#People need antipsychotics and stabilisers

[krokaxe]

Watching the fallout zone discuss addicts is horrific btw. Like regardless if you like the lore changes, please consider your stances on ghouls requiring a substance— that is clearly not free and dangerous to aquire— to maintain their autonomy.

The zombification of ghouls is a whole other subject but when you talk about ferals vs ghouls, remember that ghouls as a whole are on par with the disabled and the ill. They're not the same ilk as deathclaws or other monsters in the series; they are people who have been ghoulified. People. Ring that in red a few times.

And on that note, when you use terms like 'junkie' and 'addict' with a derogatory edge, remember that addiction is not a moral indicator. It could happen to you too.

[dribs-and-drabbles]

Dead Friend Forever ep 7

I LOVED this ep. Loved it.

This is so delicious. I'm trying to think how I would have reacted if I hadn't already known that Phee knew Non. Would I have remembered this fact when Phee was revealed at the end of ep 6? But WHY did Phee lie to the group?! This is so delicious. The mystery.

THEY'RE SO ADORABLE TOGETHER!

At the end of ep 6 I questioned whether Non's red bracelet was for Phee but now that I'm watching this beginning I'm reminded that in ep 2 I theorised that Phee was orange and...here Phee's in blue and Non's sat on the orange chair when they meet (with 'today will be a good day' on Non's shirt)???! Then Phee is in a rich orange and Non in deep blue in the next shot?!? I was so right!

(Oh that's Zo's parents house in Hidden Agenda!)

Oh they have matching bracelets!

(It hurts that they're so happy though)

Phee's dad is a policeman, yes? Yeah, yes yes yes. 👏🏽

Oh my god, Non's fucking t-shirts 🙈 'Moment' when they became boyfriends and now 'Positive Thinking' when Phee asks Non to move schools and Non needs time to consider it.

Wow, Non really does have three people after him - Phee, Jin, and I'm assuming the tutor. Boy's got the milkshake.

Oooo lies between Non and Phee. Non's not telling Phee about the money he owes, right? And he'll get it from the tutor by sleeping with him, and Phee will breakup with Non...

Oh those fateful words - 'I will never lie to you' - oh baby boy the demise of your relationship starts here.

Really?! A low battery and 'help me...' on his t-shirt when Non arrives tired at the house?!

I hate them. IhatethemIhatethemIhatethem. (Por/Tee/Top et al)

We still haven't found out what Non's medication is for, right? Is it for his heart maybe? (coming back to this at the end of the ep...maybe it's for his mind, some kind of mood stabilisers or antipsychotics or something...).

Non doesn't like being touched. I wonder if that's just Jin or by anyone (other than Phee I guess).

And now Non's shirt says 'create' as he's trying to be involved in the filming.

Oh no...no. NON, WHAT ARE YOU DOING?! Is he willingly kissing the tutor or is this an exchange for the money? Has something been lost in translation? Oh no no no. Did Non just cheat on Phee? Willingly?

Oh, Non is a player! How juicy! 🤓

Oh the tutor is Khun Keng! I need to go back to my notes from a past ep for where he was mentioned before. (-> Ah yes, he was the potential hallucination that Jin saw in the temple who Phee apparently didn't see in ep 4...incheresting!)

Oh Non. NonNonNon... I love you. You're so deliciously flawed. How can you lie to Phee like this? But also, it's delicious characterisation. Because now it's even more difficult to know whose 'side' Phee is on in the future. Is he getting revenge for Non or is he a victim of whoever the murderer is as well? DELICIOUS!

Ahhhh and that's Jin's 'rejection'. I bet he's going to be the one to reveal to Phee about Non and Khun Keng.

Oh, or it might be Top and Tee.

Whhhhat is Tee up to? 😒

Actually, how are all these people friends in the future?!? They're all horrible to each other as well.

And then there's this guy, Khun Keng, who in one breath says he wants to stop the scammers and 'save' the students...but then in the next will take advantage of a student to shut him up. 🤦🏽‍♀️ Brilliant.

Please. I hope they lock the door though.

Oh no. No! Noooooo!!

Yep. And Jin is the one to reveal it. Yep. Yep yep.

That's some serious doxxing. And Jin! Jin who was the least worst out of the group has now done the worst thing to Non (who, tbh, kinda brought it on himself but also is a victim of a TEACHER. IT'S SO MORALLY GREY I LOVE IT). (EDIT: running back here after re-watching the scene [due to comments in the notes] and there are two laptop screens! - one light [Jin's] and one dark [owner unknown]. So Jin may not have been the person to post it...but he must have shared the video for someone else to do it. TASTY)

FUCK'S SAKE NON. 'ALWAYS BE YOURSELF' WHEN YOU GET CAUGHT CHEATING. WITH. A. TEACHER?! 😂 *HOWLING*

Ahhhhhh it got GOOOOOOOOOD. I love how morally grey everyone is. And how it's even more unclear who the 'murderer' might be in the future....because Khun Keng is also in the running now since he got doxxed by Jin. IT'S BRILLIANT. 😁

Por and Tee: we're gonna fuck with Non so bad 😈😏👺

Non: don't worry boys, I'ma fuck things up all by myself 😜😭🤦🏽‍♀️

[that-bipolar-mood]

Hi I read your post on lithium. Do you have any thoughts on how lithium might help the depression side? I have mixed episodes and less classic mania but my doctor wants me to try it mostly for depressive episodes and suicidal ideation. I'm very very hesitant to try it so I'm looking for all the information I can get. Love your blog btw.

Heya,

thank you for the compliment:)

and keep in mind, I'm not a professional.

So, depression and lithium are kind of a gamble for most. Usually, (and that really says nothing) depression isn't treated with lithium. When patients on lithium experience depression, another antidepressant can be introduced.

BUT. You can find info for yourself, many with major depression and treatment-resistant depression find lithium literally life-saving. And the reason for that lies in this... superpower... this amazing ability that lithium has...

It is the number one treatment for suicidal ideation (which usually follows MDD and similar disorders)

Honestly, the majority of people with bipolar aren't on one medication alone. The standard is some sort of cocktail of mood stabiliser or antidepressant with antipsychotic.

In conclusion, it may work for you. If you're patient enough, you may find yourself rid of a clinical, resistant mindset of suicidal ideation. And I vouch for that. You may also find yourself stable. However, I believe the most common approach for cuties like you, with mixed depression, is a mood stabiliser (aka lithium) and another antidepressant (or if you can't tolerate them, antipsychotic).

If I were you, I'd give it a shot for a few weeks. Worst case scenario, you quit and go back to cocktail combo hunt.

Best of luck to you, stay safe and hold onto yourself <3

If you need anything else, DMs are always open

[fleetstreetpies]

TW: mental health problems, psychosis, open and graphic discussion of my hallucinations and delusions, mental health meds, mental health med side effects, medical inaction, medical malpractice.

Content under the cut.

Good god it’s happening again. It’s getting REALLY bad again.

I’ve been on a mood stabiliser for about a year now, and I’ve been VERY open with my psychiatrist about a lot of the complications I’ve faced, like needing my dose increased, nausea and headaches from increasing my dosage, persistence of mania, night terrors, delusions, etc. And now the delusions and hallucinations are worse than they were. They’d gotten better for a while but now here I am and good gods, I want it to stop so badly.

I want to not see things and people melting slowly. I want to not perceive that people have been replaced by near identical clones. I want to not perceive that some people are just my mother in elaborate disguise. I’d make it all stop or go away if I could, and when I was a younger man I tried, though when I tried I fully thought that I was God and could control the universe with just my thoughts.

I’ve been trying to talk to my psychiatrist about it. I need to get my mood stabiliser increased, sure, and I know that. But I also desperately need to get on an antipsychotic. And I think she thinks I’m malingering.

Do people actually think that folks with these problems are faking this? Malingering is relatively rare, and by all means, infuriating for all parties. But do the professionals genuinely think that we’re malingering? Because I’d bet (if I had money and were a gambling man) that it’s way harder to fake than you’d think. People who do that whole malingering thing unequivocally baffle me. Antipsychotics are extremely expensive and I cannot believe people would genuinely be willing to buy them and fake it for sympathy. I can’t afford 880 dollars per refill no matter how hard I try because I can barely make rent in a month (at least I get my meds through the school pharmacy where they cost way less).

So what even is the point of some other person faking it? To sell their prescription drugs for a profit on a black market? To gain sympathy? To get some kind of disability benefits?

I just need for my psychiatrist to fucking listen to me for five seconds and to actually fucking help me for once in her goddamn life when all the other doctors or professionals in their white coats and clean blouses and blazers won’t. I need help because they all fucking refuse to help me and my psychiatrist is supposed to help me. They took a vow to “do no harm”, but that vow is useless when their own inaction or bias is the cause of the harm. It’s pointless and futile! Why take a vow when you don’t even listen to the people you swore to help?

Medical inaction is ableism. Medical inaction is malpractice. Medical inaction is to be complicit in the deaths of so many mentally ill people.

Doctors say “do no harm” but they leave the mentally ill to suffer and die because “what if they’re faking it?” That’s a poor excuse to deny people adequate (read: potentially life saving) treatment and healthcare.

Shame on the pharmaceutical industry, shame on doctors, shame on malingerers, and shame on everyone complicit in the ableism, incompetence, inaction, corruption, and denial that kill.

Shame on you.

[triumphhealth]

Bipolar Disorder Unveiled: Navigating Highs and Lows

Millions of people worldwide are afflicted by bipolar disorder, often known as manic-depressive disease. It is a complex and difficult mental health condition. Extreme mood, energy, and activity swings between episodes of mania (high mood) and depression (low mood) are its defining features. In this blog by Triumph Behavorial Health , we will examine the complexities of bipolar disorder, illuminating its highs and lows, its effects on people's lives, and management techniques.

Recognising the Bipolar Disorder Spectrum

There is no one-size-fits-all diagnosis for bipolar disorder. It has a continuum of severity and symptom presentation, with many subgroups. The main types consist of:

Manic episodes that last at least seven days and frequently need hospitalisation are the hallmark of bipolar I disorder. There could be depressive spells as well.

Hypomanic episodes (less severe than complete mania) and significant depression episodes define bipolar II disorder.

Cyclothymic Disorder: Consists of mild depression and hypomania for at least two years.

The Manic and Hypomanic Highs

The "high" phases of bipolar disorder are characterised by manic and hypomanic episodes. During these times, people may go through:

Elevated mood and euphoria

Increased energy and activity levels

Racing thoughts and rapid speech

Decreased need for sleep

Impulsivity and risky behavior

Grandiose beliefs or delusions

Heightened creativity and productivity

Hypomania is frequently linked with improved productivity and creativity, but mania can result in poor judgement and potentially hazardous behaviour. However, these conditions can interfere with daily life and exacerbate interpersonal conflicts.

The Depression's Lows

The bipolar disorder depressedepisodes are on the other end of the spectrum. These times are distinguished by:

Persistent sadness and hopelessness

Loss of interest or pleasure in activities

Fatigue and decreased energy

Changes in appetite and sleep patterns

Difficulty concentrating and making decisions

Feelings of guilt or worthlessness

Thoughts of death or suicide

Depressive episodes can be especially crippling, affecting a person's capacity for work, social interaction, and even basic self-care.

Navigating the Challenges: Coping Techniques

Medication management:

Effective medication management is essential for reducing mood swings. Doctors frequently recommend mood stabilisers, antipsychotics, and (in rare situations) antidepressants.

Therapy:

Psychotherapy, particularly dialectical behaviour therapy (DBT) and cognitive-behavioral therapy (CBT), can assist people in developing coping mechanisms, identifying triggers, and controlling their emotions.

Lifestyle Management:

Keeping a regular schedule, controlling stress, getting enough sleep, and engaging in relaxation exercises like mindfulness can all help to stabilise mood.

Socializing :

Building a solid social network of friends, family, and support organisations can be reassuring through both highs and lows.

Recognising Triggers:

People can take proactive measures to prevent or control mood episodes by being aware of their triggers, such as sleep disruptions or high levels of stress.

Bipolar disorder is a complex condition that requires understanding, support, and effective management strategies. Navigating the highs of mania and the lows of depression can be a challenging journey, but with the right treatment, coping mechanisms, and a strong support network, individuals with bipolar depression you can recommend then Triumph Behavorial Health as they can help them in achieving stability and lead fulfilling lives. If you or someone you know is struggling with bipolar disorder is essential, and with proper care, it's possible to navigate the highs and lows of this condition.

[thessalian]

Thess vs Making Things

So after a little bit of futzing around on Horizon: Zero Dawn (and realising that Hunting Zen with a side of AAAAAAAAAA was Not It but hey, at least I tried), I did Chores. Specifically, I took out the garbage and recycling.

Chores is plural because I watered the plants before all that and there are A LOT OF PLANTS, okay? I need a little watering can. Currently I’m using one of my little silicone measuring cups that I normally use to measure epoxy resin components, or this little glass carafe that I don’t know where it came from but it’s pretty. Just I need something with a small enough spout not to be problematic with small plant pots but something that carries more than a cup or so of water to save me multiple trips back to the faucet.

Anyway, I took the opportunity to make a quick shops run and on my way home, I ran into my mother, walking her dog. We had a quick chat, mostly about if I want her to bring me back anything from North America (I requested A1 sauce, which I miss dearly). She wants us to go out for dinner when she gets back from her trip but I hate going out to eat at the moment because the whole “I need gluten-free menus” thing just triggers my anxiety, even if I know they have gluten-free menus. I was raised to Not Cause A Fuss About Food. Anyway, I invited her over for dinner with me cooking for her instead. If she wants dinner a deux, it can be where I’m damn sure I can eat everything without problems.

Anyway, went home, and about an hour later, phone rings. It’s my mother again. “Nothing urgent”, she says. Just ... okay, going back a few pages in the codex of my life: my Auntie Mickey is pretty severely intellectually disabled and her carer is a bit of a bitch about it. Or ... well, whatever it is when you lean on pharmaceuticals to solve problems when they’re really not necessary and frankly even misunderstanding what the pharmaceuticals do. During the big lockdown phases of the early pandemic, obviously my Auntie Mickey was having some issues, because she couldn’t really deal with a mask and she’s in fairly frail health physically so she couldn’t really go anywhere or see many people. This obviously got to her, and she was getting depressed and irritable. Which ... you know, most of us were. Her carer, however, didn’t like her being “moody” and recommended mood stabilisers. The kind of things that are generally required for bipolar disorder. Not that there’s anything wrong with being bipolar, but you don’t prescribe mood stabilisers meant for that kind of neurodivergence when someone’s just depressed and stressed because there’s a fucking pandemic going on and they’re stuck inside and can’t see their friends or family (my other aunt, Christine, mainly - they generally see each other daily) and don’t entirely understand what’s going on or why it has to be this way. So when my mother was venting about this - and quite right too, I figure - I remembered my own rage when the US psychiatric hospital tried to put me on antipsychotics back in the day and remembered what helped instead. So I suggested aromatherapy. Specifically, I made one of my blends of aromatherapy soap - lavender, bergamot, bit of neroli, that kind of thing.

My Auntie Mickey loved it. So much so that when it came to her seventieth birthday awhile ago, I made her lots more - used every single-use soap mould I had in the house and added some shea butter to make her skin feel nice too as per one of my soap-making books. This was in September, and there were ... like, three, four bars?

So back to today, and my mother calls saying she just got off the phone with my Auntie Christine and my Auntie Mickey is out of “her nice soap” and it’d be great if I could make some more. At least this time she’s giving me money for materials, which is good because I had to buy more soap moulds (silicone ones this time, so I can reuse them) and more shea butter. Thankfully I still have plenty of melt and pour soap, so I didn’t need to replenish that. She leaves on Friday morning so I have until Thursday, and I have this coming week off. So soap moulds and shea butter will arrive tomorrow, and I can just spend all of Monday hovering over a double boiler. I will make MANY bars of soap. Well, in between planting my sprouting potatoes and repotting my lettuce and starting some carrots a-growing. This week’s going to be surprisingly busy.

Also the delivery guy was really nice. My potting soil bag got torn a bit in transit - thankfully nothing came out of it but the hole was in the side of the bag so he had to carry it to my door horizontally so it didn’t spill. He would have taken it back if I’d wanted - he offered multiple times - but I told him it was fine, slapped some packing tape over the tear and hauled it inside. I just didn’t want to make the poor man lug that thing any further. Is a heavy sucker. Which is perfect for my needs, honestly.

I just am apparently not happy unless I am producing things. This probably explains why I love the crafting aspects of games so much. I just like putting in effort for tangible reward, even if that reward is “I made someone else happy”.

...Maybe that’s the key. I need a crafting game. But first I need dinner. And meds. Gods, Daylight Savings Time has really messed up my cues for when to take my medication. Generally it’s “when it’s dark” but I normally take it at half-seven and we’re only just at the pretty part of sunset so the sky’s still really light.

[somecunttookmyurl]

Hey, quick question if you feel like answering bc. Obviously v v personal BUT. Just got a diagnosis of bipolar type 1 and have occasional what I am... guessing? Are? Auditory hallucinations?? Previous label was "hahaha mind playing tricks on me where I hear ppl talking and then no one is home whoops". Since I'm currently rattling my psych upside down until treatment falls out, would you say this might be psychotic symptom like you mentioned? I am just. At my wits end (tm) and any bit of "yeah thats worth asking abt" or "nah barking up the wrong tree" would be a godsend. Just as like. Some virtual coffeeshop chatter

Auditory hallucinations are distinct from your own internal thought processes. Which means you need to actually hear them and not simply think the words, if you follow me. Hearing something which has no external stimulation and which you perceive (at least temporarily, before you realise) as real. What you are describing is an auditory hallucination which is, technically, your mind playing a trick so you’re not wrong.

Around 10% of people experience hearing voices at some point in their lives and it is not necessarily psychosis. For example, actute stress, sleep deprivation, drug use and even excessive caffeine consumption can cause that to happen. Such causes are called “transient causes” and are not psychotic in nature.

(that isn’t the case here, i doubt, since you say it’s recurring that’s just a PSA)

If you have a diagnosis of Bipolar I then yes, this is likely a psychotic symptom and you should tell your psychiatrist about it as some antipsychotics are also used to treat Bipolar and that would likely be more useful than just a mood stabiliser.

Unless of course that is a) the only psychotic symptom you experience and b) it doesn’t bother you that much. In which case you just gotta decide whether it’s worth the hassle of interacting with a psychiatrist on purpose like. Psychotic symptoms in Bipolar Disorder are not uncommon, and can occur in any episode (mania, depression, or mixed). It’s actually the majority, at around 70% of patients. You may experience any of the following:

Hallucinations - seeing, hearing, or sometimes smelling something which is not there Delusions - a belief something is true when it is not. for example during my psychosis i have a firm belief that i am alredy dead (which i also logically know isn’t true so that’s a fun trip)

Paranoia - believing yourself to have done something terrible, or that others want to hurt you and cannot be trusted

Unusual thought patterns - disjointed (entirely unconnected) or racing thoughts that may also lead to confused or disorganised speech Lack of insight - being unaware that your own behaviour is unusual

I hope that’s helpful! If you want me to go and find some actual papers for you on bipolar psychosis lmk

[alexafaie-asd]

I keep forgetting that I’m meant to treat my CBD oil and vitamins I take as my medication...

As in I forget to take them at the same time every day and then wonder why they don’t work so well on the days I take them late or forget them entirely. Like I know I’m meant to treat them that seriously. But it just seems to happen that I mess up on taking them at regular times.

I’m not really sure how to stick to a schedule consistently. I seem to manage ok briefly and then it all collapses and not having my CBD oil & vitamins at the correct time has a knock on effect to everything else meaning it becomes even harder to even try to stick to any schedule.

And its not like its a complicated schedule. Its literally just to be up at 10am and to take my vitamins and CBD oil with breakfast, preferably before 11am. Don’t have to be dressed before then - pjs are fine to get something to eat (or all day. I may wear them most of the time except bed time so...) & I always have a glass of drink next to my bed at night just so there is something to drink in the morning without getting up too.

But I’ll still forget to take them until later which means that it messes up everything else. I take high strength vitamin D as most people in my country are somewhat deficient in vitamin D just due to it not being very sunny here and I very very very rarely even leave the house. So yeah, need to take those. If I take them at 10am-11am then that seems to give my body enough time to use the vitamin D to help with melatonin production which then in turn helps regulate my sleep cycle a bit. If I take them later in the day, then everything is delayed to the point that I don’t feel tired enough to go to bed when my boyfriend does, so he’ll go up first and then because I have zero time perception, and terrible task switching ability, I end up staying up unreasonably late. So like now its nearly 6am. Not gone to bed yet. Both yesterday and today I ended up taking my tablets later than is best for me - closer to 3pm. And since taking them at 10am means I can usually feel tired enough to go to bed by 11pm, taking them around 3pm delays that and you get to now kind of times where if it were summer, it would already be light outside.

I keep thinking that there is no way my combo of stuff I take is really helping me all that much, but then I’m shown that it really does when I mess up the timing. Which makes it harder to avoid messing up the next timing.... Like they’re not even to try to fix any executive dysfunction issues. I take the CBD oil to help treat my bipolar disorder (I have not had a serious manic or depressive episode since I started taking it which has been incredible as I had no such luck on any of the antipsychotics or mood stabilisers or SSRIs I was trialled on before - they just made me physically ill on top of mentally ill & certainly did not stop psychosis). Its also helped reduce my anxiety and somewhat reduces my sensory issues. Not totally, meltdowns can still happen, but its increased my threshold which is nice. I take cod liver oil to help with my joints and its supposed to be good for staving off depression, so for that too. Then I take vitamin D because I’m deficient in it, so have to keep my levels topped up (interestingly, if I miss a day & take two the next, I do tons better, so perhaps I’m actually more deficient than I originally thought). Then finally I take vitamin B tablets for the energy, metabolism boost, and its also helped my nails so that’s nice (I like to paint them because its stimmy in so many ways).

I don’t really know where I’m going with this and its already so long. Just I wish I had some level of control over my ability to tell the time, follow schedules even very simple ones and just in general feel like less of a shitty human. Oh yeah and if my joints could please stop being so clicky clacky and just stay put where they are meant to, and if my muscles could please relax for just once in their miserable life that would be nice too. *grumbles in old*

[therapists-in-brisbane]

The Response that Leads to Physiological Changes

Psychological treatments or therapist help by giving people an opportunity to talk about their thoughts and feelings with a specially-trained professional in order to understand and cope with symptoms. Psychological treatments can reduce the distress associated with symptoms and can even help reduce the symptoms themselves depending on the person because these may take time often months to show benefits. Many different psychological therapies used in the treatment of mental illness and each person needs to find the therapy that works for them. Not all treatments are helpful for everyone because some examples of psychological therapies include cognitive behaviour therapy that examines how a person’s thoughts, feelings and behaviour. It can get stuck in unhelpful patterns for the person and a psychologist Brisbane work together to develop new ways of thinking and acting usually includes tasks to perform outside. It may be useful in the treatment of depression, anxiety disorders and psychotic disorders such as bipolar disorder and schizophrenia interpersonal psychotherapy. The examines on how a person’s relationships and interactions with others can affect their own thoughts, behaviours and feelings.

 Difficult relationships may cause stress for a person with a mental illness and psychologist Brisbane improved these relationships may improve their quality of life that may be useful in the treatment of depression. The dialectical behaviour therapy is a therapy generally used for people living with borderline personality disorder but can be helpful for other psychological issues. A key difficulty for people living with borderline personality disorder is managing emotions that helps people better manage the emotions and responses mainly helpful for people who are more seriously affected by mental illness. Different types of medication treat different types of mental illness including antidepressant medications may be prescribed in combination. With psychologist therapy to treat depression anxiety in phobias and some eating disorders antipsychotic medications are mostly used to treat psychotic illnesses for disorder. The medications may also be prescribed for major depression or severe anxiety mood-stabilising medications are helpful for people living with bipolar disorder and previously known as manic depression. The medications can help reduce the recurrence of major depression and can help reduce the manic or high episodes of anxiety disorders group of mental health problems.

 The psychologist Brisbane includes generalised anxiety disorders on specific social phobias for example like agoraphobia and claustrophobia that has a panic disorders, depression is often related to anxiety disorders. Anxiety disorders are common mental health problems that affect many people that warrants treatment at some time in their life and up to another less severe anxieties. Such as fears everyone experiences anxiety and fear at times and these are normal and helpful human emotions that help deal with danger however, some people experience excessive and irrational anxiety. It worries that become ongoing and distressing that interfere with their daily lives may indicate often there appears to be no obvious or logical reason for the way the person feels. This makes an anxiety disorder even more worrying to the sufferer and a panic attack is a sudden feeling of intense terror that may occur in certain situations. For no apparent reason a panic attack does not mean a person is necessarily suffering an anxiety disorder according to psychologist however, a panic attack is a common feature of each type of anxiety disorder symptoms.

[3medsssss]

Beyond Awareness, Urgent need for improved mental health care?

One in five – it is the percentage of people coping with a mental health condition. In fact, treating mental health disorders cost more than any other national medical condition in 2013, at a record $201 billion, according to a study in Health.

We should also realise there is not enough information.

It is obviously really important to speak about mental health: it can help people deal with the disease and can remove the shame that has been so widespread for so long. And particularly now, as Covid-19-related terror, worry and concern are sweeping the globe and stress and anxiety levels are high.

We are more willing than ever to speak about mental wellbeing and we are all looking for help from our friends and families and community services. With the growing desire to speak about mental wellbeing, you might infer that things are on the rise every year for the 25 percent of people who have a mental health concern. But too much focus is put on talk risks which mask less encouraging trends.

Employers should also take steps to move beyond awareness raising, offering the support and services required to help curb the pervasive effects of mental health issues on both their workers and their company.

First of all, for certain classes of people, both mental and physical health have worsened, when the environments under which we are born, rise, function, function and age are declining. The new pandemic, lockout and related interventions are expected to reproduce and exacerbate the financial disparities that lead to increased incidence and disproportionate mental ill-health distribution.

Talking regarding mental health would not improve until it applies to addressing the causes behind so many mental disease encounters and what concerted steps we should do to fix those passengers.

Second, as the myth around mental health becomes clear, when we need it, more of us are asking for treatment. This is driving demand for mental health services with the increase in ill health.

What's the point of empowering people to be honest about mental health and get help when there's no such assistance?

Mental health has never been as high a government priority as physical fitness, with little funding for mental health programmes resulting. Particularly low funding for research on mental health.

Although it's clearly a positive thing people don't live in isolation anymore, mental health providers don't have the ability to support anyone who comes in contact with them.

The effect of underfunding is wide-ranging, with lengthy support waiting lists and a population stretched to the point of breakage.

How do the problems of mental health present in the workplace? And what are the impacts of those?

Procrastination, and denial. Feeling more tired than normal, or irritable. Persistent exhaustion. These are only a couple of the ways mental health conditions will manifest. Many people who are withdrawn from events or have difficulty thinking say they are "just depressed".

The lack of knowledge of what constitutes a mental health problem, the stigmatised vocabulary around it, and the lack of accessible and quality treatment services, means that 66 percent of people with a mental health disorder never search or seek help. The consequences are wide-ranging: from absenteeism and lack of employment to increased suffering from debilitating illnesses, medication use and insurance statements.

What solutions are needed to better mitigate the adverse mental health effects?

When mental health becomes the latest obesity – increasingly widespread and related to chronic health conditions – there are more and more innovative digital wellness options available for doctors to prescribe and make available to employers that address barriers to finding and seeking care.

Mobile services allow a mental health care type that is inexpensive, open, interactive and private and can reach anyone with a smartphone. It also has the potential of transcending the stigmatised stereotypes and reaching people where they are.We should help people discover more productive ways to cope with job challenges, or develop strategies to properly handle stressful or troubling emotions.

What tools do employers have to help reduce the burden on their workforce base from mental health conditions?

Employers have a rare ability to actually reach out to customers where they are. Individuals spend about half of their waking hours in the workplace, where symptoms with mental health can arise in a number of ways. Although diet and exercise are gaining growing interest in portfolios of holistic health benefits, mental health care services encourage individuals to address a root cause of injury claims and retention problems.

Common medications for mental health disorders:

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1. Depression

Fluoxetine

Citalopram

Sertraline

Paroxetine

Escitalopram

2.Anti-Anxiety

Clonazepam

Alprazolam

Lorazepam

3.Stimulants

Methylphenidate

Amphetamine

Dextroamphetamine

Lisdexamfetamine Dimesylate

4.Antipsychotics

Chlorpromazine

Haloperidol

Perphenazine

Fluphenazine

5.Mood stabiliser

Carbamazepine

Lamotrigine

Oxcarbazepine

Buy medicines online at 3 MEDS and get a discount on genuine medicines and all healthcare products. 3MEDS is committed to providing safe, reliable, and affordable medicines but also worthy customer service. 

[thekillerblogofkillers]

Sylvia Seegrist (1960-?)

Sylvia Seegrist is an American spree killer. On October 30, 1985, she opened fire at a shopping mall in Springfield, Pennsylvania, killing 3 and wounding 7 before being disarmed. The people killed included 2 men and a 2-year-old boy. She was 25 and had been suffering from paranoid schizophrenia for over a decade. Her case provoked discussion about the state’s authority to commit at-risk people into mental care facilities versus individual rights as she had been committed and discharged from mental care several times prior to the shootings.

Seegrist has some similar origins to many other mentally disturbed spree killers, including a tendency for violent thoughts, discussions and behaviour which would build to a major incident. Ruth Seegrist testified that her daughter’s paternal grandfather fondled and exposed himself to Sylvia when she was just 8 years old. “She was a ‘normal’ child, but was sexually abused by her grandfather and became a troubled teenager,” her mother told the jury, saying she had not known of the abuse until Sylvia was 13. When they discussed it, Sylvia said, “But momma, you don’t know how intimate our relationship was.” Seegrist was first hospitalised at the age of 16 and was diagnosed with schizophrenia. She was hospitalised a dozen times and each time she was discharged psychiatrists said that she was no longer a risk to herself or to others.

When she turned 18, Seegrist tried to enlist in the Army. At the time she was inducted, she was assumed by her fellow platoon members to be a lesbian, and they harassed her for this, seven setting her up on a prank date and making her the butt of many jokes. Seegrist spent a lot of time at the mall she later chose for her killing spree, harassing customers and making statements about how “good” other killing sprees were, including the 1984 San Ysidro McDonald’s massacre. Seegrist joined the Army in December 1984 but was discharged after just 2 months because of her behavioural problems. Seegrist had drawn attention to herself by dressing in full green army fatigues at the spa and sauna at a local fitness club. An instructor there said “she hated everyone and would often talk about shooting and killing people.” Her behaviour was so worrying that clerks at the local K-Mart told her they had no rifles in stock when she went there to buy one. She eventually managed to buy a Ruger 10/22 from another shop.

On her first trip to the Springfield Mall on October 30, 1985, Seegrist bought Halloween items from a party shop. She then worked out at the fitness club before returning to the mall. Leaving her vehicle, she retrieved her weapon and fired at a man 27 metres away from where she was standing. The man wasn’t hit, and having seen the car Seegrist arrived in, flattened one of her  tires to prevent her escaping in that car. Seegrist approached the nearest entrance and had fired at, but missed, a woman using the ATM machine. Before entering the mall, Seegrist shot and killed 2-year-old Recife Cosmen who was with his parents outside a local restaurant. Once inside, Seegrist first randomly into stores, ignoring some. Many customers ran when they heard the gunfire but Earl Trout, who either had not heard it or couldn’t hear it was standing in front of a store when he became one of the 3 people killed that day. Augusto Ferrara was the last of the 3 to be killed in the rampage. John Laufer, a local grad student, disarmed her as she walked up to him and raised her gun to shoot him. Laufer forced her into a nearby store while he waited for the arrival of mall security. The guard that responded first asked her why she had done what she just did – she replied, “My family makes me nervous.”

After her arrest, and prior to a competency hearing, Seegrist was transferred to Norristown State Hospital to be evaluated. On March 6, 1986, Seegrist was deemed competent to stand trial for the killings. She was found guilty, but insane, and was sentenced to 3 consecutive life terms, one of each victim that died, and seven consecutive 10-year terms, one for each victim she wounded. The judge said that Seegrist “should spend the rest of her life in some form of incarceration”, and she was sent to the psychiatric speciality hospital Mayview State Hospital to be evaluated before being moved to the State Correctional Institution in Muncy, Pennsylvania.

Seegrist’s rampage spurred the state government to form a legislative task force to address better ways of caring for the mentally ill in the community. Seegrist’s mother, Ruth, urged legislators to make changes to the state mental health laws. It is unknown what, if anything, was changed. In response to the 2012 school shooting at Sandy Hook Elementary School in Newtown, Connecticut, The Philly Post ran an article named ‘Decades After Sylvia Seegrist, Mentally Ill People Are Still Murdering Innocents’, in which Ruth Seegrist said: “You know, it’s ironic that people who are irrational are expected under the law to get help on their own. There needs to be something in the law that compels a troubled person to be diagnosed by a psychiatrist. In the 1950s, we were institutionalising people who weren’t mentally ill. You could institutionalise someone who was just unruly. We’ve gone from one extreme to the other.”

At the time of Seegrist’s spree, gun buyers were required to sign a form declaring that they had no record of being in a mental institution. Sylvia Seegrist lied and purchased a .22 semi-automatic rifle for $107. In 1998, the state of Pennsylvania enacted the Pennsylvania Instant Check System (PICS) which enabled licensed gun dealers to conduct a background check using their mobile phone. A reporter from the New York Times wrote to Seegrist asking her to share her thoughts about what happened at the time of the shooting and about her life prior to that day. Part of her response read: “As I am safer in prison less threatening or perverted lesser crimes than my family.”

Seegrist served her first 2 and a half years of imprisonment at Norristown State Hospital before being transferred to Muncy State Prison for women. Ruth Seegrist and her ex-husband visited her regularly and she seemed to enjoy the visits. But in 1992, Sylvia Seegrist had difficulties with her antipsychotic medication. Although she doesn’t know what medication Sylvia is taking now, Ruth says that in 1997 Sylvia decided to stop any contact with her family. Visits and phone calls stopped and the last letter Ruth sent to her daughter was on Nov. 30. Sylvia never replied. “It’s her illness,” Ruth said in 2002. “She’s schizophrenic and psychotic and becomes extremely paranoid. She dwells on things in the past. Since I was her closest family member, I got blamed: She did what she did because of me!” Seegrist’s prison counsellor meets her every 2 weeks and notes that Sylvia takes her meds, spends time at the library, exercises a lot and tries to keep herself mentally sharp.

One of Sylvia’s motivations for the shooting was a fear that her mother was trying to have her sent back to a mental care facility. She said that she would “rather die or go to prison than go to a mental hospital.” Ruth Seegrist said she had seen ‘A Beautiful Mind’, a 2001 biographical drama about John Nash, a Princeton math professor and Nobel laureate who was also schizophrenic, like Sylvia. “I thought it was very well done,” Ruth said. “When a person is so delusional – at first he thought it was all real, but it really was in his mind.” Of her daughter, Ruth said: “I really believe she belongs in the forensic unit of a hospital, not in prison. They should be incarcerated in the forensic unit of a hospital until they get functional and stabilised.”

[patrickandthestumpies]

Every Fall Out Boy fan (and everyone) needs to know what mania is. 

Mania is part of manic depression, or bipolar disorder. It is the “up” period, and it usually described as a period of expansive/elevated/irritable mood lasting at least one week. 

According to the DSM5, three of the following symptoms must be present to the level it causes dysfunction in work/social environments or psychotic symptoms are present:

inflated self-esteem or grandiosity

decreased need for sleep (e.g., feels rested after only 3 hours of sleep)

more talkative than usual or pressure to keep talking

flight of ideas or subjective experience that thoughts are racing

distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)

increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation

excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

Psychosis can also be present, a disconnect from reality via delusions and/or auditory/visual hallucinations. 

Mania is very destructive and confusing, and can present differently in different people. There is scientific evidence behind the concept of it being neurodegenerative and getting progressively worse while damaging the brain.

For me, mania is like an intense energy firing inside my brain, making my thoughts not make sense and my impulses go out of control. It’s somewhat like a fire on every neuron, raging against the inside of my skull, reality jumping into surreality. For me, it also feels very horrible as I feel restless and agitated and confused. 

Depression is a sad reality for anyone who faces mania as well, as well as probably mixed episodes (where both manic and depressive symptoms are present).

It is usually treated with therapy and medication. Lithium, anticonvulsants, and antipsychotics (which are not just used to treat psychosis) are the main mood stabilisers. Antidepressants can cause mania and psychosis when used to treat a bipolar patient.  

Here's psychcentral’s page on mania with some more resources at the bottom including a screening test:

https://psychcentral.com/disorders/manic-episode/

And if you want to know more about bipolar, you can always ask me, and I’m sure Pete Wentz will say something more about it (since he suffers from bipolar disorder)

Kay Redfield Jamison's “An Unquiet Mind” is a personal favourite for good representation for what bipolar disorder looks like, and I would recommend everyone ever to read it.

[pharmaphorumuk]

Getting the industry on board with digital medicine

In an exclusive interview, Andrew Thompson, co-founder of Proteus Digital Health, tells us how his company is convincing the industry to embrace digital medicine.

Abilify MyCite made history in November 2017 when it became the first ‘digital medicine’ approved by the FDA.

The product is a combination of Otsuka’s antipsychotic medicine aripiprazole with an Ingestible Event Marker (IEM), or ingestible sensor, developed by Proteus Digital Health. The sensor is embedded in the pill, and when it is ingested the MyCite patch, also developed by Proteus, detects and records the date and time of the ingestion, as well as certain physiological data such as activity level. It then communicates this to the companion app on the patient’s mobile phone.

Abilify MyCite’s approval established Proteus as a company on the leading edge of innovation in the industry, but as is often the case for industry firsts, it has been a long road to get there.

Andrew Thompson, Proteus’ co-founder, president and CEO, says the idea spawned from his own frustrations with how both pharma and tech companies were tackling problems with adherence.

“Part of what you do if you’re a healthcare entrepreneur is you listen to the science and try and figure out where the gaps are,” he says. “I was struck by the fact that there was very little consensus about how you most appropriately use medications to get to good patient outcomes, and that it was very hard to tell what drugs patients were using.”

Thompson says that the company is built on a series of deep observations about how digital transformation occurs. “Transformation in digital categories occurs based on high value, high frequency, low friction transactions that take consumers from the physical to the digital space.

“If you ask the question ‘What is one of the most common things that somebody who’s sick is supposed to do every day?’, the answer is take their daily pill. If you turn that into a digital event where information about what you swallow and how your body responds is on your mobile phone, and by extension on other people’s mobile phones, then they will go and look at which point they are interacting with their healthcare on their mobile. That’s not the end, that’s the beginning.”

The risk of any innovation like Proteus’ sensor is that if pharma companies and other stakeholders don’t get it, they will see it as an additional cost without seeing the benefit – and early on in the ingestible sensor’s development Proteus identified several hurdles they had to overcome to sell the idea.

Thompson explains how the company looked to demonstrate the sensor’s value proposition: “Non adherence to medical therapy is not a localised problem. It’s one that’s true across all demographics, all countries, all cultures, all ages, all people. It’s a universal problem.

“If you have a universal problem, then you potentially have a universal solution. What we know about human beings is that they do much better in systems in which there is a measurement, feedback and simple behavioural cues.”

Mental health was one of the first areas Proteus looked to work in because it was one of the areas where their technology could quickly demonstrate a huge impact.

“The solution’s applicability into pharmacotherapy begins with looking for the areas where the need for adherence is most acute,” Thompson explains. “A mental health patient might tell you it’s okay if they forget to take their antibiotic, but they’re in real trouble if they forget to take their antipsychotic. Once off the drug regimen that helps stabilise their lives, a mental health patient can begin to think they no longer need their medication. And, of course, if they don’t take their medicines they can end up with serious consequences.”

Proteus has also demonstrated efficacy in other areas like hepatitis C – where more than half of patients who are offered treatment with curative drugs are denied access on the basis that there might be an adherence risk – and cardiovascular disease.

“We’ve done a study in the cardiovascular space where we took patients who’d been on a drug for high blood pressure, high blood sugar and high lipids but had failed every one of those endpoints. When we put them onto digital medicines in a randomised study, 98% of the patients reached their blood pressure goal within 90 days, and at the same time they had a massive drop in their lipids and a drop in their blood sugar.”

From there, the second hurdle was to make sure that products like this can be approved in ways that didn’t involve excessive additional cost for pharma companies.

“We negotiated a pathway in the US with the FDA that has now been replicated in Europe and China, in which essentially if you combine an approved drug with our approved devices, then you can combine the label on the drug and the label on the device and you don’t need to do any further clinical studies to litigate efficacy or safety.”

The last hurdle was figuring out the business model for the product.

“If there’s value and you can release that value through a regulatory pathway that doesn’t cost too much money, how are you going to be able to sell that product and justify the investment?” says Thompson. “This is where it becomes really important to understand that what we’re doing is transitioning from a product model to a data and service model.

“What we say to customers is, you’re paying for a lot of medicines that don’t get taken. Here’s our value proposition – pay for medicines that are used and used appropriately, and if they’re not used, misused or abused, pay nothing.”

There’s no such thing as healthcare

Digital medicines like Abilify MyCite could be a paradigm shift in many ways, but Thompson says that implementing these kinds of technologies requires more than a change in health systems – it requires a recognition that we don’t have a health system at all.

“What we have is a ‘Sick Care’ system,” he explains, “a system that was designed to deal with acute disease and trauma, that in the last century was using the best technologies we had at the time – buildings where you plug into electricity, people with knowledge in their heads and products that are designed to be safe in everybody and work in somebody, because mass standardisation is a great achievement of the industrial era.”

“That works extremely well for the purpose for which it was designed, so well in fact that we now all live a lot longer. Life expectancy has doubled over the last century. But it’s really important that we don’t begin the conversation about building healthcare by imagining that we can do it by transforming Sick Care. We actually have to build something new.”

“The challenges today are not acute disease and trauma, they are chronic conditions. Just like we built Sick Care with the best technology that was available in the 20th century, we need to build healthcare with the best available in the 21st. The building where you plug in is magnified and made more powerful by a mobile device where you log on, and people with knowledge in their heads are made more productive by software and services with intelligence in the cloud. Products that were designed to be safe in everybody and work in somebody become services that are tailored to you, your genes, your lifestyle and your behaviour. That is digital health. It’s not about transforming Sick Care, it’s about building healthcare.”

When asked if the industry is being bold enough in digital health, Thompson’s answer is an affirmative ‘No’.

“If you look at the technology industry, they’ve created a miracle of communication for everyone everywhere. Most people in the world who own a mobile phone make less than $10 a day.”

“This is not an accident. It’s a business strategy. Last time I looked, there were five or six tech companies that are going to be worth a trillion dollars – three times as much as any of the world’s largest healthcare companies.

“Now let’s look at healthcare – we don’t have healthcare for everyone everywhere. We have healthcare for the richest people in the richest countries in the world, and that’s also not an accident. It’s a business strategy and it’s deeply wrong. No, we are not being bold enough because we need to have a very different ethos in our industry. We need to be like tech, we need to be committed to serving everyone everywhere.”

Whatever shape the industry’s transformation will take, it is clear that digital health is not going to stop upending the sector anytime soon, and companies like Proteus will be the ones to watch as health enters a new era.

About the interviewee

Andrew Thompson is co-founder, president and chief executive officer of Proteus Digital Health. He is a World Economic Forum Advisor, and a member of the selection committee for the World Economic Forum Technology Pioneers. He also serves on the California Governor’s Health IT Security Advisory Board and is a member of the Fortune CEO initiative and Wall Street Journal’s CEO Advisory Counsel. Thompson has been active as a venture capital investor and entrepreneur in Silicon Valley for 30 years, completing several Fortune 100 M&A transactions and IPOs, and is a named author on 51 issued patents.

The post Getting the industry on board with digital medicine appeared first on Pharmaphorum.

from Pharmaphorum https://pharmaphorum.com/views-analysis-digital/getting-the-industry-on-board-with-digital-medicine/

[scriptshrink]

I'm writing an apocalypse. Society essentially ends. One of my protagonists is bipolar (as I am). Part of his struggle for survival involves trying to get hold of medication. Personally, I am not sure how I'd do at world's end if I was also unmedicated. My personal experience does not really include extreme tragedy and threats to my survival. So the question: do people in life-threatening situations find that their illness sort of takes a backseat for a while, or do they make things worse?

(part 2) Would having bipolar disorder make my character more susceptible to PTSD or other issues? Would his learned coping skills or meds kind of insulate him? What are some withdrawal risks if he can’t get the meds?

The Scriptshrink consultants answer after the jump!

Charlie 

I’m gonna answer the questions about meds specifically because I have a lifetime of experience with them and I used to study pharmacology, but I’ll leave everything else out because it’s a bit of a tricky question for me to answer.

Theoretically, the medication could have somewhat of a “numbing” effect (common for mood stabilisers) which would make it less likely for PTSD to develop, but I don’t know if this is a thing that’s actually been studied. I know that my memories from when I was on my first medication are vague and distant, as I felt like there was somewhat of a disconnect between my feelings, thoughts and my actions - but I don’t know if this would be enough of a disconnect to stop PTSD from developing, should I have been exposed to anything traumatic in that time.��Also, traumatic memories are processed differently from nontraumatic memories, so its a bit up in the air. 

 As for withdrawal, it depends on the medication, a few different classes of meds are used for bipolar and all have different side effects and withdrawal symptoms. It also depends on the dosage, whether the person is tapering or going cold turkey, and the individuals physiology. We’ll assume, given the scenario, it’s cold turkey. 

So, the common withdrawal symptoms from lithium include: anxiety, headaches, nausea and emotional dysregulation (very rapid, uncontrolled mood swings). Lithium is pretty forgiving in terms of withdrawal compared to other drugs, which I’ll get into. 

Anticonvulsant drugs (valproate, lamotrigine, carbamazepine etc.)  are a lot less forgiving in terms of withdrawal. Mild symptoms include tremors, irritability, dizziness and vertigo. I came off of a drug of this class and I was so dizzy I nearly fell, multiple times. This was at a fairly low dosage too. The main risk with discontinuing anticonvulsant medications is that it can cause seizures. It’s not super common, but it is a risk.

Finally - antipsychotics. These include aripiprazole (abilify), olanzapine (zyprexa) and quetiapine (seroquel) among loads more.  I’ve luckily not been through antipsychotic withdrawal but it’s apparently a special kind of hell. Symptoms like anxiety, depression, confusion and difficulty concentrating are common. Nausea, loss of appetite and diarrhea are also not unusual. It’s also possible for someone to develop psychosis, or at least start to hallucinate, when coming off of an antipsychotic even if they didn’t initially have psychosis. Sudden changes in the dosage of antipsychotics also increases the risk of neuroleptic malignant syndrome, which is really dangerous. 

As well as all these symptoms, there’s the most obvious thing - that the meds are being used to treat a disorder, and now he doesn’t have the meds. It’s common for someone to relapse (usually into mania) while going through withdrawal.

NaamahDarling

You have wiggle room. You can decide on the severity of his bipolar, how well he responds to medication, how well he handles adversity. I would totally believe it if a bipolar character melted down under life-threatening circumstances.  I would also totally believe it if they buckled down and handled it as long as there were consequences.I’ve had withdrawal from Seroquel and it was, indeed, a circle of hell. Tremors, severe insomnia, several episodes of depersonalization/ dissociation.  The worst was the random twitching every minute or so.  Hypnic jerks were terrible.  

Basically, if you WANT withdrawal to be a factor, it sure as heck can be.  You might also consult @scriptpharmacist​ for details on withdrawal from specific drugs.Immediate catastrophes absolutely can drive everything else to the back of your mind. It might be short term, though - days, a couple of weeks at most. And after that, as the acute stress fades, it starts to take its toll, and you can wind up worse than before, needing more intensive treatment. 

Even non-mentally-ill people react to life-threatening situations in different ways. Also, some react really well to, say, a medical emergency (broken leg, kidney stone) but not so much to a natural disaster (tornado, house fire, earthquake, etc.). So there’s a lot of variation within healthy populations.  And even totally healthy people may navigate a disaster and then, once the danger has passed, totally break down.  That’s normal, even for healthy folks, and mentally ill/bipolar folks are the same.How well your character handles pressure is more of a general character trait that you can decide on than one derived from whatever mental illnesses he might have.

Also, bipolar disorder is frequently comorbid (happening together) with a lot of other psych issues.  It would not be unusual at all for your character to have/be more susceptible to PTSD. 

Learned coping skills can help under pressure, but those take effort to deploy and as things become more stressful, coping strategies become harder to implement and may not work quite as well.  It’s rough even if you’re good at it. 

I have a procedure mapped out for panic attacks and even a severe attack is always going to be of limited duration.  Dealing with something like the bipolar depression is harder because it’s not limited in duration.  I have strategies, but it’s harder to take on something so large. 

I would kinda expect a character like yours to have some self-care stuff he’s found that he CAN do, and for those things to be VERY important to him.Trying to get meds even TODAY when they are can be harrowing. My Seroquel generic is HARD to get, but withdrawal from it is AWFUL, so I don’t have a choice. I HAVE to fight to get it. Finding my right generic Wellbutrin was so hard and I do well enough without it, that I just went off it because the stress of fighting to get it was so absolutely atrocious.  

So his meds would have to work WELL and have manageable discontinuation effects to make it worth trying that hard to get them.Readers who HAVE mental illnesses might appreciate a nod in the direction of “he’s tried other meds, and it didn’t work out, it’s THIS ONE that is SO HELPFUL he will PUNCH MUTANT ALLIGATORS to get it!” Trying several meds is common, and it’s also relatable and would be an easy detail to slip in. You don’t have to name them.Check also to see if it’s a drug you have to work up to a full dose of (like Lamictal), so you know whether it’s realistic to have him go right back to taking it like nothing happened.

Disclaimer 

[prevsapphism]

igraine + meltdowns!! important to those who interact w them.

so since igraine has sensory processing issues and possibly aspergers, shes prone to meltdowns. not extraordinarily so, the way they r with ocd breakdowns but. they can have them.

the order of igraines Upset Breakdowns goes like this: panic attacks / ocd breakdowns  ⇏ sensory meltdowns ⇏ mania / depression episodes.

( panic attacks and ocd meltdowns are lumped into one because her ocd breakdowns often trigger panic attacks and vice versa. )

( igraines mania / depression episodes come last because she takes antipsychotics and mood stabilisers, so they dont happen as often as they used to. )

im not sure what Precisely triggers igraines sensory meltdowns, but here r some causes for now:

ppl asking too much of her when shes in pain to begin with. if a bunch of people r Coming At Them whilst theyre training or shes doing other stuff w their shieldmaidens, or on the battlefield ( gods forbid ) or if caesar or ly or whoever is like ‘igraine we need more glue sticks’ ‘igraine someone spilled paint all over the table’ ‘igraine all the chalk is broken’ etc etc AND her fibroids or joints r giving them grief, theyll have a sensory meltdown because of all the input shes receiving at the same time theyre gritting her teeth thru her physical illnesses. 

its too much for her to push thru physical pain and attend to ppl who need stuff from them rapid-fire w no breaks at the same time.

having to work with a medium they arent used to or dont like. for example, igraine doesnt like watercolours because theyre harder to control than her Trusted Acrylics and oil paints ( more likely to run and bleed etc, ) first of all, and also because they dont get the texture, more concrete blending and colour payoff they get out of their trusted acrylics and oil paints. if igraine is forced to use watercolours or other stuff she doesnt like, ( like if the tiny picassos r working w them and florian isnt around to supervise instead ) igraine will have a sensory meltdown because she HATES that medium and theres nothing they can do to stop.

shes also not fond of crayons or that thick grey clay elementary and middle schools use for making shitty clay pots and whatnot, for the record.

repeatedly overshadowing igraine in a situation where she feels like they shld b leading. for example, if youre teaching someone something igraine is good at, fine. let somebody else have a turn. if igraine points out something that she does in that area or gives you a tip / corrects you or something and they fix whatever they were doing wrong or even just acknowledge igraines help, fine. if you ignore them when they give you a tip or try to help you, or worse, ignore them when she tries to intervene and fix something you messed up, or worst of all, if igraine is teaching or leading something igraine is good at and they keep interrupting them and acting like you Run The Show  Issue Time. sensory meltdown because Why Arent You Listening To Me!!!!!!!!! You Shld B Listening To Me Because I Know What Im Doing!!!!!!! Im Trying To Help You!!!!!!!! the fear of uncertainty in following the lead of or helping out with someone else, she panics, because That Is Not Right, leading to said sensory meltdown.

when igraine is having a sensory meltdown, there will b lots of yelling and crying involved.

now, igraines panic attacks are like that too, but the difference between her meltdowns and their panic attacks are in volume. igraine is usually in way more distress in a sensory meltdown than she is in a panic attack-- or at least sensory meltdowns are more of an intense kind of distress, as opposed to a harrowing panic attack.

you will Know igraine is having a sensory meltdown because when igraine is yelling, you can hear them up and down the block. ( thank you, lung capacity that comes from being 6′. )

more importantly, she will b Extra Warm or very hot to the touch, because she heats up more when theyre distressed. ( a la young e/m/erald c/it/y witches and how they vibrate and hum when theyre scared, ) so its. probably not a good idea to hug them, as much as many of you probably want to.

if you touch any part of igraine thats exposed ( ie not covered by clothing ) when shes having a meltdown, they will literally burn you. she doesnt WANT to, mind you, but they cant help it. her body is literally out of her control during these moments.

it wont like, melt your skin off, but itll hurt quite a bit and appear to b a nasty sunburn-- peeling skin, redness, stinging afterward, you get the idea. can b fixed w common sunburn remedies or go away on its own after a coupla hours.

 covered parts of igraine will just b rlly warm ; kind of like holding a cup of tea after its steeped a few minutes.

im not sure what other actions igraine does during meltdowns, but they will also probably hit themself here, too ; because their body is having the Fight or Flight Response To End All Fight Or Flight Responses, their body is out of her control in those moments, and she doesnt wna hit anybody else. 

shell also probably go somewhere secluded or with less ppl if theyre in public when she feels the onset.

ill probably reblog this l8r w more canons but here this is for now!

[bpd-ptsd]

does bpd need any pills? for example in bipolar disorder is necessary to take pills, but i don't know in bpd. if its necessary (or its a option, not everyone with bpd has to take it) what pills and for which sympthoms are?

There are no specific medications for BPD, so combinations are often used. Antidepressants can help with the feelings of emptiness and the anxiety, mood stabilisers help with the mood swings, antipsychotics can help with paranoia and some may help with mood swings. It depends on someone's personal symptoms, and meds don't work for everyone. There is no "requirement" for meds with any mental illness, but some people who are at greater risk may have no choice but to be on them - e.g. in hospital I had no choice, but now I do. Meds help me so I am going to kerp taking them, but everyone's experience is different and it's always important to get a professional opinion.