Hypomania is fun!

So it's 1:30am and I'm awake, wishing that Michael or someone was still up so I could chat with somebody. I've already exhausted a few avenues on the internet, and I'm currently reprogramming my phone. What does all this mean? I think I'm hypomanic. I'm not feeling like spending my money or traveling, but I can't sleep and I'm thinking about way too many things at once. And I'm smoking.

I'm taking my meds, though the dosage changes all the time. It just depends on what free dose the doctor has. The drug companies give him free samples and he gives them to me, so I've been on 15mg, 5mg, and now 10mg of the same stuff. He just gave me a big bag full of more today, so I should be fine for the summer while I'm away.

So what can I do about this? Is mania coming? I don't think so. I don't feel like it's going to get out of control. I feel like I'm just a little high, but not dangerously so. I think it will be good to get me through the summer. Oh! Wait! Look at me, displaying addict behavior. "I like this high. If I can just maintain it...."

So what do I really do? I think I'll split the 10mg and stay on a consistent 5mg for a while and see if that balances things out. It should even out within the week, and if I still can't sleep next week then I'll have to call the doc and see what to do. I've got to make sure I'm taking the best care of myself that I can!

Don't get forgetful

Did I take my drugs this morning? I have no idea. I got up at an unGodly hour to meet someone in the city for a meeting and I may have forgotten to take them. It's probably ok, though, cause I think I might be getting a little manic. I'm booked for lunch and dinner all week, which hardly ever happens. It's only 2 and I've already been to two meetings and breakfast. I was supposed to go to a movie tonight with a friend, but I'm slowing myself down. I rescheduled for Tuesday.

It feels good to go to meetings, even when sometimes it's just the crazy people talking about their diabetes. I suppose sometimes you just need to get stuff like that off your chest. Even if it's not AA related.

Swinging that sword

The speaker this morning talked about how her drinking never had consequences, like DUIs or loss of family, but that she always had a sense of impending doom. She always felt like that sword of Damocles was about to drop on her head. That's how I felt. I knew something would happen. Some day I was bound to get a DUI or something car related like an accident. I may not have become a "rock bottom" drunk, but it was getting to the point where something bad was going to happen, and it was going to rock my world.

As I come up on my anniversary I get more and more grateful for sobriety. I'm glad I found it when I did, too! This past year would have been hell or death if I was still using. I couldn't have made it. Who knows what would have happened. It's just another example of the promises coming true: God doing for me what I couldn't for myself.

A few people have asked what I'm going to do to celebrate for my anniversary. I might be up north, so I don't know. There's a meeting that night, so I'm definitely going to that, but maybe I can find some sober people to take me out to dinner. If I stay here, I think I'll do a marathon meeting day. I'll hit an 8:30am, noon, 5:30pm, and 8:30pm. I suppose sobriety is present enough.

Now we're cooking with gas

I've been reading old posts on Adam and I remembered the crap that went down in January, how I felt so awful (because of depression and because he told me he just wanted to be friends). I think at the time I was in such a bad place that I almost didn't care. I wasn't prepared to be living my life at all, and so wasn't looking for a relationship.

So what's changed? I'm still not looking for a relationship, but I'm open to one. I wasn't before. None of this changes the fact that he still just wants to be friends. Sigh.

In some of the posts I really should have seen where depression was taking me. I was leaving the house sometimes, sure, but I was a real mess. I knew it was bad, but I swear the Abilify is a God send. Without it I just can't seem to function at all. And what's scary is I'm almost out. I went back to the doc and the only free ones he had were 2mg instead of 15mg. I took a bunch of them today to add up to 14mg, but I may just start taking 4mg to spread it out until he gets the BMS rep back in there with more. I don't know what I'm going to do long-term. I'm trying to get on the patient assistance program, but I'm having printer issues. I need to just suck it up and go to the library to print this stuff out. I need to send it in ASAP. I just can't be without the Abilify.

Down in the dumps

Made it out of bed by 2 and out of the house to watch the elephants and circus parade into town with the 2 year-old nephew. It was a short parade, but he was really excited about it. Then off to therapy. "It sounds like general apathy," she said. "Let's call the doc. Maybe we can get you on some different meds." Yes. Perhaps it's time. I just feel - blah. I don't care about anything. Nothing is giving me pleasure. There's no reason to get up out of bed or get dressed. I just feel ick. And it's gorgeous outside; everything is blooming and the sun is out. And I don't care. I'd rather be asleep.

I called the doc on the way home and left a rambling message. "I think I feel worse. I can't get out of bed. Here's my number." I don't know if it made any sense or if she'll even know who's calling. I hope I don't have to go in again, cause it's $85 every time. I'm sick of spending all my money on face time with the doctor and nothing is coming from it. "You were such a bright spirit in October, so full of life," said Julie. And look what's happened? Now I've lost interest in everything. I'm only writing this blog post so you don't think I'm dead. I can't even be bothered to read the news and find interesting links for you. Jesus, I bore even me.

So let's hope the doc comes through with some med changes. Something that works. Apparently Celexa does not.

Do your drugs really work?

"Americans are less than 5% of the world's population, yet they consume 66% of the world's psychological medications."

That's a lot of us drugged up on Prozac and Xanax and the like. But do these meds even work? According to this article, they work 25% of the time. As much as a placebo does. Yet we're paying millions of dollars a year for them, and risking complications like permanent involuntary movements and heart disease. Psychiatry has changed from one of care and do no harm to drug and don't care about it. Who knows what we're really taking in with these medications!

I'm not saying stop taking them. I'm going to keep taking mine. They're the only thing between me and a horrible depression, and I'm much happier risking losing a few years to heart disease than dying now because of depression.

Checking for the refill

So I have about 40 minutes before I have to leave to go see the doc, and I'm trying to get my brain together. What do I feel? How am I? Am I depressed? Manic? Neither? What's really going on? And you know what? I have absolutely no idea. I mean, I'm tired as hell - which could be the Celexa or could be the lack of Abilify - and all I want to do is sleep. I'm getting fat, which is pissing me off. I'm still unemployed, which is also pissing me off. And nothing is changing. It's all still the way it was months ago. But hey, I'm not suicidal! Hooray!

What do I tell the man, then? Well, I've started having the energy to brush my teeth, which is a good sign. When I'm depressed the teeth are the first things to go. I'm sure I'm going to have major trouble with them when I'm older. Sometimes I wish for a little teeth brushing OCD but it never happens. I have a friend who was a meth head and that was his quirk. He has great teeth.

Back to me. I'm able to get up and get dressed everyday. I'm showering and putting on clean clothes that look nice. I took a trip. If anything, it's a low-level depression. And I think it's all situational. I'm pissed and depressed for really good reasons.

It's only been 2 days without the Abilify and I can't identify differences besides being really tired. I'm not sure he's going to give me more of it. He may increase the lithium, which would suck, I think. I already don't like it. It makes my stomach hurt if I don't eat with it, which I forgot to do this morning, and it makes me really thirsty. Damn salt.

Maybe he won't do anything. We shall see.

What your doctor doesn't know

"Then, his goal was to help his patients become happy and fulfilled; now, it is just to keep them functional."

A great article by the New York Times on how psychiatry has become a pill farm instead of the talk therapy it once was. I totally identify, as I'm sure you do. I see my doc maybe once every 6 months, more if I'm in crisis, and I see him for 10 - 15 minutes. I tell him I feel _____ and he flips out the prescription pad.

If I could see him an hour a week, or even once a month for 30 minutes, the man might know what's going on with me and be better able to craft my med cocktail. But instead, he has to rely on what blanks I can fill in. And I'm an informed consumer who doesn't lie to my docs. What about other people who don't know what are symptoms? Who don't know what to look for? How does the doctor know what to prescribe?

It all scares me, honestly. No wonder so many people are on meds. Psychiatry is quick on it's way to becoming sham medicine.

Do it anyway

Scientists have developed a new mouse model to test how SSRIs work. "Many antidepressants have been shown to target other proteins besides the serotonin transporter and … their efficacy in treating depression takes many weeks to develop." So basically, they still know nothing.

Doctors don't really know how or why the drugs work, they just seem to do something. They're still not really sure about lithium, and it's been used for hysteria for centuries.

The brain is a funny thing? So why do we mess with it? Why pour in fabricated chemical models that we don't know what they do? Why take meds? Because they do work (most of the time), and anything is better than the horrible depression. If you know what I mean, you know why you take meds. Nothing is worse than that black hole, that impermeable fortress of death. Yuck. Yay science!

We're doomed

Interesting article about the "epidemic" of mental illness in the U.S. Apparently, they think it's caused by the very meds used to treat us. Here, you read:

Prozac and other SSRI antidepressants block the reuptake of serotonin . In order to cope with this hindrance of normal function, the brain tones down its whole serotonergic system . Neurons both release less serotonin and down-regulate (or decrease) their number of serotonin receptors . The density of serotonin receptors in the brain may decrease by 50% or more . As part of this adaptation process, Hyman noted, there are also changes in intracellular signaling pathways and gene expression . After a few weeks, Hyman concluded, the patient's brain is functioning in a manner that is "qualitatively as well as quantitatively different from the normal state" (Hyman & Nestler, 1996, p . 161).

In short, psychiatric drugs induce a pathology.

Basically, the drugs tell your brain to quit with the serotonin production. I always wondered what exactly they were doing up there. It sounds like a not so hot thing, and my theory that once you take drugs you can't stop seems to go along with this article. Once your brain makes an adaptation like that, it relies on the drug. So if you go off drugs, like I did, you're screwed.

Abilify I love you

I'm still thinking about how I'm going to get the doc to keep me on Abilify. I mean, it's approved for adjunct therapy with lithium, so it's not like I'm off label. I wouldn't be taking it long-term when you're not supposed to; it's encouraged for people with bipolar 1, which I have apparently morphed into.

Morphed? You say? But Anne, you always had psychosis and severe depression with alternating psychotic mania. No, I didn't. I used to just get really depressed and occasionally I would get up and spend money and sleep with people. Party a lot. The depression has gotten deeper over the years, and the psychosis is new. I don't think I'm too bizarre on the outside, but my thoughts get really bad. So it's moved to bipolar I over the years.

And what's a good treatment for bipolar I symptoms? Abilify! Or it's cousins. But I've been through them. I mean, not Geodon, but Zyprexa (made me fat), Seroquel (puts me to sleep). Abilify really works. Ok, so I end up a little hypomanic, but I'll take the credit card debt over psychotic depression.

So how do I get him to keep me on it? I guess I just have to beg and plead. I'm sure he can get me into the patient assistance program, which should cut down the cost significantly. It really works for me, doc, really!

It's insomnia night!

Well, this hasn't happened in a few weeks. I'm up, it's midnight, and I can't seem to go to sleep. I think a lot of it has to do with the fact that I've been trying since 9:30 and have been constantly getting texts. No one loves me unless I'm trying to sleep. Or maybe I'm always trying to sleep and so people just text when they feel like it.

Somethings I've been thinking about: Julie mentioned something about our sessions ending in April, so I think that's when her semester is over (she's a student therapist). I suppose I'll have to go without or try to convince the center to give me someone for the summer semester, if they have a person. I wonder how their process works.

I see the doc next week, and I think he's going to take away my Abiify. I'm appalled at the thought. I can't imagine being without the antipsychotic. It's what got me out of a depression last year, and what got me free this time, too. If it's a crutch I don't care- I need it. But how am I supposed to have it? Well, I'm not going to worry about affording it. There are a bunch of folks who've taken up the cause d'Anne and said they would help pay for my meds. I think that sucks, but if it's the reason I can still go to interviews and function, then so be it.

Jesus, I need some sleep. Ugh.

Separate worlds

"You are not your illness. It's just something you have that flares up every now and again. It's not you." - Julie

I need to learn how to separate me from the bipolar. I tend to think of myself always as ill first, and everything else second. But who am I without the illness? Well, I'm hella optimistic, I can tell you that. I'm in a spot right now where anyone would be depressed, and I'm ok. I really am. I'm confused, and a little torn, but I should be. It's natural to be up in the air about everything when everything is up in the air like it is. But I'm optimistic that it's all going to work out. Everything is going to be fine; better, even.

The horrible, suicidal depression I slipped into the other week isn't me, I have to remember that. It's not who I am, it's just a thing that happens. A flair up. It's like having psoriasis or some other disease where the symptoms present sometimes and you have to fix them with medications, and then they go away for a while. Going off meds always reminds me how much I need them. I mean, look at my posts. I'm suicidally depressed and yet questioning my diagnosis. Dumb. Makes me laugh at how delusional I can get, but scared, too. I need to keep myself on track. It's not ok to go off meds.

Sanity comes with a price tag

"Well, would you rather be sane and fat or psychotic again?"

That's the first time he's used the word psychotic. He used it again later in the conversation in reference to how I was the last time I saw him, exactly a week ago. Suicidal, having delusions of things out to get me, anxious, depressed, amped, and crawling out of my skin. Psychotic. It hadn't occurred to me that it could have gotten that far. I mean, I wasn't jumping off the balcony, but I was thinking about it a lot. I wasn't seeing ghosts, yet. But he called me psychotic. He's the doctor.

"I'd rather not be fat," I said. "I lost 40lbs last year and I feel like the Zyprexa has made me gain 10 back. I can't fit into my pants. It's going to make me depressed."

So, we compromised: back on the Abilify. He had some in the magic closet, so I got a months worth of free stash. I start tonight; out with the Zyprexa. The Abilify before didn't cause any side effects and it almost immediately popped me out of that depression, so I'm hoping it keeps me moving in the right direction. And that I'll stop with this insane craving to eat; to chew. It really is a compulsion that I can't control. I start to shake if I don't eat for 2 hours or longer. I've just been grazing for days, like a goat. Bloated goat.

"Ok, I'll see you in three weeks, but you call me if anything happens, ok?"

Did you know that without insurance it's $85 for a 15 minute visit to your psychiatrist? I think that's on the cheap side, too. But hell, it's less than what I would pay for that much Abilify.

"Thanks, doc."

Bloated goat

Julie and I went over some of the characteristics of mania and depression again tonight. "Sounds like mania, a little, but you have some of the depressive qualities, too. Maybe it's the meds?" she said. I don't know. I've been feeling agitated since before I started on the meds. Thursday was my first panic, and I didn't start the new meds till Thursday at bed time.

So what is it? Do I have to put a label on how I feel? Can I just say I feel extremely agitated, irritable, ansty, unnerved, like everyone can see just how messed up I am. I feel like I can't stop eating no matter how much I don't want to eat any more. I feel bloated to incredible proportions. I just feel sick. By all accounts I sound and look just fine. "You actually look much better rested this week," said Julie. Probably the awesome catatonia I fall into at night on the Zyprexa.

I want off the lithium already. I don't want to go back to doing monthly blood work and being a bloated goat, eating everything in sight. Can't I just go back on the lamictal? It has a generic, right? I think it was still $100 at CVS. I need to price these things out. And what the hell is the Celexa doing? It's the antidepressant, and I suppose I'm not suicidal anymore, but that could be the Zyprexa. Jesus. If I can't tell and I'm with me all the time, how is the doc supposed to figure it out in 15 minutes?

Give a dog a bone

My aunt just called. She and my dad were talking about me, and then he handed over the phone. "I hear you're in a rough patch?" Yep. I'd call it a rough patch. "Did the old meds work better for you?" she asks. I think so. I mean, I was on them for a while and everything was just normal. I wasn't depressed until I went off the Abilify, and I didn't hit suicidal till I was off the other two. So I guess they were working well.

"Why don't you just tell your doctor you want to go back on the others. Don't worry about cost. We just need to get you on the right meds for you. We'll figure out the money."

I want to cry out, "Too late!" You can't just go back on a cocktail and hope it works like it used to. Chemistry is an ever-changing beast. Who knows if it would help. And I'm not one for accepting charity. I can't let them pay $1,000 for meds for me. I need to figure this one out.

Is that stupid? I want to be on the right meds for me, too, but I don't want to put anyone out. I'm going crazy with the anxiety, though. I'm meeting again with the doctor on Thursday and hopefully we can pin down which one needs to go. I'm hoping the lithium goes, cause I hate the tremors.

Syrup head is a great name for a band

Are your kids stealing your prescription meds and having "Skittle parties?" Apparently, prescription drug abuse by kids is on the rise and some people are claiming that kids get together and have parties where they share the drugs they've stolen from your medicine cabinet in order to get high. "The U.S. Department of Health and Human Services (HHS) reports that nearly 3 million teenagers and young adults (those aged 12 to 25) become new abusers of prescription drugs."

I don't think my parents were on any drugs when I was a kid, except for my moms thyroid medication. It never tempted me for some reason. I'm sure if I had access to other pills I would have thought about taking them. I was having too much fun with illegal drugs to worry about prescriptions.

Later on, of course, I discovered how much fun abusing prescription drugs could be. Need a good days rest? Take some Ativan. Have a test to study for? A little Adderall will help. Hell, Adderall is good for everything: from studying to partying.

I love this quote:
"a police officer or a drug counselor who asserts that the soirees take place or have heard young drug-heads talking about them. Given such stringent evidentiary standards, it's a wonder that preschool teachers aren't claiming that unicorns are real, too."

Zyprexa wants me to gain weight

I can feel my body pushing up against my jeans, wanting to burst out the other side. All around the hips the pants are pushing in and up, making burbles of fat roll over my waistline. I swear these pants used to fit. I wore them last week and they weren't this tight. I have a serious problem, here. If these pants don't fit, what about all my work pants?

It's only been 3 days on the Zyprexa and already I can't stop eating. I feel fatter by the moment.

"The average weight gain for an adult or adolescent patient on Zyprexa is 20 pounds in three months. Some patients have put on as much as 60 pounds. 90% of patients on Zyprexa not only put on weight, but on excessive weight." Read that again. See it? 90%. 90. That's almost everyone. Makes me want to give up now.

They use Zyprexa for anorexics because it makes you eat (and, of course, it does other good things). It's like smoking pot and getting the munchies. You don't know what you want, but you'll try a taste of everything just to see if it's good, and then you can't go wasting it....

I wish I could say I didn't care, and just let it do it's thing, but I do care. I don't want to gain weight. Again, we're back to square one: exercise. I can't eat any better, since I'm living on good foods (and the occasional ice cream sandwich or kit kat), but I can exercise. God, just thinking about it is exhausting.

It's a zombie's life

"...Zyprexa may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert." Zombie.

Celexa also makes you tired and dizzy when you stand up. Zombie.

And lithium? "Be careful if you drive or do anything that requires you to be awake and alert." Zombie.

I've been sleeping since I got off work. I just came upstairs, laid down, and that was it. I woke up about 3 hours later and started gorging. Again, it's just little food, not meals, but it all adds up.

I don't want to be a lightheaded zombie who sleeps all day and, when awake, has trouble putting together responses to customers. I really should go out and do something, but I'm kind of afraid to drive. I could take the metro, but to wear? It's all a little overwhelming right now.

I feel like I could just lean over and fall right back asleep. I bet I could. I suppose I should cut myself some slack - it's only day 2 of meds - but I don't want this to become a pattern. And it's Saturday, for crying out loud. There's a lot to do out there in the world. I think.

Oh so heavy

I feel like my tongue is dead. A big, useless piece of flesh is resting on the bottom of my mouth between my teeth; just lying there in peace, content to be unresponsive. And the fuzz. Wool has started to grow between my ears. There's a giant cotton ball being fluffed to brain-sized dimensions and spread out like a blanket inside my head.

I couldn't think of the word receipt.

I slept through my alarm.

I'm starving, but I've already eaten. Actually, it's not hunger, it's the need to keep my mouth moving so it doesn't sew itself shut. Each moment I don't open it, the heavy my tongue feels. It's like I can't even open it. My jaw is heavy, too.

As I stand here at the computer, I get the feeling I may topple over. Just lean a little too far to one side and down I'll go, straight down like a tree that's been chopped. It's taking all the effort I have to stay standing - if I sit I know I'm going to curl up in the chair and sleep.

Day 2 of Zyprexa, lithium, and Celexa.