National Bipolar Awareness Day! New Pills Day!

Today is National Bipolar Awareness Day and to celebrate I’ll be starting yet another round of mood balancing drugs.

For the past nine months I’ve been taking increasing doses of Lithium, the bipolar wonder drug that I believed would, once the right dose was set, stabilise my moods.  I assumed that bipolar sufferers weren’t immediately given Lithium because of the long term effects of the drug – thyroid and kidney problems often requiring additional supporting drugs after several years of Lithium treatment – not to mention the cost to the NHS of regular Lithium level, kidney and thyroid function blood tests.  Whatever the reasons, what I wasn’t aware of were the side effects that I, on reaching only the second highest, ineffectual dose, would experience, tremors and swelling mirroring the symptoms of Lithium toxicity.

A writer and photographer I need steady hands so the tremors quite simply weren’t a worthwhile pay off for the (limited) positive effects of the medication. And right there is what makes the treatment of Bipolar just as awful a thing as the illness itself.

Throughout my treatment, first for Post-Natal Depression then for Major Depressive Disorder then for Bipolar Affective Disorder and Social Anxiety, I have been prescribed a succession of anti-depressants; Citalopram, Duloxetine, Paroxetine, Amitriptyline, Pregabalin, and then later, mood stabilisers; Lamotrigine, Quetiapine, Lithium, I take Diazepam when I feel panicked or anxious.  Some have been taken alone, others in combination with each other.  Sometimes it’s one pill a day, other times it’s four, sometimes they have to be taken in the morning, sometimes last thing at night – the Lithium, for example, has to be taken at the exact same time every evening, the pills are huge; round and dry, sticking to the roof of your mouth if you don’t poke them right down your throat, gagging on a sharp-nailed index finger.


I wonder what the black market value is for this little lot (yes I know you’re supposed to chuck them)

For almost five years I have consumed an endless succession of pills which have made me tired or unable to sleep (often at once), too high or too low, which have made my skin itch or given me acne, swollen my feet, made me confused and forgetful, left me too dopey to drive.  I research every new drug and find that some have high values in prisons – Quetiapine is known as ‘Baby Heroin’ – or that the drugs have their own special ‘syndromes’ (such as the Lithium Tremors I’m currently experiencing) or the skin rotting illnesses of Lamotrigine. I read the pamphlets, which invariably warn me that I could become depressed or suicidal while taking this particular drug, always a reassuring thought for a depressive.

This week I’ll start to taper off my Lithium dosage, breaking the horrid powdery pills in half, while beginning a new round of Lamotrigine, one pill at a time until I’m taking four a day.

Last time I was prescribed Lamotrigine it worked well, until I developed a burning rash, a symptom of one of the handful of deadly side effects Lamotrigine can produce.  I spent the Christmas period in A&E on an antibiotic drip to treat blood poisoning, my in-laws drove a freshly cooked turkey down the M6 from Merseyside so the kids still got a proper dinner.  I’ve since been informed that the infection and the drug weren’t related – it’s a good sign that this could be the one that works, but it doesn’t change the fact that Lamotrigine, with all its side effects, scares me.

When I was first diagnosed with Bipolar I had one major problem: I was tired.  Now I’m aware that all the things I had come to accept as ‘one of those things’ are a problem, now I know that my quality of life could be improved, I want to be successfully treated.  But at the same time I can’t help but feel I was perhaps better off before, when I didn’t have to face the disappointment of another failed treatment, when I didn’t have to wonder if I was ill or if it was another side effect, when I didn’t have to fight the NHS for appointments and when I didn’t have to wait three months to tell my psychiatrist that his latest prescription isn’t working when I knew after three weeks.

By the time I’m fully weaned on to the Lamotrigine and whichever anti-anxiety or anti-depressant drug is chosen to work alongside it, it’ll be five years since I took that first low dose Citalopram.  It’s starting to feel as though the pills do more harm than they do good, I wonder if the stress of never finding the right treatment, the side effects and the knowledge that I’m going to be taking handfuls of pills for the rest of my life is worse than the illness itself.

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Government Funds Mental Health in Work Service…But Should It Have To?

An estimated £4.8m is expected to be plowed in to Remploy’s mental health in work support service.

According to this report in HR Magazine  the initiative will seek to introduce work-based counselling and mental health support, provide personalised action plans, introduce the assessment of an individual’s needs and identification of coping strategies and both provide education for employers and help them to identify adjustments that can be made within the workplace or to working practices.

On the face of it this can only be a good thing, right?  It shows the government takes mental health seriously and it assists employers in coping with staff mental health problems.

But the more I think about this the less I welcome it.  I mean, for me it’s a moot point now, I’m a freelancer who only has herself to answer to (ok, clients too but generally I only have lovely clients), but in the past I can’t imagine that this interference in my working life or my employers’ businesses would have helped my case, and boy have I had a case or two.

bipolar bear would like to request a one to one.

My very last employer, not long after I was diagnosed with bipolar and severe post natal depression made me redundant, promoting a junior colleague in to my position after my contract was terminated.  This occurred a day or two after he accused me of paranoia and blamed my mental illness for my not agreeing with him in a workplace discussion.  I successfully sued for disability discrimination and although I was unable to recover the money awarded to me the fact that I was ‘right’ and he was ‘a twat’ did me just fine (though that £7k would be lovely right about now please Mr Karma).

In that situation no amount of education or support from Remploy or the government would have helped me to keep my job or to be able to work with my manager for any longer than I did.  Would an agency bustling in suggesting different ways of working and trying to ‘educate’ my boss on my mental illness have gone down wonderfully with him?  I sincerely doubt it.  And I doubt that it would be welcomed with open arms in most companies, especially right now when they’re all too busy running round like headless chickens trying not to go under in this horrid recession that has seen unemployment hit a seventeen year high.

As for the idea of introducing and adapting working strategies…again, in theory, this is a wonderful idea.  But I have beef and here it is: I don’t want to be treated differently and I sure as hell don’t want to be seen to be treated differently.  You can educate employers all you like but that doesn’t stop the office gossip and the resentment of other employees when somebody is deemed to be receiving ‘special treatment’.

Perhaps this new strategy might work for the shorter term mental health problems of stress or short term depression – though if an employee is hit by one of these two little nuggets of nutty it might suggest their workplace needs to address issues earlier up the line – but for somebody with a long term disorder; clinical depression, bipolar, OCD for example, will a twee attempt at action plans and ‘are you ok dear?’ meetings solve the potential problems faced by an employee with one of these conditions or their employer?  I doubt it.

The one brick wall I bang my head against time and time again is the lack of understanding of my condition among people, even people who know me well or who have their hearts in the right place, who see bipolar as something to be ‘snapped out of’, or who comment “oh, doesn’t everybody have bipolar these days?”.  Until the UK is able to open up communication on mental illness, something which we prefer to keep firmly under our cosy Persian kilim as much as possible, until an employee is able to feel comfortable admitting to their condition and openly discussing it with colleagues AND employers, un-judged, and until mental illness is seen as just as debilitating as a physical disability by everybody, Remploy’s attempts to improve the workplace for the mentally ill are likely to have little more effect than throwing a pebble in the Atlantic.

How Social Networking is Working For Mental Illness

This week certain events have made me realise what a powerful set of tools we, the nutters, have at our disposal in Internet social networks.

First the level of understanding I witnessed on my Twitter feed following the suicide of Wales football manager Gary Speed was truly heartening even if one did feel that a handful of tweets were more out of a morbid desire to be involved or to have said something. Equally impressive was the quick work of mental health charities, many of whom I follow, in tweeting information related to suicide and depression in an attempt to quickly dispell myths surrounding Speed’s death and to, for want of a more appropriate term, ‘cash in’, using his death as a springboard to raise awareness amongst people who perhaps had given little thought to mental illness previously.

The second thing that made me consider the strength of social networking for mental illness was an accusation made by somebody at my partner’s place of work today.

I’ll make the story short as it really isn’t the point of this post.

Around three weeks ago I began experiencing by far the worst manic episode I have had since diagnosis. My GP promptly took me off of my usual anti-depressants to tame the crazy. In the meantime however he struggled to get in contact with my psychiatrist for a new, more effective prescription.

Yesterday on learning that there was still no progress after a week’s hard fall off of my regular drugs I lost it, calling the community mental health team in what I like to call the all-the-words-are-one-long-snotty-word tears to beg for an appointment which, bless the poor lady translating my slurps and nose blows, was immediately granted.

This meant my husband would need to leave work to look after the kids and, to his concerned mind, me. He did exactly that. I went to my appointment. I got my shiny new lithium and the promise of a lifetime of blood tests and thyroid problems.

Today my already stressed husband was pulled up by his workplace for lying. Because I was cheerfully chatting on Facebook and Twitter whilst between appointments and in waiting rooms, the only conclusion drawn from this was that he lied to get out of work or I lied to him about the illness.

Make of that what you will but I mention it as an illustration of just how wonderful a tool something like Twitter can be.

No sooner had I made my 4sq check in at the hospital (I WILL BE MAYOR OF CRAZY TOWN) than a good friend tweeted me; ‘you ok?’. Having reassured her that it was nothing she needed to rush round with my Valium and a cup of cyanide antidote for, we continued making plans to go to the cinema later this week.

I posted some stuff about music and did a Shoe of the Day post on my other blog , probably talked about owls or Leveson…whatever. It helped. It distracted me.

In this way Twitter, and the members of its social networking family, has been instrumental in keeping me sane over the last few months.

You see a large part of my problem is social anxiety, an inability to deal with day to day interactions. So on days when I can’t face talking to the woman on the till in Sainsburys or picking up the phone, even to my best friend, being able to merrily chat to people makes it all the easier to feel normal and connected with the rest of the normal world.

Twitter has even led to new friends – people I’ve got to know well before having to take the plunge and actually have one of my nonsense red-faced conversations with them. Some I’ve still yet to meet but would consider more than mere acquaintances, others I now regularly spend ‘real’ time with including the concerned friend I mentioned above who despite living just metres away became a ‘tweep’ first before flushing me out of my hole.

I’ve also met other people with bipolar through the web, had conversations with representatives of charities such as Mind and Time To Change and generally learnt more about my condition while also being able to treat it with a degree of honesty I’d shy away from in a face to face conversation.

But most important is the sense of purpose and distraction that social networking can give to a person with mental illness. Pre-Twitter what would one do in the middle of the night warding off a panic attack or fighting insomnia? Now the answer is simple – post ‘can’t sleep. Fucking insomnia!’ and receive three replies from people you sort of know all over the world; ‘me too, need…more…sleeping pills’, ‘try getting up for half hour & trying again’, ‘get off your iPhone then you dozy cow!’ etc…

Or even better are those moments when you engage yourself in a conversation about something entirely unrelated. I’ve distracted myself on numerous occasions debating the relative merits of cats and dogs, discussing international bacon festivals and naming the fourteen top moustaches of the twentieth century. All conversations I’m pretty sure busy real life friends and family don’t want to be pulled out of work for but that there’s invariably an American/home worker/abuser of lax office internet policy available for.

Whatever its faults – and it has ever so many – I think that social networking has probably saved a life or two. It’s undoubtedly saved my sanity more than once. Not only that but without Twitter where would I find an captive audience for the tale of running out of shower gel and using my son’s Ben 10 Foaming Alien Slime to wash with?

Exactly.