I'm doing better enough that I am actually thinking about lowering medications. I actually have already lowered my Effexor from 450mg to 300mg, and after a rough month I think I am in at least as good a mood as I was before. Should I go lower?
It is not that I don't have my down times- but there are things that meds can't help me with- except to get me through the moment. Like last weekend when I was so overwhelmed with everything I had to do I shut down and couldn't stop crying and took Zyprexa and klonopin. But the meds never really got me to be able to multi-task and prioritize and have the executive skills that most people have. They never helped my initiation. I have to work on that in other ways. DBT. Meditation. And when it gets to be too much, I run to my pills maybe- but that is better than taking higher doses all of the time and being too out of it.
I've also lowered my Provigil by half a pill. And the klonopin, which had been creeping up, is back to half a milligram a day most days- except for the days I am too wound up at the end of the day to sleep. Then I might take another quarter milligram.
I know that the key to this is doing it really slowly. I should stay where I am with the Effexor for a while. But the reason I think that maybe I should get off of it is that if I forget to take my morning meds (but I take my Provigil separately, so I usually take that one), I often feel better and have am less tired- until I start feeling withdrawal. I don't know why. Could it be the morning Effexor dose I am missing? The morning Zonegran? My blood pressure medication? I should experiment.
I also feel like I can't go off of the Zonegran unless I go off of the Effexor, or at least to a low dose of it. I once had a seizure- during a brief time when I was not on an anticonvulsant and just on lithium- and they said that it was from high levels of an antidepressant. So I am a little hesitant to take an antidepressant without an anticonvulsant, especially a high dose of one.
It is really nice to have a 3 day weekend with the holiday. Not just this week, but two weeks in a row. Plus we are closing early today, I think my last patient is at 1:30. Not too many people want to come to therapy on Christmas Eve.
Every year at Christmas patients give us food. This year must break the record. We have so much candy, chocolate, cookies, and cakes. It is unbelievable. And very sweet- in both meanings of the word.