Medications

In this episode, Wendy discusses medications with information on both uses, and the issues, in taking psychiatric drugs.

Wendy's novel on psychiatric hospitalizations is out on Amazon! It's called "Involuntary Hold." Check it out~ There is a plot twist you won't see coming!




International Helpline Info

 For those living outside the United States, I finally found some helpful information. The International Association for Suicide Prevention has a directory of crisis centers and helplines for over 50 countries! 

Just got to the internet and type in:

       findahelpline.com/i/iasp

 And it will bring you to a drop-down menu where you can input your country and region, and it will give you the information for your location. Granted, it doesn’t cover everywhere, but it’s a start!

** Remember if you, or a loved one, is in emotional crisis... Help is just a phone call away. Simply dial 9-8-8 for the Suicide and Crisis Hotline, or text "HOME" to 741741 to chat with someone via text 24/7 across the United States. **

Please contact us at bipolarforlife@myyahoo.com with any questions, suggestions, or comments.

Transcript

BIPOLAR FOR LIFE
EPISODE 4- Medications

Open with Theme Music

Knock on Door

Door opens to acoustic music

You found me! Yes, this is Bipolar for Life, the show dedicated to survival… Come on in! I’m your host, Wendy Foard, and I’m so glad you could make it. I wasn’t sure you’d be able to find me since we’re not in the studio tonight.

Let me turn this music down a bit… Make yourself at home! Mi casa es su casa.

I just thought since we’ve been through some really heavy topics lately, it was time to chill a little. Relax a bit.

I think I created an “Oops!” while I was in the studio. I was surrounded by facts that I just had to share with you… but upon reflection, I think that I may have accidentally bombarded you with information in my previous episodes. I pray I’ve created no “data overload casualties!” 

But be that as it may… tonight, I thought we could talk about medications, but in a more relaxed setting, my living room. 

You’ll notice the lights are dim cause I hate glaring overhead lamps. I think stark light kills creativity, don’t you? You have to be able to see the ideas dancing at the edge of the shadows, and in severe light, there are no shadows… So, my lights are always low. 

 Ya know, I’ve noticed a great deal of anxiety associated with the taking of psychiatric medications recently. Many people are afraid of changes in personality, side effects, or losing that central creative part of themselves. That’s what worried me most, losing my essential artist. But I’m here to tell you that living with bipolar disorder, or any other psychiatric issues, medications can make all the difference to your world!

They can help regulate mood, stabilize erratic behavior, and make living with a mental illness tolerable. The most important thing they do is allow you to dwell in the current reality. Meds make it easier to go to work, deal with people, and generally live! With the correct combo of medications and therapy, you can live a productive and enjoyable life.

Despite all the positives, some manic-depressives don’t stay on their medications. This is a frightfully bad move! Especially since these medications deal with your brain chemistry. 

Coming off of them cold turkey is bad for your body and can cause headaches, insomnia, depression, brain zaps, and nausea, to name only a few. If you want to come off the psych meds for whatever reason, then it’s best to have a doctor help you come off of them gradually. Definitely do NOT start and stop your medications. Either take them, or don’t ~ Your body will thank you for your resolve!

 Alright, I’m not gonna sugar coat it, there are compromises you’ll have to make to have a life with a mental illness. First, you’ll take medications for the rest of your life to regulate your symptoms, you will be under the care of a psychiatrist and a therapist continually, and there will be side effects to deal with daily. But what you get in return is far greater than the sacrifice… 

By taking my bipolar meds, I’ve lost the ability to write poetry. I used to have full stanzas of poetry come to me just as I was drifting off to sleep. If there were more than three stanzas, I’d get up and write it down. One of these poems actually won the Editor’s Choice Award in a poetry contest, so they weren’t all bad. LOL! But they were persistent.

Anyway, as I started taking the psychiatric meds, my ability to hear the stanzas was lost. It was a gradual dwindling off; the poems didn’t stop immediately. I have to admit to being really upset that I didn’t hear them anymore— an avenue of expression had been closed to me! 

But, what I got in return for the poetry I’d never write again, was a steady job, friends not acquaintances, and a sense of my own accomplishment as an individual. I was able to make a stable life for myself, something that had eluded me for many years! 

Now, that is not to say that I don’t have my ups and downs. I’m a rapid cycler so I get fluctuation in moods twice a year. But the meds mitigate the major hindrances to being a productive member of society. You will always have small fluctuations to deal with, but on the whole, the meds work to keep the major changes from occurring. 

 A fun fact about psychiatric medications is that it can take 4 to 8 weeks before the medication is fully effective. I’ve known people who have given up on the meds as “not working” before they could become therapeutic. Just keep in mind that none of this treatment is fast! It takes weeks for the meds to really help, and it takes a while to establish a rapport with your therapist as well. Yet, you will find that both of these therapies can be extremely helpful.

 The five main drug types used to treat bipolar disorder are Lithium, Anticonvulsants, Antipsychotics, Antidepressants and Benzodiazepines. 

As there is no known cause for bipolar disorder yet, many of the drugs were initially used to treat other problems such as the anticonvulsants but have been found useful in treating mood disorders as well.

The mood stabilizer of choice for bipolar disorder is Lithium, and has been used since the 1970’s. It helps control the symptoms of acute mania, and is effective in preventing periods of both mania and depression from recurring.

I found that I was allergic to Lithium in any form, of course. That would have been too easy… It attacked my central nervous system to the point where I couldn’t stand up straight, my hands would shake uncontrollably, and I even wet the bed at night. It was horrible! Thus, began my exploration of a myriad of drugs to find the right combo for me. It took several years to find the correct mix, so again, none of it is a quick fix!

 Anticonvulsants is the next category of drugs used to stabilize bipolar disorder. They have been used since the 1990’s when it was discovered that they helped modify moods. Some common anticonvulsants are Depakote, Lamictal and Depakene. Higher risks of suicidal thoughts and behavior have been associated with anticonvulsants, so care must be taken with these medications. Lamictal is known to cause a rash that can be dangerous, so report any rash to your doctor immediately.

 In fact, when taking any psychiatric drugs, you should report anything unusual to your doctor. For example, a rash, a very bad taste in your mouth, or any involuntary movements. I have experienced the bad taste in the mouth myself. It tasted like the inside of a rusty pipe. Found out later that I was allergic to the medication. So, if anything weird begins to happen after you start taking your meds, don’t hesitate to contact your doctor. Something small might mean there’s a significant problem!

Now, the field of Antidepressants is a large one. There are SSRI’s, SNRI’s MAOI’s and Tricyclics to choose from.

 While antidepressants help elevate one’s mood, they can also throw you into a mixed state or manic episode. So, most antidepressants are prescribed along with a mood stabilizer or antipsychotic medication.

 Some SSRI antidepressants you may have heard of are Celexa, Lexapro, Prozac, Paxil and Zoloft.

 SNRI’s include Cymbalta, Pristiq and Effexor.

Both of these types of drugs affect the neurotransmitter Serotonin. Serotonin helps regulate your digestion, blood flow, body temperature, and breathing.

 Now, the next type of drugs are rarely prescribed unless you don’t respond well to the others at all. They are MAOI’s and include Nardil and Parnate.  With MAOI’s you have to be careful what other drugs you take because of interaction. You can’t eat certain foods, like wine & cheese, because it can cause a dangerous condition known as Serotonin Syndrome—where you have too much serotonin in your system which can be fatal. 

 The types of medication that can lead to Serotonin Syndrome are those used to treat depression, migraine, and manage pain. Too much serotonin can cause mild to severe symptoms, that affect the brain, muscles and other parts of the body. So, you must be diligent when taking MAOI’s!

 Some Tricyclic antidepressants you may have heard of are Amitriptyline, or Elavil, Norpramin, Trofranil and Pamelor. Amitriptyline can also be used to treat other conditions such as nerve pain, eating disorders, anxiety and panic disorders.

 Last, but certainly not least, are the Benzodiazepines. This group of medications has anxiety-relieving properties. Common names are Xanax, Librium, Klonopin, Valium and Ativan. These medications need to be used with caution as there is a high risk of dependence associated with them. 

 Needless to say, all of these drugs have side effects ranging from dry mouth, weight gain, drowsiness, decreased libido and blurry vision, to memory and attention issues. But you won’t get all the side effects at once. These meds affect everyone differently, so it’s very important to keep an eye on yourself while taking these drugs. Your body will give you clues as to how well the meds are being tolerated, listen to it and report any anomalies to your doctor right away.

 Just know that you will have cotton mouth while taking these medications. It’s a given… you can ease it with a drink, or gum, but get used to it!

 I can truthfully say that I’ve had some of each option on this Chinese menu of medications. And MAOI’s were definitely the worst! I found the restrictions on food annoying. I mean, who doesn’t like cheese on their hamburger, right?! I found the dairy restriction very hard to follow. Luckily, I wasn’t on an MAOI very long. 

 Currently, I’m on an SNRI (Cymbalta) and an Antipsychotic (Abilify), with a little Trazadone added in to help me sleep.  This combination seems to be holding things steady for now. As I said, I still get fluctuations in the Spring and Winter, but I know to look for those! Knowing your cycle habits is as important as your medications, in keeping abreast of your moods. The more you know about your cycles, the better understanding you’ll have of what’s happening with your day-to-day moods and anxieties. 

 There are long lists of side effects for each type of medication, so we won’t go over those tonight. But you will want to familiarize yourself with the possibilities…  Don’t get overwhelmed, remember you won’t have them all at once. Just be aware of what to watch out for, so you’ll know. 

 Oh my, I’m so sorry! I just realized that I didn’t even offer you refreshments. Can I get you something? I’ve got a pot of Depresso Gourmet Coffee just brewed in my kitchen. 

It’s that new mocha flavor… 

Pouring of Drink

Clinking of dishes

It’s called Mornin’ Mocha Madness. I just had to pick some up for the Holidays.

Set tray on table

Clinking dishes

 Here you go… Now, help yourself while we continue our conversation.  Hope you like it. I’m mad for Mocha myself! Mmmmm…

 Yum! Where were we? Oh yes, psychiatric medications. I’d like to suggest something important that worked for me… When you get started on meds, or begin a new medication, keep a daily journal of the meds you take and how you feel. 

 I found this to be an invaluable tool when talking with my doctors! They could see what meds I took, when I took them, and then how quickly the side effects kicked in. 

In your entries, always mention how you feel! Were you anxious all day? Have trouble sleeping last night? Did you develop diarrhea? All these things are clues for your doctor and can help them find the right meds and dosage for you. 

The more information your doc has, the better he can help you. So, I highly recommend starting a daily meds journal, be sure to include how you feel. You’ll be surprised by all the things you can learn about yourself!

Oh! Another thing… You will want to avoid ever running out of your psychiatric meds! Make sure you keep them refilled or be forced into withdrawal. I’ve had this happen to me a couple of times, and man, it ain’t fun! I’ll just go along taking my meds, busy with other things, and one night find myself out~ Holy Crap! Now what do I do? 

 As it turns out, most medications have a half-life of 24 hours, so they are essentially out of your system in 4 to 5 days. This will hopefully give you enough time to get the refill done before you feel any major negative effects, but don’t rely on 5 days… you usually notice changes within a day or two. So, get them filled as soon as possible! 

However, if your pharmacy is anything like mine, you can’t always get a quick refill. If you start to withdrawal, the best thing is to recognize that fact, and then try to mitigate the symptoms. It’s the best you can do!

 The withdrawal symptoms you will experience are directly related to the type of medication you’re taking.  For example, quitting an antidepressant suddenly can cause symptoms within a day or two, such as: 

-Anxiety

-Insomnia or vivid dreams

-Headaches

-Dizziness

-Tiredness

-Irritability

-Flu-like symptoms; achy muscles and chills

-Electric shock sensations, AND

-a quick return of depression

 Now, just because you’re having withdrawal symptoms doesn’t mean you are addicted to psychiatric medications! Addiction is characterized by intense cravings, and an inability to control the use of a substance… antidepressants don’t cause these issues. The drug pushers don’t sell Zoloft on the streets! Although, with the way things are, maybe they should… 

I fear that addiction and mood disorders are kissing cousins, and we will have an episode dedicated to addiction in the future. Possibly more than one… as it is such a serious issue.

 There are some things that you should avoid when taking psychiatric meds. The number one thing to avoid is alcohol! Alcohol really messes with the meds, and can create a deadly brain chemistry where the incidence of suicide is much higher. The recurrence of major depression, and anxiety under alcohol’s influence is highly likely. So, while it may seem fun to go have a drink with your friends, you are doing yourself a major disservice by inviting the crippling issues of bipolar disorder back into your life… and alcohol gives suicide and depression a back door key.

 Another thing to avoid is Marijuana. Although it is the most commonly used illicit drug in the United States, it can cause problems as well. The combination of psychiatric meds and marijuana can cause depression and anxiety to worsen, especially in long-term use. Something else to consider is the fact that marijuana has gotten stronger over the last decade. People are perfecting different strains now, making them more potent than in the past. So even short-term use can cause hallucinations, paranoia, and extreme anxiousness when mixed with psychiatric meds.  The other thing about marijuana is that it is often laced with other unknown drugs, and even without psychiatric drugs, these can cause major problems for the user.  The only way to avoid extra unknown additives is to go to a dispensary, or abstain completely.

 Now, I hear you complaining that you can’t party anymore! But I think that the Oracle at Delphi had it right, “Everything in moderation.”

 I have to admit, that I still go out with my friends occasionally to have a drink, but ONLY one… I’ve fought hard to get to where I am now, and I’ll be damned if a stupid drink is going to take it all away from me again!

The same with weed. It’s just not worth losing everything I worked so hard to achieve, for a momentary pleasure, which is all being drunk or stoned gets you—a momentary pleasure! 

Yet, in that moment of revelry, the door is flung wide to the most negative aspects of mood disorders. I don’t know about you, but I’ve spent too many nights on the depressive streets of bipolar hell, that I never want to return! So, I basically give all “extracurriculars” a wide berth. Life is just easier that way…

Herbal supplements and certain foods can affect your medications as well. The herbal supplements aren’t regulated and there is a chance they can interfere with how you process your bipolar meds. 

 I found out just how much foods can affect your meds the hard way. I was on a diet which required drinking grapefruit juice regularly, and all day long. All my friends were trying it at the time, so I joined in hoping to shed a few pounds. It didn’t take long before I started feeling really irritated, and angry about everything. There was no reason for the increasing agitation, but it just kept building, and building, and finally I exploded on the wrong person at the wrong time…  

I reported all this to my doctor, and he suggested stopping the diet; that was the only thing different in my routine. Don’t you know that shortly thereafter, a warning label about drinking grapefruit juice was added to the medication bottle, indicating that it impeded absorption. Weird, huh? 

 See? Even information about a grapefruit juice diet becomes important. We tracked when I started drinking the juice and when I started having mood issues, there was a direct correlation between the two. So, when you change your normal routine, be sure to put it down in your meds journal. It could be the clue you need in the future!

I now feel rather proud when I see that warning label about grapefruit juice… my bad experience has possibly saved someone else from having to deal with it. So, keep those journals up to date!

 As ever, if you are feeling suicidal or are having suicidal thoughts, PLEASE don’t hesitate to get help. Just go to your local emergency room or call 9-8-8 for the Suicide and Crisis Lifeline.  Help is not far away… but you have to take the first step! Realize that you ARE worth the effort and make the call, or text H-O-M-E to 741741. Do it for your loved ones… they need you!

 Oh Gosh! Look at the time… I’ve been rambling along here, and time has gotten away from me! I’m so sorry. 

I do have one favor to ask of you, before you go. Would you please email me at bipolarforlife@myyahoo.com and let me know if you want to meet in the studio next time or back here in my living room?  I want you to feel comfortable as we discuss the issues, so please take a moment and let me know which you would like better. 

Also, if you have any tips you’d like to share with others, or questions, please put those in the email as well. I will get back to you, promise!

 Before you go, I’d like to remind you that my book “Involuntary Hold” will be coming out in December on Amazon. I’m so excited!

I’m not sure you could call it a Christmas book, but if you are interested in what life is like on the psych ward then this book is for you. I’ve put an interesting twist in there to keep it moving, so if you like surprises, this is a book for you as well. Please check it out and leave a review! 

Well, I’m sorry to see you go, but it has been a great pleasure having you here. You really livened up an otherwise dull evening! 

A quick program note, before you leave… Bipolar for Life will air a new episode every two weeks. Perhaps quicker, but for sure every two weeks. 

 Please be sure to drop me a note on bipolarforlife@myyhaoo.com as to where you want to meet next time—the studio or my house. Please be safe going home, have a marvelous Thanksgiving and I’ll see you next time when our topic will be, anxiety. Take good care ‘til then!