Of Bi-Polar Disorder, of Medication

Bi-Polar thoughts and ramblings:

I'm adding to the medical saga that I started detailing here.

My doctor and I believe I am at very low risk for recurrence of bi-polar "episodes". Both my manic depression and mania episodes were caused by hormone increases when 1. I stopped breastfeeding (since while nursing hormones were at very low menopausal levels - when I stopped, they increased back to normal), and 2. when I first become pregnant.

So... unless that happens, I guess I'm good?
Ah-ha #1! There's a correlation! Hormone increases = Nate's life gets a lot more interesting!
It's not just the swings; I know that I am affected by bi-polar disorder every day. I think it's in a very good way. I'm wired to be able to, and want to, do a LOT. Constantly. I love thinking up and embarking on new projects, new adventures, new goals... scheming as my friends call it. I have never been okay with "normal". Is graduating summa cum laude from Gustavus pretty cool? Oh, I bet if I published independent research on the side that would be "cooler". Oh, and let's be involved in X, Y, Z, and take down that GAC track record board... you get the picture. Oh, there isn't a race in/near Northfield and I'd like to see where my 5k time is at? Clearly I should try my hand at race directing!

Weee!
Bi-polar disorder is one of reasons I do so well with goals and schedules. My doctor says that's one of the best therapies for me - schedules and routines. So, Jerry's calendar of workouts is good for me in many ways!
Having a schedule and something to look forward to is probably why my bi-polar is usually so well controlled. I can simply pour my energy into the work and goals I have in front of me. As in, pour. :)

Now, are these just personality quirks? Or a disorder? It's hard to tell. I'm diagnosed because I've had instances of both poles: depression and mania. There are 6 million other diagnosed people in the U.S., but they estimate that there are at least that number that are undiagnosed. Is that individual just very vivacious? They say that you'd never know many people have it; don't look for the "institutionalized" individuals whose episodes are unpredictable, violent, [enter your negative adjectives here... as the stigma may have you doing]. The doctor that I see specializes in treating individuals who are very high functioning - either in spite, or because, of their "disorder".

I'm hoping I fit into that category, although maybe he was looking for someone to balance out his case load. Ha :)

On that note, did you know that these people had (or believed to have had) bi-polar?
Mark Twain
Virginia Woolf
Lord Byron
Edgar Allen Poe
Michelangelo
Vincent van Gogh
Tennessee Williams
Robert Schumann

Everytime I see this I think of Jimmy Chalmers. Jimmy, if you're reading this: I found your doppelganger!
Jimmy and me at TNC camp in 2014. See the resemblance?!?

No, not between the two of us, silly. Between him and Van Gogh. Although Jimmy has both of his ears.
I'm in some good company!... although I read that list to Nate and he said, "I also notice: committed suicide, cut off his ear, drugs, alcohol..." Hmm.

Another bi-polar fact: Did you also know that a recent study of 700,000 adults showed that those who scored top grades at school (especially in language and music) were 4 times more likely to develop bipolar disorder than those with average grades, even after accounting for parental education or income?

I'll continue to share more about the disorder as I read more. I'm currently reading Fast Girl, An Unquiet Mind, and Bipolar Disorder.

Medication ramblings:

I am currently working with a psychiatrist to get my medications figured out. Originally I was put on 1 mg of Haldol, a first generation anti-psychotic medication.

Yes, it still feels so odd to say that... anti-psychotic...

But, I know that's what will control and prevent future manic depression and mania episodes. So, call it what you will.

Here is what we have done:

1 mg Haldol started at the hospital ~ 9/18. No side effects seen at the hospital. Usual side effects: uncontrolled muscle movements (twitching, tremors, movement in arms, legs, jaw, cheeks).

Chose this because there is the most data to support healthy pregnancies (it's been around for a long time) - I was pregnant at the time.

Outside of the hospital, I noticed my leg clumsiness returning, but I thought that was mainly due to an increase in total training volume and intensity.

50-100-150 of Seroquel , a 2nd generation anti-psychotic. Started end of October. Decided to try this because it treats both poles vs. Haldol. Haldol treats mania very well, but doesn't treat depression, and can actually cause it to worsen over time. Seroquel is also a better long-term medication, overall.

BUT, I reacted about as poorly as one could hope. I was either walking around in a semi-sedated state, sleeping/napping, or desperately trying to function through the fog. I have never been so tired and fatigued! The first night I went up to 150mg of the drug I nearly fainted. Nathan helped me up to bed after my lips turned blue. Wow. Seroquel = not for me!

1 mg Haldol + Sertraline (anti-depressant) restarted on Saturday, 11/7. I noticed an instant change in my ability to function, and only need a normal amount of sleep. YAHOO! But..

Sunday: didn't run because of a bad cold
Monday: ran 8 miles. Noticed clumsiness, but that's still normal, infrequently. I'm still recovering from massively over training in 2013. Don't do that.
Tuesday: ran 10.5 miles. Around 8 miles I had to work hard to control my legs. Another light bulb went off! I didn't have this at all on Seroquel (which was so WONDERFUL! To be able to run without worrying about controlling my legs! WOW!)! It's Haldol's motor function side effects that manifest themselves in clumsy legs! My doc had thought this might be the case when I mentioned it a month ago! It's true!
Ah-ha #2!
Needless to say, I called my psychiatrist today to report the findings. So... now it's on to try to find something else! Except there really isn't much else that is safe for those wanting to become pregnant in the near future...

Lithium is an option, but causes heart defects in 1/1000 babies. It's repairable with surgery, he said, but STILL. NOT OKAY.
There's a second option, name escapes me, but it causes cleft lip/palate. Also NOT OKAY.

There are a lot of other drugs out there, but there isn't anything else that has much data on birth defects. So, that leaves me with two options -- unless Dr. Bond (yes, Dr. 007) has something else he hasn't discussed with me:

- stay on Haldol and just deal with the motor effects. I can live through clumsy legs... although it doesn't make running or evening thinking about training/racing very much fun...

- go off anti-psychotic medication all-together, likely staying on an anti-depressant, just as insurance. The risk would be recurrence of mania episodes...

Hoping to get in to see Dr. Bond soon! I'm just hoping to get medication squared away so I can just be on auto-pilot, not thinking about it at all.

Not having to drive an hour each way to/from all of these appointments would be nice, too!

Your turn: Do you know of anyone diagnosed with bi-polar disorder - or unipolar depression (only one of the "poles")? How has it affected them? How has it affected you?

Nichole Porath

Nichole is a blogger, elite level runner, and coach. She ran professionally for Brooks for two years after qualifying for the 2012 US Olympic Marathon Trials. During that time she founded TNC endurance, where she coaches and motivationally speaks to organizations large and small. This blog details her rise to national-level racing, and continues to follow her as she gets back into racing after starting a family. Read on, friends!

7 comments:

  1. And... Emily Nickles! I was diagnosed 5 years ago and have been on and off various meds since. Seroquel was the one I reacted to the worst, I actually fainted after my first dose (my doctor now thinks a previous doctor had me take way too much for a first go!)

    As someone who tends to "fall down the rabbit hole" semi-regularly, I hope you get your meds figured out soon, and don't discount the power of running...

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    1. Emily - thanks so much for commenting! Very interesting that you fainted on Seroquel - I almost did, just lowered myself to the floor until Nathan could help me. It wasn't until I was up to 150mg, which was the minimum at which my doctor said he sees results.

      What are you on now, and how much, if I can ask? I'm meeting with the doctor tomorrow to discuss all of my options.

      And yes, I fully know that running and competing is a HUGE piece in controlling this - maybe as much as any medication!

      Any thoughts on how to control the disorder if I were to go off medication? My previous episodes were brought on slowly (even mania was a process of about a week before I was totally out of it and hearing voices/seeing things) - so think I could catch it... but I'm not sure if future episodes would come on suddenly. And I'd hate to be alone when it happened, or alone with Greta...

      Thanks so much again!

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  2. Your honesty is so inspiring! Thanks Nichole!

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    1. Thanks :). It feels great to be able to be so open and honest about it. Plus, hopefully it can help someone else out... either to help them to be open about something, or to help with bi-polar/addiction/eating type of stuff.

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  3. You are so great to this God bless you

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  4. I appreciate your honesty and rawness - what an inspiration :)

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