March 31, 2011

Pack up the moon and dismantle the sun

Regulars around these parts will know about SawHole. SawHole is the work experience girl here at WoogsWorld but recently, after some very bad behaviour at a public event, I was delighted to promote her to intern.

SawHole sends me tons of useless facts and story ideas and spends a fair bit of her time working on merchandising items. I am currently trialling an insulated coffee flask. It is an item we are considering for inclusion in our upcoming Mother's Day catalogue.

And there are some days that she sends me a post which stops my heart for a minute or two. Today is one of those days.

At first glance, newsreader Charmaine Dragun and I seem to have nothing in common. Charmaine was a broadcast journalist and presenter, while I am the recently promoted Woogsworld work experience girl. Notice I said Charmaine was an Australian journalist and presenter because sadly she is no longer with us due to the negligence of our mental health system. Both our lives have been touched by undiagnosed bipolar disorder and we have been really let down by our nation's health services.

Following Charmaine's death, an inquest was held into the incident it also made reference to a common drug used to treat depression. That drug nearly killed me. It is called Efexor XR, I like to call it The Devil Drug, and if you try to come off it, all hell will most likely break loose. I came off the drug under supervision of a GP (who saw me every day) and a psychiatrist. I was also in hospital for part of my withdrawal.

It was not until I came home from hospital that the obsessive thoughts about suicide, panic attacks and Exorcist-type vomiting started. Charmaine went down that road too when, according to The Daily Telegraph, she began reducing her dose of the drug Efexor and started on a new medication, Lexapro. Friends described her behaviour at that time as "disturbing" and "out of character".

I pointed out the hideous withdrawal effects out to the company which makes this drug, Wyeth, and I am sure they have heard them all before. This is what they said in reply to my email: "The Consumer Medicine Information (CMI) for Efexor-XR also includes information about adverse drug reactions, abrupt discontinuation and taking the product correctly as well as precautionary statements regarding the worsening of depression and suicide risk. Discontinuation effects are well known to occur with antidepressants. It is therefore recommended that the dosage of Efexor-XR be tapered gradually and the patient monitored. The period required for discontinuation may depend on the dose, duration of therapy and the individual patient and is determined by the treating physician."

To be fair, Wyeth has no way of knowing whether doctors are inappropriately prescribing the drug so the issue seems to be one of misdiagnosis. However, there needs to be more education about bipolar disorder within the medical community. I am not an expert here so I will leave it to Professor Gordon Parker, of The Black Dog Institute, who says people are dying because doctors are not screening them for bipolar disorder and diagnosing them with depression instead. Depression medication could be dangerous for the bipolar and different treatment plans were needed, he told The Sydney Morning Herald. He conducted an audit of the first 1000 patients treated at the institute's clinic and found more than two-thirds had their diagnosis changed after being seen by the centre's specialists.

Bipolar disorder and anxiety were significantly under-diagnosed, with about 26 per cent of patients told for the first time they had bipolar disorder and 40 per cent diagnosed with anxiety. In Charmaine's case, her death was probably preventable if her mental condition had been properly diagnosed, the coroner found. The Sydney Morning Herald reported Deputy State Coroner Malcolm MacPherson as saying the diagnosis that Dragun suffered from depression was "almost certainly wrong" and she most likely had a bipolar disorder.

The coroner said if the health professionals treating Charmaine had made the correct diagnosis "she would have been properly treated with a mood stabiliser and she probably would not have committed suicide".

Like Charmaine's family, I also feel very let down by our mental health system and if I did not have the absolute dumb luck of finding a GP who has expertise in mood disorders, I would be dead. My bipolar 2 is harder to diagnose than bipolar 1, which has the classic high manias. I don't get manic, I get below manic, and am absorbed in a hostile world of irritation and agitation. However, the Black Dog does say that people who come back time and time again with depression that has not resolved, should be screened for bipolar.

When I was really sick through my Efexor nightmare, I thought about suicide all day, every day and if it was not for my little girl, I would have done the irrevocable. I bounced from GP to GP with the world's longest case of 'post-natal depression'. I found one charmer who prescribed a few sessions with a psychologist and asked me if I had considered God. There was another who stared at me blankly and had no idea what to do with my case.

You might think I am being harsh on doctors but it is not just them at fault, it is the whole health system. After Miss Charisma was born, I was overwhelmed with panic attacks and the hospital sent me a social worker. I told them I wanted a psychiatrist and they smiled at me like a mad woman, which was at the time, and sent me on my merry way to become my GP's problem.

They needed the bed.

This was happening to someone who has worked in the healthcare system for years, so if I can't navigate it, no-one can. At the time, I worked as a consumer advocate and there was no way through that maze. I just thought I was an evil, bad person who deserved to die. Everyone would be better off without me. But through dumb luck and finding a GP who was a psychiatric registrar and a patient psychiatrist and a saintly husband, I am still here.

I now take pleasure in the small things in life. Like watching Miss Charisma together with her Dad. Playing with my crazy, wacky, zany puppy and patting Mrs Paige's pregnant belly. I am still zany and love nothing more than a dance with a mop at a blogger's conference. That's my personality - big, bold and bombastic. (cue Mr Bombastic music)

I will never be 'cured' of bipolar disorder and I have to make the best out of my poo sandwich. There is one thing I can feel smug about - bipolar patients are smarter than the average bear. So I am a very good person to have on your pub trivia team.

I am also in good company. Albert Einstein, Sir Isaac Newton, Charles Darwin, Sir Winston Churchill, Alexander The Great, Christopher Columbus and Picasso were some of the great names believed to suffered the disorder. So I am going to stay here and feel smug. Besides I have to stay here because someone has to take out the Woog rubbish and empty Chuy's litter tray.

Over and Out.


PS Anyone who tells me not talk about suicide should click here. The longer we cloak this issue in silence, the worse it will be. Suicide has a catastrophic impact on people who are bereaved . Help is available – call Lifeline on 13 11 14 or Kids Help Line on 1800 55 1800 it is OK to ask for help – this is a strong and positive thing to do.

Thanks to W.H Auden for this blog post title

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