Thursday, January 03, 2008

Seizure the Day

I must say, I am tremendously thrilled with my new pdoc, Dr. B. Any doctor who would willingly give you an hour's worth of his time (and who is a wonderful listener) is a gem.

And he made a few things about bipolar disorder completely clear, stuff that had me a little confused. This guy is the first doctor who's answered my questions in a direct manner. Perhaps my questions and his responses will help you. Or at least, leave you a little better informed.

Mar's Question 1: Why was I initially diagnosed as bipolar II and then 10 years later, rediagnosed as bipolar I?

Dr. B's Answer: Because sometimes the nature of the disorder changes. Maybe originally you were more depressed and had very few incidents of rapid cycling and mania, hence the diagnosis of bipolar II. Then as the years went by, you became more manic, with dysphoria rather than euphoria, and rapid cycling. This would indicate bipolar I.

Mar's Question 2: What's the connection between bipolar disorder and epilepsy? And why do anticonvulsants seem to work so well?

Dr. B's Answer: Bipolar disorder is really a seizure of the brain rather than the body, which is what epilepsy is. Both types of seizures respond well to anticonvulsants. When you are manic, your brain seizes up and you are subject to impulsiveness, delusions, bad judgment calls, paranoia, anger, and all the things that indicate mania. The anticonvulsant helps to stop that activity and allows the brain to work properly.

Mar's Question 3: I think I finally understand that I must stay on my medication for the rest of my life. But is that really true? Will I ever be able to go off of my meds?

Dr. B's Answer: Yes, it's true. And no, you should never go off your medication. It is believed that multiple episodes of the disorder cause brain damage. Your cognitive abilities become impaired. Without medication, the brain will sustain more damage as you grow older. The medication not only allows you to function but may in fact help repair some of the damage already there.

I left his office feeling more and more comforted that I have a neurological disorder, one that can be controlled. Even though I've always espoused this, there have been times after a particularly bad episode that I've doubted it. When your brain goes haywire, it's hard not to blame yourself rather than the disorder.

Case in point, regarding anticonvulsants being of enormous value in controlling these brain seizures. Last week, I had a terrifying episode, where I could actually feel my brain seize up. It happened while I was driving and suddenly, I felt almost suicidal. I began crying. I felt incoherent. Somehow, I got home safely but suddenly, I felt a wave of sheer anger overtake me, anger directed at a dear, beloved friend and companion. I wrote an angry email but somehow had the sense not to send it. I then hand wrote a note to him, the note being rather incoherent and vague.

Now, I'm on medication but fortunately, I can take an extra Seroquel or two if this happens. Which is exactly what I did. Within a half hour, I was OK. This time, I understood exactly what was going on, whereas before, I'd just get worse and worse until suddenly I felt better.

The next time I seize up, I'll know exactly how my brain felt from the previous episode and maybe I can nip it in the bud. The path to understanding this disorder is becoming less and less ambiguous. Thank God.


Katherine said...

I never knew this. I just seem to have "ordinary" common garden depression and anxiety disorder, but my stepdaughter/son had fast cycling Bipolar and schizoaffective disorder--it's too late for her, she died of pneumonia (undoubtedly exacerbated by the mental problems and medications), but my husband has been told by one psychiatrist that he's probably bipolar rather than depressive. But has mostly dysphoria rather than a manic high. It certainly fits and he's never really been carefully assessed and diagnosed.

He's just started into therapy with a psychologist he likes and I'm somewhat hopeful. But he's definitely got some kind of dementia going on, not bad, but there and he hasn't been willing to stick with therapy for long in the past. He leaves when it gets difficult. So we'll see.

Audrey said...

I finally got an appt. after searching, not for a "good" psychiatrist, but one who was accepting new patients and was approved by my lousy insurance (who will not approve my meds as prescribed by my family doc) and one who could see me before April! I started the search in November. I am in hopes that the one I found on the big wheel of insurance fortune is good and will get me a correct diagnosis and appropriate treatment. I am working currently with a diagnosis of general depression and anxiety disorder and the meds have improved my life in general, but something still is not "right". I believe that element to be an unreasonable job (I have multiple titles, no assistance and an unreasonable work load which keeps me awake at night with mental stress). I'm working on a permanent remedy for that situation. It should take care of the work stress and the lousy insurance!

Good luck to you and yours in seeking and receiving treatment. For now, like you, we just have to keep trying and pushing and pushing and trying!

Michelle said...

Thank you for being so open. When I was first diagnosed with Post Partum Depression (which stayed on as Clinical Depression) I was embarassed. Only when I saw a friend struggling with some of the same things I was did I come clean. I told her my "story" and urged her to get help. I decided then and there that I wouldn't keep it a secret and wouldn't you know, when the subject came up, I wasn't alone! Having people to share it with is in a sense like having therapy. I am lucky in that I have EXCELLENT health insurance that covers everything (meds, psych doctors, therapy, etc.) 100% (with a small co-pay of $10 per visit). Anyway, thanks for putting it out there.

molly bloom said...

I just rode out my first Christmas and New Year's without my Dad since his suicide in July. I also got my first P-drug.

While it's pretty lousy as a mood stabilizer (hello, Topamax), it falls into the anti-Seizure drug category AND takes care of the migraines that I was beginning to have. Every. Damn. Day. And which the NHS here in the UK was giving me Ambien for- which, in turn, triggered more migraines, insomnia and anxiety. They would also only give me a week at a time because while they claimed I didn't have a disorderm they didn't want me hording pills to kill myself.

It has been amazing how much better I feel just with the removal of the constant pain I've had for the last two years. They still haven't put a 'label' on me, but if it hadn't been for seeing Doctor L in the US, I still wouldn't be on anything here in the UK. The good news is now that I've gone back, my uninsured drug cost of $125 now drops dow to a copay of about $12.

bspinner said...

I am so impressed with your blog!!
I have epilepsy with grandmal seizures and never knew bipolar disorder was a form of epilepsy but when you think about it does stand to reason.
I have my seizures under control with dilantin and hope it stays that way. I have decided if taking a few pills a day makes the difference in my life I will take them. Thank God for modern medicine.
Good luck!!! And thanks for sharing with everyone.

Gail said...

My father is a prime example of what untreated bipolar disorder does to a person. In the 70s, he came back from vietnam, married my mom, they had me, and he promptly went psychotic. He was diagnosed at the time with schizophrenia, since I guess they didn't understand back then that yes, bipolar can make people hallucinate. Plus, he had a huge dose of post traumatic stress disorder from vietnam, which they also didn't recognize.

He had "episodes" - meaning, full on, hallucinating, psychotic, police wrestling him away to the state mental hospital episodes multiple times a year the entire time I grew up, medication or not. I'm not sure what they were giving him, but it wasn't helpful.

I guess eventually they did finally nail down the bipolar part, but today, he's already diagnosed with dementia, before the age of 60. He can't even know where I live, because when he has an "episode" he tends to try and hunt me down, and he's dangerous.