Three Tips for Family Members

Three Tips for Family Members

1. Read, read, read: Knowledge about bipolar disorder is your number one tool. Read the DSM-IV diagnostic manual and learn about bipolar disorder. It’s only about ten pages- but you can learn so much! All libraries have this book in their reference department. While you’re there, read about psychotic disorders as well. And if you’re really interested, read about personality disorders and anxiety disorders. People with bipolar disorder share symptoms with all of these disorders which is why it’s such a tough illness to treat. And of course, my books are a great read as well!

2. Set limits: It’s hard to set limits when the person you care about might leave. But…. that’s what has to be done when someone has mood swing problems.

A. You cannot smoke pot or drink in my house.
B. Yelling is not an option. If you feel angry, please take care of it before you come into my house.
C. I can only see you if you’re on medications.

Tough stuff to say. It often takes families years to do this. I find that saying the following helps:

“You have bipolar disorder and I can tell you’re in a mood swing. I’m here to help, but only if you communicate with me. It’s not acceptable for you to yell at me or ignore my feelings. This is an illness and you have to take care of the mood swings if you want me in your life. I will help in any way I can.”

I’ve had to do this with a family member a few times. I used to fight when they wanted a fight, but not anymore. It’s an illness and they need help. Only they can choose to get it.

3. Learn about the Bipolar Conversation and use it 24 hours a day. I created this technique and it’s in all of my books. You can just read the Bipolar Conversation chapter in Take Charge of Bipolar Disorder and change forever the way you interact with a person who has bipolar disorder. I guarantee it.

It’s hard to care about someone with this illness. We’re difficult people when we don’t manage the illness successfully. Learn all you can about our symptoms, set limits and learn how to talk to us when we’re in a mood swing. All of these ideas can start immediately. I created the Health Cards for families just as much as for people with the illness. It really does take a village to help us stay stable! You can use the Health Cards even if the person you care about won’t take your help. They work.
Julie

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News Release
Julie will be presenting at the 2008
DBSA conference.

FRIDAY, SEPTEMBER 12
8:00 a.m. - 11:00 a.m.
More information about the program here:

If you have not signed up for the newseltter- you can do so at www.bipolarhappens.com.  There is a sign up link on the top menu. This is a great place to find out more about my Health Cards Treatment Plan.

I write as much practical information as possible in these newsletters. This is a tough illness to manage and we need all of the help we can get!

My book Loving Someone with Bipolar Disorder is an excellent resource for partners of people with bipolar disorder. ( We have some challenges!) Take Charge of Bipolar Disorder also has excellent family tips.

 Julie

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Hi! Here is the latest newsletter from bipolarhappens.com.  

 My Bipolar Brain is Lying to Me!

All right bipolar brain! I’ve had enough! Shut up!

This is what I had to say to myself today when my brain would not leave me alone.  I sat outside at a cafe to get work done today.  The weather was great, my hands which often give me trouble were not bothering me and I was actually getting work done.  But every time a couple walked by I had the thought- you will never be happy like them Julie. Or if I saw a baby- I had the thought- you’ll never have the experience of having a baby. I felt like my life was wasting away and that others were having so much more fun than I was.

This is the bipolar trap and luckily I know enough to eventually recognize what it is and then tell my brain to.. shut up. It’s a harsh way to do it, but when this happens I have to snap myself out of it. Here are the facts outside of bipolar disorder:

- I am currently single because it’s the absolute right choice for me. It’s a conscious decision. I’ve been in relationships for the majority of my adult life and I doubt a year without one will kill me. Of course I prefer a loving relationship as most people do, but now is not the time. Crazy brain.

- I have never wanted a child nor do I want one now!  It’s ridiculous what my brain says! My nephew is the light of my life and that is enough for me!

- There is no way everyone is happier than I am. Please!

- In an hour I’m going to meet friends to see  a movie and then have a bbq. Why does my brain completely disregard this information?

Bipolar disorder lies to me. It lies all of the time. If I listen to it, as I did for many, many years, I will be miserable.

Saying I’ve had enough! and SHUT UP! to my brain and writing this got me out of the episode.

Julie

 You can sign up for the newsletter on the menu bar at www.bipolarhappens.com

My mother is a genius when it comes to helping me with bipolar disorder, but it didn’t start out that way. It took her many years to know how to help me. I created my treatment program (The Health Cards) over eight years ago. There was definitely a learning curve for my family. When someone has bipolar disorder, family members want to help, but they rarely know how. All of the comforting techniques that work on others don’t work when a person is in a mood swing. Family members have to educate themselves.

It’s natural to say, “But you have so much!” when someone you love is depressed. It never works. It’s natural to say, “Why can’t you just focus? It’s a really simple thing to clean your house.” It’s natural to say, “It’s just dinner? Why is it so hard for you to cook dinner?” These questions are pointless as the person with bipolar doesn’t know the answers until they learn to manage the illness.

I always say, “You don’t have to understand why a person can’t do things when they’re having mood swings, but you can believe that what they’re going through is real and help them find a way to get better.”
Empathy is great, but it’s not really possible unless you have bipolar disorder- support is what matters to us.

Here is what makes my mother special:

1. She is not scared like she used to be.  The Health Cards have given her a tool that works, so she knows what to do when I get sick.  For example, when we first started using them, she had to say, “Get out your cards, Julie. You’re psychotic. What do you need to do?” If I was too sick to get them out, she said, “I’m getting your psychotic card out now Julie. I will see what it says to do.” As you can see, this gives us tools when I’m too sick to help myself.

2. She is often the first to read my manuscripts,  so she knows my tips really well!

3. She isn’t embarrassed that I have bipolar and tells all of her friends she is proud of me.

4. She educates others. I just had a call in radio show, (you can listen to it from juliefast.com). She gave a great piece of advice. She said, “When you have to tell someone that your child has bipolar disorder, remember that the person you’re talking to probably has no idea what it is. It helps if you explain it while you give out the information. I say, ‘My daughter has bipolar disorder. You may have heard about it as it’s in the news a lot. She has mood swings and it can be really tough, but she works hard to manage it.” This lets others know it’s an illness and not something to be ashamed of.

My mom is a genius because she educates herself in order to help me. I am indebted to her and proud of her.
 
Julie

Hello! This is a reprint of the latest bipolarhappens.com newsletter.  Please note on the newsletter that I said a friend had trouble because she went off Abilify too slowly! I naturally meant she had trouble because she went off too quickly.

 All About Abilify

Abilify is an anti- psychotic used to treat bipolar disorder psychosis as well as bipolar psychotic mania.  Abilify is also known by the name aripiprazole (try saying that three times fast!) Anti psychotics are also called neuroleptics.

Abilify is considered an atypical anti-psychotic as it has less side effects than the older anti psychotics such as Haldol and Thorazine. It is also supposed to cause less weight gain.

This is a good thing as one of the side effects of drugs such as other the atypical anti-psychotics Risperdal and Zyprexa is weight gain!

In terms of side effects, Abilify can be sedating like many anti-psychotics-  but it can also be agitating. This is a somewhat uncommon side effect for this type of drug as anti- psychotics are known to cause a lot of tiredness.

Akathisia: A friend of mine tried Abilify a few months ago and had an extreme reaction called akathisia - which is defined as a syndrome characterized by unpleasant sensations of “inner” restlessness that manifests itself with an inability to sit still or remain motionless.  She had to go off the med- but when she tried to go down too quickly, the akathisia got so intense she had to go back up on her dose. She and her doctor monitored the reduction of the Abilify very carefully.  She is now stabilized on Zyprexa.

I have akathisia when my Lamictal dose is off. It’s terrible. You know it when you have it as it feels like your body is trying to turn inside out. I get a lot of twitching with it as well. I’m actually going through it right now as I messed up my Lamictal a few weeks ago. Not fun. I am back to a regular dose and hope it goes away soon!  (My mistake was going out of town for the weekend and not bringing enough Lamictal with me.)

Luckily, there is a lot of good news about Abilify- the drug is successful for many people. I hear far more positive stories about the drug than negative stories.

All psychiatric drugs have pros and cons. If your doctor suggests Abilify- there is much you can do to make sure it’s the right drug for you.

- Talk with your doctor about microdosing- if it’s appropriate (it depends on your level of psychosis/mania at the time) you can start with small doses of Abilify so that your body can acclimate to the drug with less side effects.  You can’t do this on your own, so make sure you work with a doctor.

- Keep a side effects journal- it may be that the drug helps more than it hurts. In other words, living with some side effects may be worth it at first. The side effects often get better with time.

- If you have akathisia symptoms- talk with your doctor immediately- this agitation means your dose is not correct. You don’t have to live with excessive side effects.

And finally, DO NOT EVER GO OFF ABILIFY ON YOUR OWN. I can’t stress this enough. All of us who have tried to reduce our meds on our own regret it. These are very serious drugs and we need professional help to make sure we are on the right drugs and right doses.

Abilify may be a wonderful drug for you- it just takes homework and questions to find out what to expect.

Julie

Here is a copy of a recent newseltter.

My Brother Ed Talks About My Mania!

I recently did a radio show on mania. My guest was Andy Behrman, the author of Electroboy. It was a fantastic interview as it’s always great to two people with bipolar disorder to discuss the illness!
In order to prepare for the show, I asked my brother to tell me what it’s like to have a sister with bipolar disorder.  I did the same with my friends- if you listen to the show, you can hear the letter my friend Karen wrote explaining how she helps me stay stable when I get manic.
 
Here is what my brother wrote:

How to Deal with Julie’s Mania

Simple, blunt and to the point…

It’s hard to look for the signs that Julie has taught us. Even after all of these years, a conversation with my mom will have me saying, “Of course! How could I not have noticed the tell tale behavior of the week!”

If I were a casual friend, then I would probably never bother with it and would write off our friendship as too much work. It takes a special (unique!) person to care, learn and follow through on what Julie needs from a good friend. Actually, as an older, middle age adult, I care more about relationships and other people’s feelings.  I think I would be willing to put up with what Julie needs from a friend. As a young man. No way!
Julie’s qualities are worth it though! If it weren’t for those, I could see where some people with mental health issues would be out of luck!

Ed

**

Hmm.  It’s interesting (and sometimes painful!) to read an honest assessment of your own behaviors.  Ed and I have worked on our relationship for a long time. It took him a few years to even understand how the Health Cards work and why they are so essential to my health! He is a good brother. I will write more about how we work together in the next newsletter.

Julie

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