Archive for the ‘side effects’ Tag

THE BIPOLAR PERSPECTIVE: BEARING THE BAGGIE OF BURDENS   Leave a comment

PISSED

The other day I finally went to the urologist.  I wanted to find out why at fifty years of age I started wetting the bed three nights a week.  As I walked into my sparse HMO Plan’s Doctor’s Office, I was prepared for news of a cancerous growth in my manhood, a renegade testicle or an untreated progressive tropical sexual disease I picked up eating Cuban Food in San Francisco’s Mission District.  But I got even worse news… There was nothing physically wrong with me.  The emotionless managed care physician even managed to look at my prostate, which apparently gave him the “OK” sign as well.  I wonder if it was a “thumbs up” or it just “winked”at him like a Cheshire cat?

RESTRICTED FLOW

 If my member is not sick, that means my night-time urinary incontinence must be in my head.  Or at least that was my first conclusion.  After all these years in therapy trying to keep my Bipolar mind afloat, now I had sprung a leak down below.  And, the treatment was as vague as the apparent cause.  So the vanilla urologist gave the tasteless advice not to drink fluids three hours before bedtime and see what happens.  He also emphasized no alcohol.  I knew this was implausible. My Bipolar medications make my mouth extremely dry.  I have to keep drinking liquids or suffer from such bad cotton mouth my lips stick together when I speak, causing annoying suction sounds.  Plus, the thought of restricting the flow of alcohol prematurely during an evening on the town is out of the question.  I prefer to drink with wanton abandon.  Why should I once again have to add another limitation to my already restricted existence?

HI-HO!

And then it hit me… This was just one more annoying annotation to my treatment schedule I will have to endure due to my Bipolar Disorder.  Just like the cadre of pills I have to take twice a day, now I must regulate my liquid intake.  Another hurdle to clear, inconvenience to negotiate and regiment to be saddled with in order to remain ready for prime time.  I feel like I am in an 1800’s horse-drawn wagon, piled high with pills and their side-effects, barely inching across the baron plains of the old west.  Hi-Ho Effexor, Lamictal and Topamax! Git!

MANAGED MEDICAL INCONTINENCE

However the thing the Managed Healthcare Professional said that bothered me most is he felt the assortment of Bipolar medications I take are probably the cause of my night-time incontinence.  I’m well aware they cause dry mouth, nausea, severe constipation and weight gain, among other things.   But because my nightly dose of the anti-depressant Seroquel makes me sleep quite deeply, I may not be waking up when I have the urge to urinate.  Consequently, I go in my sleep.  And, the doctor made it clear he did not think I should discontinue any of my medications.  So in essence, he was saying it was best to continue wetting my bed.  That way “at least I have my sanity.”  I call this Managed Medical Incontinence.

BEARING THE BAGGIE OF BURDEN

One time a friend who I met in a Bipolar Chat Room came to visit me in San Francisco. When I helped her get settled in her hotel room, she pulled out an identical Zip Lock Baggie to mine filled with pill bottles containing her personal mixture of Bipolar elixirs and poultices.  I suddenly felt a strong commonality with her. I realized all Bipolar sufferers carry their own “baggie” full of unique prescriptions and medication induced limitations like mine, everywhere they go in life. I take a handful of assorted pills twice a day. Some people take theirs three times daily. Some have to take meds with food. Mine make me too nauseous to eat right away.  A number of people can drink alcohol with them, but others get violently sick or depressed and can not combine the two.  Each baggie contains a mixed bag of burdens specially formulated for that individual.  But we all bear the same baggie of burden.

MY BAGGIE IS BIGGER THAN YOUR BAGGIE

Wetting the bed is a pretty heavy burden for a baggie to bear.  You can learn to keep your shaky hands in your pockets, and take your midday dose of medication out of sight from your co-workers.  But if you are ever going to have an intimate relationship, you can’t hide the fact that you are irrigating the bed.  Or, you can wear a diaper to sleep at night and call it an “undergarment,” so it sounds more like Mormon underwear. However I’ve come to the realization that everyone’s baggie seems equally big in their own eyes.  Different people with Bipolar Illness have different medication regiments.  It’s not as simple as just popping a Prozac.  And consequently, we all have our own set of annoying side-effects. Moreover, if they are your annoying side-effects, they are bigger than anyone else’s.  When I first started taking a once daily dose of the anti-depressant Elavil in the mid-1980’s to treat my Bipolar, I didn’t even need a baggie. Conversely,  I thought taking that single pill at night would be a massive intrusion on the rest of my life.  Now I carry a heavy duty Zip Lock Baggie, and yearn for the days of simplicity that came with only needing one pill bottle.  These were the days when my side-effects could be counted on one hand, not amplified to a roar and punctuated by constantly having to change my bed sheets.

THE CAT IS OUT OF THE BAGGIE

Now that the cat is out of the baggie, do I accept my predicament or search for a solution? If you suffer from Bipolar Disorder, you are forever trying to do one thing to compensate for another.   Am I willing to discontinue the Seroquel, become sleepless, depressed and dehydrated, so I can awaken dry just in time for another miserable day of suicidal ideations? Personally I am not ready to accept the Meaningless Managed Medical Memorandum on my nocturnal incontinence. So I will go forth seeking solutions that may or may not materialize.  Will I end up adding to my baggie or shrinking it?  I don’t know. But I do know I am not alone. Because Bipolar babies all have baggies.  No matter how big or small, they are enormous to the bearer.  And all of us in the Bipolar Community anticipate with bated breath a cure for their individual intolerable side-effects just around the corner.  Side-effects are the price we pay for being alive and sane.  However they can also drive you insane.

HALF IN THE BAGGIE

I thought the only way I could write about this was if I were “half in the baggie.”  It’s an embarrassing thing to do sober.  And nobody except the person “sleeping on my bottom bunk” really has to know.  But so rarely can you showcase a Bipolar medication related side-effect that makes the non-afflicted truly realize how gruesome this business can be.  There is no free ride.  Moreover, in most cases Bipolar medication only works to a point.  It does not completely wipe out deep depression, anxiety or mania.  Just enough to get by.  But the side-effects are full strength and show no mercy.

 

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.

Elephant Mind Syndrome   Leave a comment

I’m recently single again after a broken engagement.  It would have been my second marriage, but it didn’t feel right.   This time I knew enough to dial it back before the Rabbi told me to break another glass.   I hadn’t really thought about what it meant to be single again, until I had my first weekend alone.  Unlike before, I was not ramping up with the dating sites and connecting them to my cell phone so I didn’t miss a possible connection.  I had practically hooked my phone to my belt last time, which is something I swore I would never do, along with wearing Dockers.

This time I am not motivated to go online.  I know if I do I’ll be crazed with generating activity and I just don’t feel like one more thing with which to be obsessed.  I decided to just meet girls the old-fashioned way; Screaming at them out of my car window waiving a six-pack of Bud and inviting them up to my place to get loaded.  I shouldn’t joke, maybe that does work.   It did in high school.

Actually, the old-fashioned way is just meeting girls through normal everyday interactions and where I socialize.  And I do see lots of women through the course of my work and in the neighborhood bars and coffee shops I frequent.  Usually I would balk at this method.  Just walking up to a woman and introducing myself was out of the question.  I had the self-confidence of a paraplegic dwarf with a twin growing out of the right side of my face, and all you can see are teeth and lips.

A good part of this was due to my Bipolar Disorder.  Having a mental disorder is always in the back of my mind.  It’s not so much that I think women can tell, it’s just that eventually if I met one sooner or later I’d have to drop the B-bomb.   Once I had a date who laid down the ground rules before I could even open the hatch under the plane.  She said she was fine with anything except guys who didn’t have jobs or had mental illnesses.   This is the kind of thing your therapist says will never happen in the real world.  Nobody would be so brazen to say such a thing.

I also recall all the things that embarrassed me throughout my Bipolar life and somehow thought every girl I spoke with automatically knows everything in my screwed up head.  I call this Elephant Mind Syndrome.  Like how as a kid I was made fun of constantly because I was horrible at sports.  Or, for years how my mom made me swim with a bathing cap so my ear plugs would not fall out.  I spent summers being relentlessly teased about being a topless girl.  Then there were my suicide attempts and stays in the psyche ward.

If I did meet someone and got past all that and was still trying to hang in there with a rap, I’d start ruminating on my medication’s side effects.  If my mouth was dry I wondered if I lisped like a deaf person.  I also worried if I had some crusted food or beverage in the corners of my mouth from the dryness.  Or, I wondered if she noticed my eyes shift slightly back and forth because of my nystagmus.  Coupled with the speech impediment and I thought the girl was ready to tell me “how wonderful it is that I am on my own and whether I lived in special needs housing or with my parents.?” Worst of all, I was afraid if I bought her a drink my shaky hands would dump it all over the bar.  I couldn’t tell if I was killing the relationship in my mind or these things were actually happening.   Eventually the pressure was too much and I’d go home to watch Lock-Up.  Cell extractions are so uplifting.

And what if by some miracle I found a girl who actually liked me?  Moreover, there was a possibility we might be getting intimate that evening?  First I’d  have to figure out what’s wrong with her.  I once brought a homeless woman to my apartment because she was wearing a business suit.  I had no idea that was all she owned.   So if I vetted her as normal,  I then had to worry about whether I’d be able to perform because of the meds I take.  Also, there’s the whole dilemma of how long can I put off taking my night-time medication which usually makes me very tired and useless as a bedfellow.

My point? When you are Bipolar, nothing is simple.  There is no such thing as going with the flow.  No matter what turn your life takes, there are a series of related anxieties.  And I recently realized if I let those Bipolar driven fears consume me, the only women I am going to meet are the nurses in the emergency room pumping my stomach.

I know a lot of Bipolar guys and girls reading this blog have had similar feelings attached to meeting the opposite sex.  Tired of losing the demolition derby before I even strap myself onto a bar stool, I will share my new approach to meeting the opposite sex;  If you see a man or woman you’d like to meet, force yourself to go up and introduce yourself.  The worst thing they can do is say “I’m not interested.”  “I’m not interested” can mean a million different things that have nothing to do with you.  Maybe they are waiting for someone, they are attached, not staying long or you could not be their type.  But I doubt they can see your lifetime of embarrassment playing like a video loop in your eyeballs or think you are mentally retarded because you have dry-mouth.  And if you really aren’t their type, so what?  There are a lot of pretty people out there that are not your type for one reason or another.

The important thing is that if you really want to meet someone, keep trying.  Practice makes perfect.  Keep challenging your fear.  I actually just started practicing with some “trainers.”  “Trainers” are women or men you are not particularly interested in but you try to strike up conversations just for practice.  That way if you embarrass yourself or say the wrong thing, it doesn’t really matter.   Consider it a pre-season game.  It doesn’t count.

Have you ever walked down the street and saw a really ugly guy with a very attractive woman and wondered how that mismatch got made ?  It’s because of self-confidence.  The guy was probably persistent and refused to accept his shortcomings as a reason not to be a desirable human being.  People with Bipolar Disorder are lucky in a way because our shortcomings are on the inside.   And, they really aren’t shortcoming at all.  For many of us our disease has made us stronger.  So if you are Bipolar and looking for your soul mate, the only way someone can see all your issues is if you tell them.  And if and when you tell them is for you to decide.

Is It Your Bipolar Disease or Mine?   Leave a comment

This is going to be a personal blog.  That’s why I am putting it online.  So nobody can read it.  Actually, it’s a blog about something in my life I’ve had to come to terms with, but I think it has relevance to others who have a story to tell about their experiences with Bipolar Disease.

Earlier this year I published my first book entitled Buzzkill.  It’s the story of my very disorderly struggle with Bipolar Disorder.  I tried to write it a year or two earlier and it just wasn’t working.  There was no flow nor was it the least bit compelling.  Kind of like a Daniel Steele novel.  And then one day it hit me;  I wasn’t being true to myself or potential readers.  To really tell the tale, I had to rip open my entire life with a scalpel, gut it and lay the steaming innards out on a stainless steel coroner’s table in their full rancid glory for all to read.   And when I began writing and started feeling embarrassed and uncomfortable with my prose, I knew I had begun writing the book I intended. Then the words began to flow like hot molten lava from a big dormant volcano that waited 45 years to blow its load.

Buzzkill is about my lifelong struggle with depression, mania, hypomania, suicidal attempts, hospitalizations, medications and all of the situations that arose from my erratic behavior.  Among other things, I talk about the sexual side effects from anti-depressants leaving me with absolutely no sensation in my genitals, the humiliation of being in a locked mental ward, the shrinks who almost killed me and the times I tried to kill myself.  I described wild manic buying sprees and the financial disasters that ensued along with mismatched lovers and relationships gone terribly awry.  The bottom line is that no matter how humiliating, I made it real for my readers.  I wanted to reach inside them, grab hold of their most traumatic embarrassing Bipolar experiences and say, “It’s all right.  Me too friend.”

Here in lies the problem; Nobody lives in a vacuum.  Other people were part of my life experience.  Parents, friends, doctors… They all played a role in my life.  Some of them had their own issues and were antagonists.  Some were protagonists.  And, certain characters were neither good or bad, just too damn interesting to leave out.  However you could not understand my life without discussing their lives.  Many of these people will not appreciate my portrayal of them, regardless of its truthfulness.   They will develop tunnel vision and see Buzzkill as a book all about them.  They will gloss right over the parts where I’m sitting in an emergency room being forced to drink charcoal and throwing it up all over myself.  Or, getting physically thrown out of a classroom in third grade as I was unable to control my emotional outbursts.  All that matters is I wrote “they had a nagging voice like a goat.”

No matter how big of an earthquake ensues, I told my story as it happened to me.  I make no apologies.  If I censored myself Buzzkill wouldn’t be the book I intended and certainly not worth reading.  Nobody wants to read another 300 pages of watered down drivel about coping with Bipolar Illness written by some Phd. with a pipe stuck up his ass.

The lesson learned is that we all have to be true to ourselves as Bipolar individuals.  It’s our duty to tell our stories so we can help others like us feel more comfortable with their challenges.  We can not hold back because we are afraid of the truth starting an uncontrollable wildfire.  We do not start the fires, it’s the people with blinders on who don’t want to see the truth that slash and burn.  And if you are not up to telling your story, that’s ok too.  Not everyone is required to walk on the hot coals.  Because I don’t care what anyone says, no matter how righteous of a person you are, they still burn the shit out of your feet.

Am I Obese Or Is It Just In My Mind?   Leave a comment

The other day I saw a grossly overweight woman trying to get a place in the check-out line at the supermarket.  People were jumping in front of her because they assumed she moved slowly.  It seemed like they were thinking, “She’s fat and will slow me down in the if I get behind her.”  This really bothered me.  The cashier checks you out, not the customer.  How could this woman have slowed down the check out process due to her weight?  It was simply insulting and taking advantage of someone because of the way they look.

This upset me on several different levels.  One, just because I hate seeing human beings being cruel to each another.  Mankind has enough hardships without creating more on our own accord.  That woman may not have shown it, but I’m sure in some way it made her feel like less of a person.  It made me want to cry.  Second, I have been in her position before, convinced I was grossly overweight and horrid at which to look.  I know what it feels like to have people laugh and disrespect my slovenly appearance.  I have been the Elephant Man.

In my teens and early twenties I simply could not understand overweight people.  I’d see them lumbering around town, guts hanging over their belts, flabby legs stuffed into their pants, shirts so tight they’re about to pop buttons, arms too chubby to fully rest at their sides, double and triple chins plus whatever else goes along with obesity.  And they’d be huffing and puffing up even the slightest inclines.  You just knew they were stuffing their faces with delicasies like sausage colachies, pizza with cheese baked into the crust, deep fried chicken tacos, milkshakes, ice cream by the barrel and 64 oz. bottles of soda to wash it all down.

And although I would not overtly make fun of them, I’d always think “how could they let themselves deteriorate like that?”  I don’t always feel like working out, but I force myself.  I’d rather have a super-burrito, but I make myself eat salad.  But these people have no self-discipline.  They deserve to be fat.  They should have to buy two airplane seats when they fly.  They wanna be pigs, let them pay for it.

Then one day I started to see myself as fat. My depression had gotten so bad I couldn’t get out of bed to exercise and eating was one of the few things that brought me pleasure.  I began to feel very out of shape and eventually literally saw myself as severely obese.   When I walked around I felt people were making fun of my big bobbling butt, hanging turkey gizzard of a neck and protruding stomach.  My self worth was in the gutter.  I was convinced of being the most unattractive person in the world.

Finally I got on the right medications for my Bipolar II.  And as I starting feeling better psycologically, I ceased seeing myself in the distorted image of a fat man anymore.  But it opened my mind to the depression the obese must face every day.  In my mind I felt the stares, jokes, rudeness and disrespect overweight people absorb on a daily basis.  I understood what it was like to be trapped in a body you hate with the seemingly insurmountable task of losing a significant amount of weight.  I experienced the depression that comes with thinking about all this plus the fact I may never find someone to love and accept me.

The average person does not understand obesity.  However I think being Bipolar gives special insight to obese trials and tribulations.  Many of us have been severely depressed.  Too down to exercise, the inactivity of constantly sleeping and not eating right causing Body Dysmorphic Disorder.  This is when you see your body as something other than it is.  And, you do not see it in a positive light.  Depressed and inactive, many Bipolars seriously view themselves as overweight and unattractive.  This is literally what they see when they look in the mirror.  It’s what I saw before I was on anti-depressants.

At one point I actually did start gaining weight due to a side effect of the medications I was taking.  However because I felt better mentally, I was motivated to eat right and work out extra hard to keep most of it off.  But the terror that comes with thinking you might blow up like a parade float is incredibly debilitating.  Depressing enough to make you want to stop taking your medication.  And many Bipolars would rather have Bipolar depression than be depressed about their weight and body image.

I do not look at obese people the same way anymore.  First of all, I refer to them as overweight, big, obese or large.  And I never fault them for being in that condition.  Many times it’s genetic and has nothing to do with exercise and diet.  Certain people are just large.  For others the idea of having to lose a massive quantity of weight is so ominous they become paralyzed.  Or, some individuals need a trainer to ride them, because they don’t have the self-discipline to do it on their own.  Of course there are still some people out there where in their mind food trumps weight and they don’t have a problem with their size.  I admire them for being happy with who they are.

I feel as Bipolars we have been given a gift to better understand what it’s like for these overweight individuals.  We understand the debilitating depression and other psychological obstacles that make change seem daunting or even unattainable. Since we have to take medications which have side-effects changing our bodies and curtailing certain of our abilities, Bipolar people understand what it’s like to be trapped inside of ourselves.

Overall I believe most obesce people are not happy with their self image and are likely to suffer from some degree of depression over things they can not do or have.  Moreover, in at least one aspect they have it worse than those afflicted with Bipolar Illness… You can not tell when someone is Bipolar because it all happens on the inside.  Unfortunately, overweight people have to wear their problem on the outside for the whole world to see.  I think it’s our duty as Bipolar sufferers to look past the body at the person inside.  We can not expect kindness and understanding from the non-afflicted if we don’t show the same compassion toward others in need.

Statistics: The Thing Standing Between Bipolar Treatment and The Truth   7 comments

People were so gullible back in the 1950’s and 1960’s.  “9 out of 10 doctors recommend Pall Mall Cigarettes because they are less harsh on your throat. ”  “In a side by side comparison, Lincoln is better than Cadillac.”  “More people trust Goodyear than any other tire.”  I’m paraphrasing, but you get the gist.  And people believed this stuff.  Nobody was calling out for Google Analytics, or even for Pall Mall to simply show how they conducted their survey.  All you had to do is make the claim and everyone assumed it was fact.

Before you start musing at people’s low level of bullshit detection back then, we are still eating up the same statistical nonsense in 2012.  It’s just packaged differently.  Take the Bipolar Disorder drug Lamictal.  According to Wikipedia, between 5% to 10% of patients taking Lamictal will develop a rash, but only 1 in 1,000 patients will develop a serious rash. Plus only 1 in 50,000 patients die from the rash.  This is an un-cited claim according to Wikipedia.  The information powerhouse aggregator went on to say that 9 out of 10 doctors smoke Marlboro Cigarettes because the brand gives them steadier hands in the operating room.  Personally, I’d like my doctor to smoke Marlboros while he’s actually operating on me to insure the very best outcome.

Most people reading this aren’t looking for citations.  Wikipedia has credibility because it says so.  And if 1 in 50,000 actually die from Stevens-Johnson Syndrome (the killer rash), those are pretty good odds.  They are willing to take the gamble if they are suffering from bipolar symptoms and Lamictal is their greatest hope.

Wikipedia downplays the killer-rash statistic, as does its manufacturer GlaxoSmithklein.  But just getting the rash must be scary.  The patient doesn’t know if it’s “the big one.”  And 5% to 10% of patients will get it.   That’s at best 1 in 20 people.  Maybe 1 in 10.  I see these very same statistics influencing people not to try Lamictal,  So you see, we really have not evolved from the 1950’s and 1960’s vulnerability to marketing mind melding.  Any statistics can be made to lean in any direction you favor.  It’s the interpretation you chose to believe that makes up your mind.  However,  I don’t think anyone can argue the Lincoln is a better car than the Cadillac.  Everyone says it has a better ride.  Everyone.

Personally, I chose to flirt with death and take Lamictal for my bipolar symptoms.  Fortunately, I did not get the rash.  I also didn’t know any of the rash statistics.  I just trusted my doctor when he said getting Stevens-Johnson Syndrome was very remote.  And the minute a rash developed he’d stop the medication.   Notice how I used the phrase “I trusted my doctor.”  I think when the drug manufacturers and web sites are whipping statistics at you for their own less than altruistic reasons, you need a doctor or knowledgable advisor you can trust.  Someone from the real world who can talk from experience, not an Excel Spreadsheet.

Years ago when I was just out of college and had started my first job, I had a crippling attack of depression hosted by my bipolar illness.  It was a Friday night and I was rolling around on the living room floor shaking, unable to keep still and telling my then girlfriend that I wanted to die.  I couldn’t get through to my usual psychiatrist and I needed something to help me sleep and keep me from killing myself over the weekend.  One of my Dad’s friends had a brother who was a psychiatrist who I called at home and he said he’d see me first thing Monday.  But to get through the weekend he wanted me to have a glass of wine and a couple of Benedryl whenever I needed it to calm down.  He hadn’t met me yet and did not want to start pumping drugs into me site unseen.  From 30 years of practicing, he knew this was unorthodox but safe and effective.

I didn’t do it.  I was so depressed I ended up overdosing on sleeping pills and was taken to the hospital.  But I admired the doctor’s practical grass roots approach to getting me through the weekend.   He had excellent credentials, 30 years experience and a solution, albiet a little off beat one.   I trusted him more than a statistic.  I’m sure there are many statistics telling you not to mix even Sweet Tarts with alcohol.  However, we all do it now and then usually to no ill effect.  The doctor knew this.  He was being practical and compassionate toward my deteriorating condition.  He also definitely agreed more people trust Goodyear than any other tire.

For these reasons, I am not a big fan of the statistic, especially when it is not cited or the fine print is a disclaimer for it probably being inaccurate.  I also detest when people just make a claim citing everyone as their source.  My grandfather, a Philadelphia native and its biggest cheerleader, used to tell me things like “Philadelphia has become the restaurant capital of the world.”  I’d say “Pop, where the hell did you hear that?”  And he’d say, “Hear it?  Everyone knows it!”  He also smoked Lucky Strikes because LSMFT.  (Lucky Strikes Means Fine Tobacco).   How could you argue with that kind of logic?

So when negotiating the bipolar landscape of doctors, medications and therapy, do your research.  But don’t believe everything you read, even the statistics.  Find people you trust and talk with them.  Statistics are not real.  They are man made.  Experience is real.  And someone you trust to help you evaluate it is invaluable.  Just please always remember, Michelob is the right beer when you’re having more than one.  At least that’s what they say.

Quitting Smoking? A Harder Road for Those with Bipolar Illness.   12 comments

If every morning you wrapped your lips around the exhaust pipe of dad’s Buick and told him to kick it over and give it some gas, just so you can savor the luscious fumes, the production crew of “My Strange Addiction” would be on your doorstep chronicling your life threatening compulsion.   But most people wouldn’t do that because the violently hot exhaust would instantly burn your throat and lungs, possibly killing you on the spot.

Well about 20% of the population are doing this, although the pleasure source they have selected won’t mame or kill you quite as quickly; They’re called cigarettes.  And I’m not going to go on a diatribe on how bad they are for your health.  I’ve smoked on and off for since I was 12 years old knowing full well it causes cancer and heart disease, but chose to puff forth anyway.

I actually love smoking.  The hand-mouth thing, the calming nicotine rush with the first cigarette of the day, the relaxing act of inhaling and exhaling the gray wafts of smoke and how blissful morning coffee can be with a cigarette.  I have no proof, but I think bipolar people are more susceptible to this addiction because smoking a cigarette gives them time to pause and think.  I know whenever I felt a manic display of behavior waiting in the wings, a five minute cigarette break could put things in a new prospective.  If I would get frustrated or felt my anxiety level needed a release, cigarettes came to my rescue.  I actually convinced myself it was OK to smoke because I was bipolar. It was therapeutic.

I knew I was kidding myself.  Like when I tried to convince myself I needed a ten thousand dollar Hublot Big Bang watch as a good investment.  And after a little heart scare this past weekend which sent me to the emergency room, I decided enough was enough.  I quit cold turkey.  Who’s fooling who? My body is just like everyone else’s.  I can still get cancer and heart disease from smoking.  It’s my mind that’s different.  So now I sit here writing this blog in mild misery because I want my cigarettes.

I think it’s harder for bipolar people to quit because of the way our brains work.  We are forced to take medication, endure side effects and often never feel completely well.  Since many things in our lives are so difficult we crave an outlet.  Although many of us silently suffer, we can publicly blow off steam in the form of smoke.  Cigarettes become our friends.  As long as we are in a place where we can smoke, we’ll be alright.

Then some of us have to quit.  Maybe it’s a health scare.  Maybe you promised your daughter you’d be there for her wedding.  Or, maybe you decided against having your larynx removed so don’t you have to burp out your words while holding what looks like an electric razor up to a hole in your neck.   But you didn’t count on the depression that would ensue.  You’ve lost a pressure release valvue.  A distraction from the circus in your bipolar mind.  Something you can depend on with an illness that can be very erratic at times.  It’s quite a hit.

I can’t tell you how to get through the discomfort and sometimes agony of giving up cigarettes.  I’ve been hypnotized twice and lit up on the way out of each session before I even made it to my car.  But as a bipolar man, it helps that I understand why “the quit” is so difficult.  I think even harder than for someone without bipolar disorder.  But then again, everything is harder for us.  However I have learned that the “one day at a time” way of looking at things is very applicable.  And I do try to keep thinking of all the things I will be able to do now that I am a non-smoker; like run faster, smell better, not have to always carry cigarettes and a lighter with me and most of all let go of the guilt I had for playing Russian Roulette with a pack of Marlboro every day.

The one thing I won’t miss are overzealous non-smokers yelling out 5th floor windows of downtown office buildings at me on the street that my second hand smoke is making them sick.  I call this the “magic smoke theory.”  With all the exhaust fumes, food vendor smells and other smokers on the streets of San Francisco, somehow my particular cigarette smoke can be detected above all else and make these people sick.  It’s enough to make me want to start smoking again just to annoy them.