How to Ensure You Never Run out of Meds Again

June 10, 2022June 10, 2022 Cassandra Stout

Blogger’s Note: I will be updating my blog every two weeks from now on! Thanks for reading!

This post appeared on the International Bipolar Foundation’s website, here.

Running out of meds is the worst.

If you’re regularly taking medication and you run out of pills and stop suddenly, this is terrible for your body and your mind.

If you’re bipolar, you may end up tripping into a mood episode that can devastate you and your family.

But how do you ensure you never run out of meds?

This is the process that works for me, and it might help you, too. I live in the US, take medications that work that I can afford, and have a regular psychiatrist on call that I can also afford.

If these facts aren’t all true for you, then the basics of the process may work but the entire process may not.

I’ll discuss some tips on how to afford your meds later, as well as providing a National Institutes of Mental Health link describing several ways to afford a psychiatrist in the US.

How to Prevent Yourself from Running out of Meds

As I’m sure you’re aware, keeping your supply of meds stocked is important for day-to-day functioning.

But how do you ensure you’ll never run out of meds again?

Here’s what I do.

I have an am/pm pillbox that I fill every week on Sunday morning, right after my morning dose. I recommend designating a particular time to fill your pillbox, so you are always aware of what medications you possess at any given time.

I also highly recommend taking your meds at the same times every day. I take mine as soon as I wake up and after dinner at around 6pm but no later than 6:30pm because my antipsychotic helps me sleep, and if I take it too late, I’m wired until midnight.

Now that I’ve been taking my meds at the same times every day for almost a year, the habit is ingrained in me, and I rarely miss my meds. And on the rare occasion that I do miss a morning dose, for example, my pillbox lets me know because the pills are still in the am slot.

Once I have two weeks left of pills, I call my pharmacy and have them order pills for me from my psychiatrist.

My psych doc knows these pills work for me in these doses (and if they ever stop working, I call him to make an adjustment), so he prescribes them in doses of 90 days.

If you can talk to your psychiatrist and ask them to prescribe in three-month levels (assuming you have meds that work), you can have your psychiatrist fax your meds to the pharmacy of your choice and pick them up every three months.

I have my preferred pharmacy’s–at my local grocery store–number saved in my phone. When I call them to order medications, the pharmacy has an automated phone menu that I enter my prescription bottle number (so save that bottle!) in to ask for a refill.

After entering the prescription number in the phone and confirming my own phone number when asked, the menu narrator then tells me when my medications will be ready (usually in a couple of days).

So when I see I have a two-week supply left of my medications from filling my pillbox on Sunday morning, I call my pharmacy. They order a 90-day supply from my psychiatrist, and I have my husband pick the medication up on the next shopping day, typically Mondays.

So my process is almost entirely automated. I would be surprised if your local grocery store didn’t also have an automated phone menu for their pharmacy, so you wouldn’t even have to talk to a pharmacist if you didn’t want to!

But don’t be afraid to talk to your pharmacist. They’re there to help you. They want you to have your meds, not only because that’s good for you, but also that’s how they get paid.

Get to know your local pharmacist if you can. They can help you get the life-saving medications you need on a regular basis.

Back before I got used to this process and I frequently ran out of pills, I was able to call my pharmacist and ask them to expedite my meds so I could pick them up in the same day.

Before I had a three-month supply, I also called my pharmacist to order me a three-week supply when I was going on an out-of-state trip.

I’ve also run out of meds while on a month-long trip and called my psych doc and pharmacy to transfer the “emergency” prescription to a pharmacy across the country, where I was staying.

So learning to rely on your pharmacist, who again, is there to help you, is crucial for your success!

But What if You Can’t Afford Them?

If you can’t afford your medications, ask your doctor. They may have access to free samples of the pills you need or be able to prescribe you a cheaper generic drug.

If you’re an American citizen and you’re uninsured, find out if the pharmaceutical company that manufactures your drug has a patient-assistance program. You may qualify for these programs if your income is 100% of the poverty line, but it’s unlikely that you will if you receive Medicaid benefits.

Ask your pharmacy if they have a discount program if you pay in cash. If you’re over fifty and have a membership with the AARP, you can receive discounts on pills.

As promised, here’s the link to the NAMI’s article of resources if you can’t afford a psychiatrist. This is US-centric, but you can extrapolate the process if you live in another country.

Final Thoughts

This process has taken me a long time and a lot of trial and error to perfect, but the three-month supply works very well for me. After years of never running out of meds, I have found that the process is almost automatic.

If you can automate and make routines for yourself, you will find the management of your condition a lot easier.

I wish you well in your journey.

Editor’s Note – Some states have laws that prevents you from getting prescriptions for psych meds directly from the pharmacy, so you may have to go through your doctor. IBPF is not a substitute for medical advice or treatment, so if you have any questions, please speak to your medical professionals.

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How to Stop Shoulding on Yourself

May 20, 2022April 7, 2022 Cassandra Stout

This post was featured on the International Bipolar Foundation website, here.

When you’re depressed, forget about thriving – you’re in survival mode.

Which means you need to be especially gentle with yourself.

If you’re telling yourself that you should get everything done on your impossibly long to-do list today, a trap that a lot of us in capitalistic societies fall into, you’re shoulding on yourself.

Shoulding on yourself is a terrible habit. Saying “I should do this,” or “I should do that,” is just piling guilt on yourself and zapping the motivation to do anything. Believe me, when I’m drowning under a wave of self-imposed shoulds, especially when I’m depressed, I go back to bed.

If you’re shoulding on yourself when you’re depressed, you’re being unkind to yourself when you’re in survival mode. You don’t have the “spoons” to do most of the tasks you think you should and you definitely don’t have the spoons to fret about it.

The Spoon Theory, a concept popularized in a personal essay by the same name by Christine Miserandino, explains the idea of energy in short supply due to chronic illness using “spoons” as units of energy.

If you’re low on spoons, an easy state to be in when you’re depressed and don’t start with many, shoulding on yourself is the last thing you need. Worry about what you should do will just exhaust you.

Don’t think, “I should do this and after that I should do this.”

Think, “I have one task to do. What would be the most effective use of my spoons? How crucial is this spoon usage? Will I be forced to do it later when I may have even fewer spoons?”

If you answer “I can do x because it will be effective,” or “this is very crucial,” and “yes,” then do the task.

The ONE task.

One task at a time. Don’t even worry about the others until that one task is done.

If you’re worried about all the tasks you have to do after the first–take a shower, prepare that quarterly report, clean out the storage unit–you’ll never finish even the first task. You’ll end up paralyzing yourself by how much you should get done.

Instead, prioritize. Think, “What is my most effective/crucial task?”

Many tasks aren’t as crucial as we believe they are. Crucial tasks are things like “feed the five-year-old.” Strip your to-do list down to its very basics, things you need for survival or for your dependents’ survival.

It’s time to choose your most effective/crucial task. And only one. When you’re in survival mode, you only have the spoons to do one or two, and especially one at a time.

You can only do one task at a time well, so choose the one that will get you the most bang for your buck. What is pressing on you the most? What do you want to do the least later?

You can conquer that task. You are smart and capable and able to conquer anything on your to-do list, one at a time.

I wish you well in your journey.

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Top Tips for Keeping Friends Even with a Mental Illness

March 4, 2022February 21, 2022 Cassandra Stout

In my last post, “How to Make Friends During a Pandemic Even with a Mental Illness,” I gave you a few tips on how to do just that.

Briefly summarized, the post encourages you to develop connections online, talk to your neighbors, join a support group, and/or reconnect with old friends. Using these tips, you can make friends even while stuck at home during a pandemic.

But once you’ve made those friends, how do you keep them?

Ah, there’s the rub. Keeping friends after making them is a difficult proposition for anyone, but that’s especially hard for those of us with mental illnesses.

Here are 3 tips to keep the friendships you just made alive.

1. Communicate, Communicate, Communicate

When trying to nurture your friendships, communication is key.

I have personally lost both new and long-standing friendships because I didn’t communicate properly with them.

In the case of the new friendships, usually playdates made at the parks I attended with my young daughter, I’ve neglected to text the parents after boldly asking for their numbers and establishing an initial “here’s my number” text.

My mother always said, “If you want a letter, write a letter,” implying that I should reach out first to establish the relationship. Her advice is solid; I have rarely kept a parent friend without my texting them to set up playdates often.

Neglecting to communicate is the easiest way to lose a friend. And it’s especially important for those of us with mental illnesses, as we need to let them know when we’re suffering a down day or are self-isolating.

Regarding my long-standing friendship, she frequently invited me to parties at her apartment, but because I didn’t want to drive in the downtown section of a massive city, where she lived, I refused invite after invite without telling her the truth.

This was before GPS on phones (I owned a flip phone at the time), and I was terrified of getting lost, like I’d done frequently when going to her apartment, or God forbid, driving the wrong way on a one-way street again.

I made up excuse after excuse without telling her the truth, and eventually, the emailed invites stopped coming. I lost touch with that friend and everyone in our social circle (she was the hub of all our mutual friends), leaving me virtually friendless for a few years.

Communication is key. Don’t do what I did–don’t neglect to tell your friends when you have an issue.

Here’s a rule-of-thumb: for close friends whose friendships you want to maintain, you should text them at least once a week. For casual acquaintances, call them on their birthdays at the very least.

Frequent communication will help you maintain the friendship.

2. Avoid Self-Isolation like the Plague it Is

When we’re depressed, we tend to withdraw from all sorts of social obligations. We’re exhausted and sad, and we think that socializing with friends is too much effort.

Don’t think like this. It’s a trap, one that starts off a vicious cycle and may even worsen your depression.

Just like in tip #1, if you’re open about your mental illness, communicate with your friends that you’re going through a depressive episode and ask for their grace. If you’re currently cloistered, don’t tell them details but let them know you’re struggling with something that makes socializing difficult.

And then actually socialize as much as you can handle. Sometimes that means lunches with friends are shorter, or you limit yourself to talking to your online friends, but don’t neglect to nurture your friendships.

Let your friends know you’re thinking of them via a text, phone call, or whichever way you communicate best. If you isolate yourself, your friends will think you’ve dropped off the face of the earth, and will choose not to “bother” you.

Tell your friends you need them and socialize as much as you can. Social connections are important and can help improve depressive episodes, and if you leave your friends alone, they will leave you alone, as in the example of my long-standing friendship.

3. Resolve Conflicts as Soon as You Can

Even best friends fight, but a conflict can suck the joy out of a friendship faster than air escaping a balloon.

The problem in your relationships are never all one person’s fault. If you’re facing a conflict with your friend, it’s likely you played a part in the problem.

Don’t let your friendships die because you can’t be the bigger person. Apologize for your part in it first, even if you think you were wronged more seriously than they were.

Most of us shy away from conflict. Highly Sensitive People (HSPs), especially those of is with mental illnesses, tend to be sensitive to yelling and criticism, and break down quickly when presented with problems in the friendship.

Don’t avoid conflict. Avoiding the problem only makes it worse. Swallow your reservations and, like in tip #1, communicate with your friends.

And if you can’t figure out what your part in the conflict is, spend some time in self-reflection. Being honest with yourself and your friend will help you keep them.

If you’re managing conflict in your friend group, listen to each side without judging. Getting everyone’s perspective before declaring who’s at fault (usually everyone) is tremendously important.

When conflict breeds most of the time, the participants just want to be heard and believe very strongly that the other people involved aren’t listening to them.

Listen to your friends. Be an impartial judge and resolve conflict quickly. Doing so will not only help you keep your friendship intact, it’ll also teach you skills for maintaining that friendship and other ones in the future.

Final Thoughts

I hope you’ve enjoyed this primer on how to keep friends even with a mental illness.

I’ve lost countless friends because I didn’t follow these steps. Once I realized the problem was me, I chose to nurture my friendships–two of which are extremely rewarding to me.

I’ve communicated effectively, refused to self-isolate, and resolved conflict as soon as I could. With these tools in my arsenal, I’ve made several friendships that I hope will last a lifetime.

I wish you well in your journey.

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How to Make Friends During a Pandemic Even with Your Mental Illness

February 25, 2022December 21, 2021 Cassandra Stout2 Comments

Friendships can be one of the toughest relationships to start, especially with mental illness gumming up the works. And the COVID-19 pandemic has created another level of difficulty for this.

But it doesn’t have to be this way. You can make friends during the pandemic even with your mental illness. Here’s how.

Join a Discord Server

In order to make friends, you need to go where the people are, and the people are online.

During the pandemic, meeting online has become crucial to our success, and online relationships have lost some of their stigma–which I believe is a good thing.

If you’re seeking an online relationship, you can try joining a Discord server.

Discord.com, a chatting service originally intended for gamers, has a variety of “servers”–or groups of people surrounding a theme with defined “channels” to speak in–of all types of interests.

There are over 300 million people around the world on Discord chatting about everything under the sun. If you have an internet connection, you can browse their server guides to find whatever topic interests you. There’s even an app for your phone!

The best part of Discord in my opinion is that relationships happen on your terms. You can choose to engage people or not as frequently as you wish, and you can chat with them on servers to get a bead on them before coming into their DMs, or direct messages.

This is especially helpful for people with social anxiety. I myself very much enjoy being able to think through my messages before I hit the “Enter” key to send them in the chat.

Once you enjoy talking to people on a server, you can make group DMs, too, with up to 10 specific people. If you have more friends than that that you want to chat with all at once, setting up a server of your own is easy.

I love Miraculous Fanworks, a Discord server of over 2300 people focused on producing fanart and fanfiction for the show Miraculous Ladybug. I loved the server so much, I even served as a moderator for almost two years.

And through it I met one of my best friends, whose wedding reception I’ll soon be flying across the country for along with several of our mutual friends that we also met on the server.

As a United States resident on an international Discord server, I’ve met people from:

Spain
Bulgaria
India
France
Australia
New Zealand
England
Germany
Canada
Poland
and the Philippines.

The server members speak hundreds of different languages and have taught me something new everyday about their various cultures.

A server is only as good as its people, though, and that goes double for moderators. If the server is disorganized, poorly-run, and/or the moderation team lets toxic behavior go unchecked, leave as soon as you can.

You can always take the friends you’ve made there and make group DMs or servers for yourselves before you leave. Chances are, one of your new friends will have a server made already.

So if you’re ready to make new friends during the pandemic, consider making a Discord account and joining a server based on a show you watch, a sport you like, an activity you enjoy, a mental illness you have, or even a school you attend.

Talk to Your Neighbors

One of the most interesting parts of the pandemic for me has been that my family has been more friendly with our neighbors, and our neighbors have embraced us.

Because of the pandemic, our neighbors spent more time at home outside doing yard work or walking their dogs, and we were able to connect. Going on walks around the neighborhood and opening conversations while standing six feet apart (with smiles!) has paid great dividends.

This past Thanksgiving, on the very hour I had raw bacon straws–puff pastry stripes with cheese wrapped in bacon and coated in thyme and brown sugar–sitting on their cookie sheets on my counters, ready to go, my oven broke.

Because I had an hour and a half until I was supposed to bring the bacon straws to my sister’s house, I ran over to a neighbor, whom I’d only had a casual relationship with, and begged to use his oven to bake my appetizers.

He readily agreed, and graciously and happily spent the next hour entertaining my young daughter with his granddaughter’s toys. I am deeply in his debt, and I hope that he’ll call on me with a favor next time he needs one and I can provide!

So try to overcome your social anxiety if you have it and say hello to your neighbors once in a while. There’s a large chance you can make a friend with the people who live around you, which will help if you ever need to borrow a cup of sugar–or even an oven.

Reconnect with Old Friends

Sometimes, friendships fade.

This is especially true for people who suffer from depression and other self-isolating mental illnesses. We often withdraw from all social contact when we’re feeling rotten, which is the opposite of what we should do.

If you have old friends that you have let fall by the wayside, send one of them a text today. Check up on them and see how they’re doing.

If they want to rekindle the friendship, they’ll let you know by their enthusiastic responses. If they don’t, they’ll likely be awkward and possibly ghost you. Try not to take that personally; like I said, sometimes friendships fade.

Reconnecting with old friends is a great way to reinvigorate a friendship, and though this isn’t making a new friend, not exactly, it can be a shot in the arm for you and hopefully for them, too.

Join a Support Group

This mostly applies to those of us who suffer from mental illnesses, but support groups are a fantastic resource to use when looking for new friends.

Common troubles breed closeness, and inherent in support groups is support. You could find people going through some of the same struggles you are, or people who have conquered those struggles and can help you do the same.

For some tips and resources for online support groups, click here.

Final Thoughts

Making friends during a pandemic may seem daunting, but if you put yourself out there, you will find people to call your own.

If you’re looking for friends during the pandemic, consider joining a Discord server, reaching out to your neighbors, reconnecting with old friends, and joining an online support group.

Making friends isn’t as difficult as it seems, even with a mental illness. In the future, I will post how to keep those friends, which may be of value to you.

Best of luck making new friends!

I wish you well on your journey.

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My Advice to a Relative Facing a Bipolar Disorder Diagnosis — And What This Diagnosis Really Means

January 7, 2022November 6, 2021 Cassandra Stout2 Comments

Trigger Warning: Mentions of intrusive thoughts that tell me to self-harm.

A dear relative came to me via Facebook messenger, telling me they’d been diagnosed with bipolar disorder and asking for my advice. They told me that they were scared of their diagnosis and they hoped I’d be able to understand.

Here is what I said to them, over an hours-long text conversation:

Oh, [name], I totally understand being scared of a diagnosis, especially one for a lifelong condition that can be dangerous under some circumstances. The best thing you can do to reduce your fear is to educate yourself on what this diagnosis really means.

What a bipolar diagnosis really means is different for everyone. But what it means to me is that I have an extra layer of work on top of my normal affairs to manage my moods.

I have to make sure I take my meds on time twice a day, monitor my moods so that I’m sure that the meds are working, monitor my actions to make sure they’re not wildly off base and within the range of societal norms, get enough sleep (this is especially important to avoid manic episodes), monitor my spending, avoid alcohol, and so on and so forth.

It sounds like a lot, and it is, but it’s just part and parcel with living with a mental illness. If I don’t put the work in, I become miserable and a danger to myself and others. Thankfully, the work gets easier as you get used to it.

I also used to think a bipolar diagnosis made me fragile. And to a certain extent, that’s true. There’s certain things I can’t do that other people can, like live without medication and drink and stay up all night.

But fragile is the wrong impression; if you go through life thinking you’re fragile, you’ll damage your confidence and make yourself believe you’re made of glass.

So while fragile is the wrong word, try delicate instead. With bipolar disorder, you have a delicate constitutional makeup. You need to be careful with yourself and treat yourself right. If you don’t, you won’t thrive or even survive well, and that’s no way to live a life.

I highly recommend educating yourself on what you have to do to treat yourself right. That’s the first step, and will help resolve your fears. Once you’re armed with knowledge about what the diagnosis really means to you and what you need to do to manage it, then you’ll be able to tackle it head on.

Do you have meds? Do they work? I would highly recommend finding a therapist that you feel comfortable with who can work with you through your diagnosis. A psychiatrist doesn’t have to be warm and friendly to know their stuff, but a therapist should be someone you feel you can talk to and basically share your struggles, challenges, and triumphs.

If you’re not on meds yet, go back to the psychiatrist and ask for some, especially a mood stabilizer to avoid endangering yourself or others with manic episodes.

Finding a med cocktail that actually works will take some time and a lot of wading through side effects, so don’t give up! You can find something that works for you, and even if your specific diagnosis is medication resistant, there are other things you can try like electroconvulsive therapy (ECT), but that’s mostly good for depressive episodes.

Still, there are therapies out there and you can treat this disease with a combination of medication, psychotherapy, and self-care.

But you do have to respect that this is a disease. It’s a brain disease, sure, but it’s a real and valid threat to your happiness and the happiness of those around you.

Give the disorder the respect it deserves and don’t underestimate how quickly things can fall apart. It’s a balancing act, but the more scaffolding you have in place, the less difficult it will be to balance your life.

What I mean by scaffolding is medication, a treatment team, therapy, and good habits like getting enough sleep every night. Once you have these things in place, you will find it easier to keep your mood on an even keel.

As someone who has been managing my bipolar disorder for years, I’ve realized that my brain lies to me. It does not have my best interests at heart.

I have intrusive thoughts that tell me to hurt myself, and I have to acknowledge that I had the thought and let it go. I often say to myself, “well, that was a thought! How interesting!”

And in this way I can look at those sorts of thoughts with a neutral mindset, as if I’m some sort of outside observer just looking at my brain and all its idiosyncrasies.

I know it’s hard to believe right now, but trust me: you are a human being with inherent value. Do you think your friends deserve pain? Treat yourself as a friend. That’s what you deserve, not this brain that lies to you.

You’ve got a lot of work ahead of you. But I am confident you can manage this illness and I’ll be here for you, too.

Like most people facing a bipolar diagnosis, my relative was scared and stressed. They didn’t know where to turn to start educating themselves about their diagnosis.

But there are resources out there. My blog, The Bipolar Parent, for one, as well as the National Institutes of Mental Healt h websit e. WebMD is good for an overview of the disorder, and your doctors are excellent touchstones for you who can provide even more resources.

If you can find someone in your life who has successfully managed their bipolar disorder for years, like I have, even better.

If you’re facing a bipolar disorder diagnosis, there is hope for you to have a successful, well-adjusted life. Make no mistake, it’ll take work, and sometimes there will be situations outside your control, but that work gets easier with time.

My relative asked me to check in on them periodically and offer them advice, which I plan to do. I’ve already set a repeating event in my calendar with a notification on my phone to remind me to do so.

Like I said, I’ll be here for them–and I’m here for you, too.

I wish you well in your journey.

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