Topic Summary – 2007 12/30/2007

Activities Day-to-day Activities; Brownies Television; Number of tasks a day is counter-productive; Exercise and Stress; Making Excessive lists; Recreation; Mental Health Movie Canvas; Travel; Clear farm—City of Phoenix internship for the disabled

Administrative Shall we incorporate? Shall we affiliate with DBSA for the coming year? A new catalog case was presented to the group from Tara—Thanks; Try www.depressionisreal.org Try Googling “BiPolar.org”; Handouts (3); Telephone Lists; VO AHCCCS Inquiry

Anger Management Anger Management (3); Anger in trapped environment; Feeling “pissed”; Rage (2); Abandonment

Behavior How not to be overwhelmed; Alcohol trigger; Boundaries; Controlling Stability (2); Moving creates a new person; “Pulling the rug out” results in “Blind-siding”; Sensory Overload (2); Crash & Burn in public; Decomping; Denial vs. Memory; Exasperating symptoms; Finding Purpose; Food Triggers; Measuring your growth over time; Hyper-sexual Behavior; Identify; Lethargic (2); Loss of Hope; Loss of Temper; Mid-manic Behavior; Social Isolation; Structure; Tears (2) and depression in Public; Unknowingly panicking; Verbal Abuse; When you are OK, you are well

BiPolar Issues BiPolar Basics; Informal Stages; Recovery (5); Does a Manic state manifest itself in Anger? Manic behavior; Manic Spending; is there Tri-Polar? Suicide

Coping Skills (or Not) First steps; Plan 2-3 tasks per day; Concentrating on Multiple Tasks; Concentration (2) and Focus (2); Lack of Patience; Take things Seriously; Keeping Balanced; Build on Strengths; Coping Skills; Crisis Plan (3) Crying in Public; Diaphragmatic breathing; Pushing the limits; Dogs; Don’t get involved with irrelevant things; Frustration; Getting things done; Grief after loss of a friend (2); Holidays with no family (2); How do I guarantee my safety for the next week? Danger to self (2); How to stop thinking about danger to self? Kindling effect—it grows over time; Letting it grow; Maintaining healthy boundaries; Obsessing; Old Ruts; Patience; Returning to track; Routine (2); Socializing; Staying Well and Stable; Take car of you first (2); What and who to disclose; Who is really healthy? Anxiety; Starting over using diverse skills; Coping without Therapy; A friend blind-sided me; I need time alone; Not being able to face the day; Personal Responsibility; Take a class you know nothing about; The law of positive thinking

Depression Issues Lower Mood swings; Caution to avail Depression; Restoring Confidence; The Holidays (2); Try www.depressionisreal.org

Diagnosis Difference between BiPolar and Depression; Premature cases; Does a head injury cause BiPolar Disorder? Being Rediagnosed; Individual diagnosis; New diagnosis of Depression; Psychotic features; Recovery from a Psychotic episode; Schizoaffective, Personality and BiPolar Disorder; When is the Diagnosis Wrong? Sometimes recovery is not medically expected, OCD

Disclaimers This is a Support Group and not a professional Service

Help is available if you want to hurt yourself-- (602) 222-9444

No one under the age of 18 will be admitted

We do not recommend specific doctors or medications

We not provide Legal Advice

Family Issues Spousal Triggers (2); Family Triggers; Spouses—Changes in Personality and Roles; BiPolar Families; Enabling Families; Family coming around; Family could make you “Crazy”; Family Relations; Misdiagnosis; No Attorney diverse; Non-receptive Loved One; Supporting Supportive Other when it is not otherwise available (2)

Financial Issues Excessive Spending; I don’t have a job! Mental Health Insurance

Government Programs Dogs as Rental Guides; Service Animals, Driver’s Licenses can be coded “Mental Disorder”; EEOC; Secure Horizons; Criteria for Disability; 24 hours in Jail; Advocacy (2); Art Awakenings for Title XIX Eligible; Independent exam by State and SSDI Renewal; Medicare Part D (Rx) Rejection; Medicare Supplements or Part C Advantage Plans; Medicare vs. Medicaid (AHCCCS), QMBE, SLMB (2); Mental Health Power of Attorney; SSDI vs. SSI; Provide Minimal Information for a Social Security Number

Information Issues Cognitive Issues; System problems may be addressed by John Elias (Channel 15)

Long & Short Term Current Studies underway for BiPolar Disorder; Successful Recovery; Process of Death;

Projections Projections unknown, but still scary; Exciting long term projections; Recovery

Magellan General Magellan (4); Name change; SMI Evaluation procedure; Service Changes; Magellan Morning Meeting; intake Process; Rejection due to Dual-Diagnosis; Rx Co-pays; Case Managers; Case Manager Switch; Magellan Staff; How to change Case Managers; Doctor shortage; Grievance and Appeals; Medication Process; Retroeligability for VO/Magellan; Service Changes; SMI Procedures; SMI Status; VO now Magellan; VO Migration

Medical Issues In loco Tentem Doctors; Differing Opinions by Doctors; 2 people with the same diagnosis; Heard from a Doctor: “BiPolar’s cannot prioritize and do tasks”; Colonoscopy; Do Medical Issues affect Mental Issues? Dr. Holland is closing his Private Practice to work Full Time at St. Luke’s; ECT (2); Getting out of the Hospital; Getting the most out of the Hospital; How do you find a new Doctor? Inability to think clearly due to meds; Independent Psychiatrist testing—It may take all day; LabCorp with Pacific Care; Medical Providers; Not practicing (without a license), Nurse Practitioners (3); Physical Health combines with Mental Health; Physical Pain; Therapy (2); Tremor: Should I visit a Neurologist? Visit to a Psychiatrist; What constitutes an Episode? Doctor asks “How are you’ You answer ‘Fine” Now Where are you now? Crying; Colds from Depression, Pacific Care does not pay for all blood draws, Medication or Organic Treatment

Medications Are medications provided by Magellan? Yes; Difficulty in getting off meds; If you have a med problem, call your Clinic; No med Change; Antidepressants (2); 3 down to 2; Accidental Overdose (she is OK); Abilify (3); Benzo’s, In some cases, Brand names are better than Generics; Cereal adds Weight to pill; Deteriates over time; Compliance with Over Medications; Do pills fix you? Effects of the Heart; Lithium and the Heart; Heat and the Heart; Higher doses of Tegretal; How do we know if he is taking his meds? How long fir the Primary Med to Work? How long until meds stabilize? I have waited for the right combo. Of meds; Impairment; Use a single Pharmacist; Sometimes it takes time (~ 1 hour) to determine mood and/or reason; Keep taking meds! Klonopin (2); Lamictal (2); Lamictal costs $374 in U.S., Prices in Britain, Canada may be $75 to $120; Meds slowing the brain; Meds which make me not myself; Missing Meds (2); New Meds; New Prozac; Should I take Prozac for Anxiety? Not stable, but must go off meds for Health; Omega-3 (fish oil) for Depression; Ridlin (2); Serequil (5) {Side effects, Drowsiness}; Stash of Meds; Staying on Meds. (2); Tapering off Meds. (2); Taking Zoloft and Effexor; Tegretal; Timing, Med Balance, Long Term effect (33); Too many meds in the Family; Tradeoff—Weight gain vs. Stability and Better Quality of life; Tylonol and Blood Pressure; Serequil—Up several times a Night; Vitamins and Supplements; Wal-Mart’s $4 Generic Rx beats Mail Order, Wellbutin; Is no med change right?

Mood Issues Keeping a Stable Mood; Aggression and Manic State; Coordinating a Manic State when work needs to be done; Depression and Sleep; Extremes—not Middle-of-the-Road mood; Impulsiveness; Irritability (2); Is impulsiveness part of Manic Behavior? Yes; Keeping on when you feel like a bowl of Jello; Maintaining a Stable Mood; Manic Episodes; Memory problems in both Manic and Depressive Stages (2); Wide mood variations; Moods can be non-situational; Rapid Cycling and Fear (2); Travel triggered Mania

Non-Coping Strategies Inability to Function, Isolation (2)

Other Issues Vocabulary; “World of Warfare”; Cold Weather here affects capillaries; Donald Knuth (3 of 7 computer Volumes); Effects of Heat; Mental Health Power of Attorney; Reality Review of Strengths and Weaknesses; Tom’s 5 Motivating Words; Try these websites: www.bipolarbears.org, www.magellanofaz.com, www.volunteerphoenix.com, Yoga Exercise channel 8 at 5:30 a.m.

Other Programs Dialectical Behavioral Therapy (DBT) (3); Don’t get discouraged if you are denied entrance into the Program; Service Animals

Positive Aspects You may be better off with the Disorder; What’s good about it (3)

Potpourri (Spontaneous short topics)

Related Diagnosis Spectrum Disorder; Alcoholism; Attention Deficit; Biofeedback-- Yoga, Tai Chi; Borderline Personality; Fear & Anxiety discourage new activity; Fear of Physical Violence (2); Memory and Word Search; Obsession; Panic Attack; PTSD; Seasonal Affective Disorder (SAD)

Relationships Friends with the Disorder; Telling others (2); BiPolar Friend just shuts down; Avoiding and Coping with Isolation; If bad reaction from others—Just let it go; BiPolar Disorder is like a Underground Secret life—Should I tell others? Dealing with a new Relationship; Disability after Marriage; Erin’s and Peter’s Death; Guilt—Over things you did while Manic—Do what is Natural to fix; Mending Relationships; People don’t believe my Symptoms—You are just Lazy; Reach out to others—they will reach out to you; Relationships (2); When friends disappoint you; Person asks “How are you” You say “Fine” Now What?

Sleep Issues Insomnia Counseling; No meds regarding Sleep; Sleep; Sleep Study; You need Sleep to Function

Social Security SSDI Function (3); Disability Determination (2); One Criteria—Marked restriction of activities of daily living; another Criteria—Marked difficulty in maintain concentration, persistence or Pace; Disability Paperwork; Social Security Appeals; SSDI vs. SSI; SSDI Eligibility (2); SSDI (2); How long after SSDI Rejection?

Societal Issues Acknowledge that someone in BiPolar; Ministry in Hospitals; Accidents; Are 2 auto accidents related to being BiPolar or an Excuse (2); Meds for driving differ from BiPolar Meds; Stigma; The Media

Stress Issues Anxiety about the Disorder; Before my Diagnosis I could handle Stress, but not now; Handling Stress; How do you cope when triggered? Multiple Stressors; Ongoing Stress; Panic Attacks; Simple Stress Outlets

Other Support Groups DBSA National; AAMI is holding a Peer-to-Peer class in Phoenix

Value Options NOTE: Magellan now holds the Contract for this RBHA

Value Options; Actions by the RBHA; Changing Therapists; Enrolling in VO; I am changing doctors yearly or more; Missing Appeal date; No more Benefits Specialists; Peer Support Specialists have vacancies; VO Conference

Work Issues: Protected job; Job Problems; ADA Accommodations; Anxiety in starting new Job; How do you explain absences both in the resume and during the interview? Anxiety when returning to Work; Co-worker powerless over Paranoia Behavior; Effects of Work on Mood; Employment with Bi-Polar Disorder; Explaining gaps in Employment; Grief and Loss of a Career; How to reenter the Workforce; Motivation for Work; Peer Employment Issues (3); When to tell about your Diagnosis? Work as a means of Escape; Work Shutdown; Working during Mood Changes; Working too much or too little; Looking bad at work when meds need adjustment; When you are manic and work hard—the boss is pleased—When depression slows work, the boss doesn’t know what to do?