bipolar and pain

[improtected]

i have a client ive been seeing for awhile recently diagnosed with BPD. she supposedly has had head trauma in the past. havent gotten details on that, doesn't like to talk about it.

she has very little meniscus in her knees, has had back surgery, has a PT background so knows her physiology quite well. probably too well. like the whole know too much kind of thing.

anyway, which comes first - the pain or the BPD? or is there any way to tell? am i treating a phantom pain or true pain?

and as i'm treating the pain, she has no response to pressure/stimulation. so there's this combination of too many drugs/desensitization/needing attention/trying to prove herself to me that she can withstand the pressure. it's as infuriating to me as it is challenging.

maybe this is just a vent post. i guess i need to research more about pain/BPD to figure out how to work with her best. how typical is pain and BPD? the connection? not necessarily a pain disorder, but BPD specific.

thanks

[ucicare]

Pain is usually associated with Depression. People with Bipolar D/O have Depression as well as Mania. It is the Depression that hurts. People with Bipolar D/O usually feel pretty good during the manic phases.

Depression is associated with lower levels of nuerotransmitters such as Serotonin. Norephinepidrine, Dopamine and probably GABA contribute in some way. Low levels of Serotonin are known to cause muscle and joint pain.

Cymbalta is a new antidepressant used to treat Depression related pain. I don't know anybody using it, so I don't know much about it.

As far a "Phantom Pain" it is my opinion that all pain is real, no matter where it originates. The fact that she may not feel any pressure could be the Lortab she is addicted to after her multiple surgeries. (Sorry for my cynicism about the Lortab).

[Dwaine Scum]

Pain is usually associated with Depression. People with Bipolar D/O have Depression as well as Mania. It is the Depression that hurts. People with Bipolar D/O usually feel pretty good during the manic phases.

Depression is associated with lower levels of nuerotransmitters such as Serotonin. Norephinepidrine, Dopamine and probably GABA contribute in some way. Low levels of Serotonin are known to cause muscle and joint pain.

Cymbalta is a new antidepressant used to treat Depression related pain. I don't know anybody using it, so I don't know much about it.

As far a "Phantom Pain" it is my opinion that all pain is real, no matter where it originates. The fact that she may not feel any pressure could be the Lortab she is addicted to after her multiple surgeries. (Sorry for my cynicism about the Lortab).


I was on the Cymbalta, worse two weeks of my life

[ucicare]

I was on the Cymbalta, worse two weeks of my life



I was not recommending it, only mentioning it.

I have little experience with Cymbalta.

[Lomotil]

They've got my ex on Zyprexa right now, and I'm afraid these past 6 months are the most stable that I've ever seen her.

[ucicare]

They've got my ex on Zyprexa right now, and I'm afraid these past 6 months are the most stable that I've ever seen her.


Zyprexa is magic. That annoying little side effect of triggering diabetes in a percentage of patients just won't go away though. In my opinion, worth the risk if you are treating serious BiPolar. Plus, there is the added bonus of getting your share of the class action lawsuit once it pays out.

[improtected]

the thing that's most bewildering to me is the lack of sensation, i swear i just had 170 lbs shoved into her ischial tuberosity and she was asking for more.

maybe eight years of constant fight-or-flight will do that?

[phatboy]

Maybe the pressure releives the pain?

Maybe the pressure is so bad without the pain, that the pressure, while still hurting, is less than the other pain. (Maj - please read this sentence and puncuate correctly.)

Maybe she just has the hots for you or is into S&M.

[MAJ Havoc]

puncuate correctly

Barry is trainable. Dammit, phatboy, I'm an English Major not a miracle worker.

[improtected]

puncuate correctly

Barry is trainable. Dammit, phatboy, I'm an English Major not a miracle worker.


my god, i needed to laugh more than any of you know. that was fucking hillarious.

[ucicare]

i swear i just had 170 lbs shoved into her ischial tuberosity and she was asking for more.



:o :o :o


http://www.caringmedical.com/cyberclinic/imgs/fig16_3.gif


Say it's not so.

[improtected]

i swear i just had 170 lbs shoved into her ischial tuberosity and she was asking for more.


:o :o :o

http://www.caringmedical.com/cyberclinic/imgs/fig16_3.gif
Say it's not so.


... men...

yes, it's so.

[ucicare]

puncuate correctly

Barry is trainable. Dammit, phatboy, I'm an English Major not a miracle worker.


http://toothpastefordinner.com/030905/you-can-study-anything.gif

[improtected]

puncuate correctly

Barry is trainable. Dammit, phatboy, I'm an English Major not a miracle worker.


http://toothpastefordinner.com/030905/you-can-study-anything.gif


yeah, and if you work it just right you can graduate as a psych major and 'help' people.

[ucicare]

puncuate correctly

Barry is trainable. Dammit, phatboy, I'm an English Major not a miracle worker.


http://toothpastefordinner.com/030905/you-can-study-anything.gif


yeah, and if you work it just right you can graduate as a psych major and 'help' people.



Ouch.

I take a chance and peek out from under the pedestal....... and you poke me in the eye. ;)

Note to self - wear safety glasses next time you log in ......

[improtected]

puncuate correctly

Barry is trainable. Dammit, phatboy, I'm an English Major not a miracle worker.


http://toothpastefordinner.com/030905/you-can-study-anything.gif


yeah, and if you work it just right you can graduate as a psych major and 'help' people.



Ouch.

I take a chance and peek out from under the pedestal....... and you poke me in the eye. ;)

Note to self - wear safety glasses next time you log in ......

oh, boo hoo....

[ucicare]

oh, boo hoo....


I knew that I would eventually make you cry. Surprised it took so long.

[Michelle]

I'm guessing that this person was diagnosed with bipolar disorder because of the changes in personality, hair trigger temper, and increased propensity to become easily agitated that normally occur following a head injury. Somewhat subsiding over years and years.

[phatboy]

puncuate correctly

Barry is trainable. Dammit, phatboy, I'm an English Major not a miracle worker.


:'(

[ucicare]

I'm guessing that this person was diagnosed with bipolar disorder because of the changes in personality, hair trigger temper, and increased propensity to become easily agitated that normally occur following a head injury. Somewhat subsiding over years and years.



Talk about psychological projection.......

[Michelle]

I'm guessing that this person was diagnosed with bipolar disorder because of the changes in personality, hair trigger temper, and increased propensity to become easily agitated that normally occur following a head injury. Somewhat subsiding over years and years.



Talk about psychological projection.......


One of my brothers had a head injury in a car accident when we were kids.

[phatboy]

Doesnt take much damage to the frontal lobes to cause 'personality' changes. I read about some individuals in one of my psych classes. Then there were the frontal lobotomy deals to calm 'unruly' children. F'd up.

[improtected]

I'm guessing that this person was diagnosed with bipolar disorder because of the changes in personality, hair trigger temper, and increased propensity to become easily agitated that normally occur following a head injury. Somewhat subsiding over years and years.

subsiding b/c of the meds or b/c time heals?

oh, boo hoo....

I knew that I would eventually make you cry. Surprised it took so long.

actually, "precious", i was being sarcastic, those fabulous meds that are researched and 'safe' keep me from crying...

[ucicare]

I'm guessing that this person was diagnosed with bipolar disorder because of the changes in personality, hair trigger temper, and increased propensity to become easily agitated that normally occur following a head injury. Somewhat subsiding over years and years.

subsiding b/c of the meds or b/c time heals?

oh, boo hoo....

I knew that I would eventually make you cry. Surprised it took so long.

actually, "precious", i was being sarcastic, those fabulous meds that are researched and 'safe' keep me from crying...


Once there was a Bumble B, born in a Honey Bee nest.
Struggled he to do the things that came easily to the rest.
He always knew that he was odd, though he did what all bees do.
He kept the hive, and fed the kids, and made some honey too.

The hardest part for the Bumble B was staying with the task.
Boring, pointless, plodding, doing what the Queen Bee asked.
His defect kept hid from the others, as he did all the Honey Bee things.
For the buzz that came from the Bumble B was his brain, not his wings.

....But this story sucks from here on because once a Bumble Bee gets born in a Honey Bee nest the rest is just a series of failing to be a good Honey Bee until predictabily you sting somebody that was only trying to shoo you out of the car and they wreck into a telephone pole and then your stinger gets wanked out and you die a slow and agonizing death with your entrails trailing behind you like a bad case of hemorroids.... :o

Wait, that's Honey Bees. Bumble Bees can sting more than one. Dang. The story makes no sense now.

Ok. Let me start over,

Once there was a Brown Bear, born in a Polar Bear's den...

[Nauseous]

People are diagnosed with BP entirely too much. It's fucking ridiculous. You go into the shrink and they start firing off BP related questions. Of course, anyone is going to have some of the symptoms, so then they 'grade' the BP. I was diagnosed with cyclothymia three years ago and given Lamictal, Prozac and Trazodone. Then I was switched to Lithium. Guess what? I didn't take the shit and I was fine. If you're in a shitty relationship, get out of it. That was my problem. I don't have near as much of a temper now.

I can easily diagnose myself with somatization disorder and OCD. You know, when you are so preoccupied with your health and how you feel and obsessing on every possible terrible thing that can happen all day long, it will make you mean and mood swingy.

Shrinks are nothing but pill pushers.