Monday, August 15, 2011

The Med Questions - Should I take bipolar medication?

My hesitation and problems with medication partially stem from my past experiences. About 4 years ago, I was on Lexapro for a short period of time. I wasn't in therapy, I was living at home (a mental health minefield) and I didn't see any results. My psychiatrist upped my dosage a few times, but didn't want to listen to me talk about the issues. I didn't understand that she wasn't a therapist, just a script writer. No one explained that to me. It was like:

" Hi there, how are you feeling?"
"I'm not feeling any better...my thoughts are pretty nega--"
"Well, let's just do 200mg instead of 100mg then. That should help those thoughts go away."
"But I think if I just could talk abou-"
"Here's your prescription, see you next time."


When I went to my new psychiatrist about 5 weeks ago, we spent much more time talking about the issues and I felt good about it overall. I told him my symptoms, etc. without telling him that my therapist had decided I was bipolar II. When he heard that the whole Lexapro experience, he immediately decided that I was bipolar II because the antidepresant didn't help me. I honestly have a hard time remembering 4 years ago and given the circumstances, I don't know if anything would have made me feel better at that time. It just doesn't seem like something to base a diagnosis on. But with the other symptoms I had, I figured that my annoyance with the Lexapro situation wasn't enough to ignore the diagnosis.

When I went back this last week, there had been a paperwork mix-up and the office forgot I was coming. They tried to tell me that my appt. was a different day, until I showed them the appt. card they had printed for me. Then, the dr. told me they had lost my file for a while and he had to remember who I was for the first few minutes of the appt. I was having the symptoms of mania at that time, and I was pretty irritable. I had 5 appts that day for work (!!), and a few hours of driving time all over town.  I think my doctor could really see the irritability at that moment. He suggested that I up the dose on the Lamictal I was taking even though I only had been taking the 100mg dose for 3 days. I didn't really think that was enough time to determine that the 100mg wasn't enough, but my thoughts were too scattered to put this into words. I really wanted him to give me something to calm down.

That sounds like drug-seeking behavior, and I guess technically it is if I really wanted him to give me a Xanax or Loritab or Klonopin or whatever. But I don't want to get high. I like it when I am myself, content or happy or neutral and getting things done. The idea of being a Xanax-ed out couch blob or otherwise mentally vacating is not appealing. However, when I feel like I'm losing control of my mind, my body, and all I want to do is explode, the idea of taking the edge off of that is really appealing. I want to calm down before I do something really drastic and make mistakes--(oh wait, I've already done that.)

I have smoked about 10 cigarettes in my life and didn't enjoy or get a high off of any of them. After a few rare but severe bad experiences with alcohol (think extreme hangovers), I have really cut back on drinking more than 1-2 drinks at once. I've stuck to I'll stick to a glass of wine, a beer, or a single cocktail (vodka-sodas are low cal). I've never, ever taken a pill not prescribed to me. What I really want is to minimize the damage of a manic/agitated/whatever state. 

Again, I guess I wasn't as clear on this, and I really didn't want to get blacklisted as some kind of druggie, so I didn't directly ask him for a calming/downer type of thing. I really wish I had, because that was the night that me and my bf got into it and ended up separating or something (I don't really know our status.) Enough about that.

So now I am going to go forward getting this 150mg prescription. Partly because Lamictal is supposed to be a miracle drug  with no side affects (if you're not allergic) and partly because most of the personal experiences I've read online (I've read 100s of form posts, articles, etc. from a variety of sources ranging in reliability) say the most common dose is between 200-400. So going up to 150mg for real results doesn't seem outlandish. Also, the Dr. made me a four-week follow up appt instead of 6-week or 8-week or whatever. That makes me think he wants to do extra checking in.

I have to admit, I did call a friend last night and ask if they had any pharmaceuticals. I was really desperate after what I experienced on Thursday night and Friday night (really un-fun manic episodes.) We talked about it, and I decided it wasn't worth the trouble or risk and just tried to relax instead.

Unfortunately, this is all happening at the worst time ever, a huge work deadline. And I haven't even begun on the project for the next deadline in 2 weeks after this. I did apply for another job yesterday. It's a long shot, and I don't know if it's the best idea, but I did it just to get myself going on the job search. I can't maintain this kind of stress level if I want to stop ruining my life.

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