Designated Worry Time Part 2

The other part of Designated Worry Time (DWT) is to notice when you are worrying, and delay worry to your next DWT. You can think about the topics of your worry, as long as you are planning or problem-solving and not just worrying. When you are worrying, first validate, and then delay. It might look something like this: "Oh, there is worry [noticing]. I can absolutely worry about this [validate], and I've set aside time to do so. I'll worry about this at 6:15 in the evening [delay]." Or if you've had your DWT already today, you can delay it till tomorrow. You can repeat these steps as often as needed, even if just minutes apart.

DWT was initially designed for people with chronic worry (called generalized anxiety disorder). However, it can also be used if you only tend to worry at one time of day. It usually happens when going to sleep or the middle of the night. Since we often are busy during the day, we tend not to think of our worries until getting into bed when there is less mental activity. This is when the mind often wants to run rampant, but we can remind ourselves that we'll give our mind the opportunity to worry tomorrow.

Although developed specifically for worry, you can use DWT for non-worry mental activity that interferes with our quality of life. For example, if planning, problem solving, or fantasizing become overwhelming, you can set aside time to have "designated planning/problem solving/fantasizing time."

Just a note. There is a difference between worrying and ruminating. Worry is about the future; ruminating is about the past. While DWT leads to satiation/habituation, ruminating begets more ruminating. Do NOT use this strategy to ruminate about the past. It's okay to think about a past event, but then focus on the future consequences, don't replay the past even again and again. If after several days of DWT you feel much worse, there's a good chance your are ruminating.

DWT is most effective when practiced daily over a period of time (weeks, not just days). Some people who benefit from DWT can move on to using it only as needed, but when you start, try to do it daily, even if you aren't particularly worried on a given day.

Source: Alisha L Brosse, PhD LLC (www.bouldercbt.com)

Designated Worry Time

In my last blog, I wrote that I had a mole removed to see it was melanoma. I got a call from my dermatologist that it had atypical cells, but wasn't skin cancer. I was relieved and had been trying to remain calm about the whole thing as best I could. I don't know if this is due to the bipolar disorder, but whenever I get stressed, it immediately effects my sleep. I have trouble falling asleep, and then I wake up several times throughout the night. I usually wake up early and can't go back to sleep. I try my best not to get stressed, but by my nature I'm a worrier.

So, it was interesting when the moderator of our bipolar support group, Alicia Brosse, handed out a sheet about worrying. It's called Designated Worry Time (DWT), and with this process, you set aside time one or two times each day to worry. Here's how it works.

In DWT, you "worry to death" one worry before moving on to the next, rather than jumping from one worry to another. This complete immersion into your worries generally leads to habituation - the anxiety you feel is likely to peak and then decline during your DWT, and after practicing DWT for several days, anxiety may even be replaced with boredom.This helps limit worry to one part of the day so that it doesn't interrupt other times such as at night when you are trying to fall asleep.

Part 1: Designate Worry Time

1. Pick 1-2 times a day and dedicate 10 minute to worrying.
2. Set a timer for 10 minutes. During your DWT, JUST worry. Do not problem-solve, plan or try to reassure yourself.
3. Ask yourself what you are worried about. Really worry about what comes to mind. Stick with it. Ask yourself  "what about this worries me most? What's the worst that can happen?" Imagine the worst possible outcome. Before moving on to the next worry, ask yourself if there are any other concerns related to this worry. If not, you can move on to another worry. Repeat this step until the end of your DWT.
4. If you run out of things about which to worry before the timer goes off, repeat the worries you already worried to death. It's important to keep at it for the entire 10 minute period.
5. At the end of your DWT, you may want to take a few ddep breaths, paying attention to each breath, and then shift your focus to an activity in the present moment (e.g., make dinner, engage in conversation, do some work.

I'll finish the DWT steps next blog, but this can get you started if you want to give Designated Worry Time a try.

Source: Alicia L. Brosse, PhD LLC (www.bouldercbt.com)

Melanoma and Fear

Over the past 30 years, I've had dozens of funky looking moles cut off of my body. Some have been atypical, but none were melanoma. I have so many moles, that I think I have a mole factory in my body that generates the little brown buggers; sometimes new ones show up daily. So, I went to my dermatologist, Dr. Isabell Zhu, this morning for a check-up. I had a mole that looked irregular and wanted her to look at it. It's been a few months since I saw her last, and I decided that going every six months instead of every year would be better for me. She did a full body scan, and the mole I thought was weird she said was fine, but another mole had irregular borders, so she shaved it off so that it could be biopsied.

According to the American Melanoma Foundation, the  ABCD's to look for signs of melanoma are:

A for Asymmetry
One half is different than the other half.

B for Border Irregularity
The edges are notched, uneven, or blurred.

C for Color
The color is uneven. Shades of brown, tan,
and black are present.

D for Diameter
Diameter is greater than 6 millimeters

As per the American Melanoma Foundation, melanoma is the fifth most common cancer in men, and the sixth most common in women. In 2005, at current rates, one in 34 Americans has a lifetime risk of developing melanoma. More than 73% of skin cancer deaths are from melanoma.

With these kinds of statistics, I usually get very uptight when she finds a mole that she thinks is suspicious and begin to engage in catastrophic thinking. I worry that I'll  die from melanoma. Once I start thinking fearful things, the ideas accelerate and like monkeys swinging vine to vine, the scary thoughts connect to one another and lead me in a downward spiral.  Fear rips through all levels of consciousness and my gut hurts so much that I don't want to eat. The antipsychotic meds I'm on don't seem to help keep me emotionally balanced when it comes to fear.

This time though, I'm trying to stay calm about it and not grab the "dread" thread of thinking bad thoughts. Instead, I'm trying to look at this rationally. I get regular check ups, so even if I do have melanoma, hopefully it will be caught early and then it is highly treatable. When melanoma spreads to other organs, that's when it can become deadly. In my bipolar support group, I mentioned yesterday my fears around this, and two of the women in the 8 person group had had melanoma and are fine. So, melanoma isn't a death sentence, and I need to remember that whenever I start down the path of fear.

The Eyes Have It

Went to my opthamologist today, Dr. Kevin May. Haven't seen him in several years. My eyesight had been relatively stable for years, but I noticed my vision getting worse over the past six months...things in the distance were getting more blurry...it was harder to read road signs and such. So, I had to take my mom to see him anyway, and figured I'd have him take a look at my peepers and get me a new prescription. Sure enough, my eyesight did worsen.

We chatted a bit about the health of my eyes. They were a bit dry (he put plugs in for me a few years ago when my eyes were really dry, but they didn't help very much) and the left eye had just the slightest sign of a cataract. I'm only 49, but he said that after 40 years of age, cataracts begin to grow in everyone's eyes. I did not know that. He asked me if I was on any medications, and I told him I was on Depakote, Seroquel, and Zyprexa. He mentioned that Seroquel can cause cataracts, and I said that was a concern of mine. Though Seroquel doesn't cause cataracts in everyone, it's another reason to try to get off of the meds and manage bipolar disorder through natural means (supplements, yoga, breathing techniques etc). One day I'll start the journey towards being med free, but for now, I'm waiting till a slower time in my life to begin tapering Depakote.

Fear of the Future, Dwelling on the Past...Be Here Now!

I'm the kind of person who likes to think about the past or the future...a lot. I find it difficult to live in the moment when there is so much to worry about that might happen, or hope that the past doesn't repeat itself. It's like that for me with going off of my psychiatric meds. I think about the past and how horrible I felt when I tried to taper off of them last time, and then ponder the future and get anxious whenever I contemplate how I'm going to survive getting off the meds in the future. I'm convinced that even though I've done a ton of research on alternative ways to help go off meds with as little side-effects as possible, I'm sure I'll still have problems.

This isn't such an unfounded fear. There just isn't a lot of data out on the internet about how to come off antipsychotic meds without side effects. Psychiatrists and doctors are usually at a loss as well, often saying that their patients don't have problems coming off meds. I've mentioned The Road Back and True Hope's protocol in other posts, but many of the people that used their supplements still have withdrawals or protracted withdrawals. Benzo Buddies is another website geared toward helping people get off benzodiazepenes (common class of drugs such as Klonopin Xanax and Valium), but they don't sell supplements. I keep hoping that there will be a time in my life that I can just rest for months on end to deal with the withdrawals, but that's not realistic. It's never a good time to go off meds for me, so I'll just have to stay as calm as possible and start the process. I'm still not mentally ready yet, but I'll have to face the inevitable at some point.

Some people ask why I want to get off my meds if I am stable, and that's a good question. I am concerned about the long-term side effects of Depakote, Seroquel, and Zyprexa. They can cause liver problems, diabetes, vision problems, and a host of illnesses a mile long. Some people can take these meds for a long time and never have any complications, but many people do have side effects. I figure the longer I'm on the meds, the more likely a problem will manifest. But, if I practice my "what you think about, you bring about" philosophy, then I should focus on feeling well and be grateful for every day that I feel good. Right now, I feel fine, so I'll focus on that and not worry about the future or dwell on the past. At least that's my plan for now.

Sleeping like a Baby for Now

Slept well again last night without my heart racing. Yahoo. Have been listening to my Dr. Shane Sleep Easily CD as I try to relax into sleep. My gut feels better as well, so hopefully if I remain less stressed about going off of my meds, I'll be okay. But the question is, "How do I ever go off of my meds if just thinking about the process causes me to become anxious and loose sleep?"

I'll be seeing Cara Stiles, the hypnotherapist I mentioned in a previous post, in a few weeks, and I want to address this question with her. Perhaps there is a subconscious message I can hear which will help me feel calmer about stopping the Depakote. I don't know why I'm so stressed about it. I think it was the Seroquel which made me have lots of withdrawals last time, so just going off Depakote by itself should be fairly easy. At least that's my hope. The research I've done on the web about tapering off Depakote mostly says to go slowly to avoid convulsions (it's an anti seizure medication). Some people have withdrawal symptoms with Depakote, but they don't seem to be as severe as Seroquel.

I'll continue my sleep routine and supplements (taking Theanine and Seriophos as well as powdered calcium/magnesium) and enjoy the zzzz's while they last.

Sleep and Waking Up in a Panic

Just an update about how I'm doing on the higher dosage of Depakote. I went up to 1500mg ER from 500mg ER for two nights and slept better. Then I went to 1000mg ER for two nights and still slept okay. Then went back down to 500mg ER last night and slept well. I woke up when my daughter came into my room, but quickly went back to sleep, so that was good.

I don't know about anyone else, but my heart races several nights a week, right after I fall asleep, usually within 10 to 15 minutes. I often think that there is something missing from the rings on my fingers. Last night I was convinced my wedding ring was a ring that had a large round disk on it, and the disk was gone from the ring. Other nights I'm just sure a ring is gone, and I frantically feel my fingers worrying what I'll do now that I can't find my precious ring. I have several rings on my fingers in real life, but it doesn't seem to matter. I always panic that a ring is missing or it's not the right ring.

I had an intuitive healer work on this issue several years ago, and things got better for awhile. My heart stopped racing for a few months. But, now it's back and I hope that when I do some regression therapy that I might discover the root of my ring/heart racing. For this kind of wake-up doesn't help my sleep, and right now I'm focusing on self-care and trying to keep my mind and body relaxed so that a good night's sleep is easy to come by. If you have any ideas or suggestions as to my subconscious anxiety, leave or a comment or give me a ring. :)

Change in Tapering Plan

Well, I was going to try to start my pre-taper to come off of Depakote this week, but my sleep has been an issue, so I'm going to wait awhile. I told my bipolar support group that I was having trouble sleeping, and was getting stomach issues too. This is usually a sign that I'm getting manic, and they recommended I wait to taper and talk to my psychiatrist. I also told sleep specialist Dr. Shane (I mentioned him in a previous post on sleep) that I was having issues, and he also suggested I wait. So, I'm waiting!

Spoke with my psychiatrist this morning, Dr. Will Van Derveer, and he suggested I up my Depakote 500mgER for several nights and see if that helps. Then I'd back down off of it if I can get this under control. I don't like getting 5 hours of sleep a night, and when my stomach hurts, it makes it worse. I sense this is coming up because I've been stressed about going off of the Depakote. My ego doesn't want me to feel pain, so it's throwing a hissy fit that I don't taper!

I know someday I will get off of my meds, but for now, I'll just try to relax and get a good nights sleep the next few nights. Along with the Depakote, per Dr. Shane, I'm also taking the supplements Theanine and Phosphatidyl Serine, or Seriphos. Theanine helps promote calmness, and Seriphos aids in reducing cortisol levels, which can impact sleep.

Food and Bipolar Disorder

There's lots of talk about what foods to eat/not to eat when you've got a mind disorder. Personally, I believe that each person has to find what works best for them instead of following a particular diet. It's not that a specific diet, say the Paleo diet, isn't a good place to start, but to think of changing one's eating habits as an experiment.

What I've done is to take parts of diets and make them my own. I've changed my eating habits drastically over the years. In my late 20s/early 30s I didn't eat red meat. For a few years during that time, I also had to have non-fat frozen yogurt every day. I was addicted, but thought it was okay for me since it was non-fat. I was trying to model in NYC, and believed that fat would make me heavier and could lead to cancer, so I ate hardly any fat (I'd eat pizza without cheese, add water to my cereal instead of milk for example) for at least two or three years. That caught up to me and I stopped getting my period. I didn't understand until I became a nutritional counselor at a health club that the body and brain need fat for optimal functioning. That's when I learned about different kind of fats, the Omega 3s, 6s and 9s. 

Omega 3 helps reduce inflammation and is probably the most important of the three fats.Our bodies cannot make the “parent” molecule for omega-3 fatty acids, alpha linoleic acid, ALA, on its own. Therefore, omega-3 is considered an “essential” fatty acid and must be eaten. Omega-3’s are the ones most lacking in our modern diet. Nonetheless, they can be consumed in foods such as wild-caught salmon, mackerel, anchovies, walnuts, flaxseed and green leafy vegetables or supplements.

Omega 6, or linoleic acid, LA, is found abundantly in our foods and common oils, which means there is usually an imbalanced ratio of too little omega 3 and too much omega 6. Omega-9’s are found in animal fats and vegetable oils, most notably olive oil. We need all the oils for good brain health, so a diet that addresses getting enough variety of fats is probably a good place to start.

Hormones are another important area of concern for bipolar disorder. Cortisol is an essential hormone created by the adrenal glands which is often overlooked. Too high or too low cortisol levels wreak havoc with sleep and mood. I got the book The Schwarzbein Principle II, by Diana Schwarzbein, M.D. to learn about how to eat to keep the adrenals happy and helping them heal. Briefly, the Schwarzbein Square includes proteins, healthy fats, real carbohydrates and nonstarchy vegetables. Eating thee balanced meals and two snacks a day are important because this also helps keep blood sugar level, and according to the book, insulin is always impacted when our adrenals are taxed over long periods of time. Overall, her approach is to encourage you to eat to heal your adrenals, possibly gaining weight in the short term, so that you are healthier in the long run.

I have just skimmed the surface of eating to a happier brain and body. I'm sure this subject will come up again in future posts. Till then....

    

Supplements and Mental Disorders

The concept of giving the brain the nutrients it needs to function optimally is being embraced by more and more people around the world. There are many vitamin/herbal supplements that you can take for bipolar symptoms, or when tapering off of antipsychotic medications. I've scoured books and the internet over the past year seeking to find ways to help balance my physical and mental body and I thought I'd share some of the information I've come across.

First is a link to a site called Safe Harbor which offers articles focusing on alternative mental health treatments for bipolar and other mental disorders. Though some of the articles are a bit old, the information is still very relevant. I found the article by actress Margot Kidder (of Superman fame) a good beginning resource for where to start when taking supplements. The primary remedies for manic depression she takes are the amino acids tryptophan, L-taurine and the neurotransmitter GABA. She also takes L-Tyrosine and L-Glutamine  along with a combination of choline and inositol and a multivitamin in the morning. She notes, as did my psychiatrist, that tryptophan should not be taken with a serotonin reuptake inhibitor (SSRI). It can lead to serotonin syndrome, which is an excess of serotonergic activity at central nervous system (CNS) and peripheral serotonin receptors. In other words, too much serotonin can make you very sick or even be fatal. 

Another helpful blog is Nutrients Cure ADHD and Bipolar Disorder. Here I found a man, Allen Darman, who along with his son Willy, have used supplements to treat ADHD and bipolar disorder. He gives an extensive list on the page that I linked above of what they've found to keep the mind and body in harmony. Allen updated the supplements over the years, and in 2010 he listed this protocol for his son's Willy's baggies of nutrients. I'll share just a few of the nutrients he recommends, but for more details and dosages click on the protocol link:

• multivitamin and minerals
• vitamin c
• vitamin b complex
• vitamin d
• zinc
• coconut oil
• evening primrose oil
• omega 3-6-9
• cod liver oil
• Free Form Amino Acids and Necessary Co-Factors
• N-Acetyl Cysteine
• Reduced Glutathione Source
• Taurine
• Tryptophan
• Acetyl L-Carnitine
• Phosphatidyl Choline
• Alpha Lipoic Acid

As you can see, he mentioned some of the same supplements--taurine, tryptophan and choline--that Margot Kidder said helped her symptoms. At some point over the years, I have taken most of the supplements Allen and Margot have mentioned, but not all at the same time, so I don't know of their effectiveness for bipolar disorder. Because sleep is so important to handling neurological disorders, many of these supplements, such as tryptophan, taurine, and GABA are helpful for sleep as well. There is also some debate about whether we need omega 6 and 9s. There is evidence that we have plenty of 6 and 9 in our diet, and most people don't get enough omega 3, so right now I'm taking an omega 3 pill for when I start tapering Depakote (should start the switch over to the sprinkles in about a one and a half weeks).

I'll cover some books I've read and their supplement suggestions for mood disorders in an upcoming post. 


 

Sleep and Withdrawal

Yesterday I had a session with Richard Shane, PhD. in Boulder, CO. Dr. Shane specializes in sleep, and anyone who has bipolar disorder or another neurological illness probably has had sleep issues at some point in their life. Last time I tried to get off of my meds, I had wicked insomnia, so this time I'm hoping to learn a few techniques that may help me fall asleep, and get me back to sleep again when I wake up in the middle of the night.

The session focused on feeling sensations in the body. His technique, Dr. Shane's Sleep Easily® method  is simple to learn and I was a bit skeptical that it would work. I'm not having sleep problems now since I'm not tapering yet, but I listened to the CD he gave me last night to see if I could feel any difference in my sleep pattern. I'm not supposed to fall asleep listening to the CD, and I didn't, but I did feel very relaxed and went to sleep quickly once the CD had ended. I woke up at 7am, and tried using the technique to see if I could go back to sleep, but I didn't. I just relaxed.

Dr. Shane has been exclusively working with patients who have sleep issues since the early 1990s. He's confident his method works. You only see him for three sessions, and he does phone consults as well as in person. I'll write more about how the sleep easily® method is impacting my zzzzz as I do more sessions with Dr. Shane. 

Working and Having Bipolar Disorder

I met with my bipolar support group today. We take a few minutes at the beginning of each meeting to update where we're at, and if there is anything we need help with from the group. I'm still having some apprehension about going off of Depakote, but that's nothing new. There was one gentlemen who had a manic episode several years ago and hasn't worked since then. He's been applying for jobs with no luck, but finally has a possible interview. He wanted to know how he can approach the topic of his not having worked for the past several years with the employer.

Legally, you don't have to disclose that you have a mental disorder to a perspective employer, nor are they allowed to ask. But it's a tricky topic if you want to be honest about why you were out of work for so long. This man is older, so he thought that saying he had retired and now wanted to get back to work would be plausible. It wasn't far from the truth and we agreed that with this economy, some retirees find it necessary to return to the work place.

But this got me thinking about working and taking antipsychotic medicines. I'm stressing about going off of my meds, and I don't work. I am blessed to be supported financially by my husband. But what do people who have full-time jobs do when they have to switch meds or go off of their antipsychotic prescription drugs? How do they handle having withdrawal symptoms or protracted withdrawals, and still function at the office or wherever they work? It must be very challenging, and my heart goes out to anyone who has tried to change/eliminate meds and work.

I met a woman who worked at a doctor's office who was on Wellbutrin. She tried to come off and had to go back on because she became mentally unstable. I told her it probably wasn't her depressive symptoms coming back, but withdrawal symptoms. They often mimic one another, and sometimes it can be hard to tell which is which. But she had come down pretty quickly on her taper, and had no supplements to help with her symptoms. Since she had to work, she felt she had no choice but to go back on the Wellbutrin, and deal with the side effect of feeling exhausted all of the time.

Getting a job in this day and age can be arduous, but obtaining a job with bipolar disorder makes the task that much harder. I wish the man in my support group all the best, and send the same good thoughts to anyone else out there looking for work and living with a neurological illness.

Hypnotherapy and Healing

Today I visited a LCSW (Clinical Social Worker), Cara Stiles of Boulder, to talk about her helping me get to some core issues with hypnotherapy. The fears I have around tapering off of my antipsychotic meds has prompted me to look more deeply at my thought patterns and where they stem from. I myself am a certified Transpersonal hypnotherapist. Though I don't practice any more, I'm aware of the powerful impact our subconscious mind can have on our thoughts and emotions.

Cara was recommended by my psychiatrist when I asked him if he knew anyone who did hypnotherapy. She practices Heart Centered hypnotherapy from the Wellness Institute in Washington. This is a Jungian approach to hypnotherapy, where you can explore your

• shadows (a set of behaviors established to defend against psychic and/or physical assault)
• complexes (shadow behavior patterns that have become more idealized with reference to archetypal power)
• anima/animas (the opposite gendered internal "reflection of the soul")

I'm hoping that I can begin to understand my bipolar disorder and the triggers that make symptoms worse through hypnotherapy. Perhaps I can process aspects of my shadow, and get to the root of some complexes. Though I'm familiar with hypnotherapy, I haven't done any sessions in several years, not since I was diagnosed with BP disorder. So, I'm looking forward to tapping into the recesses of my mind and becoming more comfortable with my withdrawal process and facing life's challenges head on.

The Road Back and True Hope: Using Supplements to Withdraw from Psychiatric Meds- Part 2

In part 1 of this blog, I discussed several differences and similarities of The Road Back and True Hope's programs for tapering off of psychiatric medicines. Both organizations use supplements to help the brain make adjustments to the withdrawal process. Using supplements is something foreign to many psychiatrists, and a plethora of people have complained that their pdocs (psychiatrist dr.) don't acknowledge that there can be severe withdrawal symptoms from antispsychotic meds (benzodiazepines such as Valium, Xanax and Klonopin and sleeping pills are the exception, and pdocs usually recognize that there is addiction and withdrawal from these classification of drugs). 

Since many pdocs aren't familiar with the impact of supplements during tapering, people who want to use The Road Back or True Hope's micronutrients often look for support from these organizations. Both groups have people you can call or email and ask questions, though The Road Back only has one person that I know of, whereas True Hope has several counselors. Both have forums where users ask questions and discuss various topics, but there aren't many posts on The Road Back's newsgroup. True Hope's is more active and there are new posts almost every day. I believe you need to have a True Hope account to access the TH message board.

They both offer ways to track your progress, but True Hope's is on-line, whereas The Road Back has charts you can print out and fill in. Tracking symptoms, dosage of meds and supplements, and foods eaten can be very helpful in determining what is beneficial and what makes withdrawal symptoms worse.

From what I've read on the TH message boards, one area of major concern is protracted withdrawals (PW). The Road Back's website hardly addresses this topic at all. Protracted withdrawals are the continuation of withdrawal symptoms after you've stopped taking psych meds. True Hope message board posters claim that the first six months after discontinuation are the hardest with most symptoms, but that PW can continue for many months or years after that. The reason is that antipsychotic drugs are not just in the blood, but stored in our cells and tissues. Over time, the drug continues to be released from the tissues into the blood, but at varying levels. According to True Hope users, giving the brain the micronutrients it needs makes the brain healthier, so PWs arise because you are in effect giving a healthy brain drugs it does not need. This can cause the same symptoms as when tapering or create new ones.

If TH gives the brain the nutrients it needs to be healthy, that may expalin why PWs are so long with True Hope users. In other forums I've read, such as Topix Seroquel Withdrawal, the majority of people who didn't use supplements claim the worst of PW is over within 6-8 weeks, not 6 months. Yes, some people have issues with insomnia for longer periods than that, but the nausea, anxiety, and other withdrawal symptoms usually subside within two months

Overall, I'm mildly skeptical that The Road Back supplements will help me through withdrawal, but I'm going to give them a try. I'll post how I feel, and what I think might be helping, once I start tapering in a few weeks. I hope this brief overview comparing True Hope and The Road Back programs helps you if you are thinking about getting off of your psychiatric meds.

The Road Back and True Hope: Using Supplements to Withdraw from Psychiatric Meds- Part 1

Using natural supplements to treat bipolar or other mood disorders isn't a new fad. There are two organizations that I know of that have been using supplements to help maintain brain chemistry balance for over a decade: The Road Back and True Hope. I was on True Hope's regimen when I attempted to reduce my psychiatric meds over a year ago, and I'm going to use The Road Back's supplements when I taper off my Depakote in a few weeks. I thought I'd share what I feel are the similarities/differences between the two organizations so that if you are contemplating tapering off of your meds, you can see if either organization has a program that might be right for you.

Both organizations support the use of supplements, or as True Hope calls them, micornutrients, to get off psychiatric meds. However, True Hope focuses on long-term usage of their supplements, the primary one called EMPowerplus, to give the brain what it needs long after the meds are stopped. The Road Back suggests taking supplements, the main one called JNK (sold through TRB Health), for six to eight weeks after discontinuation of a med.

A major difference between the organizations is the tapering process. True Hope has a two week pre-taper where you start on their EMPowerplus and gradually increase the number of capsules taken each day. The Road Back has a one week pre-taper and you take the JNK supplement with their Relax Day and Relax Night formulas plus other supplements depending upon the meds you are withdrawing from. Both organizations recommend tapering a med approximately every two weeks.

When I tapered with True Hope, I reduced all three meds simultaneously - Depakote, Seroquel and Zyprexa. They consider Seroquel and Zyprexa red flag medications, meaning you need to taper off more slowly at a 12.5% reduction every two weeks. I did not do that because I didn't know about withdrawals at the time and the importance of going slowly. That, and the meds are only made at certain dosages. For example, I was on 5mg of Zyprexa, and the smallest amount they make is 2.5mg. That's a 50% reduction, not 12.5%. I didn't believe I'd have any problems, so I didn't think about cutting the pill, or what I would learn about later, water titration (will discuss this in more detail in an upcoming blog).

While True Hope usually recommends tapering off all meds at the same time (at least that's what my psychiatrist recommended and he is familiar with their program), The Road Back generally suggests one at a time, unless you are taking ADD, ADHD, stimulants, antidepressants and antipsychotics, which can be reduced simultaneously (alternating weeks). I was clueless when I started True Hope's program that the withdrawals would get so intense, but I believe I may have been dumping too much med from my cells too quickly. So, I'm hoping that by doing the Depakote first this time, and using different supplements from The Road Back, I can avoid a severe reaction.

This is the end of Part 1. Part 2 to follow shortly...
   

Why Get off Psychiatric Medicines?

Over 35 years ago in jr. high school, I remember our health teacher saying that 1 out of 10 people have a psychiatric illness or disorder. That's changed. According to the National Institute of Mental Health, an estimated 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year. Though not every person seeks medical treatment, that still means there are millions of Americans on some form of psychiatric medicine, whether it be antidepressants, mood stabilizers, antipsychotics or something else that is supposed to alter out-of-balance brain chemistry. And many people take more than one med to help find balance, so there are an awful lotta meds being taken by a significant percentage of the population.

If psychiatric medicines are so popular, why would someone want to get off of their meds? Well, I've read numerous bulletin boards and forums focusing on people getting off psychiatric medicines and the main reasons people want to discontinue their meds are:
1) They don't work for their specific problem - ie. it doesn't help their depression for example
2) Debilitating short-term and long-term side effects
3) They want to try something natural to control their symptoms, such as nutritional supplements and/or cognitive behavioral therapy

From what I've read, many psychiatrists are reluctant to have someone go off of their meds unless it is being replaced with a different med. I'm fortunate that my psychiatrist, Dr. Will Van Derveer of Boulder, Colorado is open to me reducing and/or completely discontinuing one or all of the three meds I'm on. He is an integrative psychiatrist, meaning that he "combines the best practices of conventional western medicine with effective healing modalities which have not fully reached acceptance in the medical mainstream, with a specific focus on patient choice in decisions about treatment." 

Coming off psychiatric meds is something someone should always discuss with their psychiatrist or other health care professional, for it can be dangerous to taper off too quickly. That's one reason I'm writing this blog, because I want to share my experiences with others. I've found folks who have gone before me who have tried to get off of their meds and done so successfully with or without their doctor's help. This has given me hope that I too can eventually be psychiatric drug-free and approach my bipolar disorder with natural alternatives.

Going off Antipsychotic meds

I've decided to start a blog as I attempt to go off my bipolar meds for the second time. The first time, over a year ago, I had lots of withdrawal symptoms despite using True Hope's supplements, and had to go back on my regular doses of Depakote, Seroquel and Zyprexa. I've spent the last 15 months trying to find out as much information as possible as to how to go off the meds without severe withdrawal symptoms. I'll cover some of the info I came across in upcoming blogs and possibly test out some of the natural alternatives myself as well.

In a week or two, after I start a 7-day pre-taper using the organization The Road Back's supplements, I'll begin tapering from the 500mg of Depakote ER I'm currently on. We (my psychiatrist and I) are switching to Depakote sprinkles in the hopes that I can weigh the sprinkles and then gradually cut back on the dosage. If I don't do that, my cuts will be 25% with each taper (the smallest dosage Depakote immediate release comes in is 125mg), and that might be too big since The Road Back suggests 5% cuts every two weeks for an anticonvulsant (Depakote falls under this category, but is also used off label as a mood stabilizer). I'm going to try a 1/8th reduction instead, and see how that goes. I can always make adjustments for a faster or slower taper as I move along.

I'm also only tapering one drug this time around, the Depakote, since The Road Back claims that you need to go off of the anticonvulsant before the antipsychotic meds (which is the category Seroquel and Zyprexa fall under). According to The Road Back, the reason why is that the antipsychotic stimulants increase the clearance time of the anticonvulsant by as much as 50%, and if you reduce these other drugs first you will go into withdrawal with the anticonvulsant, even though the anticonvulsant dosage was not reduced.

And one more thing. I plan on continuing with The Road Back supplements throughout the taper, and I'll go into more detail about those later, but I'm really hoping that they help with some of the symptoms that I experienced last time, such as:
Hot flashes/sweats, day and night
rashes
headaches
nausea
anxiety
heart palpitations at night right after going to sleep
jaw clenching
insomnia
restless leg syndrome
overall just feeling lousy

I think that the Seroquel was causing many of those symptoms, but I could be wrong. I wish I had a magic ball that would tell me what would be the best way to get off of all of my meds (something my psychiatrist is on board with), but until then, trial and error, keeping notes on my progress, and gut instinct will have to suffice.