It isn't over until the paperwork is done

I'd like to say TGIF, but I will be going in this weekend for a lot of hours to do notes. I have so many papers on my desk and so many charts to finish and so many discharges that they don't even fit into my drawer anymore. I can't believe how many people I have discharged recently.

Still, the weather is supposed to be wonderful tomorrow, so hopefully a short hike in the morning will be possible. And I am optimistic that I will make it into work. My mood continues to be better, but not great. I predictably crash in the middle of the day and I am trying to figure out how to fix that. Yesterday I tried having an iced coffee- but it just gave me a killer headache, and I crashed anyway. I think it must be some medication going out of my system.

I am grumpy and whiney and I hate that. But at least I am not suicidal. I am on the higher dose of Zyprexa- which isn't making me as sleepy as it did last time I tried this, except in the mornings. It is impossible to get out of bed on time. 

I have a week's vacation coming up in May, right after a psychiatrist appointment. I am wondering if I should try an experiment- switching to Seroquel XR. Could I do it in a week? Would I know in a week if it was better or not? But I am adding on Benedryl to sleep- I don't want to take more klonopin- maybe the Seroquel would fix the sleep too. Maybe it would be better for the depression.

My insurance company has step therapy for Seroquel XR, and it is really practicing medicine without a license. It is not like they just say that you must have failed with two other atypical antipsychotics, they say it has to be two of the following four: Seroquel, Zyprexa, Geodon, or Latuda. Well, I've taken all but Latuda. The psychiatrist who prescribed Seroquel and Geodon is dead (he was old), so I have no documentation. They would have to take my current psychiatrist's word. 

My other thought is switching Zonegran for Lamictal. And my other thought is getting off the Effexor. Maybe going on an SSRI. 

I know this isn't all meds. I know that meds won't fix my life. But I will take any biological help that I can get. I think recently I usually say, my life is a mess, of course I feel awful, so I don't try to change my meds. But that wasn't working. I wasn't fixing my life. So maybe I need to do things differently.