Category: treatment issues

Mood Tracking for Bipolar Disorder – Why Track Your Mood? (1/2)

Ask a Bipolar: What about mood charting?

Most doctors (mostly psychiatrists) will ask you to track your mood if you have a mood disorder like bipolar disorder or depression. And while most people (psychiatrists and patients) would agree mood tracking is good, most people would also admit to not doing it.

I understand why mood tracking doesn’t get done. It’s like a homework assignment when you’re already working full-time. You just happen to be working full-time at being crazy. Homework tends to get left in the book bag.

However, there are easy, painless, simple ways to track your mood that can offer real benefits. Sixty seconds a day. Promise.

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Why Aren’t Doctors More Honest With Patients in the Hospital?

Inpatient Prescriptions of Antipsychotics

Yesterday I received this comment from Leah,

. . . At the mental health clinic [where] I stayed, they were really into prescribing low doses of Seroquel [quetiapine] for unipolar depression . . . after reading up on this stuff I became somewhat angry for the widely prescribed off-label use of these antipsychotics since side effects can be strong. Especially since I was not told. Do you maybe have any thoughts on this practice?

Thoughts? Yes. Far too many. Ask anyone.

I have, over and over, lamented about the lack of honesty and transparency in the doctor-patient relationship. Specifically, why is it doctors prescribe antipsychotics, often off label, without disclosing their risks? It’s happened to me many times. In the hospital may be a special case, however.

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Antidepressants and Addiction, Dependence – Talkback

I recently received a couple of comments on the antidepressants and dependence / addiction post from Tabby. My response to her second comment ended up being so long I decided to put it in it’s own post.

Here is an excerpt from Tabby’s comments (edited for length). If you would like to read them in their entirety, please see here and here. (Symbol […] indicates removed text. Other ellipses are from the original text.)

Antidepressants and Addiction and DependenceComment on Are Antidepressants Addictive?

I know of people who cannot go not 1 day without their medication and the medication not be a life saving med like a blood thinner but be a Anti-depressant. They become all anxiety ridden and panic filled because they just know that if they miss that 1 dose or those 2 doses for that 1 day […]

They can’t sleep and they get agitated and they get quite vile until they get that dose or doses. They resort to sobbing, they resort to melodrama of threatening suicide…

[…] I’m talking a cymbalta, or a lexapro. I work in a MH agency and we have patients call cause they’ve gone 1 day without their prescription. […]

I am also one with Bipolar and when your entire day, or entire life, is solely dependent on whether you took your pill or pills that 1 day… I dare to say, you have a dependence.

Now… you have blood clots and you miss 1 day of your blood thinner.. then we may have a major issue. You miss 1 day of your Seroquel, or your Cymbalta, or your Depakote… seriously, it will be okay… if not, use your psychotherapy techniques. Oh, that’s right… not too many actually do psychotherapy… it’s all the meds baby.

[…] I am well aware of the benefits of medication compared to no medication for those with Mental Illness. My point was – too many people seek out the comfort of the medication to handle their daily life’s issues […] than to try and work on figuring why they are having the problem in the first place.

Folks do not wake up, naturally, anxious. Something has to have occurred to trigger that emotion and anxiety is an emotion that triggers a physical response. Yet, too many run to the cabinet and down pills to “calm” the anxiety rather than try to do something else non-medicated that […] The first reaction is to kill the emotion/feeling… not to try and figure why it’s happening.

No therapy doesn’t work in all settings or all situations but if you never try, then it will certainly never work. In that your blogs are predominately med supporting… I could say that you mock those who try to use more psychotherapy than meds.

Seroquel and Depakote are not equivalent to Warfarin or some of the other medications needed for literal body functioning. Yet, if you have been on a med for a long period of time, for example Seroquel to put you to sleep every night.. and then suddenly you miss a dose or 2… YOU WILL HAVE SYMPTOMS. That’s med dependence and you’ll have a psychological dependence because you’ll become frantic wanting your med.

[…] Many folks suffer with their Bipolar symptoms, or any MI symptom, long before they ever take the 1st pill. So, the life-saving aspect is only a “feeling”.

I  know the meds help but have they literally saved me? No. They take away the uncomfortable and the frightening… but they don’t keep me from dying. If they were the sole and only reason, then I’m a walking med cabinet.

Even folks that take a plethora of meds, every single day and swear on a stack of their most revered book… still kill themselves […]

Thanks Tabby for your response. I think your thoughts on the issue represent a perspective of many.

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Are Psych Meds Addictive? – Antidepressants (Part 1)

Before I started taking psych meds, one of the major concerns I had was addiction.

I didn’t want to be an addict of any sort as I’m quite familiar with the horrors of addiction, having addicts in the family.[push]Will I get addicted to antidepressants?[/push]

And I knew people often took antidepressants for long periods of time, sometimes forever.

So weren’t these people addicted to antidepressants?

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Psych Meds Prevent Artistic and Creative Thought

Not infrequently, at the Bipolar Burble I get comments about how if famous artists with mental illnesses had of been medicated, we would have no art today. For some odd reason their go-to example is always Vincent Van Gogh. Without his untreated mental illness, they argue, Van Gogh wouldn’t have been the great artist we know him to be today.

Right then. Let’s all go off our meds and paint. And chop off our ears.

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Money Through Lies – Direct-to-Consumer Drug Advertising

Making You Want Something You Didn’t Know You Needed

I despise drug ads. No one should be interrupted from watching the season-finale of House only to have a picture of a highly unkempt woman on a couch quickly to be turned into vital young dream girl thanks to the latest wonder-pill. That is absolute poppycock.

But drug companies spent $4.2 billion in 2005 on direct-to-consumer advertising in the US.

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Depressed People Who Take Antidepressants Do Better Long-Term – Part 2

As I mentioned last week, it’s very difficult to measure long-term outcomes of depression treatment due to the confounding depression variables like severity of depression, duration of depression, number of depressions and so on.

In short, the sicker you are, the more depressed you are, the more likely it is you’ll get treatment.

Antidepressant Treatment Outcomes Long-Term, A Study

I discussed the basic outcomes of this study: The association between antidepressant use and depression eight years later: A national cohort study by Colman et al. which tries to take these variables into account.

Colman et al. showed those who took antidepressants had better depression treatment outcomes than those who didn’t, eight years later, once confounding variables were taken into consideration.

I’ll now point out the strengths and weaknesses of this study as well as some other interesting tidbits shown or cited in the study. Oh, and I’ll give my opinion on what it all means.

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Depressed People Who Take Antidepressants Do Better Long-Term

Recently the controversy over long-term outcomes of those who use psychotropic medication has flared up again. Some people argue depression/bipolar/mental illness patients do the same, or better, when they don’t take psychiatric medications long-term. However, the statistics they use to assert this claim are often faulty.

A study from Calgary, Alberta, Canada (yes, we do research up here too) has attempted to fix some of the bias seen in other long-term depression treatment outcome statistics. I’ll cut to the chase for you:

Over the course of eight years people with depression who took antidepressants had better outcomes.

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Control Over Bipolar Treatment – Learned Helplessness

One of the crazy things that will happen to you when you seek treatment for being crazy, is doctors will ask you what treatment you want. Usually your psychiatrist/doctor will give you two options: Would you like to try psych med A or psych med B? This provides the mirage of control over your mental illness and your mental illness treatment.

Frustration, thy name is bipolar.

Patients Choosing Psych Meds has an Air of Hilarity to It

This choice, of course, is ridiculous.* How should you know which medication to pick? They’re the doctor, the fancy psychiatrist, aren’t they supposed to know?

What criterion could you possibly use to pick a psychotropic medication that would conceivably compare to an actual doctor?

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I write a three-time Web Health Award winning column for HealthyPlace called Breaking Bipolar.

Also, find my writings on The Huffington Post and my work for BPHope (BP Magazine).

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