By Joe Kraynak
Several years ago, when my wife was recovering from a major manic episode, she turned over the task of paying our bills and managing the checkbook to me.
We were just looking for ways I could help, and that was an easy one. The other day, however, I came across an article by Ginnie Graham published on the Tulsa World website entitled “Bill-paying program helps mentally ill avoid becoming homeless,” and it made me realize that missed payments could lead to major problems for those with bipolar who don’t have someone who can take on that task, especially during a major mood episode or during recovery.
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By Joe Kraynak
My wife and I and one of our neighbor friends spent part of our weekend in Lafayette, Indiana training to become NAMI (National Alliance on Mental Illness) support group facilitators. We’re planning to start a support group in our town, Crawfordsville, Indiana later this spring and offer a Family-to-Family course in the fall.
I’ve been to several NAMI support group meetings in Lafayette (and Indianapolis when we lived there), and I’ve found them to be very helpful. Even when everything is going well in my family and I don’t really need the support, spending time with others who’ve struggled with mental illness in their families and having an opportunity to help someone by sharing the knowledge I’ve acquired over the years feels great.
The meetings always start and end on time, and the facilitators have been very good about giving everyone a chance to speak and not allowing any attendee to monopolize the meeting.
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By Candida Fink, MD
Maggie asks…
I’ve messed up my meds by going cold turkey due to difficulties with insurance and lack of funds. Now I have to wait for the mail order prescription and I have not had any lithium for a month. This week I started noticing some of my early signs of my hypomania returning. Tonight, I’m not sleeping.
I don’t have a psychiatrist right now since my insurance wouldn’t cover his $300 office visits. I’ve just started with a new primary MD.
What are my options until I get the meds and get them to a therapeutic level? I really want to sleep! I start struggling with anxiety, agitation, and irritability that can escalate to rage. I’m more than a little nervous at this stage. Can you advise?
Dr. Fink answers…
Your best option at this point may be to contact your primary care physician and explain your situation. Your doctor may be able to provide you with samples or a short-term prescription you can have filled at your local pharmacy to carry you through until your mail-order prescription arrives along with something for the short term to help you sleep.
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By Joe Kraynak
I always thought of recovery from bipolar disorder as a return to the BB (before bipolar) era, but as Class 10 of NAMI’s Family-to-Family course points out, recovery doesn’t necessarily mean going back to the “good old days.” It’s often healthier to look at recovery as moving forward – a process of transformation, of becoming a new you, accepting your new reality, embracing fresh dreams, and drawing up new plans. This seems to be true both for the person with bipolar disorder and his or her loved ones.
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By Bipolar Beat
In Bipolar Disorder For Dummies, we point out that as part of the initial work up for bipolar disorder you really should have a complete physical first to rule out any potential medical issues. Other possible diagnoses that may be considered by your doctor include the following:
- Thyroid malfunction
- Hormone imbalances
- Diabetes
- Mononucleosis
- Chronic Fatigue Syndrome (CFS)
- Lupus
- Cancer
- Cushing’s Syndrome
- Hepatitis
- HIV/AIDS
- Rheumatoid arthritis
- Medication or other substances that could have triggered symptoms
Sometimes we wonder whether doctors, including psychiatrists, follow the proper protocol in diagnosing bipolar disorder. Before diagnosing you and prescribing any medication, did your doctor perform a physical exam or refer you to an internist/specialist and/or order various tests to rule out medical issues that may have been causing symptoms of mania or depression?
What was the diagnostic process like for you?
Doctor image available from Shutterstock.
By Candida Fink, MD
Maggie asks…
My 21-year-old was diagnosed with Bipolar I after an extreme manic episode (he was hospitalized). It was a long and difficult few months (awful treatment, bouncing around to different doctors, etc.) during which his mania tapered down, and then turned into a deep black depression, which he is out of now.
No one can persuade him to take medication. Now that he’s feeling normal again, he seems to think that he doesn’t need medication. So no meds, no therapy, no treatment of any kind. And I am quite sure he’s self-medicating with “other” substances. (He lives with us – me/mom, younger brother, step-father.)
Advice?
By Candida Fink, MD
I recently got a call from an aging family member who has suffered with bipolar disorder, untreated for most of his life. He explained to me about the police cars that had “surrounded” his home and were “monitoring” him, but really were trying to harm him because they were involved in a “conspiracy with the gangsters who live down the street.”
I sighed. This was just another in a long line of these kinds of episodes, and I was pretty sure it would resolve on its own with my relative hunkering down in his house for a while until he was sure the police had gone away.
But then I decided to go see him as soon as I could, because he just turned 80 and I began to wonder if I should be worried that in addition to his bipolar disorder he might not be showing some signs of dementia. I wasn’t sure about the overlap between bipolar and dementia. We know from studies that people with bipolar disorder often have cognitive problems – memory, executive function, and other thinking problems. But does this put them at higher risk for memory problems in old age?
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By Joe Kraynak
I’m currently co-facilitating a NAMI Family-to-Family course. Class 6 is all about medications and includes a very important section on medication adherence. In the class, we discussed the various reasons, many of which are valid, that people with brain disorders stop taking their medications.
Atypical antipsychotics, for example, have a nasty reputation for causing significant weight gain. Many psychotropic medications have negative sexual side effects, including diminished libido and an inability to climax. Some people, especially those who have experienced hypomania feel as though the medications flat line them – as we say in Bipolar Disorder For Dummies, “Normal is boring.”
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By Joe Kraynak
Just posted three new bipolar stories on our Bipolar Blog. I encourage you to check them out and post comments, especially on Rachel’s story. Sounds like she could really use some support and suggestions.
Also, if you have an intimate relationship with someone who has bipolar disorder, I suggest that you read “Dealing with a Lack of Intimacy,” which provides a unique perspective on this topic.
A list of stories is posted on the Bipolar Stories page near the middle. On the right, stories are listed in alphabetical order.
Photo by Sugarpond, available under a Creative Commons attribution license.
