Various Interventions for Stress?

Plans to take my daughter to college next week are leaving me stressed with a capital S. I have scheduled an extra appointment with my therapist for tomorrow. I have gone up a little on my Clozapine. Perhaps not enough…? Everything feels very stressful. Making plans for wisdom teeth removal in December. Making plans to board the dog. Consider changing meds – this will be held off until September. Making sure my daughter is OK during move-in. Friends and family say this stress is normal when sending a child off to college. OK so it’s normal. Why do I feel so un-normal?

I have been taught not to be afraid to ask for what you need….. I am asking now for your understanding and support. The more “yeah it’s normal” s I get the better I think I will feel. Brother can you spare a dime? Or a least a word of support that this too will pass?

Does Anyone Have Information on Loxapine for Bipolar?

I am in the process of looking into a new psyche med. I currently use Clozapine as my main psyche med but it requires a monthly blood test and causes weight gain. I have also been on Clozapine since 2008 and wonder if its effectiveness is waning.

The drug I am considering is Loxapine which is structurally very similar to Clozapine. Both meds are used for schizophrenia mostly but have been successful in treatment of resistant bipolar which is my gig.

Does anyone have stories to tell about Loxapine for bipolar? Or for other off-label uses? Thanks in advance for sharing.

As an update: I talked to my doc yesterday about switching from Clozapine to Loxapine. He indicated it was not a good idea. And while I am somewhat disappointed, I trust his judgement completely. So there will be no switch to Loxapine. I am however still interested in stories of how Loxapine might have helped in your treatment if you have used before?

Thanks to all of you who have reached out here and before.

Night and Day – Living with Bipolar Disorder out of or in a Routine

I do not know if the experience is similar for other people with a serious mental health diagnosis, but I find myself to be very anxious and irritated when I am not in my regular routine. If I am able to function at a 9 or a 10 (on a scale of 1 to 10) while I am home, I am able to function at a 5 or a 6 when I am out of town and out of my routine. And that is just for domestic travel and travel to a familiar spot. If I have to travel to someplace new or abroad I would have to rate myself even lower due to the adjustment and/or the jet lag and jet lag recovery. As an aside, I have discovered that melatonin does help tremendously with jet lag.

What does it mean to be so tied to a routine? Doing things like taking meds, going to bed, waking up, taking morning meds and taking noon meds are all things that function pretty much on their own when I am at home. I am more or less on auto-pilot with these activities. When I am out of town, I have to create this structure that punctuates my day at several intervals. Things go wrong or even slightly wrong and I have upset the apple cart. Everything starts to tumble and there I am trying to pick up all the apples. Little things like eating dinner at 8:00pm instead of 6:00pm gets my evening off to a rocky start. Things like placing my meds in a different location than I am used to can be a form of stress as well. Sleeping in a strange bed can also be a pain. Having to get somewhere early in the morning is also a challenge as my day starts around 8:00 or 9:00am at home.

I have often thought that because of my bipolar illness I have damaged my hippocampus in some way due to all the trauma over the years of accelerated and then slowed thought processes. So there may be a real medical explanation for all this routine dependency. As I understand things, the hippocampus helps orient you through time and space and helps you keep pace with your general well-being. Getting to a new location that used to be a breeze now with hippocampus damage may seem a daunting task. I have trouble with spatial sense of direction which is one of those skills you need when you are traveling in a new or relatively new spot. This was not the case when I was in my twenties and thirties. This is also one of those problems that is self-fulfilling. The more I tell myself how difficult it is to get somewhere new, the harder it becomes.

So much for loving to travel. I much prefer to be at home in my own routine however boring that may sound. What about you? Do you find that routine is a critical element of your functioning or can you pretty much establish your day and night in a new place without much thought or effort?

Do you stockpile meds?

In the US under my insurance you can usually get meds refilled about 3 days earlier than the full month that they are covered. This allows me to create a med stockpile month upon month when those three days earlier to pickup are multiplied times twelve over the course of the year. I also tend to keep at an old prescription dosage amount even if that dosage has been changed/reduced. To explain, say my doctor originally prescribed me with 500 mg of Clozapine and then over time I reduced to 350 mg. My doctor keeps the prescription at the higher level in case I need to go back up.

The result? I tend to stockpile meds which drives my husband crazy. But for me it means being ready for a sudden trip out of town or having meds in place when I am on summer vacation. My insurance does not do vacation overrides. Not sure why. So if I need meds filled during vacation I need to use GoodRX coupons the week prior to leaving town. GoodRX allows you to fill prescriptions with a discount and they do not care whether your insurance says it’s time to fill or not. It used to be that my pharmacy would do a vacation override but I think the problem is with my current insurance.

I have also been told that you can ask your doctor to send the prescription to a pharmacy out of town (where you’ll be vacationing) and that that pharmacy will fill the prescription. But I have also been told that that fill is up to the pharmacist’s discretion. Don’t want to wait until I am out of town and have run out of meds for that to happen!

So, what do you to to be sure you have meds before vacation or before traveling in general? Do you have a stockpile like me? Does your insurance do vacation overrides? I have been told that even if you can get a vacation override it is only for once in the calendar year. Are you blessed to have universal healthcare that doesn’t penalize you for filling early? Or do you use something like GoodRX to get a prescription fill a little early before you have to leave for out of town and use that coupon for filling the med outside of insurance approval windows?

I have made a mistake

Recently I have been informed by a classmate that another classmate of mine has died. I ran into the later classmate about 10 years ago while he/she was working at a local coffee shop. Later I contributed to an account/fund to help him/her get through what appeared to be a rough patch due to illness.

When addressing my high school classmates last week I suggested that this person might have been suffering from illness including depression or addiction. Come to find out he/she did have a history of addiction. And that was made known at his/her memorial service.

While I was supposing about my classmate, I wrote a personal account of my struggles with bipolar illness so as to take the secrecy out of anything this other person might have been suffering. It has been somewhat to very destabilizing for me to share this story with classmates for the first time in about 40 years. It has also been destabilizing to realize I was wrong for sharing/supposing private information about this classmate even if it was well-intended.

In any case, I know now it was wrong to try to identify depression or addiction on my classmate’s part. The story was not mine to share. And even if I did mostly tell my story it was wrong of me to link that disclosure to his/her memory.

All in all, I feel like I f*&^%#ed up badly even though my intent was to take away stigma associated with behavioral health including addiction issues and other health concerns.

I just want to say…..

I just want to say for the record that I am feeling very worried about where the Supreme Court is going and its role in creating further divisions among people in red states and people in blue states in the US. I have a general feel of unease migrating toward anxiety or extreme anxiety when I think about where we are as a nation in the US including the prevalence of gun violence in everyday life. I try to put a happy face on it saying at least we have a “functioning” Court system where other nations do not. And that is important. But my anxiety still runs high when I think about how we are going to heal the divide that is currently among us. I don’t see a way out. And that scares me. Am I the only one worrying about this? Or is it just better placed out of sight and out of mind?

Happy Fourth of July to You!

These days I am quite thankful to be living in a place where Freedom is at the core of human experience for the most part. As a person with mental illness, I am happy to have some rights but perhaps not all I wish for. To be fair, I am somewhat to very dissatisfied with the direction of the Supreme Court in this country right now, but I have to say at least there is a Court that exists and exercises its authority to ensure rights for the people however different my interpretation is. I would say that the Supreme Court is not acting in a way that supports my beliefs but I am thankful that we have three branches of the federal Government and somewhere along the way there is or must be accountability. I just hope these recent Supreme Court decisions do not get us here in the US further divided between blue and red states. We have enough divisiveness already! Happy July Fourth to us all regardless of color of skin or color of state!

A Slippery Slope

I have written about this in comments to a friend’s post but thought I would post it here. I believe the overturn of Roe v. Wade is a slippery slope for Americans.

What’s next? Banning birth control? Gay marriage? A woman’s right to vote? A woman’s right to inherit property?

Clearly we are on our way down the rabbit hole without any way back out so it seems.

To me, a man, any man, even a Supreme Court Justice is not emotionally or morally qualified to decide what happens to a woman’s body. He has not lived through a monthly period since the age of 12 reminding him of the god given right of childbirth. He has not worried about a potential pregnancy when his period is late several days. He has not suffered the extensive trauma of a terminated pregnancy either planned or unplanned. A man seeking to tell a woman what to do with a pregnancy is not an empathetic being and is only set on controlling the outcome. What happened to “liberty” and the protection of certain rights? Lose one and perhaps lose them all….

God did not ordain the Supreme Court Justices. Man did. The Supreme Court members are thereby not entitled to act as God in this respect which is what they are doing.

The Joy of Saying Thank You

My husband and I have just passed the mark of our twentieth wedding anniversary. I would like to share one thing that I think is essential in our relationship – saying thank you to each other.

Many people talk about having a gratitude journal and remembering to give thanks to God. I have started a gratitude journal but don’t always keep it up to date. What I do do however on a daily basis is to remember to thank my husband for all that he does for me and for my daughter and for the household.

It is a fairly simple thing to remember to say thank you. Thank you for taking the dog out. Thank you for doing the dishes. Thank you for driving to this location or that. Thank you for handling the bills.

A simple thank you can go a very long way. Saying thank you means you are aware of the contribution of another person to making the day go smoothly. It is an easy thing to do and has so many benefits. It means you are noticing when your husband or your wife or your partner is doing something that affects you. You are for a moment recognizing him or her and the behavior they display toward your relationship. You are for lack of a better term in the moment.

There is no action or reaction that is too small for a simple thank you. Thank you for starting the laundry. Thank you for changing the laundry to the dryer. Thank you for feeding the dog.

The benefit of saying thank you is that the other person feels noticed and appreciated. It is so easy to feel unappreciated at times. Extending a simple but heart-filled thank you can make or break the moment. And all those moments add up to hours, days, months and years of being thankful for your mate and thankful in general.

If you don’t have a mate right now in your life, you can practice giving thanks to the people who are in your life. I even try to say thank you for your time when I am contacting customer service for this or for that. Saying thank you for your time is something most people don’t hear on a regular basis. And they typically appreciate it.

Go on! I encourage you to try it if you don’t already- saying thanks to the people around you on a daily basis.

Getting Older?

I woke up on Saturday of this past week with something called “floaters.” Theses are shadows that come across your field of vision due to regular aging of the eye ball. I just had the floaters in my left eye. They appeared as floating lines and then shortly after as floating cobwebs.

Floaters can be the sign of something more serious so I went to the eye doctor and she told me my vision was unaffected and therefore to ignore them as much as possible.

Given my propensity for anxiety, this has been a difficult four or so days. The floaters are less noticeable than they were but still in my field of vision. The internet says that in one to six months, floaters should disappear and/or your vision will accommodate as the floaters sink to the bottom of your field of vision.

This still freaks me out as I have always been afraid of something happening with my vision.

Anybody else want to share some health issue that is occurring due to aging?