27 weeks: pregnancy and medication

I had an appointment with the perinatal psychiatrist recently. I’d recently got discharged from my old mental health team and am now with them and again I have a psychiatrist and a community psychiatric nurse. The first opinion I had of my new psychiatrist was that I didn’t have one. When I told people my opinion of her after the first meeting I said that she hadn’t really left much of an impression – good opinions take a while to form whilst bad ones of someone can take an instant. But I had some faith she’d do the job.

My new CPN  I didn’t much like. She said that everything I was experiencing with my mood was normal when I knew that it wasn’t and she also made me feel pretty bad for not wanting to do antenatal classes. I got invited to some a few weeks back, but I have since been umming and ahhing over whether to do it for numerous reasons but involving the fact that it was at the old youth group centre I used to go to and I didn’t want to bump into the old youth group leaders with their judgmental opinions about a 19 year old getting pregnant. But also another reason is that I had been feeling disconnected to the baby and that I didn’t want to spend an hour or so being reminded of the fact that I was. Plus antenatal classes haven’t always been a regular thing for pregnant women to attend and women have had babies just fine without them.

Another thing she said that annoyed me was that it didn’t matter if I was ill because I could get someone else to look after the baby. It’s true, I have my dad and the father of my baby but if it doesn’t matter whether I’m there for the baby, why am I even bothering to get better? After cooling off from the appointment I realised how she actually meant it but seriously? You work in this profession, you HAVE to know how to word this properly.

But the thing I want to talk about is my second appointment with the perinatal psychiatrist. I get called in and she has basically forgotten who I am which isn’t necessarily bad except when she got things wrong about my life e.g. she said I lived in a studio apartment when I live in a 4 bedroom house with overcrowding issues and I then corrected her, she actually argued with me and told me I was wrong… I have to live there everyday, I know exactly where I live.

She then was reading the appointment notes from the new CPN and she told me that “wanting to cut the baby out” was not normal – which I knew. Then went onto imply I wanted to hurt the baby except I’ve never had any intention of hurting the baby. Hurting myself, yes. Hurting the baby, never. She said if I’m having these thoughts and feeling depressed (and I am but only every so often and I haven’t actually felt that depressed in a while) then I needed to go back on medication whilst pregnant. I’ve always been against it. I don’t judge anyone who does, I really don’t. Every situation is different. But I know that I’m sensitive to side effects, I know I can handle the low moods as they are every so often, I don’t think taking antidepressants (as were the only medication mentioned at the time) is wise for an unborn baby to be exposed to.

But rather than talking rationally about my fears and answering questions she snapped at me telling me I needed the antidepressants and when I said to her about being bipolar and that JUST being on anti-depressants could cause mania or like last time, rapid cycling moods. That would be way worse than what’s going on now. She didn’t really give me much of an answer, just that she’d talk to my old psychiatrist (whom never actually prescribed antidepressants alone) and that if need be a mood stablizer would be added.

To be honest, when medication was mentioned way back in the first appointment, I researched what people said and yes the antidepressants have been found, in recent studies, to have minimal risks to the baby (so not completely risk free like she tried to make out and when I asked about the minimal risks, she had no answers for me) but mood stablizers are very dependent on which ones and even then the research is very split between the risks to an unborn baby even in the third trimester (everyone agrees that no meds of these sort should be taken in the first trimester).

But the fact I don’t like her isn’t based so much on the her different opinion on medications and stuff, it’s that she had very little respect for me. Wouldn’t discuss options, just told me what I had to do and several times implied that if I didn’t follow her opinions I was going to be a bad mum. So when she handed me a piece of paper to take to reception to make another appointment, I just walked out and didn’t make one.

I moaned to my dad; ranted. Then GC phoned me when my dad went to pick up my brother but could only stay on the phone for 5 minutes and once he hung up, I just balled my eyes out. I felt so guilty and bad and just cried. Until I hit this point where I got pissed off. Being  pregnant hasn’t been easy for me – physically or mentally but I’m doing better now. I actually have formed a connection with my child now (which if she actually let me speak I could have said) but even so still experience lightheadedness, feeling faint (up to the point of passing out), nausea – all sorts of stuff that make pregnancy still difficult but I’m doing well with it now and coming out of a perinatal psychiatric appointment feeling worse about myself as a mother is not something I think is good and is kinda the opposite reason why I go.

That afternoon, the CPN called me but it was on an unknown number and I wasn’t in the mood so ignored it, she left a message asking if I could call her back to confirm an appointment for the 6th of May. I haven’t called her back. Partly because I just don’t want to but also because she asked me my preferred method of contact and I said text and she calls me so I’m just waiting to see if she calls me back.

All in all, I’m very underwhelmed by the perinatal team and regret being changed to them.

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Depression: Please Cut To The Chase

I find that no matter how many depressed episodes I have in a year or even a month, I’m constantly surprised when I end up depressed again. I find myself wondering why though…

Why do I expect different results. I once heard the definition of insanity is “doing the same thing over and over again and expecting different results.” So I suppose that explains it. Usually depression is awful but it’s usually more on the psychological side but recently I find myself getting headaches, chest pain, eye twitch and coughing and like when I get any symptom I just type “[symptom] stress” into google and if stress causes it then no need to worry but add that with excessive sweating, up to the where I’m willing to diagnose myself with hyperhidrosis and submit to the treatment which is small electrical currents through water onto your hands. Guess another trip to the doctor is in order. I guess it could be a side effect but I’ve always had a problem with excessively sweaty hands but now my feet are involved it’s time to say no.

Which brings me, in a round about way, to my next point: have you ever insisted medication isn’t the way to go?

I’m not a big believer in mediating. I’m a big believer in medicating. But I think the medication I believe in are the ones that give you highs. I’ve been slowly reducing my lamotrigine dose because I really don’t want to take it anymore. I think what leads me there is several things, but the main one? I like being bipolar Not in a “I wish this on people, it’s awesome” sort of way. Just it’s hard to imagine a life where your emotions aren’t felt so deeply where a natural high doesn’t happen at least one every 4 months, I mean when you get a high a lot of people would pay to have, can you just turn your back on it?

I think that’s why having someone to coach you through it is important. I say this but I’ve been cancelling my appointments with my psych nurse and why? Well 2 reasons. One she wants to do benefit stuff and I don’t want to because I don’t think I should get payment when I am technically well enough to get a part time job (despite the fact everyone I know disagrees) and two, I don’t trust her. I just don’t. I think she treats me with kid gloves because she doesn’t like my dad and then makes discreet jabs about him and if my sister and I fall out because she called him a tw** then I am going to fall out with someone I barely know and is supposed to be helping me.

I found a chart recently:

tumblr_n3t3yroYbY1qcrju6o1_1280Now based on this scale I’ll say I’m a 2 and as far as I’m concerned, there’s a whole continent between 2 and 1 and if I’m talking about Europe here with Russia being 1 and UK being 2, I’d put myself in Poland with a horrible long treck waiting to cross Russia. Whether the treck actually happens is what I’m debating myself right now.  I’d just wish depression would cut to the chase and stick in one state of discontent.

Prazosin: A review

I was going to write a blog yesterday about the fact I had been prazosin and that “yes this was the night it begins”. Now for those of you who don’t know prazosin is a medication with its main useage to treat low blood pressure. Which is a little dangerous for me considering my blood pressure is on the low side anyway. But there have been clinical trials all pointing to that it is good for treating PTSD nightmares and anxiety so my consultant wanted to give it a try.

When I first took it, it didn’t take long to kick in, sitting and lying down was fine but standing up I felt dizzy and sick and lightheaded which is why they recommend you take it at night. An hour after taking it I decided “let’s be fair, go to bed now rather than at 6am like you usually do and give the medication a chance.” So despite the worrying heart palpitations and the banging headache, I went to bed and fell asleep.

Now just looking at the time this blog was posted (nearing 4:45am – England time) you can probably guess it didn’t go so well.

Over the past few days, my nightmares haven’t been too bad since the stress of school has been dropped. But tonight, I could not tell the difference between the two. Wanna hear my nightmare? Lemme tell you about my nightmare. So I don’t actually remember the first part but here’s what I do remember. I worked at like a charity event for kids with cancer and there were these two kids and they were best friends and they had these little obsessions together. First it was those dolls for big lego/brick things and then it was polly pockets and then it was shoes. Time must have moved without me leaving but it seemed like I had just gone around the corner to check something and one of the best friends lost their fight to cancer and without even talking to anyone I knew what had happened.

I should just state that I can have PTSD nightmares that contain scenerios I’ve never been in but the end of the dream will be either a replay of a traumatic thing or an abstract adaptation of it. Back to the dream. Then it seemed like I walked into a room and I was at oakham house (for those of you who are new (hello, btw) that was the psychiatrist hospital I was in and basically was traumatised by) and I knew I was and I was sitting in a room and no idea how I got there, so I got up, sat in the ‘quiet room’ and cried and I was followed by at first a girl who came in and told me she heard about my time outside and apparently the rumours were I’d slept with a bunch of guys and did this, that and the other. Then essentially everyone came in and they were all worrying about me and asking why I was crying. After I’d calmed down I went out the room looking for someone, I found a group of adults.  I recognised three people but I didn’t realise I recognised one of them until I woke up. The three people were: my older brother, his girl friend and Delia from Ghost Whisperer (idk what the hell she’s doing there) and I asked them why I was there and I begun crying and saying “you can’t hold people against their will without telling them!” and various bouts of “why am I here?” and that is when my brother admitted everyone was worried about my mental health and he bought me here. That is when I realised it was a dream and woke up.

Here’s the thing: I love my brothers, I do but one of my brother’s isn’t that bothered about my mental health problems and so for him to bring me to Oakham house made no sense. You’re probably thinking “that’s not very scary” but just the idea of being back in that place makes me terrified and being held against my will because of a family member also a scary thing. It’s more about inflicting psychological terror by doing nothing but let me remember everything that happened in Oakham House and let me continue my survivor guilt for being able to get out of there but leave those perfectly nice inpatients in there when they hated it.

So as for my review of this medication so far to treat PTSD, considering it intensified and possibly caused a nightmare when I haven’t been having them that much means I rate it 2/10 – do not recommend. Maybe it’ll improve in time and my nightmares will stop, maybe it will treat the physical symptoms of anxiety and I’ll feel better but as a first night review I’m giving it a 2/10 and it only gets that because I’m generous and am continuing to have hope it’ll work.

Suicide blonde.

Suicide blonde – dyed by her own hand
(noun.
a bottle blonde who has bleach-fried his or her hair to a very light shade with peroxide because he or she is naturally dark-haired.)

Which is a totally applicable to me because I am dark haired and now I am very blonde especially after the last time of dyeing my roots. Also, I’ve been feeling suicidal so there’s that.

So what has happened in my bubble recently? Lamotrigine. That happened. Welcome to my new medication. Welcome to the world where any slight change of skin colour is now Steven-Johnson’s syndrome because I managed to scare myself to death by googling images of the syndrome and seeing a person without teeth. I HAVE NO GONE THROUGH 2-3 YEARS OF BRACES TO LOSE MY TEETH BECAUSE OF MEDICATION. But yes, that is now my world and I have called it ‘Paris’ Paranoid Rash World’ and you can only buy a one way ticket.

I’ve recently watched Batman cartoons because why not? And fallen in love with Gotham’s girl – Harley Quinn and Poison Ivy. Add them to the list of people I want together but will never get together. I’ve stayed reasonably on top of my tv shows but relatively underwhelmed by a lot of them because of my old demonic friend – depression. Hello, depression. You’re back in full force again and breaking me one day at a time. I learned recently that it was common to get depression for a few months and then mania a few years later and then few years later depression and so on and all I have to say is… You are relatively lucky. I mean it’s awful when you come out but to have it only once or twice every 3-5 years is pretty lucky compared to someone who never gets a break which is why I’ve been diagnosed with:

ATYPICAL BIPOLAR DISORDER

Basically that means I don’t fit into a type of bipolar. Not bipolar I or bipolar II and I thought I was bipolar II to be honest. Though I am glad the consultant has given me a diagnosis but despite the fact I write a lot of things dedicated to bipolar I have trouble believing the diagnosis sometimes, like why is it bipolar and not a bad set of teenage hormones? I mean how did they differentiate and do I have to live with this label all my life? Is it even a label I need? Are you 100000% sure it’s not something else?

My bed is now my safe haven and respite and somehow the only place that makes me feel a little less depressed when the door is closed. I took 10mg of diazepam last night to sleep and I am still tired, is a nap in order? I think so. Is depression is order? Nope. I walk past my canvases and think to myself “when will I get back to that again?” Not for a while I guess…
But hopefully sooner than I think *crosses fingers*

In other news, I have an appointment with Miss D on Thursday (I think) and psychometric test next Tuesday. So wish me luck for that too, guys. Because I have no idea what sorts of things you do on a psychometric test, anyone know?

Can we live in harmony?

I feel like the pecking order when you have bipolar is the mood you’re in and nothing else. I have turned a picture I painted whilst manic into a set of art about a guy who commits suicide by jumping off the moo(d)n. I received the pens I won from a give away that are all art and I have no idea what to draw. I drew my brother a sherlock theme picture and I drew the second instalment of the guy who commits suicide by jumping off the moon but that’s it. School and I are back at odds again, I was hoping this year would be different. I was hoping the manic episode I had at the beginning was a sign but it’s not. Or it is. A sign that I’m going to be fucked 3 ways about Sunday until I’m begging for mercy under bipolar’s thumb. 

The worst part is I’m not even in the worst of it, it’s like when you’re 9 years old and you’re in the deep pool but the shallow end of it and you know whatever happens you’re going to end up in the deep part of the deep pool fighting for breath by standing on your tip toes and keeping your nose above water anyway you can. At least that’s what it feel like to me. Right now I feel like watching an endless torrent (pun intended) of movies, especially the one’s featuring mental illness. The melancholy ones. The ones with the sad girl and the person who fixes her. Even though I hate those stories because they’re so utterly fake. 

My psychometric tests are booked for 11th Feb and I’m probably going to change medication again since lovely abilify causes:

  1. Drowsy
  2. Bad quality of sleep
  3. Which leads to nightmares
  4. and flashbacks
  5. and that causes short amount of sleep too

Least before I had good-ish quality of sleep on 2 1/2 hours. Which my dad still thinks because I survived on no hours sleep at one point, I should be able to survive with this medication that causes sleep issues. I can’t and won’t. 

Bargaining

Bargaining. A tricky little thing. We do it a lot. “I’ll work out for 20 minutes and then have a piece of chocolate”, “I’ll sleep for 5 more minutes then I’ll get up.” Some of it is so easy to bargain but some of it is not. My recent bargaining was that “I’ll just have Wednesday off school but go back Thursday”, I didn’t go back Thursday but I have to go back Friday which fills me full of anxiety because I didn’t hand in the work on Monday which I then forgot on Tuesday and I was off Wednesday and Thursday so it’s very late. So sometimes bargaining can cause problems in the long run.

I went to see my psychiatrist on Wednesday. He upped the carbamzepine to 600mg and I talked about how I hated school, how I had nobody there as a friend and how I was struggling with work. My psychiatrist then went on a long speech about having a month off again. I want to make a point that I never mentioned time off because my dad would not be happy with that and I have one more year until I go “okay, this is how I want my school life” I can’t decide what we call each day or when the lessons I’m signed up for happen but I will be the one deciding what lessons I have. I’m not going to fill myself with anxiety each day just to make people happy. I’ll be allowed to leave school by law but I’m choosing to stay so you should help me not be filled with anxiety. Anyway, psychiatrist. Long speech about month off school. Then he tells me that he’s not going to give me the month off school because I will apparently “become more depressed” – well firstly, I didn’t want time off. Secondly, don’t decide what emotion I will or will not feel. I’m not a child and bipolar isn’t exactly predictable so shut up like you know what’s going to happen.

I’ve been thinking a lot about my future. University is not for me. But evening class, distance courses. Things that aren’t heavy duty and leaves time for other things. It’s cheaper and slower to keep the stress off. Again, another type of bargaining.

And a bargaining that is probably more relateable at this time of year. Bargaining concerning money, trying to get the best deals for Christmas. It’s difficult to know what to get your family at this type of year. I’m getting my brother: Thor DVD, Iron Man 3 DVD and Supernatural season 1 DVD. I’m getting this girl whom I know purely through the internet: a book to do with her favourite disney character Eeyore, some bathy type things and my dad? Well my dad continues to remain a hard man to buy presents for.

 

My computer hates me.

It broke down again. I mean it was my fault but I still maintain it leaped off my bed itself in a kamikaze mission for a rest. I dropped my computer with the charger in and it broke the pin off inside the bit where the charger plugs into the laptop. So into the computer shop it went and well, £120 later I have more problems than before. Yes it’s working but the idiots took the hard drive out WHEN THEY DIDN’T NEED TO and put it into an old crappy computer. My charger is now not recognised by my computer and I am currently stuck with this damn thing:

Screenshotand do you know what this means? It means it’s plugged in but not charging so my charger comes out slightly it is off. Straight away. My battery was crappy before but at least it held 5 minutes worth of charge. My computer is slower now and I swear it’s because they touched my hard drive. But the worst thing is that the charger is not even straight meaning the bar was not soldered on properly and for £120 you’d want it to be on properly. It’s ridiculous.

Anyway.

Moods have been up and down. Predominantly up, well… manic. But I’m down now and the trigger for this fucking depressive episode?! Therapy. EMD-fucking-R. I didn’t see her in 2 weeks, and before that I didn’t see her for 3 weeks and I find consistency works better for me. I mean I have got it now as I have an appointment every Friday from now on but I don’t really want to as it’s the most triggering thing in my life at the moment. We talk and she asks me the same questions every time and I think it’s because she doesn’t remember and I can’t handle much more of it. I know I agreed to Compassion Focused Therapy or whatever but it’s so detrimental to my mental health, I am really considering stopping.

My manic episode went the same way all manic episodes do. Everyone is glad for the first few days then as I stop sleeping and the grandiose attitude creeps in and the excessive amount of tasks are undertaken and money spent, tempers flare and of course I don’t understand why people are angry because I’m too euphoric and that leads to anger and that leads to arguments which due to my manic goldfish attention span, I walk out. I think a period of normality would have been nice because I don’t think I can handle depression.

This may be a good thing though. Why? Well my half siblings mum died a few days ago and I am going down to see them today (Sunday) and I don’t think me with a lot of energy is the best thing for mourning people. So in terms of that it is good but for me it’s awful.

I went town today though. I needed some skinny jeans and a new bath washy thingy so I went with JLS and RH who used to date so it was awkward. RH didn’t say much and said a lot of depressive comments which JLS told me was just his way to get attention, which is why I didn’t want to show too much compassion. I tried to show some over text when I got home but he ignored me. JLS forgot my psychology book even though I asked her to bring it and I wouldn’t mind but I have psychology homework that is supposed to be done inside that booklet for Monday, first lesson. This is honestly why I hate helping people. People let you down and you shouldn’t rely on anyone to do anything for you even though you do everything right for them.

I started carbamazepine at 100 mg and no mood effects though I’ve experienced a lot of pain in my legs ever since I started taking it. I haven’t looked up the side effects because I don’t care. It also makes me feel sick a lot so that sucks but it’s the prize you pay to be asked at every fluctuation in mood if you’ve taken your meds. I mean, have you? Today? Have you eaten? Have you had a shower? Have you done what others want you to do because whilst you feel fine if you don’t they’ll worry you’re off your meds? Because I have and I totally regret them. I know it was just a shower here or a biscuit there but seriously, how long are we going to let our behaviour be dictated by wanting to not seem mentally unwell so we don’t worry our families? I’m taking a stand right here. Right now. Who’s with me?

 

Happy birthday to me.

*hands around cake and balloons*

It’s my birthday today – 11th of October and I am 17. I can now drive. Actually my provisional license came last Saturday. My first driving lesson is on the 23rd of October.

Before I tell you how my birthday went I think I should confess something… for a while – I’m not going to say how many days since it is different for everyone – I have not been taking my medication and my dad has had doubts but hasn’t fully realised I haven’t been taking it. I just wanted a happy birthday and I was hoping mania would be the prevailing emotion. Since the medication hasn’t *quite* worn off yet, I’ve had bouts of both. I know, I know. Irresponsible. But I’ve had less hair falling out since stopping, I’ve lost weight and my memory is slightly better. I’ve started taking it again which is probably more bad than good but here we are. Anyway, my birthday:

I thought it was going to be crap but I woke up to birthday cards and my dad is paying for driving lessons and my brother gave me £5. It got a little bad with my English teacher hating me because my brother is in the class of year 10’s that annoy her and then my brother didn’t turn up for the detention she gave the class so she wrote a letter home to my dad. Even though she knew it was my birthday which put a damper on things. But then things got a lot better. My friend gave me birthday presents (which included: a book called Briar Rose, chocolates, face masks and cookies) and even a cake. I hung out with some new people and I mean I did feel nervous at points (mania did actually come into play a bit so that might be why it went better) but then the pain from my second molars coming through (the ones you’re supposed to get at age 13) got worse when I was chilling out with some of my friend’s friends (and my friend) so I took a painkiller and decided just to text as I’d calmed down considerably. Then I had a lesson but I wasn’t picked on to answer a question so that is something and it didn’t go so badly – I even got something right everyone else got wrong.

My dad then took me to Mcdonalds (I know, not exactly a 5 star place but what you going to do? 😉 )  where mania raised it’s head again but I managed to keep it under control. Then I played cards with my dad and brother (my brother won once and I won once) and catching up with a friend I haven’t spoken to in years. I feel weird because we were best friends at one point but now I’m worried that we won’t get on or she will/is finding me annoying.
I’m starting coursework in English language but luckily we only have 4 days next week due to teacher training day and then half term so I can rest up because school is really taking it out of me.

Results Day

SO I got:

A* in Religious Education

A in english language

A in English Literature

A in Health (possible A*)

B in Science Core

B in Science Additional

B in History

C in Maths

One the one hand I got brilliant grades in year 10 so it was easy to make this up. On the other I was dealing with bipolar disorder, PTSD and chronic insomnia through most of it so thank God for mania and hypomania. I PASSED! HAHA YESS! But wasn’t completely happy because everyone did better than me… I suppose however it could have gone worse and due to the medication I can prove myself better in A levels so in terms of long term it was a complete success.

ON the other hand, I have to go back in tomorrow because there wasn’t a sign and the two teachers who smiled and made eye contact with me didn’t fucking tell me I have to go and sign out of GCSEs like it was some sort of bad social networking site that I signed up for in the first place and get my subject information for next year because no fucker told me what I was supposed to do and I was nervous and awkward. So on my way to EMDR tomorrow I have to stop by school. Not in the mood for EMDR at the moment so I will just talk about exam results. So yes, another anxiety filled night as I have to go into school tomorrow but this time looking like a twat.

Catch up

okay. You get one free hit, I have been very bad at keeping my blog updated. Though to be fair my internet has been poor for about a week so… not that it’s an excuse but yeah it is an excuse.

Main question I guess you’re thinking is how am I?

Moods are still a bit… well I go down quite a bit but I find they are more triggered. Like for the past two days I have been depressed because I found out my dad is drinking again but if my brother and I are in a room together for long enough mania can sprout forward and entertain us all for a bit.

Healthwise, I’ve been ill for again the past week. I think it’s because I have hit the 1000mg mark of sodium valproate and my liver just has found it’s tipping point. My hair is falling out, my stomach is upset, my cognitive skills are snail speed so overall I’d say not great.

Socially? no, can’t we avoid that topic. Okay… okay… okay… OKAY! Stop badgering me, I’ll tell you. I haven’t left the house much still. I did email SK so that was something, well she emailed first but I emailed back very promptly. I did not go to JLS’ birthday party because I frankly didn’t like the way she treated me over the holidays with the fact she text me once when she needed me and then ignored my weeks worth of messages until Thursday at which point my technology was not really working. I feel bad, I do but like she even cares.

Future events: I have exam results coming out next Thursday and probably going to pick them up at 10am, my depression starts at 10:01am and the depression continues until the moment I have to drag my sorry butt out of bed. I also have to be dragged around town, shopping for clothes and other things one might need at a school. Which I can pretty much predict is the usual: go, get bored, have fun, get yelled at, get into argument with parent routine. Also, filling in papers to get my drivers licence – well provisional. But still, I could have a licence by Christmas and I can drive my brother to school and the beach. It’s pretty much the most exciting thing I’ve got going on right now.

PTSD – nightmares every single night. Flashbacks every other day, sort of thing. Not much change. Not much EMDR.

So how are you?

Psycho-what tests?!

Another appointment with the pdoc today and up the dose again goes. 1g, 1000mg of sodium valproate. Which is basically the final level since my liver plasm (or something) is at 89 and the max level is 100 and he doesn’t want to push it. I’ve never gotten 1000 of anything before so that’s pretty awesome or the final level, without my brothers help… well I had to start somewhere.

I’ll tell you what has both Mr pdocman and Miss D baffled though is how, on 1g of sodium valproate my concentration seems to be as bad as it is. I argue memory issues but nope everyone is firmly set on my concentration being terrible and I guess maybe they have a point. I still argue my memory is pretty fucking bad though.

So my pdoc has ordered up a round of psychologist with a side of psychosomething tests. Basically they’re a bunch of tests that will test memory and concentration to see if it’s actually not something else fucking with them and if then do I need another set of pills to help with my concentration… I never realised mental illness was so hard.

Now ideally for everyone involved it would be best they were done before the end of August; before school. Also long enough away so that we could make sure the medication actually works and helps but obviously that’s not to be. My doctor also asked if when I was at the mental hospital (for the short time as everyone so helpfully points out) did I have an MRI or an EMG or EMF… I don’t think EMF was actually one. I think supernatural is coming into play here. Unfortunately my memories not only get lost but end up swirled together but it makes for some stuttering and awkward conversations and who doesn’t love that? Anyway, so I’m thinking the pdoc is already cooking up a theory as to what’s up with my noggin (my physicans, they never tell you anything). So my question is (and will plague me till I have an answer): What is Mr pdocman thinking is wrong this time?

 

Red hair and first outings

I haven’t been out in a long time with friends, definitely over a year. But I went out yesterday with JLS to town and it was just a walk round the shops and stuff and despite my tired feet, it was good. I probably would have gone whatever mood I am in because I felt guilty about not going and cancelling all the other times and I really had no excuse considering it was the holiday. But it was fun. Then I went out to JLS’ house and her mum dyed my hair permanently red and it does look good and it is a brighter shade than the last time I dyed (albeit semi-permanently) my hair. JLS also practised make-up doing on me and I played with her animals (a week old kitten, 3-4 cats though I think there was more and a lizard). JLS then invited me to an under 18 club night and sleepover with LC and Mel whom I don’t know. It sounds like a good idea but I don’t think I could based on the anxiety more than anything. Anxiety from crowds, guys, being out at night etc. I could go on but I feel gulity because if I don’t go with her then it seems like I was only going out with her yesterday because I was getting something out of it (getting my hair dyed) which I wasn’t. I’m probably just over thinking it. I’m still deciding whether I should go or not.

As for the tablets, I think it’s controlling my manic symptoms which is good but not so much the depressive symptoms. The big thing I’m dealing with that doesn’t help with the depression is I can’t access my creativity or concentration or memory as well as the dissociation due to the nightmares because of the fact I sleep more. I sort of sway to not take it, it depends what I’m doing whenever I have to write, draw, paint or anything creative I get frustrated because I can’t access it. But then I think that I can make a less dentrimental decision when I am 18 years old so that is intially my plan but it depends on how difficult the next two years for A levels. In some ways several weeks of intense dedication then forever of passiveness. If that makes any sense, which is probably doesn’t because I can’t even focus on thoughts for very long at the moment. Maybe it’ll even out before school, who knows? I’ll talk to the psychiatrist about it tomorrow.

Recovery and Headaches

I’ll admit it. I argued at some point during the week with my dad because I wanted to stop treatment. I mean at first it was just this gut instinct. But I thought about it and I realised my problems with the whole thing. Firstly, I had nightmares and they were driving me crazy because it caused dissociation once I woke up, a lasting feeling of panic and yada yada yada but I am seriously worried that one day my heart won’t be able to take the panic and be too overworked and I don’t exactly eat healthly and quit working, I dno. I feel it needs a holiday since it’s been beating fast (or hard idk) so it needs a break but it’s not like your kidney. Can’t exactly take it out and go “ok hart u stay der 4 a bit & rst” but you can with a kidney – keep that in mind. Secondly, the idea of recovery freaked me out. I know logically everyone thinks I should be psyked at the idea but it’s a frightening thing. This medication isn’t working, I want to stress that but it’s at 400mg and as of yet no real side effects except that I’m losing a tad more hair than usual but it’s only a tad. I feel as though if I was coached a little, it wouldn’t be so scary. I mean ruining your life and STAYING mentally ill is one thing but entering recovery but having your life remain in the ruins you left it in is so scary because YOU will have to rebuild it yourself, all the relationships you ruined, the schedules you broke, the exams you failed, the things you quit, the cleaning to get that depression smell out of your room and just renewing everything is so scary. I know how hard that will be and for a few days staying mentally unwell seemed easier than that.

I talked to people about it and whilst I didn’t explain myself as concisely as that, I got several different immediate reactions:
“WHY?”
“YOU JUST WANT TO WALLOW”
“THAT’S STUPID.”
… or ignoring me.

etc.

btw, that is not how you correctly approach someone who says that. You ask why in a calm manner. Press them for a reason and then talk through it with them because I swear to God if I get the cliche “i’m there for you” and you never actually help me when you know I need it or I have asked for it then I am going to kill someone because it drives me crazy.

But for the record, I talked to a friend about it and she said that I didn’t have to rebuild anything and I can just start from scratch if I want to and I can always stop the medication if I don’t like it but let’s just find a medication that works for future reference.

So since my dose was upped,. a few side effects:

  1. Headaches
  2. Mild stomach aches
  3. A tad more than usual of hair loss
  4. Sleepiness
  5. Eye floaters and just a lit bit of eye issues.

Current mood: depressed.

My dad says that I am being nicer, I am being nicer because I am not as stressed out because I get to hang in bed. Not because my depression is lifting. I don’t leave the bed unless I need the toliet. I have not left the house, well since Tuesday but that’s because I had EMDR. I haven’t got EMDR next week because I was supposed to see my pdoc but I’m seeing him the week after for a review so it seems like a waste of time and I could have had an EMDR appointment but I have not got the energy or the drive and I don’t care about it. I find I have to lie a lot in EMDR because it doesn’t actually help but then I feel bad for the Miss D because it’s like she’s just wasting her time. I just feel like I want to become the girl from the book ‘Speak’ and stop speaking – I know condradiction, right? But you should read it. It makes sense then.

I also ran out of medication last night so I took the one from the packet last night, but then find out there were two on the bread board but by the time my dad was giving me them at midday they were essentially smush (no other word, i’m sorry) and have you ever tried even slightly dissolved sodium valproate? Bitter as hell. So I missed half of last night’s dose, this mornings dose. But my chemist gave 5 days supply since he remembered giving them to my dad because they’re like friend or w/e. But my dad has to drop the prescription off. Gotta remember that if I ever get industrial strength painkillers… kidding. Sorta.

Can I just apologise if there are any spelling errors or mistakes because I’ve been very out of it attentionwise so I’ve been making a lot of them.

Checking in.

What’s everyone up to?
I know 6 days since my last update, nearing a week. I’ve just been busy. Usual excuse really but I have 4 exams left and medication that is making me sleep more. Good news. Bad news, more nightmares and dissociation which is my problem anyway. I ave EMDR today which I don’t want to do, I just want to crawl into bed and ignore the world. But can’t. I’m not a grown up in the eyes of the law, the school or my family but they sure as hell expect me to act like one. Hypocrisy at it’s finest. But whatever, I could sit here debating what makes sense and what does not. I mean I got a letter addressed to Mrs and Mr [family name] so obviously the psychiatrist doesn’t listen because there is no mum and there is not even a step mum and I bet it’s because Miss D told mr pdocman about how my dad was married before and he got confused because he doesn’t listen. Also was a letter telling my GP about the abuse – thanks for the trigger Mr pdocman. So I listened to my dad rant.

Well how do I deal with stress? With my two favourite impulse control problems. Kleptomania which isn’t strictly just reserved for manic episodes but it does seem to favour them whereas my second favourite cutting is exclusively to depression. I don’t delve into either of them too graphically because one’s illegal and I don’t intend on getting caught because I wrote it on a blog especially as I intend on cutting down on being a klepto and cutting, well. That’s triggering and depressing.

I’ve been listening to a song from 2010 I think, which I loved. Airplanes pt 1 and 2. Also trying to figure out what to get my dad for father’s day. We need new mugs so I was thinking a mug with my mug (and my brother’s) but then I don’t know. Buying for people is difficult.

Science Blog: Bipolar Brain

Now as we know there are different types of bipolar:

  • Bipolar I= Categorized by at least one manic episode
  • Bipolar II= Never experiences full blown mania, experiences hypomania
  • Cyclothymia= Mildest form, less severe mood swings between hypomania and mild depression

But how does that relate to the population?

  • Bipolar affects about 2.6% of the U.S population.
  • Bipolar disorder results in 9.2 years reduction in expected life span (scary, right?!)
  • About 1 in 5 patients with bipolar disorder commits suicide.
  • Almost 70% of bipolar patients are misdiagnosed 3 or more times before receiving their correct diagnosis.

Now there is a spectrum for bipolar and here it is:

spectrumAnd we know the symptoms of the spectrum, right?

 Manic Symptoms:

  • Easily distracted
  • Little need for sleep
  • Poor judgment
  • Poor temper control
  • Reckless behavior and lack of self control
  • Elevated mood
  • Easily agitated or irritable
  • Increased energy
  • Racing thoughts
  • Very high self-esteem
  • Talking a lot/quickly
  • Spending sprees
  • Increased promiscuity
  • Poor Judgment
  • Binge eating, drinking, drug use

 Depression Symptoms:

  • Low mood or sadness
  • Trouble concentrating, making decisions, decreased memory
  • Eating problems-weight loss or gain
  • Fatigue
  • Feeling guilty, worthless or hopeless
  • Decreased self-esteem
  • Thoughts of suicide
  • Decreased pleasure in activities once enjoyed
  • Trouble sleeping
  • Isolation from friends and family

Mixed State: When two phases of depression and mania overlap or quickly cycle after another.

But what’s the neurobiology of it all?
ee2These are pictures of bipolar brains. So what does it tell us, well it tells us that:

  • Although the abnormalities in the brain due to bipolar disorder are still unknown, the structural abnormalities believed to be linked to bipolar disorder are amygdala, basal ganglia, and the prefrontal cortex. Research is currently being conducted to find more definite information on the definite causes and changes in the brain of bipolar disorder.
  • Recently using MRI, hyperintense (bright white) spots have been found in bipolar patients. Hyperintensities have previously been associated with a change in water content in the brain tissue, but the causes of these are not known.
  • Amygdala volumes have been shown to be reduced in unmedicated patients and increased in medicated patients. This is seen in the chart below.
    1-s2.0-S1053811909012099-gr2So what does it actually look like, you know, hormonally?
    bipolar-brainAt the top is ‘normal’ brains, in the middle hypomanic and at the bottom depressed brains.

    • Abnormal intracellular function of the brain of bipolar patients, such as producing higher amounts of serotonin, dopamine and norepinephrine.
    • These abnormalities lead to “racing thoughts” or the patient feeling like they can’t “turn off” their brains.
    • In this figure, you can see the reduced activity in the depressed brain, by the presence of more dark blue and can see the overactivity in the manic brain by the presence of more green, yellow and red in the brain scan.

    DanaGuide_CH15C33_P437_spot

    • Studies done with mice have shown that mice with a mutation in the CLOCK gene will develop manic behavior. This behavior includes: hyperactivity, decreased sleep, reduced anxiety, and an increased response to cocaine. The researchers were able to get rid of the manic behavior by returning the expression of CLOCK to normal, specifically in the ventral tegmental area of the mouse brain.
    • The ventral tegmental area is very rich in dopamine receptors. Because of this, the researchers believe that the same issue that the efficacy of atypical antipsychotics in acute mania might be achieved by their ability to lower activity in neurons specifically within the ventral tegmental area.
    • Levels of expression of oligodendrocyte-myelin-related genes are decreased in brain tissue of individuals with bipolar disorder. Oligodendrocytes produce myelin membranes that insulates axons and allow nerve impulses to fire very rapidly, so a loss in myelin is theorized to interrupt the communication between neurons and lead to possible thought disturbances that are seen in bipolar disorder.

    br-800epi1

    -Although individuals with bipolar disorder do not demonstrate a size difference in hippocampus, bipolar patients have shown hippocampal dysfunction in:

    • a reduced volume in nonpyramidal cell layers
    • a reduced number of somatostati-positive and paravalbumin positive neurons
    • reduced somal volume of cornu ammonis sector 2/3
    • reduced mRNA levels for somatostatin, parvalbumin and glutamic acid decarboxylase 1
    • The hippocampal anatomy is displayed above to illustrate these problems.

    Some studies have also shown a loss in gray matter in bipolar patients, depicted in the graph below. Gray matter is made up of neuronal cell bodies and regulates muscle control and sensory perception, which include: seeing, hearing, memory, emotions, and speech.

1-s2.0-S0006322307002338-gr2 003_brain-white-matterOkay, so what CAUSES bipolar disorder?

The causes of bipolar disorder are vastly unknown, and much research is currently being done to determine the exact cause. However, it is believed to be a combination of genetic factors, environmental factors, and the individuals biochemical processes.

–First degree relatives of a person with bipolar disorder are 7 times more likely to develop bipolar disorder.

–80% concordance rate in identical twins and 16% in fraternal twins, which means that in the case of twin studies, an identical twin has an 80% chance of having bipolar if their identical twin has it, and only 16% chance if the twin is fraternal. This explains the high genetic factor seen with bipolar disorder. Because identical twins share 100% of their DNA, while fraternal twins are regular siblings that share only 50% of each other’s DNA.

–Several genes appear to be linked to bipolar disorder:

  • CACNA1C, on chromosome 12. This gene encodes the alpha 1C subunit of the L-type calcium ion channel in the brain
  • ANK3- an adaptor protein found at the axon initial segments and regulates the assembly of voltage-gated sodium channels.
  • Both ANK3 and CACNA1C genes are down-regulated in response to lithium.
  • Abnormal CLOCK gene function

And of course triggers:

  • Stressful life events
  • Certain medications
  • Major life changes
  • Drug or alcohol abuse
  • Seasonal changes
    But these only trigger episodes in predisposed individuals.

Well I’m on the treatment phase now, so what should I expect?

Mood Stabilizers are most often used because although bipolar patients experience depression, antidepressants are used to treat bipolar patients with caution, because antidepressants have been known to trigger manic episodes in individuals with bipolar disorder. If antidepressants are used, they are used in addition to mood stabilizing drugs.

  • Lithium
  • Valproate
  • Lamotrigine
  • Carbamazephine

ECT: Electroconvulsive therapy (ECT) may be used to treat the manic or depressive phase of bipolar. ECT uses an electrical current to cause brief seizure, while the individual is under anesthesia. This is considered the most effective non-drug treatment for bipolar disorder.

Transcranial magnetic stimulation (TMS) uses high-frequency magnetic pulses to target affected areas of the brain. This treatment if used more commonly than ECT.

EMDR app #1

EMDR is a tiring process. I mean I haven’t even got onto the bad stuff yet. She showed me what she would do by processing a mild irritant in the past few days which was just people annoying me with incessant texting. Basically I had to rate it and it was a one, then it went up to a three – the EMDR made it worse and then back down to less than one and I’m just tired from that. THAT. I don’t think I’m emotionally ready to deal with the big stuff but the part of me thinks “hey do it now and then you can sleep”. I don’t know, I’ll have a think. I’m not ready to promise that I’ll deal with the big stuff next week or the week after because I was almost having a panic attack just doing that and I am completely strung out, emotionally and psychially (that is not spelt right, I’m just too tired to care).

I know a lot of people find the benefit after the first session but I don’t think I’m one of those people which is okay, sucky but okay because it’s gotta get worse before it gets better, at least that’s what I’ve heard. I also got a relaxtion tape which is sort of against what I believe in, like I don’t believe it works but I suppose everything has to have some evidence behind it. It’s just a lot of things that are meant to relax me, put me more on edge. I think it’s a hypervigilance thing. I feel myself relaxing, I feel I can’t react in time to danger so I don’t relax. Just constantly feeling on edge.

A friend who did it said I’ll be emotionally raw for the next few days and more sensitive, I’ll warn my dad because I have recently been getting triggered by the fact my dad tells me about all the injustice sexual assualt stories and the barrister who wants to lower the legal age for sex limit from 16 to 13. THIRTEEN! no. I know there are 13 year olds doing it anyway but it’s not legal and it shouldn’t be.

I haven’t been to school since Tuesday. So instead of having a day off a week, I’m going to school one day in a week. Which is messed up, I just am too strung out to do anything. It’s not the prozac, never the prozac (psst side effects so far is nausea which as side effects go isn’t that bad) it’s the mental illnesses, anxiety and insomnia that are stopping me. I am lucky in a sense because natural intelligence and the bits I did go in for and my grades last year mean that I will get the 5 C grades I need to get to A levels and the only grades I need to worry about is science with a B and maths with a C and yes this is pretty much me repeating myself over and over again but it’s probably just a reassurance to me that I can just get by.

 

The I-Was-Supposed-To-Be-Aggressive Appointment

I was supposed to be aggressive in my approach about the form but they said the one thing that was confidence rocking. The traumatic event. So I began to dissociate and flashback and just became very distant. Basically what it boils down to is due to the diagnosis of PTSD, the psychiatrist is no longer willing to treat the mood swings for at least a few months of EMDR  as they COULD be related but I know for a fact they aren’t. High episodes, high episodes like I’ve have, have never been a part of PTSD and it’s the same problem that he either doesn’t know or can’t admit that I have a mood disorder that IS a chemical imbalance. I don’t know why and because he  has more expertise the bp and psychosis specialist listens to him. He gave me so antidepressants called fluoxetine 20mg and well, the last time I was on them it made my mood rapid cycle even more but it was antidepressants or no medication and I’m pretty much willing to give anything a try just so I can get through these exams. I’m pretty much willing to get high just to get through them, I don’t want to watch myself… wait, is fluxoetine prozac? I was just googling and found it has another name called prozac. Ugh, apparently there is a good chance prozac will cause manic episodes and my first exam is next Friday. Well, at least I won’t feel like killing myself so there’s that upside and sometimes hypomania is good for revision as it gives intense concentration and zoning in. So looking on the up side there’s that. But I’m just feeling really run down with it all at the moment so I might just spend the night watching DVDs.

But in terms of the letter, I just wrote “Dr [pdocman] – everything wrong in your report” and told my dad to give it to the receptionist or whatever the hell you’re supposed to call them nowadays. Well, probably going to hear nothing from that but I gave it in. I wasn’t aggressive. I was just sort of in a depressed haze.

I’m supposed to google ‘mindfullness‘ but I’m confused because I thought I wasn’t supposed to google stuff because I’d probably just diagnose myself with every disorder but according to wikipedia:

Mindfulness is a spiritual or psychological faculty (indriya) that, according to the teaching of the Buddha, is considered to be of great importance in the path to enlightenment . It is one of the seven factors of enlightenment. “Correct” or “right” mindfulnessis the seventh element of the noble eightfold path. Mindfulness meditation can also be traced back to the earlier Upanishads, part of Hindu scriptual”

Mindfulness practice, inherited from the Buddhist tradition, is being employed in psychology to alleviate a variety of mental and physical conditions, including obsessive-compulsive disorder, anxiety, and in the prevention of relapse in depression and drug addiction

From what I gather it’s a load of buddhist, mediating crap. Don’t get me wrong, mediating is so benifical to some people but I don’t think I could do it. I’ve tried it before and got bored and my mind would wander and boom, even more depressed so I’d get pissed off. I dno, it’s not something I find to be helpful but I’m glad it helps the people it does.

Up/Down Bipolar Documentary *trigger warning to video not post*

This is a video called “Up/Down” It’s a bipolar documentary. It raises good points such as how under educated the public is but one member of the public realises that a lot of bipolar cases are just having pills pushed on them but no psychological treatment. It goes through the stigma and misconception of it, history of the disorder including how it was historically treated, symptoms (for family or friends or people interested), new research including finding what chromosomes are involved and what psychological aspects trigger it. They talk to real people with the disorder as well as professionals.
Side note: Kyle has an awesome hat. KYLE HAS AN AWESOME HAT! i like kyle. because he has an awesome hat. Ok.
Information on electroshock therapy – a first hand account. Medications and how helpful they are (but remember take them with a pinch of salt as not everyone is the same). Treatment. Just watch it 🙂

Reduced dose

The bipolar and psychosis person calls us. Why? Well because apparently I had an appointment today. In my defense, if she did tell me. She told me when I was manic and like I could hold that thought in plus someone wrote all the appointments down, from the phone call from the psychiatrist  to the appointment 17th May. But yes, told her the side effects and she told me to just have one tablet in the morning now so I’m on 0.5mg dosage and apparently my psychiatrist told her I’m “sensitive to these types of tablets” and I feel like that was a jab at my age. But whatever. I just need to stop producing milk for none existence babies.

I can’t actually remember when they rescheduled the appointment for. I don’t actually care either. I feel like bipolar is my safety blanket and sometimes in the moments of wellness and emotional stability I occassionally have I get so scared because when I have bipolar episodes everything is so intense and when you don’t have that intense emotions, it is hard. Maybe that is why the further the treatment process goes the more terrified I get. It’s like what if my life becomes just blahh and not have intense emotions anymore? I mean the lows are low but least I get to feel any emotions I feel sad about when low. When high it’s like being high and what if I don’t get that anymore on the right medication?Plus I feel like my psychiatrist is doing this badly because aren’t I suppose to have a psychologist? Someone I see once a week to talk about life to? I swear in everything I’ve read that’s part of the bipolar treatment. If anyone could tell me their experience, like did they have to be stablized on pills to get a psychologist? or something?

One of the more awful side effects of risperidone

It’s common.
It’s a secondary effect to an increased prolactin level.
It’s hard to explain that you are not actually pregnant.
IT’SSSSS LACTATION.

Yes, Ladies and Gents. The aforementioned side effect from yesterday’s blog is lactating and for those of you who don’t know it’s where you produce breast milk. Now at the moment it’s just a few drops here and there but I could risk going to school it leaking through my clothes or down my top and onto my trousers and having to explain that I am not and have never been pregnant because it’s just one of those things you don’t live down.

So I read about it and apparently if that happens you have to call your psychiatrist and probably go on another antipsychotic. But try getting through to a psychiatrist on a Friday. I’ll keep taking risperidone until Monday and if we can’t get through then, then I go cold turkey.

Don’t get me wrong. I like the bigger breasts but I don’t like the pain, uncomfortableness or the milk as in it dripping.