My medication has helped me gain more control over my moods and consequently my life. I take three different medications that help treat the various aspects of bipolar disorder.
Pill #1 Seroquel XR: The Heavy Hitter
- makes me feel drowsy and calm so I can fall asleep
- it always helps me get a solid night of sleep (7-8 hrs). I used to wake up throughout the night at various intervals. Sometimes I woke up every few hours, other nights it was every 20 minutes.
- the XR in the name means the medicine is being released slowly throughout the course of the day and not just at night. Since I switched from Seroquel to Seroquel XR I have had fewer mood episodes in which I've wanted to destroy everything (preferably by smashing into tiny bits). It's also made me less likely to shriek at the top of my lungs in fury. I still get angry and I still have moments when I freak out; however, my rage is less severe and as a result less destructive.
Side effects I experience:
1. Weight Gain - Like my prescription for Zoloft and birth control one of Seroquel's most commonly reported side effects is weight gain. I like feeling more stable but I'm not too happy with the big buddha belly I'm developing.
2. Vomiting - Every couple of weeks I've felt extremely nauseous after waking up and have vomited as a result. I am not pregnant so there is no way I have morning sickness. The nausea I experience is similar to the wave of dizziness and disorientation I felt when I tried taking Depakote for a few weeks. I'm going to talk to my new medication doc to see if there's anything that can be done to alleviate this side effect.
Pill #2 Zoloft: My Saving Grace
- helps me stop fixating on sad and negative feelings. This medication changes the way I see the world for the positive.
- decreases the period of time I feel depressed. Instead of feeling hopeless and despairing for weeks or months at a time I can recover after a few hours or days. (My fear is Zoloft will randomly stop working and I will be hurtled back into the blackness of my worst depression.)
- decreases the severity of depression when I do have an episode. This might not sound like that big of a deal but it truly is. I no longer have suicidal thoughts and my inclination to be self-destructive has diminished.
Side effects I experience:
1. Weight gain - I've noticed a definite increase in my weight since I started taking Zoloft. My dosage was decreased at one time to counter the weight gain effect. Decreasing dosage han't really done much to stop the side effect.
2. Decreased sex drive - I noticed this side effect most markedly when I first started taking the prescription. After a couple weeks of taking Zoloft I felt like a weight had been lifted from me, like I could finally smile - but also like I didn't have much of a sex drive anymore. This is especially hard to adjust to after having been manic so many times. Mania makes me feel powerful and seductive and sensual. Zoloft makes it easier for me to be feel happy but it also makes me feel like my lust has faded.
Pill #3 Risperidone - Mania Manager
- reduces violent feelings of outrage and frustration
- slows down racing thoughts
- decreases the speed of my temper
- decreases risk taking behavior (anyone want to go shoplifting?!)
Side effects I experience:
1. Menstrual Cycle disruption - Taking risperidone caused my prolactin levels to be more than twice the normal level. As a result I no longer get my period at a regular time even though I am taking oral birth control. My doctor cut my dose in half in order to reduce my prolactin levels months ago but I'm still experiencing this side effect.
2. Weight gain - I've been taking risperidone for over two years now and I've definitely gained a more than expected amount of weight since then.
3. Feeling like a zombie - This only applies to the Risperidone M tab which is an orally disintegrating version of the pill I take daily. The M tab was prescribed to me for mood emergencies in which I feel extremely agitated. The medicine works in about 20 minutes and is very effective at getting me to calm down. Unfortunately it also makes it very difficult for me to focus on any kind of productive thought. I had to go home early from work before after taking an M tab at the office. I felt like someone had unplugged my brain.
Although the above medications have proved to be helpful I do not expect this will be my regimen forever.
Friday, September 9, 2011
Tuesday, September 6, 2011
shivers of rage
I found out from my psychiatrist's secretary today that he can't "guarantee" I can see my doc again until I resolve a bill from his office.
I told him that his customer service sucks because when I called for my prescription refill earlier in the day we discussed the bill; however, I received no warning that I wouldn't be able to see my doctor.
This man has been consistently unhelpful and unfriendly. I'm tired of dealing with his bullshit and I am so happy that I will never have to go back to that office. I have a new doc I'm going to see soon.
When I called my health insurance company to discuss the bill they informed me that I owed the doctor money because she was "out of the network". The psychiatrist's office had allowed their contract with my insurance company to expire. I asked if there was anything I could do to facilitate the contact being completed. This is because my doctor's secretary had claimed during our previous conversation that my insurance company told him there was no need for a network contract.
I asked if I could request that a copy of the contract be sent to my doctor directly. I explained that I was having communication difficulty with the doctor's secretary. I hoped that sending it directly to the doctor would be more fruitful.
The insurance lady said there was nothing I could do.
Here's how the rest of our conversation went down:
Me: I'm concerned that if there's an emergency I won't be able to see my doctor.
Insurance drone: If you have an emergency you wouldn't go to your doctor you would go to the hospital.
Me: Actually, if I had an emergency I would see this doctor.
At this point small shivers of rage were coursing through my body.
I had no control. And clearly this woman thought that all medical emergencies could be resolved with a trip to the ER. I wanted to scream and crush something simultaneously.
I said thank you to the insurance drone and ended the call.
Whenever I endure such a horribly bureaucratic and dehumanizing experience I am always reminded in particular of two works of art.
1. The Castle by Franz Kafka
Here's a succinct summary from Wikipedia:
The Castle is about alienation, bureaucracy, the seemingly endless frustrations of man's attempts to stand against the system, and the futile and hopeless pursuit of an unobtainable goal.
2. Brazil - directed by Terry Gilliam
Brazil is the stuff my worst nightmares are made of. The futility and powerlessness in Brazil is much more terrifying than the blood and guts of a horror movie.
Here's the first 10 minutes of the movie.
It helps me to think about Brazil and The Castle when I'm battling doctors and insurance companies because it helps me remember that the individual people I deal with are generally not the problem. The terrible confusion and powerlessness that I experience is the result of a health care system that is antiquated, nonsensical and at best absurd.
I told him that his customer service sucks because when I called for my prescription refill earlier in the day we discussed the bill; however, I received no warning that I wouldn't be able to see my doctor.
This man has been consistently unhelpful and unfriendly. I'm tired of dealing with his bullshit and I am so happy that I will never have to go back to that office. I have a new doc I'm going to see soon.
When I called my health insurance company to discuss the bill they informed me that I owed the doctor money because she was "out of the network". The psychiatrist's office had allowed their contract with my insurance company to expire. I asked if there was anything I could do to facilitate the contact being completed. This is because my doctor's secretary had claimed during our previous conversation that my insurance company told him there was no need for a network contract.
I asked if I could request that a copy of the contract be sent to my doctor directly. I explained that I was having communication difficulty with the doctor's secretary. I hoped that sending it directly to the doctor would be more fruitful.
The insurance lady said there was nothing I could do.
Here's how the rest of our conversation went down:
Me: I'm concerned that if there's an emergency I won't be able to see my doctor.
Insurance drone: If you have an emergency you wouldn't go to your doctor you would go to the hospital.
Me: Actually, if I had an emergency I would see this doctor.
At this point small shivers of rage were coursing through my body.
I had no control. And clearly this woman thought that all medical emergencies could be resolved with a trip to the ER. I wanted to scream and crush something simultaneously.
I said thank you to the insurance drone and ended the call.
Whenever I endure such a horribly bureaucratic and dehumanizing experience I am always reminded in particular of two works of art.
1. The Castle by Franz Kafka
Here's a succinct summary from Wikipedia:
The Castle is about alienation, bureaucracy, the seemingly endless frustrations of man's attempts to stand against the system, and the futile and hopeless pursuit of an unobtainable goal.
2. Brazil - directed by Terry Gilliam
Brazil is the stuff my worst nightmares are made of. The futility and powerlessness in Brazil is much more terrifying than the blood and guts of a horror movie.
Here's the first 10 minutes of the movie.
It helps me to think about Brazil and The Castle when I'm battling doctors and insurance companies because it helps me remember that the individual people I deal with are generally not the problem. The terrible confusion and powerlessness that I experience is the result of a health care system that is antiquated, nonsensical and at best absurd.
Sunday, September 4, 2011
what happens if I miss a dose?
It's time to take my nightly pill regimen and I can't find the tiny one and a half blue Zoloft pills I am supposed to ingest in order to avoid slipping into depression.
I thought I had put the almost empty bottle on my kitchen table to remind myself to fill the prescription today. However, I don't remember seeing it when I made coffee this morning or later in the day.
I've checked all the rooms in the apartment and can't find it anywhere. I looked through the contents of my purse multiple times.
I'm trying not to worry about the consequences of missing a night of antidepressants. I wasn't feeling particularly chipper today. Perhaps this isn't the best time to go without Zoloft. But then I can't think of any night when I would want to skip the best buffer I have against turning into someone who can only cry and curl up in a ball and stare at the ceiling.
I've been taking mood stabilizers and antidepressants for a few years now but I still struggle to fill the prescriptions on time. My prescriptions have changed so frequently that for a long time each month carried with it a new regimen with new dosages and new pill names (and pretty colors). I've been taking the same combination of medication for awhile now and I wish I could have prescriptions like Zoloft filled out for several months at a time instead of getting a 30 day supply.
To be realistic though I would probably just procrastinate refilling my pills until the last minute in that scenario as well.
I'm afraid to keep looking because that means eventually I'll have to either find the pills or give up.
I thought I had put the almost empty bottle on my kitchen table to remind myself to fill the prescription today. However, I don't remember seeing it when I made coffee this morning or later in the day.
I've checked all the rooms in the apartment and can't find it anywhere. I looked through the contents of my purse multiple times.
I'm trying not to worry about the consequences of missing a night of antidepressants. I wasn't feeling particularly chipper today. Perhaps this isn't the best time to go without Zoloft. But then I can't think of any night when I would want to skip the best buffer I have against turning into someone who can only cry and curl up in a ball and stare at the ceiling.
I've been taking mood stabilizers and antidepressants for a few years now but I still struggle to fill the prescriptions on time. My prescriptions have changed so frequently that for a long time each month carried with it a new regimen with new dosages and new pill names (and pretty colors). I've been taking the same combination of medication for awhile now and I wish I could have prescriptions like Zoloft filled out for several months at a time instead of getting a 30 day supply.
To be realistic though I would probably just procrastinate refilling my pills until the last minute in that scenario as well.
I'm afraid to keep looking because that means eventually I'll have to either find the pills or give up.
Sunday struggles - no rest for the wicked
I should leave my apartment. I should be out doing things. Many things. Anything.
I told myself this morning it’s Sunday and a good day to take it easy and hang out with the birds.
Part of my mind is racing and telling me I need to go faster. The other part wants to curl up on the couch under a blanket and not move for a long time.
I’d smoke more weed to calm myself down but I already feel fried.
I’ve been doing really well these last few months and feeling stable. But today I’m having a hard time believing the sign I have on my bedroom wall:
The time you enjoy wasting is not wasted time.
This is certainly not a concept I was taught growing up. I was raised by endlessly busy women, multitasking every second of the day. My impression was that to be an adult was to be always moving, always doing and never stopping. What is easy to forget are the late afternoon crashes both my Mom and Grandmother had. They fell into bed after lunch and woke up just in time to make dinner.
I am on a mini-vacation from working crazy hours at the office. I want to be able to take it easy without feeling a compulsion to run out the door.
I start getting nervous when I’m in this mood because if I get agitated I’m likely to flee the apartment. Fleeing is dangerous when you’re in a giant boat of a car and driving much faster than the speed limit.
My boyfriend has asked me over and over today if I am okay. I think this question universally makes people nervous. At least it makes me nervous.
When I was napping under the fuzzy brown blanket earlier, trying to reset my brain, I thought that it was sad I didn’t love myself. All day I have felt like I was doing the wrong thing, annoying the man I love and acting like a moron. For example, this morning I made the “idiotic” mistake of spilling coffee grounds in the wrong part of the machine. This was an unacceptable failure according to the mercilessly critical part of my consciousness.
The critical voice in my head tells me I should be able to quickly and perfectly make a cup of coffee. It also tells me I should be busier; I should be doing more on my day off and on every other day. I should be going to graduate school, cranking out poems/essays and short stories and saving for a house. I have learned from therapy that this behavior stems from my belief that I am not worthy of love unless I am perfect. Reflecting upon this brings me relief because I am less worried that I am having a bipolar mood swing. Rather, I am having a reaction to the clash between the way I want to live and the way I was taught to live.
Sunday, August 28, 2011
20 something - female - lost in space
Before I started taking lithium I frequently shrieked with rage when I saw my reflection. I screamed because I hated what I saw (myself). Or at other times I did not recognize my face at all.
I stood dazed in the mirror, wondering - whose nose is this? It is my father's nose, I thought, not mine.
I couldn't recognize myself because I was millions of miles away floating in a part of space where no one could reach me.
After a couple weeks of taking lithium I was back on this planet and able to look in the mirror without having an immediate or violent reaction.
I saw that my eye bags sagged. I looked and felt tired. Finally, I could relate to my reflection.
A few months later my face was covered with painful red pimples, worse than any breakouts I had as a teen. I went to my dermatologist puzzled because I had been taking all necessary steps to maintain my complexion.
My dermatologist said my acne was a very common side effect of lithium treatment...and if I wanted the (uncomfortable and embarrassing) blemishes to go away I would need to stop taking lithium.
I was devastated. I felt extremely lucky that lithium had helped stabilize my mood swings. I was afraid that nothing else would be as effective.
I talked to my psychiatrist about the acne side effect and she suggested I try Depakote instead. She explained that lithium and Depakote are the two most frequently used mood stabilizers to treat bipolar disorder.
I did not react well to Depakote. It made me feel zombie-like and heavy as soon as I started taking it. Worse, after a few days of being on Depakote I felt like I was stuck on a nauseating carnival ride. The ground seemed to shift beneath me when I walked. My psychiatrist suggested Seroquel as a possible alternative to the "traditional" bipolar mood stabilizers.
I've been taking Seroquel XR (XR means extended release) for over a year now. It has helped tremendously with decreasing my depression. I think it is particularly effective against depression in conjunction with Zoloft. I get depressed less frequently now and when I do it's less severe.
I stood dazed in the mirror, wondering - whose nose is this? It is my father's nose, I thought, not mine.
I couldn't recognize myself because I was millions of miles away floating in a part of space where no one could reach me.
After a couple weeks of taking lithium I was back on this planet and able to look in the mirror without having an immediate or violent reaction.
I saw that my eye bags sagged. I looked and felt tired. Finally, I could relate to my reflection.
A few months later my face was covered with painful red pimples, worse than any breakouts I had as a teen. I went to my dermatologist puzzled because I had been taking all necessary steps to maintain my complexion.
My dermatologist said my acne was a very common side effect of lithium treatment...and if I wanted the (uncomfortable and embarrassing) blemishes to go away I would need to stop taking lithium.
I was devastated. I felt extremely lucky that lithium had helped stabilize my mood swings. I was afraid that nothing else would be as effective.
I talked to my psychiatrist about the acne side effect and she suggested I try Depakote instead. She explained that lithium and Depakote are the two most frequently used mood stabilizers to treat bipolar disorder.
I did not react well to Depakote. It made me feel zombie-like and heavy as soon as I started taking it. Worse, after a few days of being on Depakote I felt like I was stuck on a nauseating carnival ride. The ground seemed to shift beneath me when I walked. My psychiatrist suggested Seroquel as a possible alternative to the "traditional" bipolar mood stabilizers.
I've been taking Seroquel XR (XR means extended release) for over a year now. It has helped tremendously with decreasing my depression. I think it is particularly effective against depression in conjunction with Zoloft. I get depressed less frequently now and when I do it's less severe.
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