Trial & Error

Bipolar disorder, regardless of what type you may be dealing with, is historically very difficult to treat. If you are dealing with bipolar yourself, you have probably already know what I mean. It isn’t as easy as going to the doctor and getting a prescription for some secret pill that will take away all your problems.

Why would they make anything easy on us, right?

For those of you who may be at the beginning of your mental health journey, you deserve to know what lays ahead. You will likely have to experiment with many different drugs, different dosages, and different cocktails before you find what works for you.

Even then, you will likely be dealing with a host of side effects that can range from weight gain, tardive dyskinesia (tremor), issues with body temperature regulation, issues with taste and dry mouth, and many, many more.

When discussing these things with your doctor for the first time, I’m sure that you will find yourself questioning if medication is even worth it? I know that I did. I felt like I would be giving up life as I knew it. In some ways, I suppose that is true. You’ll understand what I mean a little later on. However if you evaluate where your life is now and examine all of the negativity that exists because of your disorder, I am certain that you at least consider taking medication to ease your symptoms.

This blog doesn’t advocate for or against medications. I can only speak to my own experiences and how my decisions surrounding treatment has affected me. If you have made the decision to forego medication, you can find valuable resources for things like mindfulness throughout the blog and in the resources section within the links and reading list.

If you are presently taking medication or are considering medication as a course of treatment, then I invite you to read on.

There are many different medications that you can take to help alleviate the various symptoms of bipolar disorder. What you are prescribed will be tailored to your personal experiences with the disorder, as it will be different for all of us.

When I am unmedicated or symptomatic, I tend to self-medicate with alcohol (although I have been sober for 5 years now), I will have zero energy and will spend days and weeks in bed, I spend all of my waking hours either watching tv or journal writing, I lose my appetite, I obsessively hair pull (I am also diagnosed with OCD), I will go for days/weeks/months with showering, I do not participate in chores around the house.

When I am manic, it is immediately evident by the pace of my speech to the point that I will actually run out of breathe when I am speaking, I tend to jump from one topic to another of conversation.. sometimes within the same sentence, I experience the ‘flight of ideas’ (this is when you are full of ideas that are seemingly unrelated to each other), I am generally hyper, I feel the urge to indulge in substances like alcohol, I tend to wildly overspend with money that I don’t have (into the $1000s of dollars), I am more desirous and at risk of indulging in risky behaviours, I feel motivated to take on new projects (often several at once), I tend to have a grandiose opinion of myself (I think that I am “cured” or that I have somehow found a way to be free of all my problems).

There are many more symptoms in both categories, but I just needed to give you an outline of my experience when I am ill so that you will see how I am presenting when I see my doctor when he is consider what medications he should prescribe.

In the 10-15yrs that I have been taking medications, I have had the opportunity to try just about everything and every combination of everything. Some things helped a little, but were accompanied by side effects that I was unable to tolerate. Some didn’t work at all and wreaked havoc on my body. Others were effective, but only for a short period of time. And then some others were just very bleh.

Prior to being formerly diagnosed as bipolar, I was treated for chronic major depression with the drug, Paxil (paroxetine). This is going back many, many years, but I remember experiencing huge relief once I started taking Paxil. It is an SSRI that is mostly used to treat depression, OCD, anxiety disorders, PTSD, and PMDD.

You have to understand that at this time of my life, I was living in a different province from the rest of my family, I was mostly alone because my ex travelled extensively with a band that he played in, I was working long hours at a job that I found very stressful, and I was abusing alcohol.

Just because I was feeling better, mentally, all of my behaviours were still extremely erratic. This was exaggerated by the fact that taking SSRIs with bipolar disorder is discouraged, as it tends to trigger manic episodes. When you are manic, you feel pretty good all the time. You actually feel pretty great. Therefore, it is far less likely that you would seek help during this phase of your illness.

Since I was alone during this time, I didn’t have anyone to tell me that I may have been acting irrationally, making bad decisions, or behaving badly.

Common side effects of Paxil include:

  • vision changes
  • weakness, drowsiness, dizziness
  • sweating, anxiety, shaking
  • sleep problems (insomnia)
  • loss of appetite, constipation
  • dry mouth, yawning
  • decreased sex drive, impotence, or difficulty having an orgasm

It is extremely unlikely that you will ever be prescribed Paxil if you are suffering from bipolar disorder. I have only included it here because, for a time, I found that it significantly lifted my mood for the first time and many years and effectively treated my depression, which had been a very severe problem.

Around this time, I was prescribed Seroquil (quetiapine) for the first time to augment manic symptoms that were beginning to appear due to the fact that I was also taking an SSRI. It is difficult to recall at what dose I started my prescription because it was so many years ago, but I believe that it might have been 10mg.

A few hours after my dose, I was almost in a panic because of how the drug was making me feel. It felt like I was drowning in hot syrup. I was unable to eat using metal utensils because I had an irresistible urge to break the teeth out of my mouth. I even started to feel like I was hearing someone speaking my name from the vents in our living room.

By the time it came to take my second dose, I was on the phone with Manitoba Telehealth asking if it would be dangerous for me to continue with the drug. They advised that I stop and I did.

Seroquil is an antipsychotic medication that works by changing the actions of chemicals in the brain. It is used to treat a variety of disorders, including schizophrenia and bipolar disorder. It is also used together with antidepressant medications to treat major depressive disorder in adults, which had been my diagnosis at the time.

I was recently prescribed Seroquil again, which I took with a great deal of hesitance. It has been so many years since I began taking psychiatric medications that I think my tolerance has increased by quite a lot. I was able to tolerate it a lot better this time around at 20mg, however, I still experienced visual hallucinations and so I once again discontinued the medication.

When I moved back to Ontario, I went drug free for a brief time and suffered through my first “mixed episode“, which was one of the worst experiences of my life. I do not recommend putting yourself through one of these if it can at all be avoided.

Thankfully, I was very lucky to be connected with a brilliant psychologist in the Niagara Region, Dr. Dawn Good, who did some work with me and then put me in touch with a semi-retired psychiatrist, who I was very lucky to catch before he went into full retirement, because he was brilliant. He had me pegged within 15mins of our appointment and from that point on, my treatment, and my life began to change.

I was prescribed Valproic Acida mood stabilizer, and Abilify (aripiprazole), an antipsychotic.

Like most mood stabilizing drugs, Valproic Acid is also used to stave off seizures for many people who suffer from conditions, like epilepsy, as well as migraines in other patients. It is most effective in the treatment of mania in individuals who suffer from bipolar disorder.

Abilify works by changing the chemical actions in the brain. It is used effectively to treat psychotic symptoms, or psychosis, in conditions such as

Abilify (aripiprazole is an antipsychotic medication. It works by changing the actions of chemicals in the brain. It is a common antipsychotic that is administered to patients suffering from psychotic symptoms associated with schizophrenia and bipolar 1.

If it is an available option to you, I would highly recommend getting DNA tested to see if you are able to properly metabolize the psychiatric medications that are prescribed to you. As it turned out, Abilify was in my ‘red bin’, which meant that it was absolutely not recommended that I be taking it. I had been taking it for about 2 years by the time I actually got this testing done.

I didn’t find any adverse side effects with the Abilify, until my dosage was increased. I don’t recall to what dosage. I became incredibly jittery, which is representative of tardive dyskinesia. It exhibited itself in a really strange way, in that I would sit at the edge of my bed and bounce up and down. I now have a slope in my mattress to prove it.

All in all I found the Abilify to be effective and I recall going through a lot of hardship when it came to finding an appropriate replacement.

In Toronto, you can visit the CAMH website for more information about DNA testing.

Since I was prescribed mood stabilizers and antipsychotics, my treatment plan has changed more times than I can recall here. Certainly too many times to be able to formulate into any kind of sequential order. So, I will just create a section in my next post that will give you a general list of the medications that I have taken from this point forward and my experiences taking them.

I think we got a good start today.


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