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Eating Disorder Awareness Week 2/23 – 3/01

Eating disorders are serious illnesses, not a lifestyle choice. I’m taking this on a different note for a moment, to bring awareness to an important topic. Please join me in Eating Disorder Awareness Week 2014. NEDAWPartner500 I understand this is primarily a bipolar disorder blog, but I believe in overall awareness for mental health issues, and would like to take this opportunity to spread some awareness on the issue of eating disorders. On top of that, somebody very close to me has suffered from an eating disorder, so the topic hits a little close to home.

The Basics
According to the American Psychiatric Association’s Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), these are the basic characteristics of some of the most common types of eating disorder:

Anorexia Nervosa:

  • Restricting food intake to below the requirements for a particular individuals physical requirements
  • Intense fear of weight gain and obsession with weight and continual behaviors to prevent weight gain
  • Inability to recognize true body shape or recognize the seriousness of condition
  • May or may not use binge eating and/or purging behaviors

Bulimia Nervosa:

  • Eating an unusually large amount of food at one time followed by compensatory behaviors (such as vomiting, taking laxatives and/or excessive exercise) to prevent weight gain
  • A feeling of being out of control during the binge-eating occurrence
  • Self-judgment largely based on weight and shape

Binge Eating Disorder:

  • Recurrent situations of eating an unusually large amount of food at one time
  • A feeling of being out of control during the behavior
  • May have feelings of shame or guilt towards eating which can lead to eating alone
  • May eat until the individual is beyond full to the point of discomfort

Note: There are several other types of feeding or eating disorders outlined in the DSM-5. Many people may not have every symptom of a disorder, but may still receive a feeding or eating disorder diagnosis.

Eating disorders – such as anorexia, bulimia, and binge eating disorder can include extreme emotions, attitudes, and behaviors surrounding weight and food issues. It can affect women and men of varying ages and backgrounds. Eating disorders can be triggered by familial or genetic factors, media influences, or even trauma. ED’s are very common among athletes and dancers as well. (about.eatingdisorders.com)

Women LearnMalesEDMyths About EDs
These are some common beliefs about eating disorders. Please help to educate others on the realities.

Everyone with an eating disorder is really thin. Although people with anorexia nervosa weigh well below their ideal body weight, this is not true for people with bulimia nervosa or binge eating disorder: these sufferers may be at or above their ideal weight range.

Eating disorders are a female illness. While most cases tend to be prevalent among females, about 10% of those in the United States with eating disorders are male.

It’s a youth thing. Research has shown that the majority of eating disorders develop during adolescence — a period of rapid physical and social change for most people. It is sometimes assumed that people ‘grow out’ of eating disorders, and they are not an issue once middle age approaches. The truth is, several middle aged women (and men) seek treatment for an eating disorder.

Eating disorders are for white people. It’s no secret that historically, the face of eating disorders belongs to the Caucasian person. But know that the rates of eating disorders all over the world are rising, even in places like China, India, Mexico, and South Africa. Within Western cultures, eating disorders are found in all ethnicities. Note that African American women have lower rates of anorexia nervosa and bulimia nervosa, as it is believed that their cultural body ideal is heavier and more voluptuous. However, they experience the same rates of binge eating disorder as Caucasians.

Eating disorders are caused by dysfunctional families. Recent research has shown that eating disorders develop primarily as a result of biological and genetic causes, in conjunction with social and environmental pressures, which may or may not include familial stress.

Get Involved
Here’s how you can learn more about eating disorders and promote awareness.

NEDA
National Eating Disorder Association
eatingdisorders.about.com
National Institute of Mental Health – Eating Disorders
A Day in the Life of Someone with an Eating Disorder

So Very Vivid is the Art of Bipolar Dreaming

I felt her embrace, her breath. Her words were crystal clear. She said “Please stay. You can’t go”. And she held me tighter. And I did stay. It was a mind-blowing, surreal night. And it was with another woman. She was radiant. Magnetic. And I didn’t have a care in the world. Mostly because it wasn’t real. It was all a figment of my tortured imagination. And the female is simply a musician (who I will probably never meet) whom I happen to have a crush. When I dream a dream, I go all the way to produce the most vivid dreams I can, even if that means removing normal elements -such as the fact that I’m married- from the situation. If I’m lucky, I am able to remember the dream in the morning, which often then lingers in my thoughts for the duration of my day.

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Dreams are so interesting because it’s been known that most everybody has them, yet there is no solid reason why. Several interpretation theories have surfaced throughout time, and some commonalities have been determined. While everyone has dreams, some of us have much more vivid dreams than others. There are links between vivid dreams and mental illness, including bipolar disorder.

One reason is dreams and nightmares occur during REM (rapid-eye-movement) sleep. In normal sleepers, there is more deep sleep at first, and then as the hours pass, periods of REM sleep become longer. This general pattern, however, can be distorted or disrupted by any one of a number of sleep disorders or disturbances, many of which have been shown to be associated with bipolar disorder. (bipolar.about.com)

The most common sleep disorders include insomnia and hypersomnia. Other factors that disturb your sleep include medical conditions, antipsychotics or antidepressants, other over the counter medications and prescriptions, environmental factors, stress, and your sleep schedule.

Vivid vs. Average Dreams

For the most part, everybody has dreams. The majority of dreams are forgotten by morning, and those remembered are usually in fragments. About 80% of dreams are in color, but some are in black and white. Vivid dreams are like a typical dream on steroids. Basically it is so incredibly lifelike that upon waking, it is difficult to distinguish the difference between the dream and reality. It is easier to recall vivid dreams, as they leave such an imprint on the dreamer’s mind. I know I can recall each sensory detail of my most vivid dreams.

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Lucid Dreams and Nightmares

Lucid dreaming is an unusual state of consciousness where you are having a vivid dream, but you are aware that you are dreaming. This allows the dreamer the choice to exit or remain in the dream. Sometimes lucid dreams can be confusing and the dreamer may believe items or people in the room are in fact something other than what they are. This can be entertaining to the dreamer, as well as potentially embarrassing. For instance, had I acted out my steamy dream from last night, my wife would have probably wondered what was up!

Lucid nightmares are exactly like lucid dreams, except they are terrifying. What’s worse is the dreamer knows they are dreaming, but are struggling to wake up. Often feelings of being trapped or being attacked are common.

Sex It Up

According to a recent study at the University of Montreal, sex dreams make up about 8 percent of all dreams for both men and women. (Me!)  Society’s openness regarding sex, coupled with our growing interest in understanding dream content has taught us that, according to most theorists, sex dreams are rarely about sex at all – no matter how hot they might be. It is believed that the mind is hungry for the kind of psychological union represented as a physical union in the dreaming mind. I say this is an interesting theory, but I’m pretty sure many of my dreams are merely about getting down and fucking dirty!

Sleep Plays a Role

Sure, us folks with bipolar have more intense (& sexier) dreams (sorry- I’m still reliving last night!), but there are some things to keep in mind. Sleep is affected by many factors that need to be controlled. Getting quality sleep also helps regulate moods and prevent episodes. These suggestions are a challenge and I admit I struggle to follow them, but they are ideal goals and can be really beneficial.

  • Go to bed & wake up at the same time each day
  • Take meds as directed
  • Limit caffeine and alcohol 3-5 hours before bed
  • Refrain from computer, TV, or phone screen use
  • Read or meditate to wind down
  • Establish a routine for evening and morning

If you get some good, quality slumber tonight, then I wish you all some intense vivid dreaming! It’s also fun to write your dreams down in a journal to preserve the absurdity. Feel free to leave comments on this or share your dream experiences!

Bipolar Valentine Part 3: In Sickness and Health, Mania and Depression

I love you. I hate you. I want you. Don’t touch me. Marriage and bipolar. Is it a toxic combination? According to NAMI, statistically 90% of marriages with at least one bipolar spouse will end in divorce. That is a sobering number. You can’t deny that it’s a bit discouraging to those not yet married, and scary for those of us who are. So before we go any further, let’s ask- is there even a point? Absolutely.

b3265cde38e270325fd8828a36e074f0In lieu of Valentine’s Day, I’ve pieced together a three-part series on various aspects of bipolar disorder and love. This is meant to be informational with a shot of perspective, and a smooth aftertaste of personal connection. Please feel free to leave feedback or share your own experiences.

It is possible for people with bipolar disorder to endure successful long-term romantic relationships, and even marriage. There are many factors involved because every individual and every relationship is different. What works for one couple may not work for another, and vice versa.

Factors to consider:

One factor to consider is the time of diagnosis. While the symptoms are usually present for a period of time, we all know getting that official diagnosis makes a difference. It provides an answer and treatment options, as well as a name for what is going on. (I don’t like the term “label”). For several couples, the diagnosis comes years into their marriage. They receive the news together and unless they’ve already suspected BP, it is brand new information. What usually happens in these cases is a sense of relief, followed by frustration, and a new sense of responsibility. Changes must be made in the every day routine.

Other couples have it a little bit differently when the person was diagnosed prior to their union. In this instance, the non-bipolar partner entered the relationship knowing something was unique about it. In my last segment, Bipolar Valentine Part 2: Adventures in Dating, I discussed how to tell your new partner about your BP diagnosis, and about my own experience with my wife. Both types of couples face challenges.

“Following a diagnosis, the first and most dominant response from a spouse usually is sympathy, says David A. Karp, professor of sociology at Boston College and author of The Burden of Sympathy: How Families Cope with Mental Illness (Oxford University Press, 2002). “But further down the road, a spouse may experience emotions they don’t think they should be having—anger, frustration, and even hate.”

Indeed, caring for someone who has a mental illness can be more draining than caring for someone with cancer, says Dr. Karp. When a spouse does something for a mate with a physical illness, they are usually met with gratitude. People who have bipolar disorder, on the other hand, often deny the diagnosis, are unwilling to comply with medication, and—worst of all— treat one’s spouse like the enemy.”

Another factor to consider is if there are any children in the picture. Since bipolar disorder has ups and downs that can be unpredictable or inconsistent, it is especially vital to double up the top priorities to both the bipolar spouse’s needs as well as the children’s needs. Kids should never feel like the mood swings are their fault. And in reality, sometimes the hustle and bustle around the house is what triggers an episode. It is important to have a strong partnership with your spouse when you are not functioning at your best so the kiddos will have stability.

How can we make it for the long haul?

I give my wife a splintering headache every single time I go hypomanic or full blown manic. I lie about my meds. I drink. I stay out all night. I argue with her. I hate sleep. I become very self-involved. And I no doubt make her feel like shit. When I get depressed, she can’t get me out of bed. I ignore my responsibilities and don’t even care. I know she knows when my patterns will start. I know she goes through hell. But…we make it. We get through it and carry on. Have we come close to ending it all? Oh hell yeah we have. But chose to work really hard instead. Here are a few tips that really work.

I swear by education. Read about bipolar disorder and have your spouse do the same. One book I recommend is Loving Someone with Bipolar Disorder, by Julie Fast.

Finding the right doctor, usually a psychiatrist, is imperative. Make sure your partner joins you so he/she can become acquainted with your doctor in case of any future emergencies. A good doctor is someone who listens to you, addresses your concerns, and explains the recommended course of treatment. Both of you having a good relationship with your doctor is important for your relationship with your spouse.

Other factors in your treatment include the right med cocktail, and any support groups you join. It is mandatory to get your partner on board with all of it. This is one thing that has held my marriage together these last 7 years. My wife is my medication manager and during my rough times, she sorts and distributes it for me. Even when I’m able to administer it to myself, she is my daily reminder of when I’m supposed to take it. Without her, I know I’d forget or choose to not take my pills. Without the pills, I’d be a hot freaking mess! She also encourages me to attend my biweekly support group.

One of the absolute most important things in a bipolar marriage is having rules. Yes, rules suck. But in this case, rules are the glue holding the package together. Establish grounds for when to call the doctor, to disclose suicidal thoughts, to have your partner notify you of red flags, when to go to the hospital, to communicate your triggers, and a commonly broken rule- to always take your medication! In my house, my wife has given me the medication ultimatum that if I refuse to take it, she will pack up herself and our son, and go stay somewhere else. That thought kills me. So I stay motivated to comply.

My last biggie is communication. More specifically, speaking the language of bipolar. Make it clear what “highs” and “lows” are and what things you might verbalize differently in each of these states. This way there is no cause for alarm if you are transitioning moods.

Enough of the technical stuff, where’s the love?

d55dc7e5bb39d7d2ed43d96fe7dd2663I can’t say this enough- do not make your bipolar the center of your relationship! For any marriage, with or without mental illness, it is important to nurture the relationship in order for it to grow. It’s just like any living thing. If you stop feeding it, it wilts and dies. The bipolar is just a part of it. Your relationship consists of many other parts. Give these a try:

  • Re-examine your core values and what brought you two together in the first place.
  • Carve out some time in your busy lives for a date night.
  • Have passionate sex.
  • Laugh together.
  • Go on a road trip.
  • Renew your vows.
  • Say “I love you” often.

If you haven’t already, check out the first two parts of this series, Bipolar Valentine Part 1: Is It Love or Just Bipolar?  and Bipolar Valentine Part 2: Adventures in Dating.

Nectar Madness Finally on Facebook! Like Me!

About damn time, right? I guess I’m finally ready to commit to operating a Facebook page for this blog. So please click ‘like’ on the right side of the screen or click on this link Bipolar Life by Nectar Madness.  This page is a good way to give feedback and suggestions for upcoming blog posts. It’s also a great networking opportunity for fellow bloggers. If you have a Facebook page, feel free to leave it in the comments section and I’d be happy to check it out. Enjoy!

Bipolar Valentine Part 2: Adventures in Dating

You have mastered the art of first impressions. It’s easy to reel them in and land the date. As long as what’s underneath doesn’t creep it’s way to the surface, that is. How does a person with bipolar disorder survive the dating world? My answer: mindfully.

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In lieu of Valentine’s Day, I’ve pieced together a three-part series on various aspects of bipolar disorder and love. This is meant to be informational with a shot of perspective, and a smooth aftertaste of personal connection. Please feel free to leave feedback or share your own experiences.

The noise in your head is louder than the conversation between you and your date, but you somehow manage to keep your composure. Your date is beyond attractive. You still cannot believe you are here. Your head is getting louder and you can’t feel your tongue. Now this could sound like any first date jitters, but the difference between jitters and what you are experiencing is the fact that any chance of a future with you and this person, in reality, includes you, this attractive person, and your bipolar. The three of you. Admittedly, knowing this can be discouraging.

Dating in itself is hard. It is full of anxiety and expectations. Dating when you have a mental disorder creates it’s own set of difficulties because the disorder isn’t typically visible to the naked eye. Mood disorders such as bipolar disorder or depression, or even anxiety disorders don’t necessarily have symptoms all the time. Mood swings and triggers induce symptoms that result in behavioral changes. Understandably, this can be a huge pain in the ass when in the market for a mate.

So, what makes for smooth dating?

First and foremost, make sure you are ready to date. I’m not saying all of your ducks need to be in a row. (I mean really, who’s are?) I’m referring to having your mental health in check. Are you stable? Have you been consistent with your medication? Are you depressed? Manic? Having thoughts of harming yourself? You know the rest. It is so very important to be in a healthy place before bringing someone new into your life. If you are not really ready, then it’s not only unfair to that person, but it’s unfair to yourself. Besides, dating is fun and the point is to enjoy one another. You can’t do that if you are sick.

Another key to dating is to know yourself. Know where you stand on issues such as marriage and children. Odds are they will come up at some point and it’s no secret that bipolar disorder can complicate these things. But please know bipolar is not poison to domesticity! (I can tell you first-hand.)

When do you spill the beans?

No doubt this is the scariest part. The part of dating when you have to tell your partner about the thing that you try to not let define you. The thing that can turn you from Dr. Jekyll to Mr. Hyde in a matter of minutes. The thing that allows you to hear colors and taste sounds. The thing called bipolar disorder.

It’s tricky because it is possible to reveal your bipolarity too soon, and it is also possible to reveal it too late. The best time to bring it up is as the relationship has reached a level of intimacy where you are ready to be exclusive and make a commitment to one another. When you are entering a deeper trust mode.

When talking about bipolar, be mindful that the person you are talking to may not have had previous experience with it, at the same time they may have had a bad experience with it in the past. This is also a highly stigmatized disorder. Be delicate, but make it clear that what you are about to talk about is important and personal. Gauge the conversation as you go, and try not to react to their reaction if it is not what you expected. Go ahead and tell them about your treatment regime and your feelings with having the diagnosis. Try not to use a ton of technical medical terms so it’s a little less intimidating, and easily comprehensible.

d9d34d2303b499e42364119e0aef7cacBack in 2006, when my wife and I were just dating, I remember being pretty nervous about telling her my diagnosis of bipolar type 1. I really liked that girl a lot and was so scared she would think I was defective or crazy or something. I waited until we had been dating about a month. At this point we had grown exceptionally close and developed intimacy. We went on a camping trip and I basically blurted it out at the campfire. She didn’t freak out or judge me. I learned that she had previous experience with her mother being bipolar. Her life growing up with an untreated bipolar mother was mostly dysfunctional, so she has seen the ugly side of the disorder. Of course because of this I thought she would run, but instead she was very knowledgeable and chose to give me a shot. It’s about learning to trust one another and take chances.

What about the dreaded psych hospital?

So you and your new mate have been dating for a handful of months and all is peachy. And then it happens. The dreaded episode. It could be depression or mania- doesn’t matter, either is shattering. And you find yourself in a psychiatric hospital. Perhaps you’ve been there before or maybe it’s your first time. Either way, on top of regaining stability and utilizing treatment, you are going mad over the fact that you have to tell the new girl/boyfriend that their partner is in the looney bin. What is the best way to handle this situation?

Well, for starters, make sure you keep your partner in the loop prior to any hospitalizations. Granted, that may be awkward since it’s still in the beginning stages, but it may help to bring up treatment options and discuss the possibility of being admitted into the hospital for a medication adjustment.

I was first hospitalized when I was 18. At that time I was dating a wonderful girl who treated me well. While we weren’t that serious yet, after a couple of months I could see it going somewhere. Maybe it’s because I was young, or because I was freshly diagnosed, I never told her about my bipolar disorder. I think she got used to my moodiness so when I didn’t call her for a few days, she wasn’t concerned. I didn’t tell her I was in the hospital. I was too ashamed and didn’t want her to see me like that. When I didn’t call her for even longer, she figured that I just didn’t want to see her anymore. When I was finally discharged, I assumed she didn’t want to see me so I didn’t call her. For years I regretted not contacting her and I wondered what could have been. (Side note: We did reacquaint years later and she wished I’d have talked to her about what was going on with me. We have since drifted, but I was able to gain closure. And I have since been happily married to my wife.)

Try these suggestions for dating done right:

If you see things going in the positive direction with your new partner, encourage them to educate themselves a little bit on bipolar disorder. There are a lot of good books and websites available. This could make it a little less overwhelming for them and establish a connection between the two of you. It also makes it easier when you do open up about what you are experiencing.

Be honest about what you need. For instance if you are feeling depressed, maybe you don’t need someone to try to cheer you up. Maybe quiet meditation serves a better function. Make it clear what is helpful and what isn’t.

Share your positive qualities. We all know having bipolar also comes with some intriguing qualities as well. We’re vibrant, creative, passionate, and unique!

b08191d09ac31c91ed1f84e56576f8eeCan it become more?

So you really dig this person with whom you’ve been canoodling and you’re starting to feel the urge to utter the little ‘ol “L” word. Good for you! Of course there is so much running through your head. It’s no secret that relationships with a bipolar partner tend to not fare well. Statically 90% of bipolar marriages end in divorce. That’s depressing in itself. Don’t let the statistics scare you. It is possible to take it to the next level. Just check in with yourself often and put forth the effort to maintain stability.

I will be focusing on marriage and long-term relationships in the third and final segment, Bipolar Valentine Part 3: In Sickness and Health, Mania and Depression. And if you haven’t already, check out my previous segment Bipolar Valentine Part 1: Is It Love or Just Bipolar?

Bipolar Valentine Part 1: Is It Love or Just Bipolar?

You feel sexy. You feel on top of the world. Your heart has never been more full. You’ve never been so turned on. You want attention- and you’re getting it. It’s euphoric. It’s definitely love…or is it?

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In lieu of Valentine’s Day, I’ve pieced together a three-part series on various aspects of bipolar disorder and love. This is meant to be informational with a shot of perspective, and a smooth aftertaste of personal connection. Please feel free to leave feedback or share your own experiences.

Well, is it love? Or is it bipolar?

Picture that you just met someone you are insanely attracted to. You notice every single detail about their perfectly angled face, the tiny dimple on the left side near their mouth, and their adorable laugh. You are dizzy with intoxication by the very scent of this perfect human specimen. Upon this meeting, you are charming, so very charming. And you are drunk on your own sex appeal. You are suddenly very aware of your flesh. You take notice of every detail of the night air, senses beyond heightened, and you are convinced that that very moment was created especially for you. You and this person with whom you share a heavy fondness. Not only are you practicing your most seductive moves, you desire to make love all night long, and release yourself into the throes of passion. Sighhhhhh. Sounds like a scene straight from a romance novel. Could it be love? Perhaps. But in someone with bipolar disorder, these feelings could be symptoms of hypomania or mania. Common signs of mania include feeling unusually high and optimistic (or irritable), grandiose ideas, racing thoughts, impulsiveness, impaired judgment, little need for sleep, unrealistic beliefs, delusions, acting recklessly without consequence, feelings of euphoria, and increased sex drive, also known as hypersexuality.

“When you’re in a hypomanic or manic state, you’re also more likely to feel you’re in love,” says Elizabeth Haase, MD, an assistant clinical professor of psychiatry at Columbia University and a member Human Sexuality Committee of the Group for the Advancement of Psychiatry. “You may then act on that feeling when making major long-term life decisions, not understanding your state had something to do with what you were feeling.”

For someone enduring a manic or hypomanic episode, sex is often the main course in a banquet of other amplified feelings and behavior. Hypersexuality is when someone experiencing bipolar hypomania or mania has an increased libido or is excessively interested or involved in sexual activity. The thing is, a high sex drive isn’t necessarily a bad thing. In fact, most of us would think that is quite wonderful! It becomes problematic when there is no regard for consequences that could become of the sexual activity. This can include extramarital affairs or cheating on your girl or boyfriend. Sexually transmitted diseases are a tremendous concern as well, especially if someone is sleeping with multiple partners. Regret and shame are often the result of impulsive sexual activity. Hypersexuality can also trigger a sex addiction in some people. And don’t forget about the interpreted emotional connection people tend to believe they are feeling with their sex partner. The bitter aftermath of manic sexual relationships typically end in heartbreak, one side or the other.

29d9c9b8a66dc439b71fa7773c55575cI do recall experiencing a pretty wild manic episode in my early twenties where I felt like I was on fire. I was feeling hot, looking good, and my moves were working for me. (I was also delusional, had extreme grandiose ideas, drank too much, did too much cocaine, and felt on top of the world.) I was very in tune with my sexual side and ended up dating four girls at the same time! In my mind I was a sex goddess. Who needs sleep when you can do other things all night long? Of course I also felt I had an emotional connection with each of them. Everything was intense and special. That is until I started to come out of my mania. I first had a breakdown, then like most manic episodes, I had a huge mess to clean up. Needless to say, people got hurt and I was confused, emotionally.

So, how do you know the difference?

It is important to know what triggers your episodes. Examine all other areas of your life. If any of the symptoms of manic or even depressed episodes seem to describe your life, then something is off balanced. If you are on medication, make sure you are taking them as prescribed. If you take them as you are supposed to and are still experiencing manic symptoms, then it is imperative to talk to your doctor for an adjustment. And if you are comfortable with the path you are leading, regardless of how reckless, I urge you to use protection, for reasons I don’t need to explain.

If you are in the clear and pretty balanced, but still have feelings of intense passion and attraction to a certain special someone, then it sounds like you have a hot, steamy case of romance! If done right, both lust and love are very rewarding. Those intense feelings are consistent with the beginning stages of romantic relationships.

ecee8e6b34c6c1f06bd39cb5ea18f657I can’t say it enough, it is so healthy to know yourself and your bipolar patterns. New love is on the list of common potential triggers. There are so many emotions and changes that even non-bipolar folks act like fools when they are smitten by a beautiful new face. Also, don’t ever be discouraged because you have bipolar disorder. There are many bipolar people in successful relationships. I will be exploring bipolar dating in my next segment, Bipolar Valentine Part 2: Adventures in Dating.

Lithium’s Ugly Side Effect: Acne

Occasionally I bring up the topic of medication side effects, and this is one that affects my daily life. I’m referring to acne as an irritating side effect of Lithium. Screen shot 2014-02-03 at 5.38.09 PMLithium is the most widely used and studied medication for treating bipolar disorder. Lithium helps reduce the severity and frequency of mania and helps stabilize moods. It has a list of common side effects, including hand tremors, increased thirst, weight gain, drowsiness, muscle weakness, hair loss, decreased thyroid function, and acne.  While the side effects are not always easy to live with, Lithium can be a life-saving medication for so many people. The side effect I want to focus on is one that is often overlooked because it is not always considered medically troublesome. This side effect is acne.

I have been taking Lithium for almost a year and a half now and my skin hates me for it! Prior to taking this medication, I would have an occasional breakout, but nothing like I do now. At the time of being prescribed the Lithium, my psychiatrist didn’t really explain any side effects. I think this is due to the fact I was in crisis mode, suffering a severe mixed episode. He also prescribed two other medications to take with the Lithium, while discontinuing the meds I was already on. There was a lot of change going on and I probably wouldn’t have been able to fully comprehend anything too detailed anyway.

When I first started noticing my skin breaking out, I didn’t connect it to my medication. I used several different drugstore brand cleansers and ointments. I make sure to drink plenty of water and eat healthy. I wash twice a day and remove all makeup at night. I learned how to use concealer and other makeup tricks. I cried on occasion and I sometimes avoided going out with friends. My biggest problem wasn’t necessarily that I had the acne, but I really wanted to know why I had it. Then I started thinking that maybe things I put on my face aren’t working because it has to do with what I put in my body. The chemicals I put in my body. Since I don’t smoke or drink or anything like that, the only chemicals I’m really ingesting are my medications. After doing some research, I found that acne, sometimes chronic, is definitely a side effect of Lithium.

Not everyone who takes lithium develops acne, but many do. The reason lithium triggers acne is counterintuitive. It increases the activity of the immune system which in turn increases skin inflammation.

Lithium causes a condition called leukocytosis. The technical definition of leukocytosis is an increase in white blood cell (WBC) count due to any cause. When people who have bipolar affective disorder take lithium, the drug causes them to produce more stress hormones (which is actually a good thing) when they are depressed. These stress hormones make it easier to find the energy to function day by day.

Stress hormones in the skin, however, increase inflammation. They trigger the release of histamine from storage packets in the skin. Histamine is the same chemical that causes allergies. It breaks down skin cells or cells in the membranes lining the nose and throat to remove foreign bodies and germs. When the release of histamine is induced by stress, however, histamine destroys healthy tissue that has not been penetrated by foreign bodies or infected by germs. The result is redness, itching, and even pain in the skin that is worse in pores that are affected by acne. http://www.facingacne.com/lithium-acne/

Okay so now we have a cause for the ugly blemishes, but how do you get a handle on the situation?

If your acne is bothersome, decreasing your lithium dosage with your doctor’s consent can often help your skin improve. If that’s not possible, it’s best to consult a dermatologist about acne treatments, since lithium-induced pimples are generally harder to get rid of than other types of blemishes.

One possible treatment for this type of acne is tretinoin (Retin-A, Renova, Atralin), a topical drug that works by unclogging pores and promoting peeling of the affected skin. However, it is important to talk to your doctor about possible side effects before using this medication.

The drug isotretinoin (previously marketed as Accutane, but now available only as a generic) should be considered only if absolutely necessary, since its reported side effects include birth defects, depression, and psychosis (feelings of delusion and hallucination). This can be especially dangerous for someone with bipolar disorder. “You should proceed with caution so you don’t have some sort of manic or depressive episode,” says Amy Derick, MD, a dermatologist in Barrington, Ill.

Having a good anti-acne skin care routine can also be helpful in fighting breakouts while you are taking lithium. An over-the-counter cleansing product that contains salicylic acid, which reduces swelling and unclogs pores, should be used twice a day for optimum results.

When buying beauty products, such as moisturizer or foundation, be sure that the label says that the formula is “non-comedogenic,” meaning it has been formulated to not clog pores, which can lead to breakouts. Also, choose a sunscreen that uses titanium dioxide or zinc oxide as a physical barrier against the sun, rather than chemicals that absorb UV rays. “Those types of sunscreens are usually better for people who have acne problems,” Derick says.

Finally, try not to get too down about your acne. Some patients on lithium have found that their skin problems decrease after about six months of treatment, as their bodies adjust to the new medicine. “It can get better,” Derick says. http://www.everydayhealth.com/bipolar-disorder/when-lithium-causes-acne.aspx

So what am I going to do? While I would like to be able to decrease my Lithium, it simply isn’t an option. I will continue to practice healthy habits like washing twice a day, using clean towels and pillow cases, and eating healthy. I also ordered an acne cleansing system, Proactive Plus. (I do not endorse any products.) This product has gotten good reviews, so I figured it can’t hurt to give it a try. I don’t expect to get rid of the acne completely. I just want to feel attractive again. I hate being self conscious over my skin. I feel a little less stressed about my complexion since knowing the assumed cause of the issue. Hopefully this information helps out any of you with similar side effects.

“Of Two Minds”, Bipolar Documentary Review

I recently watched the 2012 bipolar disorder documentary, “Of Two Minds”, written and directed by Doug Bush and Lisa Klein. The film features the gripping real-life tales of every day Americans living with bipolar disorder.

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Take a candid view into the lives of people who have been through the perils of extreme ups and downs, succumbing to the enticing world of mania, as well as the empty world of depression. A heavy topic that seemed to be an underlying theme throughout the film is suicide. Almost all of those interviewed had either considered or attempted suicide at some point. I found it to be heartfelt and completely relateable. If you watch the film, I’d be aware of potential trigger warnings, however, for the ideals of suicide appeared to be slightly romanticized at times.

Other topics that were explored include mania, psychosis, depression, interpersonal relationships, family members, professional life, and forms of treatment. I won’t talk about all of them, but I do want to mention how refreshing it was to hear stories of success, and by success I mean every day ‘normal’ living. Also I do feel a little less crazy with my own psychosis and hypersexuality.

Overall I thought the film was nicely done and covered all bases of bipolar disorder without being too clinical. It was compelling in the sense of getting to know each of the brave individuals who bared their souls and allowed the audience inside. I recommend this documentary to those diagnosed with bipolar, loved ones of bipolar folks, students, and mental health professionals. Or anyone just curious about the realities of living with bipolar disorder.

Links:

http://www.oftwomindsmovie.com/

http://www.bipolaradvantage.com/index.php

 

How Does Change Affect You?

I’d like to say that I’m good with change and welcome it with open arms. But that simply isn’t the case. I have mood swings, irritability, feelings of chaos, and I’m often pretty manic. The bigger the change, the less I sleep, the more I obsess over things, the harder I am to deal with. Examples of difficult change for me include moving to a new home, starting a new job- or getting laid off from a job, a family member becoming ill or laid up due to injury, and any time I have too much idle time on my hands. Heck, I can’t even handle the change of seasons very well. In the coming weeks, I am about to embark upon a couple of new changes and I’m getting pretty nervous about it. First, as you know, we are having a baby. My wife is due to give birth December 15th. Of course there’s that uncertainty as to what day the baby is actually coming, and that is making my head go crazy! I want to be as prepared as possible for whenever it happens. But just having a new baby around is so much change in itself. I’m aware that this will affect my bipolar and I’ve had the conversation with my wife about it. Second, I will be laid off from work for the winter months. Last year, I worked through the winter (even though it’s a seasonal business), and had a hard enough time with the lack of work to do, but at least had a routine. Not working will replace my structure with leaving me to fend for myself. Granted, I assume the baby will keep me busy to a point, I just know the changes will be difficult. Lastly, the seasonal change from Fall to Winter is always a tough one.

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It isn’t uncommon for us bipolar folks to struggle with change. There are a few reasons why. First, if we fall out of routine, we tend to get a little lost. Routine is essential for building structure and staying on track with things like meds and moods. Off track means forgetting about tasks and appointments. It’s also easy to get anxious when we feel off. Another reason we dislike change is because it messes up our ability to predict and plan what is going to happen. Of course spontaneity is healthy, but for the most part we feel comfortable if we have knowledge to what is going on. My biggest anxiety is not feeling prepared. I will continue to post about my new life changes and whatever coping strategies I discover.

How are you with change? Do you become anxious when out of your routine? Do you have a hard time getting back on track? What helps you cope?

Peer Support in Mental Illness

This past week I had the opportunity to visit a friend in the psych hospital. She is in the process of accepting her new diagnosis of bipolar disorder type 1. My diagnosis. While I knew something was going on with her before, it is certainly best that she is in the hospital, receiving the care she needs. As her friend, and as someone who is living with the disorder, and someone educated in mental health, I want to do whatever I can to be there for her, and help her through this complicated time. This brings me to an important topic- peer support.

Peer support for those with a mental illness is so essential in acquiring mental wellness. Associating with peers who understand and can relate to what you are going through can help to form a bond. Having a support system of friends who also live with a mental illness, and who can relate is helpful in a different way from those who do not. Either way, there are things peers can do to help ease the burden of treatment and every day struggles.

Taken from the DBSA website:

What You Can Say That Helps

  • You are not alone in this. I’m here for you.
  • I understand you have a real illness and that’s what causes these thoughts and feelings.
  • You may not believe it now, but the way you’re feeling will change.
  • I may not be able to understand exactly how you feel, but I care about you and want to help.
  • When you want to give up, tell yourself you will hold on for just one more day, hour, minute—whatever you can manage.
  • You are important to me. Your life is important to me.
  • Tell me what I can do now to help you.
  • I am here for you. We will get through this together.

What You Should Avoid Saying

  • It’s all in your head.
  • We all go through times like this.
  • You’ll be fine. Stop worrying.
  • Look on the bright side.
  • You have so much to live for; why do you want to die?
  • I can’t do anything about your situation.
  • Just snap out of it.
  • Stop acting crazy.
  • What’s wrong with you?
  • Shouldn’t you be better by now?

Peer support groups are also really helpful. I attend the DBSA peer support groups twice a month and I appreciate the freedom and safety of being able to openly express myself. I can share whatever I’m feeling, if I’m having an episode, and any difficulties I’m going through. The meetings are confidential and exclusive to those with bipolar disorder or depression, and their loved ones. I will be encouraging my friend to participate in groups as well, once she is discharged from the hospital.

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Bipolar Disorder = No Life Insurance?

Defective and rejected is how I feel after learning I was denied life insurance due to my bipolar disorder. When I first got this information today, I was confused because as far as I knew, I was perfectly healthy. I wracked my brain for reasons they could deny me- maybe my psychiatrist hadn’t given enough information, maybe the insurance company looked at old records, maybe it was a technical error. I then reviewed my current situation- I haven’t had a bad episode since last year, I haven’t been suicidal in a year, I’m on a good medication regimen, I go to work, I’m in a healthy relationship. What gives? I decided to do a little research about bipolar disorder and life insurance and this whole denial thing. What I learned is this isn’t uncommon. What I think is it’s certainly unfair.

According to insure.com, there are several factors insurers look at when it comes to bipolar disorder. Two main things are control and compliance. They said that acquiring and maintaining treatment are essential. Another key factor is what type of bipolar you have. There is a heightened risk associated with bipolar I, compared to bipolar II, and it falls outside most insurers’ comfort zones. The reasoning- because people who suffer from it have a higher suicide rate. Insurers have to go by statistics when it comes to suicidal tendencies. Because I wanted to know exactly why I was declined coverage, I called to see what they could tell me. Apparently according to the report, having bipolar disorder puts me in a higher risk category, as well as the specific medications that I am taking. The agent suggested weaning off of meds, and if I could be off of them for two years, they could reinstate my application. Obviously, I know this is counterproductive so I did not consider it for a second. Instead, I tried not to feel too discouraged, and I am looking into the alternative accident insurance policies instead.

Has anyone else had this experience?

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Suicidal Ideation is A Manageable Symptom

Some of us experience it, some of us don’t. It takes over your mind and consumes you. Suicidal ideation doesn’t necessarily mean you will kill yourself. Or that you really want to. It means you are preoccupied with the thought. These thoughts drag you to a very dark place, focusing on, or even obsessing over the notion to end your own life. People with these ideations often lack the desire to fully commit suicide. In fact, many people in this position would rather not discuss it. Ideations include methods, plans, notes, the aftermath, etc. Is this morbid? Does this make someone a sick person? No. Suicidal ideation is a symptom of bipolar disorder. I am one of those people who are affected by this symptom. For me, it flares up at certain times, and goes away at other times. While some may take great comfort in their dark thoughts, it makes me more negative and depressed. I do a lot of work on myself if I start getting like that, and I practice therapeutic techniques to clear my mind.

What triggers my suicidal ideation? A key trigger is whenever someone I know dies intentionally, a.k.a. suicide, or from a preventable cause, such as an overdose. It triggers me even further when the deceased is around my age. I begin to take mental notes, as if I’m learning a lesson from these people who passed before me. What did he overdose on? How did he do it? Why her? Why not me? Now these thoughts manifest into full on imaginative scenarios, thus romanticizing the notion of death altogether. I find myself sitting at funerals, in complete awe of the entire procession. I philosophize every aspect of it. From the excessive sobber, to the take-charge family member, to the hugger, to those apprehensive to see the casket, to the hospitable funeral director, and all the awkward others who seem to follow suit along with everybody else.

Where am I going with any of this? Well I attended a funeral yesterday for a young family member of my wife, who indeed took his own life. By young, I mean a day younger than me. An unthinkable tragedy, the pain he was going through must have been indescribable. I watched as family members mourned, their hearts broken, questions unanswered. And of course while I was beyond saddened for my wife and my dear in-laws, I started to feel the sprouting little buds in my mind. I pushed it away, and have been doing my damnedest to prevent anything from growing. It’s important to know your triggers, and catch them early in development. Using positive self talk can help as well.

The focus is to celebrate life. We celebrate those who have passed before us, those who are here with us, and those who will be joining us soon. (Our baby is due next month! Yay!) I know this is a hard topic to chew, but I really felt it was important because surely there are others with this symptom as well.

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