Mood Central

I was diagnosed with bipolar disorder in 1993. From that day I have taken various medications searching for the right balance. Bipolar disorder or manic depression is a brain disorder caused by chemistry in the brain. Moods are regulated, therefore, in the brain and will have little or nothing to do with circumstances, although stressful ones will triger episodes. I had mixed episodes which means I could be flying high in the morning only to fall into depression in the afternoon or evening. All of a sudden things I did for pleasure just weren’t enjoyable any more. The challenge for the doctor is to find medications that treat you for depression but do not put you

into mania or treat the depression and then find you’re in mania. And some medications are very good at evening out the mixed moods. Very often anti-seizure drugs are used as mood stabilizers.

All psychotropic medicines work in different ways in the brain, but all of them are basically working to alter brain chemistry. And all have different side effects. One very common occurrence is dry mouth and throat. The lack of beneficial bacteria that comes with saliva is lacking and tooth decay occurs as it did with me. I become so dry sometimes that I cannot talk and must carry a water bottle or cough drops with me at all times. When I play a musical instrument, flute,

I will not be able to get a good sound without addressing the dry mouth. I recall having too little water and going through a concert trying to make it with small sips and praying I’d make it to the end.

Another side effect is drowsiness. But before being on the current medication, I would often have insomnia, so I was grateful for a drug named Seroquel, also one to even out the mixed bag. And I used an anti-mania drug called Trileptal, an anti-seizure drug, which worked to curb mania, but it took so much sodium out of the body that I had to be hospitalized twice. I had decided then to try managing moods with no medical

means. While I was able to function well for a period of time, the day came when I did not sleep all night, and I said then that I would go back on medicine. Sometimes it takes a while to arrive at a place of stability, but bipolar disorder is a very treatable disorder.

I was given Depakote, another anti-seizure drug for the first 10 years after diagnosis. Previously I had been on an anti-depressant known to affect bipolar patinets with mania. It was how my GP doctor knew I probably had this disorder and referred me to a psychiatrist. He never told me that I was eating too much because the appetite center in the brain was not working.

It wasn’t telling me when I was satisfied, and I gained a lot of weight. I changed doctors at the recommendation of a counselor, and he tried a number of drugs before we got the right balance, and as a result, I wasn’t eating as much. I am now attempting to replace the old mania medicine with a new one that seems to me to be relatively quick acting. It normally can take six weeks before you arrive at a point of knowing whether or not it is going to work.

When my Medicare D provider put a non preferred status on Seroquel, making me pay twice the co-pay for other medications, I appealed to the pharmacy review

board, who turned me down citing they needed to see evidence that all other drugs had been tried. That is cruel due to the many undesirable side effects. So I appealed and my provider then referred the appeal to Medicare. And I won only to learn that the new drug, Abilify, is also non preferred.

I’ve entitled this piece Mood Central because I want to paint a word picture of what goes on when you do go though this process of starting and stopping various medications. Picture your brain as a series of factories all addressing different body functions. And then we come to one named Mood Central for its control of moods. When things are out of whack,

what you normally find is what we could liken to factory where everyone wants to send the goods, but no one is down at the receiving dock. The receivers are sending, and that’s a problem along with the debris not being picked up. How long can a factory exist under those conditions? So the owner (me) hires a manager (the doctor) to send in medications (foremen) whose salary is being dictated by a far off treasury department which doesn’t have a clue how to run a factory. They object to paying Mr. Seroquel’s high salary and want to replace him with someone who will work cheaper.

Well, as I said, I won on appeal, using just this illustration. It’s

memorable, right? And that pretty much does describe the situation. I point out the fact that one foreman who words out very well at another Mood Central factory may not work at all in my factory and in fact will run the whole things into the ground. Why, I asked, would you want to make me so unprofitable just because you don’t want to pay the good foreman’s salary? Let me have this guy work for me while I still pay the agreed amount.

Last year’s provider didn’t like Trileptal and made it non-preferred although it is relatively cheap. They ignored my requests for a review, finally granted it, and then on a technicality unjustly charged me retail price, nearly

emptying my medical account at the end of the year, saying the drug wasn’t filled in December but January when I would not be covered. Yet they filled the others at the appropriate price. The provider saw a way to recoup their losses after granting me the lower co-pay. I filed a grievance only to be turned down and told I had no appeal rights either with them or Medicare.

It’s a sad day indeed when the treasury dictates who works in the factory rather than the managers. It’s a sad day indeed when the insurance people hold all the power and you have no appeal. I am calling for change to take power away from providers who are so

smug and arrogant about my rights.I should not have to pay more so that I am able to function and do the things everyone else takes for granted. Clearly, it’s an up-hill battle to which none of my representatives or senators have responded.