COVID-19 Quarantine

The past few months have been strange. I saved up for two years and went on a cruise with ten friends in mid-February. We cruised from Ft. Lauderdale to Cozumel and back and it was fun! When I got back to Florida, I spent the day in Miami with one of my cruise friends before flying home.

Then, in early March, my father passed away after being in home hospice off and on for three years. We couldn't have his memorial service because of the COVID-19 pandemic just beginning to take off in the United States. We still have no idea when we will be able to have the service.

I've been working from home for three weeks now. This is a strange period of time and I wonder how long it could go on. I live alone and I'm social distancing so I'm not seeing many people at all. I have had some conversations with neighbors, from a safe distance, when walking around outside. I've had teleconferences for work and also with friends. That's the only socialization I have had besides phone calls with some friends and family and also sitting on porches and far away from people in their homes when that was still considered to be safe. I guess I could also count socialization over Facebook, Twitter, and Instagram as well.

Now we have been advised not to socialize at all -- even if we are 6 feet apart. Today I played the daily briefing from our governor from a speaker so a neighbor could hear it from afar. I sat on my deck and she sat about 20 feet away in the common yard of our condominiums. We decided to listen to the radio together again tomorrow.

All of this has been kind of surreal. I know I am better prepared for this than a lot of people because my battle with bipolar disorder has put me in lots of isolating positions before and I have worked hard to develop coping skills. I have also developed a Wellness Recovery Action Plan that helps me plan for wellness every day. I also think my medication gives me an edge over my peers who are experiencing this level of trauma for the first time.

I am taking things one day at a time. I am happy with the way my governor is handling this pandemic. He is focusing on the health and the lives of the people in my state. I am not happy at all with the way the federal government is handling things. I try not to think about it too much.

Along with social distancing, I'm trying to stay as healthy as possible by eating well and exercising. That way, if I become ill, I will hopefully be able to get over it at home. I do fear anyone I know becoming extremely ill and possibly dying alone in a hospital. I hope it doesn't happen, but I am mentally preparing myself for that possibility. It seems like, by the end of this, most of us will probably know someone who passed away during this pandemic. Spring is usually my favorite time of the year. This year, it is pretty grim.

The Days Are Getting Brighter

It has been very rainy this winter. It has also been snowy and freezing at times. There have been a lot of dark days. And night comes so early. I think it is the great reduction in daylight that brings on my depression more than anything else about the winter.

I have always enjoyed the outdoors, but the older I get, the less time I want to spend outside when it's cold. I have bought some warm coats to compensate, but I often stay inside a lot in the winter.

Spending time outside in the winter becomes like a fight for me and I usually give in to staying inside too much sometime in January or February. Luckily, the days get longer as the winter progresses and I usually start feeling better by the end of March.

I had an appointment with my psychiatric nurse practitioner earlier this month and she determined by the questions I answered that I was experiencing depression. She said she thought I should try adding Wellbutrin to my daily medication regimen of Seroquel, Lamictal, and Deplin. I had told her that I was putting all of my energy into work and felt little motivation for socializing, cleaning, or working out. I have also been dealing with some knee pain that has been unpleasant and annoying, but thankfully, seems to be lessening.

I have been taking the Wellbutrin every morning with Deplin for about two weeks now. I take Lamictal and Seroquel at night. I do feel better. I am sleeping less, and I have more energy to get things done. I have spent more time taking care of myself after work and I have been socializing a bit more. I feel more activated but I also feel a little bit more impatient although it hasn't caused me any problems, it is just something I have noticed about feeling differently and will self-monitor.

The Wellbutrin seems to be helping but if I feel hypomania coming on, which I am good at recognizing after being treated for bipolar disorder for the past 29 years, I will stop the Wellbutrin and call my psychiatric nurse practitioner as she advised me to do. If all goes well, I will stay on my current medication and have another appointment next month. She had talked about me switching to Vraylar from Seroquel. She said that it might have fewer side effects and she said that some of her patients have done well with Vraylar.

I have been feeling better with my current medication. However, switching medications to reduce side effects seems like a good idea. I have done that several times over the years and I have been happier living with fewer side effects than I have in the past. My current worst side effect is weight gain. Changes with my medication that could help me to lose weight and maintain a healthy weight would be welcome changes.

It is Saturday and I have social plans today and tomorrow. That is an indication that I am already feeling better because I have mostly felt like resting and getting ready for the work week for the past few weekends and not doing much else besides sleeping, eating, reading, laundry, and grocery shopping. That is kind of natural for me in the winter, but I'm hoping that having added the Wellbutrin will make it easier to be more active for the rest of the winter. I am not sure if I will be taking Wellbutrin year-round or just taking it as needed in the winter. I will find out more at my next appointment.

Recovering From Conversations With My Mother

One of the hardest things I do regularly is talk to my mother. She is very critical. I don't make enough money, my hair doesn't look right, my lipstick is the wrong color, I need to lose weight, I need to be more social, I need to go to the gym more--the list goes on and on. There are always a quite a few things I am not doing right that I need to improve. If it is not one thing, it is another. Things are constantly being added to this list of complaints. Some of them are minor, but the negative energy and disapproval wears on me nonetheless.

These conversations full of unsolicited advice are very demotivating. They make we want to quit everything and give up. My hopeless and suicidal thoughts ramp up the more I talk to my mother. I have told her that I try very hard to stay positive and that these conversations bring me down. I tell her that I need support, not criticism. Yet these unpleasant topics come up again and again. The negative emotions that come up affect me for hours and days.

My parents are getting old. I feel like I should spend some time with them, but it is very hard. Lately, I have been limiting the time I spend with them. I do not enjoy the time I spend with my parents. I see it as a duty. Most of the time it is depressing, lonely, and painful.

I have taken to giving myself pep talks after I talk to my mother. I tell myself that I don't really want to give up everything and die. That is just a reaction I have when I am repeatedly criticized and insulted. I think of all that I have to live for. I think of how far I have come. I tell myself that I have a very good job. I do not make a lot of money, but I have good benefits and I have been getting raises.

It makes sense to keep my job even though it is not good enough for my mother. My job is flexible and I need a lot of time off to go to various health-related appointments. That is a benefit that is hard for people to understand if they do not have to live with a chronic illness. My primary illness is Bipolar I, but side effects and other health conditions have come up over the years, and other medications and treatments have been added. Taking care of my health has become a juggling act that not every employer would support.

When dealing with my parents, there is no joy, but I think of the importance of compassion. My upbringing was far from happy and stable, but without my parents, I would not be alive. You do not get to choose your family, and this is the family I got. Maybe the purpose was to make me stronger.

Saving Myself

It is hard to live with bipolar disorder. Even though I take medication, I still have symptoms. If I take enough medication to stay symptom-free, I can't hold my head up and work. That level of medication causes me to sleep all day. Medication takes the edge off of my symptoms and slows me down enough so I have time to think before I speak and act--and that has kept me out of a lot of trouble and has allowed me to develop better relationships and also to work full time. But I also have to use a multitude of coping skills to stay well, including setting healthy boundaries.

Because I experienced emotional and sexual abuse within my family, I have to limit the amount of time I spend with my parents to protect my mental health. I have had to keep very firm boundaries about how much time I spend with my parents, what kinds of activities we do together, and what we talk about. My parents are aging and now need extra help--which I give them one day a week at most--usually on a Saturday or Sunday. Sometimes I skip some weeks if they seem to be doing well. I also have to limit the time I spend talking with them on the phone--especially with my mother. My mother is disappointed by short conversations. She would prefer to talk for at least and hour, but I don't have time for that long of a conversation every day. I try to keep our conversations to less than 20 minutes and I call most days to check in on my parents. My sister, who is their Power of Attorney, lives in a different state. We have decided that if my parents need more help than I can give them, they will have to pay for that help by hiring helpers and nurses. I believe in helping my parents, even though I suffered abuse at their hands, but there is a limit to what I can do and still maintain my mental health. I have learned from my life experiences that saving myself is very important. If I am not careful, I can spiral up into mania or down into depression and end up not being able to work or take care of myself for weeks or months at a time. That is a great incentive to stay well!

Because I have a limited amount of energy, my focus is on work. I have friends, and I am involved in community activities, but I don't do everything I could possibly do because rest and sleep are very important to my staying well. I try to have fun every day and spend time with people I like, but I also try to be home by 9 p.m. every night. Sometimes, I make an exception to that rule and stay out late, but I always pay for it later with sleepiness and inconsistent moods. Currently, in my free time, I attend therapy one night a week, take a ukelele class, exercise, have coffee and dinners with friends, and go to movies, plays, and concerts. I am also a member of two social clubs, and I am on the executive committee of one of them. I stay busy, but I also rest and sleep quite a bit. Also, if I am not in a good frame of mind, which can happen at unpredictable times, I bow out of social events and work on maintaining my wellness. I would love to do more than I do, but experience has shown me that if I overextend myself, I cannot stay well. This is what led to me being on disability between 2008 and 2016. I am now trying my hardest to stay well and stay off of disability.

The Last Days of Summer

I'm enjoying the last days of summer. I feel like I've taken full advantage of the season. I've spent a lot of time outside, I took a 12-day staycation, and I've spent ample time hanging out at my condo pool where I exercised, sunbathed, and enjoyed talking with neighbors and making new friends. I also worked on decluttering my condo and having needed repairs done.

One reason I think I enjoyed this summer so much is that I focused on self-care, including working to improve my physical health, and it has paid off. I started taking Deplin for my MTHFR homozygous C667T genetic mutation and I also started taking iron supplements for an iron deficiency that I have probably struggled with for years. I switched doctors in the spring and my new doctor tested my iron levels, when I reported having heavy periods, which my old doctor had never done. Taking care of these health problems seems to have increased my energy level, and I also look and feel healthier. I have better color and my hair is growing in thicker (iron deficiency can lead to both paleness and hair loss).

I've also continued my weekly therapy sessions which I started in February of 2016. Although I've been in some form of therapy for years, this is the only time I have ever been able to afford weekly sessions. In earlier years, I tried to make it once a month, but that wasn't always possible. Having weekly therapy has helped me so much because I can work on problems I face every week. Before, therapy was overwhelming because I felt I had so much to rehash in my infrequent appointments. I have experienced a tremendous amount of personal growth over the past two years that I attribute to these weekly therapy sessions. I'm so grateful for them!

I also read two daily meditations every morning which help to give me a lot of clarity. It is a great way to start my days. I read The Language of Letting Go and A Restful Mind: Daily Meditations for Enhancing Mental Health. Both of these daily meditations have been incredibly helpful to me!

I love my job, but sometimes it is stressful. At those times, I use wellness tools from my WRAP. My favorite wellness tools to use at work are: taking a short walk, using some scented hand lotion, or doing a few rounds of square breathing. I also make sure to drink plenty of water during the day.

So, I'm feeling really good about the end of summer. I always notice seasonal changes since I feel so different at different times of the year. I'll miss the relaxing afternoons at the pool, and leisurely chats with my neighbors, but I'm ready to make the transition to indoor exercise and swimming at the Y. And, one of my new friends that I met this year at the condo pool is also a member of the Y, and we have already taken a trip there together. We are both going to miss the outdoor pool, but we both know we need to keep exercising!

Medication Change

In May, I took the GeneSight test and found out that I have a genetic mutation--MTHFR homozygous C677T. This means that I will have low folate levels no matter how much folate I consume. For this reason, my psychiatric nurse practitioner prescribed a supplement called Deplin, which is L-Methylfolate, and is recommended for people with this genetic mutation because it is a form of folate that my body can use. With enough folate in my body, I should have fewer health risks and my medication should also work better. A lot people with bipolar disorder, depression, schizophrenia, and ADHD have this genetic mutation and Deplin is considered to be a dietary treatment for these disorders.

Because I am now taking Deplin, I was advised to cut my doses of psychiatric medications in half. I am now taking 100 mg. Lamictal, 100 mg. Seroquel, and 15 mg. Deplin. I successfully cut my Lamictal dose in half, but I haven't been able to go lower than 100 mg. on Seroquel. If I take a lower dose, I don't sleep well, and feel very tired the next day. My psychiatric nurse practitioner suggested that a switch to a low dose of Vraylar, along with the Deplin, may work well for me and may end some of my dangerous side effects from Seroquel (whenever I take Seroquel, my blood sugar goes up, my cholesterol is higher, and I gain weight, and then have a hard time losing it). So, I may discuss making the change to Vraylar at my next appointment. Vraylar seems to work better than Seroquel for some people and have fewer side effects for some people.

Since this medication change, I've been feeling more alert. I've been enjoying the end of the summer, and I feel equipped to do everything I need to do with confidence that I can remain stable. I'm continuing to practice good self-care, which for me means drinking lots of water, eating well, limiting caffeine and sugar, exercising, getting plenty of rest and sleep, spending time with friends and family, avoiding alcohol, and taking things one step at a time.

Wellness

It has been 28 years since I was diagnosed with bipolar disorder, and I finally feel like I have figured out how to stay well for the rest of my life. It has been almost three years since I was  last hospitalized for mania. In the time since, I have made wellness the focus of my life. I work in the mental health field and my job is not too stressful. I work 37.5 hours a week and have good benefits and generous vacation time. It is never hard for me to get time off for doctors' appointments. It is a very good, healthy work environment. Having an interesting job that is easy to live with is very important to my mental health recovery. I have other health conditions besides bipolar disorder: PCOS, sleep apnea, psoriasis, allergies, and high blood pressure, and these health conditions are all well controlled by lifestyle changes and medications. I have found that keeping these conditions under control helps my mental health.

I am taking the lowest effective doses of my medications for bipolar disorder and they are working well: 200 mg. Lamictal and 100 mg. Seroquel. I have no complaints about side effects besides having to sleep a little bit more than I would like. It is much better than struggling with insomnia, psychosis, and mood instability as I have in the past though. When I think about the days when I was heavily medicated, being on such low doses of medications and doing well seems like a miracle. I also take the following supplements: a multivitamin, fish oil, vitamin D-3, and biotin. I take them because I believe they contribute to my overall wellness.

I stick to a routine. I have a regular bedtime and wake time. I believe that prioritizing quality sleep is the most important habit that keeps me well. I take my Lamictal and Seroquel between 8 and 9 p.m. and usually fall asleep between 10 and 11 p.m. I wake up at 7 a.m. on work days. I usually stick to the same routine on the weekends, but I occasionally stay out late with friends. Staying out late always requires sleeping late the next day because, with my medication, I always need 8-9 hours of sleep to feel rested.

I exercise every day. On Mondays, Wednesdays, and Fridays, I do a full-body strength training routine using dumbbells and a kettlebell. I have realized that I feel much better when I feel strong. Lifting weights also helps me to sleep much better. On the days that I don't lift weights, I at least take a walk, but I also enjoy cycling, hiking, and swimming.

I make time to spend time with friends and family. I am also friendly with my neighbors and people I encounter while out running errands and shopping. Having good relationships with people in my community is important to me. I eat well, limit my caffeine intake, and drink lots of water. I have made a Wellness Recovery Action Plan, and I follow it. I meditate twice a day -- in the morning and at night. I also take deep breaths as needed. I never realized how much these habits would help me until I incorporated them into my life. I go to therapy once a week. My therapist is encouraging and helpful and understands the challenges I face living with bipolar disorder. This kind of support helps me stay motivated to stay well.

Staying well is fairly simple, but it takes attention to detail and commitment. Doing all of these things regularly and keeping a routine is what keeps me well. Life is good. The things I am currently working on to improve my life are losing weight and decluttering my home, and these things are much easier to focus on when I am well.

Working Full-Time Again

I've been working full-time for the past 16 months. I work for a Behavioral Health Service Organization. I started out working part-time as an Adult Peer Support Specialist (APSS) leading therapeutic groups such as Healthy Cooking and Eating, Lifeskills, Movement For Life, and Coping with Hearing Voices for individuals like myself who live with mental illness. Now I'm working full-time as a program coordinator in my organization. I schedule and provide continuing education for Adult Peer Support Specialists and their supervisors in my state. I also collaborate with other APSSs to write a monthly educational newsletter and to hold webinars and conference calls to disseminate educational materials about providing peer services.

It has been challenging to work full-time again. I struggle with my work-life balance like I always have when working full-time. I go to a weekly therapy session on Tuesdays after work and take a group singing class on Thursday nights. The weekends are for spending time with friends and family, cleaning, doing laundry, grocery shopping, and going to the gym. I like to rest after work on Mondays and Wednesdays. I try to fit in walks on most weekdays at lunch. If I socialize during the work week, it has to be early because I have to be home by 8:30 p.m. to take my medication. Taking it that early is the only way I can wake up for work at 6:45 a.m. I usually fall asleep between 9:30 and 10:00 p.m. My medication, 200 mg. Lamictal and 100 mg. Seroquel, takes a while to kick in, but once it does, I sleep very soundly most of the time. When I have trouble sleeping it's usually because I'm worrying about something or I haven't gotten enough activity during the day. So, I try not to worry too much and I strive to get enough exercise each day.

I've developed a WRAP (Wellness Recovery Action Plan) that really helps me to stay on track with my self-care, and I've managed to stay out of the hospital since June of 2015. I've taken great measures to lower my stress levels and take better care of myself. When I was on disability, I worked with my psychiatrist to fine-tune my medication and I worked hard to change my lifestyle. Most of the time I was on disability, I was hoping to return to working full-time again. People asked me why I got up so early even though my schedule didn't demand it, and I always told them I wanted to get back to full-time work someday so I didn't want to be in the habit of sleeping late every day. I do wake up a little earlier now that I'm working full-time. Most of the time I was on disability, I woke up at 7:30 or 8:00 a.m. That allowed me to take my medication as late at 10:00 or 11:00 p.m. Sometimes I miss staying up later and having more time to socialize, but being able to earn a living and save for my retirement years is worth it.

I don't earn as much money in my current job as I did as an elementary school special education teacher, which was my job before I went on disability, but it is much less stressful and I have really good benefits compared to most of my past jobs. So far, I haven't had any mental health crises since I've been off of disability, although I have had to have my medication adjusted a few times. I have a lot of vacation time, so I plan breaks several times a year. Because I work under a yearly contract from the state, I make a yearly plan of work activities, so I always know what is coming up next. That makes it easy to decide when I will need to take vacation breaks. All of my vacations have been either weekend getaways or staycations. Since I can't afford long vacations, I splurge and do nice things at home every once in a while like going to plays, concerts, and museums.

It has been really therapeutic to work in the mental health field and to get to know Adult Peer Support Specialists, therapists, nurses, and others working in the behavioral health system. I am happy that I can use my recovery experience to help others. It is a satisfying way to earn a living. Working in a therapeutic environment where everyone is striving for good mental and physical health continues to be helpful to my recovery.

Reclaiming My Health

When I was diagnosed with manic depression (now called Bipolar I), at the age of 19, as a student at Indiana University in Bloomington in 1989, I was told that I would have to take lithium for the rest of my life. I started taking it the summer before my sophomore year, and my athletic performance was immediately negatively affected. I quit the soccer team because my coordination had become so poor. I could no longer quickly visually track the ball on the field and I couldn't handle the ball or pass or kick as well. My body felt alien to me.

I spent my sophomore year focusing on school and trying to get used to my new life on medication. I had some friends on a cycling team who knew that I had quit playing soccer, but not really why, and they asked me to ride with them the upcoming summer. After a couple of rides they told me that I was really good and asked me to join the team. So, I joined the team, but something was still off physically, and I knew it. After not performing as well as I would have liked in the first few races, and also having unpleasant problems with dehydration, I decided to quit taking lithium. I told my teammates that I had manic depression, as it was called at the time, and that I had decided to quit taking my medication because it slowed me down too much. My athletic performance improved almost immediately. After discontinuing lithium, I usually placed first, second, or third in my races and was ranked third in the Midwest in women's collegiate cycling. My team also won the Women's Little 500 bike race, which was very exciting! However, I was having trouble concentrating, and feeling very restless, unstable, and pulled in different directions, and also experiencing psychosis at times, so after not graduating on time, I decided to start taking lithium, quit racing, and focus on my studies. Of course, I ended up gaining weight and suffering physically. I did not enjoy feeling slowed down, but I thought it was the price I would have to pay to get on with my life, and I finally graduated.

After graduating, it seemed like the best thing to do would be to continue to take my medication, even though it felt like a weight was tied to my feet when everyone was encouraging me to swim. I was not only physically slowed down, but I also experienced cognitive dulling. When I moved to Louisville, where I still live, I started seeing a new psychiatrist. I remained in his care for 16 years because he had a good reputation, my parents had chosen him for me, and it is really hard to find a good, or even decent psychiatrist. He seemed to believe that I needed to be heavily medicated.  At my most highly medicated, I was taking 1800 mg. lithium, 400 mg. Lamictal, 600 mg. Seroquel XR, Ambien to sleep, and Provigil for alertness (which didn't work for me). It felt like way too much medication and I was exhausted all the time. My life was out of balance. Work was my focus because I had little time or energy for anything else. My psychiatrist was resistant to making changes to my medication, insisted that I take lithium, and told me that he would not continue to treat me if I quit taking lithium, as he considered it to be the cornerstone of my cocktail of psychiatric medications. I consulted with a lawyer to discuss filing a lawsuit for malpractice, because I felt I had been turned into a zombie, and she did some research and told me that I was taking enough medication to knock a horse over. Instead of going through with the lawsuit though, I let it go and quit taking my medication without consulting with my psychiatrist. I lost 60 pounds in a year without trying that hard, and felt better, but I ended up becoming manic and being hospitalized again. After that hospitalization I told myself I would take my medication no matter what, and I did. I still had severe mood episodes and I developed serious side effects: hypertension, borderline metabolic syndrome, and sleep apnea. I also gained a tremendous amount of weight. When I was diagnosed with bipolar disorder, I weighed 130 pounds, and after taking medication for close to 20 years, I was up to 278. I had gained 148 pounds. My weight had more than doubled.

After suffering a terrible depression, having ECT, and ending up on disability, I finally decided that the seemingly substandard psychiatric treatment was just too much for me to handle and I couldn't take it anymore, so I found a new psychiatrist. She is a woman who is a few years younger than I am and she understands my concerns about weight gain and side effects and agreed to help me change my medication since I knew I could not just quit taking it myself without serious repercussions. I had educated myself about withdrawal from psychiatric medication and I found that many medications have withdrawals that mimic symptoms of bipolar disorder. She agreed to let me taper off of lithium. When I did, I experienced a bout of hypomania, but I also lost weight, was not thirsty all of the time, my hair became thicker (it had been falling out for years at that point), my psoriasis began to clear up, and I felt sharper and had more energy, and started becoming more active and taking better care of myself, and with alternative medications, my moods began to stabilize.

I have kept regular appointments with my new psychiatrist since 2010 and my health has improved a great deal. I no longer feel extremely slowed down by my medication and it is easier to work, cook, clean, exercise, socialize, spend time with family, go to doctors' appointments, and to appointments with my therapist. I have realized that in the past I waited too long to seek treatment too many times. Mania, psychosis, anxiety, paranoia, and depression can overwhelm me pretty quickly both mentally and physically. I need to take action and get help from my psychiatrist and therapist before I get swept into a downward or upward spiral.

Now that I have time to live a balanced life, because I am appropriately medicated instead of overmedicated, I focus on taking care of myself physically, mentally, and spiritually. I do not live a perfect lifestyle, but it is greatly improved from how I lived after my first breakdown, and for many years afterward. I work part-time and try to keep my stress levels low. I exercise, meditate, spend time with friends and family, and do volunteer work. Wellness is the focus of my life because if I am not well I can't enjoy anything or be of service to others.

My Current Cocktail

Since the start of this blog I've wanted to write about the medications I take and try because it has been difficult for me to find detailed information of this sort online. The difficulty in writing about medications is that they can often change, and what works for one person probably won't work in exactly the same way for someone else, and a dose that one person might be able to tolerate might be intolerable for someone else. Still, I've wanted to share information about the medications I've taken and am currently taking. Something peculiar that I've noticed is that whenever people discuss these medications they use the brand name, but most people I know take the generics. That is how I have written this blog. I have only taken brand name medications when generics weren't yet available.

As it turns out, Latuda didn't work well for me. I took it for five months and tried to be optimistic about it, hoping that it would have miraculous effects. The biggest problem with taking it was that it made me tired shortly after taking it, so I ended up taking it at night, before going to bed (although I tried to take it with breakfast, lunch and dinner), and I took it with a 350 calorie snack as directed by my psychiatrist. I can't be sure whether the weight gain was a side effect of the medication, or happened as a result of the nighttime snack, but I ended up gaining 10 pounds in the five months that I took it. That was unacceptable to me because I had just spent two years losing 54 pounds. Also, it didn't help me with sleep at all. In fact, it made me quite restless at night. I would fall asleep and then wake up after about an hour and a half. I tried to stay still and fall back asleep, but I ended up staying awake and just tossing and turning in bed. So, I decided to discontinue it. I have now tried Latuda, Geodon, and Saphris, and they have all made me restless. They are similar medications, so this makes sense. My psychiatrist said that Haldol would probably have the same effect because it is similar to those medications. I never noticed that with Haldol because I've never taken it outside of a hospital, I took it a long time ago when I was doing extremely poorly, and I only took it for a short time, but I thought I would mention it here because someone who is sensitive to Haldol might also be sensitive to Geodon, Saphris, and Latuda.

So, my current cocktail is 200 mg. Lamictal, 1200 mg. Trileptal, and 200 mg. Seroquel. The combination of Lamictal and Trileptal has been a good alternative to lithium for me, preventing both mania and depression. I no longer experience extreme thirst and frequent urination, my hair has grown back and thickened, I no longer have a tremor, I've lost a great deal of weight, my thinking seems much clearer, and I don't have to worry about becoming dehydrated when working out. I don't miss taking lithium at all. 200 mg. of Seroquel helps me to sleep very well and my psychiatrist said that it also may be helping me with anxiety. I'm a little slow to get going in the morning, but I definitely have more energy than I have had at higher doses. Besides being a little tired from Seroquel in the morning, I'm not having any noticeable side effects, although I am possibly having metabolic side effects. (It is impossible to know whether my borderline metabolic syndrome is due to my medications or my weight gain, although I feel sure that I wouldn't have gained so much weight without the help of bipolar medications). I take the Lamictal at night, the Trileptal twice a day (one 600 mg. tablet in the morning, and one 600 mg. tablet at night), and the Seroquel at night. I've tried both lower and higher doses of Seroquel and 200 mg. is the least I can take and still sleep well. Over the past two months of taking this cocktail, I've been very productive, my symptoms are under control, I'm getting along well with my friends, boyfriend, family, and coworkers, and I'm exercising a lot, eating well, and steadily losing weight. I've lost the weight I gained while taking Latuda and am now down 55 pounds from my highest weight. I really hope that this cocktail continues to work and I won't have to change it anytime soon if at all. I've been working part time for the past five years and I still have hope that with more stable time under my belt, I will be able to get back to full time work. Of course, I will need to have a job with a flexible schedule that will allow me time off for doctors' appointments since I am being treated for quite a few health conditions now.

In my last few blood tests, my potassium level has been low. I tried eating more potassium for a few months, but that didn't raise my blood level, so my doctor prescribed a potassium supplement, and will be monitoring my potassium level. I've learned that having a healthy level of potassium should give me more energy, be good for my blood pressure, and may even help me have an easier time losing weight. Also, potassium level can affect mood, so having the correct level might also help my mental health. Having just the right blood level of potassium is important because both low and high potassium can cause serious health problems, so, besides trying to get enough potassium in your diet, any kind of supplementation should be monitored by a doctor.

Trying to stay healthy while taking psychiatric medications has been a challenge. The extreme weight gain I experienced raised my blood pressure and gave me sleep apnea. Treating my blood pressure and sleep apnea has made me feel better, this new combination of medications has made me feel better, eating right and exercising has made me feel better, and being able to steadily lose weight has made me feel better and has given me hope that I will be able to get off of my blood pressure medications and CPAP when I lose more weight. So, for a lot of reasons, I am feeling much better than I have in years, and I am very optimistic that my physical and mental health will continue to improve.

Latuda

I've been taking Latuda for almost two months. I started out taking 40 mg. for 10 days and then my psychiatrist gave me 80 mg. to take. 40 mg. wasn't hard to take, but 80 mg. is more challenging. I think it's a good medication, as far as antipsychotics go, but learning the best time to take it was tricky for me. It makes me feel good during the day if I take it at night.  I tried to take it during the day at least 8 times, and each time I felt terrible. A couple of hours after taking it, it became hard to focus, concentrate, and do work. It also made me feel anxious.

The reason that I struggled with what time to take it is that it is supposed to be taken with 350 calories in order to be absorbed properly. That is a small meal, and I'm trying to lose weight. I tried taking it with breakfast, lunch, and dinner, and that bad feeling came on after a few hours and I knew I couldn't tolerate it at those times. The only other time left is later at night, close to my bedtime. If I take it at night I feel good the next day. It doesn't help with sleep, so I'm taking 200 mg of Seroquel  for that purpose, with the goal of slowly cutting that dose down. My psychiatrist believes that I need an antipsychotic along with my mood stabilizers, and I have found that if I take Latuda at night, I feel energetic during the day and tend to ruminate less and I also feel less anxious. But, if I take it any time before bedtime I have a very negative experience. So, I've been taking it at night with a peanut butter and jelly sandwich after dinner, and I'm trying to eat less during the day to make up for what feels like an indulgence, although it's necessary.

The most challenging part of my treatment for bipolar disorder has been deciding which antipsychotic to take. The closest second to Latuda that I have tried is Seroquel. Seroquel helped me to sleep at night, and made me feel calm, but it is very sedating when taken during the day, and also caused quite a bit of weight gain when taken at higher doses. So, for now, my regimen is 200 mg. Lamictal, 1200 mg. Trileptal, 80 mg. Latuda, and 200 mg. Seroquel.

Latuda is very expensive, and that makes me nervous. If I ever lost my Extra Help with Medicare, I would not be able to afford it and would have to take something else, and I think that would be Seroquel. It would definitely be an adjustment.

Weight Loss

From the beginning of my treatment for bipolar disorder, I've struggled with weight gain. Gaining weight has been my most bothersome side effect, with excessive thirst coming in second. I was diagnosed with bipolar disorder when I was an active, thin nineteen year old. I had been playing soccer since the age of five, as well as doing other sports off and on, and I was always fit. When I started taking lithium, the only medication that was prescribed to me at the onset of my illness, I gained 40 pounds in three months. Because of that, I quit taking lithium and promptly lost the weight. I had gone from 130 pounds to 170 pounds and I could barely run. I couldn't imagine living without running, although now I can.

I wouldn't take medication again until I was twenty four and realized that medication would probably help me move forward in my life, which it did, because about a year after that decision, I graduated from college and got a job. When I decided to take medication again, I knew I would probably gain weight. I fought hard against my appetite, and I always exercised as much as I could, and even participated in sports, but I still gained weight. I was considered to be a compliant patient. Gaining weight was really hard. Not only did I feel different and apart because of my diagnosis, I also felt that I had lost control of the body that I had taken good care of for my entire life, and that had always served me well. I became plus sized and had no idea how I should dress anymore. I also worried about my health. I lost my lifelong identity of being a fit athlete. It was depressing.

I quit taking my medication a few more times over the years, always to relapse and end up in the hospital. Every time I quit taking my medication, it was because I could no longer stand the weight gain, and I always lost weight when I quit taking my medication. When I was thirty two, and hospitalized because of mania, I told myself I would never quit taking my medication again because of gaining weight. That year I had quit taking my medication when I weighed 220. I was off of my medication for about nine months before I became manic, and I got down to 160 in that time, but then I ended up in the hospital.

Even though I quit taking my medication several times over the years because of weight gain, I took it long enough and consistently enough that I was always told that I was a compliant patient. I really hated the idea of being compliant. I felt like it was killing me, but I didn't know what else to do. I had the same psychiatrist from the age of nineteen to the age of forty, and he always asked me what was more important, my weight, or my mental health. He treated my concern about my weight like it was an issue of vanity. I was scared of what my weight was doing to my health, and the weight gain was also terrible for my self esteem.

Finally, the only rational thing to do seemed to be to find a new psychiatrist. I found a young woman who I thought would understand why I wanted to lose weight. She was reluctant to take me off of lithium, but by the time she decided it would be okay to do it, my weight had gotten up to 278 and I had been diagnosed with high blood pressure and sleep apnea. This seemed to be rock bottom as far as my weight was concerned. I never thought I would weigh anywhere near 300 pounds. Lithium was interfering with my weight and my sleep. My sleep study showed that I drank six cups of water during the night. I would wake up thirsty and drink water all night long. I don't think my psychiatrist took my reports of this behavior seriously until the sleep study showed how much I was waking up and drinking water, because of the intolerable thirst caused by lithium. She agreed to take me off of lithium slowly.

I had a bout of mania when I was coming off of lithium last fall,  but I stayed out of the hospital. Last spring I was hospitalized for a suicidal depression. It was debilitating and awful, and dragged on for almost two months, but I'm glad I didn't end up taking lithium again. I've been off of lithium for about a year and I've lost 54 pounds. I now weigh 224. I'm glad to be losing weight. 54 pounds lost is significant, but I still have a long way to go. I gained 148 pounds in the time since I decided to start taking medication for bipolar disorder. I always get mad when I think of it. I complained about the weight gain the whole time I was affected by it, and not much was ever done about it until my current psychiatrist decided to take me off of lithium. I knew it was medication that was making me gain weight, but my old doctor blamed my habits for the weight gain. My appetite increased. I was always hungry and thirsty, and I was also lethargic. It's terribly hard to fight those side effects. Now that I am no longer always hungry and thirsty, and I have more energy, I'm losing weight.

I 'm doing a lot of exercise - usually the equivalent of walking five miles or riding my bike twenty miles most days, and some days walking 10 miles or riding my bike 50 miles. I'm also eating well and eating less and less. I'm focusing on eating less fat, less sugar, less sodium, more fiber, and more potassium. This kind of diet is recommended for weight loss and also for control of blood pressure. So, I've lost 54 pounds, but I want to lose 84 more because I'd like to reach my target weight of 140. I'm very happy to be losing weight, but it's hard not to be upset that my medication wasn't changed until I became very overweight and developed health problems because of it. I try really hard to focus on the positive, on the progress I've made, and I'm glad my health is improving.

I was losing weight before I met my boyfriend, but it helps a great deal that he has a mental illness and also had the experience of being an athlete who gained weight because of his medication. He understands the struggle to tame an artificially insatiable appetite. His psychiatrist has also changed his medication to something that allows him to lose weight. We exercise and eat together almost every day, and we really help each other to stay on track. He became fed up with his weight gain after he had gained about 50 pounds and his psychiatrist worked with him to change his medication. His psychiatrist told him that he wasn't going to sit back and watch him get diabetes. I asked my old psychiatrist what would happen if I got diabetes, and he said I would just have to treat it. He didn't take my concern about my health and weight gain seriously.

I'm so glad that I decided to change psychiatrists. I'm currently taking 1200 mg. Trileptal, 200 mg. Lamictal, 300 mg. Seroquel, and 2.5 mg. Saphris. I'm slowly tapering off of Seroquel, down from 400 mg., in the hope that it will decrease my metabolic side effects, and allow me to lose weight faster. My blood pressure is lower, but my LDL cholesterol and triglycerides are still high. I will continue to eat well and exercise, and work to reduce stress, and hope for medication that works without negatively affecting my health. It might take me another year and a half to reach my goal.

Sleep Study

I've been having trouble sleeping for years. I'm 42 now and my insomnia started when I was about 14. The diagnosis of bipolar disorder at 19 explained my sleeplessness at the time. About 10 years ago, I started having sleep problems again. I had gained a lot of weight because of bipolar medications, and my psychiatrist suspected that I had sleep apnea. He referred me to a sleep specialist and I had a sleep study. It was determined that I had mild sleep apnea (too mild to treat) and I was told that I would get better sleep if I slept on my side, so that is what I did.

This past summer, I started to suspect that my sleep apnea had gotten worse. I was waking up about 6 or 7 times each night, that I remembered, and I didn't feel rested. Part of the problem was that I was taking lithium, and it was causing extreme thirst, which was compelling me to drink huge amounts of water, and I was in the bathroom all day and all night. I was so thirsty that I would drink more water each time I woke up at night. Whether because of my extreme thirst, or suspected sleep apnea, I wasn't getting good sleep, so I asked my general practitioner to refer me to a sleep specialist, and I let my psychiatrist know about it. My psychiatrist was very interested in learning the results of my sleep study.

My sleep study in October was disastrous. I got out of bed 7 times to go to the bathroom and drank 6 cups of water throughout the night. I only slept for 1 hour, although it seemed like I didn't sleep at all. During that hour, I stopped breathing 16 times because of sleep apnea. That qualifies as moderate sleep apnea and is considered serious enough to treat. I went back for another sleep study in November, and this time I wore a CPAP, a device that blows a gentle stream of air into the nose during sleep to keep the airway open so that you can breathe properly. I slept 7.5 hours and was getting at least 90% oxygen all night, which is in the healthy range of oxygen. It was determined that I would get my own CPAP, and I did.

In December, I met with a respiratory therapist and was fitted with a mask and learned how to use and care for the CPAP. At first, I was given a full face mask. After three weeks of sleeping with it, I decided that it was too uncomfortable, so I went back for another mask. This time I got nasal pillows and they are proving to be much more comfortable.

I was not really excited about using the CPAP at first, but now, at the end of January, I feel so much healthier and more energetic since I've been using it, that I believe it is worth the expense and awkwardness. Also, it is thought that if you have sleep apnea and bipolar disorder, using a CPAP can lessen your experiences of both mania and depression. As an added bonus, I even look better. My eyes look much more rested and my skin looks radiant. Now, in addition to considering it necessary for good mental and physical health, I consider it to be a beauty treatment, and that makes me feel more excited about wearing it.

Unfortunately, many people with bipolar disorder gain weight from the medications, and that causes other health problems, like sleep apnea. There is a possibility that if I lose weight, I will be able to sleep well without the CPAP. Getting to my ideal weight is my next quest. When you get good sleep, you have fewer stress hormones in your body, so it is easier to lose weight.

Since I've been using the CPAP, I've lost 23 pounds. This is probably also the result of a medication change. When my psychiatrist learned, from the sleep study, that I was waking up and drinking water all night, she substituted Trileptal for lithium. I've been asking psychiatrists to take me off of lithium for years, but this was the straw that finally broke the camel's back. I'm also taking Lamictal and Saphris to control my bipolar disorder and I'm doing very well. I'm stable and alert and feeling much more optimistic about the future than I've felt in years.

Stress

Tonight, while attending my biweekly support group, one of two support groups I attend, everyone spoke of stress more than usual. We all experience relationship stress, work stress, and the stress of having bipolar disorder itself. It's stressful to think about whether or not to disclose the illness to friends, families, and coworkers, and the mania and sleeplessness that occur at times with the illness, along with the with the seemingly endless depressions, are stressful states to be in.

At many times in my life, stress has sent me over the edge into mania and depression, and has caused me to be hospitalized more times than I can remember. As people with bipolar disorder, it is essential that we try to get a handle on our stress levels. For me, medication, diet, exercise, meditation, lifestyle changes, and therapy, have helped me to manage my stress. When stress seems to be getting out of control, I know I need to do something about it. If I can't handle the stress on my own, it's definitely time to call both my psychiatrist and my therapist. Spending time in a serious state of stress often leads to unpleasant outcomes for me: mania and depression. Hospitalization always seems like a huge setback, plus it's time consuming, often at the worst times, and expensive.

The biggest lifestyle change I've made is going on disability. At the time I went on disability, I was mired in a serious depression that I spiraled into after becoming so inert that I couldn't continue to teach. I had chosen to become a special education teacher because I thought that, as a person who had experienced many years of stability, I was ready to handle the stress, and my diagnosis of bipolar disorder would give me the insight and compassion to help students who were struggling with learning and behavior disorders. I did a good job for almost five years. In fact, I earned several awards and a lot of positive feedback from students, parents, and my principal. But the stress eventually got to me and I became almost immobile and was no longer able to gather the energy to teach. In fact, waking up was hard, as was attending to daily tasks such cooking and cleaning, and even getting dressed. I got to the point where I was barely able to care for myself, and I applied for, and was granted disability.

The period before I went on disability was the lowest part of my life. After I received disability, a lot of the stress I had felt was removed. Ironically, I saw disability as a time to focus on my health. I gradually regained my mental and physical strength. For anyone who has experienced long periods of depression, it's obvious that it's physically unhealthy. Too much time spent in bed or sitting causes muscular weakness, and many people who are depressed don't eat enough, or eat the wrong foods, and the poor nutrition causes a deterioration in health.

After a year on disability, I was able to begin working at a part time job, and now I've been working part time for slightly over three years. I'm feeling much better about myself, and people are beginning to wonder why I'm still on disability. The answer is stress. It has been a breaking point for me in the past and I need enough experience with my stable self to prevent stress from harming me again. I feel that I need a longer period of stability behind me before I go off of disability. My therapist and psychiatrist have shared their opinions that I am not ready to go off of disability yet, if at all.

Although I've been on disability for several years, and have reduced my stress, I've still become manic and have had to be hospitalized twice in the past three years. And I've experienced one serious depression where I was unable to work as many hours as usual for a couple of months. I'm hoping that my medication changes and lifestyle changes will continue to work, and I'll improve in my ability to handle stress to the point where I'll be able to handle the stress of working full time. I want nothing more than to deal with my bipolar disorder in a healthy way and to live the most productive life that I possibly can.

Picking up the Pieces

For me, the hardest part of recovering from a depression or a mania is the time after the episode, when I know I'm doing better, and able to move forward, but also realize how far behind I am in things like cleaning, going through my mail, and paying bills - the routine things that are important but go out the window when I'm not in my right mind.

My mania started in March, and was followed by a depression that started in June and ended in July - thanks to a medication change my psychiatrist made. So, I've been feeling better since July. August was a month of recovery. I started going out with friends again, started my exercise routine back up, started cooking more often, and made great strides in organizing and cleaning my apartment - my cleaning routine is always the last routine to recover after a serious mood episode. So now it's September and I'm pretty much back on track. I finally feel that I have recovered seven months after my symptoms of mania first began. That's a very large chunk of time!

It's hard for friends and family to understand the recovery that needs to take place after a mood episode. It seems like once I start acting normal again, everyone assumes that I'm back on track, but that's far from the reality because I always have a lot of catching up to do.

The process of surviving mood episodes and then picking up the pieces is exhausting. It's why I take my medication, try to stick to my routines, keep regular appointments with my psychiatrist and therapist, attend support group meetings, and aim for stability. It's disappointing when I have to pick up the pieces again, but at least I have enough experience with it to know what to expect and also see it as a good incentive to stick to my treatment plan.

Financial Assistance

I had a good, unexpected thing happen this week. I am on SSDI (Social Security Disability), and I work part time. My finances are tight, but I have enough money to pay my monthly bills. However, it's hard to save money, and I've had to ask my parents for help with things such as unexpected dental and medical bills and car repairs.

My father encouraged me to apply for food stamps and I got them. I really didn't think I would. I don't think of myself as that poor. The state worker, who determined that I qualified for food stamps, also told me that I may qualify for help with my Medicare premium, and housing assistance, so now I'm in the process of applying for those programs.

If you're on SSDI , or are just living on a low income, I would encourage you to go to the agencies in your state that help with food, medical treatment, housing, etc., and apply for the various programs. You might get some benefits that could help you live more comfortably, and maybe save a little money each month.

I've been on SSDI for four years, and nobody told me that I might qualify for this type of help. When I first received SSDI, I may have been embarrassed to write about this, but after living on a very restrictive budget for the past four years, I am not ashamed. I will accept the help. I am grateful for it.

The Right Dose

"All substances are poisons: there is none which is not a poison. The right dose differentiates a poison and a remedy." Paracelsus (1493-1541)

I was depressed for the month between my last appointment with my psychiatrist and my most recent one. I didn't reach the lowest depths of depression, but it was interfering with my daily activities. I was the happiest when I was at work, but I wasn't socializing as much as usual, and I was having trouble unpacking after closing a storage space I had rented when my boyfriend (now my ex-boyfriend) moved in with me.

When I was describing my depression to my psychiatrist, I didn't use the word depression, I told her that I thought I had a more realistic view of life after switching out Seroquel for Saphris in my bipolar cocktail. I am now taking Saphris, lithium, Lamictal, and temazepam as needed. There were problems I hadn't noticed, when I was taking Seroquel, that were worrying me, but I thought I would be able to keep moving forward.

About a week later, I called my psychiatrist and asked for another appointment. I told her that I don't like to use the word depression because it is the last state I like to be in, but I was worried that Saphris was causing me to be depressed, and I wanted to quit taking it. I had quit taking it many months before, because I felt like it had caused depression.

My psychiatrist said that she thinks Saphris is probably the best antipsychotic for me because it is less likely to cause weight gain than other atypical antipsychotics. She said, "I was probably blocking too much dopamine," and changed my dose from 5 mg., morning and night, to 5mg. at night only. I was skeptical that this change would help, but it did.

I felt good the next day and have felt good ever since. I really wanted to quit taking Saphris, but during the discussion with my psychiatrist, about the dose, I was reminded of the quote above, something I was exposed to in a college biology class, and it gave me the will to try a new dose. I'm really glad I did. Maybe Saphris will turn out to be the wonder drug for me that it has been for some others. I'm going to keep giving it a try.

Mood Transitions

I was manic in March and April, and then I was hospitalized. When I got out of the hospital, I had been stabilized enough to travel from Connecticut, where I was visiting my sister, to Kentucky, the state I call home.

Now it's early July and, looking back, I realize that I was hypomanic until a few weeks ago even though I was no longer in a crisis situation. I really don't enjoy being manic because my increasingly erratic behavior eventually becomes frightening to myself and others. I also don't like hypomania because it is a step toward both mania and depression for me, but sometimes it's hard to identify. In our society, we are rewarded for high energy and productivity, so sometimes what may seem positive can really be negative.

I was very active after I got out of the hospital, which seemed good since I'm trying to lose weight. It didn't take much to motivate myself to exercise and the things that usually seem hard, like waking up early in the morning, seemed effortless. I broke up with my boyfriend when I was manic, for good reasons, but it didn't really phase me until a few weeks ago, when I closed the storage unit I had opened when we moved in together, and brought everything back home. I felt a sadness and a loss of control as I unpacked and tried to decide where to put everything. I knew that I shouldn't miss him, but I did. At least I missed his companionship.

It struck me that I'm single and may possibly be for the rest of my life. I began to worry about living independently and taking care of myself. Ever since my diagnosis at the age of nineteen, organization, especially of my living space, has proven to be challenging for me. I'm trying to solve this problem by paring down my possessions to the bare minimum. The process of sorting through everything stirs up many memories and mixed feelings and living in a mess, although it is temporary, is disconcerting.

Anxiety had nearly immobilized me for the past few weeks. A couple of good friends helped me realize that my world wasn't ending, I was just overwhelmed. They assured me that I could take care of myself and helped to distract me from my fears by encouraging me to have fun and think about other things. I'm very fortunate to have supportive friends. They have both been through trying times, but have not experienced mental illness. Their insight helped me to understand how a "normal" person would think and pull themselves out of my situation. I quit the negative thinking and started to feel much better.

A few days after I started to feel better, I had an appointment with my therapist and told her about all of the mood changes and the anxiety I had experienced. She helped me to realize that I always feel uncomfortable when I go through mood transitions. Sometimes recognizing a problem is the first step toward overcoming it. Although I don't want it to happen, I can pretty much guarantee, based on my history, that I will become manic sometime in the future. Next time I come down from a mania, I can reflect on the fact that mood transitions are hard for me, and maybe that will help me to push through negative emotions and anxiety more quickly.

Temazepam

Since my 10-day hospitalization for mania, which ended in April, my psychiatrist has made adjustments to my combination of medications. I am now taking 1350 mg. lithium carbonate ER at night, 5 mg. of Saphris in the morning and 5 mg. of Saphris at night, 200 mg. of Lamictal in the morning, and 15 to 30 mg. of temazepam at bedtime, as needed, for sleep.

I just took my first dose of temazepam for sleep last night and I feel good today. I slept well, I did not have a medication hangover when I woke up, and I have been calm and productive all day. I'm thankful that my psychiatrist prescribed it, and I'm hoping that this will complete the perfect combination of medications for me. If it works, it will be the combination I have been hoping for for the past 23 years - one that lets me feel and act like my best self.

My former psychiatrist switched me from temazepam to Ambien about 7 years ago because, he said, Ambien was less likely to be habit forming. That didn't make sense to me, as I hadn't formed a habit, but he insisted that I needed to make the change, so I did, and I haven't experienced as much stability since then as I did before he made the switch.

I told my current psychiatrist what happened when I was switched from temazepam to Ambien, and she wrote a prescription for temazepam right away. Anyone who has bipolar disorder knows how important sleep is to managing the health condition. Some doctors avoid prescribing sleep medications, because they may be habit forming, and instead use other medications, like the antipsychotic Seroquel, for example. I tried to use Seroquel for sleep, but I felt very much impaired and overly sedated during the day. I made many more mistakes than usual, and always felt like I was ready for a nap. I'm happy that my current psychiatrist sees me as a unique individual and prescribes the medications that work best for me.

Many mental health bloggers shy away from writing about the medications that they take, but I don't. I've always been told, and I've learned through life experience, that medication is necessary for managing bipolar disorder, especially Bipolar Disorder I, the most severe form, and the one that I happen to have. Since I'm sharing everything else I do to maintain balance, and since medication is so important for that, I'm describing the medication that I take, and how my psychiatrist decides to prescribe it. She only likes to change one medication at a time, so she can evaluate how each one works in combination with my other medications. This can be a laborious process, but I feel that it is helping me to experience more wellness.

Every person who takes medication is a different person with a different lifestyle. There is no one size fits all in psychiatry - at least there shouldn't be. I'm not suggesting my exact cocktail of medications to anyone else, I'm just writing that it is what's currently working for me. Reading stories of recovery, including stories of people finding medications that work, has always given me hope. More than anything else, in writing this blog, I want to encourage anyone with a mental illness, as well as their friends and relatives, to hang on to hope.

Soccer, Swimming, Saphris, and Summer!

Things are looking up for me since my hospitalization last month. I've been back to work for almost a month, and I'm enjoying my days both at work and outside of work. I started playing soccer again, after a ten year hiatus, and I'm delighting in it. I look forward to the once-a-week game all week, and it inspires me to exercise every day.

Taking less lithium, as my psychiatrist has directed me to do, makes it much easier to play soccer, and also to stay hydrated. I started taking Seroquel in the hospital to stop my mania. I've taken it before, and it caused a lot of weight gain. However, this time, I snacked on low calorie foods whenever I had the munchies and ended up losing 7 pounds also probably, in part, to playing soccer again.

Last week, when I went to see my psychiatrist, she suggested that I replace Seroquel with Saphris. The last time I tried Saphris, I was depressed, and I felt that it made my depression worse. However, I wasn't taking Lamictal, at the time, which I am now. So, I started Saphris about a week ago, and I feel great. Last night, I played better soccer than I've played so far this season, and I felt more coordinated. Also, I'm more alert and have not needed as much sleep as I did when I took Seroquel. I'm back to sleeping 7 or 8 hours instead of my usual 10 hours when I was taking Seroquel. I've heard that Saphris is a "wonder drug" for some people, and I'm hoping that will be the case for me.

Every year, I look forward to the beginning of swimming season, and this year was no different. I had a great time swimming at my condo pool for the first time this year. My conditioning for soccer consists of walking in hilly places, swimming, and taking a spinning class. I'm still going to the YMCA for swimming workouts, but my condo pool is so nice for a peaceful dip after a long, hot day, and sometimes, if I'm inspired, I swim some extra laps. This happens more often as the water warms up. I absolutely love to swim in a warm pool with the sun shining down on me!

It's definitely summer in Kentucky. The temperatures have already reached the mid nineties. I don't have any big plans for the season. It's hard to save money for a vacation, as I'm collecting Social Security Disability, and only allowed to work part-time. So, I'm working on being patient and appreciating the simple things in life, such as spending time with friends and family, and enjoying the sunny weather and lazier days.

Luckily, in my town, there are lots of  inexpensive things to do--art festivals, neighborhood fairs, free and cheap musical performances, etc. I have a lot to be thankful and grateful for, and I'm happy that I'm getting back on track. Someday, I hope that I'll be stable enough to start working full-time again. But, for now, I'm going to take advantage of the extra time that I have each day, and work on strengthening myself, both mentally and physically.