Emme0264 is offline Emme0264 Post #1  June 21,2010, 4:08pm
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Dr. Tonya, how are you feeling? I've been thinking about you and how strong you are, trying to imagine being in your situation and handling it so gracefully.

Now the question. My shrink changed my diagnosis from garden variety anxiety/depression to bipolar 2. My oldest brother is on the liver transplant waiting list due to cirrhosis caused by drinking. He has not had a drink in at least 5 years. The hospital where he receives treatment was just approved to do live liver organ donor transplants. While my brother says he will not consider this unless it's a life and death situation, his social workers and I agree that by then it will be too late and he would not be strong enough for the surgery. So we are all going to work on him to accept a donor.

Other than him, I have 4 other siblings. One cannot donate, my sister is about to be too old (within the next year), one will likely refuse to consider it and the other would do it happily if he is the last option. I, on the other hand, am bound and determined to do everything I can to donate part of my liver to him.

Here's my question. Among other things required for potential donors, the donor must be free from currently treated psychiatric disorders. I have recently started a rather extreme exercise routine to lose some weight I also need to lose to be considered donor material. I have heard that exercise can lead to stabilized moods. I am going to ask my shrink if I can get off my meds and see if I can stabilize myself through exercise. I think this is my biggest impediment to be considered a potential donor. I know I can lose the weight so that's out of the way.

My question is whether anyone has tried to stabilize a mood disorder through exercise, or in any other non pharmaceutical way? I think my shrink would certify me as stable enough to handle the transplant while I'm on meds, but I think I'd still be ruled out. I want to be able to donate so badly. I know I can get ruled out for any of a number of other reasons, such as my liver not being the right size or something else I can't control.

Any suggestions from anyone?

Emme
 
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DrTonya is offline DrTonya Post #2  June 22,2010, 5:16am
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Hi Emme!

I just want to clarify that while I am a psychologist and actively practice, my specialty is in the area of school psychology and not clinical. I work with kiddos birth-22 and not adults. When I give advice on these boards it is simply as a person and not as a psychologist - so please do not take anything I say as a "psychologist's recommendation" but rather just someone's opinion on the matter.

Now that the disclaimer is out of the way I can get to your question. I have never heard of someone "treating" Bipolar with exercise alone and without medication. While exercise has great many benefits and does lift moods, the neurotransmitters that are released to help improve mood are generally not enough to serve as an overall "mood stabilizer." The endorphins released during exercise also will do little to help with your hypomania as well, I'm afraid.

The reason why meds are prescribed to treat Bipolar (or any other psychiatric disorder) is that by taking the medication, brain chemistry can be stabilized. To fully be successful in treating symptoms, you need to take the meds every day at the correct dosage. What is released during exercise is not an exact dose; those endorphins that lift your mood also vary in terms of how long-lasting they are - so what you may produce during exercise may not be "enough" to fully stabilize you. Make sense?

So my short answer is no, I have not heard of exercise alone being able to stabilize symptoms of Bipolar. I would advise you to do exactly what your planned on doing which is to ask your doc. I know you want to help your brother and that is admirable but please listen and follow your doc's recommendations. I read your first post when you returned to the boards about your new Bipolar diagnosis and how you initially were resistant to the new "label" but could not deny that the meds were helping. You will not be able to help your brother if going off meds sends you into a manic or a severe depressive state. At least if you continue taking your meds, although that would rule you out as a donor, you can help your brother with the after care that he will need. That could be the active role you take to help him out - that you will assist him after surgery to help with household chores, meals, or whatever needs to be done while he recovers. In a lot of ways that job is a whole heck of a lot more difficult (and time consuming) than the actual donation.

Again, these are just my thoughts. Ask your doc because they would know more than I given that I only know what you say here and not the full history of your psychiatric difficulties. I'm curious to know what they tell you.

Sorry that this is not what you wanted to hear. Good luck and positive thoughts and prayers go out to both you and your brother. I hope he feels better soon.
 
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Emme0264 is offline Emme0264 Post #3  June 22,2010, 1:58pm
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Thanks, Dr. T. I never thought your comments was professional advice. I run into the sames kinds of things as a lawyer. I also have to make disclaimers.

My fear is that I will be the only family member either able or willing to be the donor. The meds work, for sure, but I'd be willing to try going off them. My diagnosis is fairly real. I hate being on meds, so the odds are good that I will try to get off them in the near future anyway. if I can have that coincide with testing to be a donor, that would be great. Another issue is that my brother refuses to consider a living donor transplant unless it's life and death, at which time it would be too late. So we need to get him on board, too. It will be a lot easier if we know there is someone in the family ready and eager to donate.

I have a phone call into the donor coordinator and hope to email her my questions tomorrow. If it can't be me, I want to circulate the info to my siblings to see if they qualify. I just can't abide his dying if we can prevent it.

Thanks for the input.
 
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camper33 is offline camper33 Post #4  June 30,2010, 10:39pm
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Dear " Emme0264 " ( " Andie0264 " ) , and " DrTonya " ,

As it stands right now , ( at least in Michigan ) , one is assumed to NOT be a donor , unless they ask to be a donor , and have it put on their driver's license , or they make some other legal notification .

Won't it be wonderful if some day , everyone is considered to be a donor , unless they have taken the time to have it put on their driver's license , or some other legal notification that they are NOT a donor ?!?!?!

As a man of faith , I believe that when we " die " , we graduate ( to heaven ) . We do not take our bodies with us . Our bodies are the luggage that we leave behind , and they merely rot in the ground . There is absolutely no reason in the world to NOT be a donor .

To those who may read this , please , take the time to have your secretary of state put it on your driver's license that you are a donor , or do whatever else it takes to be a donor in your state .

Whatever you do towards being a donor is reversible .

Tell your family that you want to be a donor , to be sure that they help the process , and don't try to get in the way of the process .

Last but not least , here is a website to help you ;

How to Be an Organ & Tissue Donor

P . S . , One of my favorite bumper stickers says something to the effect of ; " Don't take your organs to heaven . God knows , you won't need them there ! "

Sincerely ,

Alec ,

( camper33 ) .
 
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RoxyRedhead is offline RoxyRedhead Post #5  July 2,2010, 6:55pm

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Emme0264 wrote :

My question is whether anyone has tried to stabilize a mood disorder through exercise, or in any other non pharmaceutical way?
Any suggestions from anyone?

Emme
Yes Yes Yes! YES

Although my diagnosis was situational depression following the death of my husband, I had also changed my lifestyle: become less active, started eating junk and generally didn't take care of myself.

I disliked the effect that anti-depressant medication had on my body. Rather than mitigate the depression, I became more lethargic and had sleeping problems although I felt fatigued all day.

After a couple of years, I got a referral to a grief therapy specialist who helped me taper off the meds and deal with the depression instead of medicating it.

I also became more active, though it was like pulling teeth at first to make myself go to the things I committed myself for. I joined a couple of groups, started volunteering, started following Dr. John McDougalls vegetarian eating plan, lost about 20 lbs and joined a gym.

Today I am much healthier physically and emotionally.

Your diagnosis may not respond to the kind of changes mine did, but taking good care of yourself is something I encourage you to do for yourself, if not for your brother.

I commend you on your liver transplant desire-having just done a Kidney Donor support walk to honor my nephew and his donor last week, I know how important this can be to both you and your brother.

Very best of luck!
 
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DrTonya is offline DrTonya Post #6  July 5,2010, 11:37am
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Roxy I am glad that exercise and leading a healthy lifestyle helped you after your loss. Very commendable that you found a way to plow thru and get where you are today. A healthy lifestyle is recommended for everyone.

Emme, while Roxy's experiences are very encouraging I hope you realize that Bipolar 2 is significantly different than situational depression. I actually did a literature review after your posted your question initially (and after my response) - unfortunately I could not find research out there that indicated that Bipolar disorder (any of the subtypes) could be treated without meds and by exercise alone. There is a body of research out there indicating that situational depression can be overcome through exercise and with a low dose of anti-depressants; many (as with Roxy) choose to forgo the meds altogether. The difference is that situational depression is generally short-lived and in response to a very specific event; the goal is to address the event (such as overcoming grief) and the depressive symptoms would lessen. I was hoping to find anything to support what you were asking and generally what was out there was that exercising can help relieve *some* of the symptoms on the depressive swing but there was no evidence that it helped the hypomania at all. So, I strongly encourage you to check with your doctor before going off of your meds in favor of using exercise/healthy living as the sole means of managing your symptoms.

I know you want to help your brother and I commend you for that. However, your health (physical and mental) are important as well. Do not lose yourself in trying to help your brother, especially now that you have the correct diagnosis and are taking meds that are helping your symptoms. At times we feel good enough to think we can "go without" meds for a while - it is important that you realize that the meds are what is helping you feel better. Again, this decision should be made collaboratively and between you and your doc. We here can only offer our advice looking from the outside in.

I really do wish you the best of luck. Please let me know how you are doing. If your doc agrees to let you try to let you go off meds in favor of exercise, I'd be curious to know that (and if it worked for you). Some of the "ground breaking" research comes from case studies and people going against the research out there.
 
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Emme0264 is offline Emme0264 Post #7  July 7,2010, 4:35pm
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I'm doing fine. I went through the first round of evaluations to be a living liver donor and got rejected for having had 3 abdominal surgeries. The surgeon decided it would just be too risky for me physically. So the topic of getting off meds is tabled for now. But I have a new situation at work that will need some adjusting. I am incredibly sensitive to sound. Chairs rolling back and forth, sniffling, the guy in the next cube chewing with his mouth open, people crunching popcorn 3 cubes away, doors slamming, etc. I am almost beside myself with irritability and rage about these sounds. I bought myself a good pair of headphones and found a website that plays constant white, pink or brown noise. I have the brown noise cranked up to 100% and I can still hear things that are making me crazy. Next thing is to ask my shrink if this is linked to the bipolar or meds and see if he'll back me in asking for a reasonable accomodation if necessary. My office moved 3 months ago and our cube walls are only 57"high, so all the noise is very audible. They added 1 foot additions on the corners of some cubes as they are "high traffic" areas so I think they'd have to add them to mine as a reasonable accomodation. Otherwise I'm going to have to start taking sick days as I fear I'm going to beat the guy who chews with his mouth open. He is the nicest guy going but he chews like a cow. I've actually had dreams of takign a 2x4 to his head (well, to be fair, abotu taking one to my boss's head too) and would never do it, but I might lose it and start screaming and need to be sedated.

It's always something.
 
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DrTonya is offline DrTonya Post #8  July 7,2010, 9:24pm
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Emme0264 wrote :
I'm doing fine. I went through the first round of evaluations to be a living liver donor and got rejected for having had 3 abdominal surgeries. The surgeon decided it would just be too risky for me physically. So the topic of getting off meds is tabled for now. But I have a new situation at work that will need some adjusting. I am incredibly sensitive to sound. Chairs rolling back and forth, sniffling, the guy in the next cube chewing with his mouth open, people crunching popcorn 3 cubes away, doors slamming, etc. I am almost beside myself with irritability and rage about these sounds. I bought myself a good pair of headphones and found a website that plays constant white, pink or brown noise. I have the brown noise cranked up to 100% and I can still hear things that are making me crazy. Next thing is to ask my shrink if this is linked to the bipolar or meds and see if he'll back me in asking for a reasonable accomodation if necessary. My office moved 3 months ago and our cube walls are only 57"high, so all the noise is very audible. They added 1 foot additions on the corners of some cubes as they are "high traffic" areas so I think they'd have to add them to mine as a reasonable accomodation. Otherwise I'm going to have to start taking sick days as I fear I'm going to beat the guy who chews with his mouth open. He is the nicest guy going but he chews like a cow. I've actually had dreams of takign a 2x4 to his head (well, to be fair, abotu taking one to my boss's head too) and would never do it, but I might lose it and start screaming and need to be sedated.

It's always something.
Hi Again, Emme,

First, so sorry to hear that you were rejected as a live donor. I know how much you wanted to help your brother. Kudos to you for trying and volunteering to go thru the process - despite the outcome you demonstrated to your brother how committed you were to trying to aid in his transplant and I hope he appreciated your efforts. You were also brave to attempt to donate despite knowing there was a significant chance you would be rejected - most would just never have tried. I truly admire your tenaciousness.

From what you describe, adding those additional "sound barriers" to your cubicle sounds like a reasonable accommodation for you under ADA (but you are the lawyer - so I'll leave the "law" part of this discussion to you). Hypersensitivity to sound has been associated with Bipolar in general - not sure if it is only linked to specific subtypes though. I am uncertain if changing/increasing your meds would help - that is something to ask your doc (as you know). Have you tried putting in earplugs before putting on the headphones to drown out any additional noise that is distracting you? Is it possible for your cube to be moved to a more quiet area? I know how difficult it is to work where there are tons of people around (at my previous school district, our whole department sat desk-to-desk; we did not even have cubical walls to separate us and there were over 150 of us on the floor so I really do know what you mean!).

Your doc should be able to write a note to your boss stating your need to be in the quietest space possible without revealing your diagnosis (unless you have disclosed already). Hopefully that will be enough for your firm to accommodate you. Otherwise I would request exactly what you are saying here - see if it would be possible to telecommute from home a specified number of days per week.

I wish you the best of luck Emme. Hang in there.
 
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Emme0264 is offline Emme0264 Post #9  July 10,2010, 10:34am
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My brother actually knows nothing of my getting screened to be a donor. He adamantly refuses to consider a living donor transplant, so I asked the people I spoke with to not tell him I had called. Both they and I thought that if I made it past the first round of screening that we could talk to him and try to convince him to consider it, at least for as long as the rest of the evaluation lasted. We figured if I made it through all of it and was an acceptable donor that we would be in a better position to try to convince him to accept it. So he has no idea I tried and it will stay that way. In the meantime, we saw him this past weekend and I was horrified. My SIL, who hasn't seen him in a while, thought he looked good. But he is incredibly gaunt, his muscles have completely wasted, and he had trouble walking from the back deck to a chair in the yard. He was exhausted just from that walk. It's looking grim, but there's nothing we can do. We wonder if he is ready to just give up, which is his perogative even if we are deeply saddened by his choice.
 
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