Monthly Archives: February 2012

To my fellows on the battlefield

(I am not referring to war here, at least, not the kind of war people first imagine)

I want to send out a message of hope to my mentally ill compatriots, especially those who cannot speak about their illness for any number of reasons.

Keep fighting.

Stay strong.

I wish you the best, and hope that some day you can be relieved of the battlefield situation. But if you never do… you have my respect. And I hope that means something.

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Psychiatric Medication: A Primer In Medical Frustration

Imagine you have something like leukemia.

In order to know you have that the doctor has to in effect prove that you have it. Which can be done (though I know nothing of the complexity involved in diagnostic).

Now think if the doctor had to diagnose leukemia without modern instrumentation, so he’d have to just watch you and see what happens.

Look up the signs and symptoms of Leukemia and take out all those that require physiological testing outside of visual analysis.

http://en.wikipedia.org/wiki/Leukemia#Signs_and_symptoms

“All symptoms associated with leukemia can be attributed to other diseases. Consequently, leukemia is always diagnosed through medical tests.”

So if you don’t have medical tests, you have nothing to go on.

Now think about the brain. How do we know what part of the brain does what? Two ways that I know of are analyzing case studies of people who had brain damage at a specific location and look for deficits or stimulate that part of the brain and analyze what the person says he or she is experiencing.

And that’s just the low level analysis.

Consider than how difficult it is to diagnose something like bipolar, which is diagnosed via the DSM IV (or V if it’s out yet).

 

  • The presence of a hypomanic or major depressive episode.
  • If currently in major depressive episode, history of a hypomanic episode. If currently in a hypomanic episode, history of a major depressive episode. No history of a manic episode.
  • Significant stress or impairment in social, occupational, or other important areas of functioning.[13]\

 

How many of those do you think can be explained via medical testing? The answer is, at present, none. The other problem is that it’s not at all clear that bipolar II has the same cause in all cases.

So we now approach medication.

In our leukemia example, there are treatments that attempt to control it to the point of remission. Granted, this is very very hard to do and leukemia is a terrible disease, however…

How does a psychiatrist pick a drug for bipolar II?

He can’t. Or at least, he can’t obviously pick one. Except possibly in the case where only one medication exists for the specific noted behaviors. In bipolar II this is not the case. Further consider that a few of the major drugs for bipolar were originally used for epileptic patients to keep their seizures controlled or at least lower the occurrence.

This is not to say that psychiatric intervention doesn’t work. I myself am currently on a medical cocktail that seems to work (although lately I’ve been experiencing a level of depression that I haven’t felt in a while…).

But I’m on Pristiq, Wellbutrin, Lamictal, Provigil, Adderall, Cogentin and Abilify.

That’s a lot of meds.

Now what do I do when something goes bad like it has recently?

All of those drugs are working to keep my bipolar in check.

So how do you figure out which one is failing to help? Or how do you switch out one med for another?

It’s not easy. On the patient or the psychiatrist.

This becomes extremely frustrating.

And this is all without mentioning the fact that many of these medications have extreme side effects. In many cases the patient has to decide what they’re willing to live with. Do you accept the possibility of Tardive Dyskensia? Or do you accept psychosis? Do you accept the possibility that one of your drugs will stop working, because at the moment it works pretty well?

These are all hard questions.

And I don’t know the answers.

 

unconstructed

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Life And Chronic Illness

It’s a bit cold… hopefully my fingers won’t freeze ><

Consider for a moment chronic illness. I know I mentioned this last post but I think a more thorough investigation is in order.

It currently seems that I will be bipolar and on some sort of meds for the rest of my life. I didn’t really realize what this meant until yesterday. Like I said last post, it’s been 5 years… and it’ll be another 5 and another 5 and another 5… (assuming my meds don’t catch up with my liver…)

So what does this mean? It’s strange to think about. Chronic means until you die. I suppose then, I have a chronic illness, bipolar, and a terminal illness, existance.

It’s quite hard to process.

But this life is the only one we have on this earth. We don’t get a second shot free of illness and death.

I recently saw a video on youtube by AronRa talking about his granddaughter who died at three years of age.

Three years.

Now I’m not asking you to compare that to your situation. I find all such comparisons useless in general. “Oh he has it worse” doesn’t mean anything really. You don’t have a choice between his life and your life.

Children in Africa born with AIDS have it “worse”.

But that doesn’t really matter when I consider my own situation. I must not dwell on the sufferings of others. I don’t mean to ignore them, if you have the ability to help in impoverished regions or donate to some charitable organizations please do.

However all the sick children in Africa do nothing for my bipolar.

We can compare all day long.

But that won’t help our condition. We must live our lives as best we can. We should enjoy all that we can and mitigate our symptoms when possible.

We can’t change our chronic illness.

But we still can live… even if this life is harder than it would be for someone without a chronic illness.

We have to live.

Living is a direct attack at bipolar itself.

“Oh, you want to bring me down? Well f—- you! I’m not going down! I’m going to do the best I can, regardless of what life throws my way. I may have limitations, but I will not define myself by them. There are some things I will never do, but that’s ok, there are lots of things I can do.”

Live while you can. Life is precious and short… sometimes far too short as for that three year old mentioned above. While we should not compare our situation to the girl or her family, we should live in memory that we may not last another day. If this is our last day on earth, fine. We will not go into that darkness thinking “If only I had not been bipolar” but rather “I lived. And that is all that matters”.

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Chronic Means It Doesn’t End

Anybody else realized this?

Chronic doesn’t end. Chronic Illness ends when I end.

I was diagnosed about 5 years ago. And I haven’t really thought about the next 5 years.

Or the next 5

or the next 5…

Chronic doesn’t end folks.

I don’t know what else to say really