somewhat normal, but that was a seriously ridiculous two months spent undoing the damage of day one, or day two, or whatever day it was.

If I had to guess, I’d say the other part of the problem was the grief itself. Every time I hear about another child’s death, it all comes back to me – the sadness, the pain, the extreme sense of emptiness, that awful choking feeling…everything. I live near a major urban area, so being down is pretty much a weekly thing. (I gotta quit watching the news.) So you can guess what events like a school shooting do to me.

There is no one reason this happens, and no one way to deal with it. It depends on your perspective.

You can crumple up in sadness, thinking that the world is a horrible place – and in one respect, you’d be right. Death does not discriminate by age, and the younger the person, the more horrible and unfair it seems. But in another respect, you’d be wrong because you’re denying the beauty that the rest of the world offers. It’s not healthy to think in terms of a horrible world for very long.

You can be properly outraged and indignant, resolving to do everything you can to make sure it never happens again – but it always does, because the problem has no single solution and we the people can’t seem to agree on the right way to tackle it. Focus on what you can control, and let go of what you can’t. Easier said than done, I know, but it’s the only rational thing to do when nothing else seems to work.

You can blame it on the decline and fall of man’s ability to love and live God’s way of life, but the love of God by a human being is always imperfect by definition. God is powerful, but He created us so that our bodies can physically expire, and that won’t change with all the prayer we can muster together. All we can do is look forward to the time when we will all have spiritual bodies that will never die.

Or you can feel nothing, because this happens all the time, and there’s nothing you can do about it. And I have no answer for that one, because that statement gets closer to the truth in my mind with each passing year.

It seems impossible to face the death of a child when you have emotional problems, but it’s not. Consider yourself lucky if you feel something – anything at all, because it’s only when you shut off your heart that you shut off your ability to cope. The feelings may come out like a dam breaking, or they may be as lifeless as a brick wall. Either situation can make you feel completely helpless. When it finally hit me four years ago, I felt like I had a three-year-old sitting on my chest. I couldn’t breathe without physical pain for months.

That level of pain has gone down, but the hole in my life is still there and no amount of medication will ever fix that. Making sense of it has come down to realizing that sense has nothing to do with it, and that I can’t give up on life. I’m not dead yet, so I might as well make the most of it while I still can.

Grieve, in your own way, for those who are gone, for those who are left with holes in their lives, and for those who lost a bit of their innocence over having to witness it. If you can, support those who will try to make everything a little more bearable in that town. But don’t let the events of the day take away from all the good that is still left in the world, the probability that good will eventually overcome evil, and the truth that love will always be more powerful than hate. You’ll start to see your way more clearly soon. Don’t give up.

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The Patient Protection and Affordable Care Act (PPACA) began its journey into the wild blue yonder today.

You know the laundry list of benefits that went into effect today. There’s no way some part of the media has not reached you by now. Across the board, we’re getting ready to see:

  • elimination of lifetime coverage limits
  • restrictions on or phaseouts of annual coverage limits
  • extension of dependent coverage up to age 26
  • no more policy cancellations for sick people

And these changes are also being made, but only for employer plans or new individual policies – they may not apply if your insurer chooses not to amend your existing policy:

  • no more plans that deny or cancel coverage for children with pre-existing conditions
  • free evidence-based preventive care services
  • no more out-of-network increases for medical emergencies

Now, I think that making predictions about what these changes will or won’t do is a little like predicting whether getting a new job will make you a happier, more productive person. The grass may look greener, but you don’t know until you get there. There are too many variables involved.

But I have another list for you.

According to the Bazelon Center for Mental Health Law, we have the following facts staring us in the face:

  • 26% of Americans have a diagnosable mental disorder.
  • Only 29% of those people actually receive treatment.
  • 50% of Americans with a mental disorder have problems by age 14.
  • Mental disorders are the leading cause of disability for Americans age 15-44.
  • Major mental disorders cost America at least $193 billion per year in lost wages alone. This study only focused on comparative wage levels – it didn’t include the costs of presenteeism (showing up but being unproductive) or absenteeism (calling off work) on the job.

Insurance parity is an economic issue. Mental health parity is great, but it isn’t enough. Now we need to get people into treatment and back to productivity, and cost – lack of insurance coverage – is the biggest roadblock to getting that help.

Think of the cost savings if we could get people off of public disability assistance and/or Medicaid. Think of the extra cash flow that America could experience with additional payroll tax income, sales tax income, and property tax income because so many more people would be able to work and buy things like appliances and furniture and homes. Think of what could happen if all those kids got help and became productive citizens instead of being homeless or in jail.

No matter who reacts how to the new law, we’re taking another step in the right direction for the good of our country as a whole. You can talk about bleeding hearts all you want, but the return on investment here is too great to pass up.

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There’s this big puzzle I’ve been trying to figure out for years, and it’s my brain. I have to catch up with what’s going on in the mental health world, or I feel like that puzzle is never going to get solved. And the more my mood swings grumble at me, the more I go into hypomanic detective mode.

So I ran across this article in NIMH’s Science News section. I love this part of their website. I remember when I was a kid – and this was before we even had a color TV – I learned that doctors did research, and I always wondered what they were discovering. Always did like watching PBS more than the Perils of Penelope Pitstop. After I got older, I forgot all about that show…until I got cable TV and found a whole channel devoted to old TV cartoons. Rooby-Roo!!

Okay…focus…

Results of the Study

The researchers found that nearly 40 percent of those identified as having major depression also had symptoms of subthreshold hypomania (mania that lasts less than four days at a time). Compared to those with major depression alone, those with depression plus subthreshold hypomania tended to be younger at age of onset and to have had more coexisting health problems, more episodes of depression and more suicide attempts.

I could have told them that. No, really.

I think the reason I was so interested in what the doctors were discovering is because I knew I was a little off and I wished I knew why. I spent many of my pre-teen and teenage years trying to compensate in various ways for feeling so blue, and usually overdoing it. Then I would go back to withdrawing from the world because in the process of overcompensating, I had usually done something to embarrass myself. The cycle got a little more amplified over time until my late teens, by which time the ups and downs and my inability to deal with them had become painfully obvious.

The more I think about it, the more I remember being sick, too. Looking back, I think it was partly from flipping between being sedentary and being agitated. There were headaches and allergies and upset stomachs – and I remember feeling a lot better when I discovered that four Tylenol were better than two. The MDs didn’t help much. I got diagnosed with nonspecific this or that all the time in my late teens and early 20s. That was before I saw a psychiatrist and life started to make so much more sense.

Of course you’re going to get sick when your body is being unstable. We’ve always heard that it’s so important for us to take care of ourselves and be firm about giving ourselves and our kids healthy foods and a stable environment. I think we’re just now discovering the full effect of WHY we should do that. I guess the researchers can’t just take people’s word for it, though.

Can we get away from the old “because I said so” script from childhood and start being honest about the fact that mental health and physical health are intertwined in real life?

I’m talking to the people who have trouble with everyday struggles, not to the people in strait jackets. It takes practice to watch the ups and downs and to notice when the coping skills are crumbling. It takes a lot of discipline to put your foot down with yourself or your kids when you notice the subthreshold hypomania is trading jabs with the depression and something’s got to give. Find a good doctor and stay on top of your health before you end up in a corner staring at cartoons and hating life.

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The diagnostic bible of the American Psychiatric Association is getting a makeover. A rough draft of version 5 (which is still being debated by the powers that be) is posted at http://www.DSM5.org. And this debate is going to be a dilly.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the manual that doctors, insurers, and scientists use in deciding what is officially considered a mental disorder and how to tell if someone has it. Every now and then they decide to re-evaluate this based on the latest research findings. In a new twist, they were seeking feedback via the Internet from both psychiatrists and the general public about whether the changes will be helpful before finalizing them. That ended in April. Now they have a committee (called the DSM-5 work group on their website) reviewing the comments; and between public input, APA member input, and private research, they will have the new version ready for publication by May of 2013.

Why so long? Take a look at their website, especially the timeline. Then check out the list of diagnostic categories on the home page. These are only the general categories. Specific disorders in each category can be seen by clicking on the name of the general category. All things considered, that final list is going to be huge – when they decide what will be on it and why.

Here’s one issue that they have to decide before 2013. Is Gender Identity Disorder a physical problem, a mental problem, or just another way for humans to behave? The LGBT community is already on the edge of their seats waiting for the APA to have an official opinion, and one way or another, that decision will make headlines for weeks.

My personal source of amusement comes from the fact that, at the moment, PMS is lumped in with bipolar disorder in the Mood Disorders category. I have both, I can tell the difference between the two, and I think that putting them in the same diagnostic category is hilarious. PMS is a physical problem with emotional side effects, and doesn’t belong in the DSM at all (although I think several men around the world would loudly disagree with me).

In other categories, the APA is officially considering hoarding, skin-picking, tics, and olfactory reference syndrome (delusional beliefs about one’s own body odor) as formally classified Anxiety Disorders. Binge eating is also being considered for placement with anorexia and bulimia in the Eating Disorders category. There’s an idea. I could get insurance to pay for a doctor to help me stop pigging out.

Seriously, if you are concerned about the diagnostic process when it comes to mental disorders, keep checking back for updates to their website. I hope that they’re carefully considering the comments of the people who have to personally deal with these issues every day, and not just letting the insurance companies tell the APA how to interpret the research.

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You have to see this, if you haven’t already. Anyone who is interested in topics like mental health, pediatric health, teaching children, pharmaceutical research, or what to do about children with unusual behaviour should watch and pay attention. This is a 56-minute video called The Medicated Child, and it was aired on PBS recently. It really struck a nerve with me, both as a mother and as an adult with bipolar disorder.

http://video.pbs.org/video/1316921025#

What do you think?

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I can’t decide which I like best – the database itself or the information-sharing. The National Institute of Mental Health (NIMH) is gathering information on what a normal kid’s brain looks like so they can share the information with people who are researching developmental disorders like autism.

NIMH described the latest release of data on their website today. They studied over 500 kids, from infants to young adults, using MRI brain scans, physical exams, psychological exams, and measurements of hormonal activity. The point was to catch each kid at different points in their life, get all of this information for that age, and wait a couple of years before doing it again to see what changed. The younger ones got tested more frequently because development occurs faster in the younger years.

The project, called The NIH Magnetic Resonance Imaging (MRI) Study of Normal Brain Development, is looking at things like brain size, memory function, motor skills, language development, and general social skills.

Their focus in this study is only on kids with no health problems. This way, they can pass on the information to people who are trying to figure out why some kids don’t develop normally, who can then compare the “normal” scans and physiological data to that of those kids and study what’s different. Hopefully, we’ll all learn something soon about why the brain can sometimes go haywire in childhood, and whether there is anything we can do to keep it from happening.

If you’re wondering how they got the kids to lie still for the MRI, I read somewhere else that the younger ones are usually scanned while they are sleeping. Trust me – telling most two-year olds to lie down and be still while they’re awake is like asking most puppies to calm down when you come home. That research environment must have been a real trip.

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1-800-273-TALK. Call this number if you are thinking that it’s time to end it all. Why? You might appreciate it later when you’re in a better frame of mind. It might help you understand that there are people out there that really do care. It might help you see that those thoughts might be just a symptom of something bigger that’s messing up your mind. If that’s all it is, wouldn’t you want to find out what’s wrong so you can get back to the life you really want to live?

There are more and more studies being done to understand how big of a problem this really is in our country. Here are just some of the highlights:

http://archpsyc.ama-assn.org/cgi/content/abstract/66/4/398

Most suicides committed by males age 18-24 had psych problems at age 8.

http://www.nimh.nih.gov/science-news/2009/black-teens-especially-girls-at-high-risk-for-suicide-attempts.shtml

Female black teens are at risk for suicide, even if they have never been diagnosed with a mental illness.

http://oas.samhsa.gov/2k9/165/suicide.cfm

Around one percent of adult Americans planned to commit suicide last year, and half of those actually tried it. A little under four percent of adult Americans admitted to thinking about it, and that number almost doubled when they looked at just those between 18 and 25 years old. How many of us aren’t even admitting that we think about this?

Call 1-800-273-TALK. I’ll bet they’ll help even if you’re just worried about someone that is close to you. Pull the old “my friend has this problem” if you need to. Just talk about it with someone who deals with this stuff all the time, and try to find out if there’s something bigger going on that’s making it easier to think that way. You might be surprised at the change it makes in your mood and your motivation to move forward.

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