Bipolar medications

Angry, Raging, Bipolar

/ Robin / Leave a comment

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I scared the ever living poo out of my fancy beta fish a minute ago. I don’t think I’ve ever seen Victor move so fast! He hid on the bottom and refused to take his dinner from me. All I did was walk up to his tank when he didn’t see me coming.

Fish. I feel rather like a fish.

You’d think we’re fish as much as we’re listened to when time after time we beg for different medication. Something has been going on with me mentally for around 3 or 4 months. I just thought it was growing anxiety because I have one more quarter to go and then I’m finished with school. I’ll need a job. I’ve never been able to hold a job for over a year. Even my own brother had to fire me because of my behavior, and my anger.

I take that back, I have worked for longer. When I worked for myself, I was able to manage to work with the management.

This feeling that’s been growing… I told my family in December that I’d had thoughts of hurting myself, and I honestly was. I’d had those feelings on and off for most of my life. Telling them seemed to help. Maybe it did. I felt that way tonight for about 10 minutes.

Then despair, anxiety, rage. Do these feelings take your face and squeeze it till it aches with the pressure?

Anxiety. It has been growing in my mind like a pustule about to burst black tar all over my mind.

I came to understand yesterday, through thinking over the end of the quarter problems and verbally fighting very loudly with another student – repeatedly, a colonoscopy I had to have two days in a row, a painfully torn fascia in my driving foot in December that is still painful (I’m so sick of this boot thing. It causes a painful lump on my shin bone.), intestinal troubles since Christmas, and runaway away anxiety I continuously tell my med provider about (I even take my counselor with me to make sure she’s listening. Oh yeah, that’s working great.)… I get it. I’m in a rage.

I used to live every day, every moment consumed with rage. I wasn’t a good kid. I wasn’t fun for my family to be around. My mother has finally agreed with me that I was, a terrible child. I was full of hateful and blinding – rage.

I have those feelings again. The ones I fought so ineffectively to be rid of. That consuming anger. I feel like I’m about to blow up on someone who probably did nothing to me. It’s just this thing my brain does sometimes day after day, month after month til years are wasted in fury and hate or like now when I’ve been crying out in fear and pain only to be ignored by those I dutifully trust my life to.

I’m so angry. My mind burns and I want to break things and hit stupid people. But I don’t.

I am often moments from saying things that could get me kicked out of school or arrested. But I don’t.

I’m so tired of fighting all the time. I just want to have a life free of pain. No more arthritis or Fibromyalgia. No more being too big to be healthy. No more chronic back pain. This is no life for me. This isn’t what I signed up for. I’m SO ANGRY! It’s like emotional cancer that manifests in feelings that most people can say they understand, but they don’t. Not really. If you have Bipolar Disorder Type 1 and you have had violent, angry, manic episodes you probably understand.  If not, please don’t give up on me.

Question is: what’s gonna give?

Addendum: Read on, please. This changed everything.

This morning I was listening to a TED Talk called, “the role of human emotions in science and research. Great title, right? Sounds like just what I need. At the end of her story, Ilona Stengel said this: I do not suggest that we should use feelings instead of facts. But I say we should not be afraid of using our feelings to implement and catalyze fact-based science and innovation. Emotions and logic do not oppose each other. They compliment each other. And they reinforce each other. The feeling of being dedicated to something meaningful, of belonging to something bigger, and of being empowered is crucial for creativity and innovation. Whatever you’re working on, make sure that it matters, and take it to your heart as much as you like.” [I’m pretty sure this isn’t a word for exact word match.]

Suddenly I understood. All my life I’ve believed I’ve had a purpose. I thought it was within the church, but I was always told, “No, it’s not time now Robin.” And my heart would be broken and my life stripped of meaning.

I believe without meaning, we relinquish our lives to the feelings I have been feeling. For this moment, I remember the meaning of my life. It will not be easy to follow. It incurs great emotional risk (something people with Bipolar Disorder should try to avoid). But if I can remember it. If I can remember it every moment of every day, I won’t have to rely as much upon others for the stability of my mind. My mind will be fighting my emotions with logic. I’ve done it before and I’ve succeeded. I must try again. My children have left my home. They’re all grown up. That role of the parent is gone. I feel like I have no purpose.

But I do. I do. I’d just been swallowed alive by the vomit of extreme emotions that allowed rage to consume me. For this moment. For this morning. I say no.

She said: “Whatever you’re working on, make sure that it matters, and take it to your heart as much as you like.” I am taking up my mission again. I must. If I don’t, then what’s the point? 

Do you understand?

What’s your mission? Tell me.

Robin

 

 

 

Insidious Black Box

/ Robin / Leave a comment

I apologize for the length of this post. Please consider reading the entire post. It’s very important. Your life could depend upon it. (Robin)

Emotionmasks insane faces

I take two medications that I considered to have a Black Box warning. They both depress breathing. Together they can stop my breathing altogether… There are other dangers.

I have chronic pain with Bipolar Disorder and Generalized Anxiety. I am prescribed both Oxycodone and Clonazepam by two different providers. They both know that I take both medications.

I see a pain management specialist for my pain. I have for some time now. To be treated there, I have had to sign a contract that governs my behavior with regards to taking pain medications, I have to take a pee test every time I go in and they count my pills every time as well.

My med provider handles my Clonazepam prescription for anxiety. I suffer from extreme anxiety. Sometimes I feel like my brain is going to explode. Recently, this woman, who is the 4th or 5th provider I’ve had since I started going to this clinic, told me that I’m more likely to kill myself because of anxiety rather than depression. I was always told that a depressed person was more likely to commit suicide when they started to feel better. When they started feeling better, they finally would have the energy to follow through with their suicidal inclinations. Apparently, there is more to it than that.

My counselor and every med provider I’ve had is intimately aware of my massive anxiety and my inability to get it under control. We’ve tried all the counseling type of solutions including Cognitive Behavioral Therapy (talk therapy), mindfulness and other techniques. I’ve not had success with any of them.

My med provider is content for me to only take Lamotrigine, which is primarily to treat my Bipolar Disorder depression symptoms, and not to take anything other than Clonazepam for anxiety. From talking to her, it appears that this is primarily to treat the depressive symptoms that I experience. I have not been able to get any of the med providers who have treated me to give me anything for anxiety other than Clonazepam.

She, my med provider, told me at our second meeting, that people with anxiety are more likely to commit suicide than people with depression. Since I suffer primarily from anxiety, you would think someone would have warned me of this. I understand now why I feel so self-destructive while I’m exploding with anxiety.

She has told me that her goal is to get me off the Clonazepam completely. Now that I’m taking my runaway anxiety and the real chance I will kill myself because of it more seriously, I’m also taking the mix of these two medications seriously. I always have, but my frantic response to my anxiety has created a situation where I’m so afraid of what might happen if I stop taking the drug for anxiety.

I’ve always felt like I’m most insane when my anxiety is at its peak.

I understand that long-term opioid use for chronic pain is not the most effective way to treat it. I’ve wanted to find a different solution for a long time. My pain management provider doesn’t offer other alternatives than pain medications.

I normally don’t want to die. I’ve always had urges that are normally short in duration towards it, but I haven’t had times when I sit there with my bottle of Oxycodone ready to take it all. But, I could.

I’ve never told any of my mental health caregivers that I have suicidal thoughts. I know that my community does not have good facilities to treat acute mental health emergencies. I don’t want to become one of those people who is shuffled into a hospital emergency room with a guard sitting outside my little room. That’s what they do. I have first-hand knowledge of this.

So what’s the answer? Do I chance dying in my sleep? Or do I chance ending my life while I’m awake? Both are real dangers.

I’ve decided to deal with my feelings of self-destruction now. With the danger of the two medications and my new understanding the relationship between anxiety and suicide, I have promised my family that I will talk to my counselor on Wednesday when I see him. I will admit that I think about suicide. That’s a huge step for me.

I’m afraid. Admitting how I’ve been feeling for years is like admitting that I can’t control the one area of dealing with my mental health that I always felt I could say I didn’t have a problem with. I’ll finally be admitting I have no control over my depression or my anxiety in relationship to staying alive.

As I say, I don’t want to die. When my anxiety runs away I cannot always control myself. I can become violent and destructive. I break down and cannot function. I become paralyzed yet also hysterical.

Yesterday I talked to my mother and all three of my kids and admitted the truth to them. My youngest who is a psych major at the same university that I attend (so is her partner) said she had been wondering if that was a problem for me. They all agree that they would rather I call them than I call a suicide line. I’ll talk to my therapist about that.

I have tried to learn to practice mindfulness several times in the past. I never fully committed to it. Mindfulness was just part of the learning experience in one of my classes I just finished. It’s time for me to review the materials I have about it, I have lots. I need to try to learn how to harness it’s potential in earnest this time. My life depends upon it.

I have a particular fear: I’m terrified of my anxiety. I know what it does to me. I sometimes feel the insidious devil of insanity creeping through my mind trying to take over, and it literally shreds my mind.

If you have any Black Box warnings for medication yourself, please take it seriously. Now that I am self-aware of my true situation I’m ready to find a way to deal with my symptoms.

 

My main medications:

Chronic Pain – Oxycodone / Nucynta

Anxiety / PTSD – Clonazepam / Benzodiazepines

Bipolar Disorder / Depression – Lamotrigine

 

Oxycodone – Warnings

“To make sure this medicine is safe for you, tell your doctor if you have:

  • a history of drug abuse, alcohol addiction, or mental illness
  • if you use a sedative like Valium (diazepam, alprazolam, lorazepam, Ativan, Klonopin, Restoril, Tranxene, Versed, Xanax, and others)”

https://www.drugs.com/oxycodone.html

Clonazepam – Warnings

Risks from Concomitant Use with Opioids
Use of benzodiazepines, including Clonazepam, and opioids may result in profound sedation, respiratory depression, coma, and death. Because of these risks, reserve concomitant prescribing of benzodiazepines and opioids for use in patients for whom alternative treatment options are inadequate.

Observational studies have demonstrated that concomitant use of opioid analgesics and benzodiazepines increases the risk of drug-related mortality compared to use of opioids alone. If a decision is made to prescribe Clonazepam concomitantly with opioids, prescribe the lowest effective dosages and minimum durations of concomitant use, and follow patients closely for signs and symptoms of respiratory depression and sedation.
(The above Warning is taken from: https://www.drugs.com/pro/clonazepam.html)
Concomitant: (synonyms: attendant, accompanying, associated, related, connected)

Lamotrigine – Warnings

To make sure lamotrigine is safe for you, tell your doctor if you have:

  • A history of depression or suicidal thoughts or actions
  • Some people have thoughts about suicide while taking this medicine. Your doctor will need to check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

https://www.drugs.com/mtm/lamotrigine.html

Nucynta – Side Effects for Health Care Professionals

Psychiatric – Common (1% to 10%): Insomnia, confusion, abnormal dreams, anxiety, depression, irritability, nervousness, drug withdrawal syndrome, restlessness, sleep disorder, hallucination, depressed mood.
https://www.drugs.com/sfx/nucynta-side-effects.html

 

Benzodiazepines

Benzodiazepines may be used in the treatment of anxiety, panic disorder, seizures, or sleep disorders.
https://www.drugs.com/drug-class/benzodiazepines.html

 

Bipolar – Secrets

/ Robin / Leave a comment

secretsIf I were to describe depression using a color, I would say it is black. Red would fit nicely with the mania and perhaps green or yellow might be anxiety. It would be nice if things were distinct like that so that I could easily identify how I’m doing. It might even be nice for those who are part of my support system to see those colors so they can know how I’m doing. It would be easier than trying to explain how I am when I can barely breathe.

Speaking of people in my support system, sometimes there are thoughts or moods or things I’ve done or thought about doing that I am afraid to speak of, things I think are better left never spoken of.

I try not to think about those things or those thoughts. They bring with them pain and even humiliation.

I would not want my family to know parts of the person I was during some of my manic times. They are not aware of some of the more horrific behaviors that I experienced.

As much as I don’t want to revisit these horrible moments in my past I can’t help but wonder if they now contribute to the over state of anxiety that lives with me each moment of my day.

The tick I developed as a result of medication(s) I was taking seems nearly gone with one major exception: whenever I am in anyway anxious it comes back and I can hardly talk. It seems to those I’m talking to to be a violent case of stuttering, only I know it isn’t. I feel embarrassed when it overwhelms me. No matter how much I try to relax when it starts, the only way I can stop it is to remove myself from the situation or to stop talking. Imagine yourself working with your physical therapist and trying to explain how your therapy at home has been going and suddenly not being able to talk.

Is it possible that dealing with some of the long-buried moments of horror might enable me to experience less overall anxiety? In my current state, I must say “no” because to deal with those secret things terrifies me far too much. I hope that I can use the tools I’m learning to deal with these hidden anxieties. I hope I can use them by myself to find healing from my past. If I can’t do it myself, I hope one day to be able to deal with them working with someone who can help me walk through them.

Today, that’s what I’m choosing to believe: I can deal with them myself. Just because I’ve got a mental illness or three doesn’t mean I must air all my dirty laundry. Some of it I must learn to deal with on my own.

Some secrets… I choose to remain as secrets.

Bipolar – Danger Signs

/ Robin / Leave a comment

solar-flare-1Now that I’m taking 120mg of Latuda again I can consider the signs I was having that I was going into a crisis. I believe it’s important for me, for everyone, to know what happens before we reach a full-blown disaster so we can take precautions and get help early. That said, I recognize that it is often difficult if not impossible to tell when we’re slipping. It’s like standing on a beach when the tide is out. You’re talking to a friend or looking at the beautiful water or a sunset. You’re not paying any attention to your feet, which is unfortunate, because your feet have been slowly sinking into the sand. Now, when you try to move, your feet stick and you fall on your face because you didn’t realize what had been happening while you weren’t paying attention.

The biggest sign that I’m crashing is that I lose my temper violently and in an instant. Most of my life I have been consumed with anger and ill temper. It has kept me from getting to know my family. My father, who is gone now, was as bad tempered and mean with me as I was with him. We reacted to each other like lighter fluid on a bonfire. I believe that he also suffered from Bipolar Disorder.

In addition to a catastrophically hellish temper I was angry all the time. I don’t mean mad. I mean angry like I wanted to hurt someone. My adrenaline was (and is) on all the time. To this day my muscles are hard as rock, cocked as if to lunge into flight or fight. Even after a massage my musculature remains as solid as steel. I never relax.

Over the years I’ve taken medications that cause my face, my jaw in particular, to violently jerk and I can’t talk. I look like I’ve got a massive tick in my face and I sound like I’m hiccupping. Now, when I’m stressed, the tick comes back. As a matter of fact, I’ve been having it happen daily now even during Christmas vacation when I don’t have the pressures of school work. It really frustrates me. It’s so remarkable that people stop talking and stare at my face. It stops conversation dead.

So this time, when my temper soared uncontrollably and I saw my family react to my words as though they’d been slapped, I realized I was in trouble. I thought I was just feeling my temper returning. I felt like I was keeping it under control. I didn’t realize others noticed it until we were celebrating Christmas Day at my brother’s house and I was talking to my daughter and her fiancée when suddenly Sydney stopped short and looked at me as though I’d just stabbed her. I shut my mouth fast. I knew I was in trouble. I had to stop myself from talking the rest of the day unless I was paying attention to what I was saying and how I was saying it.

My med provider and I had a backup plan in place incase reducing my Latuda to 80mg didn’t work. I was to return to the 120mg dosage immediately. So that’s what I did. I couldn’t wait until I was able to get back in to see her in three more weeks. I’m feeling much less volatile now.

I know it is rarely as easy a fix as returning to a medication that I already know works for me. It’s never that easy. This time was an exception for which I am grateful.

We, you and I, impact those around us. Our behavior doesn’t happen in a vacuum. We have a responsibility to control our behavior for our own health and for our family and friends. It’s funny that I say we need to control ourselves because that’s exactly what I’ve never been able to do. Not till I got well medicated.

The take away – be vigilant for signs of crashing. Then take action swiftly.

Bipolar – Never Far Away

/ Robin / Leave a comment

I reached a stasis point, a time of going to neither depressed nor manic poles. I thought I was emotionally cramped or stunted. So, as I’ve said, my med provider and I decided to lower my Latuda to 80mg. It’s been about three weeks now and I can say without a doubt that I’m swinging again and in a bad way. I just called one of my daughters (I asked my family to watch me) and she said she’d noticed something had changed too and was wondering if that’s what was up.

Of course, I denied it. I realize now (30 minutes later) that I was protecting myself. I’ve worked for so hard for so long to be stable I didn’t want to admit that I’d have to up my medication again. I wanted to believe I could do this, be normal on my own.

I guess I feel like if I can’t be “normal” I won’t have really lived, I won’t really have given to my world or amounted to anything. I think those thoughts and feelings are always beneath the “calm” exterior of my well medicated self. It’s frustrating.

I’ve gone back to school so I can get a job. I’m 54 and I’m just going to school for a career now. It makes me so sad. See, the depression is coming like a vengeful lover, rough and dark.

If I’m already behaving “mean” towards my daughter and feeling depressed and like I’m about to have a fight I guess I’m not ready to be on a lower dose of my Latuda. So, it’s either go back up or change to something else. I’ll need to call the nurses line tomorrow and see if I can talk to my med provider as soon as I can. This isn’t the kind of thing that I should just wait until my next visit to handle.

Tomorrow I also see my counselor. We definitely have something to talk about.

Today I saw my pain management specialist. She ordered an MRI of my lower back. For some reason no one has ever had one done. I would have thought that having me on pain medications as long as I’ve been on them that someone would have had one done, but I can’t find it if they did.

Well, my new reality and I are going to read for a few minutes and then go to bed.

Be safe my friends.