Tag Archives: bipolar disorder

When your so good at hiding your bipolar symptoms, you even hide them from yourself

I was diagnosed in my mid-20s. I’ve at least grown considerably since then. One thing I’ve grown in but have not yet mastered, is self-awareness. Probably every therapist I’ve been to, and I’ve been to many, have told me that I am not self-aware.

I’ve never been a devil-may-care kind of person. I worked incredibly hard to get into university, at university (I played hard too), and during my time climbing the corporate ladder. I’ve been described by various people throughout my life with the following terms: perfectionist, hard working, smart, diligent, trustworthy, friendly, respectful etc. Ie, not someone who says skrewit and does something irresponsible because they want to. I had to be all these things. I had to work my ass off, because I know I had no safety net. I knew I’d have to pave my on way. And I did, at the cost of my own sanity.

Because while I was all of these things, I had a dark side too. Everyone has a dark side, but when you have bipolar disorder it’s even darker. I smoked and started drinking at 15. I think I wrote my first poem about death at 14, because that was the first time I wanted to kill myself. Everywhere I turned I tried to talk to grown-ups about what I was feeling, but I couldn’t, I didn’t know how. No one saw the signs. No one was LISTENING. No one saw me crying myself to sleep every night. Because I learned to put on that smile. I wasn’t even pretending that everything was okay, it WAS okay.

Fast forward to adulthood, diagnoses, and my teenage years finally making sense. I’ve been in psychiatric clinics three times. Twice I did the whole 3 week full programme. Different clinics, different doctors. And here’s the crux:

  • Week 1: Hang around kind of disinterested, attend groups, make intellectual arguments, not sure why I’m even there, tell the doc I’m wasting everyone’s time. Another patient even looked at me and said perplexed “Why are you here, you look so HAPPY?” My answer? A smile.
  • Week 2: Cry. Whether it is at a group session, dining room, with a doctor or getting my meds, I cry. I can’t stop. I cry in the shower and I cry myself to sleep. Whether or not you give me drugs, I cry and I can’t stop crying. I don’t want to see anyone I know either. I don’t want to see anyone, actually. I write letters to my inner child. I feel like I’m physically dying from the pain I feel on the inside.
  • Week 3: The crying lessens and stops. I feel like a load has been lifted. My meds start working. I start sitting outside and talking shit with the smokers. I laugh with everyone about my crying marathon.

And this has twice been my unplanned process. Why? Because I am not self-aware. I do not see my signs, or I think that it’s not THAT bad. I put on my smile and I suppress everything that I know my world can’t handle. Everything I CAN’T feel, because my little card house will then fall apart, again. So I get smashed, self-harm, listen to music I know is actually triggering, and try to drink and cut out my anger. Because I don’t know how to exernalise it.

Here is the point of this whole thing: Why do we internalise, and why do we put on our happy masks every day so that it becomes so natural we can’t take it off? For the ones we love. Because we know they want to understand but they can’t. And they want to be supportive but even those who understand the full impact, don’t really. In my case, when I get criticised like again today I want to yell: “It’s because I’m BIPOLAR, asshole! And you know that.” But I just smile, make a little joke, and walk away.

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When you want to self-harm but you can’t

First, if there is anyone who follows this blog, I don’t have the parasite that makes you sleep like my mom thought. So maybe I’m just still tired because 2017 was a pretty fucked up year and I didn’t get much holiday.

Trigger warning obviously – see heading

Here’s the problem it is 23:30 and I am enraged. Seriously explosively ‘like urbanol does anything’ enraged. A few rage-worthy things happened today, but it really ended with a boy. Doesn’t it always? First time in like 2 years I put myself out there, btw, and though he seemed interested for weeks now suddenly he doesn’t and is moving 3 hours away to a shitty remote place anyway.

So I’m raging. And when I rage I cut, because I don’t yell or punch or give another bitch a piece of my mind. No. I take it out on myself. Now the funny part is that I have absolutely NOTHING to cut myself with. No a single blade or proper kitchen knife, not a decent razor or sharp scissors. Fucking NOTHING. Shows you how long ago I raged. At one stage there was this debate by my healthcare professionals about whether I have borderline personality disorder or not. One psychiatrist and one psychologist said I did, one of each said I didn’t. Maybe I do if have the capacity to feel the way I do. I’m also crying because I would tell my very good friend S all of this and she’d listen and not judge, but oh wait, shes’s dead, so can’t do that.

Less than a week ago my psych told me that I’m absolutely glowing. I keep feeling like something is wrong just under the surface. My mother needs to be convinced that I have a physical illness. I want to cut myself for the first time in MONTHS, but can’t. I should take some seroquel but I am working hard from tomorrow, I can’t afford that fuzzy brain. Oh and I am dizzy ALL THE TIME, Venlor or Wellbutrin side-effect?

I found myself beating my chest earlier with a fist. It didn’t hurt but it was a feeling of trying to resuscitate myself. Only we can’t do that, can we?

Am I physically Ill or ‘just’ bipolar

The thing about these mental illnesses, is that one can never really be sure if a symptom is from physical illness, mental illness or side-effects from medication.

I’ve been struggling with fatigue recently. Well, basically I’ve had sleep problems my whole life, but recently I want to sleep every second I get. I don’t think it’s from side-effects, since my doses are lower than before. I did all my lithium tests recently and those are fine. My mother is convinced I have some illness which I went to test for today. Personally, I think it’s ‘just’ a symptom of my bipolar disorder, since fatigue can be a major symptom.

I”m not depressed though, so it’s not the heaviness of not wanting to get out of bed. It like to the bone tired tired. According to this article explains physical and psychological fatigue quite well I think. To be honest, writing this post is a little difficult as I am distracted and my brain feels empty.

On the one hand I kind of hope that there is something physical to my tiredness, because that would make it  ‘real’ to the people around me. Personally, I’m sure it’s just bipolar, but people don’t understand how a mental illness can give you physical symptoms. Especially when you are not exceptionally depressed or anxious. I’m kind of confused by the whole thing. I should get the test results for the other thing before the end of the week.

Can anyone relate to my absolute tiredness seemingly for no reason?

Post-festive season bipolar coping feedback

Feliz Navidad and a happy, shiny new 2018 to all. I hope you survived

As you probably know yourself and have read in every single bipolar article or heard in every support group, the holidays can be a bitch for the mentally unstable. There are of course a number of reasons: breaking routine, the stress of travel and getting kids and spouses ready if you have those. Organising kennels and a hundred other things that make your head want to explode, and then you don’t even feel festive anymore. And of course, there are those who can’t celebrate with family, or don’t have any.

Unfortunately I cannot relate to the latter so I won’t pretend to know what I’m talking about, but I can probably teach everyone about dealing with a 40 person family. Yes, 40 people. We know we are blessed but it becomes terribly overwhelming. So what I realised was that I needed to create some kind of ‘safe space’ for myself. Instead of sleeping in the house like most of the others, I pitched my little single person tent outside. We were so hot it was unbelievable, but every time I felt overwhelmed or offended or anxious, I went to sit in my little sauna until I felt ready for all the people again. I did the same when I went away with my parents, sister and her fiance. I went reasonably well until my sister smacked me with a backhanded sarcastic remark which, since I am overly sensitive, ruined my day. But I had my room, my own room, and I could close my door and create a safe haven for myself with books, blankets, chocolates and drinks. I could just walk away and go decompress.

I know this sounds incredibly simple, but I’m telling you to me, it was a revelation. Probably because I was never in the position to insist my own space, with so many people, but it really made all the difference. So this was the one thing I learned to survive the holidays. The second was to stick to whatever your poison is for anxiety, and even if you don’t feel anxious, take as prescribed. My doctor gave me Urbanol, one in the morning and one at night, and although I would have MUCH preferred Rivotril or Alzam (but family history of addiction, thanks dad), Urbanol seems to just take the edge off a little bit and make me act like a human being. Other obvious things that I should know but still got wrong was don’t get trashed, stay hydrated (Lithium) and  remember to fill your script BEFORE you go on holiday.

I’m clearly such a slow learner when it comes to this and would love to hear what you do/don’t do to cope with the festive season.

Flipping the Bipolar switch

I don’t normally post two days in a row, but I wanted to have a little rant on Facebook and realised it would be so pointless because no one would get the intensity of what I’ve been going through today. And how quickly the switch can be flipped from a ‘slightly depressed’ to ‘crazed rage’. Okay, I didn’t quite reach crazed rage; or I did, but it was not uncontrollable, so it didn’t seem that way.

I am busy with these ridiculous little projects as I think I mentioned, where my deadlines are insane and the pay is crap. I think the employer person hasn’t been able to get anyone else desperate enough to help her, so she hounds me at all hours of the day and night. Last night at about 20:00 she begged me to do a quick thing before 5am the next morning. So, working better at night anyway, I finished around 2am and was laying awake until about 3. Needless to say I snoozed my alarm until about 11, 12, and then had to fly up to start with the other project I have due in about 36 hours. And from the moment I opened my eyes everything just went wrong.

I have 0 cash, but I have money in a Paypal account. However, my country in general and it’s banks are SHIT, and turns out connecting my credit card to Paypal is theoretically easy, if my bank stopped telling me I was entering the wrong card number. Which it’s NOT. So because of this I am trying to feed my cats cheaper food and they are refusing to eat. I’m adding tuna to entice them and now my room, that has no ventilation, smells like fish, which I HATE.  I know this sounds minor, but when you don’t have time or money or energy, it starts grating. Then I realised that my dog’s whole food bowel, as well as the cat bowels, were FULL of ants. And as I look around, I realise that they are EVERYWHERE! And because of the animals I can’t use poison. So I’m drowning ants and fishing soggy pet food covered in ants out of the drain and I am so grossed out I feel like, I don’t know, my hands are going to fall off or something and I don’t know how to get rid of them and I feel like my head is going to explode and I’m going to throw something against the wall and burst into tears and slip into a puddle and cry while stomping on ants and screaming while washing my hands 10 times.

And I think this is kind of the part people don’t understand. Yes, there were a couple of things leading up to it, and someone else might also get mad and drown the ants or whatever. But when I say it feels like my head is going to explode, I literally mean it. The combination or rage and frustration and anxiety and feeling out of control is so intense and overwhelming, that it literally feels like I will spontaneously combust. It’s like my brain is swelling and my whole head is getting bigger and I’m waiting for it to pop open and for brains to splash all over the walls. I was freaking the fuck out, to be honest. I won’t just diagnose myself with a co-morbid something and maybe it’s also a bipolar thing, but I can’t stand my hands and feet getting dirty. So fishing soggy pellets covered in ants out of the sink really almost pushed me too far. As in I felt like fainting too far.

I packed my things and my dog, left everything just the way it was, and went to work at my mom’s house (who’s on vacation). My sister lives there too and she still wanted to give excuses for why I couldn’t come work there, but I had already positioned myself in the spare room. Finally I could focus and get stuff done. I only got back a little while ago and emptied a bottle of baby powder where I suspect the nests are, because apparently that works. I’m feeling calmer now. I still have so much work to do, but I think it’s shower and sleep for me. Nothing that can’t wait until tomorrow. I think this whole thing also taught me the lesson (again) about sticking to my sleep schedule. I think I still got enough hours, but it wasn’t exactly uninterrupted.

It is so difficult to describe to other people what I felt like on the inside today. Had I lost control I might have pulled my hair out or something. And this was AFTER I took Urbanol. It also shows that we don’t necessarily have those textbook episodes of 4 days hypomania/mania, months of depression, or whatever. I’ve had a psychiatrist tell me that rapid cycling isn’t real, but I think I disagree, if one just compares today with yesterday. And of course there were triggers, my switch wasn’t just flipped. I think the big difference comes in that if a non-bipolar person went through the exact same day as I did, they probably wouldn’t have felt like they were losing their minds. Or, maybe just a little bit and not the literal ‘my head is going to explode’ thing.

*Especially if you’re bipolar (but even if you’re not) I’d like to know if/how you agree or disagree with me. And if you’ve gone through these same weird combustion feelings, let me know. Would be great to know that I’m not the only one.*

When bipolar is keeping you just a little down

I try to really look at things objectively when I feel down-ish. It’s the end of the year, I am still dreaming of being on vacation, even if it’s just at home, and I am hating the work I’m currently doing. The deadlines are almost impossible, the pay is ridiculously low, the work feels kind of unethical and the woman I for is extremely temperamental and sometimes blames me for things I didn’t do wrong. But I have to do it because financially I’m a bit screwed.

It’s been a tough year; recovering from suicide attempt, quitting my job, moving back home, not really having a set job, deaths, family conflicts, moving, moving again, and moving again etc. In a nutshell. There have also been many marvellous moments, like my sister getting engaged and me getting to be part of the plans, seeing my friends on this side of the world often. Spending time with my grandparents. Getting a doggy. All magical. All special. Even though I really don’t like Christmas I look forward to the event of the whole family being together.

Here’s the thing, I’ve been feeling just a smidgen under then normal line. I’ve started taking urbanol on a more regular basis. I still try not to take it unless I really need to. Over the weekend, I just stayed in bed, not really doing anything and not really sleeping until 16:00. Twice! I am fine enough to go out and enjoy it but want to go home early. I’m okay enough to hang pictures and throw things out, but not to completely unpack. I’m fine enough to do all these stupid projects, but I’m procrastinating (which I don’t often do with work). I’m fine enough to look forward to the holidays, but the thought of interacting with people is pretty exhausting. I’m generally just really exhausted. And that I blame on all the end of year things. But I can feel it in my throat, I can feel it in my head and I can feel it below my diaphragm; the slight signs of depression. The trying to ignore it, but knowing it’s there.

Some of you must also feel like this sometimes? Like you’re just below the line of normal? And it terrifies you because staying there is crap, but you also don’t know if you are going to go back to that normal line, or just keep going down, down, down….

What is Bipolar Disorder? – The dark side of hypomania updated

Okay this is not really an update, more like a repost with a foreword. I’ve been going through my blog and according to WordPress stats, this is quite a popular post. I wrote it roughly four years ago; a year after I was diagnosed. This month marks 5 years of ‘being’ bipolar, so you can’t help but look back and think. Especially after the spectacularly difficult year 2017 that I’ve somehow managed to survive. Everything I wrote in this post still holds true: people still don’t understand dysphoric hypomania, which is actually very common and the episode I talk about here, was still the worse in my life. I am a lot smarter and wiser than I was 5 years ago, so feel free to ask questions. The post follows below, but if for some reason you want to look at the original, you can find it here. Enjoy!

 

In my previous post I explored what it feels like to have depression. As we know, that is only one side of Bipolar Disorder. What makes this illness different from ‘regular’ unipolar depression is that you have the lows and the highs.

As with my previous post, I am not going to list the typical symptoms of hypomania and mania; you can find more information about that here. A note on the two though: Mania and hypomania are not the same thing. Even with all the reading that I’ve done, I sill haven’t found a proper comparison between the two. It is generally said that hypomania is a less severe form of mania. Mania is usually experienced as an episode that lasts for a few days or weeks. As far as I know it does not last as long as a hypomanic episode. Hallucinations, delusions, psychosis and severe paranoia  are experienced during manic episodes. This is not the case with hypomania, although I know from personal experience that paranoia and delusional thinking should not be excluded when talking about hypomania (or I might just be more manic than I realise…). Mania greatly impairs the sufferer’s functioning up to a point where hospitalisation is usually necessary. People who experience mania are classified as Bipolar I, whereas people who experience hypomania are classified as Bipolar II. Suffering from Bipolar I is probably much worse than Bipolar II, but don’t think that if you ‘only’ have bipolar II, it is not serious.

My diagnosis is Bipolar II, which is why will only share my experiences of hypomania and not go into further detail about mania. Various levels of manic states are, in my opinion, largely misunderstood and the part of the illness that intrigue people and lead to their misconceptions. When someone joking refers to themselves as Bipolar because they experience a couple of mood swings, or feel really happy, I have to work very hard to keep myself from flying into a state of extreme rage. That is when I have to remind myself that people are just uninformed and ignorant, and that my talking about it is part of the solution. As the title says, this post describes the dark side of hypomania. Most people think that hypomania is flying on a cloud of endless euphoric energy and creativity. A fun feeling. Even though that is often the shape that hypomania takes (and I’ll cover that in my next post), there is a dark side to hypomania that in my opinion does not get nearly enough exposure.

Dysphoric hypomania (mixed state)

My process of being diagnosed with Bipolar Disorder started 15 months ago. I had been on antidepressants for about a year before that. I wasn’t depressed anymore, but I was something that wasn’t normal. Turns out being only on antidepressants is very dangerous if you have Bipolar Disorder. I didn’t realise it at the time, since I couldn’t recognise my thoughts and behaviour as faulty. When I look back now I don’t know how I didn’t realise earlier that something was very wrong. I had been going through a very stressful time for about a year, and I thought that what was going on with me was severe anxiety. I didn’t feel the happy, ecstatic states mostly described as hypomania. Not then. What I did feel was a sense of being stuck inside myself. It felt like I had ants crawling under my skin and that I had to keep moving. I was usually tapping my foot or standing up when everyone was sitting down. At home I put my headphones in and I would dance non-stop for hours, giving myself over to the music completely. Colours looked brighter, sounds were louder. I couldn’t sleep#. I only ate because I had to (even though I love food) and most of the time I would just feel nauseous when I ate anyway. It felt like the world was closing in on me.  I needed to get out, but  there was nothing physical to get out of. I still had a painful feeling on my chest, like when I was depressed, but I was pumped up. Frantic. My thoughts were obsessive. I obsessed over people. I drove people away. I was completely irrational and often delusional in my thinking. It felt like everyone was against me, even the people in my life who love me the most. The intensity of my emotions were almost unbearable, and I didn’t understand how people can experience something with me and not have the same reaction. I was unreasonable. I was aggressive and frustrated all the time. I had fantasies about bashing annoying people’s heads against walls. I was angry about everything all the time.

I think that my behaviour resulting from all this was a kind of attempt to get away from myself. Describing my feelings are not embarrassing to me. I felt things that I had no control over. My behaviour because of these feelings I do still feel very embarrassed about. I have to share some of the things I did to let this information make sense, but I do want to say that I deeply regret most of it. I spent much more money that I had and made debt that I am still struggling to pay off. I almost bought a flat! It was only thanks to a small admin error that the deal thankfully didn’t go through. It would have completely bankrupted me. I got traffic fines in the double digits. I drove drunk, late at night and to secluded places. When I wasn’t home, I was drinking. I took whatever pills I could find, just to try to shut down my head. I would go jogging in the icy pouring rain (and I don’t jog!). I sent out messages and emails and didn’t think about the consequences. There were things that I said and did that I had no control over. The obsessions and compulsions took over my mind. Once I established a routine or pattern, I couldn’t break it. Eg, if I got into a habit of texting one person every day and I realised that, I couldn’t break the habit, I just couldn’t. Even if I had nothing to say. Come to think of it, it might actually be what real OCD feels like (not the kind where people think you have to arrange your books alphabetically or clean a lot, the actual misunderstood disease). Even though I’m not promiscuous and not one to kiss and tell, my sex drive definitely went haywire. Theoretically it’s a small miracle that I didn’t sleep around and contract a disease or something. All of these crazy thoughts, feelings and behaviour eventually led to very bad physical and emotional self-harm.

This was an awful time in my life. I now know that it wasn’t my first hypomanic episode, but it was certainly my worse so far and landed me in the hospital. I really is only by the grace of God that I survived it. Personally I’m not sure how I didn’t commit suicide. This state of mind went on for months. I was completely lost in it. I look back with such relief and gratitude. Now that I look back, I know that I was severely ill and that has made it easier for me. I don’t blame it all on myself anymore.

Learn more about dysphoria/mixed states.

Can you better explain the difference between mania and hypomania? Have you or anyone you know experienced dysphoric hypomania? How has it affected you as a sufferer or a supporter?

‘The Diagnosis’ and other people

*Trigger alert: This post is not about, but refers to suicide*

Last week, a friend of my mom’s showed up at her house, distraught. The friend’s one child, who had been ‘going through something’ had been diagnosed with bipolar disorder.  And thanks to me not shutting up about being bipolar, these lovely, normal people now have other lovely, normal people to talk to. So I made myself available for wine and chats, but will now wait for an invitation. It is an overwhelming business, after all.

It has made me think of what I went through with my own diagnosis and what I would tell this young(er) person should they ask me ‘what the hell now?!’, apart from ‘Seroquel will make you fat’. I realised that what stung the most when I was diagnosed, was how other people reacted. I didn’t have much support because I was far away from home, and my family didn’t really understand. Before my first mental hospital stay, I somehow got myself into the ER with nothing but a few cut-marks, cigarette burns and mild benzo-intoxication, because I was desperate and thought I was literally going BONKERS. I knew depression by then, but nothing of this whirlwind of constant, irrational thoughts, hyper-sexuality, people screaming in my head, inability to sleep, ants crawling under my skin, severe irritability and aggression situation that I was experiencing at that moment. I even have some memory loss. For the life of me I cannot remember ANYTHING about that day apart from getting home in the evening and going on a ‘semi-psychotic’ bender situation.

What I’m saying is that there was a lead-up to my eventual diagnosis and hospitalisation. There always is. You don’t just wake up one morning feeling like the Mad Hatter. So you would imagine that people who know you relatively well, would realise that there is a change in you, and that something is wrong, and that they would lovingly guide you to get help, whether or not you have a diagnosis. Because the bitch about having a mood disorder is that because it makes your mood go weird, it changes your behaviour too. Every single bipolar blog you read will at some point tell you the same thing: If you are bipolar you WILL lose friends and alienate people, more so than stable people. And this is what I will tell this young person first: You will wake up one day, feeling good and ready to go out there and grab the day by the balls and you will realise that you have barely any friends left. This is not me feeling sorry for myself, or being dramatic or negative. It is the simple truth and every bipolar person knows this. It is a lonely road.

People bail for various reasons. I’ll put them in nice bullets:

  • ‘I just can’t deal with this drama’
  • ‘It’s always about you, this is an unequal friendship/relationship’
  • ‘Your CRAZY! I’m out’
  • ‘Sometimes you get really mean’
  • ‘Our friendship was fun, but now it’s too intense and I can’t deal’
  • ‘I can’t be associated with you’
  • ‘You’re just too demanding and clingy’
  • ‘You are so selfish and such a drama queen’

Of course, most people won’t actually give you the courtesy of telling you that they are walking away or why, but the above is why THEY think they do. Here’s why they really do:

  • They don’t want to have to deal with anything that disrupts their uncomplicated, perfect little lives.
  • You make things feel out of control, or out of their control, and they can’t deal with uncertainty.
  • You scare them. They see things in you that they see in themselves, but where you now have to embrace it, they still prefer to live in denial.
  • They can walk away and blame all their shortcomings on you, because YOU’RE the crazy one.
  • Your Crazy.
  • Sometimes you really are mean and intense and irrational and demanding and clingy.

The last one is the hardest, because while those reasons are legitimate, it’s not something you can always help. Maybe my next post will be on how to take some pressure off your relationships.

Me? I’ve hurt lots of people because there comes a time where I can’t stop myself from saying something mean, or inappropriate, or doing something stupid. After my suicide attempt my sister was furious at me, because how DARE I put the family through this trauma. My brother asked me what the hell I was thinking when I wrote my suicide letter, because it didn’t sound like me at all (which is kind of the point of the ‘why’). They didn’t get that I was pretty pissed myself seeing as how I was suppose to be dead but then wasn’t. At least they said it to my face. After each of my hospitalisations I found things out that people I cared about said behind my back that hurt a lot: I’m manipulative, looking for attention, lazy, mean, self-involved, I cannot be trusted etc. Every time people quietly withdraw or suddenly disappear. And it hurts like a bitch every time. Because I don’t understand how they can’t understand how that person, is not me. But they don’t. And they never will. Mostly not because they don’t want to, but because they just can’t.

But have heart little one. If you have a family who loves you, you already have more than most. You probably still have wonderful friends that WILL stick around no matter what, so treat them nicely. And if you feel like you have nothing and no-one, there is a whole virtual bipolar community out there who sometimes feels the same way.

*What reasons have you gotten for why people walked out of your life?*

Combating the side-effects of bipolar medication that affects your appearance

This post turned out to be a bit longer than I planned, so if you just want the advice, scroll down and read the italic bits. If you want to understand better, can relate or generally enjoy my self-deprecating humour, please continue. 

It seems that the side-effects of psychiatric medication is something that isn’t discussed enough by medical professionals. In my younger, more naive years I thought that if the doctor didn’t say anything about side-effects, it meant that there weren’t any. Until weird things started happening to my body and I eventually had to take to Google. What you learn very quickly is that everyone experiences side-effects differently, and something that I can’t possibly imagine is true, happens to you.

There are a few side-effects that are relatively common across most psychiatric meds: weight gain, serious fatigue, skin conditions, nausea, gastrointestinal issues to name a few. For some people, most if not all of these symptoms disappear after a while, but weight gain and fatigue usually lasts (especially with anti-psychotics). When I started Lithium almost exactly a year ago, my family couldn’t understand why my doctor hadn’t put me on it a long time ago. Neither could I really, until my doctor warned me about possible kidney failure, thyroid disease, blood tests, dehydration, balancing my salt intake and possible Lithium toxicity. She left out the ‘smaller, less important’ side-effects that I first thought was in my head until it became completely abnormal: hair loss and acne. Along with weight gain, these are the side-effects I want to talk about.

I guess that doctors don’t consider discussing the side-effects that affect your physical appearance as important since they don’t happen to everyone, and aren’t life threatening, but they definitely have a big impact on your already fragile and depressed self-confidence.

1. Weight gain

Of the three, this side-effect is the most common, and caused by most anti-psychotics (except Geodon), some anti-depressants, and most mood stabilisers (like Lithium) except for Lamotrigine. For more info about specific meds and weight gain, go check out Mayo clinic.

Get support

I can only tell you what worked and didn’t work for me. When I was first put on Seroquel (anti-psychotic), I picked up 8kg in a very short time. I didn’t even realise how much I’d picked up before it was too late. I tried going off Seroquel but I could feel myself slipping badly. Later I tried switching to Geodon, but it was extremely expensive and my dose was probably not high enough, so I had the most wonderful hypomanic episode followed by and epic crash that landed me in the hospital again with a new psychiatrist. I had to accept that Seroquel was here to stay. I joined a weigh-loss programme that conveniently had a branch at my offices. It took me a YEAR of mostly being hangry and wanting to cry when I walked past chocolates, but I lost 10kg. I did cheat over weekends, otherwise I would have died. So I was finally on my goal weight; not skinny, but not overweight. I should have continued with the programme but didn’t, and so picked up 5kg again. It was okay though, I had learned a lot and could monitor my eating better.

So my advice is, join some sort of weight support group where someone can help you plan meals, where people keep each other accountable, where you are forced to weigh yourself once a week, and where people keep each other motivated. You don’t have to tell your bipolar story to everyone, but at least tell the person leading the group what medication you are on and how it causes (in my case) sugar and carb cravings and makes you feel like you are ALWAYS hungry. And STICK with it once you’ve reached your goal weight to stay there. 

Consider a possible medical intervention

And NO, I am not talking about diet pills. That shit is bad for you. I am talking about the anti-depressant Wellbutrin. Wellbutrin is also sold as Zyban and helps people to quit smoking. It is also known for making people lose weight. Lithium causes weight gain too, but I started Wellbutrin at the same time and since then I have lost, and kept off, about 6kg in a relatively short time without consciously trying. It is only now that I have lost the weight and am back on my goal weight, that I am making an effort to keep it off. I’ve experienced it as pretty miraculous. Word of warning though, Wellburin doesn’t work for everyone. It either works or it doesn’t. It is also known to bring on (hypo)mania, which is why I am currently only on 150mg and not 300mg. It is also pretty expensive and not all health insurances cover it. Unfortunately there also isn’t a generic at the moment. So seriously discuss it with your doctor first, especially if your are taking a combination of other stuff. To me and others I know it’s been well worth it.

Exercise

I put it here because I feel I have to, not because I practise what I preach. Personally I am not a fan and apart from occasionally walking my dog a block or 2, I haven’t exercised in months. BUT it does help with weigh-loss and general health etc. There is loads of info out there if this is your thing. Just remember weight-loss is more diet than exercise and just because you exercise doesn’t mean you can eat what you want if you want to lose weight.

2. Acne 

I had problems with my skin all through my younger years, so I was pretty happy to grow up and have that stop, mostly. And then it just flared up like crazy! Especially along my jaw line where I never use to get spots before. I couldn’t understand it. I’d been on birth control to help me with moods and hormones for many years, but even on that my skin looked like crap. So I changed brands, and changed again. It was only after a few months that I looked at Lithium side-effects again, and there it was. Acne.

I didn’t want to go on antibiotics unnecessarily and there was NO WAY I was going on Accutane. Not that I can now that I have a mental illness diagnosis anyway, but that shit is BAD. Thinking about it, no medication side-effects has ever been as bad as that. So anyway, no matter how desperate you are, don’t use Accutane.

Once I moved back to my sleepy town, my mom suggested that I go for a chemical peel. She did it when she was in her 30s and swears that’s why she looks younger than all her friends who are younger than her, and it is much cheaper here than in the city. Problem was I really hate facials. The minute they put a warm cloth or steam machine over your face I  feel like I’m drowning. I was also scared that it was going to look like someone threw acid in my face. But desperate times… I wasn’t going out because even thick make-up couldn’t cover up how hideous I looked. Something had to be done.

Luckily the girl that now does my chemical peels is really sweet and professional and the whole process is not at all what I expected. They start you off with a very light peel and increase the intensity as your face gets more use to it. She also told me to switch to dermatologically recommended wash and cream with no perfumes or funny things as my skin is crazy dry. And it’s working! I’ve gone for 3 peals every 4 weeks and I look like myself again! I’ve always been vigilant about my skin routine, but now I’m SUPER vigilant and will continue to go for the treatments as long as I can afford it. The place I go to uses Placecol products, but I’m sure there are other good products out there too.

My doctor also lowered my Lithium dose a bit because my blood levels were too high, and that probably helped too.

3. Hair loss

I’m sure you could gather that the acne situation was really bad. And it was horrible. But the hair loss! Nothing could have prepared me for that.

I’ve had a beautiful, glossy, wavy mane of hair for the largest part of my life. I love my hair. It has been every colour and style under the sun (except blue and pink), but now that I qualify as an adult, I’ve kept it pretty long. I don’t have to style or use product or even blow dry my hair, and I barely comb or was it. I LOVE my hair.

Obviously long hair falls out a lot, so I’m use to that, but then I started noticing that the hairballs from my brush and the shower were getting larger and larger. I thought it was all in my head at first (no pun intended), but it got worse and worse. Making a ponytail I could actually feel a marked difference. It made no sense, this sudden hair loss problem. And then I went back to the Lithium booklet. It was the only thing that made sense and it pissed me off severely. The worse part is, there isn’t really anything you can do about it, except lower you Lithium dose and cross your fingers that it stops.

And luckily it did. Surprisingly, it also started growing back! The only stupid thing now is that I have these little Alfalfa hairs sticking up all over my head, and what my hairdresser recently referred to as ‘bum fluff’ (ridiculous little corkscrew curls) that are frizzing on either side of my forehead.

I haven’t been to hairdresser in almost a year, because I didn’t want to explain why it looks like a child got to my hair with a razor, but then I made friends with a friend of my brother’s who I didn’t mind telling the bipolar Lithium hair loss story to. Once you’ve gotten your hair to grow back, there isn’t much you can do about it, but she basically recommends:

  • Don’t touch your hair at all, because the baby hair is fine and by trying to get it flat or uncurled you just pull the hair out again.
  • After you’ve blow dried your hair, you can set it with cold air (didn’t last long for me).
  • Don’t straighten the baby hair (in my case my bum fluff) because the flat iron will also damage it and pull it out.

Someone also recommended that I use horse shampoo, but I haven’t found any yet, and I have also started using folic acid but not long enough to know if it makes any difference.

 

I hope that there is someone somewhere who has looked long and hard for some answers on how to just look like yourself again and who will find them here. If you have any other tips on psych med weight, acne and hair loss PLEASE share. The struggle is real people and I don’t want to have to choose between looking good and feeling good, because that’s just not fair!

*Please discuss any and all medication adjustments with your doctor. Don’t be stupid and make things worse for yourself. NEVER just stop your meds cold turkey on your own. You think taking meds have bad side-effects? You don’t want to go through withdrawal!

Challenging stereotypes of mental illnesses – when to let it slide

I am very open about the fact that I have bipolar disorder. I was sure that revealing this to most people would help them understand me and my situation better. Unfortunately, that is not always true. I am usually also the first one to make a noise if someone describes a mental illness incorrectly, uses stereotypes or make fun of mental illness. Turns out people also don’t really like to be corrected, or being told their joke is not funny at all but actually ableist. Most of the time I don’t really care if people get pissed with me; it is my duty to educate; but occasionally it can cause trouble for me. I’ve had to learn the hard way that like most things in life, there is a time and a place. And WORK is not the right place.

I have a client who’s husband is a psychiatrist. The other day we chatted about her life. her family, how her husband is always on call, and naturally about psychiatric patients. She tells me, “Yes, some people are really incredibly depressed they can’t do anything! But you know who’s the worse? The bipolar patients! They seem to be constantly changing their minds, calling for a doctor and then telling him not to come.” Or something like that. Honestly, I wasn’t really listening anymore, because my mind was racing back and forth, ‘do I tell her, don’t I tell her?’ You probably won’t understand what a victory it was for me to say nothing, but it was. ‘Oh really? How interesting!’ was basically my response, while thinking ‘I wish I could tell you the truth and see how you react.’ It just proves again how ridiculous it is when people say things like ‘You have depression?! But you look so happy!’ (I actually got that while IN A PSYCHIATRIC CLINIC) Like my diagnosis is stuck to my forehead. So I did not correct my client. She pays money for my services and so I kept my mouth shut, even though I was ready to give her a half hour lecture.

People are ignorant and often not interested to learn, but I guess before I was diagnosed I didn’t know much about mental illness either because it just wasn’t part of my life. Not everyone is trying to be an offensive idiot, and sometimes letting it slide, even if it is hard, is the right thing to do.