Q:  Stability & OTC Meds/Other Health Issues

I am 34 and have been diagnosed (BP II) since I was 23.  I have had three major episodes (2 with pregnancies).I am trying to develop a mood chart to better understand the phases I go through.  I am interested in knowing the over the counter meds that are hazardous and other health issues that may be harmful to my stability.  Recently I had the flew and for several days my meds were not taken and I became dehydrated then I noticed once the flew was over I became aggitated and irritable and angry with my spouse over nothing.  Obviously I see the relationship between depleating my system and the episode.  I would like more information on these such things as to better avoid the wrong medications etc.
 

Dear Julia -- 
The major destabilizing factors that are known and agreed upon include:  alcohol; sleep deprivation; steroid medications (e.g. prednisone for arthritis or poison oak); antidepressant medications when not used cautiously; and perhaps stimulants, though that is not clear (e.g. pseudophedrine, a common ingredient in cold remedies, for nasal congestion and resultant cough).  Of course there's also cocaine, methamphetamine, LSD -- but that's not what you were talking about, is it...

If you're taking lithium, just getting dehydrated is an issue as that will raise your lithium level; but this alone should not be associated with seeing symptoms emerge.  

The mood chart you're working on (here's my version, adapted from Harvard's with Dr. Sachs' permission) is a good idea for figuring out this kind of thing; some people put it on the back of the bathroom door with a pencil so that they can complete it every day.  

Can the flu-like symptoms, e.g. from an influenza virus or some such, cause destablization of symptoms such as you saw?  I've not seen that reported.  But certainly if you had disturbed sleep because of your symptoms, that could be a factor.  Much of this kind of analysis is very speculative, as you can see.  I hope things are getting smoother again now. 

Dr. Phelps
 

Published April, 2004