What to expect when reading bi-polar wife

Thoughts and feelings of living with bi-polar as a wife, mother, and person in the world.

Friday, 21 June 2013

Abilify and procyclidine

So I am on the munchies trail again, eating for 3 and trying to remain balanced. I never realised how tricky it would be trying to find a solution to the problem. I originally thought along the lines of months not years to get better when I first entered mental health services. The mind is truly a finely tuned organ that plays it's own song and doesn't take too kindly to a new conducter every 6 months.

The abilify did begin to lift my mood though. It stopped the dip but the horrid sluggishness was just painful. And to top it off it made me twitch. It also gave me a sense of butterflies in my tummy and heady anxiety known as Akathisia. It makes you feel like you can't sit still or get comfy and you pace around a lot feeling weird. So to stop this happening I was given procyclidine. Oh yes another medication in the mix. This one is an anti parkinsonian drug that stops my hands jiggling about and keeps the akathisia under control. Apparently you can't get it in America now, probably as it's not good for you I expect.

So I generally rattle as I walk along now. I take 2 tablets in the morning and 6 at night and function with a limited amount of joy at the pace of a snail. Slightly depressed snail - seems like the correct image. A little bit chubby, slightly sluggish, with a very vulnerable underbelly.

So the mood is lifting finally but I feel cross that I am now taking so much medication I can't see a future being without. It would take a mamoth effort to get off all of these tablets and be free and clear. I hate the need to be dependent on anything mood altering but I currently don't see another option. I have too much to lose by risking a complete withdrawal. I am stable, I am able to work, I function and do service at church, I am a wife and mother. Would I really want to give all of that up just to not take a handful of tablets?  Probably not to be honest. But the thought still crosses my mind every night I stand by the sink with my glass of water ready to swallow. I wonder if I can get away with taking 1 or 2 less for a few days and see what happens. Apparently I am not on my own with these feelings at all. Many people will tell you that once they feel well they decide to stop taking their meds as they no longer need them, then sadly, end up in hospital after a nasty relapse. Maybe I'd be one of the lucky ones, who knows, but it is a game of russian routlette. But I really need to talk about what it's like being a mental health wife really don't I, I suppose....

Thursday, 20 June 2013

A typical anti psychotics - a guide to

Definition: The atypical antipsychotics (AAP) (also known as second generation antipsychotics) are a group of antipsychotic tranquilizing drugs used to treat psychiatric conditions. Some atypical antipsychotics are FDA approved for use in the treatment of schizophrenia. Some carry FDA approved indications for acute mania, bipolar depression, psychotic agitation, bipolar maintenance, and other indications. Both generations of medication tend to block receptors in the brain's dopamine pathways, but atypicals at the time of marketing were claimed to differ from typical antipsychotics in that they are less likely to cause extrapyramidal motor control disabilities in patients, which include unsteady Parkinson's disease-type movements, body rigidity and involuntary tremors. Oh Good.

So the side effeects are:
Headaches -- in up to 27 percent of people
A sedated feeling -- up to 23 percent
Agitation -- up to 19 percent
Insomnia -- up to 18 percent (see Abilify and Insomnia)
Fatigue -- up to 17 percent
Anxiety -- up to 17 percent
Drowsiness -- up to 16 percent
Nausea -- up to 15 percent
Vomiting -- up to 14 percent
Restlessness -- up to 12 percent
Constipation -- up to 11 percent.

Some other common side effects (occurring in 2 percent to 10 percent of people) included:
Indigestion or heartburn
Shakiness (tremors)
Weight gain (see Abilify and Weight Gain)
Dry mouth (see Abilify and Dry Mouth)
Joint pain
Throat pain
Blurred vision
Abdominal pain (stomach pain)
Nasal congestion
Increased salivation
Swelling or water retention in the arms, legs, or feet.  

Bless my psychiatrist and his ways. This is his new idea to ensure my sanity and stability. He tells me that as well as ensuring a non hyper manic state the abilify should increase my mood to stop the dip that I am experiencing. After the quetiapine experience I am very reluctant to play ball but he promises me this will be a better experience and gives me 20 mg to set me off. I am also told that as the patent hasn't run out on this medication and is costs approx. £200 a pop for 28 days supply. Now I am an emotional burden as well as a financial one. Fabulous.   So off I trolley with my prescription and try not to be worried about the extensive list of side effects. What a nightmare. Sometimes I wonder whether or not to risk just coming off of everything and trying to go it alone. I am sure everyone would completely freak out if I did this but sometimes I fantasize about a medication free life.  I am sure at some time in  my life I was well and didn't need a host of medicines to determine my every mood but it is a distant memory. Thinking the possibilty through of being medication free though makes me think about what I did use in order to stop feeling high or low before my diagnosis. I think everyone tries to manage their mood in some way by using a stimulus whether or not it's a film, a drink, a cuddle, a prayer. I didn't realise how much your mood can shift during a day until I kept a mood diary. It's exhausting. I did a CBT course on self esteem. Have I told you that already? I had to monitor my mood every hour I was awake for a week and explain what was going on and how I felt. When the week was over I was emotionally crucified. There's nothing like a bit of mood diarying to help you feel crap about yourself. Talk about down on yourself. I have the lowest opinion of myself going - you don't need to tell me how bad I am, I am a practised and qualified person at doing that all by myself thank you very much. My bottom line is a deeply entrenched one I can tell you.    

So yes, my mood is dipped and I am struggling a little with self esteem.OK so I have no self esteem, and this is compounded by work stress, parenting and being a wife. More on this another day. So I take the damn abilify and will ride out the consequences. And the consequences begin quite soon. Sedation, my old friend, returns with avengence. I have to peel myself off the bed in the morning and hold my eyes open for an hour and force caffeine down my throat just to begin functioning. Don't let me close them again as I will sleep for a few hours without warning. I have to drive to work with music blaring and window open to keep focussed. I have a dry mouth permanently and want to EAT. EAT, EAT and EAT! Oh my goodness. Craving for food that cannot be diminished by any amount of food. After eating, give it half and hour and I feel like eating another meal again. It's an insatiable hunger that doesn't disappear. I want to gorge on MacDonalds beakfasts and cakes and all the bad things in the world. I keep wanting to buy family packs of whispers again. The quetiapine feeling is on the return and I have to trust that it will ease up at some point. If I carry on I am going to be the size of a house. I have to weigh up whether or not to carry on with these new tablets or give up on them altogether and be stuck in the depressive rut. It's not a great choice to make, but I need to decide, and decide soon.

Wednesday, 19 June 2013

Work and WRAP

Well I got through Christmas and decided to return to work. I was allowed to drive again and had been feeling quite well really so it felt like the appropriate time. The 8th January will be forever emblazoned on my memory. At the time the date was of no significance. I eased back in to the office hum drum on a gentle phased return and thought that all was well. Then on returning to my allotted hours I was called in to a meeting with my manager and the human resources woman (I want to write the word cow/jobs worth/nasty words...all the nasty words I can think of) . I clearly remember the patronising face she pulled as she feigned concern whilst delivering me a written warning for sickness. OK. So I have a disability which I thought gave me a degree of protection against this type of procedure. I was sadly misinformed. I even called the equality commission and it turns out that they cannot give me special treatment really as I am only one person doing a single job and operationally they had been compromised too much so a warning fell within the normal remit of sickness. I know it sounds wrong but they toed the line. They'd let me have impairment related sick days, let me work from home and been supportive in the past.

Now how this works is that you cannot have more than 3 incidents of sickness in 3 months or 10 days in a block together as then you'll get pulled back in to another meeting for a chat.  If that were to happen I would be given a final warning, and then if it happened again I would be fired pretty much. My lovely warning ran from the 8th January 2012 for an entire year. Considering at this point that I hadn't managed more then 10 months being well it felt like a mountain to climb. I couldn't envisage being well for that long without a relapse considering the stress they had just put me under. Essentially the warning would stay on my file for a year but the trigger system would then run again for the following year anyway, so for me to be warning free I'd have to manage about 2 years without a mental health relapse or any type of illness. Yeah right. The general response from everyone around me was one of disgust. I know employers don't want a lame duck on their team but lame ducks try hard to float and turn up most of the time when they are well.

So I showed up. I tried to do my best and tried my hardest not to be ill. Not just mentally ill but physically ill, not such an easy thing to do when you have small children full of germs. And then my mood started to dip. It was only a gradual dip, but it was definitely a dip. This is when the WRAP comes in useful. The Wellness Recovery Action Plan. It's a little booklet the mental health team give you that helps you to identify when things are going a bit awry and off beam. You have to write down what you are like when you are well, not so well, ill and under a bus. You are then meant to read through it and figure out where you are at and what intervention you might need. It is actually very useful to do as when you are becoming ill, a level of denial can creep in or the attitude of "It's not that bad really" can hang about. It gives you a fact based criteria to measure yourself against and gives you a clear direction about what to do next.

So I was at the not so well part of the plan. Needing some help but not a staged and intensive intervention. The intrusive thoughts were creeping in, the emotional fatigue, irritability, tearfulness and a general feeling of sadness.  Back to the psychiatrist I went and shared with him my concerns and guess what? May I introduce you to abilify.