Bipolar part 2

2007:

After the first phone call and after I entered the hospital there in Panama City, FL, I was feeling more like myself and less with the feeling of danger. Carted off by my wife who came there to pick me up, she was tearful as she wrapped her arms around me. She then guided me to the Yaris that we had and together with daughter in tow left the hospital grounds headed toward a new adventure with this new folly, this new disease of the brain (at least that what I thought it was).

Yet the longing for touch, feelings, and many other emotions were guiding me into a race of calming and understanding of what was happening to me was on my mind. Yet at the same time, I was feeling like I was alone, that this issue that was just starting to plague me would overtake me once more. Yet here it did not happen. Instead, the anger was the main thing that was explosive. I (for many years afterward) was angry, angry at myself, others, everyone, and anyone who would come into my life and mess it up beyond compare.

Here I was in the car, angry at everything but nothing at the same time, I sat there and brooded. Which now, I can recommend that that is not a good thing, not what anyone (MHU Specialists or any medical professional) would recommend. Here I was though, alone, and the main thought on my mind that I can remember was LOST.

Confused, rejected by everyone and anyone who would find out about this. This made me feel like I was nothing more than a body that anyone could walk on. Tread on. There was nothing to stop them from doing whatever they desired. Tiffany was not there, yet there she sat in the driver’s seat.

We arrived at my parents’ home, where we were living at the time, and got out with my belongings and new grey folder filled with things and articles to make sure I was better, as well as a number to reach them in case I needed them. waling inside was like a cold cave, filled with spiders and snakes. Rat droppings, carved stairwells that went nowhere were abundant. It was not like a star light would have been built in, but rather it seemed like a more dungeon from the old days of England. However, this was obviously not the case.

The room as I entered it was more like a house on a hill. Beauty beyond what I can recall of seeing this house than it was before Hurricane Michael (where the house was demolished by the storm). The food that my Mom prepared was fit for a King, a King that did not exist, a King who never be again. It was at dinner here when I tried my best to explain what was happening to me and how indeed did I do that?

I do not remember the exact wording so again as I done in the first, I will quote another site or Mayo Clinic once more to explain a little easier onto what I am and what I deal with daily.

• “Important Risk Information

• Prescribing Information

• Medication Guide

• Healthcare Professional Site

• Other Condition

VRAYLAR

• WHY VRAYLAR

• BIPOLAR I BASICS

• SUPPORT & RESOURCES

• SAVINGS & PRICING

• FIND A HEALTHCARE

PROVIDER

Bipolar I Basics

What is bipolar I disorder?

Bipolar I disorder is a condition that causes periods of severe changes in your mood, activity levels, energy, and ability to carry out everyday tasks. These changes are commonly called “mood episodes.”

Although you may feel like you’re the only one if it’s happening to you, there are millions of Americans affected by bipolar disorder each year.

While anyone can develop bipolar I disorder, it often starts in the late teen or early adult years and it lasts a lifetime. Children and older adults may develop bipolar I disorder as well.

Medical researchers believe that it can result from many factors, including an imbalance of certain chemicals in the brain called neurotransmitters, which may be too high or too low.

DID YOU KNOW ?

Bipolar I disorder often runs in families. If you have a family history of bipolar I disorder, be sure to let your healthcare provider know.

What mania and bipolar depression feel like

What are the symptoms?

Bipolar I disorder can cause unpredictable high and low mood swings, also known as manic and depressive episodes.

It’s impossible to predict how long mood episodes may last. You might be severely depressed for a brief or extended period of time before entering into a manic episode. Mania could last anywhere from days to months as well. You may even experience manic and depressive symptoms at the same time, which is known as a mixed episode.

Read on to learn more about the range of symptoms people with bipolar I disorder may experience.

Symptoms spectrum

Select a mood state below to see common symptoms.

MIXED EPISODES

Mixed episodes occur when highs and lows are experienced at the same time.

For example, you may be having a mixed episode if you’re:

Having trouble concentratingHaving too much energy while feeling very sadBehaving impulsively

Thinking about death or suicideFeeling exhausted but overly anxiousFeeling jumpy or wired

Feeling like you can't enjoy anythingFeeling like your thoughts are coming very fast

Forgetting things a lotBeing talkative while pessimisticBecoming more active than usual

Having trouble sleepingBehaving impulsively while feeling exhaustedHaving higher than usual energy levels

DEPRESSIVE SYMPTOMS

MIXED EPISODES

MANIC SYMPTOMS

Do these symptoms sound familiar?

Complete this questionnaire and share the results with your healthcare provider.

What can trigger bipolar I episodes?

Approaches to managing bipolar I

When you have bipolar I, it can seem like your mood episodes are random.

But both depressive and manic episodes are often triggered by something. Being aware of your triggers or warning signs can help you in managing your mood episodes.

Common triggers for bipolar I disorder may include:

• Sleep deprivation

• Medications

• Seasonal changes

• Substance abuse

• Stress

Some triggers, such as stress, you can control or manage, while others you may not. Be sure to discuss your triggers with your doctor.

How is it diagnosed?

My journey to a bipolar diagnosis

Bipolar I can go unrecognized for years by not only those who suffer with it, but by family, friends, and even healthcare providers. Manic symptoms are reported less often than depressive ones for most people with bipolar I, so healthcare providers may only see, and therefore treat, symptoms of depression instead of bipolar I disorder.

The first step: If you think you may have bipolar I, talk with a doctor. They can complete a physical exam to rule out other conditions.

Why this matters: People with bipolar disorder often have other health problems including substance abuse, anxiety disorders, thyroid disease, heart disease, and obesity. These conditions can have similar symptoms to bipolar I, which can complicate the diagnosis of bipolar I disorder.

Bipolar I depression is different

Bipolar refers to the opposite ends (the poles) of the emotional spectrum—lows (depression) and the highs (mania). On top of the deep, unshakeable sadness or emptiness felt by patients with Major Depressive Disorder (MDD), patients with bipolar I also experience manic episodes. Treatments for MDD may not be effective for patients with bipolar I disorder, so it’s important to get the right diagnosis.

How is it treated?

The most effective treatment plan for bipolar I often includes a combination of medication, talk therapy, support groups, and improving overall health and wellness.

However, the cornerstone of every treatment plan is medication and finding the right one for you could take some time. Some people may require more than one medication to experience relief.

Your healthcare provider will start the process by evaluating your symptoms and treatments. So, it’s critical to share all the symptoms you’re experiencing now or have experienced in the past, as well as the medications you’re taking now or have taken in the past.

It’s difficult to be patient when bipolar I affects your life

Maybe you've already tried a lot of solutions. You want to get your bipolar I under control, and so does your doctor.

If you are experiencing symptoms like extreme highs and lows of your mood, let your doctor know. Ask if VRAYLAR may help.

Additional Resources:

Customize A Doctor Discussion Guide

Download My Mood Tracker

Take the “Could I Have Bipolar I?” quiz

________________________________________

IMPORTANT RISK INFORMATION AND INDICATION

What is the most important information I should know about VRAYLAR?

Elderly people with dementia-related psychosis (having lost touch with reality due to confusion and memory loss) taking medicines like VRAYLAR are at an increased risk of death. VRAYLAR is not approved for treating patients with dementia-related psychosis.

Antidepressants may increase suicidal thoughts or actions in some children and young adults within the first few months of treatment and when the dose is changed. Depression and other serious mental illnesses are the most important causes of suicidal thoughts and actions. Patients on antidepressants and their families or caregivers should watch for new or worsening depression symptoms, especially sudden changes in mood, behaviors, thoughts, or feelings. This is very important when an antidepressant is started or when the dose is changed. Report any change in these symptoms immediately to the doctor.

VRAYLAR may cause serious side effects, including:

• Stroke (cerebrovascular problems) in elderly people with dementia-related psychosis that can lead to death

• Neuroleptic malignant syndrome (NMS): Call your healthcare provider or go to the nearest hospital emergency room right away if you have high fever, stiff muscles, confusion, increased sweating, or changes in breathing, heart rate, and blood pressure. These can be symptoms of a rare but potentially fatal side effect called NMS. VRAYLAR should be stopped if you have NMS

• Uncontrolled body movements (tardive dyskinesia or TD): VRAYLAR may cause movements that you cannot control in your face, tongue, or other body parts. Tardive dyskinesia may not go away, even if you stop taking VRAYLAR. Tardive dyskinesia may also start after you stop taking VRAYLAR

• Late-occurring side effects: VRAYLAR stays in your body for a long time. Some side effects may not happen right away and can start a few weeks after starting VRAYLAR, or if your dose increases. Your healthcare provider should monitor you for side effects for several weeks after starting or increasing dose of VRAYLAR

• Problems with your metabolism, such as:

o High blood sugar and diabetes: Increases in blood sugar can happen in some people who take VRAYLAR. Extremely high blood sugar can lead to coma or death. Your healthcare provider should check your blood sugar before or soon after starting VRAYLAR and regularly during treatment. Tell your healthcare provider if you have symptoms such as feeling very thirsty, very hungry, or sick to your stomach, urinating more than usual, feeling weak, tired, confused, or your breath smells fruity

o Increased fat levels (cholesterol and triglycerides) in your blood: Your healthcare provider should check fat levels in your blood before or soon after starting VRAYLAR and during treatment

o Weight gain: Weight gain has been reported with VRAYLAR. You and your healthcare provider should check your weight before and regularly during treatment

• Low white blood cell count: Low white blood cell counts have been reported with antipsychotic drugs, including VRAYLAR. This may increase your risk of infection. Very low white blood cell counts, which can be fatal, have been reported with other antipsychotics. Your healthcare provider may do blood tests during the first few months of treatment with VRAYLAR

• Decreased blood pressure (orthostatic hypotension): You may feel lightheaded or faint when you rise too quickly from a sitting or lying position

• Falls: VRAYLAR may make you sleepy or dizzy, may cause a decrease in blood pressure when changing position (orthostatic hypotension), and can slow thinking and motor skills, which may lead to falls that can cause fractures or other injuries

• Seizures (convulsions)

• Impaired judgment, thinking, and motor skills: Do NOT drive, operate machinery, or do other dangerous activities until you know how VRAYLAR affects you. VRAYLAR may make you drowsy

• Increased body temperature: Do not become too hot or dehydrated during VRAYLAR treatment. Do not exercise too much. In hot weather, stay inside in a cool place if possible. Stay out of the sun. Do not wear too much clothing or heavy clothing. Drink plenty of water

• Difficulty swallowing that can cause food or liquid to get into your lungs

Who should not take VRAYLAR?

Do not take VRAYLAR if you are allergic to any of its ingredients. Get emergency medical help if you are having an allergic reaction (eg, rash, itching, hives, swelling of the tongue, lip, face or throat).

What should I tell my healthcare provider before taking VRAYLAR?

Tell your healthcare provider about any medical conditions and if you:

• have or have had heart problems or a stroke

• have or have had low or high blood pressure

• have or have had diabetes or high blood sugar in you or your family

• have or have had high levels of total cholesterol, LDL-cholesterol, or triglycerides; or low levels of HDL-cholesterol

• have or have had seizures (convulsions)

• have or have had kidney or liver problems

• have or have had low white blood cell count

• are pregnant or plan to become pregnant. VRAYLAR may harm your unborn baby. Talk to your healthcare provider about the risk to your unborn baby if you take VRAYLAR during pregnancy. If you become pregnant or think you are pregnant during treatment, talk to your healthcare provider about registering with the National Pregnancy Registry for Atypical Antipsychotics at 1-866-961-2388 or

http://www.womensmentalhealth.org/clinical-and-research-programs/pregnancyregistry/

• are breastfeeding or plan to breastfeed. It is not known if VRAYLAR passes into breast milk. Talk to your healthcare provider about the best way to feed your baby during treatment with VRAYLAR

Tell your healthcare provider about all medicines that you take, including prescriptions, over-the-counter medicines, vitamins, and supplements. VRAYLAR may affect the way other medicines work, and other medicines may affect how VRAYLAR works. Do not start or stop any medicines while taking VRAYLAR without talking to your healthcare provider.

What are the most common side effects of VRAYLAR?

• The most common side effects were difficulty moving or slow movements, tremors, uncontrolled body movements, restlessness and feeling like you need to move around, sleepiness, nausea, vomiting, and indigestion.

These are not all possible side effects of VRAYLAR.

INDICATION AND USAGE

VRAYLAR is approved in adults to treat depressive episodes (bipolar depression) and for the short-term treatment of manic or mixed episodes that happen with bipolar I disorder.

Please see the full Prescribing Information, including Boxed Warnings, and Medication Guide.

IMPORTANT RISK INFORMATION AND INDICATION

More

What is the most important information I should know about VRAYLAR?

Elderly people with dementia-related psychosis (having lost touch with reality due to confusion and memory loss) taking medicines like VRAYLAR are at an increased risk of death. VRAYLAR is not approved for treating patients with dementia-related psychosis.

Antidepressants may increase suicidal thoughts or actions in some children and young adults within the first few months of treatment and when the dose is changed. Depression and other serious mental illnesses are the most important causes of suicidal thoughts and actions. Patients on antidepressants and their families or caregivers should watch for new or worsening depression symptoms, especially sudden changes in mood, behaviors, thoughts, or feelings. This is very important when an antidepressant is started or when the dose is changed. Report any change in these symptoms immediately to the doctor.

VRAYLAR may cause serious side effects, including:

• Stroke (cerebrovascular problems) in elderly people with dementia-related psychosis that can lead to death

• Neuroleptic malignant syndrome (NMS): Call your healthcare provider or go to the nearest hospital emergency room right away if you have high fever, stiff muscles, confusion, increased sweating, or changes in breathing, heart rate, and blood pressure. These can be symptoms of a rare but potentially fatal side effect called NMS. VRAYLAR should be stopped if you have NMS

• Uncontrolled body movements (tardive dyskinesia or TD): VRAYLAR may cause movements that you cannot control in your face, tongue, or other body parts. Tardive dyskinesia may not go away, even if you stop taking VRAYLAR. Tardive dyskinesia may also start after you stop taking VRAYLAR

• Late-occurring side effects: VRAYLAR stays in your body for a long time. Some side effects may not happen right away and can start a few weeks after starting VRAYLAR, or if your dose increases. Your healthcare provider should monitor you for side effects for several weeks after starting or increasing dose of VRAYLAR

• Problems with your metabolism, such as:

o High blood sugar and diabetes: Increases in blood sugar can happen in some people who take VRAYLAR. Extremely high blood sugar can lead to coma or death. Your healthcare provider should check your blood sugar before or soon after starting VRAYLAR and regularly during treatment. Tell your healthcare provider if you have symptoms such as feeling very thirsty, very hungry, or sick to your stomach, urinating more than usual, feeling weak, tired, confused, or your breath smells fruity

o Increased fat levels (cholesterol and triglycerides) in your blood: Your healthcare provider should check fat levels in your blood before or soon after starting VRAYLAR and during treatment

o Weight gain: Weight gain has been reported with VRAYLAR. You and your healthcare provider should check your weight before and regularly during treatment

• Low white blood cell count: Low white blood cell counts have been reported with antipsychotic drugs, including VRAYLAR. This may increase your risk of infection. Very low white blood cell counts, which can be fatal, have been reported with other antipsychotics. Your healthcare provider may do blood tests during the first few months of treatment with VRAYLAR

• Decreased blood pressure (orthostatic hypotension): You may feel lightheaded or faint when you rise too quickly from a sitting or lying position

• Falls: VRAYLAR may make you sleepy or dizzy, may cause a decrease in blood pressure when changing position (orthostatic hypotension), and can slow thinking and motor skills, which may lead to falls that can cause fractures or other injuries

• Seizures (convulsions)

• Impaired judgment, thinking, and motor skills: Do NOT drive, operate machinery, or do other dangerous activities until you know how VRAYLAR affects you. VRAYLAR may make you drowsy

• Increased body temperature: Do not become too hot or dehydrated during VRAYLAR treatment. Do not exercise too much. In hot weather, stay inside in a cool place if possible. Stay out of the sun. Do not wear too much clothing or heavy clothing. Drink plenty of water

• Difficulty swallowing that can cause food or liquid to get into your lungs

Who should not take VRAYLAR?

Do not take VRAYLAR if you are allergic to any of its ingredients. Get emergency medical help if you are having an allergic reaction (eg, rash, itching, hives, swelling of the tongue, lip, face or throat).

What should I tell my healthcare provider before taking VRAYLAR?

Tell your healthcare provider about any medical conditions and if you:

• have or have had heart problems or a stroke

• have or have had low or high blood pressure

• have or have had diabetes or high blood sugar in you or your family

• have or have had high levels of total cholesterol, LDL-cholesterol, or triglycerides; or low levels of HDL-cholesterol

• have or have had seizures (convulsions)

• have or have had kidney or liver problems

• have or have had low white blood cell count

• are pregnant or plan to become pregnant. VRAYLAR may harm your unborn baby. Talk to your healthcare provider about the risk to your unborn baby if you take VRAYLAR during pregnancy. If you become pregnant or think you are pregnant during treatment, talk to your healthcare provider about registering with the National Pregnancy Registry for Atypical Antipsychotics at 1-866-961-2388 or

http://www.womensmentalhealth.org/clinical-and-research-programs/pregnancyregistry/

• are breastfeeding or plan to breastfeed. It is not known if VRAYLAR passes into breast milk. Talk to your healthcare provider about the best way to feed your baby during treatment with VRAYLAR

Tell your healthcare provider about all medicines that you take, including prescriptions, over-the-counter medicines, vitamins, and supplements. VRAYLAR may affect the way other medicines work, and other medicines may affect how VRAYLAR works. Do not start or stop any medicines while taking VRAYLAR without talking to your healthcare provider.

What are the most common side effects of VRAYLAR?

• The most common side effects were difficulty moving or slow movements, tremors, uncontrolled body movements, restlessness and feeling like you need to move around, sleepiness, nausea, vomiting, and indigestion.

These are not all possible side effects of VRAYLAR.

INDICATION AND USAGE

VRAYLAR is approved in adults to treat depressive episodes (bipolar depression) and for the short-term treatment of manic or mixed episodes that happen with bipolar I disorder.

Please see the full Prescribing Information, including Boxed Warnings, and Medication Guide.

People with bipolar I

share their stories

HOME

WHY VRAYLAR ›Is VRAYLAR right for you? ›How does VRAYLAR work? ›Who is VRAYLAR for? ›How do I take VRAYLAR? ›What side effects are possible? ›

BIPOLAR I BASICS ›What is bipolar I disorder? ›What are the symptoms? ›What can trigger episodes? ›How is it diagnosed? ›How is it treated? ›

SUPPORT & RESOURCES ›Sign up ›Wellness resources ›Find a healthcare provider ›Find a support group ›Real stories ›Friend or family support ›Common questions ›

SAVINGS & PRICING ›Save on VRAYLAR ›Pricing ›

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VRA128208-v9 02/21

- About Bipolar l Disorder | VRAYLAR® (cariprazine)

There will be more to come, follow together with me as we go on the continuation of what Bipolar is and how to handle it.