Tis the Season

I hope this finds you well during this holiday season.  I meant to write on Christmas day but, got caught up in the festivities of the day.  Our family Christmas was one of our best ever.  It was so nice to have everyone there as we have not been all together in a number of years.  It was awesome to spend time with Elias, Rylen, Micah and Taylor and to watch them open their gifts.  It brought back a lot of memories of when I was a kid years a go.

I did cry once on Christmas day.  I  think I just caught up with all the emotions of the day.  I kind of realized that this may have been one of our last Christmas days with all of us together.  It seemed fitting that we had the day we did and I do hope we get a chance to spend a few more like that.

I got an opportunity to help out with a volleyball clinic my brother Ryan and his friend Andy were running in Palmerston.  Ryan works for Volleyball Clinic and oversees high performance programs for high school athletes in British Columbia.  I am thankful I got a chance to see him work with youth and watch how he was able to impact their volleyball skills in such a short period of time.  He is really good at what he does and I am proud of him in so many ways.  It was fun for me to get back on the court and work with the kids.  I do miss coaching and hopefully I will have an opportunity to do it again in the future.

I am pleased to announce that my youngest brother Matt and his fiance Beth were married yesterday in Toronto.  It was a wonderful service and we are so thrilled he found such an amazing person to share his life with.  The reception was a lot of fun and we were able to share our family tradition of singing a song to the bride and groom.  Matt and I are very similar as we both live with bi-polar disorder.  He has been on quite the journey in his life and I am so proud at how far he has come.  He seems to be at a good place in his life and I am thankful for that.  Beth is a wonderful person and I believe she will support Matt when he needs it but, will also challenge him in a similar way that Jodi does for me.  I wish them nothing but the best in the years to come.

I have been feeling much better the last week or so.  It has been a little discouraging with the lack of snow as I have not had a chance to work much.  But it has been awesome to spend a lot of time with Jodi and Ollie.  I am going to look in to doing some tree work in the new year as it looks as though we are in for a milder winter so I have no choice but to look for some other work.

Today is just a relaxing day.  The last week has been very busy for us so it will be nice to have some down time.  There are some bowl games on today so I will get a chance to watch some college football.   Should probably take Ollie for another run later as we were gone for most of the day yesterday.

Have a great week.  Take care,  Shawn.

“Life isn't about finding yourself. Life is about creating yourself.”
― George Bernard Shaw

A Little Off

I have not been feeling well mentally the last few days.  I worked Saturday afternoon filling salt bins.  I was not feeling too bad while I was working but, as I drove home, my mood slid downwards in a hurry.  I cannot pin point the reason exactly but, I sunk in to a mini depression.  I sat in our chair crying when I got home.  I just felt overwhelmed by everything at once.  Jodi was not home and I felt alone in my sadness.  When I sink in to these bouts, I only see negatives and my mind pushes out anything positive.  Jodi helped to pick up my mood when she got home.  She does not let me accept the mood I am in and helps me push through.

I was feeling off again yesterday.  I had forgotten to take my meds the previous night and I have not done that in over a year.  I was up really early and could never really get back to sleep.  I had a lot of cleaning to do as we had our home inspection yesterday.  We are getting closer to getting our first home.  I almost made myself sick with nervous energy as I was really worried about the inspection. I was crying again for a bit and was grateful for how smoothly the inspection went as it definitely alleviated the stress I was feeling.  I am very excited about getting a house for the first time but, I put a lot of pressure to help out as much as I can financially.  There has not been too much snow so far and I am worried that I will not get enough hours in over the winter plowing and salting.  I am still not sure about working over nights and how that will impact me mentally.  Good sleep is so important for me and it will definitely be a challenge with the hours I will be working.

Today was a much better day.  I got one of the best sleeps I have had in quite some time.  I had a chance to go for  a coffee with my dad which is always nice.  I was able to enjoy the day and not worry too much about how the next few months will play out.  I really appreciate good days and need to remind myself that this time of year is always a challenging one for me.  Things will work out as they should and I need so spend more time enjoying the small things in life as opposed to worrying about possible negative outcomes.

Looking forward to seeing my sister tomorrow.  Should be a nice day for a drive. Looks like I may get in some salting tomorrow night which will be good. 

Hope you enjoy the rest of your week. Take care, Shawn.

Schizophrenia

Schizophrenia: An Overview

 

Schizophrenia is a serious brain disorder that distorts the way a person thinks, acts, expresses emotions, perceives reality, and relates to others. People with schizophrenia -- the most chronic and disabling of the major mental illnesses -- often have problems functioning in society, at work, at school, and in relationships. Schizophrenia can leave its sufferer frightened and withdrawn. It is a life-long disease that cannot be cured but usually can be controlled with proper treatment.

Contrary to popular belief, schizophrenia is not a split personality. Schizophrenia is a psychosis, a type of mental illness in which a person cannot tell what is real from what is imagined. At times, people with psychotic disorders lose touch with reality. The world may seem like a jumble of confusing thoughts, images, and sounds. The behavior of people with schizophrenia may be very strange and even shocking. A sudden change in personality and behavior, which occurs when schizophrenia sufferers lose touch with reality, is called a psychotic episode.

Schizophrenia varies in severity from person to person. Some people have only one psychotic episode while others have many episodes during a lifetime but lead relatively normal lives between episodes. Still other individuals with this disorder may experience a decline in their functioning over time with little improvement between full blown psychotic episodes. Schizophrenia symptoms seem to worsen and improve in cycles known as relapses and remissions.

Schizophrenia is a term given to a complex group of mental disorders. However, different types of schizophrenia may have some of the same symptoms. There are several subtypes of schizophrenia based on symptoms:

• Paranoid schizophrenia: People with this type are preoccupied with false beliefs (delusions) about being persecuted or being punished by someone. Their thinking, speech, and emotions, however, remain fairly normal.
• Disorganized schizophrenia: People with this type often are confused and incoherent and have jumbled speech. Their outward behavior may be emotionless or flat or inappropriate, even silly or childlike. Often they have disorganized behavior that may disrupt their ability to perform normal daily activities such as showering or preparing meals.
• Catatonic schizophrenia: The most striking symptoms of this type are physical. People with catatonic schizophrenia are generally immobile and unresponsive to the world around them. They often become very rigid and stiff and unwilling to move. Occasionally, these people have peculiar movements like grimacing or assume bizarre postures. Or, they might repeat a word or phrase just spoken by another person. At times, the opposite may be true and these individuals appear to engage in restless ongoing activity with no specific purpose or desired outcome (for example, walking a straight line over and over; repeatedly jumping in place). People with catatonic schizophrenia generally go back and forth between more sedentary behaviors and the restless, purposeless behaviors and are at increased risk of malnutrition, exhaustion, or self-inflicted injury.
• Undifferentiated schizophrenia: This subtype is diagnosed when the person's symptoms do not clearly represent one of the other three subtypes.
• Residual Schizophrenia: In this type of schizophrenia, the severity of schizophrenia symptoms has decreased. Hallucinations, delusions, or other symptoms may still be present but are considerably less than when the schizophrenia was originally diagnosed. In addition, there must still be evidence of the disturbance as indicated by the presence of some negative symptoms (for example, inexpressive faces, blank looks, monotone speech, seeming lack of interest in the world and other people, inability to feel pleasure).

What Are the Symptoms of Schizophrenia?

People with schizophrenia may have a number of symptoms involving changes in ability, behavior, and personality, and they may display different kinds of behavior at different times. When the illness first appears, symptoms usually are sudden and severe.

The most common symptoms of schizophrenia can be grouped into three categories: Positive symptoms, disorganized symptoms, and negative symptoms.

Positive Symptoms of Schizophrenia

In this case, the word positive does not mean "good." Rather, it refers to obvious symptoms that are not present in people without schizophrenia. These symptoms, which are sometimes referred to as psychotic symptoms, include:

• Delusions: Delusions are strange beliefs that are not based in reality and that the person refuses to give up, even when presented with factual information. For example, the person suffering from delusions may believe that people can hear his or her thoughts, that he or she is God or the devil, or that people are putting thoughts into his or her head or plotting against them.
• Hallucinations: These involve perceiving sensations that aren't real, such as seeing things that aren't there, hearing voices, smelling strange odors, having a "funny" taste in your mouth, and feeling sensations on your skin even though nothing is touching your body. Hearing voices is the most common hallucination in people with schizophrenia. The voices may comment on the person's behavior, insult the person, or give commands.
• Catatonia (a condition in which the person becomes fixed in a single position for a very long time).

Disorganized symptoms of schizophrenia are a type of positive symptom that reflects the person's inability to think clearly and respond appropriately.  Examples of disorganized symptoms include:

• Talking in sentences that do not make sense or using nonsense words, making it difficult for the person to communicate or engage in conversation
• Shifting quickly from one thought to the next
• Moving slowly
• Being unable to make decisions
• Writing excessively but without meaning
• Forgetting or losing things
• Repeating movements or gestures, such as pacing or walking in circles
• Having problems making sense of everyday sights, sounds, and feelings

  Cognitive Symptoms of Schizophrenia

  Cognitive symptoms include:
• Poor executive functioning (the ability to understand information and to use it to make decisions)
• Trouble focusing or paying attention
•  Difficulty with working memory (the ability to use information immediately after learning it)

Negative Symptoms of Schizophrenia

In this case, the word negative does not mean "bad," but reflects the absence of certain normal behaviors in people with schizophrenia. Negative symptoms of schizophrenia include:

• Lack of emotion or a very limited range of emotions
• Withdrawal from family, friends, and social activities
• Reduced energy
• Reduced speech
• Lack of motivation
• Loss of pleasure or interest in life
• Poor hygiene and grooming habits

What Causes Schizophrenia?

The exact cause of schizophrenia is not yet known. It is known, however, that schizophrenia -- like cancer and diabetes -- is a real illness with a biological basis. It is not the result of bad parenting or personal weakness. Researchers have uncovered a number of factors that appear to play a role in the development of schizophrenia, including:

• Genetics (heredity): Schizophrenia tends to run in families, which means a greater likelihood to develop schizophrenia may be passed on from parents to their children.
• Brain chemistry: People with schizophrenia may have an imbalance of certain chemicals in the brain. They may be either very sensitive to or produce too much of a brain chemical called dopamine. Dopamine is a neurotransmitter, a substance that helps nerve cells in the brain send messages to each other. An imbalance of dopamine affects the way the brain reacts to certain stimuli, such as sounds, smells, and sights and can lead to hallucinations and delusions.
• Brain abnormality: Research has found abnormal brain structure and function in people with schizophrenia. However, this type of abnormality doesn't happen in all schizophrenics and can occur in people without the disease.
• Environmental factors: Evidence suggests that certain environmental factors, such as a viral infection, extensive exposure to toxins like marijuana, or highly stressful situations, may trigger schizophrenia in people who have inherited a tendency to develop the disorder. Schizophrenia more often surfaces when the body is undergoing hormonal and physical changes, such as those that occur during the teen and young adult years.

Who Gets Schizophrenia?

Anyone can get schizophrenia. It is diagnosed all over the world and in all races and cultures. While it can occur at any age, schizophrenia typically first appears in the teenage years or early 20s. The disorder affects men and women equally, although symptoms generally appear earlier in men (in their teens or 20s) than in women (in their 20s or early 30s). Earlier onset of symptoms has been linked to a more severe course of illness. Children over the age of 5 can develop schizophrenia, but it is very rare before adolescence.

How Common Is Schizophrenia?

Schizophrenia occurs in about 1% of the population. About 2.2 million Americans, ages 18 and older, will develop schizophrenia.

How Is Schizophrenia Diagnosed?

If symptoms of schizophrenia are present, the doctor will perform a complete medical history and physical exam. While there are no laboratory tests to specifically diagnose schizophrenia, the doctor may use various tests, such as X-rays and blood tests, to rule out a physical illness or intoxication (substance-induced psychosis) as the cause of the symptoms.

If the doctor finds no physical reason for the schizophrenia symptoms, he or she may refer the person to a psychiatrist or psychologist, mental health professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a psychotic disorder. The therapist bases his or her diagnosis on the person's report of symptoms and his or her observation of the person's attitude and behavior. A person is considered to have schizophrenia if he or she has characteristic symptoms that last for at least six months.

How Is Schizophrenia Treated?

The goal of schizophrenia treatment is to reduce the symptoms and to decrease the chances of a relapse, or return of symptoms. Treatment for schizophrenia may include: 

• Medications: The primary medications used to treat schizophrenia are called antipsychotics. These drugs do not cure schizophrenia but help relieve the most troubling symptoms, including delusions, hallucinations, and thinking problems. Older medications used include: Thorazine, Prolixin, Haldol, Navane, Stelazine, Trilafon, Loxapine, and Mellaril. Newer drugs used to treat schizophrenia include: Abilify, Clozaril, Geodon, Invega, Latuda, Risperdal, Saphris, Seroquel, and Zyprexa.
• Psychosocial therapy: While medication may help relieve symptoms of schizophrenia, various psychosocial treatments can help with the behavioral, psychological, social, and occupational problems associated with the illness. Through therapy, patients also can learn to manage their symptoms, identify early warning signs of relapse, and develop a relapse prevention plan. Psychosocial therapies include:
  • Rehabilitation, which focuses on social skills and job training to help people with schizophrenia function in the community and live as independently as possible.
  • Individual psychotherapy, which can help the person better understand his or her illness, and learn coping and problem-solving skills.
  • Family therapy, which can help families deal more effectively with a loved one who has schizophrenia, enabling them to better help their loved one.
  • Group therapy/support groups, which can provide continuing mutual support.
• Hospitalization: Many people with schizophrenia may be treated as outpatients. However, people with particularly severe symptoms, or those in danger of hurting themselves or others may require hospitalization to stabilize their condition.
• Electroconvulsive therapy (ECT): This is a procedure in which electrodes are attached to the person's head and a series of electric shocks are delivered to the brain. The shocks induce seizures, causing the release of neurotransmitters in the brain. This form of treatment is rarely used today in the treatment of schizophrenia. ECT may be useful when all medications fail or if severe depression or catatonia makes treating the illness difficult.
• Psychosurgery: Lobotomy, an operation used to sever certain nerve pathways in the brain, was formerly used in some patients with severe, chronic schizophrenia. It is now performed only under extremely rare circumstances. This is because of the serious, irreversible personality changes that the surgery may produce and the fact that far better results are generally attained from less drastic and hazardous procedures

Are People With Schizophrenia Dangerous?

Popular books and movies often depict people with schizophrenia and other mental illnesses as dangerous and violent. This is usually not true. Most people with schizophrenia are not violent. More typically, they prefer to withdraw and be left alone. In some cases, however, people with mental illness may engage in dangerous or violent behaviors that are generally a result of their psychosis and the resulting fear from feelings of being threatened in some way by their surroundings.

On the other hand, people with schizophrenia can be a danger to themselves. Suicide is the number one cause of premature death among people with schizophrenia.

What Is the Outlook for People With Schizophrenia?

With proper treatment, most people with schizophrenia can lead productive and fulfilling lives. Depending on the level of severity and the consistency of treatment received they are able to live with their families or in community settings rather than in long-term psychiatric institutions.

Ongoing research on the brain and how brain disorders develop will likely lead to more effective medicines with fewer side effects.

Can Schizophrenia Be Prevented?

There is no known way to prevent schizophrenia. However, early diagnosis and treatment can help avoid or reduce frequent relapses and hospitalizations and help decrease the disruption to the person's life, family, and relationships.

WebMD Medical Reference

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Reviewed by Noëlle Santorelli, PhD on April 26, 2013

© 2013 WebMD, LLC. All rights reserved.

 

 

 

“Never give up on someone with a mental illness. When "I" is replaced by "We", illness becomes wellness.”
― Shannon L. Alder

 

Take care,  Shawn. Happy Thursday.

 

Dear Bi-Polar

Dear Bi-Polar

We have been on quite the journey you and I

Probably since I was 17 years old although I did not know about you then

I tried to live with you on my own for so long but,

I realized this was not possible

Self-medicating did nothing to thwart your advances through my twenties

Alcohol and Gambling did nothing to help share my life with you

It was not until I realized I needed help managing you that we could co-exist

I wish I did not have to take medication to live with you but, I accept that

You have affected my relationships, education, finances and employment

You have almost ended my life on numerous occasions

You have confused my mind with thoughts that should not be there

You have made it difficult to make good decisions

You have put me in deep depressions for long periods of time

You have made it challenging for me to push through daily life at times

I should despise you but, I do not

Although the road we have traveled over the last twenty years or so was an arduous one

We have learned to function as one

I would never have realized this many things about myself at such a young age without you

I would not have felt the same sense of accomplishment for conquering fears and anxieties

I would not have the strength inside me that I do now

I would not be able to share with others and spread awareness about mental health

I would not have the same insight about the world around me without you

Would life have been simpler without you?

Perhaps but, you made me in to who I am today and I thank you

I am not sure where the next twenty years of our journey together will lead us

But we can do it together, one step at a time.

Shawn

Bi Polar 1 Disorder

What Is Bipolar I Disorder?

Bipolar I disorder (pronounced "bipolar one" and also known as manic-depressive disorder or manic depression) is a form of mental illness. A person affected by bipolar I disorder has had at least one manic episode in his or her life. A manic episode is a period of abnormally elevated mood and high energy, accompanied by abnormal behavior that disrupts life.

Most people with bipolar I disorder also suffer from episodes of depression. Often, there is a pattern of cycling between mania and depression. This is where the term "manic depression" comes from. In between episodes of mania and depression, many people with bipolar I disorder can live normal lives.

Who Is at Risk for Bipolar I Disorder?

Virtually anyone can develop bipolar I disorder. About 2.5% of the U.S. population suffers from bipolar disorder -- almost 6 million people.

Most people are in their teens or early 20s when symptoms of bipolar disorder first appear. Nearly everyone with bipolar I disorder develops it before age 50. People with an immediate family member who has bipolar are at higher risk.

What Are the Symptoms of Bipolar I Disorder?

During a manic episode in someone with bipolar disorder, elevated mood can manifest itself as either euphoria (feeling "high") or as irritability.

Abnormal behavior during manic episodes includes:

• Flying suddenly from one idea to the next
• Rapid, "pressured," and loud speech
• Increased energy, with hyperactivity and a decreased need for sleep
• Inflated self-image
• Excessive spending
• Hypersexuality
• Substance abuse

People in manic episodes may spend money far beyond their means, have sex with people they wouldn't otherwise, or pursue grandiose, unrealistic plans. In severe manic episodes, a person loses touch with reality. They may become delusional and behave bizarrely.

Untreated, an episode of mania can last anywhere from a few days to several months. Most commonly, symptoms continue for a few weeks to a few months. Depression may follow shortly after, or not appear for weeks or months.

Many people with bipolar I disorder experience long periods without symptoms in between episodes. A minority has rapid-cycling symptoms of mania and depression, in which they may have distinct periods of mania or depression four or more times within a year.  People can also have mood episodes with "mixed features," in which manic and depressive symptoms occur simultaneously, or may alternate from one pole to the other within the same day.

Depressive episodes in bipolar disorder are similar to "regular" clinical depression, with depressed mood, loss of pleasure, low energy and activity, feelings of guilt or worthlessness, and thoughts of suicide. Depressive symptoms of bipolar disorder can last weeks or months, but rarely longer than one year.

What Are the Treatments for Bipolar I Disorder?

Manic episodes in bipolar I disorder require treatment with drugs, such as mood stabilizers and antipsychotics, and sometimes sedative-hypnotics (benzodiazepines such as Ativan or Klonopin). 

Mood Stabilizers

Lithium: This simple metal in pill form is especially effective at controlling mania that involves classical euphoria rather than mixtures of mania and depression simultaneously. Lithium has been used for more than 60 years to treat bipolar disorder. Lithium can take weeks to work fully, making it better for maintenance treatment than for sudden manic episodes. Blood levels of lithium as well as tests to measure kidney and thyroid functioning must be monitored to avoid side effects.

Depakote: This antiseizure medication also works to level out moods. It has a more rapid onset of action, often making it more effective for an acute episode of mania than lithium. It is also often used "off label" for prevention of new episodes. Only mood stabilizers that can be used with the loading dose method -- beginning at a very high dose -- allow the possibility of significant improvement in mood as early as four to five days.

Some other antiseizure drugs, notably Tegretol and Lamictal, can have value in treating or preventing manias or depressions. Other antiseizure medicines that are less well-established for the treatment of bipolar disorder, include Trileptal, Neurontin, and Topamax.

Antipsychotics

For severe manic episodes, traditional antipsychotics (such as Haldol, Loxapine, or Thorazine) as well as newer antipsychotic drugs -- also called atypical antipsychotics -- may be necessary. Abilify, Risperdal, Saphris, Seroquel, Geodon, and Zyprexa are often used, and many other drugs are available. The antipsychotic Latuda is approved for use -- either alone or with lithium or Depakote -- in cases of bipolar I depression. Antipsychotic medicines are also sometimes used for preventive treatment.

Benzodiazepines

This class of drugs includes Xanax, Ativan, and Valium and is commonly referred to as minor tranquilizers. They are sometimes used for short-term control of acute symptoms associated with mania such as agitation or insomnia, but they do not treat core mood symptoms such as euphoria or depression.

Antidepressants

Common antidepressants such as Prozac, Zoloft, and Paxil have not been shown to be as effective for treating depression in bipolar disorder as in unipolar depression. In a small percentage of people, they can also set off or worsen a manic episode in a person with bipolar disorder. For these reasons, the first-line treatments for depression in bipolar disorder involve medicines that have been shown to have antidepressant properties but also no known risk for causing or worsening mania.  The three FDA-approved treatments for bipolar depression are Seroquel or Seroquel XR, Symbyax (olanzapine-fluoxetine) combination and LAtuda. Other mood-stabilizing treatments that are sometimes recommended for treating acute bipolar depression include lithium, Depakote, and Lamictal (although none of these medicines is FDA-approved specifically for bipolar depression). If these fail, after a few weeks a traditional antidepressant or other medicine may sometimes be added. Psychotherapy, such as cognitive-behavioral therapy, may also help.

People with bipolar I disorder (mania or depression) have a high risk for recurrences and usually are advised to take medicines on a continuous basis for prevention.

Electroconvulsive Therapy (ECT)

Despite its scary reputation, electroconvulsive therapy (ECT) is an effective treatment for both manic and depressive symptoms. ECT is seldom used to treat bipolar I disorder, but can be helpful if medicines fail or can't be used.

Can Bipolar I Disorder Be Prevented?

The causes of bipolar disorder are not well understood. It's not known if bipolar I disorder can be prevented entirely.

It is possible to lower the risk of episodes of mania or depression once bipolar disorder has developed. Regular therapy sessions with a psychologist or social worker can help people to identify factors that can destabilize mood (such as poor medication adherence, sleep deprivation, drug or alcohol abuse, and poor stress management), leading to fewer hospitalizations and feeling better overall. Taking medicine on a regular basis can help to prevent future manic or depressive episodes.

How Is Bipolar I Different From Other Types of Bipolar Disorder?

People with bipolar I disorder experience full episodes of mania -- the often severe abnormally elevated mood and behavior described above. These manic symptoms can lead to serious disruptions in life (for example, spending the family fortune, or having an unintended pregnancy).

In bipolar II disorder, the symptoms of elevated mood never reach full-blown mania. They often pass for extreme cheerfulness, even making someone a lot of fun to be around -- the "life of the party." Not so bad, you might think -- except bipolar II disorder usually involves extensive and disabling periods of  significant depression, which can often be harder to treat than if episodes of hypomania had never occurred.

WebMD Medical Reference

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Reviewed by Joseph Goldberg, MD on May 11, 2014

© 2014 WebMD, LLC. All rights reserved.

 

 

 

“Laughter is wine for the soul - laughter soft, or loud and deep, tinged through with seriousness - the hilarious declaration made by man that life is worth living.”
― Seán O'Casey

 

Take care,  Shawn.