Emergency Pill Drill

I have an emergency pill drill written down in very clear terms. I worked it out with my doctor and I have a supply of the required medications. This allows me to start medication immediately I detect a problem. It avoids a delay of a day or maybe two before I can get to see my doctor. If my doctor is unavailable it avoids the problem of a doctor I do not know failing to do the right thing. It does assume that I can detect the onset of an episode, or that if someone close to me detects it, that I will take action. I have had sufficient unpleasant experiences of manic episodes that failing to take action is no longer a problem. The emergency pill drill consists of a yellow alert and a red alert.

Yellow Alert: This only requires the mild stuff. It may be a false alarm so I do not want to put myself out of action by taking the strong stuff. It is a fairly potent tranquilizer, but not so potent that the side effects themselves render me out of action. A yellow alert requires a visit to the doctor without much delay but it does not require an emergency visit.

Red Alert: This requires the strong stuff. Take this and you can forget about going to work for a while. The side effects alone will take you out of action. There are pills to deal with the side effects and specific instructions for these too. Better to suffer the side effects than a full-blown manic episode. (These days there are newer medications that have less severe side effects.) Declare a red alert and an emergency visit to the doctor is required.

I also have some simple sleeping tablets for occasions that just call for a little assistance getting to sleep. I am now good enough at detecting episodes early that just the sleeping pills can be sufficient to ward off an episode.

Your doctor is not going to trust you with a supply of such potent medication until she has known you for a while. This is a good reason for developing a relationship with your doctor before an emergency arises — an ideal that is not always possible. A good relationship is also essential if your doctor is to believe you when you declare the need for an emergency appointment.

New Article: Teaching Wellness

Research has recently demonstrated that teaching illness self-management in addition to medication can significantly improve the quality of life for those with bipolar disorder. This article reviews the scientific evidence.

Reprinted with permission from bp Magazine, Fall 2006.