Knowing is half the battle
I mean, not to draw deep meaning from the G.I. Joe cartoons, but really, it is. Paying attention to my illness, as annoying as it is to have to be that self-aware, is the only way to ensure that I keep myself out of trouble. And I’m pretty good at that part. But. But?
Did you know that taking a B-vitamin complex supplement has been clinically found to elevate mood in people suffering depression, as has exercise?
Did you know that Omega-3 fatty acids have been shown to increase time between depressive episodes, among people suffering from unipolar and bipolar depression? I did, but I’d never read the studies.
Did you know that clinical research is tending to show that antidepressants do not affect the recurrence or severity of depressive episodes in people with bipolar disorder ? I didn’t, and when it came up during a medication discussion with my psychiatrist a few weeks ago, I was surprised. I don’t know why– we already knew that antidepressants alone can actually trigger a manic episode, leading to an even worse depressive crash thereafter.
I’m not a doctor. I am a lawyer who has worked with doctors, extensively. I am also a civil litigation attorney, used to defending cases where people’s medical records are at issue. I consider myself well-versed in the news, and I thought I’d done my reading about bipolar, by keeping up with the science and health sections of the Boston Globe (hooray for proximity to one of the top medical areas in the world) and the New York Times, my “paper of record.” But I still missed things, and I’m embarrassed. I’m not doing my work, doing the reading that I need to do to be aware of developments in the science. Especially since brain chemistry is affected by hormones from all over the body, and is “hideously complex,” as my psychiatrist says. I tend to think of it as playing darts, blindfolded, while balancing on one leg– there’s still so much to be learned.
I’m lucky to have a wonderful set of doctors caring for me. But they can’t help me with symptoms and behaviors I don’t know are important, and so haven’t reported to them. Too, doing my reading may give me a new perspective on something I’d never thought about, opening up a new avenue for treatment. Doing you bipolar homework needn’t be a hypochondriac thing, nor need it be a distrust of your doctors’ advice or ability to keep up with the reading. It’s simply this: it takes two to tango, one to lead, and one to follow. But the one who follows isn’t the patient– it’s the doctor. My doctors can only treat what they’re aware of. If I don’t stay abreast of the research, and combine that with my work to mood chart, med chart, symptom chart, then I am not leading, and we’re going to step on each other’s toes or crash into a wall eventually, having steered them in the wrong direction.
So here’s what I’ve done in my battle to know better. I’m using my gmail account more efficiently. I set up a Google Calendar on which to record when I took my meds– since I check my email a lot, switching over to the calendar for a few minutes isn’t too time-consuming. I take my meds three times a day– it’s hard to keep track of, even with my pill counter– but I’ve set up alarms in my calendar to go to my cell phone, to remind me. I also enter symptoms– diahrrhea? Worth tracking, in case I’m having a toxicity episode. More clumsiness than usual? A headache that’s different from my regular headaches? Bad sleep, without the pleasantly weird dreams my medications usually give me? Irritability? Anything, and I do mean ANYTHING, that seems interesting or out of the ordinary goes in there. I then did a brave thing– I emailed an invitation to share the calendars to my psychiatrist, my therapist, and my primary care doctor. I’m a pretty reliable patient, luckily I’ve never gotten too manic… but knowing they can read the calendar whenever they want, and see how I’m doing, is comforting. It also gives them a way to hold me accountable if I am NOT reporting things accurately, and if I’m not updating the calendar. That all keeps them in the know.
To keep me in the know? Google Alerts. I set up alerts to come to me once a week about “bipolar research,” “lithium research,” and “depression research.” I may have to tweak the search descriptions after I start getting my reports, but at this point I figure over-inclusiveness is better– I can use the “Advanced Search” options to refine the queries after I see what I get. I’m also in the process of setting up better bookmarks to mental health sites such as NAMI and DBSA, as well as NIMH, and a Google Calendar reminder to spend an hour, once a week, checking up on their science alerts. After all, an hour’s not too much time, since I can’t know too much– especially when I think of the hours that might be lost if I know too little.
(You can ask Google for an invitation to a Gmail account from the Gmail front page.)
April 28th, 2008 at 11:47 am
good for you! I love the idea of using Calendar to track moods, headaches, other symptoms.
Here’s another one- did you know that some researchers are studying a link between inflammation and depression?
http://www.granitescientific.com/granitescientific%20home%20page_files/page0016.htm
April 28th, 2008 at 1:08 pm
um, i’d say you’ve covered your bases. you are an inspiration, i hope you know that :)
April 28th, 2008 at 5:56 pm
Awesome way to take an active role in your health. You are moving energy creatively and effectively. You go girl.
April 28th, 2008 at 8:06 pm
Being pro-active with your health is a gift you give yourself. Good for you.
April 28th, 2008 at 9:26 pm
This is a really good idea – I think I’m going to start using it. I think you’re a genius!
April 29th, 2008 at 8:49 am
I have been taking the omega 3s. Haven’t noticed any difference.
Also, I wouldn’t believe the article about antidepressants. Calabrese and Co are some of the worst drug company whores around. They are pushing the atypical antipsychotics because not that many antidepressants are still on patent. And when the newer antiepileptics were new, they were pushing those. Try the last psychiatrist for a rundown of them. I couldn’t do without antidepressants with a mood stabilizer. And now, it came out that four trials of the same size as the one that decided that lamotrigine helps in bipolar depression (that is, four times as much data) that were never published show it didn’t. Same group. They just published this http://www.ncbi.nlm.nih.gov/pubmed/18271912?ordinalpos=19&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum counteracting what they said before (here: http://www.ncbi.nlm.nih.gov/pubmed/10084633?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=1 ) – because now lamotrigine is generic.
Anyway, that’s my two cents. I hope this doesn’t go straight to spam folder because it has links.
April 29th, 2008 at 3:23 pm
It is a good idea to keep a diary. I have toyed with the idea but worried that it fixed me too much as inward looking on my mental state. But knowledge is power and so self knowledge is power over yourself…or something like that!
April 29th, 2008 at 11:28 pm
There is evidence(no I am not sure what journal the studies were published in)that extra calcium can help in depression and recently they have found extra vitamin D can help in many many things but mood disorders is one of them. I would ask a pharmacist which type of vit D is absorbed best. For calcium calcium citrate is absorbed the best.
You are being very proactive and I think that’s great and helps you feel slightly more in control. Mental illness makes us feel chaotic and rudderless. You go girl!
April 30th, 2008 at 3:58 pm
I started a private mood blog on Google. Every day, I go in and log my mood, appetite, irritability/anxiety, drugs, supplements, sexual interest, task-oriented behaviour, hours of sleep, menstrual cycle and anything that could have happened that day to affect my mood.
I’ve been doing it for two months now and I’m hoping that I’ll be able to identify patterns and see what affects the way I feel/respond to situations. I think it will also be a great tool for when I finally get another appointment with a psychiatrist.
April 30th, 2008 at 10:39 pm
Wow! I’m excited for all the things you are learning and will yet learn. The journal idea is great for self knowledge, and the general knowledge you’re discovering from scientific studies is fascinating and potentially helpful for hundreds of other people. You’ve got me kind of daydreaming about a database that has this kind of information about multiple disorders…
May 18th, 2008 at 12:44 am
Wow! I just found you, through curiously following links from a tweet from Schmutzie, then to your blog, then all the way over to here. I was diagnosed bipolar II 10 years ago, and I’m still in a learning curve. After 10 years, I’ve finally allowed myself to say, “this will *not* be the last depressive episode, so let’s see how this one can teach me to make the next one less severe, more comfortable.” I’ll be back.
September 29th, 2008 at 11:57 am
I admire your dedication to an on-line calendar. I use my email calendar for many things but so far, not for mood monitoring. Yet, it is a wonderful idea. I came across this blog upon searching for a template to track moods. The last two weeks have been so blue, I can not recall the last time I felt so bad, like I have died inside, the extra effort to function particularly to get to the office (the dysfunctional part of my life). I was recently given an antidepressant and although the sudden onset of tears or anger is gone, I don’t like the feeling of dullness I have now, waking up each morning with a headache. Why I want to track what I am feeling is understandable.