Do You Care About Someone with Bipolar Disorder Who Refuses Help for Bipolar Disorder?

communicate blueYou are not alone! Many people with bipolar disorder can’t see they are ill and many know they have the illness, but stubbornly refuse help!

Here are three tips to ease your loved one into future treatment: 

1. If the person refuses to say the words bipolar disorder, don’t try to force the issue…yet. Instead, talk about feeling good, feeling down, feeling upset or feeling angry.

2. Focus on sleep. Many people with untreated mood disorders are open to getting help for sleep. Talk about sleep studies, small doses of melatonin four hours before midnight and talking to a professional to get help for sleeping issues.

3. If it feels right, talk about anxiety. I’ve learned through working with parents and partners that people who refuse to use the words bipolar disorder will often have an open discussion about anxiety, especially men.

There is always hope. People change and those who can’t see they are ill or who simply refuse help today can get better. I see it in my work all of the time!

Julie

Do You Have A Helping of Chronic Pain and Inflammation Along with Your Bipolar Disorder?

Paleo Coach coverI do! I’m currently eating a Paleo diet with the autoimmune protocol (no nightshades, dairy, etc) to deal with an intense back and hip injury from a  biking accident.   When I say I’m eating a Paleo diet, I means I’m working it, but I haven’t reached a point of following it completely.

The Paleo concept isn’t complicated. Many of the foods we eat today are so new our bodies are not always able to digest the foods in a natural way.  This way of eating isn’t about losing  weight, it’s about ending physical problems. The basics:  You eat nutrient dense foods with an emphasis on meat, vegetables and fruit.  Grains and legumes are not consumed due to their propensity to cause digestion problems. This is why beans, beans the edible fruit, the more you eat the more you toot happens! Some people eat dairy, but for myself the resulting digestive problems have made it obvious I’m not able to digest the lactose at this time, etc etc. It’s a very personal diet that represents a life style and not a quick fix.

I have so many emotional issues around eating and my bipolar disorder that changing my diet completely wasn’t a realistic beginning goal. I’m taking it slowly! 

 I’ve lost 35 pounds so far- I have miles to go before I sleep and many promises to keep and… I’ll stop the poetry here, but you get the idea! I was overweight when the accident happened, but quite healthy.  I have 60 pounds to go and will keep you posted!

My advice?

If you have bipolar disorder and any inflammation problems from joint pain and fibromyalgia to tiredness, bad skin and bloating to being overweight,  the Paleo approach offers an alternative to living a life in pain. My goal is to one day follow it fully over a long period of time. It’s what I have to do in order to stay out and about. I got my life back- I feared my injury ( crumbling back, dislocated hip, slipped pubic bone and the resulting ligament and muscle damage from the biking accident) was permanent and that the chronic pain would continue. Paleo gave me a free ticket to a happy life in a strong body. Following it is a BIG, TOUGH and DIFFICULT challenge, but I will not stop until I have a strong and trim body that can hold up my crumbling spine!!!

I taught myself to manage my severe bipolar disorder two. I can do the same to create a strong and healthy body!

I recommend the book The Paleo Coach as a primer. I’ve met the author Jason Seib and he is the real deal.

Julie

Hello Australia! Bipolar Disorder and Light Exposure. Four Keys to Successfully Manage the Illness on Sunny Days

The Key To Success

Bipolar disorder mood swings in the sunny, Australian winter. It’s not easy to figure out how sunlight and darkness affect bipolar disorder. It’s often as much to do with WHEN you are exposed to light and darkness as how much.  Learning about your circadian rhythm is essential.  Read Geralyn’s question below and think of how you would answer.  I’m interested to then know how you feel about my answer as it might be different than you expect!

I just received a Facebook question from Geralyn  in Australia.

“Hi Julie, did you know that in the part of Australia where I live the worst time for bipolar swings is Summer not Winter because you have to keep heat out by shutting curtains etc. which means less light. I’m having hypomania, I’m taking my medication – any other tips you could offer to stop it getting worse?”

 

Hello Geralyn, I didn’t know this about Australia. It makes sense though. I remember being in Thaliand where it was so hot I would just go back to my room- shut all the curtains, turn on the fan and just I didn’t melt.  It WAS dark in that room!  Here is my answer to your interesting and thought provoking question:

Hypomania and depression require different plans: Since you’re having hypomania, what you do light wise is different than what you would do when depressed. Believe it or not, being in the room in the dark is good for hypomania- the problem is the balance of light when it’s so bright outside for so many hours of the day. I would suggest that being in a dark room isn’t the problem- it’s actually what you need to do if the hypomania is persistent.  If you were having severe depression, it could be about the darkness. You may be experiences a lot of depression as well,  but for now let’s talk about what everyone with bipolar needs to do regarding light and mood swings when they are having hypomania.

We talk so much about light exposure and depression and it is a problem, but the interaction between light and our mania is just as important.

Here are four keys to managing mania when it’s sunny outside…..

The main goal is to create a circadian rhythm plan that makes sure you get light at the right times. The interaction between melatonin and serotonin holds the key to light exposure and mood swings. If it’s sunny all day- the constant light into the retina affects the brain chemicals that control the balance between  melatonin and serotonin to the point that many people with bipolar one will have severe mood swings in the summer simply from the extra light.  My coauthor Dr. John Preston has been my teacher on the topic of light, sleep and bipolar disorder for ten years now- I recently attended a full day seminar he put on here in Portland, Oregon where we have the exact opposite of what you are going through. Six months at least of darkness and rain is the norm here. I learned so much from talking with him. Here’s the latest information:

1. It’s about when you get light if you have bipolar disorder- not always how much. When it’s bright outside, we need to end light exposure starting in the early evening so that our natural production of melatonin can kick in and start to make us tired. This melatonin stops the production of the highly active serotonin that wakes us up in the morning.  To make this happen during the bright days,  Dr. John suggests .5 mg of melatonin four hours before bed.  Yes, it’s a super small dose but the latest research shows that too much melatonin is detrimental to those of us with bipolar.

Tip: No matter what’s happening with your sleep schedule and no matter how much light there is outside-   .5 mg of melatonin will help get your circadian rhythm on track.  This helps build a sleep foundation that promotes stability.

2.  During sunny times- the amount of light that goes into your EYES is the problem. It’s not about light getting into the skin- that’s more of a vitamin D situation and is more related to depression. Light stimulates the brain chemicals that create the energetic serotonin. This is why mania peaks in the sunlight. We do need light in the morning to stop our melatonin, but it has to be limited and targeted due to the fact that light in the eyes can create mania.  During the sunny days, it’s essential to get light into our eyes in the morning for a few minutes- this will stimulate our circadian rhythm to wake us up- but then super bright light in the eyes needs to STOP until the next morning.  Thus, waking up and going outside and looking at the sun for a few minutes in the morning only is the key.  You will then need to use strong sunglasses, visors, hats etc. to reduce ALL bright sunlight into the eyes for the rest of the day. This is why being in a dark room isn’t a bad idea if you’re having hypomania.  It’s probably the daily contrast of the light in the morning, being in a dark room, going back into the light and then trying to sleep at night that’s the problem. I know it seems like the dark room is causing the mood swing, but it’s probably more about not getting the circadian rhythm process on track do to the constant change in light that’s the culprit.

Tip: During sunny times, wake up and get sunlight into your retina in the morning for a few minutes (20 at most)  and then spend the rest of the day limiting the sunlight into your eyes.  This is especially true if you go to the beach or are out in the open sun .  You want sunglasses that are so dark it feels a bit abnormal. Your brain will thank you.

3.  Darkness is associated with depression even if it’s not actually making us more depressed.  When you have bipolar disorder, darkness can feel oppressive, dangerous, sad and hopeless. It’s hard to explain to others who don’t have such a visceral response to their environment, but for anyone with bipolar we know that how we feel in an environment profoundly affects our moods.  Once you have stimulated your circadian rhythm, you can then start modifying the darkness in your room with a smart use of light and other elements.  Fish tanks with bright colors, plants with big bright leaves and other positive images can make a huge difference.  It’s also fine to have full spectrum light in the room as long as it’s not too bright and you don’t look directly into the light. (Yes, the bipolar brain really is this sensitive.) What you do in the room is also important. Is it a happy place- do you enjoy being in your home, or do you feel crowded and unloved in the environment?  It really does make a difference. Having a pet or loved ones around  you will brighten any room. You didn’t mention air conditioners-  if you are cool enough, one thing you can do is find blinds that let you completely control the amount of light which means you can let some in as needed.  You are more in control of the dark room than you think.  If the dark room is something you can’t change, then changing what’s in the room is the key. I still believe that if it’s hypomania and not serious depression that you’re experiencing, the dark room is not the main problem. I’m interested to hear more about how often you cycle into depression.  Our environments completely affect our moods- and it’s not always about light. If you feel out of place where you are- this can lead to mood swings as well. Especially if your hypomania is dysphoric where you feel uncomfortable everywhere and home isn’t a sanctuary.

Tip: If the dark room is a necessity heat wise, modify the room to make it a cheerful and light place using lighting, mirrors, candles, animals and possibly new blinds.  When you’re in a place you love, it helps counteract the darkness.  If the bipolar makes you uncomfortable everywhere- then it’s more about the illness than the darkness!

4.  Electronic devices increase light into the eyes. The blue light that comes off these devises is no different than a light box. If you’re watching TV or on a computer, phone or tablet in a dark room, you will have a similar brain reaction to being outside. Amber glasses that block this blue light can make a difference, though they can make the dark room more gloomy.  Knowing that this blue light- especially from a big television at night- can completely upset circadian rhythms will help you make better electronic decisions. Darkening your devices- making sure you aren’t using them right up until you sleep and possibly using glasses that block the blue light is an essential step in managing your moods.  The contrast between the dark room and the blue light is a big problem when you’re trying to get stable.

Tip: Become more aware of how much blue light you get and try to keep it limited to the day and turn it off at least a few hours before you want to sleep. It doesn’t have to be like this always, but it’s essential to test it out and see if it helps.

These are just a few ways you can change your situation to create a plan to help manage the bipolar disorder. It’s easy to blame the darkness for the mood swings- when it actually could be the balance between when you experience the darkness and the light.  We are learning more and more about circadian rhythms and bipolar disorder. Every single person with bipolar disorder must regulate when light hits the eyes. This is a free way to manage the illness more successfully. It changed my life and it can help you as well!

Thank you for your question Geralyn and hello to everyone in Australia and the Southern Hemisphere.

Julie

Here is a great resource to learn more about light and bipolar disorder. Dr. Jim Phelps pioneered the research in amber glasses and light exposure. His website PsychEducation.org offers research on the topic.  If you aren’t aware of how light affects bipolar disorder, his site will certainly open your eyes. 😉

 

You Can Make 2015 the Best Year Ever…..

rainbow phoenixYes! I turn 51 years old today. 2015 is going to be my best year ever. The first step is to heal the back and hip- it’s certainly a challenge that will keep me on my toes. (For those who don’t know, I’m dealing with a biking injury that has certainly changed my life.) Thank you to all of my great readers and clients in 2014. Thank you for all of the kind comments on my social media. I’m enjoying coaching and will get back to writing soon.

If you have bipolar disorder and are dealing with chronic pain and or weight management struggles- guess what my next book is about! From 1995 until now my life has been all about managing bipolar disorder. Now that I have a system that works and my life is as stable as it can possibly be, I’m going to create a physical stability to match my mental stability. Integrating the mind with the body is my 2015 goal. So far so good- I will keep you posted. As always, I love hearing your success stories! Please know I read all of my social media and blog comments and though I can’t always answer each one individually, I’m thinking about you and wish you health for today so that it can build into health for all of 2015. We can do it together!

Julie

PS: Never forget- we all have the ability of the phoenix in ourselves– we can rise up from the ashes over and over again. If your 2014 was tough, you do have the strength to change. 2015 can be better.

Brand Name Lamictal and Generic Lamotrigine …2015 Update

generic medications bipolar disorderI regularly receive questions about the brand name drug Lamictal.  It’s one of the best medications around for treating bipolar disorder depression. It works as an anti depressant without as many concerns about mania.  It saved my life.  It’s the only drug I’ve ever been able to use long term. I was on it for five years. My bipolar disorder is under control these days and I’m not taking it regularly, but at one time I was on 750 mg a day and it kept my suicidal depression from getting too severe.  Lamictal (lamotrigine) has one of the highest treatment effectiveness ranges. The therapeutic dose is around 200 mg, but many people need a higher dose.

The brand name of the drug is Lamictal and the generic is called lamotrigine. When the generic came out seven years ago, it wasn’t very trustworthy. You can read about my experiences with the original generic lamotrigine on this blog- these posts are from the first week it came out as a generic- it wasn’t a stable drug at the time and I had to use the brand name for awhile as the generic literally would not enter my system. (My posts on generic bipolar disorder medications explains why this can happen even though the active ingredients in the brand name and generic are the same.)

Despite this improvement in generic lamotrigine, there are still some people who do not do well with generics and still want to use the brand name drugs. I just received a comment from Robin on this topic.  Here is my answer:

” Hello Robin, It’s always a dilemma when the generic version does not work. Brand Lamictal is one of the most expensive drugs on the market, but you can petition your insurance company and prove that the generic version does not work and sometimes they will approve the brand name. This was because when generic Lamictal (lamotrigine) came out, there were some concerns about the make-up of the generics. Now, that the generic version has been perfected and works for most people, insurance companies are not as likely to allow you to switch to the brand-name option. This is why you have to prove that it doesn’t work for you. I should note here that if the generics didn’t work for you in the past, there is a chance they might work for you now. If you have determined that the lamotrigine does not work for you and you do not have insurance, you can contact Glaxo Smith Kline and ask them about their medication discount program, but it can still be quite expensive. Another route is to ask if your healthcare professional can obtain some samples, but this is not a long-term solution. Another option is to look for authentic drugs from Canada, but you have to be very careful and make sure that the quantity is clear. Sometimes, you find that the drugs are a lot cheaper, but it turns out to be for only half the amount. Good luck! 

I want to stress that once generics have been used for a few years they can get a lot better-  in the bipolar disorder medication world almost all of the drugs used are generic. All of the work I do with my parents and partner coaching clients is about bipolar disorder medications. I’m lucky that my coauthor Dr. John Preston has been my advisor and teacher on the topic for ten years.  I don’t give medical advice, but it’s essential that anyone associated with bipolar disorder knows what each medication does and the typical dosage ranges.

You can read one of my posts from 2012 below to see how generic lamotrigine worked at the beginning. It wasn’t as well manufactured as it is now!

Julie

****

Hi Everyone,

Thanks for the great comments you leave on the blog. Here is some information on Glaxo’s prescription program. They make Lamictal- it’s now available in generic, but if you qualify, this may be cheaper. For those of you new to Lamictal- it’s an anti convulsant used to treat bipolar depression.  It has helped so many people, but it’s expensive.

**

Most major drug companies have programs to help low income people with bipolar disorder get prescription help.  Here is a link for GlaxoSmithKline, the makers of Lamictal.

http://www.gskforyou.com/

I have to ask this- where is the help for the middle class ?!!!

Julie

BP Magazine Blog: Are Cortisone Shots Safe for Bipolar Disorder?

I’m on a cortisone awareness crusade! It’s essential that all people with bipolar disorder and the family, friends and health care professionals who care for those with bipolar disorder understand the facts behind the shots! 

 

Excerpt:

You would not believe the horror stories I’ve heard from people with bipolar disorder who had cortisone shots. This is also a common theme I hear from my family member and partner coaching clients.

  • Full blown euphoric manic episodes.
  • Aggressive dysphoric manic episodes that lead to jail.
  • Suicidal depression and hospitalization.

…. one series of shots can cause severe mood swings even if a person has been stable for years.  Prednisone for swelling due to a head injury or asthma and the ever present testosterone treatments for ‘men over 50’ have the same risks as cortisone shots.

This is why I am so adamant that those with bipolar try everything to treat an injury, before they take the risky move of getting a cortisone shot.

Please click here to go to my BP Magazine blog for the remainder of the newsletter. I wanted to put this on the BP Magazine blog so that everyone can leave comments. I think you will find this information very timely, important and interesting.

Julie