Friday, August 30, 2013

Summer's end, I can't believe it

It is Labor Day weekend, the unofficial end of summer. I can't believe it. I am a little bit worried, because my moods are very seasonal, and I tend to get very depressed in the fall. Light therapy helps a lot, but it can still happen. Well, at least I am unlikely to get manic this time of year.

Before I figured out the light thing and started doing light therapy, I had a string of years in which every fall whatever antidepressant I was taking would stop working and by December I was in the hospital. I remember mentioning the pattern to a psychotherapist who tried to convince me that I found the holidays stressful. This was a long time ago, before everyone knew about SAD and light boxes. It was all still new.

So I have started my light therapy already. One psychiatrist told me that, as long as I am not getting manic, there is really no reason for me to stop- I should do it year round. But then this year I did get manic in the spring, so I don't know.

There are too many unknowns in psychiatry. Too many variables. I keep thinking that they should be able to design a computer program in which you enter your age, history, and symptoms, and it can tell you which antidepressant you ought to try first. Last year, when I was really depressed, and thinking of changing antidepressants, I was trying to find research on comparative effectiveness, and there is basically none (well, every little). Almost all of the guidelines and advice say that they all are basically the same, so start with an SSRI because it has fewer side effects. Really? Is that the best you can do?

We went with adding lithium, and that worked. I didn't want to do it, but as he was the second psychiatrist to suggest it I thought maybe I should really give it another try. And lithium the second time round has been a much better drug, because I am on a lower dose.

I actually have plans for a meetup group on Saturday, and Sunday I will help my dad to extract honey- if he has enough to extract. He doesn't know yet- he is going up on the weekend to his bees. Monday I am hoping to swimming in the pool in their development if the weather is nice enough. I didn't go all summer- it is my last chance.

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