To Antipsychotic or Not to Antipsychotic, That is the Question

One of the hardest decisions about my course of treatment has concerned the use of Antipsychotics. My psychiatrist and I (with the often not helpful input of my over-eager family and friends) have gone both ways with me using Abilify, a very modern anti-psychotic medication, alongside my mood stabilizer, Lamictal. I think one of the major problems with my using this (in my family's eyes) is that it is a medicine used by schizophrenics. "There is no way that she is that mentally ill" they say. However -- and this is a big however -- this is just to do mainly with social stigma and also not fully understanding what is happening here.

First of all, that us address what this 'psychotic' nonsense is all about. What does an anti-psychotic prevent?

Well, I have learnt that a manic episode can be with or without psychosis, and I'm pretty darn sure that mine have been with. The BBC Website on Health describes it thus:

If a mood swing becomes very severe, you may have 'psychotic’ symptoms. These include:

• When depressed, you feel guilty, worse than anybody else, or even that you don't exist.
• When manic, you may feel you’re on an important mission or you have special powers or abilities.
• You might also experience hallucinations - when you hear, smell, feel or see something that isn’t there.

An issue with all of this, is about the severity of an episode. So my family might be upset thinking that I am a severe manic (although we know very well that I am Bipolar I but nonetheless...). Let's just say that although psychosis is most commonly known regarding schizophrenics, its also prevalent amongst people with epilepsy, people with cancer, oh, and err people who are drunk(!). So please calm down everyone, it's possible that you were psychotic at some point yourselves....

Due to seeing, hearing, feeling and smelling things that aren't actually there, I am becoming increasingly convinced that I do require an Antipsychotic in my mental health regime. Unless I just get used to the feeling of creepie crawlies on my head, the musty smell that I'm certain cannot possibly be everywhere in this city, the flashy disco lights when I close my eyes, and oh yeah, the Dark Lord or whatever at the end of my bed. But, I do also heed the idea that Abilify is just one of the newest evils out of the best evil of the corporations, the Pharmaceutical companies (just reading this article is enough I think). Just the fact that it costs me $160 a month (after the insurance covers 80%) is enough to make me KNOW that I do not want to take it. But are there alternatives...?

One idea that I have recently got, is from this research paper on Cannabidiols. I may well do a little of my own self-study here...

Diagnosis: Bipolar I

On December 19, 2008, I was officially diagnosed with Bipolar Disorder. Here is my story (please note that this is a very honest and thorough account of my experiences and thoughts and may be uncomfortable/unsuitable to some readers):

Throughout my life, I have encountered periods of depression. As a child, I was often considered 'moody' and 'intense'. By the start of my teenage years, my mind had turned darker. I often considered death a desirable option, a release, and even half-heartedly had a suicide pact with a friend.

I acutely remember my first major episode of depression, which happened during the Summer vacation when I was 16, just after taking school examinations. I was constantly teary, not wanting to do anything or even get out of bed, and very unsure as to why. However, like the other periods of depression I had, I recovered exceptionally well. I often went into a jubilant and productive mood period, where it was strange to even consider me as previously being depressed. But because of my darker times, I reached out for medical help during university with limited success, and then more permanently when I got my first career job. However, I never committed myself thoroughly to any talk therapy that I received, and dismissed ideas of me being possibly 'manic depressive' as absurd and ridiculous.

In November 2008, due to a variety of life events and traumas, I was deeply depressed and having intense and deeply concerning suicidal thoughts. I was in many ways having a full breakdown. In panic, I called my previous psychologist who I was seeing earlier in the year and asked him to put me on medication. After some discussion, we decided to try Lexapro, a anti-depressant that I knew my father -- who has Major Depression -- successfully took.

Immediately after beginning taking Lexapro, I felt a dramatic difference. I felt very 'high', with pulse racing and body tingling, whilst feeling rather sedated, drowsy and socially unresponsive all of the time. My memories of this time, such as Thanksgiving Dinner, are most peculiar. At the same time, the suicidal thoughts were still very much present, only I was once more able to get out of bed and function again. Not knowing what to expect from my medication -- and with my therapist unavailable on a long holiday vacation -- I had little understanding that I was having an adverse reaction to the anti-depressant.

About four weeks after being with Lexapro, on a rainy Monday morning, I flipped and decided to kill myself that day. The previous night I was at a social function, where I had felt totally paranoid, thinking that everyone was thinking and talking about me, and unable to communicate at all. I was acutely uncomfortable in my own mind and in my skin, and as I was on medication already, the only answer seemed to be death. Having been thinking and researching about suicide on the internet for several weeks, I knew that a combination of drug overdose and suffocation was the quickest and most pain-free way to go. So, after saying goodbye to my best friend and my husband, I got into the car with all the over-the-counter and prescription medications available to me and with a pack of plastic trash bags. I then drove to the remotest place I could easily get to, thinking that I could kill myself undisturbed and at peace.

I was found two days later by an unknown local to the area, who after dragging me semi-conscious and puking blood out of the car, called for an ambulance. I was taken to hospital where after a heavy time in the ER, I was admitted for a three day stay in the Psychiatric department. I was diagnosed as Bipolar I and having a Mixed episode with psychotic behavior. I was prescribed 200mg Lamictal and 20mg Abilify, and released under family intervention, and under the understanding that I would immediately seek out-patient psychiatric treatment.

In this blog, I intend to catalog my personal journey of treatment, understanding and acknowledgement, as well as looking into Bipolar research and the history of people with Bipolar disorder.