If you’ve been around for the last couple of weeks either at the Burble or at Breaking Bipolar, you know it’s been pretty much all suicide all the time. And there will probably be more to come on suicide as it’s an awfully big topic.
But I do have a question for everyone:
What topics would you like to see on the Burble?
Are there questions about me? Bipolar? Mental illness in general? A timely topic?
A reader recently suggested a topic on mental illness and euthanasia / right to die. A great idea. (Although really hard. Someone is clearly wanting me to tackle a rather large challenge.)
I can’t promise I’ll address all your questions / suggestions, but I would like to hear them nonetheless. Because if there’s one thing I’ve learned by writing the Burble for so long: Readers will surprise you.
Hi Natosha,
An area I’m struggling with when communicating with a family member with bipolar, is how to be supportive but not enable or encourage irrational ideas. Sometimes, when we’re talking, I really know I’m talking to him – with his innermost ideas, thoughts and so on. Other times, I’m confused wondering how to handle the interaction because some of the thoughts are either irrational, denial, negotiation or all. My struggle is to be supportive without joining ideas that may actually be harmful. When I think of some of the comments or ideas, I think that doesn’t really seem to be an idea that will help or that could end really badly, but then I think what if this is his reality and this is an idea that he’s not going to let go. He’s an adult. I really don’t know where to go with alot of it. And, the big issue for me is many of the ideas don’t come up with solutions that will help him support himself and move forward in life. But he questions what moving forward really means and may say – what’s the point? Any ideas on better communication would be helpful. This person is unmedicated and doesn’t plan to follow through with traditional treatment methods.
Hi Natasha,
I am interested in finding out the statistics for bipolar and other mental health issues as oppossed to say 10 years ago. Is it just that the diagnosis is more recognized now than it was then or could it be environmental?
What about getting into a new realtionship. How far into the relationship do you bring it up?
How do you prepare yourself with materials to help make him understand so that he doesn’t run for the exit? And what about friendships…should you even tell them?
Hi Patricia,
I have actually address the issue of telling a boyfriend/girlfriend about your mental illness here: http://www.healthyplace.com/blogs/breakingbipolar/2011/08/when-do-i-tell-my-boyfriendgirlfriend-i-have-bipolar-disorder/
Hope that helps.
– Natasha Tracy
Thanks Natasha. That was helpful. I guess it is always better sooner than later before either of you are committed and there is a chance for broken hearts. I hope I find the courage to bring it up. With friends, I have decided to ony tell the ones I am really close with, I don’t feel it is necessary to tell acquaintances. Thanks for your help with this :)
Well, aside from suicide, I’d love to see topics on depressive episode triggers, as well as an article(s) that relate what it was like for you to be living in bipolar, what happened, and how you are now living in recovery.
Hi Katherine,
Good suggestion – you’re not the only one who wants that, so it’s definitely on the list.
Regarding suicide, I’ve actually written quite a lot on that:
See: https://natashatracy.com/mental-illness-issues/suicide/mental-health-suicide-information-round-up/
and
https://natashatracy.com/mental-illness-issues/suicide/start-feel-suicidal/
Thanks,
Natasha Tracy
What kind of toll do bipolar medications have on those who take them. The medications quite possibly do harm health wise if taken for a long time. I myself have stopped meds in the past because of the fear that they may be harmful in an unhealthy way. I don’t see much written on this topic at all.
Hi Crazyneadrider,
The reason you don’t see much written on this is because we don’t know much – if anything about it. Most medications are this way. Long-term studies are rare due to their cost. There are likely case studies but there probably isn’t anything definitive. I’ll have to take a look.
– Natasha Tracy
I should add, this varies depending on the type of medication and the meaning of the term “long-term.” We are learning more, particularly about antipsychotic’s effects in the longer term (there are concerns for some of them).
– Natasha Tracy
Dear natasha,
Would love for you to tackle the success rates of talking therapy versus listening therapies or any against just medications alone.I imagine that research will be hard to find as most research is drug company/goverment funding.
Hi Patrick,
What would you consider to be a “talking” or a “listening” therapy?
Also, you might find this interesting: https://natashatracy.com/mental-illness-issues/research/evidence-effectiveness-psychotherapy/
– Natasha Tracy
Patrick,
Part of this question has been answered in a post I wrote here: http://www.healthline.com/health-blogs/bipolar-bites/therapy-plus-medication-no-better-medication-alone
– Natasha Tracy
Other topics suggested by people:
– rapid-cycling
– postpartum bipolar
– ECT, side effects, negative aspects
– managing yourself in your relationships when you’re super activated (romantic, friendship, family, whatever.
– how to keep yourself safe when your emotions are in flux and you don’t necessarily know how to define how you are feeling. How to deal with the desire to set (possibly over-ambitious) goals
– juvenile bipolar disorder
have you written anything about auditioning doctors and therapists and evaluating whether people will be productive members of your therapy team? assuming people have coverage that allows them to choose. I’ve had a lot of bad therapists whose non-cooperation and incompatibility was downright harmful (gaslighting Pollyanna “think positive!” counselors helped push me into a psychotic break).
Hi KG,
I haven’t written about therapists, specifically, but I have written about choosing a good psychiatrist: http://www.healthyplace.com/blogs/breakingbipolar/2011/12/how-to-choose-a-good-psychiatrist/
Hope that helps.
– Natasha Tracy
Hi KG,
I’ve also now written about choosing a good therapist: http://www.healthline.com/health-blogs/bipolar-bites/how-find-good-therapist
– Natasha Tracy
Triggers for episodes and how to deal with them. I need more help with this cause I overreacte and make a bad situation worse…..or I harp on what bothers me till I drive hubby crazy. I can’t shut up till I have wore myself out. I repeat the problem feeling I have to overexplain myself. I get set off also by roomates behaviors too yet we have to have them live with us yet I am worse since they r living here. How can I shut up and let things that don’t matter run off my back? Why is everything they do upset me? I know I need a calm life to prevent episodes but it isn’t always possible….how to cope then?
Hi Jeri,
Another good suggestion. I think this is a common problem for people (myself included) so I’ll put it on the list.
– Natasha Tracy
Oh…and she is also an alcoholic
Hi Natasha, I would like to hear about mutiple mental illness. Let say ar “friend” of mine was diagnosed with bipolar 2, ADHD, OCD, and PTSD. How would the symptoms and drugs interact? Is it common to have multiple mental illnesses? and ask people how they deal with them. Thanks for writing your blog and giving us all a place to air our feelings and concerns.
Hi Patricia,
We call those “comorbid conditions.” I know this sounds bad, but it’s just a medical term. Comorbid conditions of addiction and anxiety disorders are very common in bipolar disorder.
Thanks for the suggestion.
– Natasha Tracy
Hi Natasha! I have had clinical depression all of my adult life. First diagnosed with it, however, in my mid thirties, but had suffered with it since actually late teens. I am now mid forties, and lately I seem to be cycling through highs and lows a lot more. Wondering if clinical depression can become bi polar, and what are the rates of that occurring?
Hi MichaelL65,
I’m happy to answer that one right now :)
If I had to guess I would say that you had “bipolar tendencies” all along and they just weren’t severe enough to get noticed. There are a series of “soft signs” of bipolar that you may have experienced that indicate bipolar tendencies without major mood episodes: http://www.healthline.com/health-blogs/bipolar-bites/soft-signs-bipolar-disorder
If, in fact, this was the case for you, it’s possible that taking antidepressants for prolonged periods (I’m assuming that’s what you’ve been doing) may have made the bipolar part of your illness worse as treating bipolar disorder with an antidepressant alone is contraindicated and some feel makes the overall course of the illness worse.
Don’t panic though. This may just mean you need to add a mood stabilizer to your medication (or you may be able to replace your existing medication with a mood stabilizer).
As for how many people this happens to, I couldn’t say. Misdiagnosis of bipolar disorder is a huge problem and is common with many people who present with depression being diagnosed as unipolar depressive rather than bipolar: http://www.healthyplace.com/blogs/breakingbipolar/2012/06/misdiagnosing-bipolar-disorder/ (I wrote about misdiagnosis and there are many people with stories of it in the comments.)
So I wouldn’t say that one goes from unipolar to bipolar depression, I would just say that the bipolar part wasn’t seen. Bipolar (and depression) are spectrum disorders and not everyone falls right at one pole or the other.
I hope that answers your question.
– Natasha Tracy
I am interested in hearing about your experiences with the larger world. How is life in your neighborhood, at the coffee shop or bookstore or with friends? Do you work outside the boundaries of the mental health community, and pitch in on broader civic issues? Many issues relating to mental illness are now at the center of civic debate – criminalization, homelessness, prisons. Regards, –pk—
Hi Paul,
May I ask in what regard you’d like to hear about “the larger world?” Are you interested in a mental health topic or just more about me as an individual.
Just trying to get a sense of what you’re looking for.
– Natasha
Hi!
I’d like to suggest a topic. I’m bipolar myself and when I’m really depressed I try to hide it from my family because I don’t want to worry them. It’s very tiring to wear this sort of “I’m okay-mask” but I don’t know what else to do. What do you think about this problem? And how should it be handled?
P.s. English is not my first language so sorry. I hope you can understand what I’m trying to say anyway :)
That’s a hard one because our being depressed can have a knock-on effect on other members of the family and make them feel low. On the other hand, we need some acknowledgement that all is NOT okay with us and some measure of consideration for being that way. But then … some of us don’t have a family that even want to hear that we’re feeling bad, who refuse to acknowledge there is a problem at all, or who say “I don’t want to know – I have my own problems.” Sometimes it feels kinda lonely out here!
What I do, or try to do, is build a network of people who also have chronic health issues. They don’t all have to be BP, but you find a lot of them have depression anyway because of their other illnesses. We have an agreement, which is that it’s okay to moan and bitch about how we feel! We don’t have to think we must put on the happy face for each other but give the story straight. “How are you today?” “I feel cr@p! What about you?” “Same as you by the sound of it!” That gives me a way to let off steam, so I may feel not so desperate to paint the house blue. It’s no magic solution but every little helps and lots of little things can become a big thing and make a truly critical difference. At least, that’s how it goes for me, but everyone is different.
Hi Mari,
You’re in a common situation and it is really hard. I think you do need to learn to be open with your feelings but in saying that, it’s not an easy thing to manage. I’ll put this on my list of topics and get back to you.
– Natasha Tracy
I suggest it might be useful to help raise awareness of the side effects of some medication as I find doctors do not always tell us nor take into account other health issues. An example:
It has been suggested that my dosage on Lamotrigine (250mg per day) is not having sufficient effect to help control my mood swings. So, it was suggested I try Quetiapine.
However, I was not told that the side effects of this are, amongst others,
+ weight gain,
+ interference with the Pancreas causing Diabetes Type II,
+ fatigue,
+ inflammation or swelling of the sinuses or pharynx.
However … I’m already struggling with weight and fatigue, I’m already Diabetic and I have a long history of sinus problems and I’ve got Obstructive Sleep Apnoea!
So, I am presuming Quetiapine would be likely to exacerbate all of those existing conditions. I have, therefore, chosen to decline the offer and stick with the Lamotrigine. But my point is this:
I would not have found out about these side effects unless I had done my own research about Quetiapine. Therefore, I suggest it may be helpful to make a list of the known side effects of all the common medicines used to treat Bipolar Disorder.
If you like the idea, I’ll be glad to help.
Hi Graham,
I understand your frustration (or even outrage) at not being told about devastating side effects of medication. I have faced that same problem.
My best advice for people is to look it up using the full prescribing information available at rx.list.com. I don’t think it adds any value for me to replicate that information here. Not only would it be oodles of work, that type of information can go out of date very quickly. While the full prescribing information isn’t fun to read, it is complete and will tell you things you likely can’t find anywhere else.
(I just happened to have discussed the full prescribing information on quetiapine here: http://www.healthyplace.com/blogs/breakingbipolar/2010/08/decoding-bipolar-drug-information-e28093-seroquel-e28093-part-1/ and as you can see, it’s a 3-part article. Just doing one drug takes a very long time.)
– Natasha
More on mental illness other than bipolar e.g. regular depression, ocd, Schizophrenia etc. Also these illnesses and their relationships to sleep problems.
I would love to hear about the effects of psych meds on sexual desire in women, and strategies for dealing with dead libido. My doc (medical) told me that sex isn’t the most important thing in a relationship. Ok, yeah, but is it irrelevant? A guy tells a doc he is having issues, he gets a pill.
That is _such_ a great question.
Mini-rant time.
Doctors tend to be men and they are still under the mistaken impression that women don’t (or don’t need to) enjoy sex. You are exactly right – men want sex so they get a pill, women want sex and no one cares. It’s still from that patriarchal, uptight, sexually-repressed society that some people think we still live in. And it’s completely unacceptable. It’s hard enough for a woman to go in and talk about sexual problems (just as it would be for a man) but to then be told they don’t matter ticks me right the heck off.
Rant off.
So yes, excellent topic. Totally on the list. Thanks for bringing it up. You’re far from the only one with this concern.
– Natasha Tracy
I struggle so much with the fact that doctors don’t seem to respect that sex and sexuality are important when you have bipolar.
I had a case where my medication made it impossible for me to orgasm (not get aroused, I could do that just fine given proper stimulation). I had a huge blowout with my doctor who told me it wasn’t important or a big deal, but it was certainly a big deal to me.
So just saying, they minimize the importance of sexuality for men sometimes too.
Ashavan,
I’m sorry you went through that. It’s not fair that doctors don’t take _all_ of your health issues into account – including sexual health issues.
– Natasha Tracy
I would like to see success rates for medicated, non medicated, medicated with therapy, and those using natural methods.
Hi,
I suspect that data make not exist exactly how you want it.
I do recommend looking that this article I wrote in the meantime: https://natashatracy.com/mental-illness/depression/depressed-people-antidepressants-long-term/
– Natasha Tracy
Women’s issues in general would be welcome beyond just pregnancy. PMS may seem mundane but can escalate. And with your book idea, dynamics when dealing with male doctors?
Hi MMC,
While I think pregnancy is the major female issue, but I agree there are others as well. Good suggestion.
And thanks for the idea about the female-male doctor relationship. Do you feel there are any problems you have identified specifically?
– Natasha Tracy
Hi Natasha! You run a great blog and it’s of great service to many Depressive and Bi-Polar people and their friends and family.
That being said, can you come up with an article for friends on how to help and be a friend to someone who has a mental illness? I’m sure I speak for a lot of people when I say I’ve lost friends due to my depression and the odd behaviors that come with it, and it makes one feel even more worthless and unwanted.
Thank you so much for what you do! ((huge hugs))
Hi Christopher,
I’ve lost friends from bipolar too. It is an extraordinarily painful thing.
I have written about what friends can do for friends with a mental illness: http://www.healthyplace.com/blogs/breakingbipolar/2011/03/how-to-help-someone-with-a-mental-illness/
I’m happy to write more on the subject though as it is such a big issue for so many people.
– Natasha Tracy
Hi Natasha,
I’d absolutely love to see more about bipolar mixed states. I tend to end up in mixed states more than mania or depression (which sucks because, in my opinion, mixed states are the absolute WORST of all moods) and there seems to be very little decent information about them.
Thanks!
That’s a great suggestion Tara, thanks for bringing it up.
You are correct, mixed states are considered to be some of the most dangerous episodes in bipolar disorder and are generally hard to treat.
I agree, there should be more information about them out there.
Thanks!
– Natasha Tracy
Hi Tara,
I’ve now done a 4-part series on mixed states: https://natashatracy.com/bipolar-disorder/mixed-bipolar-disorder-mixed-mood-episodes-bipolar-1/
– Natasha Tracy
Natasha, can you talk about any physical, cognitive or emotional sensations people might experience when they rapidly shift from one mood to another. Or aren’t there any, and one moment someone may be in one mood and the next they just exist totally in the other. I’m not sure if this makes any sense.
Hi Kerri,
That absolutely does make sense. I call it mood whiplash.
Thanks for the suggestion.
– Natasha Tracy
I’m curious about your take on bipolar management strategies like mood charts and workbooks, a la Julie Fast. Are they effective? If so, why? Have you tried them? Etc.
Hi HM,
I’m looking at a mood-charting piece now, actually. Perhaps that’ll be up next week.
I’m not against workbooks and these sorts of things but I would say they are of limited use.
– Natasha Tracy
I think the hard part about mood charts etc is that they have to be kept up to be useful, and that’s something that I have one HECK of a time with! So if you could talk about strategies for doing so in your article (beyond the standard-issue “do it at the same time every day” cuz ya know, if my life were that steady I might not have this problem to begin with!) that would be wunderbar!
Thanks for all your hard work on our behalf (behalves? eh, whatevs)
Hi Lynoth,
Excellent point. I’m planning on discussing some software that I think makes keeping a mood journal daily really easy.
(You’re welcome.)
– Natasha Tracy
An answer to your mood charting question is now available.
Why track you mood: https://natashatracy.com/mental-illness-issues/mood-tracking-bipolar-disorder-track-mood
How to track your mood (including how to remember to do it): https://natashatracy.com/bipolar-disorder/mood-tracking-bipolar-disorder-how
Let me know if you have any further questions.
– Natasha Tracy
I would be interested in ways to combat weight gain from bipolar medications. I’m tired of hearing, eat more salad! I exercise and eat carefully, yet it has been an uphill battle. In exasperation, I finally did some doctor shopping a couple of weeks ago and found a general practitioner who gave me adipex. In just two weeks I’ve lost 13 lbs and within 3 lbs of my goal weight. But surely there are some other options out there that may not be as risky.
Hannah,
Eat more salad isn’t good enough for you?! (joke)
I can so some research, but I really suspect there is no secret. See, antipsychotics change the way your body metabolizes food and there’s just no lifestyle way to combat that for many people.
(And FYI, I’ve never heard of anyone being put on a weight-loss drug while on meds, especially for such a small amount of weight. Did you know that _every_ drug that has been approved for weight loss has had to be recalled due to health issues? Who knows what’ll happen with this one, but I’m just saying….)
I’ll see if there’s a more concrete answer I can find.
– Natasha Tracy
I’d love to see something(s) about managing bipolar during pregnancy – meds, therapies, supports, etc. I know it’s something that is a bit murky and scary to many women!!
Hi Lynoth,
That’s a great suggestion, thanks.I’ve actually written a few articles on this for clients and it is a murky and scary subject. But the fact of the matter is women with a mental illness get pregnant all the time and more information on the subject is definitely better.
– Natasha Tracy