Ask the psychiatrist what are the typical side effects to expect over the next week. You should get clear answers which tell you (a) specific symptoms to look out for and (b) how long the symptom will last. For example:
Expect to have blurry vision, which should pass in next 2-4 days.
Expect to have a medicinal taste in your mouth. It should lessen over time, but it doesn't ever completely go away.
Expect to feel nauseous, like you might want to throw up, which should pass in about a week.
Expect that you might feel groggy for about 1-2 weeks. You might not be able to drive for 2-3 hours after taking the medication.
Expect that you might gain weight over the next 2-3 months. It might be 5-10 pounds, or it could be quite a lot more. You should keep an eye on your weight and let me know if your weight gain is excessive.
Ask the psychiatrist what are the possible really bad side effects to look out for. You should get clear answers which tell you (a) specific symptoms to look out for (b) what are the chances of getting them and (c) what to do if you notice them. For example:
Some people may have an adverse allergic type reaction to the medication. It's pretty rare - only about 1 in 1000 people get it. Look for symptoms of an allergy - itching arms or lips, or difficulty in breathing. If you notice this, call me immediately (here's my mobile number) and stop taking the medication.
After you leave the psychiatrist's office, check online for what the side effects of the medications are. Check sites like mine which offer personal experiences, online forums about experiences, and the large drug websites like RxList.
Yes, spending 1-2 hours online to check up the information is worth your time. You'll get a better feel of what to expect and the information will supplement what your psychiatrist told you.
Be aware. The large drug websites will list every possible side effect, even if they are extremely rare. Rare side effects are unlikely to happen to you, so do not worry that the medication you are taking sounds like it will cause grievous harm (for comparison, here's the entry for Tylenol /
acetaminophen) Your psychiatrist should warn you if a drug is potentially damaging in the short run.
Ask someone to look out for you for the first week after starting on a new medication. I call this person a handler This person can be your parent, sibling, roommate, or friend. Your handler's job is to
Know what drugs you are taking, when you are to take them and what dose you are to be taking. This means that you have to write down the names of the drugs, the amounts for each dose, and when the dose should be taken. This information should be pinned to your refrigerator where you handler can see it or be given to them.
Make sure that you indeed take your medication. See "I just can't"
Ask you about your side effects or listen to when you tell them about what you are experiencing. Yes, you have to explicitly tell them at least twice a day.
Check in on you 3-4 times a day to make sure you are okay. Respond if they can't contact you (this also means that you have to answer any phone calls they make).
Deal with other people on your behalf - I'm sorry he can't make dinner this afternoon, he's not feeling well - It's okay if she's quiet at dinner, she's not feeling so good.
Keep a note
Clear a few days so if things go wrong you can deal with it.
Life isn’t a path from here to there. It’s a meandering amble where you see sights that you never thought of. It’s meeting people and sharing part of the trip. It’s about trust and sharing and sometimes diverging paths.
The path will not be what you’ve been expecting (and it’ll certainly keep on changing). It may not meet the expectations of others or what society thinks is success or is typical. But really, all it has to be is a path where you’re happy.
All of us will be there to offer help when you need it, just as you do the same for us. It’s not a bad thing to know as you start the new year.
Cheers!
This inability to look into the future and make plans is actually quite a problem. I could try harder, I suppose. But I've been trying harder for the last 10-12 years or so and it doesn't seem to make much difference. It's also nigh on impossible to keep up the 'harder' part of 'try harder' 24/7, which is what I would have to do.
My failure rate for any task is around 75-80%. At that level, ongoing maintenance like looking after the garden or fixing minor house repairs don't happen. Or don't happen reliably.
I could try harder, I suppose. But I've been trying harder for the last 10-12 years and it doesn't seem to make much difference. It's also impossible to keep up the 'harder' part of 'try harder' 24/7.
My failure rate for any task is around 75-80%. At that level, ongoing maintenance like looking after the garden or fixing minor house repairs don't happen. Or don't happen reliably.
Do note on Family Friends - what to say when you havent seen someone who you know has depression
This award winning website provides you with information so you can figure out if the things you are going through might be related to mood swings, or depression, or mania. You'll learn what kinds of things might go wrong. You'll be able to understand yourself, or your child or parent, or why your partner or the person you are going out with is behaving the way they do.
Practical.
You'll learn what you can do to try to stop the mood swings from happening, and how to recover gracefully if things go wrong. And instead of providing vague suggestions, the website offers specific, practical ways to deal with problems. This covers everything from dealing with medication to how to handle a relationship with a depressed boyfriend.
Real life.
The descriptions here are not in confusing medical terms, but in straightforward language describing the real details of our lives. After all, if you can't figure out how to get the ideas and suggestions to work in your life, they're not much good.
This website is written by someone who was diagnosed as bipolar in 1996, who has had mood swings since the age of 17, who has put up with all the frustrations that the changing moods can cause in daily life, and who is aware how much the mood swings affect family, partners, and friends.
the bottom line.
Here's the bottom line: The mood swings are survivable. You can learn to manage your life and the mood swings. If you get the hang of managing your life, you can be successful enough, satisfied with your life, and happy. Really.
the price.
There is a price, of course. You do need to accept that you have mood swings. You will need to pay attention to and understand what is happening to you daily. And you will need to make the conscious effort to take control of your actions when things start to go awry.
And yes, it will take time to get to get your stuff together, measured in years. And it's a frustrating journey. So expect that.
no magic solutions.
I'd like to tell you there is a magic solution. But so far, there are no magical pills or actions that will properly stabilise our moods. There are some lucky people for whom the medications will work well, but for a lot of us that won't be true.
What you'll find is that you will have to discover some medications that work somewhat, plus you'll have to make changes to your habits to minimise the mood swings. The amount of changes may be a lot or a bit depending on who you are and how severe your mood swings are. It turns out that the people close you will also have to make a few changes to adapt to you as well.
Finally, it will probably do you good to get therapy to sort out the problems the mood swings have caused over the years.
It's a lot of work. But it's also your life. Remember that. And life really can become pretty great.
END
last updated 6 Jan 19
first published 11 Jul 11
More Snippets
You haven't seen your friend in a while. You know they were depressed. Now you are meeting them and you aren't sure how to act or what to say. Here are some pointers.
A quick step into your friend's shoes
For us bipolar people, the depression episodes are NOT fun. We are unable to do things, and we watch helplessly as projects we are doing fail. We can't even do personal or home maintenance. We stop going out and meeting people because we can't get out of the house and because we become afraid of people.
We spend a lot of time guilty that we aren't reliable enough to stop these things from happening. We feel that the world is closing in on us, that nothing will ever be good in our lives again, that people are angry with us, and that we are terrible, useless, worthless people.
None of these feelings are our fault. They are the symptoms of depression, just the same way a runny nose and sneezing are the symptoms of the flu. We can't stop these feelings by thinking differently or positively any more than you can stop your runny nose just by thinking about it. We can't take action because we can't do things.
The drugs / medications that we take are hit and miss. They may work or they may not, or they may make things a little better or a little worse, or they may create side effects bad enough to be problems in their own right.
Basically, depression is a traumatic process.
So by the time your friend's depression episode had finished, they've spent a few weeks being guilty about the things that failed and had mental anguish that was not their fault, and they had nothing that could definitively work to make things better. When they emerge, they now have to rush around to pay bills that were unpaid, sort out the weeds in the garden, contact work to apologise for not being there, clean the house with is a pigsty, try to see if tasks or projects can be restarted or if they should just be abandoned, and repair all the broken social contacts including marriage or boyfriend relationships.
If the depression episode last 3-4 weeks, it takes another 3-4 weeks after the episode to repair all the damage that was done. Meanwhile, life goes on, so there really is no catching up.
When you meet your friend after a depression episode...
Assume that they are stressed out in addition to any residual social anxiety which leaves them nervous around people.
We don't want to talk about the things that have gone wrong. Why should we? Rehashing unpleasant experiences is no fun. Besides somone who does that is just a complainer / whiner and we don't want to be that person in a group.
What we do want is an acknowledgement that you are still our friend and that things are good between us. We'd like you to acknowledge that the depression episode happened and that it was hard, but we don't you to necessarily ask about the details.
We don't mind you asking about projects we were doing, but we'd like if you could accept that if we said that we can't do them that they probably crashed and burned and we don't want to talk about it.
Telling people is still hard though...
The really hard part is to deal with the people who say "I thought you were taking Spanish classes" or "When are you leaving to go Italy" or, god forbid, "Have you started your diet yet." These are my parents and my family and my friends, and they are all well meaning, but it's embarrassing to tell them about my constant ongoing failures. It's embarrassing to tell them that I won't be going to Italy or that I dropped out of Spanish classes.
But I'm tired of people being concerned and making excuses, and when my annoyance is added to my ongoing mild "fear of people" anxiety, it's easier to avoid people. So I've been shying away from reconnecting with friends and family. Which of course just makes the problem worse. It's a vicious circle, a perfect storm.
What can be done...
There are a few ideas which work best if they work together.
I try to overcome the mild fear of people like I described in the article Pushing Through Panic Attacks. Intellectually I know that concerned family and friends are on my side and want to look out for me. Training myself to believe it and actually meeting people will only come with practice. I should just get out there and socialise!
Which I suppose means that I should organise to meet my closest aunt within the next few days. Sigh.
I develop the a laid back attitude about telling people the same excuses over and over, just as I did for accepting when my tasks and projects fail. Basically, just stop being embarrassed - these are people who are on my side. Heck I could use the following excuses all the time.
"I haven't been well recently, so...
I've had to put off...going to Italy, continuing my Spanish classes, continuing on my diet, etc.
I wasn't able to attend the...family gathering, committee meeting, wedding, Thanksgiving dinner, etc.
I couldn't...make the sweater, bake the cookies for Bake Sale, meet you last week for drinks, etc. like I promised.
When asked about why I wasn't well, I've found it's always okay to say "I'd rather not talk about it if you don't mind."
For really close family or friends, I've found that I can get away with saying "I've been depressed so..." instead of saying "I haven't been well". At least then I'm truthful.
My friends and family should learn that if they haven't seen me for a while, it's because I was depressed, and that's excuse enough and they don't need to ask me why I was missing in action again.
They should also know that inquiring about my depression episodes isn't helpful. I don't really want to be reminded of the things that I failed to do while I was depressed, I just want to continue from here on.
What IS helpful is bring me up to date and telling me about things that I missed out on while I was depressed.
So don't do this: "How come you weren't at Ayesha's wedding?"
Do this: "Hey, we missed you at Ayesha's wedding. It was really nice - they did up the place with yellow tulips which was unusual, but looked great. The speeches were short, except for Uncle Joseph, who went on an on as usual. And once the formal part was over, the DJ started and we danced until 1 am."
Alternatively, here's how a conversation could go. I tell the truth and you accept the truth and then we both continue on the conversation.
Them: I haven't seen you for a while.
Me: I've been depressed for the last 6 weeks.
Them: I'm sorry to hear. You know I'm here if you need me. That's a bitch. Everything okay at the moment?
Me: Going well enough.
Them: How are your Spanish classes going?
Me: Had to drop out because of my depression episode.
Them: Jeez. That's really a bitch.
Me: Yup. How are the kids.
Them: Jake has just started kindergarten. I cried when I dropped him off, but he just went in and was chatting with the other kids.
Me: Did you get any office work done that first day?
Them: Nope. All I was thinking about was picking up my son.
<and so on>
END
update 10 Jan 19
first published 9 Jan 19
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Areas of Interest (or How to keep on Keeping On through Depression)
List of major projects Dogs / Garden / Work / Socialising
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Time Management / Scheduling
Need to keep it flexible.
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