Coping with Disability

Probably everyone reading this will have or know someone with a disabilty of some kind. The list of disabilities is endless.

I myself was born with slight Cerebral Palsy which later in life contributed to me developing Epilepsy. Although my seizures are controlled by medication I sltill suffer the odd Focal or Partial seizure (though i haven’t had any for weeks).

My Cerebral Palsy is giving me more cause for concern at the moment as I keep loosing my balance.

Fortunately because of my positive mind I think I try not to let my disabilities get me down .

For more information check the link below

How to Emotionally Cope With Having Disabilities: 14 Steps (wikihow.com)

Dogs for Bipolar Disorder

Service dogs have a long history of providing assistance to people with physical challenges and are increasingly used to aid those with psychiatric challenges. Psychiatric service dogs are extensively trained to perform specific tasks to meet the individualized needs of their handler and are permitted access to public places in accordance with the Americans with Disabilities Act (ADA).1

Psychiatric service dogs can be trained to assist people living with bipolar disorder as well as other mental health challenges, including autism, schizophreniapost-traumatic stress disorderdepression, and panic disorder. The tasks a service dog is trained to perform to aid someone living with bipolar disorder ​depend on the individual’s circumstances and personal challenges and needs.

The Role of Service Dogs for Bipolar Disorder

The ultimate function of a psychiatric service dog is to alleviate or diminish the negative effects of bipolar disorder on the handler’s life. Examples of tasks a dog might be trained to perform for its human partner include:

  • Bring medication or remind their partner to take prescribed medicine at a specific time(s)
  • Awaken their partner at a specific time each day
  • Remind their partner to go to bed at a specific time to keep sleep cycles regular
  • Bring a portable phone to their partner or call 9-1-1 if the handler exhibits behaviors that might indicate a manic episode or severe depression
  • Interrupt potentially dangerous behaviors in their partner by nudging, nagging, or distracting with play
  • Alert the handler to the telephone, doorbell, or smoke alarm if their partner is asleep or possibly sedated due to medication
  • Calm or interrupt hypomanic or manic behaviors by leaning into their partner, or placing their head in the handler’s lap
  • Provide a link to reality if their partner experiences delusions during a manic episode2

While not considered a service dog function per se, the emotional support provided by a canine helper is often as valuable as the tasks the animal performs.

The presence of the dog can also help ground an individual with bipolar disorder and introduce a sense of stability and routine.

Laws Relating to Service Dogs

It is important to note that to qualify for the protections and allowances of the ADA, both the individual and the canine must meet specific criteria. In short, an individual must have a disability and a service dog must be specifically trained to meet the needs imposed by that disability.

  • An individual with a disability is defined by the ADA as a person who has a physical or mental impairment that substantially limits one or more major life activities, a person who has a history or record of such an impairment, or a person who is perceived by others as having such an impairment.
  • The ADA defines a service animal like a dog individually trained to do work or perform specific tasks to provide assistance to an individual with a disability. If a dog meets this definition, it is considered a service animal under the ADA, regardless of whether it has been licensed or certified by a state or local government.3

Importantly, a psychiatric service dog differs from an emotional support dog, also called a comfort dog. While emotional support dogs certainly provide love, companionship, and comfort to their human partners, they are not trained to perform specific tasks that aid the handler in daily functioning. As such, emotional support dogs are not covered under the ADA.3

Other Considerations

If you’re living with bipolar disorder and considering getting a psychiatric service dog or an emotional support dog, talk with your doctor to determine what type of canine companion is best for you. A psychiatric service dog involves a considerable financial commitment because of the extensive training required, which may take up to two years to complete. Depending on your specific needs, however, you may consider this an invaluable investment.

Bipolar disorder

Photo by Chalo Garcia on Pexels.com

Everyone has changes in their mood, but with bipolar disorder these changes can be extreme, overwhelming and have a big impact on your life.

What are the symptoms of bipolar disorder?

If you have bipolar disorder, you’re likely to have episodes of depression (feeling very low) and mania (feeling very high). You may feel well between these episodes.

Bipolar symptoms can make daily life hard and affect your relationships and work.

During a depressive episode, you may:

  • feel sad, hopeless or irritable
  • lack energy and appetite
  • lose interest in everyday activities
  • have difficulty concentrating or remembering things
  • feel empty, worthless, guilty or despairing
  • have difficulty sleeping.

During a manic episode, you may:

  • feel full of energy
  • feel self-important or have lots of ideas and plans
  • be easily distracted, irritated or agitated
  • have no desire to sleep or eat
  • make decisions or say things that are out of character, risky or harmful.

Some people experience psychosis during a severe episode of depression or mania. This means you may see or hear things that aren’t there or believe things that aren’t true.

Episodes can last for several weeks or months with periods of less extreme mood in between. Depending on how you experience these moods and how severe they are, your doctor may diagnose you with a particular type of bipolar disorder. Mind has more information on these different types.

What causes bipolar disorder?

The exact cause of bipolar disorder is unknown, but researchers believe a combination of factors make someone more likely to develop it. These include:

  • genetics – if you’re related to someone with bipolar disorder, you’re more likely to develop it yourself
  • chemical imbalance in the brain – too much or too little of certain chemicals could make you develop depression or mania
  • childhood trauma – abuse, neglect or bereavement in childhood can cause you to develop bipolar disorder. This could be because of the impact on your ability to regulate your emotions
  • stressful life events – a relationship breakdown or financial difficulties can be the trigger for bipolar symptoms.

You usually develop bipolar disorder before you’re 20. It’s rare to develop it after the age of 40.

Getting support

Treatment for bipolar disorder aims to reduce the severity and number of episodes of depression or mania you experience. The right treatment for you will depend on your type of bipolar, current symptoms, and your preferences and circumstances.

If you think you have bipolar disorder, start by speaking to your GP. It can help to keep a record of your moods to help you both understand your mood swings. You can download a mood scale and mood diary from the Bipolar UK website. Your GP may then refer you to a psychiatrist, who can give you a diagnosis.

There are different types of help you can get with bipolar disorder.

Talking therapy

There are different talking therapies that have been shown to work well for people with bipolar disorder.

  • Cognitive Behavioural Therapy (CBT) can help you recognise how your feelings, thoughts, and behaviour influence each other and build strategies to change these patterns.
  • Interpersonal Therapy (IPT) focuses on your relationships with others and how your thoughts, feelings, and behaviour are affected by your relationships and vice versa.

What you’re offered may depend on what’s available in your area and what you and your GP feel would be best for you.

Medication

There are different medications available to treat bipolar disorder. It’s likely your GP or psychiatrist offer you one of more of the following:

  • medication to prevent episodes of depression and mania. These are known as mood stabilisers
  • medication to treat the symptoms of depression and mania as they happen.

The NHS website has more information about medication for bipolar disorder.

Longer term plans

You may work with healthcare professionals to learn to monitor your mood and recognise what triggers your depression and mania. They may help you to develop a crisis or risk management plan so you know how to manage any early warning signs. This may involve friends and family, so they know how to recognise any early signs of distress and support you.

You can also help yourself by taking care of your physical health as well as your mental health and making sure that you get regular exercise, good quality sleep, and eat a healthy diet.

Epilepsy – Carbamazepine/Tegratol

What is carbamazepine?

Carbamazepine is an anticonvulsant. It works by decreasing nerve impulses that cause seizures and nerve pain, such as trigeminal neuralgia and diabetic neuropathy.

Carbamazepine is also used to treat bipolar disorder.

Carbamazepine may also be used for purposes not listed in this medication guide.

Important Information

You should not take carbamazepine if you have a history of bone marrow suppression, if you are allergic to it, or take an antidepressant such as amitriptyline, desipramine, doxepin, imipramine, or nortriptyline.

TELL YOUR DOCTOR ABOUT ALL OTHER MEDICINES YOU USE. Some drugs can raise or lower your blood levels of carbamazepine, which may cause side effects or make this medicine less effective. Carbamazepine can also affect blood levels of certain other drugs, making them less effective or increasing side effects.

Carbamazepine may cause serious blood problems or a life-threatening skin rash or allergic reaction. Call your doctor if you have a fever, unusual weakness, bleeding, bruising, or a skin rash that causes blistering and peeling.

Some people have thoughts about suicide while taking seizure medicine. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

Do not stop taking this medicine without asking your doctor first, even if you feel fine.

If you are pregnant, do not start or stop taking carbamazepine without your doctor’s advice.

Before taking this medicine

You should not take carbamazepine if you have a history of bone marrow suppression, or if you are allergic to carbamazepine or to an antidepressant such as amitriptylinedesipraminedoxepinimipramine, or nortriptyline.

Do not use carbamazepine if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include furazolidoneisocarboxazidlinezolidphenelzinerasagilineselegiline, and tranylcypromine.

Carbamazepine may cause severe or life-threatening skin rash, and especially in people of Asian ancestry. Your doctor may recommend a blood test before you start the medication to determine your risk.

Tell your doctor if you have ever had:

You may have thoughts about suicide while taking carbamazepine. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Do not start or stop taking seizure medication during pregnancy without your doctor’s advice. Carbamazepine may harm an unborn baby, but having a seizure during pregnancy could harm both mother and baby. The benefit of preventing seizures may outweigh any risks to the baby.

Tell your doctor right away if you become pregnant.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of this medicine on the baby.

Carbamazepine can make birth control pills or implants less effective. Use a barrier form of birth control (such as a condom or diaphragm with spermicideto prevent pregnancy.

You should not breastfeed while you are using carbamazepine.

How should I take carbamazepine?

Take carbamazepine exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Take with food.

Swallow the extended-release tablet or capsule whole and do not crush, chew, or break it. Tell your doctor if you cannot swallow a pill whole.

The chewable tablet must be chewed before you swallow it.

Shake the oral suspension (liquid) before you measure a dose. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and call your doctor promptly if this medicine seems to stop working as well in preventing your seizures.

You will need frequent medical tests.

Store at room temperature away from moisture, heat, and light.

Do not stop using carbamazepine suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor’s instructions about tapering your dose.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include severe drowsiness, weak or shallow breathing, and loss of consciousness.

What to avoid

Drinking alcohol with this medicine can cause side effects, and can also increase your risk of seizures.

Grapefruit may interact with carbamazepine and lead to unwanted side effects. Avoid the use of grapefruit products.

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.

Carbamazepine could make you sunburn more easily. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Carbamazepine side effects

Get emergency medical help if you have signs of an allergic reaction to carbamazepine (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (feversore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).

Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes.

Report any new or worsening symptoms to your doctor, such as: sudden mood or behavior changes, depression, anxietyinsomnia, or if you feel agitated, hostile, restless, irritable, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

  • a skin rash, no matter how mild;
  • loss of appetite, right-sided upper stomach pain, dark urine;
  • slow, fast, or pounding heartbeats;
  • anemia or other blood problems – fever, chills, sore throat, mouth sores, bleeding gums, nosebleeds, pale skin, easy bruising, unusual tiredness, feeling light-headed or short of breath; or
  • low levels of sodium in the body – headache, confusion, severe weakness, feeling unsteady, increased seizures.

Common carbamazepine side effects may include:

  • dizziness, loss of coordination, problems with walking;
  • nausea, vomiting; or
  • drowsiness.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.Carbamazepine side effects (more detail)

What other drugs will affect carbamazepine?

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Using carbamazepine with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety, depression, or seizures.

Many drugs can interact with carbamazepine, and some drugs should not be used together. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all your current medicines and any medicine you start or stop using.

Psychosis

What is psychosis?

Psychosis is characterized by an impaired relationship with reality. It’s a symptom of serious mental disorders. People who are experiencing psychosis may have either hallucinations or delusions.

Hallucinations are sensory experiences that occur within the absence of an actual stimulus. For example, a person having an auditory hallucination may hear their mother yelling at them when their mother isn’t around. Or someone having a visual hallucination may see something, like a person in front of them, who isn’t actually there.

The person experiencing psychosis may also have thoughts that are contrary to actual evidence. These thoughts are known as delusions. Some people with psychosis may also experience loss of motivation and social withdrawal.

These experiences can be frightening. They may also cause people who are experiencing psychosis to hurt themselves or others. It’s important to see a doctor right away if you or someone you know is experiencing symptoms of psychosis.

Recognizing the symptoms of psychosis

Symptoms of psychosis include:

Suicide prevention

  1. If you think someone is at immediate risk of self-harm or hurting another person:
  2. • Call 999 or your local emergency number.
  3. • Stay with the person until help arrives.
  4. • Remove any guns, knives, medications, or other things that may cause harm.
  5. • Listen, but don’t judge, argue, threaten, or yell.
  6. If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline.

What are delusions and hallucinations?

Delusions and hallucinations are two very different symptoms that are both often experienced by people with psychosis. Delusions and hallucinations seem real to the person who is experiencing them.

Delusions

A delusion is a false belief or impression that is firmly held even though it’s contradicted by reality and what is commonly considered true. There are delusions of paranoiagrandiose delusions, and somatic delusions.

People who are experiencing a delusion of paranoia might think that they are being followed when they aren’t or that secret messages are being sent to them. Someone with a grandiose delusion will have an exaggerated sense of importance. Somatic delusion is when a person believes they have a terminal illness, but in reality they’re healthy.

Hallucinations

A hallucination is a sensory perception in the absence of outside stimuli. That means seeing, hearing, feeling, or smelling something that isn’t present. A person who is hallucinating might see things that don’t exist or hear people talking when they’re alone.

Causes of psychosis

Each case of psychosis is different, and the exact cause isn’t always clear. There are certain illnesses that cause psychosis, however. There are also triggers like drug use, lack of sleep, and other environmental factors. In addition, certain situations can lead to specific types of psychosis developing.

Illnesses

Illnesses that can cause psychosis include:

Some types of dementia may result in psychosis, such as that caused by:

Risk factors for developing psychosis

It’s not currently possible to precisely identify who is likely to develop psychosis. However, research has shown that genetics may play a role.

People are more likely to develop a psychotic disorder if they have a close family member, such as a parent or sibling, who has a psychotic disorder.

Children born with the genetic mutation known as 22q11.2 deletion syndrome are at risk for developing a psychotic disorder, especially schizophrenia.

Types of psychosis

Some kinds of psychosis are brought on by specific conditions or circumstances that include the following:

Brief psychotic disorder

Brief psychotic disorder, sometimes called brief reactive psychosis, can occur during periods of extreme personal stress like the death of a family member. Someone experiencing brief reactive psychosis will generally recover in a few days to a few weeks, depending on the source of the stress.

Drug- or alcohol-related psychosis

Psychosis can be triggered by the use of alcohol or drugs, including stimulants such as methamphetamine and cocaine. Hallucinogenic drugs like LSD often cause users to see things that aren’t really there, but this effect is temporary. Some prescription drugs like steroids and stimulants can also cause symptoms of psychosis.

People who have an addition to alcohol or certain drugs can experience psychotic symptoms if they suddenly stop drinking or taking those drugs.

Organic psychosis

head injury or an illness or infection that affects the brain can cause symptoms of psychosis.

Psychotic disorders

Psychotic disorders can be triggered by stress, drug or alcohol use, injury, or illness. They can also appear on their own. The following types of disorders may have psychotic symptoms:

Bipolar disorder

When someone has bipolar disorder, their moods swing from very high to very low. When their mood is high and positive, they may have symptoms of psychosis. They may feel extremely good and believe they have special powers.

When their mood is depressed, the individual may have psychotic symptoms that make them feel angry, sad, or frightened. These symptoms include thinking someone is trying to harm them.

Delusional disorder

A person experiencing delusional disorder strongly believes in things that aren’t real.

Psychotic depression

This is major depression with psychotic symptoms.

Schizophrenia

Schizophrenia is a lifelong disease that is generally accompanied by psychotic symptoms.

How is psychosis diagnosed?

Psychosis is diagnosed through a psychiatric evaluation. That means a doctor will watch the person’s behavior and ask questions about what they’re experiencing. Medical tests and X-rays may be used to determine whether there is an underlying illness causing the symptoms.

Diagnosing psychosis in children and teenagers

Many of the symptoms of psychosis in adults aren’t symptoms of psychosis in young people. For example, small children often have imaginary friends with whom they talk. This just represents imaginative play, which is completely normal for children.

But if you’re worried about psychosis in a child or adolescent, describe their behavior to a doctor.

Treatment of psychosis

Treating psychosis may involve a combination of medications and therapy. Most people will experience an improvement in their symptoms with treatment.

Rapid tranquilization

Sometimes people experiencing psychosis can become agitated and be at risk of hurting themselves or others. In these cases, it may be necessary to calm them down quickly. This method is called rapid tranquilization. A doctor or emergency response personnel will administer a fast-acting injection or liquid medicine to quickly relax the patient.

Medication

Symptoms of psychosis can be controlled with medications called antipsychotics. They reduce hallucinations and delusions and help people think more clearly. The type of antipsychotic that is prescribed will depend on the symptoms.

In many cases, people only need to take antipsychotics for a short time to get their symptoms under control. People with schizophrenia may have to stay on medications for life.

Cognitive behavioral therapy

Cognitive behavioral therapy means meeting regularly to talk with a mental health counselor with the goal of changing thinking and behaviors. This approach has been shown to be effective in helping people make permanent changes and better manage their illness. It’s often most helpful for psychotic symptoms that don’t completely resolve with medications.

Complications and outlook of psychosis

Psychosis doesn’t have many medical complications. However, if left untreated, it can be challenging for people experiencing psychosis to take good care of themselves. That could cause other illnesses to go untreated.

Most people who experience psychosis will recover with proper treatment. Even in severe cases, medication and therapy can help.