Bipolar Opiate Addict

[weaver71]

I am a bit over a year clean from a 150-250mg of methadone habit. I learned about my bipolar at age 19, I'm 42 now. I self medicated all my life. I seem to control it okay. I feel it happening and don't start new projects and ride it out. No real consequences anymore, it seems to be mellowing with age. My question is, is it worth trying meds or lithium, are the side effects worth it? Again, it's not ruining my life like it used to, I do have trouble maintaining friendships from changes in my character. What do you think?

[persephonedemeter]

Thanks. Sounds good. Have a great Sunday!

[weaver71]

Thank you, and I will keep all info private as well. I haven't found anything local, only addiction therapy, but that helps. Thanks again.

[persephonedemeter]

I just wanted to let you know that I'm stillworking on your contacts. I didn't have time and got wiped out the last 2 days, and one of my contacts is on vacation right now. I'm still plugging away. Also, I'll be contacting you through your My  MedHelp message center. It's on your right  hand column of your My Medhelp home page. I'll alert ou through this forum post of yours and tell you Inleft the message for you. I don't want to compromise confidential information. I think you understand:)

[weaver71]

Thank you. I just came out of a depression, so this is a good time to form a plan. In the addiction forum I always encourage forming a plan before tapering or going cold turkey. I am applying that idea to bipolar. Detox and recovery is similar to any mental illness, I have to use the windows of clarity when I can. Thanks again, I want to try everything before meds. I don't wake up on a plane to Asia anymore, so I feel it's safe to take my time. I used to really get manic and make radical life changing choices. I or my wife notice it's happening and she makes all the decisions. That's how I've dealt with it so far. I'll keep searching and check in for what info you find.

[persephonedemeter]

I meant, I'll contact the therapist of the group I went to and pick her brain also regarding dual diagnosis resources for you.

[persephonedemeter]

You are very welcome and I will assist you with the names of the groups here with contact info, because I haven't been in touch with any of them for a few years. I also want to make sure I'm not leading you to a deadend, but I'm pretty confident I can get you at least 1 or 2 contacts. I'll try for all I can get and focus on East Bay so that you don't have to deal with traffic and parking. I will contact the therapist of the group, and pick her brain about Sacramento resources if one isn't available closer to you. Confidentiality is strictly maintained so no one feels threatemed, so it's possible one is under your nose and you just haven't got wind of it. I went to, because that therapy community are tight and like to know about each other. I'm in San Francisco, btw, and I've been up to Shasta to waterski at the Lake a few times. Beautiful, especially with a clear view of the Milky Way at night.  I figured something that beautiful had  a few hidden secrets under the trees and mountain outsiders didn't know much about. It's like that in Alaska and Hawaii also. As you know in SF, we don't care if we let it "all hang out."

411  should work for you since you are in Northern Ca. Just dial 411 on your phone. It's a resource phone number tfor a listing of all the services, agencies, etc that can help people. I used it to find grief support groups and suicide help lines in my area for myself and whle I was desperate.. It' should be free. I was never charged for it and if it isn't free these days the fee (charged to your bill)  will probably a $1 or less per phone call. It came about for people with vanishing phonebooks, don't have computer access, quick reference for desperate people and provides info spoken by real people on the other end, and in different languages, at least, Spanish. . Almost all the resources listed  are free or on sliding scale from nothing to whatever, but these days, it's probably good to ask. I will get back to you within a week and send you the info. Have a great day!  

[weaver71]

Thank you I'll look into those groups. My issue is resources. I live in Mount Shasta, CA. There are less people in our county than a suburb in the bay area. I'm about 5 hrs north of San Francisco and Sacramento is 3 hrs away, that could be doable. If you have a name of a group or contact info, I can start with a meeting in the Bay. For all the drugs up in these mountains, marijuana gets all the press. Opiates, benzos, methamphetamine, and mental illness are bigger issues than hippies smoking pot. Dunsmuir had a safehouse for mentally ill people, it's doors where closed and those people live alone now. Our county has the highest drug/alcohol abuse, child abuse, domestic violence, mental health issues, but we have the lowest population and the second biggest county in the state. Anyway, thanks again, maybe I can learn about those groups and try to get one started up here. 411? How does that help, if you don't have the name or location what you seek?

[persephonedemeter]

In California (and other States, but I'm in CA) there sre dual diagnosis therapy programs tailored to people suffering from mental disorders (primarily bipolar in all the spectrum) AND recovering or with drug addictions. I don't have a drug addiction, but I participated in group a couple of times with the therapist who is very good and is a recovering addict. I really got a lot out of group, and the people who had the dual diagnosis felt the experience invaluable for the understanding, relating, and wisdom shared that the general population do not know about. There's no judgment and it's very proactive. It's also not depressing. It's the best group I've ever been to, but I wasn't allowed to go more than twice because it's specifically for dual diagnosis. Oh well. You can look for one through your bipolar community meeting, from your therapist, or from the state's mental health department. If anything, they'll point you to a phone number, website or whatever for your search. I find the mental health network in California well connected and "small." You sound very sound, practical and reasonable in managing your health. I wish you well. I wish I could give you more definite information. I don't know if 411 is available in your area, but I find it another good phone resource for support information.

[Anonymouse88]

No problem.  The CrazyMeds site is great for connecting with people who have taken just about any med combo for the "mentally interesting" available, and there are at least some who have kicked opiate addictions and benzo addictions.  You should let any doctor know right off the bat that you've had a problem and REALLY want to avoid anything with that potential.  Some of the people on the forums are pretty up on their neurochemistry/psychopharmacology, and should be able to tell you about different meds.  You should also make sure any doctor you work with knows that you want to be a full partner, and that they need to give you enough info to make sound decisions.  Going in like that gives you a lot of credibility, especially if you've done your research, and being willing to be treatment-compliant and being willing to involve your doctor in your decisions will also give you credibility.  

For schedule, you could try melatonin.  It's sold as a supplement, and it's a chemical your brain makes that's involved in your biological clock.  It's pretty mild as a sleep-inducer, but taking it at the same time each night can help regulate your clock.  It's been giving me bad dreams, I think from some sort of med interaction (since it didn't used to), so I don't take it, but it's a good "natural" option.  Light therapy is also good.  Get a sunlamp and sit under it for 30 min each morning, or make sure to get up early and get early morning sunshine on your face.  This helps cue your body to the time of day and keep your schedule more regulated.

Odd about the seizures.  Methadone doesn't really play well with other drugs, as far as I can tell, but the benzos are usually anticonvulsant, not proconvulsant.  

Let me know if I can do anything else for you, and best of luck handling everything.

[weaver71]

Thank you for the tips. I'm gonna do some research, while I try the natural route. I am focusing on diet high in amino's, b vitamins, trace minerals, etc... Any other suggestions? I try to maintain a schedule, but that can be tricky for me.  It can take 2 years for methadone detox to balance out. I want to be prepared, if I do need meds. I will no longer take a drug just because a doctor said I should. I've seen addiction, psychosis, and death from following doctor's advice. Not talking about abuse, I'm talking about taking them as prescribed. Our local doctors prescribe benzos, opiates, and AD's all together. The doctors and policticians/police are on the same team, so we have to watch out for ourselves. A friend went to the hospital from a seizure 3 times from taking Klonipin with methadone, as prescribed. They still didn't change his script. With knowledge about some of this, I will know if a doctor has my best interest in mind. I live in rural mountains, all the good doctors live 5 hrs away. Knowledge is power, so thank you for helping me know where to look for more info. I like the psycheducation site. I'll be sure and let you know how things progress. I'm on the addiction site a lot, helping others, so I know it helps to get feedback and it's nice to know what happens. Thanks again.

[Anonymouse88]

Some people find a med that has no or minimal side effects for them, but there is no med that is guaranteed to come without side effects.  Everyone's reactions are different, so while most people will get a subset of common side effects, you can have weird reactions.

Since you are BP II, I strongly recommend looking into Lamictal before looking into lithium.  It is arguably the best drug for BP II with the best side effects profile, provided you don't get a rash.  Lamictal is famous for having a risk of a life-threatening rash, but the chances are only 1/1000.  About 1/10 will get a benign rash, and the risk is lower if you do a really slow titration.  But lithium comes with risk of thyroid and kidney problems, so nothing's perfect.  Lamictal is great in that it's really good for bipolar depression, and doesn't have so much anti-manic power, although it is approved as monotherapy for BP I.  In contrast, lithium has more anti-manic properties.

I recommend trying out the CrazyMeds page.  They have wikis with info on a LOT of psychiatric drugs, both the laypeople version and the official prescribing info.  The normal English summaries tend to overstate side effects, in my opinion, but they're a good way to get a lot of info, fast.  There are also forums where you can ask about people's experiences with various drugs.

As for specialists, that's up to you.  It would probably be good to get someone who has experience with bipolar and substance abuse populations, although hopefully a good bipolar specialist would be good with substance abuse, since it's a common issue in bipolar people.  What really matters in therapy is clicking with your therapist.  CBT for the bipolar can help with medication adherence and necessary lifestyle changes especially, although the data are mixed overall as to its effectiveness for mood episodes.

If you haven't seen the psycheducation.org site, you should check it out.  It has a lot of info about bipolar, especially bipolar that is not BP I.

[weaver71]

Sorry, was boardering on type I as a younger man. Typo. It was intense, not sure I hallucinated, but I would totally lose touch. It's been 10 yrs since anything like that. CBT is helping.

[weaver71]

I am type II, was boardering on type two as a younger man. No self-medicating, took some meds for methadone detox, but I'm clean otherwise. I wanted to wait a year off opiates to even consider this issue. Cognative/behavioral therapy seems best for me. I suppose I appear withdrawn or self-absorbed. Those who know me just flow with it. I seem like a know it all when I quote things I read 20 yrs ago, I catch myself and withdraw, but it's others response that reflects the intensity in my eyes. I know when it is safe to make life changes, I just feel socially awkward. Nobody usually sees the depressed, let down me. Lithium is where they suggested we start. The recovery therapy for opiates seems to be helping the bipolar. I caught myself giving a lecture on belladonna therapy and Bill W.s thoughts on LSD. His work with Auldes Huxley is fascinating, but I don't have to share all my thoughts. It's okay in 12 step meetings, I can practice cognatve therapy safely there. It can be funny. Crisis is crisis, I think my recovery applies to my bipolar.. It's only been a year off drugs, so this is just a research thread. I don't trust doctors to know about what they suggest. I 'm working on that resentment. I'll keep observing myself, I think good nutrition and self discovery may be enough. I've heard lithium is like pot at first: Dry mouth, bloodshot eyes, kinds sleepy, relaxed. I don't trust my sources. Is that true and is there any drug with no side effects. Being sober is the best it's been so far, you can imagine my concerns. What do you think about addiction/bipolar therapy? Do I need a specialist?

Thanks for your time, it means a lot. It's so hard to know who to beleive concerning bipolar. We should discus it when I'm manic, I could tell you the things you already know about it. Ha! I enjoy being manic sometimes, thanks again.

-Tony

[Anonymouse88]

If it's causing issues with relationships, then it's still screwing with your life.  If your mood symptoms are manageable and it's more behavior you have trouble with, then cognitive behavioral therapy (CBT) might be the next logical step.  Meds might be warranted, depending on what a psychologist or counselor thinks.  If you go to most psychiatrists, they're likely to recommend medication (just like surgeons will recommend surgery).  An exception would be a psychiatrist who does a lot of psychotherapy with their patients, which will be more convenient if you truly need meds.

Are you BP I or II, and do you still self medicate with anything?  Those are important considerations in the med equation.  And you can always trial some meds and decide you don't like them.  No one can force you to take meds outside of a court order or (I think) involuntary commitment.