Bipolar Medication

It’s been a few weeks and I’m still manic.  My therapist really doesn’t know what to do with me now.  My psychiatrist started me on Latuda.  At first it was just 20mg for a few days, then 40mg for two weeks.  At the end of the two weeks, I increased my dosage to 80mg as instructed.  This caused severe problems that took me a few days to recognize.

The Saturday I increased my dosage, I had planned a trip to Tomoka Brewery with the girls.  A friend is visiting from North Carolina and she was joining us as well.  I started feeling nauseous and uneasy for some strange reason so I decided to drive myself.  The entire drive I felt restless and remained uneasy.  I couldn’t focus and I couldn’t sit still.  For a 90 minute drive, this was bad news.

The entire drive I noticed myself looking at the time every five minutes.  I felt like time had slowed down and I couldn’t make it move quickly enough.  Normally, I don’t mind long drives by myself.  I’ll put on my favorite music and enjoy the trip.  This time, I needed to desperately get out of the car.

I ended up stopping halfway to the brewery at a gas station in the middle of nowhere.  There were about ten people at the station and I probably could have taken all of their teeth and made two full sets.  I still think I heard banjos in the background too.  As I got a bottle of water and a quick snack, I made sure to not look any of these creatures in the eye for fear someone may think I have a purdy mouth.

I hit the road as quickly as I had stopped and started drinking the water.  This didn’t help calm the restlessness at all.  By the time I got to the brewery it was so much worse.  I felt like I wanted to cut my skin off and step outside of my body.  Now the agitation and need to just keep moving settled in.  I couldn’t make these feelings stop and I thought it was the mania.  At this point, I hadn’t realized that this was related to the new medication.

The next day a friend and I went to the Renaissance Festival in Tampa.  We stopped for breakfast before driving out and during I still felt restless.  Luckily for me my companion for the day tends to have a polarizing effect on me and stabilizes my mood.  It’s his energy that works in my favor.

At the Festival we had a good time looking at all the vendors.  One of which was the corset vendor.  I stopped to try on a corset and absolutely loved it!  I got cinched up in a beautiful corset that fit me perfectly.  Unfortunately, they wanted $180 for theirs and I’m not willing to pay that price.  I can find one very similar online for half that price.  As much as I fell in love with the corset and felt I looked damn hot in it, I let it go.

The morning was hot and steamy so we left early.  I spent some time with my friend and we eventually made our way to Gators Dockside for an early dinner.  After, I went home.  Thankfully the restlessness was there but not too bad throughout the day.  I still think my companion was the reason for all this.  I find it amazing how the energy one person puts off can affect another person so easily, especially when the person being affected is emotionally empathic to others in the near vicinity.

After I got home I started thinking more about the medication but couldn’t really find anything that would cause this new, strange feeling.  I again took another 80mg tablet and went to bed.  Monday morning I woke and went to work as normal.  I made my cup of coffee (I keep a Keurig at my desk) and drank it as normal.  Within just a few minutes of the caffeine hitting my blood stream I was wired and way more agitated than normal.  I felt like my insides were trying to jump out of body and I couldn’t get comfortable at all.

I started doing a little more research into Latuda and found this strange medical term pop up a few times – akathisia.  I read it in the prescription documentation but I figured it was some disease.  Once I started reading up on this medical term, I realized it is exactly what I’m feeling – inner restlessness.  Bingo!  I immediately called my psychiatrists office and was told to go back down to 40mg.  It’s now been a few days since and the akathisia has subsided for the most part but it is still present.  Tonight, I am not taking this medication.  When I speak to my psychiatrist next he will be giving me a whole new prescription because I am NOT taking Latuda again.  It was way too expensive and way too many side effects.

Now that has me thinking, do I really need bipolar meds?  Of course my therapist and psychiatrist will say yes, but I’ve been without medication for years.  I should be able to get through this without going back on medications again, right?  I hate being used as a science experiment.  There isn’t one particular drug that works for bipolar disorder and I’m constantly playing with the drugs I’m ingesting. 

I feel like a lab rat and I want to stop.  I know it’s best for me but to what end do I have to do this?  So we’ll find the right drug cocktail that will work for a while but when my brain chemistry changes the drugs will need to be modified all over again.  It’s frustrating.

Top it off, the medications end up making me feel numb.  I will eventually miss the swing of the highs since I won’t feel them anymore.  I won’t miss the depression but that’s what the medication is for, to even me out.  This is also another reason why many patients wind up off their medication because they start to feel numb. The highs are great and we start to miss that rush but once we realize it’s the medication putting the brakes on the roller coaster we stop the meds.  That’s why I stopped the medication the first time and opted for CBT (cognitive behavioral therapy, pervs!).  I learned my triggers and how to compensate for them for so long.  It’s just recently that I’ve needed a little extra help.

Why does my brain chemistry have to be so far off?  Why can’t I be normal?  No wait, I like being abnormal.  Normal is scary.  Normal is for the people who are bland.  I like having a little spice to my life.  I wake up wondering, is today going to be moody and depressed or is today going to be manic and crazy?  Not really each day but you get the point.

Being Manic

Most people don’t understand what it is like to live with a mood cycling disorder so let me give you a little taste of what the roller coaster we suffer from on a daily basis.  For months I’ve been depressed with feelings of isolation, grief, loneliness and complete despair.  It’s caused me to push away the people that love me the most and withdraw from the world around me.  It makes me see a delusional reality filled with distrust, anger and cynicism.

Recently the fear of losing an important relationship caused me to snap out of this depression streak.  Overnight I went from a moody, depressed, and miserable existence to one filled with happiness, hopefulness and the feeling of being giddy all the time.  It was like a light switch that was flipped in my brain.

My thoughts come rapidly like a freight train that is careening off course, or better multiple freight trains.  I have a tremendous amount of energy that I cannot contain.  My speech is rapid and my hands flail all over the place as I talk.  I don’t quite have grandiose thoughts but they are up there.  I act on impulse rather than thinking through my decisions in an analytical fashion and I don’t worry about the repercussions.  In other words, I feel like I am flying and I don’t want to come down.

As for chemically what is happening in my brain, I have an excess of serotonin and norepinephrine running free.  These two hormones are what creates the manic state in a person that has bipolar disorder.  The serotonin is necessary but there are not enough receptacles to attract the serotonin and therefore it produces the elated feelings.  This also increases the norepinephrine which results in the erratic behavior that I experienced along with the increased heart rate and blood pressure.

When a bipolar patient is experiencing the depressed side of the spectrum, the serotonin levels are very low and there are too many receptacles waiting for the brain to release more of this hormone.  The reduction of serotonin causes the negative feelings, the lack of enthusiasm and dreads the goes along with depression. 

While it is easy to discuss the chemical reaction that occurs in the brain, the resulting emotions are much more difficult to describe.  When I am manic like I am today I feel like I want to bounce off the walls.  I laugh easily and there is not enough stimulation in the world to keep my attention.  I want to run and jump and play and be happy.  I don’t want to think about anything that can ruin this high nor do I want to control it.  I just want to be free.

As I meander through this stage I am very much aware of what is happening to me.  It’s like I am a bystander watching my life careen out of control as if I’m having an out of body experience.  I’m watching myself from above with no care to stop myself.  This part of me that is floating above me just watches and waits for that next moment that is going to bring me crashing back to earth.  Eventually it will happen.  Something will hit me and reverse the chemical reaction in my brain to make me depressed again.  It’s just a matter of time.  So until then, I will enjoy this ride for all it’s worth.

A Day of Apathy

I had no desire to speak to anyone yesterday.  I made it to work but I did as little as possible.  For most of the day I wrote, read Facebook along with my favorite blogs and listened to music.  I didn't really care what was going on around me.  My co-worker mentioned I was quiet and asked what was wrong.  What can I say?  I have cycled heavily for the past two months and now I feel drained.  Mood cycles up and down as rapidly and frequently as I have been having is hard on my mind and body.  Some days I just want to give up, put my life in someone else's hands and just... be.  Let someone else pilot this body for a while.  Unfortunately, that's not going to happen.

For breakfast I made a couple pieces of turkey bacon along with two pumpkin pancakes.  I brought them to work with me and used sugar-free syrup.  With my coffee, my breakfast was a total of 359 calories.  Lunch was left over salmon over a bed of greens and homemade dijon vinaigrette.  Total calories for lunch was 402.  Dinner I baked lemon chicken with whole grain lemon orzo (it was a lemon kinda night).  Total calories for dinner that included a Skinny Cow mint ice cream sandwich was 701 calories.

Overall my food intake was pretty good.  I ate all my allotted calories for the day which felt great.  I even went to the gym and did 20 minutes on the elliptical and 10 minutes of pumped up strength training with my upper body.  Rather than resting and taking my time when I'm strength training I push harder and quicker with the weights.

Since I started running on the elliptical for my exercise and taking the stairs daily at work my quadriceps have been inflamed.  Last night was no exception.  I laid in bed and they were so sore I couldn't sleep.  All I wanted was for someone to massage them with eucalyptus oil so that I could rest and go back to sleep.  Add on to that the pressure that I've had in my head for the past two days and I nearly started crying.  It took me a while but I finally got back to sleep.  This morning, my quads hurt just as much as last night.  I've already taken naproxen sodium and acetaminophen to try and help.

Later this morning I have an appointment with a new psychiatrist.  I finally broke down and decided to make an appointment to talk about medications again.  I've suffered from bipolar disorder (cyclothymia), ADHD, and generalized anxiety disorder for years.  I've been able to cope on my own but lately it feels like I am not able to any longer.  I'm cycling far too much and I've had way too many anxiety attacks over the last couple months.  It's starting to affect my quality of life.  I don't want to be drugged up.  I don't like how it makes me feel - numb.  We'll see what he has to say.

Weekend Recap Part 2

Sunday I woke up very early - I just couldn't sleep past 6am.  The night before I went grocery shopping and bought the ingredients to make pumpkin pancakes.  It is fall after all.  The twist is that I am making these pancakes healthy.  Instead of processed white flour I am using unbleached whole grain flour.  I also bought turkey bacon to go with the pancakes.  I’m not a big fan of bacon, especially turkey bacon, but I wanted a healthy protein for my breakfast.

Pumpkin Pancakes Per Serving:

214 Calories

41 Carbs

2g Fat

10g Protein

350mg Sodium

3g Sugar

I felt pretty good with my breakfast.  It was still pretty early when I finished breakfast.  My head was filled with pressure and I was still very emotional from being in a down swing so I decided rather than feel sad for myself that I would try to get some exercise in the hopes it would make me feel better.  I did my normal 20 minutes (still working on endurance) on the elliptical but I just didn't feel like doing any strength training today and my mood was not changed.  As I got in the shower I was reminded again of my dad and I cried.  Maybe I'll make some cookies and visit a fire station this weekend.

The entire morning I just kept telling myself to not let myself get down and to keep moving.  I picked up peaches from the farmers market the day before with the intent of making jam so I figured I'll go get the supplies needed.  

The best place for canning supplies is Wal-Mart.  Oh how I loathe Wal-Mart.  I absolutely hate the store.  As I drive through the parking lot I am reminded why.  There are some very strange people that shop at Wal-Mart and most seem to be stupid idiots.  Don't get me wrong, I'm sure there are some very intelligent, nice people that shop at Wal-Mart.  However, it seems that when most people pull into the parking lot they lose their ability to think logically and with common sense.  Add on the parents with screaming, wandering children and I just cringe.

I successfully make it in and out of Wal-Mart with my canning supplies without a major incident.  It was a close call a few times but I managed to not get touched or yell at anyone.  I'm quite proud of myself.  

I venture on to Publix and pick up items for lunch.  Staying on the path to weight loss, I picked up whole grain Rye, lettuce and tomato.  I figured I'll make a BLT with the turkey bacon I have at home.  I also picked up some veggie chips from the farmers market to go with my yummy sandwich.

BLT on Toasted Rye with Dried Veggie Chips (Hellmans low-fat mayo)

312 Calories

32 Carbs

12g Fat

13g Protein

917mg Sodium

0 Sugar

I discovered while in the grocery store that whole grain rye has fewer calories and carbs then whole grain flour bread.  I silently did a little happy dance because I love me some rye bread!  This sandwich was so yummy.  I could have eaten a second one and been a happy girl.

I rested for a little while and then decided to make the jam.  Instead of regular jam, I wanted a healthy alternative so I found a recipe on Splenda's website for no-sugar added peach jam.  I've made many jams but I've never made a jam with Splenda before.  This was going to be a first.  Usually when making jam the amount of sugar added double's the volume of the fruit added.  Because I was adding just a 1/2 cup, it only made four half-pint jars.  I was a little disappointed but in the end it tasted phenomenal!  Of course I had to taste it with a slice of the yummy rye bread.  

No Sugar Added Peach Jam
Serving Size - 1 tablespoon
10 Calories
0g Fat
5mg Sodium
3g Carbs
1g Sugars

Overall the day was productive.  I like when my days are productive.  It helps normalize my moods and that is always a good thing.  I had a salmon filet and roasted brussel sprouts for dinner.  I finished the night with a Skinny Cow Mint Ice Cream Sandwich and a movie.

Daily Total

1608 Calories

151 Carbs

69g Fat

95g Protein

2717mg Sodium (little high)

27g Sugar

I felt great at the end of my day.  I stayed moving and went to the gym, I ate healthy, and I finished the jam.  

Two weeks ago I purchased bath salts from Fresh Market.  I made up a mixture that was recommended in the store to help me sleep so I decided to try it.  WOW! It actually helped.  I made a mixture of spearmint, grapefruit and eucalyptus.  My skin felt incredible and my muscles seemed to melt under my skin.  I got in bed after my bath and I was OUT.  I usually wake several times in the night but last night I slept hard until 6am.  I woke feeling great.

Weekend Recap - Part 1

This weekend was emotionally rough for me with the first anniversary of my father’s death coming up on Oct. 5^th.  I’ve also been cycling up and down frequently for the past 2-3 months which is abnormal for me.  I have cyclothymia – a form of bipolar disorder.  For days I will cycle very low and experience profound depression.  When I come out of the depression cycle, I tend to be hypomanic (not hypermanic).

When I’m low, I can get really low.  During this low swing I will cry and have irrational thoughts while the world seems to be a bleak place for me.  I don’t want to talk to people and I usually pull away into my own little bubble.  It is very difficult to find my way out of these feelings and takes a few days for my neurochemistry to even out again.

The great part about having cyclothymia is before my neurochemistry has a chance to regulate itself I usually swing into a hypomanic mood first.  During this cycle I experience a euphoric state and can quickly become agitated.  Unlike when I am depressed I am talkative, confident and assertive.  I also appear to be flighty, have short-term memory problems and I change my mind often.  I am probably a little narcissistic too but I tend to keep that side of myself at bay.

Thankfully I am not an emotional eater.  In fact, I am the opposite.  When I am emotional, I am overly critical of myself and that includes my food intake.  I am working really hard to lose weight and I’ve lost 24 pounds in the last 10 weeks.  I feel great.  People around me tell me they can see the change – I cannot see it so much as feel it (especially in my clothes).

Friday my girlfriends and I went to a bar that was unveiling a new beer that was brewed with the collaboration of two breweries nearby.  It ended up being a dull night.  Rather than sticking to my diet I gave myself a reprieve and ate Chicago style pizza and a Greek salad.  It was good, but I regretted it the next day.  I tried not to beat myself up too bad considering weight loss is not about the short term but about the long haul.  It’s a marathon and not a sprint.  One day of eating badly is not going to derail me from my goal.

Saturday morning started out rough.  Before I explain Saturday it must be known that a person like me with cyclothymia does not handle ambiguity well.  We see things in black and white – not in shades of grey. 

Earlier in the week a friend sent me an e-mail stating he was going to take his dog to the farmers market and then the park.  Since he didn’t specifically ask me if I wanted to join him I replied back asking if he wanted company.  He replied sarcastically with “No, I just thought I’d tease you with it.”  Unfortunately, he doesn’t understand that I have difficulty with ambiguity.  I have trouble seeing the forest from the trees – well – more like trouble seeing the tree in the forest since I’m counting the leaves.  We agreed to meet at 8am but he didn’t specify where. 

So here I am driving to his place since I figured we would ride together.  Last week when we planned this same trip I was to meet at his place and we would ride together but his work plans got in the way.  At about a mile away from his place I get a text message from him that he’s early.  What?!?!?!?  I ask if he’s at the market and he was.  Well, crap!  So I text him that I’m running late (I didn’t want to admit that I misunderstood) and I’ll be there soon.  I turned around and made it to the farmers market about five minutes after 8am. 

At this point I’m frustrated.  Things are not starting off well for me this morning.  I have NOT had my coffee and I have not had food.  I am upset at myself for not understanding where we should meet and for getting my hopes up to spending the day with him.

We walk around the farmers market and pick up a few items.  Then we start walking toward his car.  In fear of being wrong again I stopped and asked where I am going.  Am I riding with him or should I be heading toward my own car?  That’s when he told me I could ride with him.  I finally admitted that I misunderstood his messages and went to his place first.  We glossed over the ambiguity issue.  This tells me we need to have a talk about communication.

The dog park was fun.  We walked around a bit and then sat on the bench watching his dog play in the lake.  I adore the affection he gives me.  He put his arm around me and caressed the skin under the sleeve of my shirt.  I sunk into his side and rested my head on his shoulder.  It always sends warm fuzzy feelings to my brain.  I never have to worry about upholding my end of a conversation with him.  I can be quiet and introverted all I want.  He doesn’t push me to talk, he just lets me be.

On the way back to my car the area around the market was crowded with cars and people walking.  I had asked my friend to let me out so that I could simply walk to my car.  He was being a gentleman and offered to drive me to my car.  While he was attempting to navigate the cars and the people, while listening to my directions, he missed a turn.  I have trouble in crowds and this started flaring my anxiety.  I was doing everything I could to maintain composure as I did not want to have a full-on anxiety attack in the car sitting next to him.  I asked again to let me walk but he was determined to drive me to my car.  By the time we made our way to my vehicle I was so flustered that I couldn’t think straight and nearly left my phone in his vehicle.  I just wanted out of there.

I left fairly upset with myself.  I wanted more time with him since he makes me feel good.  He is my “safe place”.  Unfortunately, he had to work so that was out of the question.  Not wanting to be alone I called up my best girlfriend.  Although the morning started off rough, we ended up having a great day together between shopping and an early dinner.  A little retail therapy and BFF support never hurts.