31 Days of Bipolar: Day 30. My quest for the magic cocktail of medication

Day 30: What meds are you on now? Have you found your ‘magic cocktail’?

My current medication regime consists of:

• Anti-psychotic: Solian (100mg/daily)
• Anti-psychotic: Olanzapine (10mg/daily)
• Anti-depressant: Fluoxetine (60mg/daily)

For those of you familiar with bipolar medications, you will notice a glaring omission from this list, namely a mood stabiliser. Up until January 2015 I was taking 1000mg/daily of Sodium Valproate (Epilim), but this was cessated upon the discovery that it had caused a rather nasty bout of pancreatitis. Since then, my doctor has been hesitant to introduce a new mood stabiliser into the mix. Partly because he is fearful of causing a return of my pancreatitis, partly because the only other option, Lithium, has a negative reaction when used in conjunction with Fluoxetine. So instead of introducing this a new mood stabiliser, he has been attempting to fix the mood fluctuations I’ve experienced since ending the Sodium Valproate by tweaking my other medications. In fact, over the last several weeks I have had my dosage of Fluoxetine increased twice in a valiant attempt to assist my increased depression and anxiety. As such, there has been little to no change, but I hold out hope that something will happen in the coming weeks.

Without a mood stabiliser, which I am adamant I need, it is fairly safe to assume I have yet to find my ‘magic cocktail’. Even when Sodium Valproate was part of the mix, I felt I was still missing something when it came to my medication. My moods still fluctuated. My depression still raged. Personally, the best drug I ever took for my bipolar was Lithium, which I took for some time in 2011 before it was cessated by the psychiatrist who destroyed my faith in the profession. He, without even exploring how it had affected me, decided that no medication would benefit me so immediately withdrew it from my treatment strategy; something I have never (repeat: never) forgiven him for. When I was on Lithium I was far more cohesive, far more present, far more able to control my moods and manage my behaviour, more so than I was ever able to do on Sodium Valproate.

After the Sodium Valproate was stopped I begged my GP to restart me on Lithium but because he didn’t want to interrupt my Fluoxetine, he denied me the possibility. I understand why he did that. I have no ill-will toward him. But given the positive effect Lithium had had on me in 2011, I feel we missed a trick. Personally, I would sacrifice the Fluoxetine for Lithium, but when it comes to my medication, I don’t really have a say.

Over the last few weeks I have been discussing with my support worker the possibility of seeing a psychiatrist in order for them to undertake a comprehensive review of my medication. The only problem with this is that I have no faith in the profession, courtesy of the last psychiatrist I saw. So to see a psychiatrist would require a lot of strength, a lot of confidence and a lot of advocating from my support worker. But who knows, perhaps it will happen, perhaps in a few months I will have a whole new mix of medication to take, perhaps then I will be one step closer to my ‘magic cocktail’.

31 Days of Bipolar: Day 22. Side effects of medication

Day 22: What meds gave you the worst side effects, how did/do you treat it/them, and do you still get any side effects now?

Without question the worst side effect I’ve ever experienced came from Sodium Valproate (Epilim). Although I’d been taking it without any major consequence for several years (on and off, depending on homelessness), earlier this year it decided to revolt against my system in a huge way, by inflicting excruciating acute pancreatitis on me. The pain was unbearable and led to me being hospitalised for nearly three weeks whilst my body fought the pain. This then led to me developing a cyst in my pancreas, which has bothered me on/off for the last three months. For a time the abdominal pain was utterly intense, but fortunately it has been decreasing over the last few weeks and now only bothers me once or twice a fortnight. Hopefully, within the next couple of months, the pain will disappear entirely – because I’m really, seriously, over it!

Other than this rather serious side effect, I have to say I’ve been relatively lucky when it comes to medication side effects. I get headaches quite frequently, and my digestion is seriously effected, with frequent bouts of diarrhea alternating with periods of constipation. I also receive tremors in my extremities (mainly hands and legs) as well as the usual lack of motivation, energy and drive that accompanies most psychiatric medications.

Of course, as with most people who take psychiatric medication, I experience weight gain as a side effect, mainly from the Olanzapine. Even though I lost quite a lot of weight during the pancreatitis episode, I’ve put it all back on (and then some) over the last few months. Without question it is one of the worst side effects, as I suffer from quite extreme body image/dysmorphic issues at the best of times, without having the large rolls of fat that cover my body to contend with as well. It seriously damages my self-esteem and confidence and I wish, I really utterly wish, that weight gain wasn’t a side effect of psychiatric medications because of the sheer damage that it can cause to an already vulnerable individual.

But it could all be worse, so I’m not complaining – well, except for the pancreatitis, I’m complaining about that because it was bloody painful!

31 Days of Bipolar: Day 18. Dear Big Pharma…

Day 18: If big pharma was actually listening, what would you say about bipolar meds?

Dear Big Pharma,

So, what exactly was going through your minds when you created medication for bipolar? Were you actually trying to create something with so many side effects it would take a novel the length of War and Peace to list them all properly, or was that just a happy little outcome for you callous and heartless individuals?

I mean really, weight gain. You think this is an acceptable side effect for people with mental health issues? You do realise that many people who suffer from mental ill-health have self-esteem issues, don’t you? What do you think weight gain is going to do to their self-esteem? Do you seriously think it’s going to improve it? Of course not! It’s going to make it ten times worse you ridiculous individuals!

And suicidal ideation!? I am so pissed off with this particular side effect you’ve forced me to illustrate it with an exclamation mark and a question mark! At what point did you think it was a wise and noble idea to create a medication for someone suffering from depression that has a side effect that makes them more depressed and potentially suicidal. Do you not see the problem there? Really? Because most people who are forced to take this medication sees the problem quite clearly and these people are considered insane by large (and ignorant) portions of the greater population. So if they can see the problems inherent with your side effects, why can’t you?

As for side effects as serious as pancreatitis, I mean c’mon! No-one wants to spend three weeks of their life in a hospital bed, solely because they were taking medication that you deemed safe for someone to take. How is it safe when they end up in hospital for three weeks?

I refuse to believe there is nothing you can do about this side effect issue. Personally I think it’s a wonderful money-maker for you, forcing people to take medication to counteract the side effects of their initial medication; a situation I myself have been forced into in the past.

And while we’re at it. Does medication really need to be so expensive? Granted I can’t really complain about this as being on the disability pension and the holder of a magical pension card, I get my medication for $6.10 a script, but if I wasn’t, I’d have to remortgage my future house in order to afford one months worth of medication.

They’re tiny, almost insignificantly small, tablets; how much do they really cost to make? A few cents? A dollar? I’m willing to bet it’s nothing close to the price that you slap on these medications, the price that you force sick and needy individuals to pay in order to improve their quality of living.

You see we people afflicted with a mental illness have no choice about taking medication. It’s not something we do for fun, it’s not something we do to warm the cockles of our hearts. We have to take these medications in order to function as a healthy and happy individual. So we’re forced to pay for them. We don’t have a choice. But you know that, don’t you, you know you have a nice little captive audience to keep you merrily in business. Of course you do. But even so, I still believe you could do something about it, just like you could do something about your side effect con.

Okay. Mini rant over. You may return to ripping people off and making their lives a living hell. It is, after all, what you do best.

Regards,
Addy

31 Days of Bipolar: Day 05. Six of the best treatments for bipolar

Day 05: What treatment, therapy etc do you do?

Most people who I’ve spoken to that are afflicted with bipolar have a psychiatrist monitoring their progress, medication and moods. In fact, I would go so far as to say that having a psychiatrist is pretty much a prerequisite for someone suffering from an illness as serious as bipolar. However, as the last appointment I had with a psychiatrist went so badly, I no longer have any trust for people in this particular profession. Thus, I am left to navigate the ups and downs of bipolar all on my lonesome.

But that doesn’t mean I don’t undertake treatment, I do, and here are six examples to prove it:

Medication

First and foremost, there is medication, something that pretty much everyone who is diagnosed with bipolar has to contend with. I say contend with because some of the side effects of psychiatric medication can be pretty brutal, as I discovered this year, but regardless of these side effects, medication is quintessential for dealing with bipolar.

At this point in my life my medication regime is: an antidepressant (Fluoxetine, 40mg/daily), an anti-psychotic (Solian, 100mg/daily) and a second anti-psychotic (Abilify, 10mg/daily).  For those who have some knowledge of bipolar, or medication in general, you will notice something pretty obvious is missing from this chemical cocktail…and that is a mood stabiliser.

I had been taking Sodium Valproate (aka Epilim) at 1000mg/daily, but this was immediately cessated in January 2015 after it caused a particularly nasty bout of acute pancreatitis that saw me hospitalised for two and a half weeks. Since then, I have had numerous conversations with my GP about starting an alternative mood stabiliser, as my mood as been rather unstable over the last three months. He ruminated over starting me on Lithium, a drug that works exceptionally well for me, but because it negatively interacts with the Fluoxetine he decided against it. Whether or not I will ever be back on a mood stabiliser is beyond my control. Personally, I would be happy to stop the Fluoxetine in favour of Lithium, but my opinion is neither here nor there. All I do know is that without a mood stabiliser, my moods will continue to fluctuate wildly, and it’s doubtful I will be able to stabilise myself, regardless of how many anti-psychotics I’m taking.

Support Worker

My only form of real-world contact comes from the weekly appointments I have with my support worker. In all honesty we don’t do all that much, mainly because my anxiety prevents me from opening up to her. So our appointments are basically her battling to get me to say anything whilst occasionally recommending a particular course of action for me to take.

This is yet another example of how my anxiety impacts on my life. It would be wonderful to have an open and honest relationship with my support worker, but no matter how much effort I put in toward achieving this, anxiety rears its ugly head and prevents me from saying anything. It’s frustrating. It’s annoying. It’s all manner of badness. In fact, more than anything, it’s gloriously ironic. Here’s a person who could potentially help me manage my anxiety, but I can’t talk to them because of my anxiety. Grrrr!

Talking Therapy

Okay, I’m being a little cheeky here. As I write this I’m not technically undertaking any form of talking therapy. I don’t have a counselor. I don’t have a therapist. I certainly don’t have a psychiatrist. But I am hoping that I will soon have a psychologist with whom to examine the intricacies of my life.

During my last visit to my GP I informed him of how difficult it is to deal with my anxiety, to deal with my PTSD and to deal with the fluctuations of mood that bipolar causes. He suggested I see a psychologist (it’s been several years since I last saw one) and dutifully referred me to someone.

I’m still waiting to hear from them about my first appointment (if I haven’t heard by tomorrow, I’ll be calling them next week) so will keep you abreast of developments in this area of treatment.

CBT and DBT

Without someone to help me with these forms of therapy, I am left to navigate them all on my lonesome. This may sound difficult, and it is, but I have a number of books on both subjects that have helped me understand the basics of each form of therapy and allowed me to partake in them as and when I’ve been focused enough to do so.

I have to be honest, I am hoping that the psychologist I’ve been referred to will be a practitioner of DBT, as I believe it would be of tremendous value to have someone assist me in working through this particular form of treatment. Fingers crossed!

Acceptance and Commitment Therapy

This is something I’ve been practicing since I first learned of its existence in 2013. Back in that heady year of mayhem, busyness and fun I undertook an ACT based psychosocial rehabilitation group and learnt  many of the exercises and metaphors that populate this method of treatment.

Some posts I’ve written on Acceptance and Commitment Therapy (in case you were interested!):

• What is Acceptance and Commitment Therapy
• ACT: Identifying your Values

Writing Therapy

Although my blogging isn’t as prolific as it was in 2012-2013, it is still one of the primary methods of therapy that I undertake. There is something gloriously cathartic about writing about your life, feelings, emotions, moods and thoughts before sharing them with the world. Even if no-one reads, likes or comments on a post, I am still proud of myself for having the courage to put it out there in the first place, especially as my anxiety often interferes with my blogging and works to prevent me from posting anything at all.

Day 22: My (not very high) opinion of psychiatric medication!

For anyone who is interested, my current medication regime is:

Sodium Valproate (Mood Stabiliser): 1000mg Daily
Citalopram (Anti-Depressant): 20mg Daily
Olanzapine (Anti-Psychotic): 10mg Evening, 2.5mg Morning
Oxazepam (To aid with sleep): 7.5mg Nightly
Phernergan (To aid with sleep): 25mg Nightly
and
Vitamin B12 (Supplement): 100mg Daily
Vitamin D (Supplement): 2000IU Daily

I’ve been taking this regime of medication for the last two months, and I have to say, my hatred of psychiatric medication is as strong as ever. I hate what it does to me, I hate the side-effects and I hate how it makes me feel nothing like ‘me‘.

Six reasons I hate psychiatric medication…

1. Weight Gain

For someone with body dysmorphic issues, even the slightest weight gain can cause chaos in their minds. Over the last two months I have gained nearly five kilograms. The fact I’ve been going to the gym three times a week, eating healthily, banning soft drinks and cycling in excess of 100km a week doesn’t seem to matter when it comes to my weight. In fact, right now, I have begun to believe I will be a blimp for the remainder of my life.

Seriously, I hate how I see my body almost as much as the social anxiety that eats away at my soul!

2. Side Effects

Since I’ve been on this medication I’ve noticed an escalation of my self-harm urges and suicidal ideation. I’ve experienced a plethora of physical symptoms (including diarrhea, nausea, dry mouth, trembling limbs and unquenchable thirst) and, as previously mentioned, the somewhat odd incidents of sleepwalking that have never happened to me before.

3. Sex

Granted, I’m not fortunate enough to have anyone in my life who wishes to take a tumble betwixt the sheets, but I am a thirty-something male who, on occasion, does enjoy partaking in some ‘private time’ to assist with stress, happiness and general nurture.

However, since I’ve been on this medication, I’ve been unable to reach or maintain an erection, thus rendering another source of pleasure obsolete.

4. They’re not “happy pills”

I hate when people refer to anti-depressants as ‘happy pills’, because they’re not. If they were, I would feel happy after taking one. I don’t. In fact…I feel nothing!

It’s one thing stabilizing moods so that I’m not oscillating between mania and depression, but it’s another thing entirely to render me so zombified I feel nothing. For the last two months I’ve felt no sadness, no happiness, no excitement, no joy. Nothing. It’s just been me, feeling nothing like “me“, every day for every week for the last two months. It’s soul-destroying.

And wholly unpleasant.

5. My people hate medication more than I do

This is a major issue for my people. They hate me being medicated as they believe I’m trying to medicate them out of existence. This causes an increase in the abusive and negative content of all of them. In fact, they would be much happier if I wasn’t taking any medication and believe I would be too.

6. Financial burden

I’m not a rich man. In fact, I’ve shared numerous times in the past that I basically live in abject poverty and, once rent and bills have been factored out of the equation, it’s a challenge to feed myself properly from week to week let alone afford anything ‘fun’. So the added burden of the cost of my medication has had a massive impact on my already frustrating life.

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This has been Day twenty-two of the 30 Days of Mental Illness Awareness Challenge. Apologies for two ‘six of the best’ posts in a row, but I wanted to write a list of the reasons why I dislike psychiatric medication and I like things occuring in sixes! :p

What is the single best thing we can do for our health?

This video was shown during the Introduction Day I attended last week and – courtesy of the excellent illustrations and wealth of information – is one of the better presentations I’ve seen on the topic of “Exercise as Medication”.