SRS A Couple Bi-Polar Questions

Discussion in 'On Topic' started by curious_jane, Mar 25, 2009.

  1. curious_jane

    curious_jane New Member

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    I dont know if this is the best place to post this. Feel free to move it if not.

    So apparently I'm clinically Bi-Polar. Not that I dont believe it, I just think theres still a little bit of denial there about not being entirely emotionally functional. I knew there were problems well before I took it to my doctor, who in turn sent me to a psychiatrist for a couple sessions to confirm his suspicions.

    I was then put on Zyprexa (Olanzapine), which I took steadily for about 6 months. Note that this was done after they gave me anti-depressants and I completely lost my mind and almost seriously hurt myself. he also added Epival (a medication mainly used for epilepsy) about 2 months in to help with the anxiety.

    so anyways, I'm told I pulled a typical Bi-Polar move and went off my meds (the epival first, then later the Zyprexa). Basically I didnt like the way they made me feel and I really felt that I didnt need them.

    But lately, I'm so all over the place. I really dont know which way is up, if I'm coming or going. My moods are totally erratic. I know that I should go back on my meds, but I cant bring myself to feel like that. I dont know whats worse, dealing with the side effects of the medication or being totally unpredictable. I've been told by a really close friend that its probably best for me to start taking them again. I definitely think that its starting to affect my relationships.

    My questions are; Is there a better Bi-Polar medication for me? Something that wont leave me so tired and emotionally void? Also, I dont have medical coverage. Cost for the meds I'm supposed to be on (just the Zyprexa) is right around 300 for a months supply. Is there anything that would be easier on my finances? or is there anything I can do to help the condition and not go back on them? (Note: I attend therapy sessions once a week and I find that helps a bit). any advice or information is geatly appreciated....

    Thanks in advance...
     
  2. Scootin

    Scootin OT Supporter

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    It's very important for you to get on a medication again. Traditional talk therapy never hurts but you will need something to help control your mood swings so you don't hurt yourself or others. Suicide risk goes through the roof when you're cycling, for example. I'm not saying you're psychotic or anything, but it is important to control.

    Most of the antipsychotics work pretty well, in addition to Depakote, some antiepileptics, and good old lithium. These are all options to discuss with your doc but be aware that there's no "best" medication. Psychiatric medicine is an inexact science and you might need to try a few before you find something that works. Don't be afraid to tell your doctor if you can't handle the side effects of a med, but MOST IMPORTANTLY do NOT stop a med without talking with him first. Compliance is absolutely key in psych medicine and you will need to be open and honest with him, while at the same time expecting him to do the same with you.

    There are quite a few bipolar people on this site, and you would do well by talking with them about their experiences. Finding an online community or forum would also be terrific, to learn a little about what others do to cope.

    Good luck! :wavey:
     
  3. brokengold

    brokengold New Member

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    Don't let the psychiatric powers-that-be bully you into taking a drug that doesn't work for you. There is a wide variety of drugs that they can prescribe for you, and if you are suffering an adverse reaction, do not feel the slightest guilt about bringing that to your doctor's attention. If you feel like you're not being listened to, then perhaps you could switch doctors.

    It often takes time for the correct "match" to be made between the right psychoactive substance and the individual patient. It's important to have open communication between you and your psychiatrist as you both work to find the right medication and dosage.
     
  4. Falconer

    Falconer OT Supporter

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    just out of curiosity, did your doctor warn/discuss with you about Tardive Dyskinesia before he started you on Zyprexa?
     
  5. CaminoReal

    CaminoReal Custom User Title

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    I would definitely go back to your doctor and see if you can try any of the other atypical (or typical) antipsychotics out there...

    Realistically, though, most of the available medications out there for bipolar disorder have some shitty side effects.
     
  6. CaminoReal

    CaminoReal Custom User Title

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    I surely hope so
     
  7. CaminoReal

    CaminoReal Custom User Title

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    :werd:
     
  8. Scootin

    Scootin OT Supporter

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    It's actually not a big concern on Zyprexa. :)

    Edit: I should qualify that statement. It's not as big of a concern as with the typical antipsychotics. Still a possibility, though.
     
    Last edited: Mar 26, 2009
  9. Falconer

    Falconer OT Supporter

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    <noob>

    How does the dopamine inhibiting action of neuroleptics have a beneficial effect on bi-polar?

    </noob>
     
  10. Scootin

    Scootin OT Supporter

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    Honestly, we don't really know. It's not a n00b question. :)

    From a traditional "antipsychotic" standpoint, you work off the dopamine theory of psychosis - that dopamine overactivity in the mesolimbic pathway, especially at certain dopamine receptors, causes psychosis. By inhibiting that action you decrease hallucinations and delusions. Unfortunately that also causes terrible side effects in the motor pathways that use dopamine, pretty pronounced sedation, etc. The traditional or typical antipsychotics (Thorazine, Haldol, etc) are pure dopamine antagonists.

    The new atypical antipsychotics are both serotonin and dopamine antagonists - the theory being that the serotonin pathways present in three of the four main dopaminergic pathways (Mesocortical, nigrostriatal, and tuberoinfundibular) inhibit dopamine firing. So - you inhibit the inhibitor of dopamine in the three pathways not dealing directly with psychosis and you inhibit dopamine in the pathway dealing with psychosis, with the hope being the net result is normal dopamine firing in the pathways related to motor side effects, etc, and inhibition of dopamine in the psychotic pathway (the mesolimbic).

    Whew. Anyway, the best answer for bipolar disorders and depression is that we don't know exactly why they work, but we know they do. Without going in to too much detail on some theories, the serotonergic inhibition probably plays a big role in reduction of manic episodes, while they probably don't do as much for depressive episodes. While the atypical antipsychotics aren't exactly the old "using a nuke to cut your lawn," they are far from specific for the underlying neurochemical causes of bipolar disorders - which are also not 100% understood.

    Research is ongoing, as always. :wiggle:
     
  11. Falconer

    Falconer OT Supporter

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    So on that theory, dopamine increasing agents, such as cocaine or L-dopa, would make psychosis worse, correct?

    Is it possible to have bi-polar and Parkinsons, which is caused by not enough dopamine, at the same time?

    I'm familiar with how antipsychotics supposedly treat Tourettes but not their action in bi-polar. Thanks for the reply.
     
  12. Scootin

    Scootin OT Supporter

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    Yep. There's actually a condition known as amphetamine psychosis that happens with overdoses of Adderall, methamphetamine, and most other dopamine agonists.

    Sure. I don't know how much bipolar is related to dopamine, but the symptoms of Parkinson's are actually a result of degradation of a part of the nigrostriatal pathway - that pathway that causes the extrapyramidal (motor) side effects in the older antipsychotics. If you look at someone with Parkinson's and someone with antipsychotic induced EPSE you'll see their movements are very similar.

    No problem :wiggle:
     
  13. Falconer

    Falconer OT Supporter

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    By EPSE you mean extrapyramidal side effects, right? Isn't "Parkinsonism" included in that list?

    I know dopamine agonists make Tourettes symptoms worse so I figured the same might be true for bipolar.

    Scientists need to hurry up and figure out how all this stuff works. Too many medicines have harsh side effects.
     
  14. Scootin

    Scootin OT Supporter

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    Yeah, EPSE is extrapyramidal side effects, sorry :o And "parkinsonism" isn't "Parkinson's disease," per se - but a similar set of movements. So yeah, it's included.

    And everyday companies are developing new drugs, but unfortunately there are some side effects that are just inherent to changing neurochemistry, regardless of how specific you are. :hs:
     
  15. Falconer

    Falconer OT Supporter

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    <nerd>

    We need some Borg technology. Inject some nanoprobes that go into the brain and modulate dopamine or repair a defective basal ganglia or whatever they need to do.

    </nerd>

    Seriously tho, if they can map out which part of the brain is faulty, this might be an application for stem cells.
     
  16. Scootin

    Scootin OT Supporter

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    Already been done :)
     
  17. Falconer

    Falconer OT Supporter

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    o rly? For which conditions? Most of the ones I've talked about I still hear that "scientists don't know exactly what causes them."
     
  18. Scootin

    Scootin OT Supporter

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    For Parkinson's...I can't remember whether it had been done in humans yet but I know it's for sure been investigated in animals, and I think it worked pretty well.

    Theoretically it should work very well, I think. May also be applications for Huntington's as well.
     
  19. cerberus

    cerberus New Member

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    Throughout my life I have grown up with a mother who is bipolar, I am also in my 3rd year of premed so here's what I think, you can take it or leave it.

    There are many medications out there for bipolar and if one isnt working for you its really important to go back to your doctor and tell him it isn't and that you want to try something else.

    Talk therapy will help a little but with bipolar (depending on how severe it is) talk therapy alone may not work since bipolar is caused by a chemical imbalance which is something that you can't control.

    Talk to you doctor and be honest about how you are feeling and that should help alot. From growing up with a mother with bipolar who took herself off her meds I can tell you this, it can be really really hard on your friends and family if it isnt under control. The main reason being they care alot about you, so just keep trying and if something isnt working just keep going back to your doctor :) good luck hope I may have helped
     
  20. RyRy

    RyRy Active Member

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    I found a nice place with lots of info called DailyStrength.org it's got a forum and a bunch of nice people that will talk about a lot of things depression, bipolar, anxiety, etc. etc. etc.
     
  21. Falconer

    Falconer OT Supporter

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    I'm interested in the answer to this question.

    Intuitively I would say that the answer is, at least in extreme cases (are there even varying levels of bi-polar? can it be "mild," for instance?), "self-control" would not be enough as the issues are caused by chemicals in the brain. Since those chemicals themselves are responsible for all aspects of your personality, including emotions and self-control, it would not be possible to control it yourself. It's kind of an infinite loop type of thing... you need self-control/correct emotions to control bi-polar, but bi-polar causes abnormal self-control/emotions. It's like the key to a lockbox being locked inside the box. You need the key to open it, but you can't get the key without opening it. Did that analogy make sense? It made sense in my head.

    Don't take any of this too seriously tho. I'm not a doctor or anything. That's why I'm interested in the answer to this question.
     
  22. cerberus

    cerberus New Member

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    I think alot of it depends on how severe the case is. I think of it like this, if you were to be diagnosed with something like diabetes which is caused by an imbalance of a hormone (insulin) you wouldnt think twice about taking medication for it because the symptoms present themselves as physical and not something that you would think you should be able to control, as such you wouldnt have a problem taking medication for it. In bipolar which is also caused by a chemical imbalance (ephedrine and serotonin among two of the chemicals involved) the symptoms present themselves as emotional and something you think you should be able to control, the thing is you usually can't hence the problem.
     
  23. memyselfandi

    memyselfandi OT Supporter

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    Good post. Many people seem to be of the opinion that because bipolar disorder manifests itself as a mood disorder people can will themselves out of it. This simply isn't the case.
     
  24. illectronic

    illectronic I'm Coming Home OT Supporter

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    I'm bipolar 1. From my experience, finding the right meds take time. Without my meds, I become manic within a few months. I am on seroquel (soon to be generic), and lithium. Like everyone else is saying, there's a shitton of other meds you can try. Try going to another psychiatrist for a second opinion. Search for a hospital that has a good psychiatric reputation in your area. They can put you on a sliding scale, or if you qualify, you can apply for medicaid there and pay nothing for visits and all meds.

    There is light at the end of the tunnel. Good luck!
     
  25. TheManLouisianaFace

    TheManLouisianaFace and decide!

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    It can be a long road. I've tried around 10 different meds, still haven't found what works for me.
     

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