Manic Monday: Mental Illness Healed?

So, this may be oddly titled, but here is the weird thing…. Can pregnancy reverse, or perhaps, repair some of those missing or defunct synapses in the brain that was causing mental illness in the first place? I would like to know. I have looked and looked for studies that may explain how a person who had mental illness could be doing so well on minimal medications after pregnancy?!

You see, I would have loved to see what my brain looked like before I was pregnant. There have been studies that individuals with mental illness, or more specifically Bipolar disorder, have enlarged or smaller areas of the brain than those without a mental illness. No articles, however on before or after pregnancy. What is the significance of these enlarged or smaller areas of the brain? Some areas that are smaller are tied to creating memories. Positive memories create larger areas of the brain. Neutral memories or experiences cause for smaller areas of the brain, and lack of need to create new memories. For individuals with major depression, those areas are really small.

The enlarged areas of the brain that have been found with those that have bipolar disorder, may effect different functions of memory, cognitive function, as well as stimulating creative thinking and artistry. I am curious if my brain structures have changed with having been pregnant compared to where I was at before. This research is really interesting to me.

I am by no means, healed. But I am, however, doing really well. I feel good, but not manic. I still have some hypomanic episodes and still fluctuate throughout the day, but the highs and lows are minimal… they aren’t as high or low. I feel tired and a little depressed at times, but this is minimal compared to where I have been.  So, why is this? How can this be? I have no clue other than I am content with just being me and not so anxious that I am going to screw up at work, or be faced with some huge life altering decision. Just happy with myself as I am.

So, while I wanted to share information on pregnancy possibly curing mental illness, all I could find was more information on bipolar disorder and brain structure. I was also hoping to find the PBS special that spoke specifically about the brain and bipolar disorder. The film discussed the enlarged portions of the brain and how that could contribute to the expanded creativity, artistry of individuals with bipolar disorder. Unfortunately, I didn’t find that one either. If any of you do, please let me know. Otherwise, I hope you enjoy!!

Structural and Functional Brain Changes in Patients with Bipolar Disorder http://www.pendulum.org/treat/structure.htm

History of the Scientific View on Bipolar Disorder as a Disease: http://www.pendulum.org/disease.htm This article is more focused on the new findings that individuals with certain mental illnesses (bipolar disorder, schizophrenia) have brains that show or exhibit similar functioning or issues as those who have had traumatic brain injuries.

http://womensneuroscience.stanford.edu/wellness_clinic/Pregnancy.html

http://www.infobarrel.com/My_Brain_Needs_Drugs – I thought this was funny, but was wondering if he was referring to the same PBS flick that I did… but nope. Still out of luck. Wanted to share anyways.

http://www.pbs.org/thisemotionallife/topic/bipolar/what-bipolar-disorder

Manic Monday: Power of Sleep

This Monday I dedicate this post to myself. For almost 10 months I have had severe sleep deprivation, but have hung on, clung to, and gripped for dear life to my sanity so that I may be a better mother to my daughter, and continue to nurse her. Almost 10 months! I didn’t know if I would be able to be a good  parent for a few days or few months while on medications, let alone off of them in order to nurse. I am doing pretty well. While I am not able to dedicate as much time to blogging as I would like, I can at least focus on some good things every once in awhile.

My Life Today

Over the years I have learned more about the restorative powers of sleep. What is more important is how bad sleep, or lack of sleep, would cause me to cycle more.

This is different for everyone, with or without a mental illness. Being an ultradian cycler (swinging back and forth from happy to sad several times a day) lack of sleep would either send me into depression or my hypermania would become worse and my cycling would speed up to swinging several times an hour. An exhausting way to live. Often my medications compacted or made side effects worse.

What is important to note is that hypermania often induced insomnia. Can we call it a vicious circle? So sleep medications were given regularly. Usually an antipsychotic. My anxiety shoots sky high if I didn’t get good sleep. I believe this is still true… if I don’t get sleep than I tend to worry. Sometimes worrying about the fact I didn’t get good sleep. (Stupid, I know. But I had to perseverate on something, right?) In the past, I would be unable to get out of bed let alone the house. It was scary and detrimental to my ability to work.
So, to say sleep is important is really too simple. There are many studies sighting the effects of lack of sleep on mental illness, or mental illness effecting lack of sleep.  Either way, it is important to note that my lack of sleep has reduced me to blethering idiot and crying fits at times.  Compound this with bordering on post partum psychosis. In fact, lack of sleep might be the root cause of post partum psychosis. I thought I would provide some information regarding this issue, in case anyone would be interested in learning more.

Sleep Loss and PostPartum Psychosis “It is argued that sleep loss resulting from the interaction of various putative causal factors may be the final common pathway in the development of psychosis in susceptible women. Clinical significance of these findings, including strategies to prevent postpartum psychosis, are discussed and suggestions are made for future research directions.” Sharma, V. and Mazmanian, D. (2003), Sleep loss and postpartum psychosis. Bipolar Disorders, 5: 98–105. doi: 10.1034/j.1399-5618.2003.00015.x

Canadian Medical Association Journal “The only possible exception is puerperal psychosis, which emerges much more often in women with a personal or family history of a bipolar affective disorder than in women without, a finding that probably explains the reluctance of some researchers to recognize puerperal psychotic episodes as distinct from psychotic episodes at other times.” G E Robinson, D E Stewart, CMAJ. 1986 January 1; 134(1): 31–37.

Healthy Sleep

About.com- Bipolar and Sleep Disorders

Sleep Medicine Reviews

General Psychiatry Archives

Manic Mondays: The Diagnosis

For my second installment of Manic Mondays I am going to cover the diagnosis of a disability. In my case, mental illness.

While some people discuss the ins and outs of being diagnosed, I am talking about the positives and negatives of having a diagnosis. More along the lines of mental/emotional health after being diagnosed.

The bottom line is that its just a diagnosis. I view it as a tool only. It is the means in which you figure out whats going on, get the resources you need to deal with it, and then MOVE. ON. WITH. YOUR. LIFE. It is a diagnosis only. It does not define you. It does not tell you who to love, who to hold close to your heart, what you like to do, what your passions are. Those people who choose to stand by you throughout it all are your “support people.” Your diagnosis may help you figure out who those people are, because many people will cut and run when they find things are too tough for them. Those who stick close, are the ones you count on. Your diagnosis may influence some of your future decisions, to identify what would be good for you in the long run, or challenges that would exacerbate your disability. Ultimately, you are you. You have these experiences to build on that have created you as a person. The diagnosis is just a tool. This is where you say, perhaps years later, “Okay. This sucks, but its just a diagnosis. Now what do I do about it?”

Don’t get me wrong. If you had asked me about this 10 years ago you would have gotten a different response. It has taken me 15 years (holy crap! Has it been that long??!!) to figure some of this out.

I know that there are always nay-sayers who read a blog and disagree vehemently with what a person says. You have that right. However, people have the right to write and express their opinions in a blog. And that is just what this is. My opinion. This is just my view of having a disability, and as a professional who has helped many students and adults identify their disabilities, and how to go about continuing on with their lives afterwards.

What I have learned is that there is a fine line to my mental illness and how it has challenged me, caused me to rethink some of my decisions, and influenced me to make some really poor choices. My mental illness has created in me a creative spirit that I think is intuitive to seeing and experiencing life passionately and deeply whereas others may float along in life never truly exploring life’s adventure. That fine line is so difficult to discern where my disability ends and where the “me” truly resides. Whatever and wherever that line leads me, I like who I am. I may not like some of the things I do or say (as my mouth tends to spit things out that are random and stupid), but I ultimately like WHO I am. This may take years for others to figure out. It is a journey that each person takes. A person with a disability takes a whole different path, one of struggle, one of finding your “support people,” and one of ultimate redemption and happiness in knowing and liking who you are.

A diagnosis is a tool. Whether the tool leads you to taking medications, avoiding large crowds, getting a new piece of software to do your job, modified school or work schedules, accommodations and what not…. it is just a tool to help you get what you need so you can be successful. You are who you are based off of your experiences. Having a disability or diagnosis is just one of those experiences. That disability may color the hues of your final life’s painting, but it is just one aspect in the whole of your life’s masterpiece. You get to choose whether to let the diagnosis make you, or for you to remake it into something beautiful in your life. To me, it is all about perspective.

Manic Monday: It’s All About Quality of Life

For my first installment of Manic Mondays, I am focusing on Quality of Life. As a person with a mental illness, I have pretty much been on every kind of mood stabilizer, anti-psychotic, anti-convulsants, anti-depressant, anti-anxiety medication out there. What have I learned about it all? That though these medications were helping combat the mental illness, if they caused more problems with their side effects and made me feel worse in different ways, it wasn’t worth it.

Note: For those out there that are currently on medications and feel this is true for you, I am not proposing for any of you to go off your medications. What I am proposing is having a good sit down with your ARNP/Psychiatrist/medical doctor to discuss your medications.

Second Note: If your medication practitioner isn’t willing to discuss changing your medications, or just gives you the medications without explaining first what the side effects are, the goal of the medication treatment, and how to measure that progress… THEN I propose getting a new practitioner. It is your life, your mental health and if these people want your buy in, your commitment to take these medications, than you damn well better have a say on the effectiveness of said medication and whether it is negatively exacerbating other health issues in your life and your well-being.

Each person is different. One medication may work with a person’s chemistry positively where the person next door has negative side effects. The issue is finding that balance where you can live with the side effects and they do not outweigh the purpose or success of the medication you are taking.

For example: If you are given Depakote, at a high dosage, and this is for mood stabilization, but gain 60 lbs in six months…. changes are you aren’t feeling really good about yourself, depression has become a major factor, your health has gone down the tubes, and the stretch marks on your body are contributing to a significant lack of good feelings about yourself. I would say a good sit down with your therapist might be needed. Now, Depakote mostly likely isn’t the main culprit, but it is a big factor in some individuals weight gain as well as weight loss. Take it from me…. I was the one who gained 60-70 lbs in six months with Depakote after having my gall bladder removed.

Here is another example:

I had an ARNP that had me on significantly high dosages of Lithium at one time. I had to take several other medications to combat the side effects from being on Lithium. 2400Mg of Lithium can do a lot of damage to the body, especially if you are at toxic levels. I had my lithium levels done fairly regularly, but didn’t know to ask my ARNP what the results were, what level would signify toxicity, and whether it was really doing what it should. This woman never told me that I was at a toxic level, and when I moved down to California and saw a really cool psychiatrist, I found out my thyroid had stopped functioning because of the high dosages and was most likely the contributor of why I lost my gall bladder as well. Thank God I moved to California for a time, or who knows what else I might have lost from these high dosages of medications?!!

Now, Lithium works for me. It is one of the few medications that truly does help my racing thoughts and mania. But I have been doing fine on only 300-600mg of Lithium for the last few years, and rarely need any other medications on top of that to combat depression and anxiety. These other medications are taken on an “as needed” basis. I feel that when I was on the high dosages of medications, I was barely functioning and this made my symptoms seem worse than they probably would have been at a lower dosage. I had major shaking issues from the lithium, as well as struggles with completing sentences and thoughts. Before I was on lithium my thoughts raced crazily from one topic to the next. On high dosages of lithium, I shook like a meth addict and I couldn’t make one cohesive thought. The middle ground has worked for me.

So, learn from my mistakes. If your ARNP doesn’t explain to you why you are taking a medication, adequately communicate to you how this can affect you physically as well as mentally, and what the long-term side effects that could occur from taking said medication, then you may wish to communicate to your practitioner their ineffectiveness/ineptitude while working with you, and possibly search for another provider.

A lot of practitioners are type A, logical, linear people. They require data. Proof. So what I have done was when starting a new medication, I kept a journal. I wrote down what I was taking that day, and how I was feeling in the morning, afternoon, and evening. (This helps in identifying if extended release tablets are needed, or ineffective). I usually wrote a number between 1-10. Ten feeling awesome, one being suicidal tendencies. I wrote down at the end of the day, my overall reactions and feelings and this gave me good documentation over time on whether I was feeling improvement, or side effects were hindering my quality of life.

Not sure if this helps any of you… but for me… being honest with myself about what I can deal with and what I can’t, when it comes to side effects, helped me have a better quality of life. This way I stayed on my medications, and became a healthier me.