Bipolar 1 Disorder

I got into my first car accident Friday morning. The person ran into my vehicle, It all happened so fast. Thank goodness no one was hurt. My car is severely damaged. I have no way to get to work, grocery shop or getting to my doctor's appointments. Quite frankly I could use the break, but I really miss having my own car and being independent.

My family is trying to convince me that the accident wasn't my fault and that the car is replaceable. They have repeatedly expressed how grateful they are that I am alive. A small part of me is a little relieved to hear them say this, but their words aren't touching my heart the way it should I'm afraid.

The incident has thrown me into depression and bouts of anxiety. I'm restless and embarrassed, sorry and disappointed and feeling guilty for some reason. I don't want to sleep or dream about the accident. I just want to be by myself to process what happened. I also feel like I can't do anything right. I should've been more careful that day. I'm also very very numb, I mean I feel like I should be hysterical or something given the circumstances right? I've had no urge to shed tears and that bothers me.

I never have the correct emotions or feelings for what goes on in my life. Depression has made me very numb over the years, it's like a callous has grown over my heart. All I feel is the symptoms that my bipolar disorder gives me, the anger, the paranoia, the anxiety, the depression and more.

I never feel right or comfortable. The accident keeps replaying in my mind over and over again, I can't help it. I'm not sure if this is trauma or something but I know it will take time to recover from this terrible ordeal. #Bipolar1 #Anxiety #Trauma #Depression #numb

I got into my first car accident Friday morning. The person ran into my vehicle, It all happened so fast. Thank goodness no one was hurt. My car is severely damaged. I have no way to get to work, grocery shop or getting to my doctor's appointments. Quite frankly I could use the break, but I really miss having my own car and being independent.

My family is trying to convince me that the accident wasn't my fault and that the car is replaceable. They have repeatedly expressed how grateful they are that I am alive. A small part of me is a little relieved to hear them say this, but their words aren't touching my heart the way it should I'm afraid.

The incident has thrown me into depression and bouts of anxiety. I'm restless and embarrassed, sorry and disappointed and feeling guilty for some reason. I don't want to sleep or dream about the accident. I just want to be by myself to process what happened. I also feel like I can't do anything right. I should've been more careful that day. I'm also very very numb, I mean I feel like I should be hysterical or something given the circumstances right? I've had no urge to shed tears and that bothers me.

I never have the correct emotions or feelings for what goes on in my life. Depression has made me very numb over the years, it's like a callous has grown over my heart. All I feel is the symptoms that my bipolar disorder gives me, the anger, the paranoia, the anxiety, the depression and more.

I never feel right or comfortable. The accident keeps replaying in my mind over and over again, I can't help it. I'm not sure if this is trauma or something but I know it will take time to recover from this terrible ordeal. #Bipolar1 #Anxiety #Trauma #Depression #numb

What is akithisia?

According to Lohr et al (2015) ‘’Akathisia is one of the most vexing problems in neuropsychiatry. Although it is one of the most common side effects of antipsychotic medications, it is often difficult to describe by patients, and is difficult to diagnose and treat by practitioners.’’ Additionally, ‘’akathisia is generally either underdiagnosed or misdiagnosed, which is a serious problem because it can lead to such adverse outcomes as poor adherence to medications, exacerbation of psychiatric symptoms, and, in some cases, aggression, violence, and suicide.’’ (Lohr et al, 2015).

‘’Akathisia is usually grouped with extrapyramidal movement disorders (ie, movement disorders that originate outside the pyramidal or corticospinal tracts and generally involve the basal ganglia). Yet, it can present as a purely subjective clinical complaint, without overt movement abnormalities.’’ (Lohr et al, 2015).

In Van Putten (1975)’s The many faces of Akathisia, it is stated that akathisia ‘’can be mistaken for an exacerbation of the original mental illness.‘’

‘’The inner agitation of akathisia is always subjectively stressful. Kalinowsky15 states that akathisia can be “more difficult to endure than any of the symptoms

for which [the patient] was originally treated” (Van Putten, 1975).

In my opinion (as someone who is not a healthcare professional), Van Putten’s article is outdated and incorrect in many respects.

However, as a patient who has experienced akathisia many times - I believe that it is worth thoroughly screening psychiatric patients for akathisia. In my own experience, clinicians often fail to recognise akathisia unless it fits within a very narrow interpretation (a patient pacing or being visibly restless/agitated). While this is certainly an indication of akathisia, it can also present in very subtle ways (whilst being excruciatingly painful).

I think that it may manifest in vastly different ways depending on how different individuals express feelings of distress. In some individuals, it may be invisible.

I believe that further research into patients’ subjective experiences of akathisia would be beneficial.

It is fairly easy to treat.

I also believe that patients taking psychiatric medication should be educated about akathisia and tardive dyskinesia. Many patients have no idea about these conditions, and therefore do not recognise symptoms as they arise. They may believe that their condition is deteriorating, without realising that there is a fairly simple solution which could alleviate some of their suffering (or a great deal of their suffering).

References:

Lohr, J. B., Eidt, C. A., Abdulrazzaq Alfaraj, A., & Soliman, M. A. (2015). The clinical challenges of akathisia. CNS Spectrums, 20(S1), 1–16. doi.org/10.1017/S1092852915000838

Van Putten, T. (1975). The many faces of Akathisia. Comprehensive Psychiatry, 16(1), 43–47. doi.org/https://doi.org/10.1016/0010-440X(75)90019-X

#MentalHealth #Schizophrenia #SchizoaffectiveDisorder #BipolarDisorder #Bipolar1 #Bipolar2 #Depression #Anxiety #Psychosis

What is akithisia?

According to Lohr et al (2015) ‘’Akathisia is one of the most vexing problems in neuropsychiatry. Although it is one of the most common side effects of antipsychotic medications, it is often difficult to describe by patients, and is difficult to diagnose and treat by practitioners.’’ Additionally, ‘’akathisia is generally either underdiagnosed or misdiagnosed, which is a serious problem because it can lead to such adverse outcomes as poor adherence to medications, exacerbation of psychiatric symptoms, and, in some cases, aggression, violence, and suicide.’’ (Lohr et al, 2015).

‘’Akathisia is usually grouped with extrapyramidal movement disorders (ie, movement disorders that originate outside the pyramidal or corticospinal tracts and generally involve the basal ganglia). Yet, it can present as a purely subjective clinical complaint, without overt movement abnormalities.’’ (Lohr et al, 2015).

In Van Putten (1975)’s The many faces of Akathisia, it is stated that akathisia ‘’can be mistaken for an exacerbation of the original mental illness.‘’

‘’The inner agitation of akathisia is always subjectively stressful. Kalinowsky15 states that akathisia can be “more difficult to endure than any of the symptoms

for which [the patient] was originally treated” (Van Putten, 1975).

In my opinion (as someone who is not a healthcare professional), Van Putten’s article is outdated and incorrect in many respects.

However, as a patient who has experienced akathisia many times - I believe that it is worth thoroughly screening psychiatric patients for akathisia. In my own experience, clinicians often fail to recognise akathisia unless it fits within a very narrow interpretation (a patient pacing or being visibly restless/agitated). While this is certainly an indication of akathisia, it can also present in very subtle ways (whilst being excruciatingly painful).

I think that it may manifest in vastly different ways depending on how different individuals express feelings of distress. In some individuals, it may be invisible.

I believe that further research into patients’ subjective experiences of akathisia would be beneficial.

It is fairly easy to treat.

I also believe that patients taking psychiatric medication should be educated about akathisia and tardive dyskinesia. Many patients have no idea about these conditions, and therefore do not recognise symptoms as they arise. They may believe that their condition is deteriorating, without realising that there is a fairly simple solution which could alleviate some of their suffering (or a great deal of their suffering).

References:

Lohr, J. B., Eidt, C. A., Abdulrazzaq Alfaraj, A., & Soliman, M. A. (2015). The clinical challenges of akathisia. CNS Spectrums, 20(S1), 1–16. doi.org/10.1017/S1092852915000838

Van Putten, T. (1975). The many faces of Akathisia. Comprehensive Psychiatry, 16(1), 43–47. doi.org/https://doi.org/10.1016/0010-440X(75)90019-X

#MentalHealth #Schizophrenia #SchizoaffectiveDisorder #BipolarDisorder #Bipolar1 #Bipolar2 #Depression #Anxiety #Psychosis

Anyone else feel the need to help “fix, help, or heal others because they feel like they can’t fix, help or heal themselves? #Bipolar1 #MentalHealth #BipolarDepression #Anxiety #PTSD

Anyone else feel the need to help “fix, help, or heal others because they feel like they can’t fix, help or heal themselves? #Bipolar1 #MentalHealth #BipolarDepression #Anxiety #PTSD

I haven’t been able to regulate my emotions the past couple of weeks. It’s getting worse and I don’t know what to do. I can’t see my therapist anymore because my insurance won’t pay for it and they won’t pay for medication that my doctor wants to switch me to. I’m struggling. I’m afraid of ending up in the hospital again and losing my job as a peer support specialist. I was doing so good for so long and now I’m not. I just don’t know what to do. #MentalHealth #Bipolar1 #BipolarDepression #PTSD

I haven’t been able to regulate my emotions the past couple of weeks. It’s getting worse and I don’t know what to do. I can’t see my therapist anymore because my insurance won’t pay for it and they won’t pay for medication that my doctor wants to switch me to. I’m struggling. I’m afraid of ending up in the hospital again and losing my job as a peer support specialist. I was doing so good for so long and now I’m not. I just don’t know what to do. #MentalHealth #Bipolar1 #BipolarDepression #PTSD