I have this fear

It's bad today. I have this fear that something bad will happen: that my kids will get killed, that I won't be able to pay my bills, that my kids will get into horrific car accidents, that we'll get robbed... These types of thoughts plague me a lot- sometimes everyday (like now). And they all happen over and over- so quickly its as if they are one thought. Often, my mind makes me believe that these scenarios are true- then anxiety turns to panic: heart pounding, fast breathing, circular racing thoughts, dread... I hope I can sleep tonight.

Hallucination?

My youngest son and I decided to go out to lunch this afternoon. We ate, chatted... He ate his food including a chocolate shake then finished my food! (Teenagers!) But while still seated, from across the room, I heard a metalic voice say "patties"- something about flipping the patties? I'm not sure but I thought there must be a voice built into the grill. Clear as day it was but nobody seemed to own those words! Except... I asked my son if he could hear it - he could not. ? Then a confused yet stern "Mother!" From my son. All leads up to... You guessed it: was I hallucinating today?

Depressed? (part 2)

My daughter has cleaned the whole house and im getting "what have you done?" My friend stopped by starbucks and told me I shouldntve missed church- and reading the bible on my own "doesnt count". If I said "I got a shower- and got out of bed" they would just say "so?" I just dont want to do anything. Even at starbucks with friends I didnt really care. I just sat there with my head in my hands staring into space.

I think I'll go water my money tree. That will cheer me up. I love seeing my tree thrive. Its got six babies sprouting!

I Don't DO Anything! (Depressed Part 1)

I know what people will say: "A week off from what?" Good question. Whatever it is I do. I need to blog more. I missed my voice lesson yesterday and my teacher was none too thrilled with me. I missed choir rehearsal and im contimplatimg missing church tomorrow so i can sleep in. (I always take my kids to/from school/work.) I probably won't be able to sleep in but I'd like the option. So every day I read and write and I need to do this. Today even I met someone from the local symphony orchestra committee. We knew a lot of the same people and not just orchestra members but choirs and their directors as well! That was a highlight of my day. However I didn't take a shower the last sevetal days and its getting to be a problem. I dunno what to do. How can I take a day(s) off when I "don't DO anything?"

New lamictal safety warning

https://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm605628.htm

Lamictal (lamotrigine): Drug Safety Communication - Serious Immune System Reaction

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[Posted 04/25/2018]

AUDIENCE: Health Professional, Patient, Pharmacy

ISSUE: The FDA is warning that the medicine Lamictal (lamotrigine) for seizures and bipolar disorder can cause a rare but very serious reaction that excessively activates the body’s infection-fighting immune system. This can cause severe inflammation throughout the body and lead to hospitalization and death, especially if the reaction is not diagnosed and treated quickly. As a result, we are requiring a new warning about this risk be added to the prescribing information in the lamotrigine drug labels.

BACKGROUND: The immune system reaction, called hemophagocytic lymphohistiocytosis (HLH), causes an uncontrolled response by the immune system. HLH typically presents as a persistent fever, usually greater than 101°F, and it can lead to severe problems with blood cells and organs throughout the body such as the liver, kidneys, and lungs.

Lamotrigine is used alone or with other medicines to treat seizures in patients two years and older. It may also be used as maintenance treatment in patients with bipolar disorder to help delay the occurrence of mood episodes such as depression, mania, or hypomania. Stopping lamotrigine without first talking to a prescriber can lead to uncontrolled seizures, or new or worsening mental health problems. Lamotrigine has been approved and on the market for 24 years, and is available under the brand name Lamictal and as generics.

RECOMMENDATION: Healthcare professionals should be aware that prompt recognition and early treatment is important for improving HLH outcomes and decreasing mortality. Diagnosis is often complicated because early signs and symptoms such as fever and rash are not specific. HLH may also be confused with other serious immune-related adverse reactions such as Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS).

Evaluate patients who develop fever or rash promptly, and discontinue lamotrigine if HLH or another serious immune-related adverse reaction is suspected and an alternative etiology for the signs and symptoms cannot be established. Advise patients to seek immediate medical attention if they experience symptoms of HLH during lamotrigine treatment. A diagnosis of HLH can be established if a patient has at least five of the following eight signs or symptoms:

fever and rash

enlarged spleen

cytopenias

elevated levels of triglycerides or low blood levels of fibrinogen

high levels of blood ferritin

hemophagocytosis identified through bone marrow, spleen, or lymph node biopsy

decreased or absent Natural Killer (NK) Cell activity

elevated blood levels of CD25 showing prolonged immune cell activation

Patients or their caregivers should contact their health care professionals right away if they experience any symptom of HLH while taking lamotrigine. HLH can occur within days to weeks after starting treatment. A physical examination and specific laboratory blood tests and other evaluations are used to diagnose HLH. Signs and symptoms of HLH include but are not limited to:

fever

enlarged liver; symptoms may include pain, tenderness, or unusual swelling over the liver area in the upper right belly

swollen lymph nodes

skin rashes

yellow skin or eyes

unusual bleeding

nervous system problems, including seizures, trouble walking, difficulty seeing, or other visual disturbances

Read the patient Medication Guide, which explains the benefits and risks of lamotrigine, every time you get a new prescription because the information may change. Do not stop taking lamotrigine without talking to your health care professional first as doing so can cause serious problems.

Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program:

Complete and submit the report Online: www.fda.gov/MedWatch/report

Download form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178

[04/25/2018 - Drug Safety Communication - FDA]

More in Safe

Blank

My memory is like a sieve. Long-term about my childhood is fine but not this. I cant go from moment to moment tracking my thoughts a lot of the time. This makes it difficult to function because I have to back track a lot and in fact that is how I function: with a running trail of back-tracks of checking on if I did this or that. All of this is (usually) subconscious. My thoughts are also stilted. I feel blank and cant bring up any congrete thoughts. It just makes me feel blank.

Radio 2 - God?

Today I heard a radio coming from my 16 yo son's room. I thought I was hearing things. Then I saw hed built a radio out of tine bare little parts in a board and lots of little wires. I heard a man's voice talking about God and angels. Ok some religious station. But its not Sunday. Still playing clear as day. God and angels and The Lord....

I went to ask my son about his radio. It was indeed a radio. But it is tuned to a jazz music station and again its not even Sunday.

Caring for his Wounds

My 16 year old wanted me to drive him to his friend's house but thete was an ice storm so I said no. He begged and tried to changed the plans but I said no, so he took off alone in the freezing rain to walk.

I worry so much when these types of things happen and also because he doesnt listen to me. I try not to worry but I do. For everything. I try my DBT techniques.

Then my mind plays out all the bad things that could happen and they are 100% real. Even the emergency responders are there trying to find me while taking his vitals and caring for his wounds.

Bipolar & Math

bipolar and math

Very much my math life throughout high school and college!

Mathematics deficits in adolescents with bipolar I disorder.

Lagace DC, et al. Am J Psychiatry. 2003.

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Abstract

OBJECTIVE: This study examined mathematical ability in adolescents with bipolar I disorder, compared to adolescents with major depressive disorder and psychiatrically healthy comparison subjects.

METHOD: Participants (N=119) included adolescents in remission from bipolar disorder (N=44) or major depressive disorder (N=30), as well as comparison subjects (N=45) with no psychiatric history. Participants were assessed with the following measures: the Wide-Range Achievement Test, Revised 2 (WRAT-R2), Peabody Individual Achievement Test, Bay Area Functional Performance Evaluation Task-Oriented Assessment (functional mathematics subtest), Test of Nonverbal Intellegence-2, and a self-report of mathematics performance.

RESULTS: WRAT-R2 and Peabody Individual Achievement Test scores for spelling, mathematics, and reading revealed that adolescents with bipolar disorder had significantly lower achievement in mathematics, compared to subjects with major depressive disorder and comparison subjects. Results for the Test of Nonverbal Intellegence-2 were not significantly different between groups. Adolescents with bipolar disorder took significantly longer to complete the Bay Area Functional Performance Evaluation mathematics task. Significantly fewer adolescents with bipolar disorder (9%) reported above-average mathematics performance, compared with the other groups.

CONCLUSIONS: Adolescents with remitted bipolar disorder have a specific profile of mathematics difficulties that differentiates them from both adolescents with unipolar depression and psychiatrically healthy comparison subjects. These mathematics deficits may not derive simply from more global deficits in nonverbal intelligence or executive functioning, but may be associated with neuroanatomical abnormalities that result in cognitive deficits, including a slowed response time. These deficits suggest the need for specialized assessment of mathematics as part of a comprehensive clinical follow-up treatment plan.

PMID 12505807 [Indexed for MEDLINE]