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"Nurse to be" worries-any advice psychnurse?

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Posted 4/28/2005 2:45 AM (GMT 0)
Hi All

I was glad to find this forum, it is very difficult to find practicing medical professionals who also suffer from Bipolar. I am 8 months away from my BN and am very nervous about how I will cope in a stressful, demanding, sometimes unforgivable work environment. I was dx in Dec. and have been on a medication roller coaster ever since. I am a high functioning individual who struggles to keep the mood swings at bay...ironically, I would like to work in psych (I knew that before I was dx). Any advice psychnurse?

Thanks a million,

Shannon

Posted 4/28/2005 3:27 PM (GMT 0)

Hi nrs2b!  Congratulations!  I bet you are very excited. 

How bad was it before dx?  I'm always curious, what meds have you tried thus far?  I know it's darn hard to find the right ones, it definitely takes a while  It has took me a year of trying almost everything!  We finally got the cocktail right, now doing very well. :-)

Are you type I or II?  I'm type I, originally II. 

Like you I was a highly functioning BP; actually got dx at age 25, but had all the symptoms since elementary school.  But it started getting in the way of relationships, so I figured something was wrong.  I always knew it, just didn't know what.  Needless to say, I was shocked at the dx!  I went on lithium, but didn't like the drugged feeling and the pain in the ass of getting frequent blood tests, so I stopped.  I didn't really believe I had it anyway.  Went on and off every few years, but didn't like it and stopped.  I actually DID do awesome work (people were amazed at the multitasking LOL!), but it started to get harder and harder to deal with the stress.   I worked for many years, stopped working after a couple hospital stays, my pdoc had recommended stopping working for a couple of years, but I am very stubborn and proud!  I am 40 now, and now I stay stable, due to very little stress in my life.  But that's me, when it turned to type I, I really couldn't control it on my own.  Even on meds, it's fragile.  I have to baby myself and keep an ever so close eye on symptoms.  I still have more mood swings than average people, but no psychosis, hallucinations, voices, illusions.

Anyway, I started out in internal medicine - best way to learn everything!  When you work in an office setting you learn TONS - about diagnosing, treating, names of and how most meds work, constantly learning more and more, way more than school ever taught me.  It's an excellent way to start out.  Most docs will teach you tons.

After several years in that, I went to psych.  It was really fascinating!  You get to really see the symptoms, not just what you've read.  But yes, it took a huge toll on me, just too much stress.  I absolutely loved nursing with a passion; I was very proud of what I had learned over the years and I adored helping people.  I still keep my license, love to continue learning about medicine.  Nurses care about people, and educate patients in their conditions in many cases.  I had many patients thank me for taking the time to care about, listen and explain things that the doc didn't do, because they have no time.  That was the ultimate payment - no amount of money can match that.  God, I am crying now.  I really miss it, but can't afford to risk my health.

On the flip side, I have known MDs that are bipolar and do just fine.  I think most BPs can function well.  If it's not a severe case, once you find the right comination of meds, you will do just fine.  If you have gotten thru school unmedicated  I'm sure you will.

I really hope I haven't given you doubts about your success - The advice I would give you is find the right meds and stay on them, unlike what I did.  I know I sound like a broken record but you HAVE to stay in very close contact with your pdoc.   (You are seeing a psychiatrist, not a GP, aren't you)?  If not DO!  GPs do not have the knowledge of such a complicated mental illness.  I don't care if you have to call your pdoc every week at first, if you let symptoms go, it takes much longer to get them stable.  Catch them before they progress.  I have to change my levels of some of the 4 meds I take about every couple of months.  Being in medicine I do adjust whichever one I need to myself; have discussed with my pdoc; if it doesn't work I am on the phone double quick!

Let me tell you, getting stable feels sooooo good; I would never go back.  But I didn't have the euphoric mania too much, mostly severe irritability, anger, occasionally psychosis.  These are type I mania, but I just thought it was normal for me, until I almost lost me beloved husband.  Then I got my ass treated!  And stayed on it!  Now I am the kind, caring, giving person I really am deep inside, and my hubby of 11 years and I have never been happier - almost like a fairy tale for gosh sake!  No, I wouldn't trade it for anything.

I'm sure you know by now that BPs have a long history of stopping their meds several times until they are so sick they reach a place where they can no longer go without.  Please don't be one of them.

Well, like a typical BP, I am rambling!  Please write back and tell me your story, I am always fascinated with BP's history!

I hope this has helped you and hopefully not bored you to death! :-)

Posted 4/28/2005 4:06 PM (GMT 0)

Dear Psychnurse:

It was great to hear your story.So far I have not spoken to anyone who has BP, so I have felt very alone at times, even though I have the support of my family. Unfortunately, they don't REALLY know how it feels. I must admit that my passion for nursing has fizzled as time has gone on, I think I am just tired of the hoop jumping. The only place I can see myself working is in psych-all of the other units were so stressful I fell to pieces. But in psych, I cared about the patients and worked my butt off to help them help themselves. I cried when I left that rotation, and I think that is when I really knew that was my forte.

Wow, so what's my BP story? I can trace it back to when I was about 13-14 yrs old. I suffered from depression, cutting, which then progressed to binge drinking, too many boys, etc. I remember the highs very well, and I remember the lows just as well. I was moody, and made many impulsive decisions that I later regretted. I was also manipulative. So, I went for counselling (my family life was less than healthy, so my mom arranged it) and stayed in counselling for YEARS. I tried so hard to better myself, and it never seemed to be enough. Half way thru nursing school I began to get violent, irritable, moody, then suicidally depressed. I was still in counselling and couldn't understand why my CBT wasn't working. I went to my GP who rx Celexa for PMDD-I thought that's what it was. I did super well on that for a few weeks, and then I crashed and got hostile, etc again ( cycling induced via Celexa). She then dx me as possible BP and rx Celexa and Zyprexa. I liked the Zyprexa, but within a couple of months I gained 20 pounds. I saw a Pdoc who dx me as Bipolar NOS, mixed state. He put me on Mirapex and zyprexa, then mirapex and risperadal, then mirapex and seroquel, then mirapex , seroquel, and lith, and clonazapem prn (for akathisia). However, I have not been well as of late, so we're adj the meds one by one. I know it will take a long time, and I would never stop them, because I know better. I have quit drinking and try to live well. I struggled with being labelled BP, and thought it could be something else. But the evidence is overwhelming really. I'm like you, I don't get those really happy highs-most of my hypomania is irritability.I do hate the drugs, I feel stoned, but as the day goes on I feel better. I want to try Topamax, but I fear the cognitive effects-I can't work in a compromised state! Anyhow, I am lucky in that I have insight, that I don't have hallucinations, that I don't spend all of my money. No one would know I had BP if I didn't tell them. I guess all those yrs of psychotherapy may be coming in handy!!! Did you ever tell anyone at work that you had BP?

Oh, about my pdoc. I see him about once every two-three weeks. At first I was hesitant about him b/c he didn't seem anxious to "label me". I wanted a label! However, he conveyed that he was more intersted in treating my symptoms than labelling me, and I must agree. He works WITH me in my care, and respects me and my input. I never knew the tx was so hit and miss and experimental. I would NEVER stop seeing him, although there are times that I still slip into denial, all the while, still continuing treatment. What do you take for meds? Do they help? Why did you stop the lith? How did you manage the side effects?

Anyhow, it was very nice to chat with you. I enjoyed your post (no, it was not rambling!) and look forward to chatting with everyone some more. It's nice to chat with those who REALLY understand!

Shannon

Posted 4/28/2005 4:09 PM (GMT 0)

Oh, one more thing!

I am thirty now, was diagnosed last year! I think it is so sad that many of us have lived with this nasty disorder for soooo long, all the while, never being accurately diagnosed. The literature I have read states that many many people with BD are misdiagnosed for years and finally "caught" around my age....sad. Never in a million years would I have ever guessed that this is what I had! I just thought I was moody!!

Posted 4/28/2005 4:32 PM (GMT 0)

My, god, Shannon!  I experienced every one of those things!  Promiscuity, we are now bankrupt, alchoholism, illicit use of coke (in the 80's, haha), presciption drug addiction, the gammut!  By the way, my name is Shannon!!  I thought when you first posted you were saying Thanks, Shannon! LOL!

I could not tolerate lithium.  I was on it for a year, had congnitive slowing from it and acne that left me with scars.  Awful.  Tried it again 10 years later, same thing, only hypothyroidism, too after only a few months.  I gained weight on depakote and in 3 months most of the hair around my forehead fell out!  Tegretol is messy.  Pain in the ass.  I finally tried Trileptal and it works beautifully!  No side effects to speak of for me, at least.  Also on lamictal for depression - saved my life.  Welbutrin, and Seroquel.  I take the Trileptal and Seroquel right before bed, and sleep a little that way.

They put me on Zyprexa first, and I gained almost 50 pounds in 4 months!!!!  I need to gain some; the mania had me down to 102 lbs and I'm 5'9".  But it was too much.  I lost it, now 130.

I always say NO SSRIs in BP!  In more severe cases it almost always causes mania, and/or panic attacks even with a stabilizer.  Some people do OK, but it's very risky; my doc won't even hear of it.

It's true, getting a dx is really tough.  I did get it on the first visit; I guess he had a lot of experience with it.  The questionairres help, too.

I wish when you reply to these posts they would show the latest; I'm going to have to go back and reread yours and then reply again.

Posted 4/28/2005 4:44 PM (GMT 0)

Ok, I'm back.

I told one employer in confidence that I was BP.  Well, it somehow "leaked" out a few months after I started working there.  Many people started treating me differently.  I also knew that they talked about me behind my back.  As if I had suddenly changed!!!  I always was proud of the fact that I got along very well with everyone I worked with.  One girl that never like me much to begin with started calling me pscyho, and did other things.  Mangagement didn't do jack about it, so obviouly I left and never told anyone again.  It's hard for them not to know because BPs are kind of famous for missing more work than  other people due to bad mood swing, illnesses from extreme stress, etc.  They don't understand, they just think you're taking a day off.  It's a catch 22, for sure.  I was sick  ALL the time, migraines, vomiting, diarrhea, back pain, etc.  Since stopping work 4 years ago, I haven't had so much as a cold.

Speaking of Topomax, my pdoc calls it Dopomax, LOL!  Try Trileptal if you haven't, not congitive blunting unless too much.  It can make you very sick at first, try a very low dose, around 300 mg and work up.  I take 1800mg hs.

It was great reading your story, it's kind of like a mirror.  I look forward to hearing from you soon.  And the people on this site are GREAT for support.  It's awesome to talk to people who KNOW what it's like.  You are so right; no matter how educated people can get about BP, they still will never understand.

Shannon

Posted 4/28/2005 6:47 PM (GMT 0)

one more thing...while I'm at it!

I just got off the phone with a friend who said to me "I don't think you have BP" . Do any of you guys have problems with people in your life thinking that you were misdiagnosed? It seems just as I come to terms with the fact that I have this thing, someone instills doubt which inturn leads me to doubt the whole thing. Especially considering I don't fit neatly into the DSM categories, hence the NOS. Others think I am overmedicated. Any experiences like this??

Shannon

Posted 4/28/2005 8:15 PM (GMT 0)
Oh yes!!!!!! Doubt doubt and still more doubt plague me every day. I find out they are wrong and I am wrong when I go off my meds and feel worse. And find myself in a pickle.

(hey both of our nurses named Shannon)

Nurse Shannon and Nurse 2 be Shannon.... ha lol

Welcome to the forum and I admire nurses so very much and you have wonderful aspirations.
Posted 4/28/2005 8:19 PM (GMT 0)

HI Dana!

Thank you for your kind words! What meds do you take? Are you a pharmacist? How have you been dealing with BP now that it has been a few years?

Shannon

Posted 4/28/2005 8:49 PM (GMT 0)
Hi Shannon,

I am a pharmacist. I currently take Lamictal and zoloft (I do need the zoloft in there and by itself puts me on a rollercoaster, however in combination with the lamictal I'm fine). Right now I am only biplar II and am hoping it will not progress to bipolar I.

It was a rough a few years after being diagnosed. I had a lot of anxiety also. I've come to acceptance, however I still try to get off my meds. Just recently I went off Lamictal because they thouught it might be contributing to the lupus. (which come to find out it was not and the lupus stands alone). However, I did not go back on because I was having issues with doubt and I wanted so much for my lupus diagnosis to be med related.

I then took a pharmacy residency and found myself a mess and having suicidal thoughts. (this was about 6 or 7 months after stopping my meds). I freaked out and cofided in someone and she let word out and I was asked to resign.

But right now I work retail and am fine. I'm thinking about trying to have kids and I just ordered Briggs new release on Drugs in pregnancy and lactation. New edition released today actually. I have a pregnancy consult May 19th and I pray all goes well. And my husband and I just bought a new house. So very exciting things happening.

My mother and brother are also bipolar. They are bipolar I. And my mom is doing great, however my brother is not. I pray everday that things will turn around.

I like my job very much and think that if controled you will be good at what you do. And some advice, don't tell employers. I had a bad experience that was very devistating to me and it looks as though psychnurse shannon has as well. Unless you know they will not judge and talk. Ug....grrr.....people.
Posted 4/28/2005 9:23 PM (GMT 0)
Where are my last two posts?

Posted 4/28/2005 10:02 PM (GMT 0)

Hey Shannon

I have not seen your posts-oh dear. Are they under something else??

Posted 4/28/2005 10:09 PM (GMT 0)

Dana, I wish you the best on your planned pregnancy.  Just be soooo careful, you don't want to be off meds and hormonally challenged, too.    But you know more about meds than I do for sure, I'm sure you will be fine.

Shannon, I really do think doubt about the diagnosis is a lifelong thing.  I STILL doubt it sometimes.  I just think, it's only about 1-2% of the population, right?  How could I be in that small percentile?  But I have to remember all what I have suffered, and the fact that on meds, I don't.  None of us want to believe we could be seriously mentally ill; I blame society's attitude for that.  Even my own GYN thinks I'm a "loon".  He said it jokingly one day, but it wasn't that funny to me.  I usually don't even tell MDs that I am on meds or even have it.  You would think they would understand; they don't.

If you get that temptation to stop your meds, just don't.  You do sound like a reasonable and level headed BP, tho - a rarity LOL! :-)

Posted 4/28/2005 10:09 PM (GMT 0)
They were there, for some reason at least on my end, the thread is going backward!

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