Straight Talk on Managing Bipolar Disorder

Here is a long blog… it was a long day!

I lost an entire day today. That has not happened in a while. I’ve been traveling to see friends and for the most part, I’ve had a wonderful time.  I was able to work with my friend Lorraine as we are both writers. When Lorraine went back to her regular job, my concentration and ability to work plummeted. I’m used to this. Yesterday, I made myself work using my normal techniques and ideas. I made sure I told Lorraine the projects I was going to get done so that I could show them to her when she got back. It’s a technique that works. When I know I have to show my work to someone, I can focus more.

Then today… I am in Florida, so I wanted to go to the beach. The plan was to drive there, walk on the beach and write at a coffee shop. I have a very important deadline for a new book I want to write, so working is essential.

Here is a short version of what happened: The place where I rented a car gave me a piece of junk that was not clean on the inside. I should not have taken the car, but it was the only one. As I drove away, I started to get upset with myself as I felt like a dummy for letting them get away with this.  Then the brain looping started- you never stick up for yourself. Remember when you got that bad manicure and didn’t even say anything? They scammed you! This car is dirty! On and on. To make things worse, the GPS I had didn’t work so I had to use my written driving directions and this is extremely stressful for me.

The result was a panic attack- it was mild, but it was not fun. I finally got to the beach and the weather was dark and windy. And… the beach looked just like the beach in Oregon! I was expecting white sand, blue water and palm trees. Of course,  that is not what you get in Jacksonville!  By this time, I’m losing it. My mind is racing, I’m crying and the stress of having to work is too much. So I decide to go home – and I get lost. Finally, I get the GPS to work and I arrive back at my friends,  almost four hours after I started. It was awful.
I knew I had to do something to feel better. I called the rental company and complained. They are picking up the car and will not charge me.

 I drank a Coke and had fries. (Guess what, this didn’t work! ha ha) Then I went back and took a walk with my Ipod. That helped.  Finally, I accepted that this would have to be a bipolar sick day. The illness was stronger than my ability to work.  I took a break and felt a lot better in the early evening when my friend got home.  I would like to be a different person sometimes. One who doesn’t get sick when they get the wrong rental car!

Julie

Hi Julie,

I just read all the blogs and comments on Lamictal (and the generic Lamotrigine) and they really answered a lot of questions for me. First off, and I know you’re not supposed to do this, but my daughter had some left over meds when she tried it, so I used those up before I refilled my prescription. I noticed a couple of different things that happened to me while taking her prescription, but I blew them off not even thinking about them until I read the blogs. The first one was a twitch I got in my left hand when using the computer mouse and the second one is the rash that I got on my chest just above the breast. I am very thankful that you talk so much about Lamictal side effects. The only thing is these symptoms didn’t show up until I used my daughter’s prescription. Could it have been because of the age of the pills? Everything else about them is the same as mine. I just wasn’t sure if there is an expiration date on them or not but this is my only explanation of these 2 symptoms. What do you  think?

Tamara

Hi Tamara,

It’s always best to talk with your doctor regarding the Stevens Johnson Syndrome rash.  It’s serious, but very few people on Lamictal get this rash.  I know of one person who had to stop the drug out of the hundreds of people I know who take Lamictal. The rash is usually  benign and can be treated with benadryl.  Definitely call your doctor though and give an update.

I have to stress that a mild rash is very normal. A rash that really itches with oozing sores like poison ivy is not ok! It’s estimated that .3 % get the rash. That’s a very small number compared to the lives saved by Lamictal.

You do not have to stop Lamictal/Lamotrigine if you get the rash. It may just mean your dose is too high at first. Lamictal is started slowly in order to prevent the rash. Then if you go up in dose and it shows up, you can go back down and slowly go up again. Your health care professional will know all about this.

I still get some itching from the Lamical, but I live with it.  My coauthor Dr. John Preston is my source of info, so I’m lucky I can call him with all of my questions and he mentioned that most of the rashes are benign.

Remember, I am not a medical doctor!

As for the twitching- you should see me when it really gets going! It’s pretty comical. It’s very uncomfortable- especially in the legs. I know it means my dose is too low.  So twitching is not uncommon, but it shouldn’t last.

Regarding taking your daughter’s pills, I use my mom’s pills if I forget mine. She is on Lamictal as well.  Lot’s of people do this.

I know that doctors say not to do this- and I am NOT saying to do this, but reality is reality.I say it’s a lot better to take what is there than to go without! Also, to throw out expensive pills simply makes no sense.  I tell my nurse practitioner what I am going to do and she is supportive in these kinds of situations.

The age of the Lamictal is a question you can ask you doctor or pharmacist- but I doubt it is too old if it’s a semi recent prescription. If you switched between regular and generic that may be the problem. As you may have read in my other posts- generic Lamictal (Lamotrigine) did not work for me. The twitching side effects were quite intense. Once I switched back to Lamictal I was better.  This is beacuse the way they make the pills can be different and we absorb the drugs differently. I write a lot about this on the blog under the term ‘generics.’

I love Lamictal as you know. My coauthor John says it’s the most effective bipolar depression drug with the least side effects.

Thanks for your question and definitely check in with your doctor about the rash if it continues, spreads or oozes! If not, you should be fine.

Julie

PS: There is an excellent comment from Heidi in the comments section.

Sorry guys, I am going to be a broken record for a few days about my travels and how they affect bipolar disorder. I’m on the East Coast and wow, I have had sleep problems. Last night I stayed up late (midnight) to watch the football playoffs and when I finally got to bed I had visions of Payton Manning (quarterback of the Indianapolis Colts) throwing the ball all night. Then I heard words from the game and words from the conversations with my friends. I really love being with people, but I easily get overstimulated. It’s not good for me.

This brain chatter is like having a train go through my head. It just won’t turn off. I have a section in my book Get it Done When You’re Depressed called Expect Brain Chatter.  I just read that strategy again. It’s true- the running commentary in your head that keeps going even when you’re sleeping can be very stressful and tiring!

Eventually, at 2:30 I just took some of my Ativan (Lorazepam) in order to sleep. I am lucky it works well for me at a very small dose. I can get to sleep on 1mg or even .5 if I’m already a bit tired.  I don’t know why I just don’t take it from the beginning. It’s like I feel I have to get to sleep on my own in order to prove something. This has always been a struggle. I just need to take the darn stuff.

I am worried about these sleep problems, but I want to have fun tonight with my friends! We are going to watch football and talk. So what can I do to make sure I sleep well! I will work on that. It’s always a trade off, isn’t it.

Julie