About a year ago, I made the mistake of reducing the dose of my Lamictal – the one medication I can tolerate for bipolar disorder. I remember thinking, “This med isn’t helping my depression much. Maybe it’s not working at all!” I talked with my coauthor about this and let my therapist know what I was doing. Then I reduced it until I was taking half. I thought I was making the right decision. I originally started the medication to help with my constant depression- and though it helped reduce the depression by about 25%, I didn’t think it worked enough. The normal dose of Lamictal is 200 mg and I was on 500. I started to worry what it was doing to my body- was the high dose causing problems I couldn’t see? Did I really need that high of a dose? It doesn’t seem to be doing much anyway! I think I’ll reduce it and see how much I really need. Looking back, this reasoning is not very sound. I went with my emotions instead of looking at the facts. Medications are always tricky- we know we need them, but we don’t really want to take them. This is when we start making excuses and often convince ourselves that they aren’t really working well enough or that we don’t really need them. That is what happened to me. Within one month of reducing my dose, I was so ill I could hardly function- all of my energy went into staying well- I used my treatment plan all day long just to get my work done. I thought my trouble was due to holiday stress or the result of a relationship problem I was having at the time. My depression wasn’t much worse, so I didn’t connect the problems to reducing my meds. I started to get very anxious, my OCD symptoms got out of control, my psychosis got worse and my rapid cycling just went into overdrive. And yet I still thought, “Lamictal is a drug for depression and my depression is about the same, so the drug wasn’t needed.” I was so blind! Then one day my therapist said to me, “
Archive for January, 2008
Bipolar Disorder Medications
Wednesday, January 30th, 2008Just keep taking your meds!
Tuesday, January 29th, 2008 A friend of mine just had to up her Zyprexa due to paranoia. She was really trying to make it on a lower dose, but had to face the reality of her psychosis. I am so proud of her for being able to take care of herself. Another friend went off her meds and called me crying on Saturday- she said, “I was doing so much better! I thought I didn’t need them.” The interesting thing is that she’s a doctor! No matter how educated we are or how smart we are, bipolar disorder can still trick us regarding medications. When the meds are working long term , it’s hard to feel them working. My mind often says, “You’re doing well today
Julie’s latest TV appearance – Britney Spears and bipolar disorder
Thursday, January 17th, 2008[flv]http://www.bipolarhappens.com/bhvideos/juliefastamnorthwest.flv[/flv] Julie appeared on KATU’s AM Northwest in Portland, Oregon on January 17, 2008. You can see the interview by pressing the arrow in the screen above.
Cortisone and Bipolar Disorder
Thursday, January 17th, 2008I’m on a cortisone awareness crusade. There is so much ignorance surrounding its use and how it can affect bipolar disorder symptoms. I’ve had two cortisone shots in the past few years and both times they caused profound depression and a spike in hypomanic episodes. On both occasions my doctors assured me that the dose was very small and localized- thus it should not affect my moods. This was unfortunately not true. Here is some information on the drug: Cortisone is a corticosteroid hormone (glucocorticoid). It decreases your body’s natural defensive response and reduces symptoms such as swelling and allergic-type reactions. This medication is used to treat conditions such as arthritis, blood/hormone/immune system disorders, allergic reactions, certain skin and eye conditions, breathing problems, and certain cancers. **
I used the cortisone for a serious hand injury I couldn’t get to heal. I talked about the side effects pretty thoroughly with my doctor- he was understanding, but still felt it would stay localized in my hand. It was my choice to give it a try and I regret that I did. After three months of mood swings, including one that included a lot of aggression, I know that I don’t want to take cortisone again- no matter how small the dose. Not everyone responds in this way of course, but all people with bipolar disorder need to be educated on its use. If you or someone you care about is faced with a decision to use cortisone, think carefully about how it may affect moods. I tend to be very reactive to medications, so people like myself have to be extra careful. It’s also up to us to educate doctors on how to use it correctly with people who have mood disorders. No matter how small the dose or how localized, it can and often does cause mood swings. Join my cortisone awareness crusade!
Monitor Your Bipolar Disorder Mood Swings
Monday, January 14th, 2008I’ve kept a chart of my mood swings for the past year. It’s amazing to see what triggers most of my downswings. Without question, it’s difficult relationships. I knew that this was a problem, but seeing the reality on a piece of paper forced me to make some serious behavioral changes. I have to limit contact with certain people, no matter how much I care for them. I wish I were the type who could have exciting, but difficult people in my life, but as my chart clearly pointed out. I can’t.
There is a mood swing chart and an example of one of my charts at the back of my book Take Charge of Bipolar Disorder. The Health Cards can provide you a lot of information as well. I faithfully chart my mood every night. It’s depressing to see how this illness controls my life, but I at least know I am doing what I can to stay stable by seeing the reality of what causes many of my mood swings. Interestingly, the chart has shown me that my hypomanic episodes are usually not triggered by anything I do. Truly interesting. Julie
Get It Done When You’re Depressed
Thursday, January 10th, 2008Dear Miss Fast,
I want to say “thank you.”
I have read every textbook, self help book, etc. and was still beating my head against a wall until I read your book. I can tell you that chapter 11, Expect Brain Chatter, was the answer to prayer. I don’t know what it was about this specific chapter, but it opened up serious dialogue after 14 years of marriage. This chapter gave me a simple way to explain the on-going dialogue and loop of music in my head and why it is so painful.
Thank you again.
Sincerely,
B. G.
Is Britney Spears Bipolar?
Thursday, January 10th, 2008Many of my readers have written and asked if I think that Britney Spears has bipolar disorder. I don’t normally try to figure out the behavior of superstars. The pressures of their careers can often cause behavior that mimics bipolar – as does the drug and alcohol use that accompanies the lifestyle. But the Britney Spears situation is different. Something is wrong here. .Usually when I hear an incident on the TV or read something in a magazine I can tell if bipolar is involved. Britney Spears is more difficult to figure out.
Here is a recap of her life in the media:
She was a child star on the Mickey Mouse Club show- along with Justin Timberlake, Christina Aguilera and the actor Ryan Gosling. She had a mega hit with the song Hit Me Baby One More Time and was known much more for her sexy dancing and costumes than her singing ability. And yet, it was obvious that she was very talented. She was in the news quite often during her relationship with Justin Timberlake, but there was very little scandal or over the top behavior. I think for many people, she was sexy, but not considered too talented. I’ve always disagreed! Anyone who can maintain a career in the music industry and make millions of dollars from her singing and concerts is talented. I think it has always just been fun to bash Britney Spears. I also think that many people would agree that she worked very hard for her success and always had. There is no comparison to her and someone like Paris Hilton. Britney put in the time.
A few years ago she met and married a dancer named Kevin Federline. He had quite a reputation for being a party boy and she started to follow his lead. Now, here is where things get difficult. If Britney does have bipolar, and I’m not sure that she does, it’s common to meet someone who seems to influence you in a bad way and yet you may be the one leading the situation with your manic behavior.
In other words, if Britney did have signs of bipolar mania it would be pretty easy to find someone to take along for the ride. I’ve done it so many times I can’t count them all.
She got pregnant very quickly and then got pregnant again as soon as her first son was born. This further complicates things as post partum depression can cause so many symptoms that mimic bipolar disorder. She was interviewed last year and said she didn’t have post partum depression. She also posted a lot of odd messages on her blog. I was watching all of this with interest- simply because she’s so famous and I’ve always liked her as an artist, but then things just kept getting worse. She was caught driving with her child in her lap. She was accused of being a negligent mother. She did a reality show with Kevin Ferderline that was supposedly quite… interesting.
Eventually, she started to party and neglect her kids in a very obvious way. There were a lot of pictures of her drinking and the drug rumors got stronger- there had been drug rumors for quite a while, but these seemed pretty substantial.
Eventually she and Federline broke up and agreed on joint custody- but Britney couldn’t seem to handle that. There were more pics of her drinking and taking off her top in a swimming pool while surrounded by strangers. (Does this sound familiar to any of you who have experienced mania!) but once again- this can all be drug centered behavior as well.
She then started going in and out of rehab. Finally, her behavior got out of hand- she shaved her head in public, went after her own car with an umbrella and checked in and out of rehab again.
This is when it became pretty obvious that bipolar is a possibility. So many of her behaviors are familiar to those of us affected by the illness- depression, manic behavior, impulsive acts, sexual mistakes, drugs and alcohol- a complete change in behavior from the past- I know I went through all of this…
She eventually lost custody of her sons and her very sad drugged out performance on the MTV Music awards a few months ago pretty much sealed her fate in the media- she was destroying herself and her career all at once. It truly has been a train wreck – and they haven’t let anyone forget it.
I don’t think that anyone who has watched Britney Spears over the years from her very controlled, professional and amazing dance performances on MTV with snakes and Madonna just to name a few, would have ever thought any of this was possible. She honestly didn’t fit the pattern of many self destructive Hollywood stars.
A few weeks ago it came out that her 16 year old sister, Jamie Lynn Spears is pregnant. That would be a trigger for any sister, whether she has a mental illness or not. And then finally, this weekend, Britney locked herself in a bathroom with her young son and refused to come out. She was taken away in restraints. She tested negative for drugs and alcohol.
All of this is making me sick. The poor girl. I happened to see a few minutes of an ‘entertainment’ show on TV last night and it showed how she was not even able to talk to her car without dozens of cameras in her face. I would lock myself in a bathroom as well.
Rumors are that Britney was on a psych drug and went off which caused the erratic behavior- others say that she is a pill addict, etc. etc. Who knows? We don’t know her and never will. I try to keep myself separate from gossip in my life and certainly don’t want to make celebrity gossip a part of my daily conversation, but here in the states it’s quite the norm. Everyone is talking about Britney.
Back to the bipolar- the illness is quite easy to diagnose is a person finds the right doctor who knows how to ask the right questions. This means taking a very deep family history in terms of mental illness and alcohol/drug use. The next step for bipolar is to establish if there is true mania. This can be difficult if a person is constantly in the limelight or is using drugs and alcohol. As you probably know, mania is the deciding factor for bipolar- without mania- there is not bipolar disorder. Post partum depression also has to be examined- a person can become depressed, psychotic or manic from post partum- so this assessment is very important. Whomever examines Britney needs to talk with close family and friends as well- not the people she’s been hanging around with since the behavior started a few years ago. Then, the doctor needs to go over all of the questions in the DSM IV- as I said, this is not a difficult illness to diagnose once a full history is taken- the problem is that people can be very avoidant of getting the diagnosis. No matter what- there are so many indications of bipolar disorder right now that the illness must at least be ruled out.
Another scenario is that she has been diagnosed and is not complying with the treatment.
Here is my take on the situation: First of all, those of us on the outside only get what the media tells us. It’s all negative all of the time and it’s disgusting. I know that I would not be able to survive it. The vicious media around her is just like the type that surrounded Princess Diana- and we see what happened there. Can someone put a restraining order on the media if they are endangering someone’s life? So, in that respect- I don’t think the media is necessarily a good source of information- but considering that she has literally had her life catalogued in pictures for the past few years, there are a lot of indications that suggest bipolar disorder.
There are also a lot of indications that the problems could be pressure and drug use. It’s actually too complicated to figure out. I recently saw Bill Clinton speak- he briefly mentioned the cut throat world of the media and said, “And that poor girl Britney Spears! Just leave her alone. She’s a kid.” Everyone nodded and cheered. They agreed, leave her alone.
But she will never be left alone and that’s sad. Does this have to be a part of fame? Before I was diagnosed, I lived a life much like what Britney is going through- no fame of course, but a lot of world travel and huge mistakes- if it had been detailed in pictures I would not be here now I’m sure. I would have killed myself in shame and from all of the stress. A harsh truth isn’t it.
I think that there is a good chance that Britney has bipolar disorder and the only way to know is to get her away from the media frenzy and into a place that is calm and far away from Hollywood and all of her entourage- where she can talk to someone and find out what’s really going on. I’m not talking about therapy- that is not what is needed right now and it won’t work anyway. Therapy is for treatment, not diagnosis. She needs to know what is going on in terms of her behavior… she needs to have some peace to stop the runaway merry go round- which is how I used to describe my mind when I was really sick.
Taking the time needed for a diagnosis is essential. I don’t even think my books are something a person uses before they are diagnosed- I write treatment plans- I help people once they are diagnosed and there are millions and millions of us. We need help before we kill ourselves or lose our kids or wreck our careers. Then we need the books- I always recommend that family members do read my books if they suspect someone they love is bipolar, but the person with the illness often needs stronger treatment at first.
I hope that Britney’s family can listen to what her behavior is saying- it’s not saying, I’m a typical Hollywood screw up- we can leave that to Lindsay Lohan, Paris Hilton and Nicole Richie. Britney Spears is different. She is in pain and danger. She’s obviously in a situation she can’t control. No one wants to act the way she’s acting- her behaviors suggest a brain problem- not a personality problem. She has become a part of the American way of life whether we like it or not, and we have an obligation as people affected by bipolar disorder to make sure she gets the help she needs- whether it’s bipolar or not. Not one of us needs to go through what she’s going through and I think that you are probably someone who understands- bipolar ruins lives- I hope she doesn’t have it… that is for sure. But if she does, it’s a good thing to have a diagnosis. Then the craziness can end and she can rebuild her life. I’ve done it- you’ve probably done it or know someone who has. She can do it too.
Julie A. Fast
www.bipolarhappens.com
