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.

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Starting Lithium

October 29, 2009

The initial symptoms of Lithium are comparable to those of Depakote — with the big caveat that YOUR MILEAGE MAY VARY.

I’m feeling shaky and jittery and electrified as though I’m manic, but I’m pretty sure that it’s the Lithium.  The brain fog of my depression the last week seems intensified.  I’m also sleepy all the time, but that may be in large part to the Seroquel I’m taking to calm down the jitters.  My focus at work is shot to hell.  Hopefully next week will be better!

All this is affecting my work performance — I need to tell my new boss about my illness soon before she questions my dedication or judgment.  More to come on “coming out” about bipolar in the workplace.

Self-diagnosis

October 13, 2009

This is what I want to find out from my therapist this morning:

Is bipolar always treated in priority to anxiety, even when the latter is more currently a problem?

My first diagnosis was anxiety & depression, for which I was given a mild SSRI (celexa/citalopram), with the warning that it may trigger mania if I were bipolar.

The SSRI or extreme stress (not sure which) caused a hypomanic episode, months after I’d started the SSRI.

I’ve had 4 manic episodes & at least 1 major depressive episode (self-diagnosis), but they were all over 4 years ago.

Therefore it seems like the anxiety should be the primary focus of treatment, with the caveat that my meds need to not trigger my bipolar.

I’ve been self-medicating with some extra Seroquel the last couple of days, but it makes me too drowsy to function… it’s otherwise great.

UPDATE:

My therapist gently asked, “What about yesterday, when you emailed me about how unstable you were?”

Yesterday is a whole internal universe away, so I had no idea how to answer.

My next step? See the psychiatrist armed only with a few charts that give him a clear picture of my ups, downs, and problems, not with my ego.

From salted lithium (who is an excellent, excellent writer):

“I need a fucking intervention… I need people who know what they’re doing to stand up and hand me a plan. Because, really, I’ve spent twelve of nineteen years not knowing what it was I was supposed to do… and it’s gotten me exactly here.”

Exactly.

These side effects made me think I should go off of Depakote (1000mg/day) and try Lithium:

  • itchy face
  • extremely sensitive scalp
  • more hair in the hairbrush than usual
  • my latest period lasted less than 2 days
  • weight gain (not that I expect it to be better with Lithium!)

The psychiatrist agreed (in his typical terse one-sentence-fragment-email), and I’ve been dialing off the Depakote and will be entirely unmedicated by the start of my work week.

I was initially excited about the manic boost I’ve been getting by going off the med….   I was able to start a blog, write over a dozen queued blog posts, clean the kitchen, and make pizza.  Then it escalated, and my thoughts were racing and I was panicking, and I couldn’t get to sleep last night. I had to take a third of a Seroquel today in order to function.

A long talk with my partner made me reassess everything, including starting Lithium.  My serious manic & depressive episodes are in the fairly distant past now, and I’ve only had hypomania and minor depression this year.

The serious stuff has been the anxiety and the mixed states (rages, dysphoria, etc), and I really want to primarily treat that.  If I can do so without going on a hardcore bipolar drug, that would be awesome.

Stay tuned for manic fun or manic horror!

Who knows what medications lurk in the pockets of co-workers?