Julie A. Fast's Blog, page 66

Newsletter: Seasonal Affective Disorder and Bipolar Disorder

Oh yes, the dark weather has started here in Portland, Oregon. I am getting ready for the winter depression way ahead of time. I have found that preparation for symptoms is the best way to prevent symptoms! Here are some tips:

- Determine your worst time of the day when the weather is dark? It’s around 4-7 for me. So… here is what I do:

- Make sure I work in the morning when it’s light so that I have something fun scheduled at that time. I can have coffee with a friend or I can go see a movie. Yes, the theater is dark, but seeing a comedy is often a great antidote to the outside gloom.

- Exercise during your worst hours. This is often right after work for many people. Gyms have very bright lights and that helps. This is also a great time to schedule a walk with a friend. You can get into the habit now.

- Try not to complain too much about the weather. Portland is funny. The weather is terrible many months of the year. It has always been this way and yet we still complain. It’s crazy! It’s Portland. Or course it rains all of the time!

- Hang out with people who don’t have SAD. This helps with the complaining.

- Light boxes are not recommended for people with bipolar-but if you are on a mood stabilizer, you may be able to use them. Talk to a health care professional who understands mania.

- I’ve found that heavy duty exercise helps the best- an hour or more.

Ok. Prepare for the 4PM dark days.

And let’s write the government and tell them that daylight’s saving time is dumb!

Julie

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Published on October 20, 2012 01:52

You Don’t Have to Watch the News. You Don’t Even Have to Follow the Election!

I don’t! I stopped reading the news, listening to NPR, reading the news on the internet and even talking with my friends about the topics I found upsetting.

Interestingly, I still know everything that’s going on. I haven’t read a Time Magazine in years. I went to dinner at a friend’s on Monday night and saw the magazine and thought that it would be interesting to read. Guess what. It was the same stories I’d read years and years ago! I’m not missing anything.

Regarding the elections. My blood starts to boil when I even look at pictures of the debates. My head begins to explode when I think of the money being spent that could go to schools, etc. Though I know it rarely does.

So, I will read a headline and see what’s going on and know that nothing will sway me from my political leanings, so why watch?

It’s hard enough to stay stable when things are calm, I don’t need elevated blood pressure from our death! murder! election! mayhem! Kim Kardashian! world.

PS: Obama went to MY highschool in Hawaii.

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Published on October 17, 2012 19:11

Accepting New Family and Partner Coaching Clients

Writing books on bipolar disorder has been my career for over ten years. I enjoy writing and plan to do a lot more. (It can be a challenge when the mood swings are paying a visit, that’s for sure.)

Over two years ago, I started coaching partners and family members of people with bipolar disorder as an addition to my writing career.

I never, ever thought I would find work that I enjoy as much as I enjoy coaching. I feel at home with the parents and partners as I have been where they are- and I remain calm during the crises that many of my clients are going through while we are working together. Bipolar disorder is like a puzzle. It’s not always easy to find the right pieces on your own. It helps to have a coach as a guide.

My coaching practice has room for new clients. I take new clients about once a month-and then help them as best I can. It’s a partnership that saves relationships and often lives.

Coaching is not for everyone, but if you are concerned about your relationship with a person with bipolar disorder, it may be a good fit for you. The following link will tell you more. I look forward to talking.

Julie Fast Family and Partner Coaching

Julie

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Published on October 15, 2012 13:55

Bipolar Disorder and Dating Poll

This is one of the site’s most popular polls. How would you answer?

Take Our Poll

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Published on October 13, 2012 16:04

Reader Question: Julie, what is the best lithium level?

All people with bipolar disoder know the medication called lithium. Did you know that lithium is measured in the blood to make sure the dose is not too high? In the question below, Dyane asks how she can know what level works the best. I wrote a long answer- so be ready to become a lithium expert!

Hey Julie,

I have been taking lithium for the past 4 years. I think it’s a great drug, and I have accepted the fact that I need to take it for the rest of my life as long as it doesn’t poop out on me or destroy my organs. I wondered if you take it or have taken it, and if so, how low a dosage did you take? My other question is do you know ***how low*** do people ever go with lithium – of course everyone is different, everyone has different blood levels of it, etc., so that’s a difficult question to answer well, but I figured I’d throw it your way. I currently take 900 mg of lithium a night, with no adverse side effects (thank God) and my blood level is at the low end of the therapeutic range. .7 I think. THANKS for anything you can share with me! Take care, Dyane

Hi Dyane,

Your question has many levels- the kind of question I like!

First of all, drug efficacy as well as side effects are completely dependent on our physiology. It’s about the brain and the liver as this is basically the train station for most drugs. My coauthor Dr. John Preston has a theory that those who experience severe side effects tend to keep a med in the liver for a longer period- which means the meds stay in the body longer. Interesting theory.

Lithium, unlike most bipolar disorder medications is processed through the kidneys. Kidneys are sensitive creatures which is why people taking lithium absolutely must have blood tests to measure their lithium level. I talk to a lot of people who take lithium and the main reason they go off of lithium even though it’s working is for kidney safety. This is usually after taking the drug for many years. You don’t have to be scared to take lithium- you just have to be careful.

I started lithium last year and it has profoundly changed my life. Though it’s basically an anti mania drug, it’s also used for serious depression. I added Zoloft to the lithium and kept on my Lamictal. I also take Ritalin and use Ativan when I can’t sleep.

My lithium side effects were off the chart for months- weight gain, fogginess, apathy ( a very serious side effect), memory loss and sleepiness- intense sleepiness. But I waited it out. Maybe I just gave my liver and kidneys enough time to process all of pills. I am depression free for the first time in ten years. Interestingly, my lithium levels have stayed the same even though my side effects have lessened considerably.

I’m glad the lithium is also working for you and you don’t have side effects. Awesome!

This means that my brain/body reacted differently to the lithium than yours. I wish I were more like you.

Regarding lithium levels: the goal is 1.0, but this is just a benchmark. It’s mostly to make sure people don’t go in to lithium toxicity. All med dosages are based off average milligrams, but it’s common to go way under and way beyond the dosage with meds such as Lamictal. For example, my mom takes 125 mg for her depression and I take 700mg. Lithium dosage is more compact. Most people I know who take lithium are between 900-1200 mg. But this is not really the important statistic- it’s all about the lithium level in the blood.

The reason I’m writing an encyclopedia here is to point out that successful lithium use is a combination of a dosage that works with the minimum of side effects and a level as close to 1.0 as possible. Your .7 level is very close to 1.0 and is not low at all. When my friend Sharon went to the hospital in a manic episode, her lithium level was at .3 That was too low for her and the mania broke through. But, this isn’t to say that a low level will not work for someone else. If it works, it works. We just have to keep it from going too high. It’s so important to remember that when blood levels are too high it can lead to lithium toxicity which can ruin the kidneys.

I was in and out of an extremely severe depression for almost five years. Lithium with added Zoloft saved my life. To be honest, I would give up a kidney for this, but I prefer to stay healthy! This is why I get my lithium level checked regularly. I’m glad it works for you. Lithium works well with other drugs, so if any of you reading this are desperate for relief, lithium may be the answer.

You are now an expert on lithium! Julie

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Published on October 11, 2012 19:45

Are you a parent of a child with bipolar disorder?

Parents of kids with bipolar disorder..

I often feel sorry for my mom. She has to deal with so much concerning this illness. I’m having a super tough day today and she knows it. I always tell her what I’m going through. I am very honest: “I’m sick today. The depression is really bad.”

My mom has used the Health Cards for seven years- this means she knows what I need, but it doesn’t make it easy. She knows I am safe and that I know how to take care of myself. But it must just break her heart to see her child so sick.

I’m lucky that she was willing and able to learn my system. It has saved our relationship – and my life! many times.

I have options, as we all do- when I’m this depressed. On some days, I really do need to see friends and hang out. But friends aren’t always available- on some days, like today, I know that working is my best recourse. I always feel better when I work. A lot of my depression comes from work situations that don’t work out- or that cause too much stress- so when I get things done and do them well, the stress is less!

It’s important to look at what is going well. It feels impossible to do this when you’re depressed, but it’s possible.

I see my nephew this afternoon
It’s not raining!
I have work ideas that will be successful

For now, I’m going to get to work. No list making, no wondering what I should be doing, no crying and feeling sorry for myself. That is depression, not me.

I promised on my last post that I would write down my accomplishments before I go to bed tonight. I will do this.

I’m glad my mom has the Health Cards- I need her help today and she knows exactly what to do!

If you have a child with bipolar disorder, it’s NOT easy to know what to do. The parenting skills that work with non bipolar kids don’t necessarily translate to kids with the illness. You have to learn a new set of skills, as my mother did with the Health Cards!

Julie

PS: The picture is of my mom and my nephew David.

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Published on October 11, 2012 17:41

Leave a blog comment- I love them!

Hello to everyone,

I want to say thank y0u to all of the readers who leave comments on this blog. I know that we all can learn so much from each others. I get a lot of questions from readers- I want to let everyone know that I read all of them- I try to answer in the blog posts themselves. I still have not found a way to get to the questions as mush as I would like to. My books answer the questions about bipolar disorder treatment and management- so that is where I lead people first- but I know there are many personal questions I would like to answer. I do encourage readers to leave their opinions and advice on the comments.

Julie

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Published on October 09, 2012 22:10

Julie, Is it Possible to Have a Life free from Depression?

If you had asked me this last year, I would have skirted the question. I had been so depressed for so long I no longer told people the truth. I focused on what I could do despite the depression. I could work part time- do a great job as a coach, have fun with friends, love my family, walk, eat, sometimes sleep and do all that I could to keep myself alive while helping others do the same.

My life has changed 100%.

The truth is that I was only half alive- because half was managing this illness. No matter how succcessful I was- how many books I wrote or how many friends I had- it took so much effort to stay alive.

I found a new medication regime last year that gave me a LIFE. When I combined this with all of my management strategies, I felt whole for the first time in over five years.

Can a person have a life free from depression? Yes- as long as we all understand that free means we can be free the majority of the time. My depression is never gone- I keep it at bay. I still get down- but it isn’t so dangerous.

How did I know I was really doing better? A few days ago I went into my mom’s back yard- sat down and read a book. It had been five years or more since I was able to do this!

You can get better. The person you love can get better. It takes a plan and that plan usually includes meds.

Julie

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Published on October 09, 2012 16:12

Thanks to all 10,000 a month blog readers! A Podcast is Coming Soon

The bipolarhappens.com blog receives an average of 10,000 visitors per month. Wow, that is a lot of people. I want to let everyone know that I read all comments and think about all readers daily. I want to answer comments- now that I am doing better (I promise to write all about this soon!), I am more able to work. That has been my goal for ten years- I just want to work more than 20 hours a week and I want it to be easier that it has been for those ten years.

Here is my idea- my fabulous manager Sheri and I are starting a weekly podcast. I will use this podcast to answer the questions on this site. They are such good questions.

I’ll go back to the beginning of the year and catch up. If you have new questions, please post them. I will answer them soon! Also, readers love it when you answer their questions.

10,000 people. We are never alone.

I post my personal information on my facebook site. Please send me a friend request and let’s connect! My Twitter is @JulieBipolar. I’m still trying to figure out that darn Tweet thing!

How are you? Please know I am thinking of you.

Julie

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Published on October 07, 2012 15:06

Bipolar Disorder and Sleep: Levomepromazine,Neurocil and Nozinan

I’ve written a lot about Lamictal and Generic Lamictal (Lamotrigine) the past few months. This is the drug I take as do many other people with bipolar disorder. One reader commented that she couldn’t sleep when she was on Lamictal. That was a side effect I had not heard. Other people have had the same problem- here is a comment from a reader:

Hi Julie,

It took nine months before I could sleep without some sleep aid. Low doses of Zyprexa or levomepromazin helped.

Lena

Hi Lena,

A friend of mine has had trouble sleeping and her doctor suggested that she use a small dose of Zyprexa. She knows it will work, but she’s scared to feel like a zombie again. She just started a new job. It’s frustrating for her. Others use the Zyprexa with great success. She has to find something that will work for her.

I wasn’t familiar with the other drug you mentioned, so I looked it up.

Levomepromazin is an anti psychotic that has strong sedative effects. I can see how it would work like Zyprexa in terms of sleep. Currently, Levomepromazine is not registered in the USA. In Europe it has been marketed for decades as Neurocil® and Nozinan®.

Nozinan® is also available in Canada.

I also read that it has a lot of side effects in high doses which may be why it’s not used as an anti psychotic in the US. Or, of course, it could just be something economic!

Severe sleep problems are really dangerous for people with bipolar disorder, so if you’re having trouble sleeping, talk to your doctor and get more information. Also, make sure your sleep problems are not a result of mania!

Some drugs, like Lamictal produce such unbelievable relief- people are willing to stay on then despite the side effects. Sometimes the side effects are just too strong. It depends on the person. The good news is that side effects often get a lot better if you can make it through the first three to six months.

Julie

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Published on October 05, 2012 22:51