My mom is a bipolar treatment genius… newsletter

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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

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ABOUT THE AUTHOR: Julie A. Fast, bestselling author of Take Charge of Bipolar Disorder, Loving Someone with Bipolar Disorder and Get it Done When You're Depressed is a critically acclaimed six-time author, award winning columnist, national speaker, and sought after expert in the fields of bipolar disorder and depression. You can read more about her Health Cards Treatment System for Bipolar Disorder at http://www.bipolarhappens.com. Please use the byline... by Julie A. Fast when quoting from this blog.
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Bipolarhappens.com Newsletter: Abilify - an Atypical Antipsychotic

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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

My Brother Talks About My Bipolar Mania

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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

PS: If you are not on the mailing list, please visit www.bipolarhappens.com and click on the newsletter link.

New audio - Get It Done When You’re Depressed Interview with KINK Radio

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I think you will get a lot out of this radio interview. You can play this right through your computer speakers or download it to your computer or iPod or MP3 player and listen to it later.   Just push the arrow to activate the audio.

 
icon for podpress  Get It Done When You're Depressed - KINK Radio Interview [27:44m]: Play Now | Play in Popup | Download

Enjoy!

Summertime and the mania is brewing!

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Mania prevention newsletter

My next newsletter is on mania. I will write about it constantly for the next few months. I’ve seen the destruction it causes in the spring and summer.

It’s the weather for sure- as well as many other factors.

Do you know the difference between full blown mania and hypomania? Bipolar I has full blown and Bipolar II has hypomania.

This is why it’s so important that you know your exact diagnosis.

I’ve been manic off and on for the past few days. It’s from work stress- and the stress is not necessarily bod, but it is a stress to my system.

How are you?

julie

Bipolar Disorder and Travel to the NAMI Conference

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I’m a presenter at the National Alliance on Mental Illness conference this June 13th-16th in Orlando, Florida. For those of you outside the US, NAMI is a large mental health advocacy nonprofit organization.  They have a strong focus on family. I’m teaching a class called Loving Someone with a Mental Illness.  This is the first time in the past six years that I have been well enough to travel and teach!

All of this sounds great, right? Well… let me tell you… travel is very, very difficult for me. I sometimes wonder if it’s worth it. I booked my flight today- I had to get a flight that leaves at midnight in order to get to the conference on time.

That freaks me out. How am I going to get enough sleep? Will it cause mood swings? What if I don’t sleep at all? Will I have to take meds and sleep in the afternoon which means I will miss part of the conference?  How will I deal with the time change? I don’t do well with that at all. It’s also expensive- NAMI doesn’t pay my way as they are a nonprofit. Is it really worth doing all of this just to teach one session? I then have to miss one of my radio shows…… which means prerecording before I leave. bla.

I could go on like this forever. So here is what I’m going to do.

I booked the ticket so that I have plenty of time coming and going. This means less stress so that I can at least get some sleep on the plane. In the past, I would have worried more about booking the tickets than actually doing it. This is one of the strategies in Get it Done When You’re Depressed- you don’t have to be depressed to use the strategies in this book! The one I used says, “Don’t worry about something- do something.” Oh, how true.

As for the three hour time change- I will get on Florida time a week before I leave. Then the time change won’t lead to mood swings. I can change my schedule about 30 minutes a night. The bipolar brain responds to this a lot better than just doing it all in one day.

I can box and send my books to the conference ahead of time. This costs a bit more, but it much easier than bringing them in a suitcase.

Many people there have a mental illness, so there will be a lot of understanding company! They worry about the same things I do.

I can pack ahead of time for once- using a list I prepare way in advance. Wow, what a novel idea.

I also have a travel health card I can look over – it has a lot of tips that I wrote the last time I traveled- such as how to handle stressful airports.

I will be fine.

I’m much, much healthier than I used to be bipolar wise and can actually travel alone again. That is a huge improvement. I want to focus on that.

Do you have to travel anywhere in the next few months? If it has been a problem in the past, you can start preparing now!

I have two months before I leave, and much of what I have to do will be taken care of in the next few weeks. I’m learning!

Julie

Work and Bipolar Disorder

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I’ve had a lot of work stress lately- maybe you have too! I am sure you’re laughing- all people with bipolar have work stress- either the work is too much, too little or not at all. There is a good chance that if you care about someone with bipolar disorder, you have supported them financially at some time in the past. My former partner Ivan supported me off and on from 1995-2001. Wow, that is kindness.

I just finished the amazing book Electroboy and was struck by a scene in the book that is all too familiar for many of us. After Andy Behrman, the author went through a series of ECT treatments, a vocational rehab counselor suggested that he try, ‘Volunteering.. or a bookstore.”

I had to laugh at that- So many of us with bipolar disorder have heard this suggestion- “Ok, you’re not well enough to do the high powered, creative and stimulating job you want to do.. So how about volunteering?”

As though that is ANY substitute for not being able to work the way we want to. There is nothing wrong with volunteering- but most people do it by choice and often as a adjunct to a regular job- when you’ve been sick and want to work but can’t, volunteering can be a bit of a letdown. I know-  I did it for years when I was too sick to handle a job.

And then there are the bookstores- Why do so many people think that working at a bookstore is so easy and that all of us who just came out of the hospital or a major mood swing would love to work there?

Ha ha. I have a friend who works at Barnes and Noble and there is nothing any more relaxing about a bookstore than many other jobs!

The real problem is that people with bipolar desperately want to be productive and make MONEY. Thus, volunteering is helpful, but not always the help many vocational rehab specialists think it is.

I get so fired up thinking about this! I am 44 and for the first time in my life I’m working like a ‘normal’ person. By normal I mean that I can work for more than 20 hours a week- sometimes I can work 25! I have used the Health Cards for so long, I have them memorized- they help me get through the tough work days- like today when stress is giving me a stomach ache. I have so much work to do it feels impossible that I will get it done. But I will. I’m finally stable enough to WORK. It’s a privilege and I’m thankful.

If you have the Health Cards, a work card is really helpful. It took me a few years to see what I could and couldn’t handle- so give it plenty of time. Your future can be a lot more successful work wise if you do.

PS: I interviewed Andy Behrman for my last radio show. He was amazing!

Julie

Medical Treatment of Bipolar Disorder

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My coauthor, Dr. John Preston has written an essential book for anyone with bipolar disorder or the people who love them. His book, The Medical Treatment of Bipolar Disorder covers everything you need to know about the medication treatment of the illness. It’s now available exclusively from BipolarHappens.com. It’s available in download or hard copy format (as so many of you requested). I’ve provided links to the book and ordering information below.

We all need to stay informed about our bipolar disorder medications and their possible side effects. This last episode I experienced really reminded of the importance of correct medication management. Don’t be in the dark about your medication treatment!

More information about the book can be found by visiting Medical Treatment of Bipolar Disorder If you have trouble with the link you can copy and paste or type this address directly into your web browser.
http://www.bipolarhappens.com/mdtx.php

Thank you for all of your support. It means a lot to me!
Julie

Bipolar Disorder FAQ Newsletter

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Bipolar Disorder FAQ

There are questions I regularly get regarding bipolar disorder- what better way to answer them than in a newsletter!

#1 WHAT IS THE DIFFERENCE BETWEEN MANIC DEPRESSION AND BIPOLAR DISORDER? 

There is no difference. Manic depression is the old name of the illness. The term bipolar disorder better represents the reality of the symptoms- as there is a lot more to bipolar than mania and depression. When I first started managing my own illness in 1998, I made the discovery that bipolar has many, many mood swing symptoms outside of mania and depression including: anxiety, psychosis, mixed episodes, paranoia (a form of psychosis), OCD and ADHD symptoms and so many more! The diagnosis of ‘bipolar disorder’ represents the illness as a continuum between the lows and the highs with many, many symptoms in between.

#2 WHAT IS THE DIFFERENCE BETWEEN BIPOLAR I(ONE) AND BIPOLAR II (TWO)? 
It’s often difficult to know the difference between the two main types of bipolar disorder. It can even be difficult for health care professionals to explain unless they have had special training on the topic. When you know the facts, you can see that the difference between the two is actually quite simple.

Bipolar I and Bipolar II (two)have the exact same symptoms in terms of depression and both have mania.  The difference between the two diagnoses is the type of mania a person experiences. Bipolar I (one) has full blown mania while Bipolar I has hypomania.

What is the difference between full blown mania and hypomania you may wonder? The difference is intensity.

Full blown mania if untreated usually leads to a hospital stay- especially if it’s someone’s first episode. This episode usually starts around the age of 20. The mania can start off mildly with a sense of creativity and then spin out of control very quickly. When my partner Ivan had his first full blown episode it started with agitation and confusion, then moved into a complete behavioral change as he started to talk more than usual and couldn’t hold a coherent thought. The night before he went into the hospital, he wasn’t able to remember how to write a check or even have a normal conversation. He was seemingly very creative, but it was agitated and not fun and very scattered. He talked over people and moved around very rapidly. His face looked different and he talked with a different voice. He had what is called dysphoric mania- in other words he didn’t feel very well! This mania was accompanied by severe psychosis.

Euphoric mania is the opposite of dysphoric mania. When it’s full blown, it’s very dangerous as it feels so good. The person almost always refuses help when they are really euphoric. When a person has euphoric mania, they feel no pain and have no reasoning ability- and most importantly, they can’t see the consequences of their behaviors as they feel invincible. This is very, very dangerous mania as it can just seem like excessive enthusiasm, creativity and charisma from the outside.

All full blown manias lead to disasters and most people go into a deep depression if medications are not used successfully.

Hypomania

Hypomania is much less intense and doesn’t put a person into the hospital. As with full blown mania, a person can have euphoric and dysphoric hypomania. Extreme psychosis is rare with hypomania- though it’s common to have grandiose thoughts as well as negative thoughts. I get euphoric mania at the beginning of my hypomanias. Nothing feels as good as euphoric mania- absolutely nothing- but I always do something stupid and I always crash. I work very hard at preventing hypomania.

As I say in my book Take Charge of Bipolar Disorder, it’s essential that you have a distinct diagnosis of either Bipolar I or Bipolar II as the treatments for the two can be quite different! You have to know if you have full blown mania or hypomania. No matter what form you have, the mania is serious- you can make horrible and life altering decisions when you’re full blown manic or even hypomanic. Prevention is the only way to make sure this doesn’t happen.

Straight Talk for Parents of Teens with Bipolar Disorder Newsletter: Part Two

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In part one of this series, I told my story of how I was very obviously bipolar when I was a teenager- but had no idea what was going on! My mother read the newsletter and said, “We didn’t think there was something wrong with you- you just seemed typical- you weren’t way out there ever. You were bored, but not to the point that we thought we had to do anything about it. I had no idea about the mania. I wondered why you didn’t do more things with your intelligence and that kind of stuff- but not even to the point that you would even be classed as ADHD.”

She was right- I didn’t have severe depression.  I lived at home and all of my hypomania was away from home. She never saw me hypomanic until I was 23 - (wow, that was a bad one!) All of my mania happened during trips. I was wild at least a few times a year, but never in the presence of my family! I find it amazing that I started with more mania than depression, because once I hit my later twenties- it was 99% depression. What a tricky illness.

A Friend’s Story

I asked a friend of mine who has bipolar I to tell me her teenage story. She said, “I was mostly depressed when I was a teenager. I don’t remember being manic.” After she wrote out her story she called and said, “Julie. I can’t believe it. I can see I was manic. I went to five proms!”

Here is my friend’s story:
 
I had my first depressive episode at 17.  I was so depressed I couldn’t understand anything in school, even though I had been an honors student.  When my sister, my main support, left for college, I didn’t want to live.  I overdosed on Contact and when I realized what I had done, I called an ambulance and got my stomach pumped.  And then, as though it never happened, I started feeling better.
But then I lost my period for 8 months and was feeling depressed the following year.  At the same time the following year, I overdosed on pills and went through the same thing over again.  My parents, divorced then, stood over the hospital cot, blaming each other.  But get this, even though I had two major depressive episodes, I ended up going to five proms, yes five.  And I did well in school, taking all the AP classes. Because I had some upswings. I can see that now. I believe I was undiagnosed as BP, and had been treated by an incompetent doctor for a couple of years.  I don’t remember what he put me on.  I remember feeling sedated in high school.  It wasn’t until 1990, when anti-depressants were spoken of that I started taking them which then in turn made me go manic and was finally diagnosed as having bipolar disorder.

**

If you’re a parent of a teen with bipolar disorder, here are some tips for helping your child while helping yourself. These are general tips. I know that many of you are in crisis. That is a separate topic- one I will address in the future.

#1 Know that your teenager may have no idea what is happening: Being a teenager is confusing. They are just beginning to learn about themselves and how they interact with the world. Their brains are immature- in other words they are literally still growing. Because of this, the maturity to deal with the symptoms caused by bipolar disorder is very limited. They don’t want to hurt you- they don’t want to run away or refuse meds. They want to be happy. Doesn’t everyone? So, when they yell, act up, leave, take drugs, have promiscuous sex, hear voices, have nightmares, flunk out of school, say mean and untrue things, try to kill themselves or make you feel like a terrible or ineffectual parent- remember, this is an illness. This doesn’t excuse their behavior at all- it still hurts and damages families- but you need this understanding before you can start a successful treatment plan with your child.

#2  Write down your teenager’s symptoms: All of them. As you know from the Health Cards, we can only treat what we understand. Get out a yellow pad and on the top of each page write: depression, mania, OCD, anxiety and psychosis. Then, on each page write as much as you can regarding what your teenager says and does. Once you have a list, memorize it- this is how you know what is bipolar behavior and what is teenage behavior. For example, typical teenagers get angry, but they don’t beat up strangers; typical teenagers have ‘low self esteem’ but they do NOT try to kill themselves; typical teenagers may want to stay up all night- but they get tired. Kids with bipolar can stay up all night and not get tired - or simply can’t sleep at all. As you can see, you can learn the differences. I use the Health Cards for this- and yes, I started with yellow pads!

#3 Read books on bipolar disorder - all that you can find. Especially mine as they are written by someone who was a teenager with the illness- even if your child will not listen to you or even admit they have the illness after they are diagnosed, you have to know all that you can. This helps you have compassion and understanding versus constant confusion and frustration. Remember, just because you may have a teenager who won’t read- you can. You have to know what you’re up against before you can help your teenager get better.

#4 Give your child a yellow pad with the same words on the top that you used and say, “Please tell me what you feel when you have these mood swings. I want to know what you’re going through.” Many kids can write down what they can’t say. There are many teens who have bipolar disorder and accept the diagnosis, but they are often very confused and not aware of their symptoms. Seeing them in black and white is comforting- especially if they can compare them to a list from someone else with the illness. You can then compare your lists and actually talk about the illness and how you’re going to treat each mood swing separately- this is the foundation for my treatment plan. It changed my life and the life of my family.

#5 Take care of yourself first. This is an amazingly hard thing to do when you have an ill child. But you have to do it. Or you will get sick - you will lose your relationships and have trouble at work. You will lose YOU. This means you have to get used to feeling guilty, worried, lonely, worthless, hopeless and very scared. These are often the feelings that come up when you put yourself before your child. I don’t mean to do this all of the time- but you have to do it often enough to be well enough to get through a crisis. You need to do this so that you can provide the stability your child desperately needs.

It’s Not Fair!

Life is not fair when your child has bipolar disorder. It certainly hasn’t been fair for my family, but we have survived. We get along well - and that is amazing considering that I was untreated for over 15 years! Creating a management plan that can be used for the whole family takes a lot of work, but it can be done. No matter how hard it is now, always remember, your teenagers will not be teenagers forever- and if you have a plan in place, they will appreciate it so much when they are adults. 

The next newsletter will address the big stuff: refusing the diagnosis, drugs and alcohol, running away and jail, just to name a few. You are not alone- at all- if your teenager with bipolar has these problems.  Never forget- there is HOPE. It takes a management plan and a lot of love- but you can have a stable and happy family.

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