I’m undergoing a series of ketamine infusions for treatment-resistant depression. It’s a series of 6 sessions over the course of several weeks. 1-2 sessions per week.
I had my first infusion on Wednesday for an hour and it was certainly trippy. I listened to soft rock in a completely new way.
I was kind of hoping that effects would begin to take place soon after the infusion. Relief can start to take place within an hour of the first treatment. While I was not depressed or suicidal, I was not happy. In fact, I was irritable. Angry. My doctor and I are on guard to ensure that the ketamine doesn’t trigger mania since I actually have bipolar disorder and not unipolar depression. At this point, I feel like mania would be an improvement.
I’m already pessimistic about the treatment even though my doctor says it can take 3-5 infusions for relief to kick in. My next infusion is Monday. Well, there’s one thing: If I ever wondered whether I’d like doing drugs recreationally, I’ve gotten my answer by getting it legally. (That’d be a no.)
Ebselen, an experimental bipolar disorder drug, has been found by British researchers to work like lithium but without lithium’s side effects. In mice. In testing, mice that were somehow made manic with “small doses of amphetamine” were placated with ebselen. Researchers are now moving on to testing on healthy human volunteers before studying those suffering with bipolar disorder.
According to Time magazine, ketamine—a drug that induces hallucinations and other trippy effects—may hold potential as an antidepressant.
And now scientists report on two formulations of drugs with ketamine’s benefits, but without its consciousness-altering risks, that could advance the drug even further toward a possible treatment for depression.
Ketamine is seen as a fast-acting antidepressant for those at high risk for suicide. GLYX-13, mentioned here previously, is a ketamine-like antidepressant currently in clinical trials. AstraZeneca has AZD6765, a “ketamine mimic” that does not appear to be as effective as actual ketamine.
It finds that women with symptoms of depression were 2.5 times more likely to have experienced domestic violence over their lifetimes than those in the general population, while those with anxiety disorders were more than 3.5 times more likely to have suffered domestic abuse. The extra risk grew to seven times more likely among those with post-traumatic stress disorder.
“From our study, we don’t find any reason to stop taking your medication, because untreated depression may be harmful for the pregnancy and the baby,” [Dr. Olof Stephansson, the lead author of the new report] told Reuters Health.
Finally, “gender identity disorder” has been removed from the DSM-V and has been replaced by “gender dysphoria,” a condition in which people are concerned about their gender identity. “Gender identity disorder” seemed to stigmatize gays, lesbians, and transgender individuals. The continuing inclusion of “gender dysphoria,” however, ensures that people suffering with gender identity disorder still have access to health care treatment. (In my opinion, the renaming of “gender identity disorder” to “gender dysphoria” is really a politically correct change. Homosexuality was removed from the DSM back in 1973.)
An antipsychotic inhalation powder has been approved by the FDA for the treatment of agitation in adults with schizophrenia or bipolar I disorder. While loxapine (brand name: Adasuve) by Alexza Pharmaceuticals acts rapidly, the side effects include “bronchospasm and increased mortality in elderly patients with dementia-related psychosis,” according to Medscape. In case you don’t know, bronchospasm can lead to acute respiratory problems in people with lung disease, asthma, or COPD (chronic obstructive pulmonary disease).
Plans are for the drug to only be accessible through a medical facility with the ability to treat bronchospasms.
In related and somewhat interesting news, the Medscape article also notes that 3.2 million people in the U.S. are being treated for schizophrenia or bipolar I. “Of these, approximately 90% will develop agitation during the course of their illness.”
That’s an incredibly high number of people who develop agitation. Just sayin’.
According to an article in U.S. News & World Report, patients in a study dealing with depression seemed to have high levels of C-reactive protein (CRP), a marker for increased risk of heart and inflammatory disease. The lead researcher notes that “people with increased CRP have a two- to threefold risk of depression.” It is not clear whether CRP causes depression or is simply a sign of it. Increased levels of CRP tend to be seen in obese patients and those with chronic diseases.
“More than 21 million Americans suffer from depression, a leading cause of disability, according to Mental Health America.”
Note: the 2011 estimate of those residing in the U.S. stands at more than 311 million.
Depression is increasing among Japan’s public school teachers.
“A report by the Ministry of Education, Sports, Culture, Science and Technology shows that in 2011, around 5,200 public school teachers had to go on sick leave due to various mental illnesses, including severe depression.”
“The study also highlights the fact that the main reason for the increasing depression is a school environment that puts too much workload and pressure on the teachers that they cannot have a healthy work-life balance anymore, much less deal with students, their guardians and the paper work that comes with all of these. (emphasis mine)”
I recently finished a book by actor Tony Danza called I’d Like to Apologize to Every Teacher I Ever Had in which he chronicles his yearlong stint in Philadelphia’s inner city public school system. He echoes some of these sentiments as well. After trying to teach his students, he notes that it is difficult not to get involved in their personal lives as well. In the Epilogue, Danza writes:
“…I can only do so much. Where does teaching stop, and start? Where should it? I don’t really know. To engage my students, I found that I had to become engaged in their lives, their problems, and their futures. That connection was what made the job the most rewarding. Yet it was also the intensity of that involvement that, by the end of the year, had made the job of teaching so much tougher than I’d ever expected.”
It seems that Japan’s public school teachers are no different from American public school teachers.
And surprise, according to a recent study, pot could lead to psychosis in teens or teens who smoke pot can later develop psychosis. I find it interesting that teens were actually evaluated after smoking pot.
After 2 years of not being on medication, I am back to a daily regimen of lamotrigine (Lamictal) and aripiprazole (Abilify) with lorazepam (Ativan) as needed.
Many of you may know, or may not know, what I decided to taper off of medication so that I could get pregnant. Well, that hasn’t happened. And my thoughts got to a point where it became life and death again. I didn’t want to go back to the psych hospital so I asked my psychiatrist for help.
My psychiatrist (God bless him) is a very conservative psychiatrist. He was the one who helped me off of medication 2 years ago, and he’s the one titrating my dosages up now. Lamotrigine is for long-term maintenance of the bipolar disorder, aripiprazole is for short-term maintenance of bipolar disorder and SAD (seasonal affective disorder), and lorazepam assists with severe anxiety as needed. I started taking the medication four weeks ago, and I’m only on 50 mg of lamotrigine and 5 mg of Abilify. There will be no increase on Abilify and I titrate up on lamotrigine every 2 weeks. My next big jump is 100 mg.
My psychiatrist expects me to come off of aripiprazole within the next few months (hopefully by December). If not, I will have to get regular blood sugar and cholesterol tests performed. He will adjust all medications as necessary in the event that I am pregnant. He’s a great psychiatrist; he’s willing to work with me based on my situation rather than him throwing drugs at me. He allows me to have complete control over my treatment regimen, which is something I like and respect.
In the past, I may have come off as anti-medication, but really, I’m not. I advocate for use of medication in a necessary, responsible manner. In 2010, 253 million prescriptions were written for antidepressants.¹ (Keep in mind that the U.S. is estimated to have 307 million people in the country.² That’s about 82.4% of the population taking antidepressants.) This is not responsible; this is too much. In the comments, people have rightly corrected me in the assumption that 1 person can get multiple prescriptions in a year; I failed to remember that.
Let’s assume a person is on 1 antidepressant (the majority of people take 1). Beginning in January, that person gets 5 refills for 30 days. By May, the person will need another 5 refills. Then another prescription is dispensed in October. That’s 3 prescriptions per person. Of course, this can vary depending on how often the doctor will see a patient so let’s generalize and say 5 prescriptions per person per year. My calculations for prescriptions per American mean that nearly 20 percent (about 17%) of the population is on antidepressants. Sure, it’s not my original ridiculous number of 82.4%, but I still think this is pretty high. (By the way, feel free to correct my stats in the comments if necessary; I don’t claim to be a math wizard.)
While I am not on an antidepressant, I am one of the millions of Americans who is on medication for mental illness. For 2 years, honestly, I’d forgotten I had anything relating to mental illness. It was nice to wake up and be myself without thinking about me plus bipolar disorder. Every morning and every evening, it’s now me plus bipolar disorder plus SAD plus anxiety. These are all real symptoms that need to be managed. I don’t want to be dependent on this medication forever, but I may have to. If it helps me manage my suicidal thoughts and function with people in life, then it’s worth it.
Your turn: What do you think about taking psychotropic medication? Do the symptoms outweigh the risks for you? What’s been your experience in taking (or not taking) psych meds?
“This is a disorder that affects millions of people and I am one of them,” the [Zeta-Jones], 41, tells PEOPLE in an exclusive statement in this week’s cover story. “If my revelation of having bipolar II has encouraged one person to seek help, then it is worth it. There is no need to suffer silently and there is no shame in seeking help.”
Last month, Lovato said:
“I never found out until I went into treatment that I was bipolar. Looking back it makes sense,” she says of her diagnosis. “There were times when I was so manic, I was writing seven songs in one night and I’d be up until 5:30 in the morning.”
I’ve said before that I’m not a fan of mental illness fads, but bipolar disorder has such a stigma attached to it that celebrities who seriously suffer from the disorder have a chance to put a face on and say “There’s no shame in getting help.” And while psychotropic drugs certainly aren’t a cure-all in conjunction with talk and behavioral therapy, bipolar disorder can be managed—not just for these celebs but also for anyone who suffers from the disorder.
Of all the celebrities I would have pegged with some kind of mental health disorder, Ms. Zeta-Jones would have never made the list. After supporting her husband Michael Douglas through his cancer treatment, she remained quiet about herself only outspoken on issues pertaining to how upbeat and positive the couple was on Douglas’s treatment.
But clearly, being a bedrock for her husband has taken its toll on her. Last week, she checked into a mental health facility seeking treatment for her bipolar II disorder. Bipolar II is characterized by frequent depressive episodes rather than a constant swing of manic-depressive ones. While only Ms. Zeta-Jones knows what’s been going on inside her mind and her heart, I can only imagine that she’s been suffering with some depression for a while but quietly put it aside as her husband struggled to become healthy again.
In the past, I’ve used the Celebrity Sensitivity feature of this blog to mock celebrities who seem to be diagnosed with nearly any mental illness fad that goes around (normally, depression), but this time my heart goes out to Ms. Zeta-Jones who decided to seek treatment for herself instead of putting on a face like everything’s okay and toughing it out.
This is old news but I’ve been wanting to write about this for a while.
In 2008, bipolar disorder became a list of covered psychiatric conditions under the American Disabilities Act (ADA). While I support the move, I’m somewhat guarded about it since there are a variety of symptoms within bipolar disorder that can make it difficult for a person to perform his or her job. From PsychCentral’s post about it in September 2010:
For ADA purposes, major life activities that may be limited by a mental health disorder could include learning, thinking, concentrating, interacting with others, caring for oneself, speaking, or performing manual tasks. Sleep also may be limited in such a way that daily activities are impaired.
Someone with bipolar disorder may temporarily experience “limits” to handling life activities. A deep bout of depression or insomnia may create a need for time off or for flexible hours. An individual may need time off for doctor appointments. In the daily work environment he or she may need a quieter work area to decrease stress and enhance concentration or more frequent breaks to take a walk or do a relaxation exercise. He or she may need office supplies to help them organize and focus more effectively.
I’ve experienced all of these issues at one point or another (sleep issues have been the most frequent and debilitating) in the past and I completely understand how it can affect someone’s ability to work. However I worry that someone might use this to their advantage to cover bad behavior rather than someone who legitimately needs this protection. But alas, abuses to systems exist everywhere.
This coverage prompts me to ask the question: is bipolar disorder (and depression as well) a legitimate disability?
“While I’ll always be bipolar, I find it easier to deal with now. With marriage and fatherhood, I’ve finally found two fixed points in my life. They’ve taught me patience. They’ve also taught me that I don’t need to feel guilty about being happy. My emotional seasons are less extreme.
“In the past my brain would never stop. Now I’m a father, the world no longer revolves around me.”
I’ve always wondered whether having a child would change the way I deal with bipolar disorder. Of course, I’m not going to have a child simply as a test case in the hopes that he or she would “cure” me but I think having someone so completely dependent upon me would cause me to think twice about trying to kill myself.
I thought the wine was working but I guess isn’t or I didn’t have enough. No matter, I’m out of the light blush anyway.
It’s nearly 4 in the morning and I crawled in bed sometime between 11:30 and 12. Reasonable bedtime for this nightowl. But I’m not sleepy. Not at all. Laying I’m bed for 4 hours ends up being restless. I’m surprised I can blog at all but this is really mindless drivel since I’m not doing much else other than typing this post out via the Typepad app for the iPhone.
Am I manic? I don’t think so. I am feeling a bit weary. I’ve been manic; i’ve experienced that energy of cleaning the apartment and rearranging the room at 2 am. I don’t have that kind of superhuman energy right now. In fact, I’d love to do nothing more than sleep but it eludes me. I’ll be trying to snag some natural remedies but in the meantime, I don’t feel like being up until 5! I have counseling at 7 tonight. However I fear I’ll see the sun come up. Five isn’t too far away.
I haven’t really read of anyone suffering from insomnia as a result of Lamictal withdrawal but I am. And by golly, if you like sleep like me, this is torture. I don’t know how I’m going to right myself. I can’t go on sleeping during the day.
Oh wait–I can’t sleep during the day either. And this is simply within the past month down from 200 mg to 125 mg. And to think! My doctor said I could just quit cold turkey.
WHAT IN TARNATIONS MADE HIM SAY THAT? Did he want me to die? Suffer from seizures? Seriously, doc, what the heck?
And then I’ve got the friend who is psycho stalker ex-girlfriend in training who doesn’t understand the meaning of, “I don’t want you get out of my life,” but we’ll save that story for another day.
(Btw, sorry for the misspellings if any. I’m typing this on my itouch keyboard and not spell checking too closely as I go along hoping autocorrect will catch most of mistakes. Guaranteed it has even if there are tons visible. I’m much too tired and apathetic to fix it or care right now. Maybe later. I just want sleep.)
Have you ever obsessed about sleep when you felt like it was constantly eluding you?
And I wrote a heckuva long post for typing this via mobile. 😛