Oh, fantastic

[cleolinda]

So I had my quarterly medcheck today, and my doctor sat there listening to me with an unusually perturbed look on her face, and by the end of the hour, we were discussing changing my medication levels. Um. So. That's going to be interesting. Y'all longtimers may remember when we adjusted my medication something like two years ago, and I was plunged into two separate, crippling bouts of medication-wonk depression. I'm just not the kind of person who can contemplate active suicide--if nothing else, my sense of curiosity is too strong; I can't stand the idea of not knowing how things turn out. Also, the idea of my dogs wondering where I went wrenches me--so rock-bottom for me is, "Oh my God, I sincerely hope I don't wake up in the morning." Not that I ever would have told you at the time, but... I hit that point both times my medication levels were out of whack in 2006.

And I reminded her of this--for those of you possibly getting concerned because you are also on antidepressants or have been recommended them, what happened was that we increased my Zoloft, and... that turned out to not be the answer. Yeah. That was a real bad idea. And when that didn't work, we went back to my doctor's original idea, which was to decrease the Zoloft and start Lamictal, an anti-seizure drug now being used to treat bipolari... tacious... ness. The possible side effects of Lamictal had kind of scared me (two words: "fatal rash"), so we had tried screwing around with only the Zoloft at first (I also take Wellbutrin) rather than adding a third drug. In the end, Lamictal ended up working really well for me, although--like any drug--it doesn't work, well or otherwise, for everyone. We inched up the doses cautiously, no fatal rashes, all was well.

And then we went up a little too high too soon, and I went into tailspin #2. I did end up continuing to increase the dosage, but MUCH, MUCH more slowly, and I set the pace on that one. My point is, of the three medications I currently take, only one of them is--rather notoriously, actually--associated with suicidal thoughts, and that's (DUN DUN DUNNNN) Zoloft. What if the Lamictal wasn't the problem at all the second time? I mean, yes, the Lamictal increase triggered that problem, but the actual culprit was the Zoloft? Because the reaction was exactly the same as the time I was taking too much Zoloft, rather than some new and scary Lamictal side effect. What if reducing the Zoloft at that point would have solved the problem entirely? So today, when we were talking about what to reduce and what to increase, this finally occurred to me, and I suggested that we not wait to decrease the Zoloft. The idea would have been not to change too much too quickly by changing both dosage levels, but if what I'm thinking is right, it's a delicate balance and both sides have to be taken into consideration. And Lamictal doesn't have the same rep for exactly the same problem I had twice in 2006. So... there we are.

The theory behind this particular cocktail, by the way, is that I seemed to be type II bipolar--the kind with the nice, pleasant hypomanic swings. Except that I told her about the episode this past May, where I was so uninterested in food that I literally could not finish chewing it (in addition to being unable to sleep and feeling this sort of staring hyperintensity that left me unable to concentrate on work), and while she didn't actually say this, I suspect that I was edging into mania on that one. And this kind of thing can get worse over time. And antidepressants can "tweak your cycling" between depression and hypomania/mania, as she put it, possibly speeding it up or intensifying recurrences. Whereas Lamictal, as an anti-seizure drug, would tend to even that out. So logically, it would probably be good to decrease the antidepressant and increase the anti-seizure drug whether the manic episode happened because my mood cycles were naturally worsening, or because massive stress was causing it. And personally, I don't really see that stress going away any time soon, because even after I finish the annotations and/or the financial problems go away, I'm still trying to finish Black Ribbon. There are very few major projects that I have actually finished in my life, and as I know from the Movies in Fifteen Minutes book and school in general, finishing things tends to drive me around the bend. Mostly because I psych myself out, and I then have to fight my own highly effective self-sabotage tactics, which means that actually finishing something turns into kind of a Pyrrhic victory by the time I've had half a dozen breakdowns. Anyway, I'm kind of scared of screwing with the medications again because--not that you ever need a quasi-suicidal tailspin, but I really don't need one right now. On the other hand, I really don't need increasingly scary manic episodes either.

So... I'm telling you now, I guess, that this may end up being a... difficult? delicate? sketchy?... time for me, these next few months. I'm generally pretty good at pulling myself together for an audience--family, friends, social gatherings, y'all--so you may not notice much. And like I said a long, long time ago, I'm not the kind of blogger who's going to put you through the awkward experience of watching someone beg for validation in real time if I have a really bad day (zomg you guys I am totes going to kill myself if you don't tell me how wonderful I am!!1!). And you know, this medication adjustment may end up being fabulous and this entry much ado about nothing, I don't know. I just spent so much time writing about it in 2006, and people with similar problems seemed to find sharing helpful, that I'm going to be doing it again. Always behind easily skippable LJ-cuts, of course.

That said... uh, I kind of have a headache. So... who knows, if I can't sleep tonight I might do the linkspam. Otherwise, it'll have to wait for tomorrow. I am going to see Wanted (I honestly can't say whether or not I'll do a 15M. I have seriously given up trying to plan these things; they just happen) tomorrow night, so that'll be good for getting out of the house. Tonight I'm reading The Great Gatsby, because somehow we never had to read that in high school, and I just found out that it's Sister Girl's favorite book. Seriously, she's my sister and I didn't even know she'd ever read that, much less that it was her favorite (I found this out during an anguished phone call in which she ennumerated the differences between the Fitzgerald short story "The Curious Case of Benjamin Button" and the movie trailer FRAME BY FRAME), so... I'm making up for lost time. Which is probably for the best, as I'm far more likely to enjoy reading it on my own. I'm right up to the part where Jordan Baker tells Nick what the deal with Gatsby is, so I'm going to curl up and finish that now, I guess.

Comments

[jcipa.livejournal.com]

I understand what you're going through with medication switching. I got so fed up with it all, with the side effects and constantly changing prescriptions without feeling any "better"-- just varying degrees of sedated, depressed, suicidal, hypomanic, or manic. I decided to go med free (with the agreement that I would go back on medication if/when my family/friends felt it was necessary) and stick with cognitive behavioral therapy. It's not been easy-- please, do NOT think it's been easy-- but I do feel more myself. And I don't think it's for everyone. But I do understand what you're going through. Hang in there.

[cleolinda.livejournal.com]

Yeah, I spent several years in cognitive behavioral therapy, and my med checks last an hour, I suspect, because my doctor doesn't want me to get away without at least some kind of self-analysis. And you know, I really feel like medication isn't for everyone. If you feel like you're "on drugs," it either isn't for you, period, or you're not on the right meds at the very least. (I felt like I was "on drugs" when I was on Adderall. Right now I don't feel them at all; I just feel "normal," in the sense that I still have ups and downs, but I'm functional enough to deal with them.) I feel like it works for me because I've been showing the same symptoms since I was old enough to talk in full sentences, basically ("Mommy, I feel sad and I don't know why"), which suggests to me that it's a chemical imbalance. So I view medication for me as being like insulin for a diabetic on some level, but medication still isn't going to fix everything. I think it's all about figuring out what works for you as an individual, and if you can hash that out--and like you said, it's definitely not easy--then that's what's best for you.

[akathorne.livejournal.com]

I just started taking Zoloft (for fibromyalgia) (two days before having my wrist operated on) (I'm BRILLIANT) and I swear, it's the most interesting legal drug I've ever been on. I didn't know, previously, that I could FEEL MY BRAIN. So far it's been ok, though, barring extreme thirstiness (could be a byproduct of the surgery) and not feeling like I need to eat ever again.

[cleolinda.livejournal.com]

I... huh. The only part I really associate with Zoloft is the not eating, and that ought to wear off as you get used to it. A lot of the immediate side effects are only temporary, and go away after a while. Like... probably feeling your brain.

Now, Adderall--that was interesting. If meth is anywhere near as creepy-crawly feeling, I want no part of it for sure.

[sigma7.livejournal.com]

Rrrgh. I highly appreciate your willingness to blog through this, because I think you're right -- I know I've relied on the collective wisdom of my f-list from time to time, especially in pharmaceutical matters, and I've learned from many a post (perhaps some of yours, too; there are some days when it all dissolves in the mush of recollection into some sort of happy conglomeration of Other). I admire your forthcoming-ness...I think for too many of us, we still approach disorders of the gray matter with a 19th century mindset, perceive them as some sort of character flaw to be hidden or left unacknowledged, and that hesitation and modesty ends up costing us dearly.

But you're willing to stare this thing straight in the eye -- that's impressive. And I know, with the width and breadth of your f-list, it's going to help someone at some point. Maybe lots of people. Maybe me. Maybe someone who'll not quite be able to tell you how influential this is. So I'll say thanks for them and for me.

Rest, relax, take care of yourself, don't stress out about linkspam or M15M or anything. Your readership ain't going to abandon you. We're patient. We'll still be here.

[cleolinda.livejournal.com]

I don't quite know how I managed not to acquire the "shame" mindset--maybe because I was diagnosed right when antidepressants had just started entering the mainstream ten years ago? Zoloft was the new hotness at that point; Prozac was the trendy one just before that. Anyway, at first I didn't really want people to know, but I ended up seeing doctors and therapists because of my parents' extremely traumatic divorce, so people were more understanding than they might have been. And somewhere along the way, I guess I read a lot of newspaper/magazine discussion of the growing usage of antidepressants and the idea that mental health is pretty much exactly like physiological health: it's a spectrum, and hardly anyone is entirely "healthy." You can have mild, passing ailments or serious longterm problems, and they all have about the same moral weight--which is to say, none. It's not some binary of crazy/not-crazy. Besides, it's hard to feel ashamed of something when they run soothing, friendly commercials for the medications on TV 24/7.

[sound-of-bells.livejournal.com]

I absolutely adore The Great Gatsby. It is just such a -- a gem of literature. Which I imagine you've figured out by now, but anyway.

I hope the changes in your medication go smoothly. I've been reading your journal for quite a while and I don't comment very often, but I'm always glad when one of your posts pops up on my friends list, be it linkspam, family anecdotes, updates about your writing, or anything else. I just wanted to let you know that my thoughts are with you.

[cleolinda.livejournal.com]

Aww, thanks. : )

[sneaky-minx.livejournal.com]

I had barely started reading this and I started crying. I've been there with medicine frustrations, love. *hugs* (Went through anti-depressant after anti-depressant. Anti-anxiety seemed to help, but then they needed to add something because of my crippling depression bouts. So, am currently on two meds when I don't even want to be on one.) I'm sorry you're having to go through another possible medicine shitstorm. Just take care of yourself, okay? Seriously, I will send you money via paypal or something to make sure you take care of yourself. Your snark is a gift to the world, but if you need to take a break, you deserve one more than anyone!

I also should note that The Great Gatsby is a gorgeous piece of writing, loved it. I hope you enjoy it, though, like most classic lit, it doesn't necessarily leave you feeling uplifted at the end.

[cleolinda.livejournal.com]

Awww! It'll be okay. I've had some really, really bad bouts, and I'm to the point where I'm better at recognizing them early and getting help. And also--this is so sad, but this is why I didn't finish grad school (besides the fact that if I had to write one more paper, I was going to throw up and die): I was afraid that I'd go into another tailspin, fail a class from not turning in the work, and we'd be out $1000 for no good reason. And it's why I've wanted to finish Black Ribbon without pitching it to a publisher and trying to get a contract first: I didn't want to have a deadline looming over me in case I got depressed again. Better to take as long as I need and try selling it when I'm done, I figured. So I've tried to minimize stress in my life where I could, even if it made me feel like a loser and a slacker, while I tried to sort all of it out and learn to deal with it better. The next few months may not be fun, but I think they'll come out all right in the wash; I've got a pretty good support system. : )

[redcoast.livejournal.com]

You can't finish things? Do you have ADHD?

[cleolinda.livejournal.com]

I was diagnosed with some form of it in college, yes. I think it was eventually suggested that attention problems--the dreamy, distracted type rather than hyperactivity--may have been related to the chronic depression/bipolarity/whatever we were calling it that week. The thing is, it's not really that I have a problem finishing small tasks, which is what I would think ADHD would imply; I have a hard time finishing longterm projects (writing books, writing term papers, that kind of thing) for emotional reasons. Like, "Oh my God, I can't possibly make this good enough, so I'll just keep working until it is good enough, WHICH IT WILL NEVER BE OH GOD." I don't really think that's ADHD.

[callmesyd.livejournal.com]

Changing medications is always an adventure. Fingers crossed for you. :x

Don't be afraid to make some noise here if you need some support - we're all here and willing to catch you anytime you feel like the ground's slipping away.

[cleolinda.livejournal.com]

"An adventure" is probably a really good way of putting it. : )

[particle-person.livejournal.com]

Have you ever considered taking a "medication break" and checking how you do without them for a while? My sister, who has had clinical depression and lots of other stuff, got weaned off all her various meds by her doctor as a test to see if her brain had changed since the time she started taking medication, and it turned out she didn't need anything at all now. Bear in mind that she's been on some kind of med ever since elementary school, so her brain would have changed no matter what just from growing up. Anyhow, I don't know how long it's been since you were last med-free, but if the answer is something like "high school," you might want to consider taking a break sometime just to see if things are as bad as they used to be.

[cleolinda.livejournal.com]

Hmm... it's a thought. My history here, though, is that I've been showing these symptoms (depression, whatever kind of mania) since I was four. I was diagnosed when I was nineteen. On the other hand, simply taking the meds for ten years could have changed my brain chemistry, I don't know. I'd have to go on a pretty long break, though, because I already have slight withdrawal side effects if I skip a few days (which only happens when I'm sick--if I can't keep food down, for example), and I'd have to wait until those passed to get an accurate idea.

Something else that women in particular have to think about: if I were to get married and decided to have children, I'd have to go off them during pregnancy, wouldn't I?

[leucocrystal]

I wish you all the best with your medication changes, Cleo. I think it's great that you share this info with everyone, because, like you say, there's a chance it might be useful or helpful to someone else out there. I really hope this pans out for you!

[cleolinda.livejournal.com]

Aww, thanks. If nothing else, I figure it helps other people with similar problems feel less alone. I know it always helps me when people chime in and say, "I've had that problem, too."

[percysowner.livejournal.com]

I wish you luck with your medication change. It can be so hard to get the right cocktail. If posting about how this affects you helps, please do so. If you aren't up to sharing, don't worry about it. I will keep you in my thoughts.

[lesbiassparrow.livejournal.com]

Well that's just horrible news. I hope it doesn't go into the dark, dark days again and that the change goes right for you.

[cleolinda.livejournal.com]

Well, I don't know that it's horrible--more like "an adventure," as someone else in the comments put it. I mean, it could go really well, and in the long run it'll probably help the bipolaritaciousness a good bit.

[setauuta.livejournal.com]

I feel for you with the med switching - my doctor just started me on two different headache/pain medications and has me weaning myself off the Cymbalta (taken as a headache preventative, at which it's utter crap, and as an anti-depressant, at which it's eh), which should be...interesting. As it's an emotionally difficult time of year for me, I'm not looking forward to it.

I'm hoping that it won't be nearly as difficult as we think it will be, for both our sakes. *hugs*

[aayesha-r.livejournal.com]

Good luck weaning off the Cymbalta. it's a bitch of a med. It doesn't come in small enough capsules, so you end up doing the one every other day, then one every two day weaning toward the end, and you may go through withdrawal.

[elbales]

Changing meds can be so very unfun. Best of luck. But really, I have every confidence that you will be okay. You have a wonderful family and a pretty good support structure in general, seems like.

[cleolinda.livejournal.com]

Yeah, I really do. I was very luckily not in high school when I was first diagnosed--I have a feeling it wouldn't have been received so well then. But I made some very good, close friends in college very quickly, and the diagnosis came near the end of my freshman year, I think, so they knew me well enough to be very supportive and not judgmental at all. They're still my closest friends today, ten years later, in fact. And while my mother's struggled to understand exactly what it's like, it was a huge eye-opener for her--in a good way--because it suddenly explained a lot about my father, my sister and me: the chemical imbalance runs in his family, and it suddenly lifted a huge amount of guilt off her, I think. You know, we weren't having problems because she'd failed us in some way; we were having problems because of a chemical, biological quirk. So we've tried to frame the whole thing that way, as a valid, chronic medical problem on par with, say, her arthritis or my uncle's diabetes, and that's made it so much easier to live with.

[atalantapendrag.livejournal.com]

Hunh, we have some meds in common. I was pretty terrified by the legendary Lamictal rash when I went on too, but the only side effect I had was frequent headaches.

Me, I'm trying to figure out if my recent improved mood is due to getting my Zoloft increased about six weeks ago, or the frequent loose leaf tea drinking I've been doing for the past week or two (hcolleen enabled me to The Tea Table (http://www.theteatable.com/), I found Dragonwater (http://www.dragonwater.com/) on my own, and a kind soul from the BPAL forums sent me samples of Tempest (http://www.shoptempesttea.com/customer/home.php) and Adagio (http://www.adagio.com/)), which it correlates with pretty much exactly. Sounds really weird, but bot bergamot and lavender are supposed to have antidepressant properties and one of the teas I've been drinking is... lavender Earl Grey. I certainly won't throw out my meds in favor of a cuppa, but I'll be knockin' back that tea regular-like.

I really, really hope your new med adjustment works out well. It can be a really frustrating process. I'm very glad to hear that your pdoc takes time with you and listens to you.

[cleolinda.livejournal.com]

Huh. I don't drink tea as much as I used to, but I always liked Earl Grey, so that might be worth looking into.

the only side effect I had was frequent headaches

HEYYYYYYY... that would explain A LOT. (Is there anything you're able to take for headaches that's effective? I mean, does Advil work better for you than Tylenol, anything like that?)

[laurelin-kit.livejournal.com]

I can't believe it's been two years since you were working out the kinks with the Lamictal. I remember all that. I hope this turns out to be easier on you.

[sapphires13.livejournal.com]

I think I've mentioned this before, but everyone that I've ever talked to (offline and online) that's taken Zoloft has not been helped by it whatsoever, and in many cases, was made worse, myself included. The only thing worse that I've ever been on was Prozac.

[annlarimer.livejournal.com]

I'm actually pretty groovy with Zoloft. Prozac made me into the Joker, albeit without all that pesky crime and murder.

[txvoodoo.livejournal.com]

Ah girl. If you ever just wanna TALK about it, w/ no judgement and however much response you want - I'm here. Having been thru a lot of this.

[foresthouse.livejournal.com]

I LOVE Gatsby. Great, great book.

I have seriously given up trying to plan these things; they just happen

Sometimes that's the best way to do it.

You know if you ever need moral support or reviewing of annotations or anything at all, I'm glad to try to help! Or just chat. I hope the meds adjustment goes well. I know from friends that it can be so hard to figure out (and from my own experience, not with anti-depressants, but with that stuff that gave me digestive difficulties for awhile, bleh).

*hugs*

[padawansguide.livejournal.com]

I don't have experience with the meds thing, but I wish you the best of luck figuring it out, and with a minimum of pain! :-)

[dramedy.livejournal.com]

So, I was mis-diagnosed with depression about 7 months ago, put on Prozac, and I went, in a word, insane. Immediately got taken off those meds, when I got a proper psychiatrist, and started on Abilify, for my 'mild bipolar disorder' which is what it was at first. But the more I read, the more that I realize that I need a med change, because my meds are doing nothing for my borderline crippling depression and my massive anxiety/panic attacks.

so, in short, thank you for posting about this because it's given me courage to go to my doctor with my concerns and stuff. Sometimes I just need to hear that I'm not alone, that I'm not the only person dealing with depressive episodes. It's just, I get freaked out at med changes, because coming off Prozac into Abilify was messed up and it freaks me out. and I don't want that to happen again. but somethings gotta change, you know. so yeah.

/ramble

So, tl;dr version: thanks. :D

[strega42.livejournal.com]

My daughter is on Abilify after trials of Depakote & Seroquel. The Abilify works pretty well for her. My son is stable on the Seroquel.

Dramedy, one thing I'd like to specifically point out to you is that ADHD is very often mis diagnosed as bipolar disorder especially in adult women who were never diagnosed with ADHD as kids.

Cleolinda, the next time you talk to your doc (I'm assuming it's sooner than three months since she should be following up closely with any med changes) I would suggest asking her about the different medication profiles of Abilify and Seroquel and whatever the hell else is "standard" now, so that if this med change doesn't work for you there's plenty of time for you to consider your next step. You might also want to ask her if she can offer anything to help you handle the significant mood changes you get with med changes.

Anyway, just my $0.02 cents' worth (and, of course, it's worth what ya paid for it LOL).

Hugs!

[gabsy.livejournal.com]

I wish you all the best. And "an adventure" sounds nice, like you're a Hobbit daring to go outside the limits of the Shire for the first time. No, seriously, it's the first image that came to mind: Gandalf talking to some Hobbits and taking them with him.

But yeah, good luck. I sincerely hope this transition goes well!

[r-a-black.livejournal.com]

I remember what happened back then, I do hope things run more smoothly this time around. Good luck, :)

[dzurlady.livejournal.com]

Best of luck, and I certainly don't feel like you're going to be spamming us. I like to hear how you're doing.

[edda.livejournal.com]

*HUGS*

[elvensapphire.livejournal.com]

This will sound cliché, but I don't care - I think you're quite brave to share all of this in a public forum. I'm glad you did. I relate on certain levels - the Also, the idea of my dogs wondering where I went wrenches me--so rock-bottom for me is, "Oh my God, I sincerely hope I don't wake up in the morning." in particular, because I was just there, and it was recently. I've never been on medication for depression, but the chronic illnesses that have basically stopped life as I knew it wear rather severely on me at times and near the beginning of this year, I finally hit a rock bottom emotionally. I pulled out of it, but it hasn't been easy. And when I came back to LJ and shared what had happened, in the safety net of my own little locked journal, it was scary somehow. You lay yourself bare whenever you tell a group of people about struggles you're having, and that feeling is nerve-wracking. I think the most amazing thing is getting a positive response, realizing that you can tell the truth about it and receive support.

I'm rambling, but I just want you to know that I honestly respect you for sharing this and that I understand, that I hope everything goes well for you, and that, most importantly, you're close in my thoughts. <3

[elvensapphire.livejournal.com]

Oh, and Gatsby is a great book. It was one of my favorites from high-school. Very sad, but beautiful too. :)