Mr Spock was always my favorite character on Star Trek. I wanted to be a Vulcan. And the worse my depressions are- and the more dysphoric I feel- the more I think I should have been born a Vulcan, or at least a robot. And I wish for a pill that would take away all feeling, but let me function.
Except that it doesn't work that way. If you take away emotion, you take away any motivation, as well as any reward. Somehow Vulcans are permitted to keep curiosity, but not much else. But for me it is all or nothing. And make me numb, and there is no reason to keep going, no reason to push on.
And that is what I feel right now. Between adding on the lithium and a little klonopin at night, I have been pretty numb for 3 days. And I was kind of content to lie in bed for 3 days. Nothing got done, and things needed to get done. But a large part of me doesn't care.
To trade a piece of the depression for apathy isn't much of a bargain.
Monday, September 3, 2012
The side effects start
My 3rd night of lithium. I slept well last night- and no napping today. But tonight, after about 3 hours, I have woken up, somewhat wide awake, feeling sick to my stomach and with a cramp in my left calf. I wish I had some ginger ale, but I don't.
I have been trying to figure out how much my ACE inhibitor is likely to raise my lithium level, and I can't find a good answer- I have seen estimates from 30-60 percent to 2-4 times. I take a HUGE dose of Lotensin. I wonder if my psychiatrist realizes how much I take. And I am wondering if 600mg of lithium will still be "low dose" given my ACE inhibitor. Maybe I shouldn't go up that high. We actually didn't even discuss the Lotensin. I was too busy crying to think about it during the session. But he has all my meds, so I will assume that he knows at least that I am on it- and he has that electronic medical record that probably flags all drug interactions.
Lithium is one scary drug if you read all of the side effects. But then again, I took the MAOI's, and I was glad to take them, because they worked so well on my depression (for a while). Anything is better than severe depression. Even life without cheese!
I have been trying to figure out how much my ACE inhibitor is likely to raise my lithium level, and I can't find a good answer- I have seen estimates from 30-60 percent to 2-4 times. I take a HUGE dose of Lotensin. I wonder if my psychiatrist realizes how much I take. And I am wondering if 600mg of lithium will still be "low dose" given my ACE inhibitor. Maybe I shouldn't go up that high. We actually didn't even discuss the Lotensin. I was too busy crying to think about it during the session. But he has all my meds, so I will assume that he knows at least that I am on it- and he has that electronic medical record that probably flags all drug interactions.
Lithium is one scary drug if you read all of the side effects. But then again, I took the MAOI's, and I was glad to take them, because they worked so well on my depression (for a while). Anything is better than severe depression. Even life without cheese!
Saturday, September 1, 2012
Day 1 on Lithium
My psychiatrist gave me a prescription for Lithobid, which is extended release. However, when I got home and looked at what the pharmacy had given me, it looked like they had given me regular, instant release generic lithium carbonate. At least that is what the label said. Oh well- I wasn't about to go back. I knew the price was too cheap. And they are not open on weekends.
So I started with a 300mg capsule last night. Which made me feel- strange. Sleepy, but I couldn't sleep- until about 4am, even though I took a klonopin. But then I napped half the day. I felt calmer. I felt less depressed, I think- but mostly I felt numb. And that feeling is still with me today. Maybe I don't care enough to feel depressed.
I don't do illegal drugs. But when I start a new drug, and I am looking a bottle of brand new pills, wondering how it is going to make me feel- I know there really isn't much difference. I am doing drugs. Let's see what this one does!
I am supposed to do 5 days at 300mg, and then go up to 600mg. I think I will have to wait until next Friday night to make the increase.
I know that meds are only half the story-my life is a mess- but my life is a mess because I have been depressed for so long. I can't fix my life if I don't fix the depression. But then, sometimes I think my life is too broken, I am too broken, that even if lithium turns out to be the wonder drug, it is too late.
But this is just day 1. I have to be a little more patient than that.
So I started with a 300mg capsule last night. Which made me feel- strange. Sleepy, but I couldn't sleep- until about 4am, even though I took a klonopin. But then I napped half the day. I felt calmer. I felt less depressed, I think- but mostly I felt numb. And that feeling is still with me today. Maybe I don't care enough to feel depressed.
I don't do illegal drugs. But when I start a new drug, and I am looking a bottle of brand new pills, wondering how it is going to make me feel- I know there really isn't much difference. I am doing drugs. Let's see what this one does!
I am supposed to do 5 days at 300mg, and then go up to 600mg. I think I will have to wait until next Friday night to make the increase.
I know that meds are only half the story-my life is a mess- but my life is a mess because I have been depressed for so long. I can't fix my life if I don't fix the depression. But then, sometimes I think my life is too broken, I am too broken, that even if lithium turns out to be the wonder drug, it is too late.
But this is just day 1. I have to be a little more patient than that.
Wednesday, August 29, 2012
Doing what I don't want to do, part II
Well, raising the Zyprexa didn't work out too well. All of the side effects I expected, sedation, being out of it, eating everything in sight. But when I couldn't focus enough to study or do paperwork, I knew it was time to stop it.
The past week has been miserable, but I have kept myself together (as much as I could), as my dad was having surgery. Today I saw my psychiatrist again. And he is recommending the same thing that my last psychiatrist did, and what I didn't want to do: low dose lithium.
Well, that is two doctors recommending something that makes sense. I'm just scared of lithium because of the last time I was on it- a very long time ago, and at a very high dose. I had bad side effects. I got lithium toxicity- bad, because it was not recognized. And then I was taken off of it cold turkey, and became crazy manic, for the first time in my life. I really think that changed the course of my illness. It sure changed the course of my life.
But this will be low dose. I will take it all at night, so hopefully the side effects won't be too bad. I will try it. And if it doesn't work, or if I don't like the way it makes me feel, I will come off of it VERY SLOWLY.
But I will try it.
My psychiatrist also had good advice- just as good as a prescription, I think. And that is to stop studying for this exam. There is no way I can do what I need to do to be ready to take it this year, so I am only beating myself up every time I try to study. He said it was like a marathon runner with a knee injury who keeps trying to run instead of resting it, only to prove to himself that he can't run right now.
It was the best advice. It was what I needed to hear. It was giving me permission to do what part of me knew I needed to do, but couldn't admit.
When my head is working better, when I can concentrate again, I will start studying again. On my terms.
I do think I will wait until Friday night to start the lithium. No work the next day.
The past week has been miserable, but I have kept myself together (as much as I could), as my dad was having surgery. Today I saw my psychiatrist again. And he is recommending the same thing that my last psychiatrist did, and what I didn't want to do: low dose lithium.
Well, that is two doctors recommending something that makes sense. I'm just scared of lithium because of the last time I was on it- a very long time ago, and at a very high dose. I had bad side effects. I got lithium toxicity- bad, because it was not recognized. And then I was taken off of it cold turkey, and became crazy manic, for the first time in my life. I really think that changed the course of my illness. It sure changed the course of my life.
But this will be low dose. I will take it all at night, so hopefully the side effects won't be too bad. I will try it. And if it doesn't work, or if I don't like the way it makes me feel, I will come off of it VERY SLOWLY.
But I will try it.
My psychiatrist also had good advice- just as good as a prescription, I think. And that is to stop studying for this exam. There is no way I can do what I need to do to be ready to take it this year, so I am only beating myself up every time I try to study. He said it was like a marathon runner with a knee injury who keeps trying to run instead of resting it, only to prove to himself that he can't run right now.
It was the best advice. It was what I needed to hear. It was giving me permission to do what part of me knew I needed to do, but couldn't admit.
When my head is working better, when I can concentrate again, I will start studying again. On my terms.
I do think I will wait until Friday night to start the lithium. No work the next day.
Thursday, August 23, 2012
Doing what I don't want to do
I am raising my Zyprexa. This is that last medicine that I want to raise- I don't even want to be on it- but at some point, when things are bad enough, the hell with future side effects and neurological problems- at this rate I am not even going to live long enough to have those things.
I am re-thinking antidepressants. Maybe they are making me worse. For people with bipolar, they often do. But the one time they tried not giving me antidepressants- just piling on the mood stabilizers, I became so depressed I got psychotic. So I have been so sure that I need antidepressants. But maybe they make me worse in the long run. Maybe I need to give it another shot without antidepressants. Maybe there is no answer for me, and I am just screwed.
What is pretty clear to me is that in the last 4 or so years, my depressions are more frequent, and I don't get as good as I used to between depressions. There are probably some situations reasons for this too, but still, it is enough to question both my life and my meds.
Creatine has not turned out to be the magic answer that I had hoped for. If anything, I feel like I have been more emotionally unstable since I have started taking it. So it is not necessarily making my mood worse, just more reactive. Which I don't need right now. Still, I will probably try continuing with a small dose of it.
I have my escape fantasies. Quit my job, live off my 401K money, backpack and travel for a year. If I was debt-free, I might do it. I have too much debt. And having been on disability once, I am so scared that if I stop working, I won't go back.
I saw my therapist again last night- she asked me again if I "need a higher level of care." I hate that kind of talk. And that kind of language. Just say it. Am I suicidal enough for the hospital? Dysfunctional enough for day treatment? What?
My psychiatrist is on vacation this week. so I'm limited with med options. I can either raise things or lower things that I already have. Which is a little frustrating. I think I want to try switching my Effexor for Prozac, which worked in the past, and which is a lot easier to get off of- if I do decide to try to get off of anti-depressants.
I went on Prozac back when it was new. I switched from amytriptaline, which was making me too tired. My psychiatrist told me, there's this new drug out, prozac, with much less side effects, and it even has this very nice side effect called hypomania...
Of course at the time my diagnosis was depression, not bipolar. And hypomania, as she described it, did sound very nice. Pretty ironic.
I am re-thinking antidepressants. Maybe they are making me worse. For people with bipolar, they often do. But the one time they tried not giving me antidepressants- just piling on the mood stabilizers, I became so depressed I got psychotic. So I have been so sure that I need antidepressants. But maybe they make me worse in the long run. Maybe I need to give it another shot without antidepressants. Maybe there is no answer for me, and I am just screwed.
What is pretty clear to me is that in the last 4 or so years, my depressions are more frequent, and I don't get as good as I used to between depressions. There are probably some situations reasons for this too, but still, it is enough to question both my life and my meds.
Creatine has not turned out to be the magic answer that I had hoped for. If anything, I feel like I have been more emotionally unstable since I have started taking it. So it is not necessarily making my mood worse, just more reactive. Which I don't need right now. Still, I will probably try continuing with a small dose of it.
I have my escape fantasies. Quit my job, live off my 401K money, backpack and travel for a year. If I was debt-free, I might do it. I have too much debt. And having been on disability once, I am so scared that if I stop working, I won't go back.
I saw my therapist again last night- she asked me again if I "need a higher level of care." I hate that kind of talk. And that kind of language. Just say it. Am I suicidal enough for the hospital? Dysfunctional enough for day treatment? What?
My psychiatrist is on vacation this week. so I'm limited with med options. I can either raise things or lower things that I already have. Which is a little frustrating. I think I want to try switching my Effexor for Prozac, which worked in the past, and which is a lot easier to get off of- if I do decide to try to get off of anti-depressants.
I went on Prozac back when it was new. I switched from amytriptaline, which was making me too tired. My psychiatrist told me, there's this new drug out, prozac, with much less side effects, and it even has this very nice side effect called hypomania...
Of course at the time my diagnosis was depression, not bipolar. And hypomania, as she described it, did sound very nice. Pretty ironic.
Saturday, August 11, 2012
A lot of drama at work
As if I didn't have enough drama in my personal life, I've had a lot of drama at work. Just a difficult work week with patients not doing well, etc., and having to call doctors more than in the past 2 weeks than I think that I ever have.
But I made it through the week, and no I did not quit. But I was quite grateful for the week to be over.
This week I also swallowed my pride and called my therapist- yes, the one I just quit, to go back to therapy. I will see if it helps.
And I am doing something that has me very hopeful. I read about a study conducted in South Korea in which they gave depressed women Lexapro, and then either 5 grams of creatine or a placebo as an add on. The people who got the creatine got much better, much faster. And no, they did not try the creatine by itself. That, of course, would be too radical. Much less radical to say that creatine augments antidepressants than to say that it is an antidepressant.
So I went to the local Rite Aid after work yesterday, and found some in the body building aisle (yes, there was a whole aisle for body building). I felt strange buying it- like I wanted to tell the cashier- no, I'm really taking it for depression (as one look at me will tell you that I am not a body builder).
Just what I need, another expensive supplement to add. I take too many supplements, I think. If I didn't take any medication, I don't know if I would take any supplements. But now that I am in the routine of taking pills every day, and in the mindset of "better living through chemistry," why not add on more pills to take? At least these supplements I control, and I don't need a doctor's okay or prescription for them. I like that. The downside is no insurance reimbursement.
I didn't know what to expect with the creatine. I took my first dose last evening, my second dose this morning. And I think I actually feel it. It is a little energizing, it feels good. I feel a little better. Without any of the agitation of something like wellbutrin. So I am hopeful. I just hope that this is not a temporary effect.
Also good news. I just got back the results of lab work for my physical. As someone who takes Zyprexa and is overweight, I am terrified of diabetes. But my blood sugar and A1C are still in the normal range- in fact even lower this year than last year. Something I attribute to the large dose of resverotrol I am taking, I think. Because I have been eating horrible the past few months with this depression, and it shows- my cholesterol is up. But still in the borderline high level, so hopefully my doctor is not going to try to put me on a statin come Monday.
But I made it through the week, and no I did not quit. But I was quite grateful for the week to be over.
This week I also swallowed my pride and called my therapist- yes, the one I just quit, to go back to therapy. I will see if it helps.
And I am doing something that has me very hopeful. I read about a study conducted in South Korea in which they gave depressed women Lexapro, and then either 5 grams of creatine or a placebo as an add on. The people who got the creatine got much better, much faster. And no, they did not try the creatine by itself. That, of course, would be too radical. Much less radical to say that creatine augments antidepressants than to say that it is an antidepressant.
So I went to the local Rite Aid after work yesterday, and found some in the body building aisle (yes, there was a whole aisle for body building). I felt strange buying it- like I wanted to tell the cashier- no, I'm really taking it for depression (as one look at me will tell you that I am not a body builder).
Just what I need, another expensive supplement to add. I take too many supplements, I think. If I didn't take any medication, I don't know if I would take any supplements. But now that I am in the routine of taking pills every day, and in the mindset of "better living through chemistry," why not add on more pills to take? At least these supplements I control, and I don't need a doctor's okay or prescription for them. I like that. The downside is no insurance reimbursement.
I didn't know what to expect with the creatine. I took my first dose last evening, my second dose this morning. And I think I actually feel it. It is a little energizing, it feels good. I feel a little better. Without any of the agitation of something like wellbutrin. So I am hopeful. I just hope that this is not a temporary effect.
Also good news. I just got back the results of lab work for my physical. As someone who takes Zyprexa and is overweight, I am terrified of diabetes. But my blood sugar and A1C are still in the normal range- in fact even lower this year than last year. Something I attribute to the large dose of resverotrol I am taking, I think. Because I have been eating horrible the past few months with this depression, and it shows- my cholesterol is up. But still in the borderline high level, so hopefully my doctor is not going to try to put me on a statin come Monday.
Wednesday, August 8, 2012
Today was (very slightly) better
I am on day 2 of increased Wellbutrin, and feel a tiny bit better. But really, it has to get better than this. But I have to give it more time, I know. I am not very patient.
I called my psychiatrist to make a appointment- progress. But the week I want he is on vacation, so it will have to wait. Why do all doctors go on vacation in August? Is it some kind of rule? The surgeons that we work with are all going on vacation now too.
I am going to break down and call my therapist (well, technically now ex-therapist), and try to get back in. Maybe it will help.
Exercise: I'm giving up on it, at least for this week. If I can make it to work each day, not kill myself or anyone else, then I have done more than can be expected of me. Really, sometimes I think that if my pain were physical, they would give me morphine.
I am getting really tired of feeling a little bit better, being a little bit more functional, a little more dry eye'ed. When is life not going to suck? When am I going to feel joy? Be glad that I am alive?
Meanwhile, I am trying to decide if I am more tired or more hungry. No food in the apartment except for a bit of left over Chinese food that I ate as soon as I got home (I had no lunch). I am still hungry. But really don't want to go out. Which force will win?
I called my psychiatrist to make a appointment- progress. But the week I want he is on vacation, so it will have to wait. Why do all doctors go on vacation in August? Is it some kind of rule? The surgeons that we work with are all going on vacation now too.
I am going to break down and call my therapist (well, technically now ex-therapist), and try to get back in. Maybe it will help.
Exercise: I'm giving up on it, at least for this week. If I can make it to work each day, not kill myself or anyone else, then I have done more than can be expected of me. Really, sometimes I think that if my pain were physical, they would give me morphine.
I am getting really tired of feeling a little bit better, being a little bit more functional, a little more dry eye'ed. When is life not going to suck? When am I going to feel joy? Be glad that I am alive?
Meanwhile, I am trying to decide if I am more tired or more hungry. No food in the apartment except for a bit of left over Chinese food that I ate as soon as I got home (I had no lunch). I am still hungry. But really don't want to go out. Which force will win?
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