Managing Side Effects

Managing Side Effects

Managing all of your medications is difficult to do when you take multiple medications. Individuals with bipolar disorder often have this problem. My meds have been changing quite a bit lately. In the past three weeks I added one medication and got off three. I’m off Seroquel, Cogentin, and Lunesta. I now take Lithium, Tegretol, Mirapex, Cytomel, Deplin, and Clozapine on a daily basis as my psych meds. I have Valium, Zofran, and Percocet that I can take as needed. I also have to take hormone replacement therapy because of my hysterectomy. It can be difficult to figure out which medication is causing which side effect, especially when so many things are changing at once.

I’ve been gaining weight for a while now; however, since I started the Clozapine, it has gotten much worse. I seem to be hungry more often. I’m definitely eating much more that I should be eating. I keep trying to stop, or even just slow down, but it doesn’t seem to work. My increased appetite didn’t start until I started Clozapine. Up until now, I didn’t think that this was a side effect; however, it makes more sense that it would be a side effect since I seem to have no control over it at all and because of the timing. This is something I should definitely mention to my psychiatrist, maybe there’s something he can do to help.

I’ve had medications cause all sorts of side effects. For example, Abilify made me go into a manic episode, I started losing my hair on Depakote, I gained 80 pounds on Risperdal, Seroquel causes dystonia, a high Lithium level causes me to shake uncontrollably, Mirapex makes me nauseous, and Lexapro made it harder for me to sleep. Those are just some of the side effects I’ve dealt with previously and still deal with. I started getting treated for bipolar disorder when I was 14 years old, which was 17 years ago. In the past 17 years, I’ve tried a lot of medications and dealt with a lot of bad side effects.

I’ve tried so many different medications that I can’t remember them all. It would probably be a good idea to make a list of all the medications I’ve taken and the side effects I experienced. Then I could just keep the list updated. The only problem is that I can’t remember every med and its corresponding side effect. I do have the notes from my previous psychiatrist that I saw for several years. I could try to go through his notes, but that could also be a very upsetting task. I’m not so sure I want to read what he wrote about me. I suppose I should at least give it a descent try. Having a list of all my past and current medications and corresponding side effects would be extremely helpful for the future.

Fatigue, Low Energy, and Weight Gain

Fatigue, Low Energy, and Weight Gain

The Clozapine that I started almost three weeks ago has been causing some problems for me. Most of the side effects went away; however, I’m still dealing with fatigue and low energy. The fatigue has greatly improved, but it is still there. During the first couple weeks of this medication, I could fall asleep in the middle of doing something. For example, I fell asleep while I was eating dinner once. Luckily, I only dropped my fork and not my bowl. But for the first couple weeks I was nervous to drive. I was afraid that I would fall asleep while driving, so I took some precautions such as bringing my dog in the car with me, calling someone on speakerphone, rolling down the window, or playing music that I can sing to. Some of these methods were thankfully effective.

I’m no longer dealing with that same intense fatigue that I had before. I’m still tired, but I don’t feel as if I have no control over whether or not I stay awake. I’m just tired; it’s been hard to get moving. I’m trying so hard to get today’s to-do list done, but I have such low energy that I’m not sure if I can get off the couch and even get dressed. I don’t even have many things to get done today, and I’m still having a hard time doing everything. I think the reason my psychiatrist had me increase my Clozapine dosage from 100 mg to 125 mg was because the fatigue and low energy side effect finally started to decrease. I’m so happy that things didn’t really change with the dosage increase. My fatigue and low energy hasn’t changed. I wish it would go away, but at least it’s getting better rather than getting worse.

One other problem I’m having recently is weight gain. I’m not sure if this is a side effect from the Clozapine or what else it could be from. The weight gain started before I got on the Clozapine, but I was gaining weight slowly at that point. Now, I seem to be gaining weight much quicker. I know one factor is because of my fatigue and low energy. I barely have the energy to get up, of course I don’t have the energy to workout like I was doing before. I really need to push myself harder. Maybe I will start with taking the dog on a walk tonight. I know for me, the more I do physically, the more energy I end up having. Sitting on the couch doing nothing makes my fatigue/energy and weight gain issues worse. Hopefully, I can create a new cycle that involves energy and weight loss.

I Hate Confrontation

I Hate Confrontation

Confrontation scares me, I hate it; it puts me into a panic attack. I keep everything inside and I do my best never to let it out. I would rather hold it all in and be a complete mess, than confront someone about any situation, whether it’s serious or not. I don’t show my anger, I just keep stuffing it down, holding it all in, although I am a pretty sarcastic person. I know that one day I’m probably going to explode, but I just don’t know what else to do with it all.

When I was in rehab, we had to confront each another in a large group setting using the form, ‘When you…I feel…’ format. It may sound somewhat corny, but it does work, when you have the guts to actually do it. I remember when I would have to confront someone, my heart would race so fast and I would start sweating; I would even forget my words, why I was confronting someone, and even how it made me feel. I would do it while I was in rehab because I had to. Now, I do everything I can to avoid it.

I guess I’m afraid to upset other people. I don’t want to hurt anyone else’s feelings or make someone mad. I would prefer to be extremely uncomfortable if it would make other people happy. That sounds weird when I say it out loud, but it’s just how I am. My therapist is trying to get me to work on this, but it’s not as simple as he explains it. Even admitting to myself that I’m angry is difficult for me, why would I be able to tell someone else how I feel?

There are several things that I deal with, such as my anxiety and fears, and I know where those things originate. I think my fear of confrontation probably comes from the same place as my other fears. My ex used to get very physically and emotionally abusive when I would get upset with him. It didn’t take long for me to realize that I just shouldn’t confront him on anything. I guess I just let that issue seep into every other part of my life. At some point, I need to start taking control again. Right now, that’s too scary for me, but I’ll keep it in my mind as an option.

Weekly Blood Work – Same Phlebotomist

Weekly Blood Work – Same Phlebotomist

I have been nervous for days now about the blood work I had to get done today. Most of my nerves were because of the inappropriate phlebotomist from last week that kept asking me personal questions and telling me what I should do for my bipolar disorder. I have been practicing all week just what to say to her if she was the one drawing my blood again. I was prepared; at least I kept telling myself I was prepared. I was ready to tell her, “I don’t want to talk” if she asked me a question, or to ask for someone else completely. To be honest, I wasn’t prepared. I took a Valium to calm myself out of my anxiety attack and I went to the lab.

I arrived at the lab and stood in line to check in. I made a 2pm appointment, but they were running late. At least my Valium was kicking in, I was able to breathe, my chest pains stopped, I started shaking less, and my mind began to slow. I looked behind the counter and only saw one receptionist and one phlebotomist. Then my heart started to beat a little faster again, it was the same woman from last time. As I walk past her, she asks me “Did you think about what we talked about last time?” I can’t believe that she was that invasive two weeks in a row, better yet, she broke HIPPA laws two weeks in a row. I was surprised, but my response comment came to me quickly. I told her, “Yes, and I’m happy with the way I’m doing things.” I couldn’t believe it, but she actually backed off. The only other things she said was just normal chit-chat, to make time go by quicker. What I said was nothing like what I planned on saying, but it still seemed to work, and that’s all that really matters.

If she says something to me again next week, I will report her. It’s really hard for me to report her or tell her boss about the situation; I’m not sure why it’s so difficult, it just is. My husband keeps telling me I should report her. He’s probably right; I should probably do it for the people she treats after me. Even just the thought of reporting her, or having my husband report her, makes me start to have a panic attack. I don’t know if I could do it; I don’t know if I want to do it.

An update regarding the Clozapine: My fatigue has been decreasing every day and I have no other side effects that I’m noticing. I informed my psychiatrist these facts and that I completed my weekly blood work today. He told me I could up my Clozapine dose to 125 mg. I was so excited when I heard, I was worried he was going to stop the medication because of my blood work results, but he is still allowing me to move forward on my dosages.

Preparing To Travel

Preparing To Travel

Traveling is something that can be fun to do, depending on several factors such as how you get there, who you’re with, and your destination. I have two different getaways coming up, and I know that it’s time to start getting ready for at least the first one. I want to be prepared for them, and the only way to do that is to actually do the work, both physically and mentally. Traveling when you’re bipolar takes more than just packing. The more prepared I am for the actual traveling, time management, and visitations with others, the more I will enjoy my trip.

My first getaway is this Wednesday and it’s just one night away with my husband. A friend of his is getting married and we decided to go away the day before so we don’t have a lot of driving to do all in one day. Plus we get a night away from our normal lives, which every couple needs to do now and then. I should be looking up activities to do while we are away other than just go to the friend’s wedding. Instead, I’m just anxious about going somewhere I haven’t been before and going to a wedding where I’ll be surrounded my other people. I know that I’ll be with my husband, who makes me feel safe, so I’m sure everything will go okay. I just need to stop playing it all over and over in my head, that’s doing me no good. As I was writing this, I realized I need to start planning some things to do while I’m away with my husband, we like to stay active. With one simple Google search I found a Dolly Steamboat tour and an entire Ghost Town to explore! It was so simple, and it looks as though we will have a lot of fun together. We can start making plans soon when he gets home from work. I’m actually looking forward to it.

My next trip to plan for will take a lot more planning. I’m going across the country to visit my mom and the rest of my family. I will actually be with my mom on Mother’s Day, I can’t wait! The most difficult part of the trip is the flying. I love to fly, my dad was a pilot, but it’s the airports that get to me. People don’t respect each other’s space and everything is crowded from the security lines to the bathrooms. People act as if you’re going to win a million dollars by boarding the plane as quickly as possible; it’s the same problem when it comes to deboarding the plane. I don’t like to be rushed, so I get there early, but that just means I have to deal with the crowds longer. All I really want to do is find a quite place to myself, anywhere I can sit down and plug my laptop in while I wait for my plane. I look for the same thing during my layover. It’s not usually a successful venture, but it’s still worth a try. To keep myself calm I take my Valium and I remind myself all the time that I’m on my way to see my family. Nothing is better than being able to see my family.

I’m going to visit with my mom, nieces, nephew, aunt, grandmother, family friends, and even some old friends I’ve been out of touch with. I’m lucky that my family is extremely accepting of my bipolar disorder and my anxiety. It can be difficult to fit in everything I want to do during the short amount of time I’m there, especially when you’re trying to adjust to a different time zone. This time, I’ll be there for eight days. I’ll get as much done as I can, but I can’t overextend myself, traveling is hard enough already. It is hard living away from my family, I need to take advantage of the time that I do have with them while I’m there. This visit in particular, I’m looking forward to one-on-one time with certain people such as my mom, aunt, and grandmother. I mostly just hang out with my family, but there are a few things I want to do while I’m there. I want to complete my Wellness Recovery Action Plan (WRAP) with help from my mom, I still have to do blood work and get medication, I have a birthday gift for my niece, and there’s a 3D Leonardo Di Vinci exhibit I can’t wait to see. This is all I can think of at the moment. If I want to get all of that done, then I better start planning.

Rapid Cycling

Rapid Cycling

Rapid cycling is described as a pattern in an individual’s bipolar disorder. The individual must experience at least four or more episodes in one year. These episodes can be either manic or depression, I’m not sure if mixed episodes count. My specific diagnosis is Bipolar 1, rapid cycling, with psychosis. Maybe, my previous post where I was wondering if I was crashing is just another part of my rapid cycling. That could be why it feels like my episodes come in waves; they happen so often I have a hard time keeping track of them all.

People who are rapid cyclers can still crash; I guess the crash just doesn’t last as long. However, rapid cycling is a diagnosis that is not necessarily permanent. It can change as time goes on. A person’s bipolar symptoms tend to change with time, generally based on their experiences and treatment. This makes it possible for the rapid cycling diagnosis to be temporary for most individuals, although the diagnosis can come and go.

I find rapid cycling difficult to manage. Just when it seems as if I’m getting a handle on current emotional status and its symptoms, my episode changes to something else. Lately, it’s changing slowing, which is nice, but it’s hard to keep up with. One day, I can be cleaning, getting stuff done, and reaching out to others, and then the next day I can’t get off the couch. It usually takes me a couple of days to mentally realize and accept my current state, and that is extremely difficult when things are always changing.

I have a couple of questions. Is it even possible to cycle daily or weekly? What I find tells me that rapid cyclers usually cycle at least four times a year. Are there any other individuals diagnosed with rapid cycling bipolar? Do mixed episodes count towards rapid cycling? It would be great if anyone wanted to tell me about their experiences; I would appreciate hearing from you and finding out how often you cycle and how you handle your cycles.

What’s Coming? I Hope It’s Not A Crash

What’s Coming? I Hope It’s Not A Crash

I wouldn’t necessarily say that I’ve been manic lately; I’ve been in a mixed episode more or less. Everything changes day by day; whether or not I’m able to get things done, how much energy I have, my emotional state, how much I reach out to others, if I can complete my goals, and how impulsive I am. These are my major signs that show what state I’m in; manic, depressive, or mixed. Since I had an ECT treatment yesterday, I generally slow down for at least a few days as my body recovers.

When I’m manic or mixed, I tend to get a lot of household responsibilities done. I can go all day without stopping. I make sure that I can complete every goal I set out for myself. I can’t stand not being able to cross off every item on my to-do list. I also usually reach out to others, both friends and family, when I’m manic or mixed. I withdraw as the depression sets in. I usually don’t have elated feelings to begin with during mania or mixed episodes; I still tend to feel bad about myself, unable to see the good things that I have done.

Every day, I see certain symptoms changing. For example, today I’m having a hard time getting things done. It is the day right after ECT, so I’m trying to give myself a break, but reaching out to others is also very hard. I’m also feeling the emotional depressive symptoms, wishing I wasn’t around is a common feeling for me. I’m not sure if there’s a crash coming, or if I’m just reacting to life’s circumstances. The worst part, in my opinion, is I keep gaining weight. It’s been happening for a few months now. I’m up 30 pounds, and I don’t have the will power to fight it. I have been wondering what’s coming for a little while now. Sometimes I think my episodes happen in waves; often never-ending and they don’t often last long enough to realize what’s happening, which is an improvement from before, now that I think about it.

If this is a crash coming, then it’s probably the easiest one I’ve gone through. Or maybe the new medication, Clozapine, is helping ease the fall a little bit. Other times, I have spent all my money, gained 80 pounds, or withdrawn completely from my loved ones. I’m still productive, no matter how difficult it is, and I’m working at keeping my relationships healthy, which is extremely difficult for me. I’m still trying, that’s what matters. Maybe I should just be grateful that I am still able to work at it. When my depression hits, it doesn’t matter how hard I try, I still don’t get things done like I want to.