Day 77 "Depression Is Lifting Again"

Today has been a little better for me in terms of depression.  I haven’t felt so overwhelmed today like I have this past week.  I finally feel like my nurse practitioner made the right choice in raising my Seroquel 300mg XR dosage to 600mg XR.  The new dosage isn’t masking reality for me but helping to lift my depression.  The reality is easier to deal with when the depression isn’t there.  I’m extremely worried about my Mother’s health and have to be strong for her to recover.  Because my depression is lifting I’m able to be stronger for her.

Last week my aunt who is a registered nurse with over 45 years experience asked me if I would let her know what my bipolar treatment plan was.   I made her copies of my weekly tracker, listed all my medications and the times I take them, and wrote her a letter.  Today she called and first spoke to my Mom about her injuries then she wanted to speak to me.  She told me that she was impressed with the detail that I put in to my weekly tracker and said that I should share that with my therapist and nurse practitioner.  She said that my treatment plan looks really solid and that if I follow it I could possibly get off of some of the medication down the road.

Well, in an effort to do something I enjoy that will hopefully make me feel good I’m going to try and watch the Perseids MeteorShower in the early morning hours of Monday August 12, 2013.  They say this should be a great year for them because a fat crescent Moon should be setting just when the shower is revving up.  I read that if the sky is dark enough I could possibly see 50 to 100 shooting stars an hour.

Day 76 "Depressed And Worried About My Mom"

Today my mood has been really low.  I slept just about all day.  I was just depressed and upset about my Mom.  She sustained a broken pelvis in the car accident she was in last Saturday and I worry she’s never going to be right again.  The doctor told her that it would take about six to eight weeks to heal but that’s just an estimate.  Mom and I don’t always see eye to eye on things and sometimes argue about the dumbest things but we both love each other a lot and I just want her to get better.

I read that a broken pelvis is one of the most serious conditions a victim of a vehicle accident can endure.  The pelvis is the ring-like structure of bones at the lower end of the trunk which cradle and protect the lower digestive tract.  Even a small fracture from an accident can cause the victim unbearable pain.  More severe breaks do not only affect the bone, but can damage the delicate internal organs shielded and protected by the pelvis.   The pelvis takes a great deal of time to heal, and during that time eating, moving, and sleeping often become sources of agony.  The healing time for a broken pelvis is anywhere from 6 to 12 weeks depending on the overall health and age of the person affected.

Facts about a broken pelvis

• Almost 60% of all broken pelvises are caused by high impact vehicle accidents.
• Victims of fractured pelvises usually have peripheral injuries such as head, chest, abdomen, and genitourinary trauma.
• Multiple organ damage is also a common aspect of broken pelvises, and 40% of people die of hemorrhaging.
• Overall, the fatality rate for pelvic fractures is estimated to be as high as 55%.
• Surgery generally follows broken pelvises between 24 to 72 hours after the accident.

Treating a broken pelvis is a very expensive regimen of rehabilitation and medication.  Many X-rays are needed, and depending on the condition of the victim and the severity of the injury, surgery is often a requirement to repair the damage.  Screws, bolts and metal plates facilitate the healing of the bones, but do not make the recuperating process any easier for the victim.

Treatments for fractured pelvises

• Bed rest.
• Pain control management of symptoms.
• Isolation of potential complications such as deep vein thrombosis, pulmonary embolism, pneumonia, constipation, and infection.
• Proper nutrition rehabilitation.

So from what I've read my Mom has a long road a head of her to recovery.  As hard as it is for me to take care of myself I need to help my Mom by doing the grocery shopping, cleaning the house, doing her laundry, making sure she eats, and takes her medications.  I hope that Guardian Angel that was with her the day of the accident is sticking around for a while. 




Normal pelvis. Click to enlarge.



Broken pelvis. Click to enlarge.

Day 75 "Hypomania All Day Today"

Today has been a hypomanic day for me.  Due to my Mom being pretty much helpless I haven’t been sleeping very well.  I have been sleeping with an eye and ear open in case something bad would happen.  I’ve noticed that the decrease in sleep is causing me to be a little manic.  There just doesn’t seem to be enough time in the day to get everything done.  Today I mowed the grass, cleaned two bathrooms, cleaned the kitchen, swept the floors, and did two loads of laundry.  That was all for my Mom and I have yet to do my laundry.  Thank goodness I can do all mine in one load.  Anyway, I have been  hypomanic today and I would say that lack of sleep is the reason for it.  On average I sleep ten hours a night and when I get below the eight hour mark I tend to become hypomanic or have a mixed state.

Had I not had to do all those things for my Mom today the hypomania might have not been so good.  When I’m hypomanic I need to do something which results in some sort of release.  If I have a plan to do a bunch of activities, yes I may be hypomanic but I get a bunch of things done or get to do a bunch of activities.  The release for me is that I feel great that I got so much accomplished.

Had I nothing to do today and only slept six hours that would be a red flag for me that I may be in for some hypersexual behavior.  Before I was medicated I would most likely look at porn on the computer and place personals on Craigslist looking for sex.  This activity would take place whenever I had less sleep.  I would spend hours placing ads and waiting for replies.  There were times when I would look for sex up to ten hours.  The release for me was when I would meet someone.  However, a lot of times I would spend all night looking and come up with nothing which would make me very angry.

There are a lot of times when I've have mixed states.  I tend to be down on myself, depressed, have no hope for my future, isolate myself, and feel a lot of anger.  With that said I can be hypomanic, hypersexual, and depressed all at the same time which makes it ten times worse when I can’t get that release I need.  I end up getting a little psychotic sometimes.

Since starting Lithium 900mg per day the severe mania I was having pretty much stopped.  I have had a few instances of being hypersexual since starting Lithium but I have been able to stay away from Internet porn and haven’t wanted to place ads looking for sex.  However, on Lithium alone I became deeply depressed.  I was then prescribed with Seroquel 300mg XR and that started helping me feel less depressed.  After about a month my dose was raised to 2 300mg XR tablets and its making me feel even less depressed. 

In therapy we have been talking about what triggers certain behaviors I do.  For the most part I can tell you what the main triggers are that cause me to do certain things but I want to dig a little and find those secondary triggers.  Mania in its minor forms includes heightened feelings of well-being, increased alertness, drive, inflated self-esteem, and extensive sociability.  In addition to a general elevation of mood, instability is typical.  Irritability may easily be evoked and other mood states such as anxiety or sadness, fleetingly but intensely expressed, may become apparent.  In mixed states pronounced symptoms of both depression and mania either coexist or alternate during different periods of the day.  As mania deepens over activity and over talkativeness become more obvious.

Day 74 "Stable Day, Back On Diet"

Today has been an over all pretty good day.  I wasn't happy nor was I very sad.  I have followed my diet for three days in a row and that has made me feel a little bit better about myself.  I had started losing weight in February and up to being diagnosed bipolar 1 in May I had lost 33 pounds.  I have always been heavy and losing this weight was and is a big deal for me.

After I was diagnosed as bipolar 1 and started taking medications my weight began to fluctuate which caused me a lot of concern.  I was so upset that I might gain all the weight back that I almost didn't go through with my treatment.  I've always wanted to be skinnier and I was finally on my way there and then bipolar happened.  Well, if I don't follow a treatment plan my life is over.  I definitely won't be able to hold a job and I'll never be able to get approved for SSDI.  So the only choice for me is to learn how to deal with it.

My diet isn't perfect but it's better than no diet at all.  I don't drink any kind of soft drinks and drink about a gallon of water a day.  This is good for weight loss plus it helps keep my body from becoming dehydrated which could cause Lithium toxicity.  I'm not a big fan of vegetables so I drink a can of low sodium V8 juice every day which counts for two servings of vegetables.  I also have tried  both low sodium corn and kidney beans from a can and like them as well.  I also eat a lot chicken, turkey, and tuna fish.  Once in a while I'll buy red meat but I make sure it's very lean. 

I may never be skinny and I may never be cured of my bipolar but I'm going to do whatever I can to control both.  If I don't control them I'm setting myself up for failure.

Day 73 "Communicating in a depressive state....NOT ALWAYS GOOD"

Today, I have felt depressed all day and all I wanted to do was sleep.  Being in a depressive state is horrible.  I sometimes have thoughts about death.  I have very low self esteem.  I have no hope for my future.  I 'm always really tired and can sleep for 15 to 20 hours at a time.  I also don't enjoy doing the activities I once enjoyed.  When I'm in a depressive state anger and irritability sometimes guide my thoughts.  However, the most challenging part of being in a depressive state is trying to communicate with my family, getting them to understand my needs, and the barriers I face.

I try not to communicate with my family when I'm in a depressive state because my family doesn't believe that I'm bipolar.  It's easier if I just keep it to myself.  My mother was told when I was five by a psychologist, I saw regularly, that something was wrong and she told him he was wrong and wouldn't hear it.  She acts like that today when I talk about being bipolar and doesn't want to hear it.  Sometimes she acts like I'm not in the room and walks away.  So since I live with her and am around her a lot I have to try and not talk about it especially when in a depressive state because I get really angry and end up saying lots of hurtful things which I end up feeling guilty about later.

In terms of trying to get my family to understand my needs when I'm depressed is pretty much pointless.  I can't get them to understand my needs when I'm doing good so why would I waste what little energy I have in a depressive state on trying to get them to understand my needs.  I have tried to explain on many occasions what I need to do to remain in control of my life and it always meets deaf ears.  Since I was diagnosed as bipolar 1 I have put myself on a daily schedule which helps to keep me even and my Mom and sister are always changing things up on me even though I've explained to them how it throws me off.  You would think that they would start to believe me and show a little understanding.  I guess they like all the angry hurtful things I say and do.

The barriers I face are being unemployed, having no medical insurance, and a family that refuses to see what I'm going through.  As long as I don't bring it up we can get along but as soon as the word bipolar comes out of my mouth everything goes down hill.  It hurts but I don't really care anymore what my family thinks.  The only thing that matters to me right now is getting stabilized on my medications and learning to control this illness and not let it control me.  Maybe then my family will see that everything I'm doing is for my own good.

Day 72 "Trying To Regain Some Normalcy"

If you've been following along you know that the last few days have been pretty horrible for my family as well as myself.  I've done a good job of being there for everyone but when I'm alone I've binged, purged, had thoughts of death, all at the same time which is a mixed state.  Yesterday I started on a higher dose of Seroquel which is supposed to help me sleep better, relax, and mostly work to reduce reduce my depression.  Well, today has been a little better for me.  I'm still depressed about myself and everything that happened this weekend but I seem to be in more control today which makes me feel more content.

I'm having to pick up a lot of the slack at home since my Mom is no position to do anything besides sit in a chair which is challenging but I'm managing.  I've had to make myself a daily schedule so that I don't forget to do something or do the wrong thing.  Tonight I had to do the grocery shopping and if I wouldn't have made a list it would have taken me six hours and I would have bought all the wrong things.  However, it went pretty smooth and I remained in a pretty good mood.  Tomorrow I have to get softener salt for my Mom's water softener and I have to take her to see her doctor in the afternoon.  As long as I keep myself  a schedule I think everything will work out fine. 

Tomorrow, I'm going to try and work in the yard after we get back from Mom's doctor appointment.  I need to mow and there are a ton of weeds that need to be pulled.  I think the yard work will do me good and help me to get my mind back on a positive track.  I also will be eating better following my diet on SparkPeople.  I didn't buy any junk food at the grocery store tonight and have no money to go and buy any so diet it is.  Once I get my diet back on track I 'm going to start getting in the habit of exercising.  I like to bike but I've thought about walking and maybe even running.  Hmmm, maybe a combination of the three would help me stick to exercising better.   I just know that I would prefer not to be on blood pressure medication and diet and exercise is the way to accomplish that.

Day 71 "Seroquel Adjustment Today"

So, as of tonight, I'm up to 600mg Seroquel xr.  I went to see my nurse practitioner/pdoc and she upped my dose because I was having mixed states the last few days.  I was binging and purging which I do when I’m manic and I was really depressed and not caring about anything all at the same time.  She left my Lithium at 900mg a day and Klonopin at 3mg per day as well.  I really like how the Klonopin takes away some of the anxiety I have but I did tell my nurse practitioner I wish I could have had something a little stronger this past weekend after getting news that My Mom, sister, and her entire family were in a horrible car crash in an intersection where many have been killed before.

Even though I wasn’t in the car accident I can’t shake the racing thoughts I’ve been having about the accident and what my Mom looked like when I first saw her in the hospital after the accident.  All I can think about is that I could have lost her.  It’s hard enough looking at your parents some days and watching the aging process but when you see your only parent laying on a back board, in a neck brace, with bruises all over them and not knowing what all is wrong, it can be very traumatic.

Anyway, I feel very conflicted about taking all these medications.  When I look down at the pills I think “god this is strong, mind-altering stuff” and I just want to stop taking all of it.  At other times I think “wow this stuff is miraculous and is helping to stabilize my bipolar so much”.  I guess I should be grateful that I live in a time where there is choices in treating bipolar.  Fifty years ago I probably would have ended up in a mental ward somewhere.  I actually had a cousin who in the 1940’s was placed in the county home due to mental illness.  Maybe he was bipolar.  

Today my mood has been very down.  I’ve thought a lot about death and dying.  All I’ve wanted to do is sleep all day and have had no hope for my future at all.  I also binged and purged this evening for the second time in less than a week.  I realize that most of this behavior has to do with everything that’s happened with my family so I’m not going to just say that my treatment isn’t working.  What I am going to conclude is that I’ve had a bad weekend, life happens, and hope the new amount of Seroquel helps.