dreams in neon
05-05-2009, 05:20 PM
Hi everyone,
I just came home from seeing my tdoc and the appointment went better than expected.
My tdoc told me politely that it sounds as if I'm in a mixed state right now. He said he could tell this by my rapid speech (mania) and thought content (depression). He also said that I looked tired.
We spoke about what mixed episodes were as well as my feelings about them. Next week we are going to work on some techniques I can use to help me deal with my feelings the next time I'm having a mixed episode.
I expressed my frustration about what happened on the other message board to which he said that even if you're on meds, it doesn't prevent you from having a manic, depressed, mixed or psychotic episode. He also said the person who told me that I should take responsibility for sleeping regularly should understand that not everyone with bipolar is stable and that there are many of us who continue to struggle even if we are on meds and do everything we can to reduce mood swings.
He looked at my mood chart and said that April's chart looked very, very good. When he looked at May's chart, he said it appears that I'm having a bit of a rough time, but agrees that this is due to my health problems.
He suggested that I think about trying a different med combo given my mixed state or at least try a different mood stabilizer. I told him I'd rather not since the regimen I'm on addresses all of my symptoms and I was doing really well until I started having headaches and allergy attacks.
Besides, I don't want to take Lamictal because of the titration that is necessary to reach a therapeutic dose. I don't want to wait 6-8 weeks for the med to kick in. I also don't want to be on Lithium and have blood tests every 6 months or check my salt and water intake.
I said that I also worry about having another manic/psychotic episode and so far, Depakote has been preventing that for the past 3 years. I don't want to fix what isn't broken.
I told him that I took 2 Klonopin before our appointment so that I wouldn't end up crying. He said it would have been perfectly fine if I did. I expressed a great deal of anger today about my diagnosis and it felt good to get it all out.
My tdoc told me to remind myself that when I'm in a mixed state or am depressed to think about how far I've come since the early 90s. I'm not as severely depressed as I was back then and I'm certainly not the same way I was in 2006.
He told me that this mixed episode won't last forever and that it will pass. He also told me it was a good sign that things are already starting to improve since I was able to fall asleep this morning for 2 hours before my appointment.
I feel better, but am still feeling mixed although I'm not as depressed as I was earlier today.
I just came home from seeing my tdoc and the appointment went better than expected.
My tdoc told me politely that it sounds as if I'm in a mixed state right now. He said he could tell this by my rapid speech (mania) and thought content (depression). He also said that I looked tired.
We spoke about what mixed episodes were as well as my feelings about them. Next week we are going to work on some techniques I can use to help me deal with my feelings the next time I'm having a mixed episode.
I expressed my frustration about what happened on the other message board to which he said that even if you're on meds, it doesn't prevent you from having a manic, depressed, mixed or psychotic episode. He also said the person who told me that I should take responsibility for sleeping regularly should understand that not everyone with bipolar is stable and that there are many of us who continue to struggle even if we are on meds and do everything we can to reduce mood swings.
He looked at my mood chart and said that April's chart looked very, very good. When he looked at May's chart, he said it appears that I'm having a bit of a rough time, but agrees that this is due to my health problems.
He suggested that I think about trying a different med combo given my mixed state or at least try a different mood stabilizer. I told him I'd rather not since the regimen I'm on addresses all of my symptoms and I was doing really well until I started having headaches and allergy attacks.
Besides, I don't want to take Lamictal because of the titration that is necessary to reach a therapeutic dose. I don't want to wait 6-8 weeks for the med to kick in. I also don't want to be on Lithium and have blood tests every 6 months or check my salt and water intake.
I said that I also worry about having another manic/psychotic episode and so far, Depakote has been preventing that for the past 3 years. I don't want to fix what isn't broken.
I told him that I took 2 Klonopin before our appointment so that I wouldn't end up crying. He said it would have been perfectly fine if I did. I expressed a great deal of anger today about my diagnosis and it felt good to get it all out.
My tdoc told me to remind myself that when I'm in a mixed state or am depressed to think about how far I've come since the early 90s. I'm not as severely depressed as I was back then and I'm certainly not the same way I was in 2006.
He told me that this mixed episode won't last forever and that it will pass. He also told me it was a good sign that things are already starting to improve since I was able to fall asleep this morning for 2 hours before my appointment.
I feel better, but am still feeling mixed although I'm not as depressed as I was earlier today.
Sponsor
katlin09
05-05-2009, 05:27 PM
Dreams,
Good job, it doesn't seem liek you had any problems getting your points across today, that's great.
kat
Good job, it doesn't seem liek you had any problems getting your points across today, that's great.
kat
dreams in neon
05-05-2009, 05:30 PM
Kat,
No, I was quite clear and direct today. My tdoc said I sounded a bit agitated as well which he said was understandable. I knew exactly what I wanted to talk about and we were able to cover everything except my journal and a letter I had to write to my late mother (as part of my PTSD exercises), but my tdoc said he will read that before our appointment next week. We also need to work more on my PTSD exercises as well as helping me learn how to cope with flashbacks and nightmares. As he said, "We've got a full plate of things to discuss."
No, I was quite clear and direct today. My tdoc said I sounded a bit agitated as well which he said was understandable. I knew exactly what I wanted to talk about and we were able to cover everything except my journal and a letter I had to write to my late mother (as part of my PTSD exercises), but my tdoc said he will read that before our appointment next week. We also need to work more on my PTSD exercises as well as helping me learn how to cope with flashbacks and nightmares. As he said, "We've got a full plate of things to discuss."
CarenR
05-05-2009, 06:58 PM
YOu are so lucky that your-doc talks with you.. when I go to my appoinment for meds. he just gives me prescription refills.. ........he doesnt anything with me I have Bipolar 1...
hugs, Caren
hugs, Caren
dreams in neon
05-05-2009, 07:33 PM
I'm sorry to hear that Caren. I used to have a pdoc who was the same way. Every time I told him I was rapid cycling or manic he would tell me to schedule an appointment with him in 3 months.
Update: I spoke to my pdoc again because the Clonazepam that I'm taking isn't working long enough like it used to which he thinks is due to my mania. He suggested that I take 1 tablet 4x/day. He also told me I could take Melatonin. My Trazodone regular and PRN doses will remain the same since they cannot be increased much higher. He feels that the extra Clonazepam during the day and night will help me fall asleep. If it doesn't, he would like to increase my dosage of Clonazepam to 2mg until this episode passes. I was told to call him again on Monday to let him know how I'm doing. I'll be crossing my fingers that this change works.
I forgot to mention that I asked him about my Depakote and Fluoxetine. He said that given my weight (114), I'm on enough Depakote. As for Fluoxetine, he said it can cause mania and thought about taking me off of it, but after I told him about my IP hospitalization in December and the fact that I haven't been depressed since, he decided to keep it in my regimen.
Update: I spoke to my pdoc again because the Clonazepam that I'm taking isn't working long enough like it used to which he thinks is due to my mania. He suggested that I take 1 tablet 4x/day. He also told me I could take Melatonin. My Trazodone regular and PRN doses will remain the same since they cannot be increased much higher. He feels that the extra Clonazepam during the day and night will help me fall asleep. If it doesn't, he would like to increase my dosage of Clonazepam to 2mg until this episode passes. I was told to call him again on Monday to let him know how I'm doing. I'll be crossing my fingers that this change works.
I forgot to mention that I asked him about my Depakote and Fluoxetine. He said that given my weight (114), I'm on enough Depakote. As for Fluoxetine, he said it can cause mania and thought about taking me off of it, but after I told him about my IP hospitalization in December and the fact that I haven't been depressed since, he decided to keep it in my regimen.
katlin09
05-05-2009, 09:24 PM
YOu are so lucky that your-doc talks with you.. when I go to my appoinment for meds. he just gives me prescription refills.. ........he doesnt anything with me I have Bipolar 1...
hugs, Caren
Caren,
Dreams was talking about seeing her tdoc today her therapist...do you not have a tdoc to talk to, besides your pdoc?
kat
hugs, Caren
Caren,
Dreams was talking about seeing her tdoc today her therapist...do you not have a tdoc to talk to, besides your pdoc?
kat
katlin09
05-05-2009, 09:26 PM
Kat,
No, I was quite clear and direct today. My tdoc said I sounded a bit agitated as well which he said was understandable. I knew exactly what I wanted to talk about and we were able to cover everything except my journal and a letter I had to write to my late mother (as part of my PTSD exercises), but my tdoc said he will read that before our appointment next week. We also need to work more on my PTSD exercises as well as helping me learn how to cope with flashbacks and nightmares. As he said, "We've got a full plate of things to discuss."
Dreams,
When my tdoc has me write something she'll just take it and read it, no problem. But if my pdoc has me right something, he makes me read it out loud and then we go though and analyze each part. I hate that 'cuz I always feel self conscious about it and I already know what I wrote and don't partiuclarly want to read it again. But he doesn't let me off the hook.
kat
No, I was quite clear and direct today. My tdoc said I sounded a bit agitated as well which he said was understandable. I knew exactly what I wanted to talk about and we were able to cover everything except my journal and a letter I had to write to my late mother (as part of my PTSD exercises), but my tdoc said he will read that before our appointment next week. We also need to work more on my PTSD exercises as well as helping me learn how to cope with flashbacks and nightmares. As he said, "We've got a full plate of things to discuss."
Dreams,
When my tdoc has me write something she'll just take it and read it, no problem. But if my pdoc has me right something, he makes me read it out loud and then we go though and analyze each part. I hate that 'cuz I always feel self conscious about it and I already know what I wrote and don't partiuclarly want to read it again. But he doesn't let me off the hook.
kat
dreams in neon
05-05-2009, 11:42 PM
Dreams,
When my tdoc has me write something she'll just take it and read it, no problem. But if my pdoc has me right something, he makes me read it out loud and then we go though and analyze each part. I hate that 'cuz I always feel self conscious about it and I already know what I wrote and don't partiuclarly want to read it again. But he doesn't let me off the hook.
kat
When I wrote a letter to my father for my last PTSD exercise, my tdoc read it out loud in front of me. He didn't read the letter to my mother today because we had alot to discuss about mixed episodes as well as the frustration I had about what happened on the other message board. My pdoc has never asked me to write anything. When I see him, we discuss how I've been feeling, med changes and he answers any questions I have. Now that I'm doing a mood chart, we will be talking about that as well.
When my tdoc has me write something she'll just take it and read it, no problem. But if my pdoc has me right something, he makes me read it out loud and then we go though and analyze each part. I hate that 'cuz I always feel self conscious about it and I already know what I wrote and don't partiuclarly want to read it again. But he doesn't let me off the hook.
kat
When I wrote a letter to my father for my last PTSD exercise, my tdoc read it out loud in front of me. He didn't read the letter to my mother today because we had alot to discuss about mixed episodes as well as the frustration I had about what happened on the other message board. My pdoc has never asked me to write anything. When I see him, we discuss how I've been feeling, med changes and he answers any questions I have. Now that I'm doing a mood chart, we will be talking about that as well.
katlin09
05-05-2009, 11:54 PM
Dreams,
Made was probably too strong a word, asked was more like it, or suggested. See I'm still in that wierd situation where I have therapy with my pdoc, as well as with my tdoc, from when he took over my therapy for 4 months last summer. We do 45 min. appts with 15 min. for med mgmt. and 30 mins for therapy and him keeping in touch with all the issues that I still have going on, I just don't see him every week like I do my tdoc, I only see him every 2 to 3 weeks. But he does request that I write letters to my father or mother, and when I do that, he has me read them out loud and then we rip them apart so he can help me understand my anger, sadness, fear, etc. It reall is effective I guess, but even with him, one on one I still get nervous reading in front of him. When I give him my food diaries, mood charts, or sleep diaries I try to just hand them to him and he'll sit and hold them and ask me "So, what do you want to say about these?". I didn't think of it, but I guess in his way he's trying to help be get past this paranoia about speaking in front of people.
It just gets very interesting sometimes when I see him and my tdoc in the same week, because their therapy techniques are pretty different, even though they do speak with each other frequently regarding my case and how I'm doing or not doing.
kat
Made was probably too strong a word, asked was more like it, or suggested. See I'm still in that wierd situation where I have therapy with my pdoc, as well as with my tdoc, from when he took over my therapy for 4 months last summer. We do 45 min. appts with 15 min. for med mgmt. and 30 mins for therapy and him keeping in touch with all the issues that I still have going on, I just don't see him every week like I do my tdoc, I only see him every 2 to 3 weeks. But he does request that I write letters to my father or mother, and when I do that, he has me read them out loud and then we rip them apart so he can help me understand my anger, sadness, fear, etc. It reall is effective I guess, but even with him, one on one I still get nervous reading in front of him. When I give him my food diaries, mood charts, or sleep diaries I try to just hand them to him and he'll sit and hold them and ask me "So, what do you want to say about these?". I didn't think of it, but I guess in his way he's trying to help be get past this paranoia about speaking in front of people.
It just gets very interesting sometimes when I see him and my tdoc in the same week, because their therapy techniques are pretty different, even though they do speak with each other frequently regarding my case and how I'm doing or not doing.
kat
dreams in neon
05-05-2009, 11:58 PM
Kat,
How do the therapy techniques of your pdoc and tdoc differ from one another?
I have a great deal of paranoia whenever I'm around groups, but I feel very comfortable speaking to my tdoc and poc because I know I'm safe. I know neither of them will judge me or expect me to do something I'm uncomfortable doing. I see my pdoc for 25-30 minutes which is plenty of time to discuss everything I need to. I see my tdoc for 55 minutes which doesn't always seem like enough time, but it's better than nothing.
How do the therapy techniques of your pdoc and tdoc differ from one another?
I have a great deal of paranoia whenever I'm around groups, but I feel very comfortable speaking to my tdoc and poc because I know I'm safe. I know neither of them will judge me or expect me to do something I'm uncomfortable doing. I see my pdoc for 25-30 minutes which is plenty of time to discuss everything I need to. I see my tdoc for 55 minutes which doesn't always seem like enough time, but it's better than nothing.
dreams in neon
05-06-2009, 12:03 AM
I finished taking my BP meds, 2 Klonopin and 300mg PRN dose of Trazodone. Let's hope it will help me sleep tonight.
If it doesn't, I'm going to buy some Melatonin to take in addition to the Klonopin.
If neither of these help in the next 2 days, my pdoc wants me to call him back so he can increase my Klonopin to 2mg.
I still feel manic right now, but I no longer feel as depressed as I did earlier today.
If it doesn't, I'm going to buy some Melatonin to take in addition to the Klonopin.
If neither of these help in the next 2 days, my pdoc wants me to call him back so he can increase my Klonopin to 2mg.
I still feel manic right now, but I no longer feel as depressed as I did earlier today.
katlin09
05-06-2009, 12:14 AM
Kat,
How do the therapy techniques of your pdoc and tdoc differ from one another?
I have a great deal of paranoia whenever I'm around groups, but I feel very comfortable speaking to my tdoc and poc because I know I'm safe. I know neither of them will judge me or expect me to do something I'm uncomfortable doing. I see my pdoc for 25-30 minutes which is plenty of time to discuss everything I need to. I see my tdoc for 55 minutes which doesn't always seem like enough time, but it's better than nothing.
My tdoc is very caring,compassionate, gentle....in her mannerisms and her therapeutic approach. She does more of the deep breathing excercises and stuff like that. I like my tdoc very very much, but she always harps on the cuts on my arms, and then we have to discuss it, and I get tired of that. Since my tdoc has a background in chronic pain it's easier for her to understand when I'm in pain.
My pdoc is very "in your face" which is how I am most of the time, so we get along well on that front. He doesn't let me "get away" with anything, you know? And if I get too upset or riled or "pissogenic" which is favorite way to describe me, then he'll table that discussion and suggest we go onto something else and when I cool down he'll lead me back to the previous conversation half the time without me even realizing he's done it. He also starts the conversation the minute I get in his office and sit down, which I like. And don't get me wrong, he is also very caring, compassionate, and can be gentle but her interjects some humor into our discussions which breaks some of the ice. He also can always tell whether I'm talking to him in my grown up self or as my 6 yr old self as he likes to put it. If I had my choice I would use him for therapy and med mgmt., but his therapy schedule if full for full time therapy appts. every week. All my pdoc says about my cutting is how often since I saw you last, how severe, and what's setting it off. And as far as the med mgmt goes, he listens to me and if I've researched a med, he considers it and lets me know if it could work for me or not. My pdoc thinnks I should not be taking the narcotics/opiods that I'm talking, but until I get my other knee done I don't have a choice. I also like my pdoc very very much.
Hope that's a good enough explanation.
so they're just different.
How do the therapy techniques of your pdoc and tdoc differ from one another?
I have a great deal of paranoia whenever I'm around groups, but I feel very comfortable speaking to my tdoc and poc because I know I'm safe. I know neither of them will judge me or expect me to do something I'm uncomfortable doing. I see my pdoc for 25-30 minutes which is plenty of time to discuss everything I need to. I see my tdoc for 55 minutes which doesn't always seem like enough time, but it's better than nothing.
My tdoc is very caring,compassionate, gentle....in her mannerisms and her therapeutic approach. She does more of the deep breathing excercises and stuff like that. I like my tdoc very very much, but she always harps on the cuts on my arms, and then we have to discuss it, and I get tired of that. Since my tdoc has a background in chronic pain it's easier for her to understand when I'm in pain.
My pdoc is very "in your face" which is how I am most of the time, so we get along well on that front. He doesn't let me "get away" with anything, you know? And if I get too upset or riled or "pissogenic" which is favorite way to describe me, then he'll table that discussion and suggest we go onto something else and when I cool down he'll lead me back to the previous conversation half the time without me even realizing he's done it. He also starts the conversation the minute I get in his office and sit down, which I like. And don't get me wrong, he is also very caring, compassionate, and can be gentle but her interjects some humor into our discussions which breaks some of the ice. He also can always tell whether I'm talking to him in my grown up self or as my 6 yr old self as he likes to put it. If I had my choice I would use him for therapy and med mgmt., but his therapy schedule if full for full time therapy appts. every week. All my pdoc says about my cutting is how often since I saw you last, how severe, and what's setting it off. And as far as the med mgmt goes, he listens to me and if I've researched a med, he considers it and lets me know if it could work for me or not. My pdoc thinnks I should not be taking the narcotics/opiods that I'm talking, but until I get my other knee done I don't have a choice. I also like my pdoc very very much.
Hope that's a good enough explanation.
so they're just different.
dreams in neon
05-06-2009, 12:29 AM
My pdoc mentioned today that I require a higher dose of meds than most people which I didn't know until I found out that the lowest prescribed dose of Depakote (for bipolar) is 750mg while Risperdal is 1mg and Trazodone is 50mg. Then again, my pdoc told me at my last appointment that I'm on a pretty high dose of meds which means there isn't alot of room for increases to be made. I don't mind though. As long as my meds work the way they're supposed to, that's all I care about.
dreams in neon
05-06-2009, 12:36 AM
My pdoc has a wonderful sense of humor as well. In the 18 years I've been working with pdocs, he's the first to joke around with me. He's very laid back yet knowledgeable about bipolar -- especially atypical bipolar since this is what he specializes in. After he told me he had over 40 years worth of experience, my jaw dropped to the floor. The pdoc I saw in December had 38 years of experience. As for my previous pdoc, I have no idea how much experience he had since I never asked. Then again, since my appointments were only 5 minutes long and consisted of the same canned response, it's no wonder I never asked a single question during the entire 1.5 years I saw him.
Llama
05-06-2009, 12:52 AM
dreams, it's so great that you are able to talk so openly to your health care providers. That is definitely a great skill to have. I'm glad things went ok even though you are experiencing some mixed episode symptoms. I hope you feel better soon!
dreams in neon
05-06-2009, 01:23 AM
dreams, it's so great that you are able to talk so openly to your health care providers. That is definitely a great skill to have. I'm glad things went ok even though you are experiencing some mixed episode symptoms. I hope you feel better soon!
Thanks Llama! According to what my pdoc told me, my mixed episode shouldn't last any longer than a few more days which I'm very happy to hear. I can't wait until my moods are level again. Now that my allergies are under control and I no longer have a constant headache, I think I should start to feel alot better soon. I also feel more confident about calling my pdoc after today's conversation. It's evident that he wants to help me when needed (which is what any pdoc should do) but I had concerns after what was said before. He returned my call this afternoon and answered all of my questions. If I can't sleep for the next 2 days, I will call him back so that my Klonopin can be increased. He says the reason why my Klonopin isn't working as well as it normally does is because of my mania. He also told me something I didn't know: Klonopin can be used for controlling mania. I knew it could be used to prevent it, but I didn't know it could also be used to reduce it.
Thanks Llama! According to what my pdoc told me, my mixed episode shouldn't last any longer than a few more days which I'm very happy to hear. I can't wait until my moods are level again. Now that my allergies are under control and I no longer have a constant headache, I think I should start to feel alot better soon. I also feel more confident about calling my pdoc after today's conversation. It's evident that he wants to help me when needed (which is what any pdoc should do) but I had concerns after what was said before. He returned my call this afternoon and answered all of my questions. If I can't sleep for the next 2 days, I will call him back so that my Klonopin can be increased. He says the reason why my Klonopin isn't working as well as it normally does is because of my mania. He also told me something I didn't know: Klonopin can be used for controlling mania. I knew it could be used to prevent it, but I didn't know it could also be used to reduce it.
dreams in neon
05-06-2009, 04:10 AM
I'm beginning to worry that Klonopin may no longer be working for me. I took 2 tablets awhile ago and I still don't feel tired. I know I'm manic right now, but shouldn't I feel *some* sedation? I don't feel anything at all. I guess it looks like I'll be spending my 5th night without sleep. *sigh* Klonopin isn't doing anything for me. Why isn't it working???