Can The Health Cards work when a person with bipolar disorder refuses to get help?   

Many people with bipolar disorder either don’t believe or can’t see that they have bipolar disorder. This is a scary and very frustration experience for family members, friends and health care professionals. You probably see very clearly see that the person needs help and when they refuse, it’s like watching someone ruin their life. This is a common problem when a person has bipolar disorder. So the first thing to remember is that you are not alone and the person you care about is not doing anything out of defiance or unkindness. They are ill and the illness will not let them see what is wrong. They may constantly blame others or drink and use drugs to deal with their out of control emotions.   

Can I use The Health Cards to help them see they need help?   

The Health Cards are designed to be used by anyone who has bipolar disorder as well as family members, friends and health care professionals who want to help the person. The reality is that getting them to see they have an illness is very difficult, but it is NOT impossible or difficult for you to help yourself by understanding the illness thoroughly and teaching yourself and others how to interact with the person.   

Do people who refuse to eventually get help benefit from The Health Cards?   

Definitely. There is always a chance that the person will see what direction their life is taking – especially if they see you make the significant positive changes you can go through by using The Health Cards. When you change from reacting to what the person does, and start responding in a way that HELPS YOU, you can see some amazing changes – especially in yourself. It takes time and you may still be very scared and frustrated, but you will have a plan that works every day. Trying The Health Cards is up to you. I know that when my family, friends and therapist started using The Health Cards everything in our relationship changed. Everything. They know EXACTLY what to do when I’m sick- even when I start to get manic. Without The Health Cards, all of the mistakes of the past would go on indefinitely. I will use The Health Cards for the rest of my life to maintain stability. You can do the same. They are guaranteed to help.   

================================

I walked into a trigger this weekend. This is like walking into a brick wall you refuse to see even when it’s staring you in the face. It’s a hallmark of bipolar disorder. My real brain says, “Sure Julie! Of course you can do that! “ and then once you do it, the bipolar brain says, “Oh no Julie. Look what you’ve done! You caused the monster to come out once again!” 

I know better. I write the books right? I know not to be so hard on myself. This is a tricky illness. I can get mildly manic and not realize it and then make a decision that seems just fine at the time.  Then the effects of the decision hit my brain and I go down, sometimes way down.  It’s completely unfair. 

The good news is that I have a plan I put into place immediately. This shortens the inevitable depression and lets me get back to my life in a day or less instead of the weeks I used to experience in the past. 

I try to remind myself that it’s depression when the really sad, lonely and negative thoughts start- but it can be hard to maintain perspective.
I call my depression team: my mother and friends. I may talk to three or four - one after the other. They all know what to say: 

“Julie, remember the Health Cards. You’re talking like this because you’re depressed. You know what you’re saying and feeling isn’t real. Let’s work on getting you better.” 

They remind me not to listen to the voices that tell me my life is worthless. Instead, they remind me to focus on stopping the depression.  I have a terrible illness- but I do have a wonderful life. 

It always works. 

Julie

In honor of Mental Health Awareness month here in the United States, I thought a series of newsletters on how to create a comprehensive treatment plan would be timely. Part 1 of 4 - The comprehensive treatment of bipolar disorder 

The Power of a Comprehensive Treatment Plan Current research states that 4-6% of the population of the United States has a form of bipolar disorder.  When you factor in the family, friends, coworkers, teachers and health care professionals who are affected as well, the number of people impacted by the illness reaches well over 25,000,000 people.  Considering  that the world has a similar rate of bipolar disorder, the numbers are staggering!  

My Story About two years after I was diagnosed with bipolar disorder, I realized that medications would not be enough to help me manage this illness.  There were no books on the market to help me find stability, so I created my own comprehensive plan.  This plan is now called The Health Cards Treatment System for Bipolar Disorder. I also talk about comprehensive treatments in my other books:  Loving Someone with Bipolar Disorder, and Take Charge of Bipolar Disorder.  I know that I sound like a broken record sometimes.  I always say, “You Must Have a Comprehensive Treatment Plan!” This is true for people with bipolar disorder as well as the people who care about them.  It’s the only way to manage this illness successfully. 

What Is a Comprehensive Plan?   A comprehensive plan recognizes that simply relying on medications to treat this illness is not enough.  It also understands that exercise alone is not enough -diet is not enough- a stable relationship is not enough.  In other words, the illness is too complicated for a one step solution.  What’s needed is a plan that recognizes the complexity of the illness and provides a clear and concise system that is created by you and your support people for managing all of the mood swings that come with bipolar disorder -with the ultimate goal of preventing the mood swings before they take over a person’s life.  It took me nine years to create the plan I write about in the Health Cards and my other books.  Because I now understand how to manage this illness, I no longer have a life that’s controlled by bipolar disorder.  My plan makes sure that I have the control and teaches the people in my life how to help me stay stable. This doesn’t mean I don’t get sick.  I do.  Unfortunately, that’s the nature bipolar disorder.  The difference between now and nine years ago is that I have hope and I know what works to keep me stable. 

A Simple Goal  My goal is to help people throughout the world find a plan that works for them.  If every person on this newsletter mailing list learns to manage this illness more effectively, it’s a really great start. 

A Good Start  The comprehensive treatment of bipolar disorder is a large subject, so in these newsletters I will give four effective and easy to implement ideas on how to manage the illness more successfully. These can be added to any plan you already have. Here are the tips: 

1.     Find Helpful Medications with Limited Side Effects

2.    Regulate Sleep

3.  Improve Relationships

4.  Create a Written Treatment Plan

It’s important to remember that a comprehensive plan is not something a person with bipolar disorder has to do alone.  The above ideas work better when family, friends and healthcare professionals are involved in the process.  This requires a lot of communication, education and time, but the results are worth it. If someone you care about has bipolar disorder, your role is very important which is why you need to be a part of any plan that is set up to manage the illness. On a side note, I truly understand how hard it is to love someone who won’t get help- this means that you have to create your own plan in order to take care of yourself. And continue to learn about bipolar disorder and it’s symptoms so that you gain a better understanding of your loved one. 

This first newsletter covers tips for managing bipolar disorder medications.   

** 

#1 Find Medications that Work for You-with Limited Side Effects 

For many people with bipolar disorder, discovering the right combination of medications is the most difficult and frustrating part of treating this illness. I know that I spent many years trying to find meds that worked for me and when I did, I became even more effective at managing the illness.  It was hard for the people in my life to see what the medications did to my mind and my body as I was trying to find one that worked.  It was harder for me to live through it!  I’ve now found a medication that works very well for me in certain areas.  And believe it or not, I have very few side effects.  This can happen for you as well. 

Here are tips on how to make the process easier: 

 - Try Microdosing.  Everybody processes medications differently.  Our bodies are very individual which is why some people can take a certain drug with no side effects while others, like myself can have every single side effect listed on the drug warnings. There is a way to get around this.  My co-author Dr. John Preston introduced me to something called microdosing  many years ago. If your body has trouble processing a medication at the recommended dose, you can start with very small doses of the medication (microdosing) so that your body can acclimate to the drug with limited side effects.  This is what I did when I started Lamictal- an anti convulsant used to treat depression, rapid cycling and psychosis.  It took six months for me to get to the right dose, but for the first time in my life I was able to tolerate a drug.  If you’re someone who has a lot of trouble with side effects, make sure you talk to your doctor about microdosing. 

 - Understand the Medications You’re Taking. I remember being on six medications when I was first diagnosed.  I had no idea what they were for.  I just know that they all seemed to make me more ill than I was before I took the medications.  This was because my doctor kept trying new medications – one on top of the other -instead of working with me to find what really worked.  I would never go through this now.  I know too much about medications and know what questions to ask.  It’s important that people with bipolar disorder as well as the people in their lives understand exactly why a certain medication is used.There are four classifications of medications you need to understand: 

Mood Stabilizers — in general terms these include lithium and the anticonvulsant medications such as Depakote, Tegretol and Lamictal.  These are the first medications used when a person  is diagnosed with bipolar disorder. 

Antidepressants: Prozac, Effexor, Zoloft, and Wellbutrin are commonly used antidepressants   .  The most important thing to remember is that antidepressants are not a first-line treatment for bipolar disorder.  In fact, they need to be used very carefully as they can cause mania and rapid cycling.  If you’re on an antidepressant and have trouble with mania or rapid cycling, you must talk with your doctor about the mania. 

Anti psychotics:  Zyprexa, Risperidone , Seroquel and Abilify are commonly used anti psychotics.  There is often a lot of confusion around antipsychotics as people with bipolar disorder are not always educated to the fact that most people with the illness have psychosis! These drugs are life savers for people with severe mood swings as they not only suppress psychosis, but can also keep a person out of a dangerous depression or manic episode. 

Anti anxiety: And finally, there are the benzodiazepines (anti-anxiety medications) such as Klonopin, Valium and Ativan.  I know that Ativan is a lifesaver for me.  Unfortunately, these drugs can be addictive which is why the amount prescribed is often limited. 

If you are on any or all of these medications, you need to know why.  If you’re a family member or friend, and you suspect that the person you care about is on the wrong medications, educate yourself so that you can ask the right questions and get them the help they need.  My co-author Dr. John Preston has written a fantastic book called The Medical Treatment of Bipolar Disorder that covers the medications used to treat bipolar disorder in detail.  It’s available at bipolarhappens.com. I feel that all people with the illness as well as their family members need this book. It answers all of the questions that doctors don’t have time to answer. Take Charge of Bipolar Disorder also has an entire chapter devoted to medication and side effect management. 

- Reduce symptoms naturally. I found that the best way to live with bipolar disorder medications is to take as few as possible with the smallest doses possible.  I’m not saying that you should decide what dosage to take.  I’m saying that the more you can reduce symptoms naturally, the less medications you will need.  This is the entire goal of The Health Cards.  The more I can control my symptoms on my own, the less need there is for heavy doses of medications.  This naturally leads to less side effects. 

- Keep Trying. I found a medication that worked for me on my 23^rd try. Hopefully you will not have to go through this! But I’m so thankful that I kept searching for something that would work. Doctors are so much more informed these days.  They seem to understand that side effects are not something we can simply live with.  Drug companies are working on creating medications with less side effects-especially when it comes to weight gain. There will be new medications on the market in the future, so there is always hope that you will find something that works. 

One Final Tip: 

Accept that medications are the most effective treatment of bipolar disorder symptoms. This may be difficult, especially if you don’t believe in medications or have a lot of trouble with side effects, but facts are facts. People who have the right meds lead more stable lives. All comprehensive plans need medications as a foundation. I’m proof that you can manage the illness without meds, but why do this if you don’t have to?  It’s far too difficult with less positive results. Today, medications take care of about 50% of my symptoms when I watch my triggers. I know for sure that my lows are not as low and my highs are not as high because of the Lamictal. This makes it a lot easier for me to manage the remaining symptoms. 

Never Give Up! No one really wants to take medications for the rest of their lives.  I know that I don’t.  But I’m willing to do it.  The relief I get from the two medications I can tolerate is a gift.  Medications are very large part of my treatment plan, and I know that using them along with my other strategies makes my life a lot more enjoyable and stable. If you struggle, or you know someone who struggles with the reality of medications, just remember my story.  It took me years to find a combination of medications that helps manage my symptoms.  I honestly didn’t think medications would ever work for me, but I was wrong.  Never give up. 

A Newsletter on Sleep 

The next newsletter will explain why regular sleep is so essential to bipolar disorder management. In the next week before you receive the information, watch your sleep patterns – What makes it difficult to sleep? What makes you sleep too much? The newsletter will help you find these answers in depth.

Julie

Never forget that depression is an illness that clouds everything. Your goal is to find the real you and base your actions on that person.

 Julie