More lithium, please

November 29, 2009

After a month on lithium, I’ll be emailing my psychiatrist today to tell him about my symptoms and see if he thinks I should increase my dose to 1250mg.

My symptoms have been a whole lot of anxiety, irritability, obsessiveness, and not being able to sleep much in the morning.  And occasional rage.  Sounds mostly like anxiety, but has enough of mixed state in there that more lithium might help.

I’m fed up.  There’s no one person or thing to be angry at, but I just feel angry that several months of acceptance, drugs, DBT (Dialectical Behavioral Therapy) classes, Bipolar informational classes, talking to co-workers and family….  none of it seems to have been effective.

It’s hard to keep going.  I’m in no danger of suicide, just in danger of losing the will to do anything but acquiesce to the couch.

Things that will make me happy include reaching out to distant friends, going outside, and doing interesting activities, but this all seems just beyond my grasp.

I feel haunted by something my doctor said at our last visit: “I can medicate you, but I can’t medicate your life”.  I hope just a little more lithium will help me make changes in my life.

Why am I unmedicated?

At first, it was because I was switching from Depakote to Lithium.

Then, in the mild mania presumably triggered by going off the mood stabilizer, I started a blog and began to question my diagnosis and my treatment.  I thought that treating my anxiety might be the way to go, since it’s the only diagnosis I felt confident in.

Then the mania turned into a few terrible days of mixed state — an activated, jittery, but negative place.  I was very irritable, and flew into several rages at my partner, after which I felt consumed by self-loathing and the desire to hurt myself.  I took some Seroquel during these days, because it was just too unbearable, and I was worried I would do serious damage to myself or my partner.

My horrible mixed state helped me accept that I have an illness — my partner pointed out, as he often does, that I would never choose to feel or behave like *that*.  It’s hard to distinguish the illness from myself — this mostly genetic, maybe environmental, uncurable, somewhat treatable disorder sometimes seems like all of me and other times seems so alien.

Having accepted that I need medicine to treat my illness, I called my psychiatrist.  I proposed staying off meds for another few weeks and documenting my moods, to give both him and me a better sense of my symptoms. He seemed to like the idea, and we made an appointment for November 13th.

Since then, I’ve been in a mild depression.  Showering is hard.  Going to work seems impossible, but I am still able to do it.  Everything seems hopeless and worrisome.  I’m tired all the time, but I can’t sleep well.

I think I might have rapid cycling, but regardless of my diagnosis, I just want some treatment. I’m going to call my pychiatrist on Monday and ask what I should take.