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Which Pole am I on These Days?

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I have to say I have made significant progress since I was initially diagnosed with Bipolar 2 earlier this year.

Just having a better understanding of myself sure makes a great difference to start. Knowing my body and mind better, knowing what my limits are and therefore knowing when I need to slow down...

Of course, the medication does also play an important role. Currently I am on Depakote ER, which is technically an anti-convulsant but also have great mood stabalizing properties. Unfortunately, all medication has its risks and side-effects and with Depakote, there is not a "one dose fits all" solution. But after several months, I think me and my doctor finally achieved a good balance between the benefits and side effects.

There are still some side-effects I have to deal with on a daily basis. The major ones that affect me from Depakote are hair loss, weight gain and sleepiness/grogginess. The only other thing to be warry of with such medication is its potential impact on the liver. They can be somewhat harsh on the liver and therefore your blood levels and liver function has to be monitored periodically.

The hairloss isn't a huge problem yet as I have really thick hair and I generally lose alot of hair anyways due to that, it just seems worse with the medication.

In regards to the waight gain, it is not well understood wether it is the medication itself that causes it or it simply increases one's appetite. In my case, my "carb cravings" have definetly gone up. Since I started taking the medication, I have gained about 40 pounds. More recently I've started to watch my food intake and have lost about 10 pounds so far. So I think that with a proper diet, my weight should return to a more normal level...

The biggest annoyance is the grogginess. How hard is it to focus on activities such as work when you constantly feel like you're on a constant turkey dinner coma. The godsend here is Provigil. It is somewhat of a new medication, which is aimed at people with sleep deprevation disorders such as Narcolepsy. Although not technically approved by the FDA for use as a counter grogginess from other medications such as Depakote, several doctors have recognized its effectiveness and have started prescribing it.

Provigil is a fairly new medication and the exact mechanisms of how it works are not fully understood yet. The main plus of Provigil is that it is not a stimulant such as the various forms of Emphetamines that are generally prescribed in these situations. Scientists think that it acts as a GABA inhibitor, which essentially inhibits the mechanisms that make you feel sleepy. And since it does not have a direct effect on the CNS (Centran Nervous System), it does not produce any form of high and shows no signs of addition or withdrawl. Somewhat interesting as apparently, from my Internet research, Provigil is now the new study drug of choice by students for cram sessions. And its effects are long lasting 12-16 hours meaning that a single dose should keep you going all day without having a significant effect on your ability to sleep.

Well, so far so good. I have been so much more optiistic and energetic over the past few months despite all that would have normally dragged me down. Now, we just need to get the Flight Simulator Service Pack and Expansion Pack out the door so I can finally get some real rest :)

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