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

[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.

[akathorne.livejournal.com]

My problem is complicated by the fact that I'm also on Vicodin for the pain of the surgery. So I'm pretty much high all the time, heh.

The non-eating part of the Zoloft has improved some already, and I'm not nearly so zappy as I was that first week I was on it.

[cleolinda.livejournal.com]

I will say, I spent a couple of months feeling very pleasantly apathetic about things. I was afraid for a while that I'd never write creatively again, except that I couldn't even care too much about that. And then it subsided, and I was back to being myself. I mean, you do need to watch out for that kind of thing and switch or stop meds if it doesn't improve, but you do also have to make allowances for early side effects that will go away.

Also: Vicodin, woooooooo! How's it going now--didn't you say the surgery was for your wrist?

[akathorne.livejournal.com]

Yeah, since the Zoloft is not really for depression (...exactly. In some patients with fibro, antidepressants can help with the pain that has no measurable physical cause. A lot of times, I feel like I have full body bruises, but there's nothing there. Fun!), it's weird. I definitely do not want to feel emotionally flat, but I wasn't sad/depressed before, so if I feel like it's not helping the pain, my doc said to just step it back and stop taking it.

Vicodin, wooooooo indeed! I'm enjoying it probably more than I should. I had a ganglion cyst on my left wrist that was wrapped around two tendons and a nerve and was painful, so I had it removed. It's pretty...gross right now. And swollen, and bruised, and painful. But it's only been a week since the surgery, and it will get better. And then I'll be able to use my wrist again, which would be very nice.

[thyroyalmajesty.livejournal.com]

Huh. I'm starting to suspect that I have a weird immunity to drugs. I've been on Zoloft for three months now (just went from 50 to 100 mg last month) for depression/anxiety, and though getting on it made it possible for me to get out of bed in the morning, I'm not feeling any difference with this increase. I also recently broke my wrist (stupid Prius driver not looking where he's going!), and was prescribed Vicodin, and all it did was make me sick to my stomach the first time. I didn't feel anything after that when taking it. Nothing like the rapturous feeling spoken of by a few recreational users I know. Hell, even the three time I've tried pot I didn't feel any different.

It's not that I'm seeking out a way to get high, but I do want to work on my depression, and I'm beginning to wonder how high my dosage will have to be to see any real effects. It's a little scary.

[vampirepig13.livejournal.com]

Sounds like maybe Zoloft just isn't for you. I tried it for my depression/anxiety, and it didn't give me suicidal thoughts, but it didn't make anything go away, either...I say talk to your doc about trying something else. What kind of therapy are you working with?

[lokifin.livejournal.com]

It might be that you have a naturally higher threshold for medications. I have a higher threshold for a lot of them, though I can feel the difference between no antidepressants and low doses, but I need way higher doses for them to really do me any good. My shrink says that in his experience, people with long term depression or dysthymia that lasts for years tend to need the upper limit or more of recommended dosages.

Which makes for really interesting times trying to navigate the side effects that happen at that level of medication.

[smadronia.livejournal.com]

You had the apathy thing too? I took Zoloft for 2 weeks and turned into the human slug. Went back to my doctor and told her I couldn't live like this. They switched me to paxil, which did nothing, and finally wellbutrin, which helped. That was years ago though. Sometimes I think I should be back on them.