Archive for the ‘mood stabilizers’ Tag

The Bipolar Perspective: Floating Down The Nile in Denial   2 comments

THE 530 GANG

There was a time in my life when I could walk into a car dealership to look at a car I didn’t even need and allow the salesman to run my credit.   The middle-aged pot-bellied red in face sales-manager would then come off his dealmaking perch and introduce himself to me in person.

“Mr. Goodman.  We rarely see credit this good.  You can buy any car on the lot.  Just let us know which one you want and I’ll personally give you a great deal.”  Then I’d get to shake his hand sweaty from greed.

Now if I were to walk into that same dealership the sales-manager wouldn’t even look up from his paperwork to acknowledge my presence.  This is because the salesman who greeted me flashed him “the 530 gang sign” after he ran my credit.   530 is my new subterranean credit score.  I still could have any car on the lot… I just had to pay cash.   I was now in “The 530 Gang,” whether I liked it or not.   We were real low-riders in every sense of the word.

How did I go from the “good credit poster child” to the example of “this is what can happen to you with bad financial planning” in the Charles Schwab Introduction to Investing pamphlet?  Denial.

TWO FOR THE PRICE OF ONE

Bipolar Disorder affects many facets of a person’s behavior.   Aside from the depression and the mania, it could also include Obsessive Compulsive Disorder, Rapid Cycling, Dissociative Disorder and even Schizophrenia.   Often the afflicted suffer from two diagnoses simultaneously.  For instance, Mania and Obsessive Compulsive Disorder.   Mania often occurs to satisfy some sort of compulsion.  I was monomaniacal about purchasing new cars because my OCD would not let me run up more than twenty-thousand miles on my current one.   I was convinced the car would become junk at that point and needed to rid myself of it before I get stuck with a pile of scrap metal.

THE NILE IN DENIAL

Denial is a manifestation of Bipolar Disorder.   However, not a separate diagnosis.   When money started getting tight I started prioritizing what and what not to pay.  And parking and speeding tickets took a backseat to car payments and insurance.   But eventually they started piling up.   When I didn’t hear anything for several months on a speeding ticket, I’d convince myself the highway patrolman who pulled me over thought I was a good guy and probably tore it up.  He just wanted to scare me into driving slower.   And all the parking tickets?   I changed cars every six to nine months.   The parking authority won’t even know what car to boot.    I had it all figured out.

Unfortunately, ignorance is bliss and I was haplessly floating down The River Nile in utter denial.   Whenever I tried to get a handle on things the task seemed overwhelming and I figured somehow it would work its way out.   Sooner or later a nice person from the Parking Authority or Traffic Court would call to help me straighten everything out.   In the back of my mind I knew this to be false.  There are no nice people at The Parking Authority or Traffic Court.

I’M THAT IDIOT

You can take all the anti-depressant and mood-stabilizing medication in the world for Bipolar Disorder, but it can’t force you to pay attention to your life.   And when I got pulled over for a burnt out tail light, I learned my driver’s license had been suspended for months due to numerous unpaid speeding and parking violations.   All at once I was without a driver’s license and stranded in the middle of nowhere unable to legally operate my vehicle.   The cop didn’t like me nor did he tear up that ticket after all.   And there are definitely no nice city workers ready to assist me in cleaning this mess up.   Nobody was to blame but myself.

And I had no idea where to start in order to untangle this spiderweb of speeding infractions and failures to appear.   I was the loser you see the judge reprimanding in traffic court for having so many unpaid tickets.   You wonder what kind of idiot could let his life get so out of control?   Well pleased to meet you.   I’m that idiot.

THE BIG DIG

I had two directions I could dig.   Up or down.  Digging down meant my I was going to let the State of California bury me.   No more license, no car and no dignity.  Or, dig up and out of this self-created seemingly constantly quadrupling quagmire of fines.  I chose to dig skyward.  Unfortunately, digging uphill is always harder.

I literally forced myself to get all my infractions together, sort out what I owed to which country, paid what I had to pay immediately and set up payment plans for the rest.   It took weeks of running back and forth between city offices, talking to half-asleep city workers more interested in their next break than giving you a break and waiting in monstrous lines that often extended outside the building.

THE AFTERMATH

When all is said and done, if you do the math, after I paid all my fines procrastinating cost me at least an extra five-thousand dollars in late fees.   And the time it took me to straighten things out cost me unfathomable hours of valuable work and personal time.   But I also learned something valuable about my Bipolar Disorder which applies to others like me.

People with Bipolar Disorder tend to become overwhelmed more easily because we are dealing with managing our disease, which is a full-time job in itself.   And if we have a secondary diagnosis, like OCD, it adds another layer of dysfunctionality to our lives.   It’s easy to let things go with so much happening in our heads.   You put bills, fines, banking information and ominous looking letters aside unopened to handle at a later date when you feel better equipped to deal.

IT’S RAINING MONKEYS

But we never feel more equipped.  And the bills and fines will not go away.   So we must train our Bipolar minds to deal with things immediately instead of procrastinating.    You will always feel like it’s raining monkeys.   But the objective is to get them off your back one at a time before they start piling up and dragging you down.  Bipolar Disorder distorts reality.  The secret is not to give it a helping hand.

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Sex and Psychotropic Side Effects   Leave a comment

I’ll never forget my Dad and I taking a long walk when I was twelve years old.  It was longest walk of my life.  Not because of the distance, it was the subject matter discussed that made it seem like it would never end.  It was his big “sex talk,” where my father proceeded to tell me most of the things I already knew only in more clinical terminology.  And every time I tried to make a joke to lighten things up, he’d smack me in the head.  And when he told me things about my Mom I didn’t want to know, I wanted him to smack me in the head again to knock the disgusting image out of my mind.

Well now it’s time to have my sex talk with you.  However, it’s going to have a little twist; I’ll be talking about the side effects antidepressants and mood stabilizers have on many people’s sexual performance and enjoyment, or lack thereof.   It’s the one side effect from psychotropic medications used to treat Bipolar Disorder that everybody wants to talk about but nobody wants to talk about simultaneously.  So I’ll spare everyone the embarrassment and put myself out there, because whenever I mention it in a blog, I get the most responses and inquiries.  Obviously it’s a major concern.

Many antidepressants and mood stabilizers diminish sexual sensation, gratification, performance and sometimes the ability to even participate at all.   It’s a consequence for men and women, obviously manifesting itself differently between the sexes because men have penises and women have vaginas.  I’ll speak from my experiences and try to offer some solutions that don’t involve leaches or blood letting.

The sexual side effects of psychotropics on men can be devastating.  A lot of them depend on the drug(s) you are taking.  I have taken many.  Personally I have been through not being able to get an erection, no matter how much my partner or I feverishly worked, occasionally producing a soft orgasm at the very end,  just to mock me.  Through it all the lack of sensation in the penis is greatly muted.  Your mind is sexually charged but your penis doesn’t want to party.  It feels like it’s wrapped in a thick wool blanket killing all sensitivity.

If a man can achieve an erection, the sensation can be so muffled that it takes forever to have an ejaculation.  Finally when you do, you barely feel a modicum of pleasure.  Enough to wonder “why bother?”  It is literally as pleasurable as going pee.   Again, your mind wants to have sex, but you have the libido of a dead Mexican rumba dancer. Plus, you have to force penile stimulation, which is counterintuitive.  If you achieve an erection, it is like trying to walk into a hurricane.

Unbelievably, some drugs will let you fight the good fight until you can get and maintain an erection.  Then you “anti-climax” with a dry ejaculation.  Absolutely no semen emerges, nor does it feel very good.  This is the ultimate emasculating effect of Bipolar medication.   It’s only good for people with hand-washing obsessive compulsive behavior because there is nothing to clean up.

The best overall description of how psychotropics can effect sex drive, and maybe only guys can get this, is that physical charge you get starting in the pit of your stomach when you are really excited.  When you are super attracted to your partner and know you are going to have a big orgasm almost just by looking at them.  With antidepressants and mood stabilizers it’s very difficult to get that electrical current to radiate throughout your body.

When discussing what psychotropics do to women, I have to go with what Bipolar sexual partners and friends have told me.  Virtually all experience a diminished sex drive with desensitized genitalia.   But what I hear most is that it’s almost impossible for them to achieve an orgasm.  I have tried over and over to patiently orally stimulate a Bipolar girlfriend and she just couldn’t get “over the mountain.”  It’s even more difficult through traditional intercourse.  Women experiencing psychotropic sexual side effects need intense clitoral stimulation for a long period of time if they are interested in sex at all.  And, many can only reach orgasm with the help of sexual aids that vibrate alone or in conjunction with their partner.  Many times the man feels very inadequate when the woman is forced to introduce  appliances in boudoir.

So what’s a penis and vagina to do?  Can you imagine if a “normal” man or woman started facing these sexual dysfunction issues?  They’d be beside themselves calling their urologist or gynecologist on the golf course in an utter state of panic.  “Doctor, I think my penis is dying.  Is this what happens before it shrivels up and falls off?”  Or, “Doctor, my vagina has a severe loss of sensitivity.  Is this a sign I’m turning into a bitter old spinster with no interest in men?”

If you are experiencing these sexual side effects, “what can you do about them?” is your next question.  Right now there is not a lot medically you can accomplish.  But before you scream in anguish, there are things that do work, you just may not hear about them from your doctor.  As far as pills go, you can ask your doctor to switch your medication(s) to something that may have less or no sexual side effects.  And this does work for some people.  It helped me to a noticeable degree.  However I was also once prescribed Yohimbine, which is some kind of plant extract.  The only thing that gave me was false hope.

Another medical option is just for men; Viagra, Cialis or other erectile aids.  I have not heard from any Bipolar men that they are the solution to getting and maintaining an erection.  I was prescribed Viagra and it did very little.  I also tried taking three times the recommended dose with wanton abandon for having an erection lasting more than four hours and having to go to the hospital, as they warn in the commercial.  I actually would have loved having that problem.  I’d be proud to be wheeled in on a stretcher with the sheets at my midriff noticeably aloft. But nothing. However everyone is different.

Women, I have heard that taking anti-histamines can help produce heightened sensation and lead to orgasm.  This is an off-label use of these over the counter drugs and in no way am I recommending it.  But I’ve heard it works for some.  Since I don’t have female organs, I have no idea why.  I haven’t seen any Bipolar women trying to catch colds or delighted to have allergies either.

A non-medication related solution requires you to change your sexual habits.  For a man or woman with this problem, you need to set the mood.  Just don’t jump into bed.  Have a romantic dinner.  Wear provocative lingerie if you’re a woman.  If you’re a guy, take a goddamn bath.  Have a candle-light dinner.  Talk dirty.  Watch some porn.  Tease one another.  Engage in each others fetishes.  Just do things to raise the level of excitement before you move forward with actual sex.  There is something to be said for mind over matter.

Also, do not drink alcohol before sex.  Medical evidence shows that it decreases the man’s ability to get and maintain an erection and for a woman to fully lubricate and reach orgasm.  Most people know this by having learned the hard way.  If you haven’t, any college student can validate my advice.  Just coupling alcohol with psychotropics could produce negative results unrelated to sex.

The big controversial possible solution is smoking marijuana before sex.  For me it heightens my arousal, increases my sensitivity and enjoyment of  an orgasm.  Some women report increased sensitivity and stimulation as well.  However, pot isn’t like buying a prescription, even when getting it legally from a California Dispensary.  Every “grow” has a different potency no matter how accurate the growers try to be with their various strains.  Plus, different people have different tolerances.  So you have to do a lot of experimentation.  And you don’t want to get so stoned you forget you’re having sex and drift off to slumber.

Exercise is one thing I am positive helps on the sex front.  A vigorous workout gets the blood pumping through all your organs.  When I am done running I almost always have an increased libido.  Better yet, I have less trouble achieving an erection, which is actually a function of getting blood flow to my penis,  a direct result of aerobic exercise.  Furthermore, it makes my orgasm much more forceful and enjoyable.  I have heard of similar sexual benefits regarding exercise from women.  But it has to be activity that really increases and sustains your heart rate for at least a half hour.

Finally, be conscious of when you take your medication.  I found if I take mine too close to having sexual activity, I can not perform well.  But if I wait several hours I can do better.  I realize it can ruin spontaneity, but so can a soft penis or dry ejaculation.

The reason I wrote this blog is so people with bipolar Disorder experiencing these embarrassing sexual side effects from antidepressants and mood-stabilizers know they are not alone.  There are a lot of us out there who have spent years making excuses to sex partners why we can not be adequately stimulated, fully enjoy sex or even perform in the first place.  Do not give up on a solution.  This can be overcome.  It requires patience and willingness to experiment.  And the great thing about our bodies is that we can even experiment on ourselves!

If anyone ever tells you there is more to life than sex, they are right.  However sex is one of the few benefits about having a  human body.  Our bodies are constantly causing us sickness, inconveniences, ailments, embarrassing situations and in this case mental illness.  Everybody, especially people with Bipolar Disorder, deserves sexual pleasure.  It’s free, it feels great and it’s good for you.  Don’t deny yourself.  Apply yourself.

Take a Drink in My Blues   Leave a comment

The other night a friend commented to me that I drink and smoke pot every evening. She questioned, in a very nice way, if it may be in excess.  I think she was taking a mental inventory of how many wine bottles were in the trash and “roaches” in the ash tray at the end of the week.  She said so out of concern because I am Bipolar II and alcohol is not a recommended additive with anti-depressants and mood-stabilizers, of which I have both taken for years.

My friend is a mental health worker, so I gave her concern more weight than if the elderly Chinese lady who scours our trash for bottles and cans made the comment.  And as a writing-hack, I sat down to construct a blog justifying why it’s actually healthy for certain people with Bipolar Disorder to drink and smoke in moderation, visa vi there was no reason for my friend to be worried.

It took me days to write the blog.  I just could not get the wording right.  And then I finally realized it was because I was full of shit.  I was not being honest with myself and that’s why I was unable to summon the appropriate words.  So to coin a stupid phrase, “let’s get real.”

Alcohol is a depressant.  The reason people with Bipolar Disorder are told not to drink when taking anti-depressants is because it’s counterintuitive.  It will make the drug work harder or render it ineffective.

It’s the same thing with mood-stabilizers, prescribed to people on anti-depressants to make sure they don’t become overly happy.  They are meant to keep you somewhere in the middle where you are devoid of emotion, or at least that is my experience.  You won’t hit rock bottom, but you also can’t summon up a whole lot of excitement about anything either.  And of course adding alcohol into the mix can destabilize the entire situation.

Marijuana.  Who the hell knows what that does to people with Bipolar Disorder?  Some say it helps their mood, some say it makes them more depressed.  There really isn’t much information that I know of on how it interacts with anti-depressants and mood-stabilizers.   Plus with pot, even if you buy it from a legal California Dispensary, you really never know what strength and properties you are getting with every purchase.

With all this information, why would someone on anti-depressants and mood-stabilizers drink and smoke?  Well imagine a life built on a base-coat of depression with suicidal thoughts and side effects that range from constant nausea to sexual dysfunction.  Shaking hands to extreme dry mouth.  Short term memory loss to irritable bowel syndrome.  And this is all courtesy of the best medication cocktail I have ever been on.  Without it I am positive I would be dead.

In light of all this, I just can’t see anything wrong with coming home and having a couple of glasses of wine and smoking a joint over the course of the evening if it makes me feel good.  It’s nothing that many non-afflicted people do on a daily basis.

Am I addicted to drinking and smoking?  No, but I would be very unhappy if I had to stop.  And if it doesn’t affect my work or other aspects of my life, I don’t see the point.  Even if I were alcohol dependent (pot is non-addictive), at my level of consumption I would not really care.  I’m already addicted to anti-depressants and mood-stabilizers.  Take those away and it would be like withdrawing from heroine.  It’s much easier to stop drinking.

Please don’t misunderstand me.  I am not recommending the consumption of alcohol and marijuana to people on psychotropic drugs.  Everybody has to make their own decisions.  I know some Bipolar people who drink, some who drink and smoke pot, some who just smoke pot and others who do nothing.  And if I were prescribed a drug that makes me feel wonderful, I would stop drinking and smoking in a heartbeat.  Why rock the boat?  Not many people with Bipolar Disorder get to sail those pristine waters.

I make no excuses for my alcohol and marijuana consumption.  Just like everyone else, blessed with Bipolar Disorder or not, I like the way it makes me feel.  I enjoy the taste of good wine and micro-brewed beer.  Pot takes away my nausea and has almost eliminated the sexual side-effects that have plagued me for years.  And for a little while I can relax and stop constantly worrying about whether I’m heading for a cycle of depression or not.

So I will say to my good friend, thank you so much for your concern.  I appreciate your vigilance.  And I hope you’ll keep looking out for me, as I will for you.

Sunday Kind of Blues   Leave a comment

I’m sitting here in a local San Francisco coffee shop, which is how most San Franciscans spend their days.  Everybody is busily working on business plans for new start-ups or milling around outside on their cell phones trying to convince venture capitalists to fund their new ventures.  The problem is about 3% of these nonsensical deals actually come to fruition and even fewer actually survive the first two years.  But everyone wants to jump on the get rich quick technology bandwagon.  I prefer to call it a hayride.

I’m even embarrassed to say I had a partner and we drank the micro-brew Kool-Aide too, which was all the rage, back in the late 1990’s.  Unfortunately, my partner had an aversion to making money, I bailed out and he floundered around by himself for awhile and then moved out of the area.  But we could have had something.  It was my big chance at making a serious nest egg.  Instead the hen just farted.

So, I’ll share with you today that I am a little depressed.  However I think it’s more  situational than chemical. I’m sad at 46 years old that with all the things I know how to do, I have never done anything exceptional.  I’ve done a lot of good things, but nothing that I feel will leave a mark that says “Peter Goodman was here” after I am gone. Except, for the circular water stain on the coffee table I left from putting my drink down without a coaster.

Could it be my mood stabilizers kicking in just making sure I feel neither good or bad and just exist in a quagmire of nothingness? Mine keep me in limbo from feeling excitement or despair, in this military “no fly zone” where nothing ever touches me.  They are always there to remind me how much I don’t feel, never even giving me 15 minutes for a mental coffee break.

In all my star studded brilliance I decided to sleep all weekend.  Sleeping is something we bipolars are really good at.  I wish being a good sleeper could help me leave my mark on the world. “God, that Peter Goodman wasn’t much of a guy when he was awake, but boy could that motherfucker sleep.  We’ll never see a sleeper like that again in our lifetime!”

I was already literally sick and tired when Friday rolled around.  And when my girlfriend decided to start in on me about so something ridiculous only her mind could conjure, I decided to go for a world record.  I went to bed and didn’t get out until late Sunday morning.

I love sleeping and disconnecting from my bipolar tormented mind.  I don’t know what it’s doing when we are not together, but at least I don’t have to deal with it.  It probably goes out to get a burger and a beer and then picks up hookers at the adult movie theater.

Actually, sleep has become my new therapy.  If I don’t want to deal with something, I just go home, get in bed and go to sleep.   I’m not talking about work issues or being a father to my daughter.  I’m referring to problems with my relationship, getting a speeding ticket, owing a lot in taxes, etc.  And as soon as I put my head down on that pillow and trail off to sweet slumber, I am free.

I often wonder if this is the effect people are trying for when they commit suicide?  The mindlessness of being permanently unconscious.  I have tried to do away with myself before.  And I can not promise I won’t do it again.  What people do not understand is the constant distress of the bipolar mind.  The depression, sadness and disconnection from the world and everyone in it is unbearable.  And if someone is at the point where they can not stand one more minute of it and medications, electroshock and therapy have proven benign, I believe they have the right to end it.

People do not ask to be born, and certainly not bipolar.  If they want to leave this world it should be on their own terms.  I am not advocating suicide, but I am not going to put a pad lock on the door.  And of course I don’t think it should be a rash decision.  But in the end it’s our decision.

So if you are having a hard day today making sense of it all and questioning what you are doing here, you are not alone.  I am right here with you in the blogesphere.  And if you are looking for a reason to get up tomorrow morning, do it because you might make a difference in someone’s life and without you it never would have happened.  Also, just maybe something good will happen to you.  The odds are a lot better than winning the Lottery.

The other reason to slog onward is because you still can make change in your own life. Get out of that awful living situation.  Find a better job.  Get a better shrink.  Change your meds.  Set something positive in motion and give yourself something to look forward too.  Kick those mood stabilizers in the ass and say “Not today, I’m making a change in my life and you aren’t going to sabotage my motivation.”  Then press the “override” button.  You know, the one between your…. Uh, you know where it is.

And of course always feel free to blog back at me.  I read everything and answer back if requested.  I’m not a doctor and have no psychotherapy credentials.  I’m just a guy who cares about other people with Bipolar Illness and those who love them.