Jennifer Marshall

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Mental Health Mindset Key #2: Ideal Medicine

{continued from my Mental Health Mindset Key #1 post…}

I was extremely fortunate to be working through my diagnosis with my incredibly loving and supportive husband and my parents who were there to listen to me talk through tears every day when I’d call them in Florida from Virginia. Months of clinical depression kept passing, with only psychiatrist and therapist appointments breaking up the monotony of the day-to-day. My psychiatrist added an anti-depressant to my anti-psychotic medication to try to lift me out of the depression. Only it had a different effect - a very scary side effect of suicidal thoughts. Imagine that, a medicine that’s supposed to lift depression actually can make it worse. Thankfully, I noticed the thoughts and immediately told my husband and parents who insisted I talk with the doctor about them right away. I did and he took me off of the anti-depressant and the thoughts retreated.

Researching my condition online and talking with my parents and psychiatrist revealed that the gold standard treatment for bipolar disorder was Lithium, yet I was fearful of the regular blood tests because I had always hated needles. But I was sick of suffering. I was ready to face repeated blood draws if it meant I might feel better. So in the fall of 2006 I began taking Lithium and although the side effects were almost unbearable at first (I’ll spare you the ugly details), I worked through them with my doctor and within a few months I began to feel pieces of my old personality emerging.

Photo by Alicia Bruce

I took Lithium, and continue to take it to this day, beginning in October of 2006. I did go off of it during my first pregnancy, which I’ve written about my first postpartum experience on the blog before where I experienced postpartum psychosis when my son was 4 weeks old. And I went off my Lithium again when I found out I was pregnant with our second child and experienced antenatal psychosis (psychosis during pregnancy) when I was five weeks pregnant with Vivian.

Once stable after both hospitalizations, I quickly went back to my tried and trusted med, Lithium.

The thing about the medicines we have for mental illness is sometimes they may stop working, or you may need to supplement them with a second or even third medication as odd as that may sound at first. They each have different properties and do different things for our brains.

For example, Lithium is the gold standard mood stabilizer medicine for Bipolar. It helps keep me “in the middle” as my dad says. But with bipolar disorder, you have to be able to treat the symptoms which are depression and mania. For the mania side of things, there are antipsychotic medications like Zyprexa, Risperdal, Abilify, and Seroquel, among others. And thankfully we have a number of antidepressants that are helpful to people with Type 2 bipolar.

With type 1 bipolar disorder however, it’s generally advised by psychiatrists to not put patients on antidepressants because it can push their mood too high into mania, which can lead to a manic episode and hospitalization.

Fortunately, doctors are finding that certain types of medicines have antidepressant qualities and can be helpful to patients with type 1 bipolar who are experiencing severe depression. For example, Lamictal is a medicine - an anti-epileptic medication actually - that is also used to treat bipolar depression and can work for type 1 AND type 2 bipolar patients.

I’ve found all this information out by being my own advocate and doing the research online and by talking with my doctor. There’s so much information on the internet that sometimes it can be overwhelming, but if you dig you can find what you need. There are published studies of patients who have taken the medicine so you can see which are most effective, and also talking with peers can be helpful. The only thing to keep in mind is that everyone’s body is different and may react differently to different medicines. So just because a medication works for a friend, that doesn’t mean it will work for you. You need to listen to your body and be your own judge.

One thing that was helpful to me when I first started on medicine for my bipolar in 2006 was to keep a small journal and write down these three simple things everyday:

  1. What medicines and dosages did you take today?

  2. What side effects are you experiencing?

  3. How do you feel today?

You can also keep a mood chart like this one.

Regardless of which method you choose, it’s crucial to document this information because if you don’t, time goes by and you’re not able to remember and then it makes it difficult for your doctor to help you make adjustments.

Next up I’ll be sharing Mental Health Mindset Key #3. Stay tuned! ;)