Status Update

Well, went to the shrink. I was in fact taking the prescribed amount of Lamictal. Shrink is puzzled. I am not. I’m extra-super-sensitive to anything I take. Maybe the increase wasn’t gradual enough, you say. No, perfectly ok to go up by 100mg when have already reached minimum (yes, folks, I was on the minimum therapeutic dose). Shrink puts his little shrunken brain to work. Maybe we should get you off this anti-seizure crazy stuff. Yes, I say, it freaks me out, always has. Maybe we should get you off the Wellbutrin (which I had just started) too. Great idea, I say. Let’s take you off of everything, he says. I begin to freak out. I have not been med-free in, oh, about ten years, and absolutely religiously faithfully taking a mood-stabilizer since my brain broke in 2004. Very afraid this makes me, all this talk of getting me off of everything. But then he amends this with, let’s get all this anti-seizure drug out of your system. Still a little wide-eyed in fear. Then, he says: What do you think about lithium? I love it; I think it’s the best thing ever, I say.

Lithium has its scariness factor, but is very easy to monitor and manage. It’s very simple: you take too little and you’re still crawling up the walls (or out of your skin, whichever the case may be); you take a little too much, you get sick; and if you take way too much, you die. But, see, the easy part is that if you start getting sick, you can immediately stop taking it without the danger of, say, having seizures or other freaky things. Easy to get out of the system, and quickly. And the thing with lithium is that it is, outright, the best option for stopping a crazy episode in its tracks. This happens to be one of the reasons that I am happy to switch back right now. Lamictal is a great maintenance med, but lithium straightens things up quickly when the moods go all wonky.

I got on Lamictal after thinking long and hard about being on a drug that is meant to control seizures in epileptics and is only somehow accidentally effective in controlling bipolar disorder. I was very anxious about this sort of experimenting on myself. (As I have said before, anyone with bipolar disorder is an experiment in progress, no matter the choice in meds or in choosing not to get treatment.) I really thought that Lamictal, with all of its freaky side-effects and possible seizure-inducing potential, was scary. But at that point, this is what I felt and why I chose to begin taking Lamictal. And, it seems that Lamictal is better at staving off depressive episodes than lithium, which is best at keeping the mania at bay.

I could keep going on and on about Bipolar Disorder I vs. Bipolar Disorder II, etc., etc, and spring and mania and fall and depression and pretty little line graphs illustrating the peak suicide times of the year, but, well, I’ve had enough. Haven’t you?

So, for now, I’m getting off of (almost) everything mental. I have a sufficient enough supply of Xanax (prn) to keep me from offing myself in a fit of feeling that I’m about to succumb to impending permanent madness–my personal flavor of severe, not-so-existential panic attack. As much as I hate feeling stupid, I abhor the thought of so viscerally feeling like I’m trapped in my head with myself ’til the end of time. And at some point soon, I’ll be getting back on lithium and also starting on one of the tricyclic anti-depressants, the name of which I cannot remember at the moment. We’ll see what happens this time.

Guess Where I Was Friday Night

The ER. Why? Well, children, there is a simple answer: I overdosed. Not intentionally. Not on illicit drugs. No. On Lamictal.

N.B. When the double vision doesn’t go away, and in fact gets worse, (have your shrink) reduce the dosage.

Of course, figuring all this out while loopy and the middle of a general med change can be a bit tricky. I can’t say that it wasn’t my fault–I misunderstood the dosing directions[actually I was taking the prescribed dosage]–but I still say my shrink sucks. I’m still waiting to find one who is somewhat more communicative. I know that shrinks these days aren’t supposed to be therapists, but this guy goes so far as to point at the next patient in the waiting area rather than, oh, I don’t know, saying a name.

So, anyway. I was incredibly nauseated, vomiting, dizzy, and that double vision thing had intensified to the point that that I was seeing the world as if through a VHS badly in need of tracking adjustment–jumping all over the place and static-y. Very, very unpleasant. My husband left a message on the shrink’s phone (no answering service) to which he still has not responded. (Yet another reason to get a new one.)

Back to Friday night / early Saturday. I stayed in a very, very uncomfortable bed with lots of needles sticking into me and lots of tubing coming out of me. The IV cleared out all but the extreme nausea. The nausea was so intense that I had to be dosed several times for it, and I’m usually ultra-sensitive to the effects of any drug. Did I mention that I stayed in a very uncomfortable bed for at least six hours while the ER doctors poked and prodded me for various other things they found out of whack? I ended up getting two ultrasounds and an EKG. I’m not sure if they were actually concerned about things or just happy to get someone with medical insurance.

The nausea is an on-and-off thing still, but I have pills for that (huh? me plus pills = dumb). I really should call my shrink to figure out what to do about the meds, but since I have an appointment with him Thursday, and I hate him, I’ll just chill out on very low dosages for now since I can’t just get off them cold-turkey. The husband is monitoring me for now–24 hours a day.

I really wish I could find the magic pill (in the correct dose). Don’t we all?

Oooh…Wow, Man. Can You Dig It?

Fun with side-effects:

• Getting off of Paxil: Severe panic attacks for hours and hours while sleeping. The worst ever panic attacks I have had ever at any time ever–and I have had a few. And waking up to, oh my god am I awake, is this real, and boy I can’t tell what was real or not, is, well, disorienting. Sounds normal, right? No. At this point I’m starting to panic (as in further feeding the anxiety attack that is already in progress) because I feel like I’m still sleeping even though I am walking around and telling people that if I completely freak out, please bring me to the hospital, but in the worst panic attack ever, convinced that the feeling will never stop, and since the Xanax doesn’t work, thinking oh my god I can’t live like this and the feeling won’t go away and I have to do something about that. Really, the shocks in the head thing are fun and groovy in comparison.
• Upped the Lamictal: This one can actually be kinda neat, but is really inconvenient if you want to go anywhere. Seeing double. No, really. Actually seeing every object as two things one on top of the other. Starts to hurt after a while, especially since the muscles of one eye versus the other get tired. I can’t tell if it’s the dominant or weak eye that hurts the most. Again, pretty lame versus that everlasting panic attack thing. But it certainly is not conducive to typing or reading. And it goes away after an hour or so.
• Starting the Wellbutrin: Nothing anymore, but for the first few days, a tremendous headache. And, you know, that other thing that happens when you take Wellbutrin.

Waiting for the double vision to subside so I can go biking.  

It Sucks…

…that I have spent the majority of the past four years of my life in either lethargy and apathy or consumed with trying to assess whether the meds are making me a certain way or the disease. All of this plus brief “happy” periods of hypomania and not-brief-enough mixed states. All these years wasted in “self-contemplation,” i.e. tremendous, perverse narcissism.

But who else cares?

In the many years before 2004, I was impulsive, self-destructive, and foolish at the very least. I was also a horror to deal with. But, I really didn’t care. The moods came and went, but I lived them. I lived an extremely fucked-up life in varying states of misery and elation. Introspection was infrequent and brief. But I was out there living a life.

Identity Crisis

From my favorite source of all things news and news-like:

Who Are We? Coming of Age on Antidepressants

The article raises an issue that I have often contemplated and found disconcerting, particularly after starting on mood stabilizers. I am not one of the victims (?) of being medicated as an adolescent, a period that for many is a time of self-exploration and personality development. While not far removed in age from the patient mentioned in the article, mine was still a time in which major mental diagnoses were delayed until adulthood (mostly because of the belief that many are not truly triggered until then). I had had mild mood swings as a teen, enough to make me seem somewhat different from my peers, but nothing debilitating. Behavior that was different was not necessarily considered deviant.

I was the classic case for my generation. I was not diagnosed with major depression (incorrectly, of course) until young adulthood. And of course not diagnosed correctly until about 10 years later (the average for what is now called bipolar 2). I was diagnosed with major depression at nineteen, an age I consider to be on the far side of the cusp of transition to adulthood, in my case anyway. (It is my mother’s view that I left home at the age of 15.)

Back to the actual issue. Obviously, one becomes a much different person with age. But for those who have been on anti-depressants since (sometimes–shudder–before) puberty, what do they have as a comparison, a control in the experiment? Is your brain different from what it would have been without taking meds? Lithium has recently been reported to grow gray matter. What can those meds do to the physical brain of children and adolescents, whose brain structure is different from those of adults, and still forming?

I do believe that introducing anti-depressants and similar medications at any age changes the neural pathways. I do believe that this forms a “personality” different from the unmedicated potential. Now is there nothing the same? If you replace some of the boards on a boat during repairs, is that the same boat that you had before? Hell, what if the new boards work better? Different, but fundamentally the same? (Sorry for that mutilation of the metaphor.)

This issue is a difficult one, particularly when one tries to take one’s life experiences into the equation. Did I walk into that situation as a result of emotional problems that are known to cause really bad judgement? Or I am I just that stupid on a fundamental level? Would I have taken a different direction had I been on meds?

What I find most disturbing is that question of identity. Who on earth am I? There is no better way to describe the difference these meds make on perceived identity. Is that angry, impatient, unhappy, raging thing really me? Or, better yet, where has that quiet and thoughtful introverted person gone? Is that an aspect of my personalty that doesn’t come out so much anymore, or is that a symptom of depression? Have all these meds over the years created (or let loose) other, completely different aspects of a personality?

Do moods intensify my “personality”? Do meds conceal it? At least I have a baseline.

But, still, who am I?

N.B. The omission of the question of the dangers of suicide versus being put on meds is deliberate.

Ugh

I hate the world.

There is very little in the brain that is more hateful than changing meds.

Begin Rant:

I find it very interesting that, as far as I have read, no one who hates on Paxil ever really talks about how fabulously it can work. It really knocked out the panic attacks that I had been having nearly every day, reducing them to reactions to stressful situations rather than random everyday unprovoked horrors. It kept the depression at bay without making me completely stupid. Unfortunately, I was a victim of the nasty hypomania that antidepressants, especially the more “activating” ones, can cause. Certain SSRI’s (Paxil is probably at the top of the list) can trigger bipolar episodes in previously undiagnosed bipolar II cases. A recent reoccurrence of this (despite being on a mood-stabilizer) as a result of med tampering by my doc for a recent health issue not directly related to mental health is the reason I am trying to make the switch.

Another thing that I take issue with is everyone talking about how horrible the “shocks” that are experience by those getting off off Paxil are. So many experiencing this commiserate with each other on blogs and support forums, but never really try (at least as far as I have read, which is admittedly not much) to describe this sensation in any rational or objective way. Something that, in my opinion, would be far more helpful to those who are getting off of Paxil and have no idea what the hell they are experiencing, than the constant vitriol directed at a drug that isn’t exactly conscious of its effects–much like haters of lithium.

So, here is my attempt. First of all, I think this might be a fair description as I am having them at this very moment. Every time I move my eyes from keyboard to screen (can’t touch-type), my mind/brain experiences either a single or a rapid series of weird-feeling pulses, that are similar to the heart-beat pulses that come with really bad headches, but without the pain.

It is a true “sensation” in that it actually affects the senses: there are the pulses that feel like real physical shocks–the way it feels when you accidentally touch a live, naked wire–that when you feel them in your mind, your sight very briefly blacks out and your ears hear static. I guess it’s a lot like almost fainting, but freakier. Maybe it’s even a micro loss of consciousness, like micro-sleep. I know that when I am driving a car, or even riding a bike, it’s not at all pleasant and probably not really safe.

The “shock” sensation generally (for me anyway) happens whenever (though not always) I shift my eyes or turn my head (which is why driving is not such a great idea). In the very first days of getting off of Paxil, the sensation it is not so frequent as later, but far stronger (again, at least for me), while in the following days, the “shocks” happen more often (like nearly every waking moment whenever you move) but are less intense. We’ll have to see if they ever go away in my case, as many others say is their experience.

This is my second experience getting completely off of Paxil. The first was 15 years ago with the immediate release form, so I don’t remember much of that experience, which probably means that getting off was not as bad an experience than actually taking it, which made me so sick that I spent the first hour of every morning on the bathroom floor so nauseated that I couldn’t move.

So, that’s all I have the energy for now. Hopefully more later. I’m having more of a problem with depression and spontaneous crying-fits right now (which I must note, were not an issue when on Paxil), than the freaky shocks, so hearing from me is a good thing. Writing about all this unpleasantness and ranting against the blind emotional rants that others make is therapeutic, mostly because it distracts me from hating myself, my life, and the world in general.

Oh, and something I am wondering about is that since some speculate that these “shocks” are actually mini-seizures, does taking anti-seizure medicine help control them? As far can tell, I think they might, but then again, maybe it’s all in my head. (Heh, heh.)

Shock Me

Not much to say other than an update on the meds. Doctor upped the dosage of Lamictal, so I’m seeing double for a couple of hours a day. I’ve been off the Paxil for three days and those lovely shocks are getting more frequent, but pretty mild. (Google “paxil shocks” for some crazy opinions from some crazy people. Seriously, though, even the company that makes Paxil acknowledges this weird withdrawal effect.)

Still a little hypomanic–husband says I talked the entire time we were at the coffee shop today, which was several hours, and he was reading, so I was pretty much talking and ranting about various things to myself somewhat loudly. And the funny things is that I never really noticed.

Meds Again

I just don’t have it in me right now to follow up on my teaser, but maybe someday….

What I can say is that, about a week ago, my shrink finally started moving me off of Paxil, for which I am very grateful, because the dosage had been so messed up by the events of the past few months that I started toward hypomania & a lovely mixed state. I was talking a mile a minute and couldn’t stay still on some days and was turning into Mr. Hyde on the others–you know, mean, cruel, impatient, yelling at people, and hating the world in general and my own life in particular.

So, anyway, I’m getting off Paxil and moving onto Wellbutrin. We’ll see how that works. It’s pretty good so far, but I’m still on a tiny dose of Paxil right now. I’m feeling pretty good during the day, but am having trouble getting to sleep.

The shrink gave me Xanax because I was climbing the walls the day I saw him and had been having anxiety attacks. I have used it a couple of times since making the change, but mostly to get to sleep (because I have a constant dialogue going on in my head, yes dialogue) since the anxiety is fading.

But see, the problem with Xanax is that it makes you stupid. Yesterday I was noticeably (to me) stupid and, what is worse for me, losing words again. The words are there in my brain, but I can’t access them, which is incredibly frustrating to me, and doubly so now that I have been getting better.