How to Treat Common Side Effects of Bipolar Medication

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A picture of a green prescription bottle with pink pills spilling out of it. Credit to flickr.com user Rakka. Used with permission under a Creative Commons license.

Trigger Warning: Discussions of suicide.

To treat bipolar disorder, adhering to a medication regime is crucial. The medications used to treat bipolar disorder are antidepressants, antipsychotics, antidepressant-antipsychotics, anticonvulsants, and mood stabilizers. Downing your pills day after day keeps you from becoming manic, or worse, suicidal. But some side effects to medications are difficult to deal with. But there are better ways to deal with side effects than simply stopping your medication.

A Dangerous Side Effect: Suicide

A dangerous but very rare side effect of bipolar medication is suicide. The Food and Drug Administration (FDA) has placed warnings on anticonvulsants–which are sometimes used to treat bipolar disorder–and antidepressants, especially in the case of adolescents taking them. Antidepressants aren’t frequently used to treat bipolar due to the risk of inducing rapid cycling or mania. Anyone starting these medications must be monitored closely by a treatment team looking out for worsening depression or the resurgence of mania.

The antidepressants mirtazapine (Remeron) and venlafaxine (Effexor) were found to increase the risk of suicidal or self-harming behaviors, according to a 2010 study. Also in the class of antidepressants that increase these risks are all selective serotonin reuptake inhibitors, or SSRIs.

Side Effects That Tend to Diminish Over Time

Many of the side effects of bipolar medications are temporary, and will diminish over time. While all medications and individuals taking them are different, side effects that tend to be temporary include:

  • Headaches
  • Dizziness
  • Digestive issues, such as diarrhea and constipation
  • Drowsiness
  • Blurred Vision
  • Rashes
  • Rapid Heartbeat
  • Nausea, bloating, or indigestion

Side effects of bipolar medication should be reported to a doctor, as they could be indicative of a larger issue.

Managing Other Common Side Effects

Other side effects of bipolar medication can be tolerated or treated with lifestyle changes. Some common side effects and the ways to manage them are;

  • Dry mouth: treated with an over-the-counter gum or spray. Sucking on ice chips also helps
  • Sexual issues: treated by reducing the dosage of medications used, changing medications, or using sexual aids
  • Sensitivity to the sun: use sunscreen or protective clothing, or stay out of the sun entirely
  • Sensitivity to cold: avoid cold weather and dress more warmly
  • Joint and muscle aches: ibuprofen and other over-the-counter pain relievers may be used
  • Menstrual issues: birth control may be prescribed
  • Anxiety or restlessness: changing medication dosages or adding a drug can reduce this side effect. Yoga may also help
  • Heartburn: treated by changes in diet and exercise, but over-the-counter and prescription meds are used as well
  • Increase in blood sugar, Diabetes: medications used to manage the blood sugar can be taken to lessen this side effect
  • Acne: medication is available to treat this side effect
  • Mood swings: adjusting dosages and types of medications taken is generally the only way to handle this side effect
  • Weight gain: see mood swings. I will be covering weight gain specifically in a future post.

The Bottom Line

Side effects of medications are an unfortunate and expected part of treating bipolar disorder. Fortunately, most side effects can be managed, or diminish over time.

If you suffer from intolerable side effects, talk to your doctor about how to manage them better. Don’t stop taking your meds without a doctor’s approval, and never stop taking bipolar medication immediately. Treating your bipolar disorder is worth dealing with side effects. For example, it’s better to manage acne than to have to pick up the pieces after a manic episode.

Good luck!0

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What Does High Functioning Depression Look Like?

Individuals with high functioning depression suffer greatly–and their pain is often undetected. The people at BetterHelp.com have put together the following infographic to explain what high functioning depression looks like, and have chosen to share the picture with The Bipolar Parent. Enjoy!

High-Functioning-Depression

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4 Ways to Educate Someone About Mental Illness

Note: This post has been translated into French by Stephane at Espoir Bipolaire! Click here to read the French translation!

How often have you heard an insensitive–and inaccurate–remark about mental illness? How about something like, “the weather can’t decide whether to be hot or cold. It’s so bipolar!” or “these basketball players need to talk to each other. They’re so schizo!” These expressions are stigmatizing because they connect mental illnesses to undesirable behaviors.

It’s not your job–and it certainly isn’t fair–to have to educate others about mental illnesses. But, if you feel the need, how do you approach someone who uses terms of disorders in a healthy way? These four tips will hopefully help.

1. Is Engaging Worth It?

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Credit to flickr.com user Flixel David. Used with permission under a Creative Commons license.

First, figure out whether you want to engage the person. You’ll be opening yourself up to criticism, especially if you have a mental illness yourself. If you’re dealing with a stranger in a crowded place, it may not be worth it to correct them. However, if you’re dealing with a well-intentioned friend, feel free.

2. Watch Your Tone

As difficult as it is to not become defensive, try. Coming across as positive and kind will go a long way towards educating the ignorant, because they’ll be more likely to open a dialogue with you rather than getting defensive themselves. It’s not fair to have to police  yourself like this, especially when tempers are boiling hot, but if you want to correct someone, it’s better to not go on the offense.

3. Get Personal

Try to use “me” statements such as, “When you say things like that, it really hurts me.” If you’re comfortable talking about your mental illness, tell a bit of your story to demonstrate the effect of their words on you.

4. Offer Resources

Hopefully, the person you encounter will be open to discussion. If so, then you can offer them resources which they can use to educate themselves further. Websites like nami.org, for the National Alliance of Mental Health, are a good starting point. You want to make sure your resources are as comprehensive as possible.

Again, it’s not fair to have to educate anyone about your struggles with mental illness, and it’s certainly not pleasant to have to police yourself in order to engage with someone. But, the more you educate, hopefully the less you’ll have to deal with insensitive remarks in the future.

Have you ever educated anyone?

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Mental Illness in the Media–An Incomplete Picture

The mass media has a horrible track record when it comes to factually portraying mental illnesses. Television, movies, and newspapers all characterize suffers of mental health issues as violent, slovenly, and unpredictable. Unfortunately, many misconceptions about mental conditions are born here, because this is where many people get their information about mental conditions.

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Credit to flickr.com user Magnus Karlsson. Used with permission under a Creative Commons license.

Up to 73% of sufferers of mental illnesses in television shows are portrayed as violent, compared to roughly 40% of “normal” characters. And, to make matters worse, only 24% of female characters without mental health issues are violent, which makes the 71% of violent female characters with disorders even more shocking.

Films are just as bad. The most typical example is Psycho, where mild-mannered Norman Bates is dominated by his “mother-half,” a homicidal split in his personality run by his deceased mother. Even if the director has the best intentions and portrays bipolar disorder accurately, like in Silver Linings Playbook, having the two main characters’ issues washed away because they end up together is highly inaccurate and almost insulting.

Print media gets it wrong as well. In 2011, 14% of articles referred to suffers of mental illness as a “danger to others.” Tabloid newspapers especially focus on violence, using graphic descriptions and terms like “crazed” in the headlines to attract attention. Most newspapers engage in armchair diagnoses, which means they speculate on the mental state of article subjects without evidence to back up their claims.

But the fact is, people with mental illnesses just aren’t more bloodthirsty than the general population. A new study published in the scientific journal JAMA found that only 8% of those with schizophrenia and no substance abuse were violent, compared to 5% of the general public, a statistically insignificant number. Research demonstrates time and time again that the media is dead wrong in its estimation of violence among the mentally ill.

So how can you sift through the information presented and gain a critical eye, and instill that in your children as well? First, you can ask why you’re being told something. What bias do reporters lean toward, and, if applicable, what are they trying to sell you?

Second, recognize that crimes are more reported on than everyday, slice-of-life stories. Violence sells, and mental illnesses, when involved, become the focus of the story. Very few stories about recovery are published on a daily basis, because therapy is boring to read about.

Third, seek other sources, especially first-hand accounts. There are several reputable websites available, like nami.org, the official site of the National Alliance on Mental Illness, and nimh.nih.gov, the site for the National Institute of Mental Health.

What about your kids? Train them by following the first three steps, with the addition of asking them why they think people with mental illnesses are portrayed the way they are.

With these steps, you can learn to filter the mass media you consume, and help combat the stigma that sufferers of mental illness face everyday.

What sorts of portrayals of mental illness have you seen in the media? 

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5 Ways to Cope with a Diagnosis of Mental Illness

Hearing a diagnosis of mental illness can be heartbreaking for many. Some people feel relief at finally having a name to put to their issues, where others may become angry or afraid because they have a disorder to cope with.

However, a diagnosis is important because it means that you can move on to treatment. Doctors can use their experience with similar diagnoses to construct a personalized plan to address disorders, and advise you about future health risks. Most importantly, insurance companies will have a reason to apply aid now that they have a name for the condition.

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Credit to flickr.com user ccarlstead. Used with permission under a Creative Commons license.

But what do you do with a diagnosis once you have one?

1. Learn

First, learn about your diagnosis. Ask your doctor to recommend books or websites, like nami.org, the official site of the National Alliance on Mental Illness. Once you learn the basics, like what the symptoms of your illness are, you can transition to learning about treatments and what you can do to help your recovery.

2. Find Doctors

Next, create a treatment team. Ideally, you’d have a therapist and a psychiatrist–or nurse practitioner–who can prescribe medication for you. Presumably you already have one, if you have a diagnosis. But make sure your team is rounded out. There are low-cost options for mental health services out there. Try looking into support groups offered by local NAMI chapters or ant your local library. Ask your doctors if they offer sliding scale fees based on income. If you’re near a university, see if they have a graduate program for psychology, where a therapist-in-training can take you on as a client. Here’s a list of 406 free or low-cost clinics in Washington state, 138 of which offer mental health services.

3. Journal

Writing down your troubles is a proven way to start addressing them. If you have concerns about your diagnosis, write them down so you can bring them up with your doctors later. Scribble down what you plan to do as a result of this diagnosis, whether it be sharing your condition with loved ones or keeping it close to your chest. Figure out whether you need to adjust your treatment team, regarding whether or not you’re relating to the people responsible for your care.

4. Find a Team You

Team You, a term taken from the delightful blog Captain Awkward, is a term used to describe the supportive, unbiased people in your life like counselors, psychiatrists, parents, reliable sitters, religious figures, and friends who may or may not have kids of their own. This assistance is invaluable to a person dealing with a diagnosis of mental illness. Unfortunately, collecting a solid Team You takes time. If you’re a parent, then hopefully you have parent friends—ideally ones who you are comfortable explaining your struggle to. Attend groups from Meetup.com or local libraries. Try out classes, and take notes on your classmates as well as the subject material. Toddler groups are excellent places to search for potential allies, too.

5. Hold Yourself Accountable

Once you have a treatment team and a Team You in place, don’t flake out on them. Attend your doctor’s appointments and take your meds. Keep updating your journal regularly with shifts in your moods, so you can find out if the treatment plan you’ve been given is working. Keep up with your friends and allies.

A diagnosis of mental illness isn’t a life sentence. Many people can and do recover completely from their disorders, and more severe mental conditions can be managed. Help is out there. You are worth exploring every avenue of care.

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8 Myths About Mental Illness

Mental illness is widely misunderstood by the general public. People who suffer from mental disorders can find that many myths surround their condition. These misconceptions contribute to stigma, making it more difficult to seek treatment and manage disorders. We’d like to dispel some of these fictions.

1. People Can Use Willpower to Recover

While there is no definite cure-all for mental illness, it definitely can’t be treated by willpower alone. People can’t just “snap out of it.” If only managing a condition were that easy! Conversely, treatment such as medication, psychotherapy, and Electroconvulsive therapy (ECT) actually works. Scientists are frequently discovering new advances in treatment, and with them, sufferers of mental illness can manage their disorders and lead healthy, productive lives.

2. Mentally Ill People Can’t Work

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Credit to flickr.com user Cat Branchman. Used with permission under a Creative Commons license.

Nope, this is bogus as well. People with mental disorders can and do contribute to the workplace and home. Most of the time, the mentally ill are excellent at “covering” for their illnesses, which basically means that they can successfully pretend that all is well. They can be so good at covering, friends and family don’t even recognize that the disordered are mentally ill.

3. It’s Just Bad Parenting

No, no, no. The causes of mental illness are varied, including genetics, physiological changes, and environmental stressors. Neglect and unusual stress in the home tend to exacerbate underlying conditions which have biological causes. It’s not the parent’s fault that a child develops mental illnesses. Which leads us into our next point…

4. Children Can’t Be Mentally Ill

Children make up a great percentage of the mentally ill. More than half of all mental illnesses show up before a child turns fourteen, and three-quarters of them appear before the age of twenty-four. Even very young children can demonstrate symptoms of mental disorders.

5. Mentally Ill People Are Violent

Dead wrong. Suffers of mental illness make up a meager 3-5% of the incidences of violent acts in society. Hollywood has a terrible habit of stereotyping the mentally ill as violent, from Norman Bates in Psycho to Jim Carrey’s character in Me, Myself, and Irene. In fact, disordered people are ten times more likely to experience violence than the general population.

6. Mental Illnesses are Uncommon

This is absolutely not the case. One in five adult Americans endure mental illnesses each year. Roughly six percent of the population suffers from a debilitating disorder. You’re not alone if you have a mental health problem.

7. Most Mentally Ill People are White

Actually, most mentally ill people are minorities. African Americans are the most at-risk group, vulnerable to mental disorders such as depression due to increased stress from economic disadvantages.

8. People Can Recover With Drugs Alone

Medications and ECT are only part of the equation. The rest is talk therapy, which most people prefer to use rather than drugs, and peer support groups. These latter strategies try to lessen the effect of environmental stressors, which can trigger or exacerbate underlying conditions.

These myths are damaging to the mentally ill. By educating yourself about mental disorders, and spreading the truth about them, you can help combat dangerous misconceptions which stigmatize sufferers of mental health issues.

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Nature vs. Nurture: The Causes of Bipolar Disorder

What causes bipolar disorder? Scientists aren’t actually sure, but are taking into consideration several risk factors, such as genes, brain structure, and environmental causes.

Genes

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Credit to flickr.com user CIFOR. Used with permission under a Creative Commons license.

Genetic studies of twins have shown promising results with regards to bipolar disorder. According to a a study by Berit Kerner, “The heritability of bipolar disorder based on concordance rates for bipolar disorder in twin studies has been estimated to be between 60% and 80%.” However, if one identical twin develops Bipolar I, the rate of the other twin developing it is roughly 40%, compared to fraternal twins at 5%. Parents have a 10 to 15% chance to pass bipolar disorder to their children if one parent has the disorder, compared to 30 to 40% if both do. This means genetics play a crucial role in the transmission of bipolar disorder.

Brain Structure

Recent evidence suggests that the structure of the brain may contribute to people developing bipolar disorder. MRI studies have found the over-activation of the amygdala, which processes memory, helps decision-making, and controls emotional reactions. People who are manic showed decreased activity in the interior frontal cortex, which assists problem solving, memory, language, judgment, and impulse control. Certain psychiatric medications work on neurotransmitters, suggesting that these messenger chemicals play a significant role in the function of bipolar disorder, but no one knows how exactly they’re responsible.

Environmental Factors

Stress is a significant predictor of bipolar disorder in people who are susceptible to the disease. Life events such as childbirth, trauma, job loss, or grief over a death in the family may trigger a mood episode. My mania and subsequent psychosis was set off by the birth of my first child, Nolan, but my second child’s birth did not trigger anything. However, substance abuse, hormonal issues, and altered health habits can also spark the illness.

Many factors set in motion the development of bipolar disorder. With more research, scientists will discover the roots of the disease, and possibly be able to prevent it in the future.

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How to Talk To Your Kids About Mental Illness

“Mom, are you crazy?” my eight-year-old son, Ryan, asked after reading over my shoulder while I worked on my book. My memoir, Committed, is about my stay in a mental hospital one week after Nolan’s birth, and the page he read demonstrated a particularly erratic behavior from me.

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Credit to flickr.com user Evan Long. Used with permission under a Creative Commons license.

“No, honey,” I said. My heart sank. I was not ready to have this conversation yet, but Ryan’s question made me think otherwise. “I do have bipolar disorder, which is a mental illness.”

“What’s bipolar disorder?” he said.

“Bipolar disorder is when I sometimes feel depressed–like nothing in the world matters anymore,” I said, patting him on the arm. “But it also means I feel super energetic sometimes, and can’t control myself very well.”

“Will I get it?” he said, his eyes widening.

“I don’t know,” I said. “You might. It comes when you’re a teenager or young adult. But there are medications available to help manage it, so don’t worry.”

“Oh,” he said, giving me a hug. “I’m sorry you have bipolar disorder, Mama.”

And that was that.  The dreaded conversation–the start of many–was over.

Arming your kids with age-appropriate information about your mental illness can help them feel secure. If you talk to them about your disorder, they will know what to expect when you have a down–or up–day. They’ll also learn to separate you from your illness, and from any negative feelings that might occur. If you don’t talk to then, they’ll invariably draw their own conclusions, which can make them feel unsure about you and their position in the world.

Here are some tips for talking about mental illness with your kids.

1. Keep it Simple

Children only need to know the basics of mental illness: it’s not contagious, they are not destined to have a disorder, there are treatments available, etc. Another important factor that goes into talking about mental disorders with your kids is stressing that it’s not their fault. They can’t make their parent better, nor should they try. They can only support their mother 0r father by checking in on them, watching movies with them, and generally being their awesome selves.

2. Reassure Them

Explain to your children if they ask that they might get your disorder, but reassure them that there are treatments available and that you’re getting help yourself, if you are. Tell your kids that you still love them, and no amount of mental illness will change that.

3. Know Your Child’s Maturity Level

All kids are different, and mature at different rates. Preschoolers will only want very basic information about why you’re sad. Preteens will want more information, so give them as much as you think they can handle. Teenagers will often turn to their friends when seeking information about things that bother them, so make sure they’re well-informed.

4. Address Their Fears

Ask your children if they have any worries now that you’ve brought up the topic. Reassure them that their needs will be met and that you’re not going anywhere. Repeat information if they appear confused. It may be helpful to bring their fears up with a mental health professional, so you can make a plan to address them.

5. Make Yourself Available

Make sure you don’t end the conversation there. Children will have questions as they grow, and it’s important that you be available to answer them. Explain to your kids that they are always welcome to ask questions of you about this topic.

Talking with your kids about mental illness can be tough. But if you’re open to it, they’ll appreciate your candor and feel more secure knowing what’s going on with their parent.

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