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There’s been a long delay in my blogging again, mainly caused by the swinging of moods, a merry-go-round of meds and the general see-sawing of life. As you can see I’m in the kiddies’ playground at the moment — some fun, some falling over in tears and a lot of stupid immaturity (at 55!).

It’s been a hard time at home with my husband having radiation therapy for lip cancer, a terrible treatment that involves considerable pain in the form of a burnt, blistered lip and extensive swelling. As always with cancer there is the added stress of worrying whether the treatment will be successful. He’s being very strong and composed outwardly but I know that he’s concerned on the inside and that his sleep is disturbed due to the pain waking him. However, he’s coping much better than I would and I admire him for that and I try to be here for him if he needs me.

My mood? Oh God, depends on which psychiatrist I’m talking to for the “official” label. One calls it Mixed Affective State, the other Rapid Cycling. I believe, at this time, I’m rapid cycling because I’m having distinct mood swings throughout the day. Who cares what it’s called, it is bloody awful but it’d be nice if psychiatrists could agree on terminology!

In February my psych trialled me on an adjunctive treatment agent called n-acetyl cysteine. What is it? Well these sites can explain better than I can: NAC and Adjunctive N-Acetyl Cysteine Effective for Bipolar Depression

Unfortunately I didn’t take it long enough to test its efficacy because my psych was concerned that it may have been associated with my hypomania. However he did say this is unlikely and I think he was just being cautious. Fair enough. In some ways though it would have been good to give it a fair chance because it’s so different to any of the usual drugs approved for bipolar.

My most recent therapy event was to see a mood disorder specialist for an overview of my moods and medication. It was an interesting session inasmuch as it removed any doubt I may have had about the difficulty of seeing a new psych. I felt physically ill and extremely emotional. It was hard to answer the questions I was asked; hard to think about what I needed to say and the whole experience left me feeling hopeless and empty. He made changes to the dosages of some meds and said he will suggest other changes, including a different drug, to my regular psych.

The final adventure in my playground is related to the above discomfort of seeing a different psychiatrist. My psych is reducing his hours again and will definitely be tapering off towards retirement. He will only be working one-and-a-half then one day(s) per week. Furthermore he told me that a psychiatrist who is only working one day a week cannot provide the support that a mood disorder patient needs, i.e. mood disorder patients need someone they can contact during the week if they become ill. I’ve only ever done this once although I have been asked to check in and have been checked up on. What this means is that my psych is looking for another psych for me to transfer to. This may seem totally stupid, and I’d agree with you that it is, but I don’t want to start again with another psych. The thought of going through my history again makes me feel sick and I know that all my treatment will be changed.

Every psychiatrist has their own way of diagnosing Bipolar 1 or Bipolar 2 and I’ve had both diagnoses from seven different psychs over the years. Not only that but they all have their preferred ways of treating either of the above. Each has his/her favourite medication regimen, followed by second-in-line drugs if the first don’t work and then onto a choice from all the drugs available — but you usually get the favourite ones first. Some prefer to only deal with medication while others provide therapy as well. Therapy might be structured CBT or a more general talk therapy. Some offer long appointments but with others you get short ones to do a meds check. A number of variables.

Everytime I’ve seen another psych, including in hospital, I’ve had my meds changed and have experienced therapy that has been incompatible with what I’ve been having. I really don’t want to go through all this again, plus it is all made worse when you add Borderline Personality Disorder into the mix.

I admit I feel angry about these upcoming changes even though I fully accept that my psychiatrist has a right to retire. My thought at this time are to wing-it and to get my prescriptions from my GP, if possible.

To be continued ……..


    • strugglingwithbipolar
    • Posted April 13, 2012 at 7:43 am
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    I would love to learn about NAC. I have several mental health diagnoses – my major one being bipolar disorder – and I am always looking to find treatments that may be effective. I think we FINALLY found the med cocktail for me, but I’ve only been on it since February.

    • The possibilities of NAC treatment are very interesting. It has already been used successfully for other illnesses. There isn’t much information available on the internet but you could try to gain access to a study done in Australia. It might be worth discussing NAC with your psychiatrist to see what he/she thinks as it can be safely used along with other meds. Great that you have found a suitable cocktail that is working for you.

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