Sodium Valproate = Relief

After being on Lithium a couple of years with bad side effects and decreasing effectiveness, I changed to sodium valproate (aka Depakote, Valproate) about 8 weeks ago.  I found some useful info on this site about side effects and such that might help if you are considering switching or using this drug.  The main side effects I noticed were weight gain and severe sleepiness for the first 6 weeks or so, but those side effects are lessening now.  I’m glad I stuck with the drug because the new side effects felt overwhelming and as though I was attempting to jump on a trampoline made out of putty.

The longer-term side effects I am most concerned about are liver damage, changes in blood platelet levels and harm to an unborn fetus if I were to accidentally get pregnant.  I think I gained around 11-12 lbs (5 kilos) in a month and increased my sleep to about 2-4 hours per 24-hour period.  My weight has decreased about 4 lbs (1.5 kilos) over the past month, but I get help with this from a drug called Vyvanse.  My understanding is that it is approved for adult ADHD but has been gaining traction to treat Binge Eating Disorder (BED).  That’s what I take it for, and it has been working pretty well for me for about 8 months.  For example, my binging has decreased from about 10 times weekly to 1-2 times monthly!  There is a discount coupon for Vyvanse your doctor can hook you up with, so look into that, too. The benefit-risk ratio, that is, the amount of relief and stability sodium valproate gives me versus the side effects’ severity, is worth the current risks.

I didn’t realise some of the ways in which lithium was messing me up until I ceased using it and changing to sodium valproate.  I did this gradually with my psychiatrist’s care.  I could tell within a week after ending lithium completely that my brain felt more flexible and less rigid.  I was able to think more complexly and vibrantly again.  My nausea and diarrhea were gone.  I felt less confused and like I was no longer swimming in glue all the time.  It’s important to note that lithium toxicity is dangerous, and I had my lithium levels regularly checked and closely monitored.  These were side effects I had taking a safe dose.  The dose I needed to *somewhat* stabilize my mood was narrow and would often give me unwanted side effects.

So, what has this meant for me in practically and in real life since I’ve been settled into taking sodium valproate?  I have been able to attend work without needing to hide in an office, call the suicide line and cry to them for an hour before returning to my desk and pretending that I am a perfectly stable human being to my colleagues.  It has meant that I am mostly not needing a nap during the day.  It has meant that I can practice mindfulness (I love the Headspace App).  It has meant that I feel consistent enough in myself that I can make plans for the next day, or sometimes even a week ahead of time, and follow through with my commitments.  It means that I have consistent energy to do my mood charts almost every day, take showers, do exercise, prepare healthy food and have healthy boundaries with others.   It’s created better self-awareness.  Most importantly, it means that I have started the healing process as a parent and partner around some of the damage caused the last couple years due to my severe bipolar II, suicidality, and time doing ECT as a hospital inpatient.

To those out there reading (and I thank you heaps and heaps!), please find the right informal and formal supports, medical team and things that nourish your soul.  I NEVER thought I would be able to have a day without pain, much less a whole two months.  I’ll share some of the random resources that have really helped me in an upcoming post.  I hope they can help you, too.  Please share this if it has helped you or could help someone you know. xo

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Posted in Binge Eating, bipolar, Meds, Mood

Planning for Depression

One common suggestion for people with bipolar is to document how you would like things to proceed when you are unwell.  This is my plan.  Feel free to adapt it for your use.

Wellness Strategy (ongoing pretty much daily – this are the minimum actions I have to do to keep me well)

  • Eat a balanced diet and watch weight
  • Exercise and move as much as possible
  • Practice mindfulness and listen to podcasts
  • Drink water and avoid soft drinks
  • Take meds religiously
  • Track moods
  • Go to my psychiatrist at least fortnightly
  • Nurture my support system
  • Do not let work become higher than #3 on my priority list
  • Do essential self-care (shower, brush and floss, shave, iron, do hair)
  • Freeze healthy meals or have meal replacement shakes handy
  • Keep sleep schedule as normal as possible (9 PM – 6 AM)

Depression Strategy (when I rate a 3 out of 10 or less).  Do the above when possible plus:

  • Attend doctors visits more often, if needed
  • Get help with tracking mood
  • Ask friends/family to check on me
  • Have good work excuses ready
  • Ask for help on self-care items and try to eat healthy, easy food
  • Avoid bingeing

Super-low Depression Strategy (for when I rate a 1 or lower).

  • Make sure there is someone there to bring me healthy food
  • Have someone around that can be with me to try to keep my sleep schedule normal
  • Have someone around that will help me get out of bed and walk short distances
  • Arrange with psychiatrist to do transcranial magnetic stimulation (1st try of this, ECT done and didn’t work in the past)
  • If I’m an inpatient, have someone call me once or twice a day and visit me once a week
  • Have someone that can tell work that I’ve been ill and make arrangements for my role to be covered for 2-6 weeks.  Talk to work about this to plan (if/when appropriate/safe)

Hypomania or Mixed State:

  • Avoid going on social media.  Use crisis lines, blogging or journalling instead.
  • Listen or watch positive TV, music or podcasts
  • Avoid negative people
  • Call into work or adjust work schedule for the week.  Re-arrange client appointments.
  • Focus on repetitive cleaning or doing creative projects that are towards bigger projects that have already been started instead of starting something new.
  • Exercise more.

 

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Posted in Actions, Basics, bipolar, Health

Should I Disclose My Mental Illness?

There are varying sources of advice on whether or not to disclose a mental illness to family, friends, and employers.  I disclosed to my 2 closest family members – my husband and my mom nearly right away after my *final* diagnosis of bipolar II.  I have had other diagnoses in the past that I did not trust for one reason or another (generally by doctors that I felt knew me for too short a time or couldn’t explain personal examples of why I fit their diagnosis).  This time was different because I trust my current doctor, and because we journeyed on the diagnosis track together for 2 years before he “labeled me.”  We collected data over those years that backed up the diagnosis.  Plus, my doctor supported my in seeking a second opinion from another well-respected psychiatrist that has a professional interest focused on bipolar II.  Too many doctors had been playing too casually with my life for too many years prior to this *final* diagnosis.

Now that I am confident and fairly adjusted to the reality that I have bipolar II, I have been cautious about who to tell and how much to tell them.  I gathered a small group of trusted family (6 people) and had a serious meeting for about 2.5 hours.  I covered personal experiences, symptoms, barriers, myths, frustrations, etc.  They tend to be people that stay mostly on the surface, and I asked them to start genuinely asking me how I am doing.  It’s been about a year, and they still have not been able to master this skill.  I feel glad that they know because they are more supportive of my husband when I’m less well, but they haven’t come to my aid in a noticeable way.

I chose which friends to disclose to by asking about each of them, “how could disclosure to this person benefit me (or harm me)?  Who should I disclose to first so I can get used to the idea of expanding my support circle without making myself feel vulnerable? In order, I told:

  • Friend 1 because she is closest to being family without actually being family and could be an advocate or physically there if I needed her.
  • Friend 2 because she is awesome at sympathy and making me feel better.
  • Friend 3 because she is analytical and knows a lot about the mental health sector.  She will tell me the truth.
  • Friend 4 because we are friends from a former job, and she can help me navigate the politics of my industry and be a sounding board or mentor if I need help.

I think I phased this subconsciously as a test to see if any of my friends would be untrustworthy or weird towards me.  Each of them has seen me in varying states of wellness, and I told the one that has seen me the most unwell first.  She was excellent and treats me no different (in the good ways) but asks me kind questions about my bipolar when the timing is right.  She has been an invaluable source of support simply because I was able to exhale after telling someone.  We are not in super-close contact, but I know she is someone I can call if the “shitake” hits the fan, and she will know some background info that will help her to help me.

The next friend I told had a similar response.  The third friend I told ended up having some rough patches in her own life shortly after my disclosure, and she has not been a support. Positively, though, I have been able to offer some basic support to her.  Helping her has helped me feel needed again in a world that pretty much forgot about me.  Finally, I told another friend this week who I trust but who runs in the same professional circle as me.  We have known each other for about 5 years, and I know she will respect my privacy.  I feel like she can be a mentor and resource for when I have professional difficulties and can give me some “on the ground advice” for how to handle my illness both as a friend and as a professional.

So far, I do not regret telling others about my bipolar, but time will tell.  I think the key to telling others has been because I feel more comfortable with my own diagnosis, how to handle it and because I have been without a depressive episode for 2 months now.

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Posted in Basics, bipolar, bipolar II, relationships, work

BP Relationship Pain – Breaking it Down

My bipolar II is affecting my partner, and I’m not sure how to reverse the hurt it has caused, mainly because I don’t remember a lot. My partner is one of those people that has a chronically joyful smile and is just the salt of the earth; he’s reliable and his goodness has seemed boundness.  He is one of the loveliest and kindest-hearted people I’ve ever known.  My BPII seems to be affecting that – a lot.

I have substantial memory problems from depression and some from ECT.  My partner told me recently that I have said some mean things over the past few years in both relative wellness and illness.  I can’t remember any of those things, and it’s distressing because I feel like I’m being held accountable for things I do not remember saying.  I have examined this, and I do not think he is using gaslighting, a form of emotional abuse, or that he is exaggerating his feelings or the truth.  What he says I said is in line with what I *would* say.  I simply do not remember saying it.

I am trying to swallow the reality that I have said extensively hurtful things, and I’m trying to figure out how to resolve them.  Some of the things that hurt him are my truth, such as how I feel about the mental load in our relationship or how motherhood has affected my sense of self.

We had very few relationship concerns until we were hit with the motherload of major life stressors in a period of about three years: a stressful pregnancy and postpartum period, becoming new parents, a mental illness diagnosis, buying a new house and unemployment.  It seems like everything now is festering under the surface, and it’s hard to know what to say or not say.  More importantly, it’s hard to know what to do.  I like the saying, “Love is a verb.”  I believe it is.  I’m not very good at showing my love through my mental illness.  I’m angry I have bipolar.  It’s hard for me to feel love because most of the time I hate living.

I have been critical of my dedicated partner, and he’s doing his best.  I’ve been expecting perfection, but he’s doing his best.  I find fault with him because I’ve basted in my own faults for so long that I know them thoroughly.  Maybe I was getting bored criticising my own faults, and that’s why I’ve moved to his.  I feel self-hate and since he is an extension of me maybe that feeling has been oozing onto him.  I realize some of this is toxic thinking and not BPII.

The learning I need to do is to figure out

  • what is my unhelpful thinking?
  • what emotions are his responsibility to identify and manage?
  • where did I cause harm and what can I do about it?
  • how can I prevent it again?
  • how can we both get better at sharing, hearing and responding to the needs of each other?

Any other ideas?  Thanks for reading.

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Posted in bipolar, Feelings, relationships

Losing Lithium’s Side Effects, Gaining Sodium Valproate

Lithium has caused some nasty side effects for me over the past few years.  I did not even realize that my symptoms were likely a direct result of the drug despite working very closely (once weekly) with my psychiatrist.  I have been on other medicines while taking lithium, but I’m fairly certain most of what I felt must be chronic issues one gets in their mid-30s are actually lithium-related.  Some of my side effects have been:

  • Increased thirst, especially at night (I can easily down 3 litres throughout the night)
  • Increased urination, especially at night (waking 6+ times a night)
  • Weird headaches
  • Decreased appetite sometimes
  • Weight gain
  • Vomiting
  • Poor memory often affecting my work life and household tasks
  • Feeling weak all over on occasion
  • Shakiness in my hands on occasion
  • A weird pressure in my stomach that feels a bit like nausea
  • Developed problems with my thyroid
  • Hair loss (Lithium caused thyroid issue which caused hair loss, from my understanding).

Now, a caveat to these symptoms is that some of them are related to having too much lithium in my system (severe headaches, vomiting, and diarrhea).   These can be dangerous, and I know my lithium levels needed a dosing change.  However, even when my blood tested at my optimum lithium level (over .7), I still had most or all of these symptoms at times.

Most of my symptoms were probably exacerbated at times by my binge eating disorder since salt and fluid intake influences lithium levels in the blood.  For the most part, me being on lithium probably did not work great because it was a crap shoot to keep my lithium level since my eating habits vary so widely.  I think I’ve mentioned this before, but taking Vyvanse (a drug for binge eating disorder and ADHD) has made a HUGE, HUGE, HUGE difference in my binge eating problems.  I have lost a few kilos, and I usually cannot follow through on my impulse to binge.

My feedback on sodium valproate (brand names depakote, epilium) will be forthcoming as it builds up in my system.  I started it today, and of the side effects I’ve read about, I’m most nervous about weight gain, nausea and memory issues.

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Posted in Binge Eating, bipolar II, Meds

Bipolar 2 Symptoms That Don’t Make Sense

As always, I’m a person with lived experience and not a medical professional.  (Which I find is more often valuable for other folks, anyway).  Enjoy!

The past couple of days I have been in my bed.  It has been a legitimate, all-consuming love affair with the comfort and warmth of my bed.  I averaged about 21 hours a day asleep or in a foggy, dreamlike trance that felt like sleep.  At around 2 PM today, I woke and wanted to leave my bed.  I haven’t returned.  Why was I there in the first place, and what suddenly switched in me to want to do all sorts of stuff?

Unpredictability

So with Bipolar 1, it seems pretty cut and dry: mania or depression.  Yeah, I don’t have that.  I don’t even have hypomania and depression.  I have a lot of mixed states where I feel rage and confusion teamed with highly suicidal depression.  I often find myself “sneaking” out of the house in a rage at midnight about 500 metres in the rain.  I park, have a good cry and have intense feelings that someone is stalking around the car.  I freeze with paralysis then finally work up the courage to drive back home and go back to bed.  I don’t think I’m God, sleep with strangers or spend my life savings on lavish things I don’t need.  I get up and go to work the next day (mostly).  The main thing I feel is a weird, secret, shameful pain that I am batshit crazy but that only one other person in this universe besides me knows that.

Suicidality

Depression makes me harmless like a wet noodle on a bench.  Depression with energy makes me a danger to myself.  I wept the other day – like truly wept – when I felt a huge truck whizzed past me as I was getting into a parallel parking space that faced the road.  I was DEVASTATED that I had missed my opportunity to die.  I pulled myself together and went onto work pretending that I had not just come literally within inches of taking my own life.  Like seriously, nobody asked me the BS of “R U OK?” because I was high on life, or so they thought.

People That Don’t Get It

The reason I have mixed feelings about R U OK? Day is because most people have zero clue about how to inquire beyond R U OK?  If they do happen to ask with more depth and insightfulness, what do they do with that information?  There are limited services available, particularly free and around the clock.  If a service is available, most of them are average.  I sometimes think my sanity is more on par than some of the overworked and underpaid people employed by mental health organizations.  Many of us with persistent mental illnesses have had “forced fun” with these services at some point or another so often they are not comforting.  They represent a miserable cycle.

Patterns

If I could predict these feelings they would be much easier to manage, but years of trying to mood map, journal, blog, etc., has not improved my self-knowledge in this area.  I have a complex life recipe I try to mix together each day to make things in life tolerable.  The main keys that consistently help are to maintain employment somehow and to somehow keep my partner happy and connected with me.  Otherwise, I do the normal diet, exercise, limit consumption of types of info (like news and Facebook), avoid boredom, pat the dog, sleep enough, keep a schedule for everything, bathe, do mindfulness, connect with friends, get sunshine, take my meds religiously, go to my doctors’ appointments like my life depends on it, be one with nature, etc.  You name it….I have probably done it, become bored with it, “rediscovered” it (often after ECT causing me to forget I did it in the first place), and done it again with a similar result.  If someone suggests I colour another mandela, I will probably act like a 7-year-old, roll my eyes and scream uncontrollably.  That shit don’t work (for me that is).   Even when drugged up beyond recognition in hospital, I found colouring in patterns painfully boring.  Give it a go though.  It might be your cup of tea.  I won’t judge you.  🙂

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Posted in bipolar, Feelings, Mood

Suicidal yesterday, good today

Trigger Warning: I talk about some dark stuff here.

Last week about this time I was in such great emotional pain that I was thinking about suicide every few minutes.  I pulled up to a roadside diner that had parallel parking on the road.  When I got out of the car I was feet away from traffic screaming by.  I could feel the gush of air from a Mac truck just feet away from me, and the only thing I could think of is that I had missed my chance.  I obsessed about how I would plan another perfect opportunity.  They would say it was a tragic accident.  I called the Suicide Call Back Service while I hid away in my office.  I hung up thinking, “What the hell am I doing calling them from work?”  I somehow stayed alive.  The death in my thoughts left as easily as it came.

This week, life is working for me.  I can’t figure out how or why I was suicidal (again).  I did miss one dose of meds (something that is extremely odd for me), but I still don’t understand the contrast of feelings.  I physically and mentally feel different when I’m suicidal.  I am working on ways to explain HOW the feelings are different.  I’ll break it down one day once I can keep track of it when I’m in a negative space.  All capacity for blogging, tracking, talking, caring, etc., goes out the window.  Now I am good.  Now I’m getting back on track.  I’m not sure why.  I’ve learned that I will be knocked over again soon.  Nonetheless, I keep on going for now.

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Posted in Feelings, Medical, Mood, Uncategorized