So whenever you get a diagnosis of bipolar the first thing the docs, and reasonably so, want to try is medication. Of course this is along with behavioral therapy but they definitely want you on meds. This can get very interesting as you sometimes have to try dozens of different meds and/or med combinations to figure out what works – and more importantly, what doesn’t. When they don’t work, well that can trigger any number of reactions, some fun and some not so much.
I have been on at least two dozen medications and countless combinations over the ten years since my diagnosis. I can’t even tell you what’s worked with what anymore. It wasn’t until well into dealing with this that I even started keeping records of such things. I can tell you I’ve learned there are some that really don’t work well with Sudafed (that turns me into a raging bitch if I take it for more than three days) and I can also say with confidence that there are others that will simply knock me out cold. If there is a side effect I’ll find it and sometimes it can really make this challenging. Although there are certainly physical side effects (fatigue, weight gain, skin problems, etc.) I’m going to focus today’s blog on my mental side effects, which by the way, are some of the most difficult to identify when trying a new med. I’m unable to even figure out a good analogy for the process but when you have a mental condition figuring out which mental issues that arise are caused by the condition vs. the new medication can be very tricky.
Before I get started, let me say it can be hard to tell between a good mood and early mania (or alternately situationally sad and early depression), so that right there adds the first layer of annoyance. Sometimes I just want to think I’m normal and just happy or sad, you know?
Anyway, my manic side effects often seem appealing at first as I suddenly have more energy, I’m ready to try new adventures and I’m generally much more pleasant to be around. I’ll drive myself into the ground trying something new and often find myself sleeping much less than normal, around 4-5 hours a night. I’ll be up at odd hours trying some new “thing” I just had to do. I’ll find myself getting more agitated than usual (which is how I know its mania and not just a good mood) at minor issues, responding to a small problem with an overblown reaction. I’ll start talking faster than normal and my thoughts start to ramp up in speed.
But I really know it’s mania when the “Well I can buy that, it’s only X dollars.” starts, something I nearly always do when manic. Note that money issues and bipolar often go hand in hand. It’s very difficult to manage and personally you’ll find my debit card in my wife’s wallet on those occasions. I can easily get to the point where I just can’t trust my own judgement on spending so…off to her wallet it goes and I move on a cash-only basis. You might also find me kicking off a road trip at the last minute or planning some new adventure that we just must do! It can be overwhelming for the folks around me to keep up. These are about where my mania has reached although I know others have found much higher and more difficult heights than I have, I just wanted to give you an insight into mine as part of this process.
My depressive side effects can be hard for me to notice at first. I just start to slow down and don’t do as much around the house, I don’t call as many friends or post as many things online, I simply begin to delicately (or sometimes not so much so) step back from my life. I’ll let myself go a bit and won’t pay as close attention to what I’m eating or even if I am throughout the day. Then I stop doing pleasurable things. You won’t find me coloring, or reading, or eating tasty things just for the fun of trying them. I’ll pass over the chance to go out and see friends or go to a movie.
If it gets even worse I’ll start to have a hard time getting out of bed and will have to pull myself physically up to make sure I function, as I have a lot of responsibilities and few of them go away or can be pushed off just because I’m having an episode. I mean, the kids still need to head off to school, right? They deserve a hug from mom on the way out and a bit of supervision to make sure they eat first (I swear those kids would voluntarily starve if they had their way!). On rare occasions though, even that’s not enough and the days start off without me. I just stay in bed. Not for the whole day but at times it can be hours. I’m not even sure what I do while laying there. I think I just generally obsess about something and my mind wanders while I drift in and out of resting. Regardless, I’m definitely not productive and am wasting time and energy in ways I’d rather not.
Obviously both types of side effects can impact my life in pretty dramatic ways and let me tell you, they are rarely appreciated by the people around me. Especially the depressive ones, those are met with concern and worry (and sometimes frustration that I can’t just “pull myself out of it”) while the manic ones are generally greeted with excitement at first as people think I’m “better” and “okay now”. It’s a bit difficult to explain to them when suddenly I’m not. Both mania and depression can be difficult to identify at first and, as you can see, clearly mental side effects of meds can be overwhelming and complex. So the next time you have a friend trying a new med combination, be compassionate and try to understand, it’s just as confusing for us as it likely is for you.