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Bipolar & ME: Part 3. Treatment

First off: apologies for the gap between postings. I’ve been a combination of on holiday, depressed, hypomanic (not “full” manic though, yay), stressed, ill, and fatigued/exhausted. I will try and be better. Anyway, onto the blog post!

Treatment!

Well, where to start. Like any mental illness, most kinds of treatment can be broadly split into two:

  • Talking therapies, including
    1. CBT (Cognitive Behavioural Therapy)
    2. CAT (Cognitive Analytical Therapy)
    3. Psychoeducation Groups
  • Medication, including
    1. Antidepressants
    2. Mood stabilisers
    3. Antipsychotics
  • “Other”

By no means is this list exhaustive, but I’m just going to cover the ones mentioned because not only are they the most common, they’re also things I have either knowledge or direct experience of.

NOTE: I think I’ve made the point in earlier posts that mental illness can present in varying ways. We are all individuals, even if we have the same illness. THE FOLLOWING INFO IS JUST MY KNOWLEDGE AND EXPERIENCE ONLY. SPEAK TO YOUR PSYCHIATRIST/PSYCHOLOGIST/DOCTOR ETC. BEFORE CHANGING MEDICATIONS OR TREATMENT.

  • Talking therapies

So I admit here and now, I have not had the best experience of talking therapies so far. I tried counselling, was referred to CBT (that went terribly, though partly because I don’t think my therapist and I “gelled”, I might not have been ready for it, or whatever…but I had three sessions and was just sent back to my GP), tried ACT (Acceptance and Commitment Therapy) which was a group trialled at my university. It went better than CBT, and a lot of the ideas behind it made sense, but I’m not sure I managed to take enough of it on-board seeing as it was during my final year of university and I was basically one huge ball of stress/fatigue/badness.

I don’t know if it’s relevant, but I tried all of these methods before my eventual diagnosis of bipolar. Since diagnosis, I have been to a Psychoeducation group, and am on the LONG waiting list for CBT (and eventually CAT) with a clinical psychologist, as opposed to a wellbeing practitioner or therapist. I’ll update the blog after I have the treatment with my feelings on how it went, but I don’t expect it to be soon unfortunately). Since I have not had a full course of CBT or any CAT, I’m just going to provide some links so you can read about it from people with more knowledge on them:

http://www.nhs.uk/conditions/Cognitive-behavioural-therapy/Pages/Introduction.aspx

http://www.acat.me.uk/page/about+cat

The Psychoeducation group is pretty much what it sounds like; a group that helps educate you on your psychiatric/psychological condition. There was a group of us, maybe 9 or 10, who had all been diagnosed with bipolar (mix of I, II, cyclothymia), of varying lengths of diagnosis, treatment, experience and severity. This was particularly useful as I’d only been diagnosed for around a month or so, so learning what things I had been experiencing were actually due to this illness was eye-opening. You might expect this kind of thing to be incredibly depressing but surprisingly, I didn’t find it so. Yes, there were topics that were covered that weren’t exactly pleasant but we were given so many resources and a variety of methods to try and help us cope. No, they didn’t all work, and the paperwork we were given was a little overwhelming but I appreciated the variety because many of the things have really helped me. I know that for many people however, much of this course was too basic, as they’d lived with it so long that they knew all the symptoms and had tried most of the things we were recommended. I hope they didn’t think it was a complete waste of time, because their knowledge and experience was incredibly valuable to me. According to a talk given to the group I attend run by Bipolar UK, Psychoeducation groups have been shown to be one of the most helpful and beneficial groups for bipolar patients, in terms of helping them stay better for longer (I won’t go into the full details of that talk, though it was very good…maybe in another post).

  • Medication

Ah. If there’s anything that causes more controversy, stigma, and newspaper articles than psych medications…well, OK, there are a lot of things that cause that, but you catch my drift. There’s a lot of misinformation, scaremongering, and stigma about medications for mental illness, and I can’t deny that there’s probably a whole lot of over prescription going on. (The reasons for that last thing are many, but generally underfunding of the mental health sector and understaffing of specialised doctors and therapists are two big ones). Medications are not the be all and end all, and god knows they don’t solve everything. However, for some people, medication can/will save their life. And for me, they allow me to live relatively safely and ‘normally’, hold down a job, etc. There are still life stressors that affect me and I have to watch out for them, but even when I do get ill, it’s significantly less severe than when I was not on medication.

Also, some medication carries more stigma than others, so don’t be put off if medication that helps you has a bad reputation from people that don’t understand, or have had bad experiences on it. For example, as well as a couple other medications for other ailments, I take Lithium and an antidepressant, Venlafaxine. Now Lithium is very well known, and it’s been around for a long time. It’s also very cheap, and has been shown to be incredibly beneficial at treating bipolar, and also significantly reducing suicidal behaviour. It also has a number of side effects, and can cause serious damage if not monitored closely (kidney and thyroid damage or even failure). Now I admit, I was scared off lithium initially. I was offered it a few years ago and I was pretty much of the mindset that I would try anything but that. This was, in part, due to the stigma, and to the research project I had done at university on it. (I do wonder what might have been different if I had tried lithium when I was first offered the chance, but there’s nothing that can be gained from wondering “what if?”). So whilst I heartily recommend researching medications before you decide to take them, don’t be so informed that you scare yourself away from something that could potentially really help you.

I think a good rule of thumb is if the side effects make you feel worse than the illness itself, they’re probably not for you. However, it is often very difficult for the ill person to notice if they are feeling better, as we (ill people) have a tendency to see and focus on the bad far more than the good. I had someone tell me they could tell exactly when my medication was changed to my current ones because I was so much better. I hadn’t realised it was such a big difference so their perspective was really helpful.

  • “Other”

Please notice I’ve put this in little “air quotes” as these are not prescribed treatments, but anecdotally, there’s sometimes things we can do for ourselves to encourage longer times in remission.

While many people with bipolar and other mental health illnesses self-medicate using alcohol, illicit drugs etc., I can’t say I can recommend either of these things. What I can say is that it’s completely understandable why people go down this route. But I’m going to try and focus on some other ways I/people/you can use to try and ease the struggle of mental ill-health.

It helps to have things that you can throw yourself into when you start feeling the first signs of depression or (hypo)mania. Depending on your personality, these things will differ hugely, and I have different activities to help with different directions of mood. Colouring helps with creeping manic symptoms, as it gives me something to completely focus on, and I can jump to any number of different books, colour schemes, pages, but it often helps my head slow down eventually. When I’m feeling the beginnings of a downward mood, I try and go skating/go to derby practice (if physical health allows), or go for a walk, or go throw my phone folder of silly pictures I’ve saved and send them to close friends to strike up a conversation. Basically, anything to stay out of my head/bad thoughts, something to stop the downward spiral before it fully starts. If I’m veering towards the manic side however, these actions would be things to avoid, as sport/exercise is actually a big thing I’ve noticed sends me into hypomania (mania, before my medication).

 

I’m sure a lot of people will see the things I’ve listed and think it’s twee or useless things they’ve been told before, but all I can say is that they’ve helped me. I think roller derby has been helpful for me as the continuity of practice and knowing my attendance is monitored helps me regularly go out and mix with people, and skate/do physical activity when possible. Structure is hugely important to me, so a hobby with classes or regular practices was a big bonus and ones of the reasons I stick with the hobby even when it seems “crazy” for someone like me to do.

 

Obviously nothing in this section is actually ‘treatment’ per se, but I think living with mental illness means learning how to treat you. You have probably heard of self-care recently, but no one really says what it is. And that’s often because it varies person to person. So think, what makes you calm, what do you need when everything is getting on top of you? Think about this, and try and stick to this self-care plan, paying particular attention to it when life throws a curveball at you.

 

There is just one of these blog posts left in this series, but I have another one I’ve been working on to post before I finish the last of my bipolar posts.

 

Let me know in the comments if you think I’ve missed something from my treatment ideas, or if you have another PoV on the topic. Always love to hear from you!

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Bipolar & Me: Part 1. Introduction

OK so this is not easy for me to do,  but I’ve been wanting to do it for a while. So I’m going to write a series of posts about mental health. My mental health. Specifically what mental health struggles I have.

First things first: surprise, surprise, I have bipolar disorder (or “manic depression”).

You may have seen Stephen Fry’s latest documentary on BBC “The Not-So Secret Life of the Manic Depressive: 10 Years On”. I watched the first documentary 10 years ago, before my own diagnosis. I’m trying to hunt it down to watch it again to see if my perspective has changed since receiving the diagnosis. From what I can recall, it seemed the follow up documentary was more of a depressing watch, there didn’t seem to be much hope portrayed for any of the bipolar sufferers depicted, including Stephen Fry himself. While I have only been officially diagnosed myself since ~March last year, I thought I would try and offer my own personal perspective on the diagnosis process, the medication, and the resources I’ve found available to me through a series of posts.

I have to admit, I struggled watching the most recent documentary. I found that a lot of what was said resonated with me and I understand that it needed to show the truth of living with this disorder. However, I think it really could have benefitted from showing just one person coping, one person managing their condition to balance out the rest of the quite depressing situations. I am by no means in control of my illness as it stands, and I’m still trying to work out how to manage it with my CFS/ME. It is exhausting. But I have found a medication that works for me, which is phenomenally beneficial (I will go into this in a later post). I’m able to stay more balanced and when I do have episodes, my lows are less low, my highs less high. I am considerably safer than I used to be. I am also fortunate in that it doesn’t make me numb, it doesn’t make me a zombie. I am still working full-time in a fast, stressful industry that I love. I have blogged before how I am so lucky because my employer is so patient and flexible in how they let me work.

I wish others with ME, others with bipolar could be able to do this. Many with these conditions have to work part-time, if they can work at all. I reiterate: I am incredibly lucky, and it is something I’m going to have to keep fighting for every day of my life to keep doing. But I am doing it. And I think that someone newly diagnosed with this illness would benefit from knowing that it can be possible. Hence these posts on “Bipolar and me”.

See Part 2 for my thoughts on the illness itself, dispelling some common misconceptions and just trying to fill you in on what living with bipolar really means.

Molecules at an Exhibition: The Science of Everyday Life by John Emsley

So I promised to do a popular science book review and it’s been in the pipeline for long enough have also started working on my next post, which requires a lot more research but I’m hoping to have it up by the weekend. It is something that is close to my heart so I want to do it to the best of my ability.

Also, as it is Mental Health Awareness Week, I’d just like to point out Time to Change, a UK charity that is aiming to end the stigma surrounding mental health and make the services easier to understand and access. This is especially important as the rates of suicide have been rising year on year, dramatically so in men. So any male readers, please know you aren’t alone and that it doesn’t make you any ‘less of a man’ to have this illness. Just get help if you need it, please.

Back to the topic at hand!

The book I’ve reviewed, Molecules at an Exhibition, first came to my attention almost 4 years ago now. A group of friends and I went on holiday and of course we never bring enough books so we got around to swapping. It is only a small book, at 240 pages and it is split into 8 ‘Galleries’, where the author has grouped certain molecules together depending on their actions and descriptions.

The book begins with a light introduction outlining the why’s of the book (he is particularly interested in these molecules) and a quick guide to some chemical terms and measurements so all readers are at a level pegging.

The galleries are:

  •  Nearly as Nature Intended: food and drink
  • Testing Your Metal: essential metals for the body
  • Starting Lives, Saving Lives, Screwing Up Lives: helping and harming the young
  • Home Sweet Home: detergents, dangers, delights and delusions
  • Material Progress and Immaterial Observations: molecules that make life a little easier
  • Environmental Cons, Concerns and Comments: molecules that stalk the world
  • We’re on the Road to Nowhere: molecules that transport us
  • Elements From Hell: mainly malevolent molecules

The food and drink section was probably my favourite purely because of the two sections on garlic and caffeine, which I think was a brilliant start to the book as it sets the tone of the book and eases the reader in easily. It is not a serious, sluggish read, the author writes with an irreverent tone throughout. For example, when talking about garlic:

“Uncooked garlic in salads can be enjoyable to the eater but not to those they come into contact with afterwards”
“Some people [who] eat it regularly…protects them against illness because it keeps others at a distance”

There is a hint of Ben Goldacre about his style although a lot more subdued in how he disagrees with certain lifestyle choices and supplements; he holds something back but makes it very clear what he thinks on the matters.

As well as being an informal guide through some common molecules, it is also full of factual gobbets you can casually throw into conversation (eg. Smoking cigarettes reduces the time that caffeine has a stimulatory effect by two hours! And we need 14 different metal elements to function properly).

Add to this, the historical and cultural context of the discoveries of the molecules themselves and it makes for an absorbing read. Due to the fact that it is split up into Galleries means that the book is great as a pick up and go read, say on the commute to work or train to town.

However, nothing is ever perfect is it? Despite this book calling itself an exhibition, I feel that it would have benefitted from some pictures, even some diagrams throughout the book. I think it would be a nice start to the chapter and an interesting way to split up the text. This may sound a little childish but I think if you’re going to call it an exhibition of molecules, he may as well have gone the whole way!

Despite this, I think this is a good quality book, for readers wanting to get back into science, for students…for anyone really, who has an interest in the unseen world around them.

Science and Creativity

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I have never really understood the idea that people are either creative or logical, artsy or sciencey.
I remember being told this and of course, yes, some people do follow this trend. However, during my time at university I have discovered that I am not alone in enjoying and taking part in both.
Take my a levels- I did biology chemistry maths and classical civilisations. It was a struggle having it at that as at school drama and music had been huge parts of my life and I have always loved the reading and writing of fiction (though I sadly do little of the latter anymore, can never seem to start them or get my ideas going).

I then watched a documentary yesterday from BBC, unsurprisingly from the Horizon team looking at the creativity mind or the neuroscience of insight. This is what inspired this post really, it was fascinating stuff but it did also fall into looking at the differences and not the similarities.

If you think about it, all scientists have to have that creative spark inside of them to think of the experiments and hypotheses that have led us to where we are now. And it’s beautiful.

Don’t get me wrong, human biology has its share of ick factors and there’s some pretty grim stuff I get to learn about. But if you really think about it, the way the ideas flow into each other, the processes of the body (and yes even plants) is pretty astounding.
And it takes an incredibly creative mind to look at life and think…there’s more to this. And you know, then there’s the people that looked at fish and thought, you know what they need?
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TO GLOW!

Before this becomes a ramble about the beauty of life, there’s also the fact that biology and science in general can lead to some pretty creative outlets. There’s science journalism, science photography, colour manipulation of scanning electron microscopy (SEM)…in fact I’m just going to show you some incredible examples of these SEM images. You’d be amazed at how pretty the common cold can look…

ImageImageImage

Look at how cool the common cold is! Then the other pic is pretty-in-purple chromosome.

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And finally, who knew a tangled hair could look this pretty?!

Graduation: Where do we go from here?

Apologies for the delay in my blog- it has been one hell of a time recently and not in a woohoo! way. Reports, being poorly and the second half of my dissertation module…it’s a busy busy time.

It is a shame I started this blog in my final year as I keep thinking of things I want to write about but I just have so much to do! I have only just come to realise that I have just under 3 weeks of my undergraduate degree left. I now feel slightly nauseated, especially as I still have coursework deadlines and revision season looming…

Add to that the ever-present knowledge that I have to keep filling in applications for PhDs, for graduate schemes, for funding, for jobs. I know that this summer, I will be unemployed most likely (though my fingers are firmly crossed for the applications I’ve sent off/interviews I’ve done).

That’s the climate we’re in now and whereas the other summers I’ve known uni will be there in September. God knows, I wish I could be applying for an MRes or MSc but I just don’t have the money, so I need to follow different routes to hopefully get to the place I want to get to.

As a graduating biologist, there are many routes I could go down and that’s going to be the main body of this post or it’ll just end up in me talking about being in something of a blind panic and if you wanted to read an incoherent mess of babble then you’d be back on Facebook.

Now.

NB. The pros and cons are what I have heard of others opinions. I don’t want to insult anyone’s jobs/future career choices!

INDUSTRY

This is a large area of recruitment for science graduates and that makes sense. There are a variety of different areas for all interests, from pharmaceutical research to agricultural.

There are large numbers of graduate schemes to ease you into this new environment from university because let me assure you, it is a very different experience. I have some industrial experience at a cell line manufacturing company and the volume information you needed to take in and the hours you needed to put in were astounding. If you are working with cells, you work around the cells, so you work when they dictate you work, which meant that there were staff coming in on weekends, on evenings, on weekend evenings! But this is not the case at other companies, but going from your university hours to 37.5+ hour weeks, every week is a lot more exhausting than you will expect.

There are pros and cons to his area of work. The pay is good and the opportunity for career progression is immense. You will get to work with a variety of companies so there is the opportunity for a lot of networking as well as carrying out work and research.

The con is mainly that you are not in control of what you research and there is the potential for some to feel restricted in the area of work you’ll be doing.

PhD/Academia

 

So the big draws of industry I just mentioned? Don’t be banking on those straight into your career of research scientist and academic. A lot of PhDs are funded to some extent at least, though that often only applies if you’re interested in the ‘right’ area of biosciences. There are large funding bodies like the BBSRC and the MRC who fund a lot of the medically beneficial research but that is absolutely not saying that there aren’t studentships for animal biology, plant sciences and all other realms but I’ve been told there aren’t as many (please correct me if I am wrong!). The benefits obviously include you getting to choose the area of research you go into, you direct it and follow it from the beginning to the end. The pay is different depending on the studentship but I very much doubt that is why anyone goes into undertaking a PhD. You need to have the passion and the drive for it. You have to motivate yourself; it’s your project after all, your results at the end of it.
Also, having a PhD put you in excellent stead if you eventually want to leave academia for, say, scientific publishing or editing.

Health

In the UK, the NHS offers the NHS Scientist Training Pathway that is highly competitive and a tough 3 year course. If lucky enough to get on it, there are a whole number of specialisms for you to choose from (though you can only apply for two) from microbiology to genetics to reproductive sciences, there’s something to interest everyone. Some roles are very much lab based but others, like Cardiovascular, Respiratory and Sleep and Reproductive have large patient contact aspects as well. Over the 3 years, you work throughout your department, learning a variety of laboratory skills which you will be assessed on. You will also be working on an MSc degree at a university that the NHS has accredited. At the end of the course then, you have 3 years full time work in a hospital/clinical setting and a masters funded by the NHS.

I can imagine you can see why it is so competitive.

Other!

Obviously, many science graduates don’t go into either of these options, as a science degree sets you up well for many areas of life! There are graduate schemes in all areas that respect the work ethic and knowledge from a strong degree, there’s obviously teaching which is especially important for sciences at the moment, even though biology is seen as one of the more popularly subscribed sciences, there is still a huge demand for teachers.

There’s going into health and safety work for councils, helping with policies…in fact, let’s face it, you could do anything! Not everyone who enjoys and has an interest in science wants to do it as a career. Fortunately, at university there are graduate talks from all sectors and careers fairs and the Cv clinic to make sure you have the best chance at getting into your graduate career of your choice.

If you can think of something I’ve missed out, please comment!

What do you plan on doing once you’ve left the status of student?

Science and Stereotypes

http://occamstypewriter.org/athenedonald/2013/02/10/lets-get-stereotypes-out-of-science-education/

I strongly advise you all to read this small but perfectly formed blog post on the topic of gender stereotypes in sciences. An article was published in the Guardian online (there’s a link to it in the post above) that was just awful; claimed that it was trying to come up with methods about getting more girls into physics and engineering by giving them science in the form of recipes, jigsaws and saying that “well, maths is supposed to be hard”.

Yes, really.

The Guardian piece also failed to address the lack of boys in biology, psychology, veterinary and general medical sciences, which is efinitely something to be looked into. The fact that the two former subjects are seen as ‘softer’ sciences won’t help, similarly to the myth that veterinary science is all about cute and cuddly animals (which obviously boys can’t like *sarcasm*).

The seems to be a rising trend in the belief that men and women just are fundamentally different (which I have little problem saying as even some medicines has differing levels of efficacy in each sex)- Scientific American Mind did an excellent issue last year on the similarities and differences between the male and female brain and mind.
However, what I hate is that these thoughts are being twisted into the idea that “girls brains just aren’t suited to maths/physics/engineering” (and according to this link http://www.independent.co.uk/arts-entertainment/art/news/whats-the-biggest-problem-with-women-artists-none-of-them-can-actually-paint-says-georg-baselitz-8484019.html us girls can’t paint/draw/compose music/come up with original ideas/write incredible literature, so maybe we should just give up now. Really people!?!?)

I’d like to think most people would acknowledge that male and female brains are capable of the same potential but from the toys we are given to play with and up through to the education system, these things guide our minds to be better at learning in different ways.
There’s also the obvious social expectations (girls are more empathetic so they just ‘make better’ teachers/nurses etc and these careers are seen as care giving roles which aren’t masculine. Which is rubbish. There are many other careers/roles where this happens again and again, but that would take a long time to list so I will leave it there).

I also don’t want this to veer into the realm of becoming a post about sexism in the past and present world as that is a subject unto itself, but they obviously play a significant part.

So please, before spouting putrid and frankly, out of date ideas, have a thought about how damaging generalisations really are and how our children should have the chance to follow whatever career path they want, regardless of their sex/gender.

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