Troy Steven's Blog

There are good and bad psychiatrists, just as there are good and bad professionals in any trade or industry. The skills, abilities, and competence of your psychiatrist to repair, tune up, and maintain your mind can be likened to that of a trusted auto mechanic who is the only person you let work on your car. Finding a good psychiatrist who is right for you can seem like a long, involved process; however, knowing that this doctor is the one you are trusting to treat your bipolar illness and keep you healthy and sane (and alive) is an important weapon in your bipolar battle plan.

Choosing a psychiatrist is no easy feat because someone else’s “good” may not be good for you. The best course of action is to research and interview a doctor—just like hiring any other employee. While “good” is different for each person, one thing remains the same: a good psychiatrist is one with whom you are happy. That’s all.

Trust is by far the most important aspect to consider when choosing a psychiatrist. You are putting your trust in this person with your emotional and physical well-being. This is your life. The most important aspect of your psychiatrist’s role is to be available anytime, day or night, in your time of crisis.

For your first appointment, you need to decide what to ask the doctor to find out if he’s a good fit for you. During the first meeting, the doctor is going to be interviewing you. But remember that you are the client and should be interviewing him or her as well. What you ask depends on what you care about in a doctor and in your treatment.

Here are some questions you may wish to ask:

How long have you been practicing as a psychiatrist?

What percentage of your patients are bipolar?

What happens if I have an emergency outside of office hours?

Have you ever worked in a psychiatric ward or hospital?

What is your treatment philosophy?

What is your view on bipolar disorder and psychotherapy?

How often do you typically see your patients?

How long are appointments?

What medications do you typically prescribe for your bipolar patients?

What is your view on supplements and alternative medication?

Are there any medical conditions that could be causing or exacerbating my mood swings?

You will know if you are not happy with your psychiatrist in general. Make sure it’s not just because you are in a bad mood that week or have taken offense at something he said. Don’t continue to stagnate with the same psychiatrist if you are not seeing any benefit.

If you decide to move on, don’t burn bridges with your current psychiatrist until you have found another psychiatrist whom you trust to prescribe your medication. This is important because you don’t want to be at a disadvantage when interviewing a possible new psychiatrist because you need him to write you prescriptions right away.

Finding the right psychiatrist to team up with to battle your illness is crucial in winning the war against bipolar disorder.

Bipolar Contingency Plan  

The purpose of the contingency plan is, first, to safeguard you from having a bipolar episode and, second, to help you avoid catastrophe if you do have one. When it becomes hard to ignore your manic or depressive symptoms, that’s the moment you must do something about them. Bipolar episodes escalate like wildfire, so a rapid response is everything. The stakes are too high to allow yourself to slide into a bipolar episode of disastrous proportions.

Creating Your Contingency Plan

It is imperative to have a contingency plan in place and ready to execute if you start having worrisome bipolar symptoms. Equally important is creating a team that is aware of your contingency plan, should you need their help when it is critical. Bipolar episodes happen fast, you need to be ready to act.

My friend Jane, who is also bipolar, has used her Contingency Plan twice in the past 3 years to keep from going off the deep end because of a bipolar episode.

Jane’s Contingency Plan

When I begin having bipolar symptoms I will take the following actions:

-       Adjust my medication dosage(s) per the prearranged plan I made with my                                      psychiatrist.

-       Call my psychiatrist and make an appointment to see her ASAP or talk to her on the phone.

-       Call the person (people) I have recruited to be part of my contingency plan.

-       Distance myself from my loved ones if I feel agitated, violent, or out of control so they are safe.

-       Check myself into the hospital if things get bad enough.

-       Carry extra medicine with me and take it immediately if symptoms start getting out of hand.

-       Remove myself from stressful situations.

-       Ensure I am getting sufficient sleep. If not, I will call my doctor and        request a sleep aid.

-       Start taking my medications if I am not currently taking them.

-       Stop drinking alcohol and/or taking illegal drugs or at least slow down the pace.

-       Exercise and get fresh air every day.

-       Take vitamins and eat healthy.

Create your own personal contingency plan and put it in writing. Give copies to your team—primary and secondary contacts (psychiatrist, family, and good friends) and talk to them about what they should do if you launch your contingency plan.

A wise man has taught me to always have a contingency plan.—Abraham Lincoln

Bipolar Contingency Plan  

The purpose of the contingency plan is, first, to safeguard you from having a bipolar episode and, second, to help you avoid catastrophe if you do have one. When it becomes hard to ignore your manic or depressive symptoms, that’s the moment you must do something about them. Bipolar episodes escalate like wildfire, so a rapid response is everything. The stakes are too high to allow yourself to slide into a bipolar episode of disastrous proportions.

Creating Your Contingency Plan

It is imperative to have a contingency plan in place and ready to execute if you start having worrisome bipolar symptoms. Equally important is creating a team that is aware of your contingency plan, should you need their help when it is critical. Bipolar episodes happen fast, you need to be ready to act.

My friend Jane, who is also bipolar, tells how she created her contingency plan.

I asked my psychiatrist whether I could call her at 2:00 a.m. if I were experiencing bipolar symptoms. She said, “Yes, absolutely, anytime twenty-four/seven. If I am not available then another doctor in my practice will be on call.” We discussed what steps to take if I started to have an episode. She told me one thing I could do immediately was adjust my medication. She told me if I start to have noticeable bipolar symptoms to increase my Seroquel dosage to 400 milligrams from 200 milligrams for several days. She also told me to carry Seroquel with me and if symptoms became severe to take some immediately, even if I have to chew it.

Jane then offers how she shared her contingency plan with others to ensure it would be put to use.

Another thing I did was asked two people I trust implicitly to be part of my contingency plan. I asked my sister, an ex-alcoholic, whom I am very close with. She knows how to deal with mental adversity and has been sober for five years. I also asked my Uncle Bud who knows the issues I have dealt with through the years. They are both aware of my disease and told me to call day or night if I need help. The final thing I did was put my contingency plan in writing.

Jane’s Contingency Plan

When I begin having bipolar symptoms I will take the following actions:

-       Adjust my medication dosage(s) per the prearranged plan I made with my                                      psychiatrist.

-       Call my psychiatrist and make an appointment to see her ASAP or talk to her on the phone.

-       Call the person (people) I have recruited to be part of my contingency plan.

-       Distance myself from my loved ones if I feel agitated, violent, or out of control so they are safe.

-       Check myself into the hospital if things get bad enough.

-       Carry extra medicine with me and take it immediately if symptoms start getting out of hand.

-       Remove myself from stressful situations.

-       Ensure I am getting sufficient sleep. If not, I will call my doctor and        request a sleep aid.

-       Start taking my medications if I am not currently taking them.

-       Stop drinking alcohol and/or taking illegal drugs or at least slow down the pace.

-       Exercise and get fresh air every day.

-       Take vitamins and eat healthy.

Create your own personal contingency plan and put it in writing. Give copies to your team—primary and secondary contacts (psychiatrist, family, and good friends) and talk to them about what they should do if you launch your contingency plan.

On a personal note, I recently used my contingency plan to keep from having a  bipolar episode.  It was a close call, but I was able to stabilize by taking extra medication for several days in a row.  I am darn glad I had my plan to put into action.

A wise man has taught me to always have a contingency plan.—Abraham Lincoln

Free Book to the first 3 people who visit my website  http://www.bipolarbattleplan.com and send me a message (using the Contact tab).  Please indicate what age you or someone you know had their first bipolar episode. Also, specify your preference of paperback or ebook.   All information will be kept confidential (enter first name only).

FREE BOOK GIVEAWAY  

BIPOLAR BATTLE PLAN: FIGHTING THE WAR AGAINST BIPOLAR DISORDER        

PRECIOUS MOMENTS

Everyone is different, but Bipolar Disorder and how it affects us is consistent. We experience ups and downs that are at times so severe that feeling utterly average would be a welcome change. Good days – waking without that uninvited guest lurking, waiting to pounce seem so rare. It is a struggle to be productive, to gain the trust and the respect of others, but most of all, to trust that things will indeed get better, that the episode will pass, and yet there will be another battle in the future. There are no quick fixes. Accept that this is a lifelong struggle requiring immediate attention and long-term remedies.

Precious moments have already been snatched from your life by the enemy, and it will only try to steal more – if you allow it to. Make the decision to win the war against bipolar disorder no matter what. Winning means you will decrease and eventually eliminate your bipolar episodes as well as be able to make your dreams come true.

Armed with a battle plan for bipolar disorder, you and those who care about you will be ready for the worst and, more importantly, at last embrace all that life has to offer.

BOOK GIVEAWAY

Be one of the first 3 bipolar individuals to visit my website and do the following:

Click on the “BOOK” tab on my website and view the pie chart of nine weapons.

Choose the top three weapons you will use to battle bipolar illness

Decide the number 1 choice you want from your bucket list.

Click on the “CONTACT” Tab and enter your first name and the rest of the information.  In the “YOUR MESSAGE” block enter your bucket list choice and choice of three weapons.

If you are a winner I will send you a book, your choice of either paperback or e-book.

http://www.bipolarbattleplan.com

 Any time you start taking a new medication, you must be on the lookout for side effects. A side effect is any unwanted, nontherapeutic effect caused by a drug. Most psychiatric medications have side effects of one kind or another. Some people are prone to experience side effects from a particular medicine, while others do not experience any side effects from the same medicine.  Be wary because some side effects are more serious than others. Some can actually kill you!  Your psychiatrist should inform you of the possible side effects when prescribing medication. If he or she doesn’t warn you of the possible side effects of the medication, then get a new psychiatrist.

Side effects lie in wait like a lion stalking its prey until the medicine reaches a certain threshold in your bloodstream. Side effects may happen quickly or may occur several days after you begin taking the medicine; some may not show up until much later, when you have increased the dosage to a certain level. Take heed because this could be weeks or months after you start taking the medication. Everything may be going along smoothly, and then BAM! Things turn bad—and very quickly. If something is going wrong physically or mentally, always look to the medicine as the possible culprit.

You may be taking more than one medicine at the same time and are not sure which medicine is causing the side effect. Very likely the side effect is a result of the most recent medicine you added to your regime or a change (increase) in the dosage of a medication. However, this is not always the case. Either way, take immediate action if something strange or unusual is going on.

I recently experienced side effects from a new medicine my psychiatrist prescribed to treat my bipolar.  The reason for adding the new med was to counteract sedation I was experiencing.  It took about a month to ramp up the medicine to the target dosage for someone my weight and I definitely felt positive effects.  However, after another month went by I had gained over 10 lbs. I also began having a noticeable tremor in my hands.  Both of these side effects are unacceptable, so I made an appointment with my psychiatrist and modified my medications.

Generic Side Effects from Bipolar Medications Include:

 • severe anxiety                            • sedation

• insomnia                                     • sexual dysfunction

• tremor                                         • excessive thirst/dry mouth

• increased urination                     • stomach pain

• agitation                                      • muscle stiffness/pain

• loss of coordination                     • vomiting

• weight gain/increased appetite   • hallucinations

• weight loss                                  • drowsiness

• constipation                                 • blackouts

• rashes or itching                          • sensitivity to the sun

• headaches

Positive Personality Traits Common to

Bipolar Individuals  

Okay, enough bad news! Let’s get to the good stuff. Take heart in the fact that when bipolar episodes are not occurring, individuals with bipolar disorder are busy living their respective lives, often excelling at their professions, being moms or dads and students, just like anyone else. In fact, many bipolar individuals currently living or who have lived in the past will be remembered as successful individuals who left legacies of greatness and fame. Despite a deep depression throughout his life, Abraham Lincoln saved the United States and freed millions from chains. Winston Churchill summoned the strength to inspire a world at war, never bowing to the Nazis or depression. Beethoven gave us the most moving music ever to grace ears. Van Gogh and Dali blessed our eyes with surreal paintings, so bright and expressive. Ernest Hemingway captured a lost generation in words. Edgar Allan Poe perhaps channeled his demons to give us tales of horror. Florence Nightingale pioneered battlefield nursing, while Marilyn Monroe reinvented the notion of beauty. The people who make us laugh out loud are oftentimes bipolar, including Ben Stiller, Drew Carey, and Robin Williams. Look around -bipolar people are striving daily and despite their condition, they are bringing the best out of themselves. They have carved their paths through life and so can you.

Warcraft of all types must be mastered. Developing expertise and proficiency in fighting against bipolar disorder is probably the most important trade for you at points in your life. Precious moments have already been snatched from your life by the enemy, and it will only try to steal more – if you allow it to. Make the decision to win the war against bipolar disorder no matter what. Winning means you will decrease and eventually eliminate your bipolar episodes as well as making your dreams come true.

TEAMWORK

 Teaming up with your support personnel, like your significant other, family members, and friends, can be a powerful weapon in your war against bipolar illness. It also carries great risk. Admitting to others that you need help and, more important, that they are part of your contingency plan takes great trust, both in yourself and in them. It is essential, though. This is a great leap into the unknown for you and them, so pick your team carefully, accepting that this is a lifelong condition and that there will be times when you need them.

How does bipolar disorder affect the people closest to you? The people closest to you are the ones who are most affected by your bipolar disorder. They take the brunt of your actions and live with the consequences. Understanding and untangling the complex array of issues and the emotions that surround them is difficult and usually takes much time and effort. For your loved ones, the issue often comes down to finding ways to maintain a loving relationship through the long process of finding effective treatment and achieving greater stability.

The most important thing the people closest to you can do is to be on your side. Trust is paramount for teamwork. If they offer love, support, understanding, and tolerance, they will gain your trust, and you can team up and battle bipolar disorder together. By assuring you that you are not alone, you will not be as stressed and will have a better chance to win the battles against the enemy.

Other ways your support personnel can be valuable members of your team include:

Become knowledgeable of the disease

Understand that it takes time to recover from an episode

Help you watch for symptoms

Support your recovery plan

Urge you to stop (or reduce) drinking alcohol or taking Drugs

Get support for themselves

Guard against taking the “Holier than thou” attitude

Not try to make you dependent on them

Let you decide for yourself how to handle situations

Respect your independence

Your loved ones should not do for you what you can do for yourself. They cannot take the medicine for you; they cannot feel your feelings for you; they can’t solve your problems for you. They shouldn’t try. They should not remove problems before you can face them, solve them, or suffer the consequences. This is your life. They are on your team, but this is your battle to fight.

In summary, choose your team members wisely, enable them so they have the knowledge and tools to help you if you need them, and if you start having bipolar symptoms then don’t hesitate to call them for help.

Finding the “Holy Grail” of Medications

It is up to each of us to push the limits of our medications in order to find the “sweet spot” where we are mentally sharp and focused; have plenty of get up and go, a positive attitude, and no bipolar symptoms; and are happy with ourselves and our lives.

This isn’t easy by a far stretch. It would be awesome if the first time you are prescribed medicine to treat your bipolar illness, the medicine worked great, suppressed your symptoms, and kept you from having future bipolar episodes. However, this is rarely the case, and it is more likely that adjustments will need to be made to your medications as time goes on. Don’t be afraid to take calculated risks in making changes. You don’t want medications to make you feel mediocre; you want them to make you feel great!

What are the steps involved in finding the “Holy Grail” of medication to treat your bipolar illness?

The most important thing to remember is that while medication is the foundation of bipolar disorder treatment, therapy and self-help strategies also play huge roles. You can help control your bipolar symptoms by exercising regularly, getting enough sleep, eating right, monitoring your moods, keeping stress to a minimum, and surrounding yourself with supportive people. Living with bipolar disorder is challenging. But with medication, healthy coping skills, and a solid support system, you can live fully while managing your symptoms.

Tips for managing your medications:

1) Strive to find the best combination of medicines to treat your disease just as heart patients or cancer patients search for the right medicines to treat their disease.

2) Learn to monitor yourself closely and keep an eye out for bipolar symptoms daily.

3) Collaborate with your psychiatrist regarding the medications. Communicate your exact symptoms and how the disease is affecting you to your psychiatrist. This will help him or her prescribe the best medication for you.

4) Learn how to rate your medications and tweak the dosages based on how you feel mentally and physically. Tweaking the dosages of your medications as well as knowing when to go off of a particular medication is a skill as well as an art form. You are the judge, jury, and victim when it comes to whether your medications are working and working well.

“Laugh Your Laugh”

Personally, I know I have found the “Holy Grail” of medications for treating my bipolar illness if laughter is in my life. Not just smiles and chuckles, but to Roar with laughter and “Laugh my Laugh”. It happened the other day for the first time in a long, long time, and I hope it happens again soon. I added a new medication about a month ago, and have been ramping up the dosage trying to find the “optimal dose”. This medicine seems to be helping.

Best of Success,

Troy Gillem

http://www.bipolarbattleplan.com/

For each of us, our stressors and triggers are different. Identifying the triggers that may set you off beforehand can help you to avoid an episode. Once you identify your personal triggers, you can work on recognizing them as they occur and handling them more effectively. A list of triggers should include a list of those things from past episodes that were occurring when your episode started.

Keeping a weather eye out for your triggers is especially important around the holidays. The holidays are stressful for many people, and can be even more difficult if you are bipolar. It is highly likely you are going to have more stress and anxiety than usual when being around your family.

It can be particularly hard being around family members who know you are bipolar and are aware of what happened in your past bipolar episodes. They can be nervous that you may be unstable, be judgmental or bring up events that happened in the past that are now perceived as related to your “mental illness”. Even if your relatives may not have any of these feelings, you may project that this is what they are feeling.

My friend Scott tells about two bipolar triggers he has learned to avoid over the holidays:

I used to get stressed out whenever I traveled back to Ohio for family gatherings at my mom and dad’s. A couple of years ago, I came back from a visit for a week over the Christmas holidays and ended up having a bipolar episode and being depressed for a couple of months. I figured out that the two biggest stress factors for me during these visits are being around a large group of people and not having my own place to retreat. I still go home to visit but not during the holidays. I go when I can visit with just a few people at a time. Also, I stay in a hotel instead of staying at my mom and dad’s place. Since I made these two changes, my last two visits have been good.

To alleviate stress over the holidays make sure you are getting good sleep. Regulating sleep is often one of the best ways to balance moods and the circadian system. When you go to sleep easily, sleep and dream deeply, and then wake up refreshed on a set schedule every day, you’re experiencing regulated sleep. Maintaining a consistent sleep schedule and wake time can help you avoid nighttime sleeplessness or daytime exhaustion, which can increase the risk of new episodes of mania or depression.

By being aware that the holidays can be extra stressful, and taking precautionary measures like monitoring and avoiding your personal “triggers”, you can weather the holidays successfully and prepare yourself for the new year of 2014.