Bright and Sunny Bipolar Afternoon

Ah, it's feeling like spring here in Southern California today.  It's a sunny afternoon without a cloud in the sky.  This has me in a light and jovial mood.  


My depression mutes much of the good mood.  I know it won't last forever.  But I'm certainly not complaining!




Anyway, I thought I'd find some things to laugh about and have done just that.  Here is some funny bipolar stuff I found from around the web.  Hope you enjoy! 

(1) You know you have bipolar disorder when:

• You can identify medication in the dark merely by shaking the container;
• Your drugs help you achieve reality, not escape from it; and
• You know more about mood disorders than your physician, yet still question your bipolar diagnosis.

(2) You know you have bipolar depression when:

• You have been told to “just snap out of it!” more than 3 times today already;
• Your "not talking" becomes the reason others want your antidepressant dose increased; and
• Instead of looking at the weather in the morning, you stay in bed, read about moon phases, work on your mood chart, count meds remaining until refill, and .

(3) You know you have bipolar mania when: 

• Your pharmacist (who you have on speed dial) stops trying to explain side effects of your meds, and starts asking you for information; 
• You can recite half of Homer’s Iliad and your bank account numbers, but can’t remember where you put your keys, car, or drivers license; and
• It's February and you’ve already spent the entire year’s budget.

After getting settled down for their first appointment the psychiatrist made the innocent mistake of asking the acutely manic patient how he was doing overall.  The excited individual replied, "I am fine.  I have bipolar disorder but I'm not crazy.  Crazy?  I was crazy once.  They put me in a room strapped to a chair in the middle.  That bugged me.  Bugs?  I hate bugs.  They drive me crazy!  Crazy?  I was crazy once.  But now I'm on seven psychiatric medications.  I take medication three times a day.  This constantly puts me in touch with the illness I have.  Do you know how that feels?  It drives me crazy!  Crazy?  I was crazy once. . ." 


A psychopath may think that 2 + 2 = 5 and could care less.  The neurotic knows that 2 + 2 = 4 and worries day and night.



After the acutely manic individual became relaxed and settled on the couch, the psychiatrist began the first therapy session. 

"I'm not aware of your problem." the doctor said.  "So perhaps, you should start at the very beginning."   

"Of course." replied the patient.  "In the beginning, I created the Heavens and the Earth..."

In a deep depression the patient says, "Doctor, doctor, I can't concentrate.  One minute I'm fine, and the next I'm blank!

Doctor asks, "Well, how long have you had this symptom?

Patient replies, "What symptom?"

Two psychologists were silently walking down the hall together.  One turned to the other and said, "Hello, how are you?"  Immediately the other thought, "What does he mean by that?  I hate when he uses psychology on me." 


If you are in a bipolar mania and want to avoid another 5150 (involuntary psychiatric hospitalization), then be careful what you tell emergency officials.  It is best to be selectively obscure, with clarity and sincerity when answering questions from police, emergency personnel, and mental health workers.  This will cloud their ability to recognize that you are delusional.


Two doctors opened offices in a small town and put up a sign reading, "Dr. Smith and Dr. Jones, Psychiatry and Proctology."  Some town members were concerned that the sign was too formal and proposed "Hysteria and Posteriors."  Both doctors quickly disagreed and proposed the catchy phrase "Schizoids and Hemorrhoids."  The town's mental health advocates felt this would be politically incorrect and suggested "Catatonics and High Colonics."  As soon as the controversy hit the papers thoughtful suggestions began rolling in: "Manic Depressives and Anal Retentives", "Minds and Behinds", "Lost Souls and Assholes", "Analysis and Anal Cysts", "Nuts and Butts", and "Loons and Moons."  Finally, after considerable debate they decided it would be "Dr. Smith and Dr. Jones, Odds and Ends." 

THE 10 COMMANDMENTS OF BIPOLAR DISORDER

1. Thou shalt not worship the bipolar condition.
2. Thou shalt not obsess over dangerous things, people, and places when severely manic or depressed.
3. Thou shalt not doubt, feign interest, or blame the holy chemical imbalance theory. 
4. Remember the ritual of taking your psych meds.
5. Thou shalt honor and not manipulate family or friends.
6. Thou shalt not kill or beat up anyone while in a manic fit, no matter how much ye really want to, or how much they deserve it.
7. Thou shalt not commit adultery unless in a manic state.
8. Thou shalt not throw and break stuff that does not belong to thee.
9. Thou shalt allow others to occasionally get a word in edgewise.
10. Thou shalt not covet other people's attention nor send crazy e-mails at odd hours of the night.


Do you have any good bipolar or mental health jokes?  If so, please comment here or you can send it to me at bipolartrail@gmail.com.  


Added 3-17-12.  A son and his father are traveling on the interstate.  There is a bad accident.  Both need medical attention.  The father, a schizophrenic, gets taken to a nearby mental hospital.  The son, believed to have early onset bipolar with schizoaffective tendency, was taken much further to a mental hospital for children.  The physician enters the room to attend to the boy and says, "I can't treat this child, he is my son!"  How is this possible?

7 Novel Bipolar Treatment Medications

This post is a brief overview of seven emerging or novel drugs for treating bipolar disorder.  This should not be considered a thorough analysis of the state-of-the-art in psychotropic medications. Most of these products have not finished being tested.

Your psychiatrist has probably not even heard of them.  So don't get too excited about seeing if they will work for you anytime soon.  I am posting this out of curiosity and hope for the future.  I think it is encouraging to know science is making headway towards more effective drugs with less side effects.

Current treatments for bipolar depression have a considerable lag of onset of action.  An alternative product with rapid antidepressant effects (hours or days versus days or weeks) is needed.  Ongoing research is promising with newer, faster acting drugs in the testing or approval stage.

1. Ketamine is a drug that has some clinical testing and appears to work well for treatment resistant bipolar depression.  It is fast acting and generally well tolerated.  An IV is used for administering the drug so you better like getting poked.  

It seems product development on this drug has stalled since it can cause hallucination and significantly interupts normal brain function.  Because of the ability to experience abnormal states ketamine is popular at underground parties and raves.

2. Oxycarbezepine is a derivative of the mood stabilizer carbamazepine (Tegretol).  It is being studied for acute mania, hypomania, mixed episodes, and rapid-cycling.  For now a lack of sufficient quality trials precludes us from knowing its effectiveness and tolerability. 

3. Riluzole is a novel chemical that is being studied for treatment of bipolar depression.  It is already an FDA approved prescription drug used to treat Lou Gehrig's disease.  Studies show it effective in treating acute bipolar depression alone or in combinations with other antidepressants.  The first large controlled trial of Riluzole is being conducted at the Yale Depression Research Program.

4. Tamoxifen has been evaluated for acute mania treatment.  Results from several trials demonstrate that it is both effective and well tolerated.  One researcher said that Tamoxifen isn't perfect but it fits the bill.  Is that an endorsement?  It is a promising antimanic drug but larger studies are needed before it can be sent to the FDA for approval.  Interestingly, the drug has been in use for two decades to treat breast cancer under the brand name Nolvadex.

5. Tiagabine is an anticonvulsant being studied for maintenance treatment of bipolar disorder.  It is already FDA approved for treatment of partial seizures under the brand name Gabitril and it is already being used off label for controlling anxiety.  As with most of these emerging treatments tiagabine needs better studies before a determination can be made as to its therapeutic potential for bipolar disorder.   

6. Saredutant is a promising neuropeptide being studied for treatment of major depression disorder.  Neuropeptides work on different neurotransmitter systems than conventional antidepressants.  Saredutant produced favorable results and is in clinical trials for long-term efficacy and safety.

7. Scopolamine.  Scopolamine showed rapid, robust antidepressant properties in clinical testing.  It is being tested for relief from both depression and bipolar depression.  It is interesting to note that this drug is already in use for motion sickness relief.  If it ends up working then you can go boating without puking or being sad.  

Research for drugs that can effectively treat bipolar disorder continues.  It is exciting to note they are finding chemicals that work much faster than what we are used to, showing effects in hours instead of days or weeks.  It is also promising that some of these medications are already approved and in use for other treatment purposes. 

The understanding of bipolar mood mechanisms is increasing. While promising solutions are being discovered it can be disappointing at how long it takes for them to get studied and approved for use.  However, we should be grateful for what we already have and hopeful that science will make enhanced meds that work even better.


Do you know of other medications being studied for bipolar treatment? 

ALERT - Meds Change

I'm making my first medication adjustment for my bipolar in over a year.  I'm reducing the Abilify I take by 50 percent from 30 mg/day to 15 mg/day in the evening.  We'll see soon how this works out, stay tuned.

Abilify was prescribed for my depression - specifically, it is being used as an add-on treatment for treatment resistant depression when an antidepressant alone is inadequate.  The exact way Abilify (or any other psychiatric medication for that matter) works is unknown. It is thought that it may work by affecting the activity of some key brain neurotransmitters — adjusting dopamine, instead of completely blocking it, and adjusting serotonin.  Okay, whatever.

I reported to my psychiatrist last Friday that some depression symptoms were not acceptable.  I was having too much difficulty getting out of bed and starting my day.  She said Abilify can sometimes make people groggy and get the "stuckness" feeling.

So, we decided reducing the Abilify was worth trying.  I was skeptical at first since Abilify was the last drug I added to my medication regime back in October 2010.  It was added at that time to curb an oncoming depression episode.  I do remember it helping some at the time.

With the current adjustment my new medication cocktail is: Morning - 450 mg Wellbutrin, 60 mg Cymbalta; Evening - 15 mg Abilify, 300 mg Lamictal, and 60 mg Cymbalta.  I also take a multivitamin and 300 mg of omega 3 from a fish oil capsule.  I'm glad the fish oil is in a capsule because it tastes pretty nasty.  Is this stuff the extract of fish guts or what?

Here's a mosaic of my current medication cocktail. ==>  ==>  That's all for now.  Join me next time for a look at bipolar disorder and stress!