It’s so depressing. From the Times Online, Bullied girl ’stepped in front of train’.

A 14-year-old girl stepped in front of a train after her stepbrother confronted a classmate accused of bullying her, an inquest heard yesterday.

Kay Miller, who suffered from anorexia and a borderline personality disorder, panicked after her brother, a Welsh Guardsman, pushed the alleged bully over a wall and warned him to leave her alone…

…In a written statement her sister, Chloe, said: “I was with Kay, my stepdad and Geraint when we saw Scott Walker.

“He was in Kay’s class at school and he was saying things to her. Geraint went over and said, ‘Leave Kay alone.’ More of Scott’s friend’s came along. Scott’s sister slapped Geraint across the face. But he didn’t react. Tim told us to go home but Kay just ran away crying. She was a bit hysterical.”

God, I hate bullying. I’m so glad I’m not in junior high anymore. I’m so glad I got through it without killing myself, even though one of the bullies suggested that I should commit suicide. Yeah, like I was going to do anything that they said to do.

The inquest heard that the teenager had suffered from “borderline personality disorder” for six years. But she was tackling her problems and had lectured to more than 300 people on her eating disorder.

Also, how much do you think it helped this girl to diagnose her with borderline personality disorder at the age of eight? Would you say not at all? I would. Would you say it probably hurt her more than it helped her? I certainly would.

I’m just mentioning that this Associated Press article exists: Benefits trump risks for children taking antidepressants: study. I don’t remember reading about it before.

The authors of a new comprehensive analysis of antidepressants for children and teenagers say the benefits of treatment trump the small risk of increasing some patients’ chances of having suicidal thoughts and behaviours.

The risk they found is lower than the one the U.S. Food and Drug Administration identified in 2004, the year the agency warned the public about the drugs’ risks for children.

After the warning, U.S. youth suicides increased and some mental health experts said reluctance to try antidepressants might be to blame.

The new analysis includes data from seven studies that were not part of the FDA analysis…

The abstract of the actual journal article is here, but I don’t think I can read the whole thing for free and don’t really feel like commenting on the study results without having read it.

Anyway, more from the AP article:

“The medications are safe and effective and should be considered as an important part of treatment,” said study co-author Dr. David Brent of the University of Pittsburgh School of Medicine. “The benefits seem favourable compared to the small risk of suicidal thoughts and behaviour.”

Effective, when only Prozac worked better than placebo in depressed children under twelve, and none of the other antidepressants in the studies did? When overall, 61 per cent of depressed kids and teens in the studies improved on antidepressants and 50 per cent on placebo? (The data are better for OCD and other anxiety disorders, which I think we already knew, but I’m less personally interested in anxiety disorders.) I know that research-wise, you can define this as “effective,” but as a patient, it’s not good enough for me. So I at least appreciate that the article mentions the need for careful monitoring of the effects that antidepressants have on children and teens taking them:

Dr. John March, chief of child and adolescent psychiatry at Duke University Medical Center, welcomed the study as “the most comprehensive analysis of the data yet put together.”

He said the suicidal behaviour risk, although lower than that found by the FDA, demands that doctors and families watch for warning signs…

If I thought antidepressants were completely evil, I wouldn’t be taking them. I’ve taken them since I was a teenager. I have found them beneficial at times. I’m finding Zoloft beneficial now. But I think that even if this study is accurate and antidepressants will cause suicidality in only one out of 101 kids who take them (and I’m not saying it is accurate; I haven’t even read the thing), that’s still a cause for concern. And so do the parents of kids who are suicidal or dead because of antidepressants.

Is it wrong for me to be amused that one of the co-authors of the study has the same name as the incompetent boss from The Office? Probably, but hey, if it’s wrong, I don’t want to be right. No offense meant to Dr. Brent, I swear.

As I think I’ve mentioned before, I’ve had a few job interviews lately. Preparing for them has taken up much of my time. I’ve been pretty enthused about it. Okay, make that REALLY enthused. By which I mean that I stayed awake for over forty hours at one point last week. I’m not worried, though. Maybe I have ideas for a bunch of new projects and I REALLY want to go shopping and one night I purposely didn’t take my pills just ’cause I didn’t wanna, but I’ve been sleeping okay since that forty-hour stretch of wakefulness and I haven’t done anything stupid yet.

Since I recently spent eight years being a mentally ill university student, and also since I’m a human being who cares about other human beings, of course I’m deeply troubled by the Virginia Tech shootings. I don’t know if I’ll have any meaningful commentary on it in the future, and I don’t have any now except to say that my thoughts and prayers go out to those students and their families and friends.

There’s a post at Furious Seasons today commenting on the Portland Identification and Early Referral programme in Portland, Maine and an Associated Press article about the program. My personal favourite part of the programme’s web site is the line “Mental disorders are diagnosed in the same way as asthma, diabetes and cancer.”

Ah, so mental disorders are diagnosed with a pulmonary function test? No? A blood glucose test? No? A biopsy? No? Is there any type of biological test that can conclusively prove someone’s particular psychiatric diagnosis? Again, NO.

I was in an early psychosis programme when I was nineteen. The psychiatrist I was seeing for depression when I was eighteen thought I might be schizophrenic, so she prescribed me Risperdal, only saying that it would “help my concentration” and not bothering to tell me that she thought I had schizophrenia. Six months later, she moved away and my GP referred me to the psychosis prevention programme based on whatever was in my file. The next summer, another psychiatrist I saw told me that my file said the first shrink thought I might be schizophrenic because I had told her that I was bullied in junior high school and sometimes I still worried that people might not like me. That was the basis upon which she had prescribed me an antipsychotic: she somehow mistook my occasional worries caused by past trauma for delusional paranoia. The best part is that the bullying was something I had mainly worked through and it bothered me so little at that point in my life that I didn’t even remember mentioning it to her. It was just something I’d said in passing.

During the psychosis prevention programme itself, I saw a psychiatrist and a psychiatric nurse and talked to them about my depression. I knew the programme had something to do with psychosis, but didn’t know why I was in it. Nobody told me that my previous psychiatrist thought I was psychotic. Nobody told me I wasn’t psychotic. Nobody told me they thought I might become psychotic. Nobody provided me with any education about psychotic disorders. Nobody thought they should take me off my Risperdal, so I stayed on it (and my Zoloft, which has been nearly ever-present in my life for the past eight years). I think I just quit seeing the psychiatrist and the psychiatric nurse on my own without them referring me elsewhere; I think my psychologist eventually referred me to my next shrink.

So I wound up in a psychosis prevention programme because I made an offhand remark about sometimes worrying that people might not like me. Even before I was in the programme, I wound up on an atypical antipsychotic because of that same remark. I was not schizophrenic then, and I’m not now, although I was tentatively diagnosed as such at the time. I was not psychotic then, nor was I showing any signs of psychosis. I didn’t get psychotic until years later. My worst psychotic episode was when I’d been off all of my medications for months, but I’ve been more mildly psychotic while on antipsychotics, too. I was misdiagnosed, unnecessarily prescribed heavy-duty medications, and kept in the dark about everything. I don’t believe AAPs caused my eventual psychosis (although such a thing is not impossible), but I sure wish I hadn’t been taking drugs with such serious side effects for years before there was ever any real sign that I might need them. In the long run, being prescribed antipsychotics at eighteen didn’t stop me from getting psychotic at twenty-one or twenty-two. I’ve also been off AAPs for over a year and a half without having any serious episodes of psychosis in that time.

Years later, I reread some old journal entries from the three weeks I was taking Zoloft but hadn’t yet started taking Risperdal. I seem pretty damn hypomanic in them, which I didn’t realize at the time. Although my behaviour shortly before being prescribed Risperdal wasn’t entirely normal, it appears that the only rationale for the prescription that my psychiatrist actually bothered to write down was that one comment I had made. Either that was her entire basis for considering me a possible schizophrenic, or she mistook my hypomania for schizophrenia and did a really sloppy job documenting it.

P.S. I should have knocked on wood while I was writing yesterday’s post. I didn’t sleep very well last night.

In the past few days, I’ve rediscovered what it feels like to get a lot of sleep. I’ve always had trouble sleeping, and although I’ve had the type of insomnia where you keep waking up in the middle of the night and the type where you wake up really early in the morning although you’re tired, usually I have sleep-onset insomnia, which means that it takes me hours after I’ve gone to bed to actually fall asleep. When I was a small child, I usually wanted to get up around 4 a.m. because I felt ready to start my day at that point (my parents did not think this was a good idea), but at some point in elementary school, I started having problems falling asleep.

The insomnia comes and goes, and it’s been present again for the past few months, but I haven’t found it very bothersome, partly because I’ve had much worse trouble sleeping at other times, and partly because I know that my chronic exhaustion and hypersomnia while on Topamax and Zyprexa were a lot harder on me than mild to moderate insomnia is.

The past few days I’ve slept considerably later than usual and I really haven’t wanted to get out of bed. I know it was a holiday weekend, but still, I slept a lot. Usually, not wanting to get out of bed means I’m depressed, but my mood was fine, so I only wondered very briefly if I might be getting depressed before dismissing that thought. Then I wondered if maybe I was anxious about the job interviews I have coming up and trying to avoid preparing for them… but I have been preparing for them when I do get up, and I don’t feel unreasonably nervous about them. (I’m allowed to be a little bit nervous. They are job interviews, after all.) My interview prep and increased sleep have also left me with little time to blog lately.

My conclusion: I am just enjoying this rare joy of eight, nine, or ten hours of sleep per night to the fullest, because who knows when it’ll happen again?

Holy crap, this is a boring post. Maybe it’ll have a soporific effect on someone else, though, and do some good that way.

Okay, there are multiple problems with mood charts. Yesterday, the bipolar chicks blogging pointed out how inadequate mood charts are for rapid cyclers, or even just for trying to accurately explain how you feel. The post is funny because it’s true.

Lately I’ve been noticing another problem with mood charts: The times it might be most useful to keep them tend to be the times that you just say, “Screw it,” and don’t bother filling anything out. You’re too depressed to think a mood chart could be of any use, or you’re too depressed to hold a freakin’ pen or open your mood chart file on the computer, or you’re too scattered to have any idea what day it is, or you can’t remember yesterday, or you can’t remember that you even keep a mood chart, or you think that the FBI and your boss are monitoring your mood chart because it’s really a secret code, or you feel so good you don’t know why you ever thought you needed a mood chart in the first place.

To be fair, I guess this isn’t so much a problem with mood charts as it is with mood disorders themselves. Maybe it wouldn’t even be so much of a problem if I had a little more self-discipline. I usually keep a mood chart at Mood Tracker. But sometimes, for whatever reason, I just can’t be bothered to.

I saw a new GP today. Her practice isn’t actually in my city, but it’s much closer to it than the GP I was seeing before that. No, I can’t find a family doctor in my city who’s taking new patients. There are none.

I really like her. The written medical office policy there states, “We will treat everyone with respect.” I thought, How nice that it says that. If they mean it, it’ll be even nicer. I think they do.

Although I also liked the doctor I was going to previously, it’s so much more convenient to find someone closer to where I live. She is also going to refer me to a psychiatrist in town. Since I trust her, I am actually hopeful that this psychiatrist will listen to me and treat me with respect instead of contempt. I had some very bad luck with psychiatrists last year and I had been finding it hard to be hopeful about these things.

Man, it’s so nice when somebody actually listens to what you have to say. Seriously, how hard is it to listen, and why do so few people do it? Why do so many psychiatrists not bother to take the time to listen to what you are actually saying, and instead make assumptions about what they think you’re thinking?

For the most part, I feel lucky today. Grateful and all of that. I don’t know if I can actually see a psychiatrist who doesn’t work in the hospital, though. I have no health plan, I don’t know if my boyfriend’s health plan will cover this, and I do know that I can’t afford to pay out-of-pocket. Sigh. We’ll see what happens, I guess.

Currently I take 50 mg of Zoloft and 500 mg of Epival (that’s Depakote to those of you not in Canada) per day. Actually, I have very little money and no drug plan and take generics rather than brand name drugs, but it’s easier to say “Zoloft” and “Epival” than “sertraline hydrochloride” and “divalproex sodium.” This is the least amount of medication I’ve been on in eight years, barring the times when I’d decide I’d be much better without the drugs and would stop taking them all.

I used to take 200 mg of Zoloft a day, not 50 mg. I was on antipsychotics for about six years. For about a year and a half, I took an antidepressant, a mood stabilizer, an antipsychotic, and an antianxiety med every day, some of them multiple times a day. I haven’t been on a lot of different medications (only eight) because usually when something didn’t work, my doctors would just increase my dosage rather than try something new.

The side effects from all these drugs were bad, particularly from Dope-a-max Topamax and the antipsychotics. I was lucky enough to be one of the few people who didn’t gain any weight from antipsychotics, but the pills made me completely exhausted every day for years. That is no way to live your life. So a few times I stopped taking my pills, things would go all right for a brief period, and then the really bad episodes would come. It’s not as if the medication ever really stopped my mood swings completely, but at least it made me less likely to be severely suicidal or psychotically manic.

For a long time, I thought, as a lot of people think, that my only choices were being out of control or being a zombie. But these low dosages of medication are actually helping me without making me tired and confused all the time. Five hundred milligrams of Epival isn’t even supposed to be effective for bipolar disorder, but it’s helping. I’m a bit hypomanic right now; I get that way in the spring. So far, though, it’s hypomanic in a good way, and I’m keeping a close eye on the way I’m feeling and acting. If I start feeling hypomanic in a bad way, I’ll call my family doctor and/or my therapist. I don’t have a psychiatrist right now, but that’s a post for another day, or probably several posts for several other days.

I’m not saying that drugs are all I need to stay healthy. Oh, HELL no. There are a lot of things I need to do. Plus, I’ve been taking these pills at these dosages for less than four months, so I don’t know if they’re going to keep helping me for a long time or just suddenly stop working. But for now, it’s good.

Seven years ago today, I was diagnosed with bipolar disorder. I tend to prefer the term “manic depression” to “bipolar disorder,” but when I thought up “polarcoaster” it was just too amusing and appropriate for me to ignore, due to the terribly obvious roller coaster rider imagery, and I had to do something with it. I don’t often use the word “bipolar,” but if the shoe fits, well, I might as well be a polarcoaster.

I’m apprehensive about mental health blogging again. I used to journal online about my mental health or lack thereof in the late ’90s, but I’m not sure that I had anything useful to say then, or that I will now. (What, you think that just because I wasn’t correctly diagnosed until 2000, I — and everyone around me — didn’t know in the late ’90s that something was wrong? Just kidding — I’m sure that anyone who finds this site will have had their own experiences with misdiagnoses.) Philip Dawdy discusses clinical trials and current news stories much better than I could ever hope to. All I’ve got to offer are personal stories with the details blurred, and opinions whenever I’ve got ‘em and can marshal ‘em into relatively coherent sentences and paragraphs.

I’m the kind of person who gets really affected by anniversaries. April 3 is not only the anniversary of my diagnosis, it’s also the anniversary of one of my most spectacular breakdowns. No, these two things didn’t happen in the same year. This doesn’t mean, however, that I sit around in the dark, wallowing in misery, on anniversaries of bad days. I remember them, though, and today I want to do something to commemorate this one (these two?). So I set this blog up tonight even though I don’t have an important idea for a post and even though I don’t have any time to work on the site’s design in the near future, which irks me because I love web design and this place will probably be dull and generic for ages.

One way to let you know a little bit about me, quickly, without actually telling you anything, is to mention that I loved Seaneen’s post yesterday because I could relate to so much of it. I might as well have said a big “Me, too” to the entire entry.