serendipity

When i graduated from vet school a billion years ago one of the speakers used the premise of serendipity in her speech.  I haven’t thought of the word much since then until recently.  I actually got a much needed job offer from this woman [most of my classmates already had jobs lined up by graduation] and i took her up on her offer and worked happily for/with her for 13 years.

 

Anyway, serendipity popped back into my head because i discovered by accident that burning myself in the oven helped put the brakes on a uncomfortably manic day.   I happened  to sizzle my hand on the broiler about a week ago and immediately felt the vibration and electricity ease in my head and body.

 

A couple of days ago when i felt too much energy again, i purposely preheated the oven to 425,, put a pizza pan in to heat and used that to burn myself, resulting in a 2nd degree burn on my forearm.  Today my T looked at the bandage on my arm and asked me if i had cut too deep.   “No, it’s a burn, it helps slow me down.”    He frowned inside and moved on.

 

I did a little reading about self harm and bipolar disorder and it seems that some people use self harm during depressed and/or manic phases.  I’m certainly not advocating this behavior for anyone else, but for me it’s good to find a non-medicinal approach to slowing things down to a manageable level.

 

Doc

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It’s unofficial….

but i now believe i am bipolar. For the past 9 years i have carried the diagnosis of MDD. This has been debated between myself and my shrink several times but he has stuck to his original dx. I couldn’t decide whether the occasional good days in between months and months [years] of depression meant anything.

My therapist has long suspected BP, Dr. Laura asked me to consider my treatment-resistant depression as a possible sign of BP and a couple of in-house shrinks at Hopkins thought i was, but they didn’t commit to it [ha] on paper.

I spend an hour weekly with my T and 15 minutes with my shrink every 3 to 4 months. I should have listened to my T, it would have saved time. But, for some reason, i wanted a shrink to agree.

It doesn’t matter anymore. For the last 10 days, i have been fantastically happy, better than before i became ill. I have enjoyed singing and dancing around the house, buying lots of clothes, working on long-neglected projects, and GASP! being sociable.

I did start weaning off my AD’s and anxiety meds last week but my “happy, happy, joy, joy” times started before that. My hypomania is probably helping me with the drug wean as well.

Like many people, i LIKE it and i don’t want it to end anytime soon. For now, i am going to pretend it won’t. Doc

Behavior

I decided to drink a little wine today.  For the past 6 months or more I’ve lost my taste for it.   I used to drink a couple of glasses each week, sometimes going way overboard to utter drunkiness and general dishibition and silliness.  (I’m a happy drunk).  To be honest, I was hoping for more with todays’ drinking. 

I’ve been reading more about bipolar disorder and possible triggers for hypomania.  From what I’ve read from some sufferers, alcohol can  sometimes be a trigger.  Unfortunately, my drinking today did not lead me into the promised land of hypomania. 😦  If that sounds odd, too bad.  I’ve only recently had or recognized an episode of hypomania and I like it.  (It’s only rock and roll, but I LIKE it.)  I liked the mental sharpness, the sudden flow of good ideas, and the productivity.  Instead of walking past the overflowing laundry basket and moaning “I really should wash those clothes” it’s “yea, I can do some laundry.  Great”.

Caffeine, another reported trigger does nothing for me.  Sleeplessness, on the other hand, shows promise.  But i’m not sure if being awake leads to hypomania or it’s the other way around.  

For the duration of my illness, about 4 years now, I have been depressed.  Lots of different meds., lots of “therapeutic interventions”, and years of talk therapy.  Nada.  So, now I am drug free (I don’t count the pot).  I’m not symptom free, but i’m not worse.  In fact, maybe i’m finally going to see how my illness truly manifests itself. 

I read recently about a woman my age who used cocaine to treat her bipolar depression.  I used coke a little in my twenties and while I enjoyed it, eventually I left it behind and got serious with my life.   I told my therapist this week that I kinda long for the way coke made me feel back then.  I want to feel that way again .  (Concentrated scribbling in my chart by him.)  But I told him  I do recognize that it is quite expensive and sometimes it’s hard to stop. I know it’s not the “real” thing, but a break from this would be welcomed.  For now, this option is on hold.  I’ll be good.   

 Anyway, the reason for this post is to relate my experience at a recent veterinary continuing education meeting.  The speaker was a board certified veterinarian of small animal (dogs and cats) behavior.   Dr. S. spoke about psychoactve medication (sound familiar?) and behavioral modification techniques.  One of her main points was that we often need to medicate our patients first so that they can then engage in and learn from behavioral modification ie:  therapy.  Anyone who has had the pleasure of seeing a psychiatrist these days will recognize the mantra of “medications are only one tool in recovery”. 

As the lecture progressed she discussed all the familiar meds :  SSRI’s – Prozac, Paxil, Zoloft, SARI’s – Trazodone,  alpha-2 adrenergic agonists – Clonidine, antipsychotics/neuroleptics – Thorazine, Mellaril, Haldol, acepromazine, narcotic antagonists – Naltrexone, TCA’s – Imipramine, Elavil, clomipramine, azapirones – Buspar, GABA analogues – gabapentin, benzos – Valium, Xanax and clonazepam, and MAOI’s – selegline.

 

 

  

     

She also discussed nutraceuticals, herbs, antioxidants, dietary therapy, melatonin, pheromones, acupuncture/pressure, and aromatherapy. She provided worksheets of tested and proven protocols for various problems. She covered a lot of bases.
Interestingly, dogs and cats suffer with many of the same mental/behavioral problems that we do. Anxieties, phobias, panic disorders including panic attacks, compulsive disorders, aggression issues, cognitive dysfunction, self-injurious and stereotypic behaviors like circling, pacing, barking, and tail chasing (not the same thing here!)
Apparently, antipsychotics are not used for psychosis in animals. I have to question the assumption that dogs and cats do not suffer from psychosis. I mean, how would you know for sure that they aren’t hallucinating or delusional? I’ve known quite a few animals that were reacting to something that either wasn’t there or I couldn’t hear/see it. How do you ask them? “Say, Buster, do you see a cow in the living room right now?” “Do you hear bluegrass music coming from the wood stove?” “Do you think animal control officers are watching you?”
She also made the comment that animals don’t get depressed. Bullshit. I’ve met plenty of them who display the classic symptoms of depression – loss of appetite, excessive sleeping, amotivation. Usually situational like the death or absence of a loved one.
Bipolar disorder and schizophrenia spectrum disorders? Again, hard to tell. But I do have some breeds I have my doubts about.
One area that was mentioned but seems to have less occurrence in animals is medication side effects. Side effects in small animals include – dry mouth, constipation, increased appetite and weight gain, ataxia, cognitive impairment, GI upset, sedation, tardive dyskinesia, and restlessness. Many of my significant side effects included unwanted and unpleasant thoughts and beliefs. How do we assess this in our companion animals? How do they tell us about these? I don’t know, but I worry about it.
Doc.