How Am I Doing On My New Medication?

I was diagnosed with Bipolar II on October 30, 2014.  Within a week I was on a mood stabilizer.  My primary reason for this post is to examine how that's working for me. 

However, that's not the only major change recently, so I offer this background on my health and meds.  While I have no way of knowing for sure what treatment caused what effect, my gut tells me.  So I will tell you what my gut says (knowing I could be completely incorrect).

Each morning I take:

• A multivitamin for women over fifty - even though I am forty-five, because the complete hysterectomy and oophorectomy I had last year put me into instant menopause
• Vitamin D - because I don't get nearly enough sunshine and it can help with depression, especially during the winter (which it feels like we didn't even have here in Utah, oh well)
• Estrogen - because I am in menopause an estimated ten years early and my doctor wants to protect my bones and I don't like the idea of breaking a hip when I fall
• Gabapentin - which is often prescribed for anxiety, but that's not why I take it; sometimes my skin hurts for no reason, and gabapentin can help with neuropathic pain; I've been on it since April of 2014, I think;  does it work?  I'm not sure; my skin was hurting a lot over the last week; it feels like a first degree burn, but there is no discoloration and I haven't been burned; I'm going to talk to the doctor about getting off this one at my next physical
• Lamictal - the mood stabilizer I've been on since the first week of November, 2014; the reason for this post

Each afternoon I take:

• Gabapentin
• Vitamin D
• Omeprazole - a proton pump inhibitor that I take for gastroesophageal reflux disease (GERD); otherwise I often have stomach acid that comes up my throat and makes it so I have a chronic cough, chronic sore throat, chronic hoarse voice, and so I can't sleep; without this medication it will often wake me with a burning in my throat that can't be soothed

Each evening I take:

• Gabapentin
• Melatonin - because I don't sleep well, like at all; I need all the help I can get, but everything else I've tried leaves me super groggy the next day; and melatonin is what our bodies naturally produce to induce sleep
• Armour Thyroid - which is pig thyroid glands "dried and powdered for therapeutic use" (according to Wikipedia); I take this because I have hypothyroidism, which means my thyroid doesn't do it's job very well anymore; I used to take a synthetic thyroid medication but never felt better on it; I found out about this through a thyroid health group on facebook; I had to fight my doctor for it because it isn't as consistent a dose as synthetic, but I have felt better on it; I started this in April of 2014

(I also have Xanax that I take for occasional anxiety and Meclizine that I take for occasional dizziness and nausea associated with my headaches.)

So as you can see, I have gone through many health changes over the last year.  How would I compare where I am now to where I was a year ago?  I am better.  Much better.

I do not have the constant, intense pelvic pain I had before my hysterectomy.  I have more energy on the new thyroid meds, although still subpar for sure; I can get out of bed and do things more often than before.  I don't go through intense PMDD/PMS every month; my moods are more in flow with what's actually happening in my life instead of attacking me out of nowhere.

But, most significantly, I haven't had any episodes of severe depression since I started the mood stabilizer.  I was initially put on it to control the hypomanic episodes that can come because of Bipolar II.  Those were hard to give up.  They were days of extra energy, lots of extra energy, when I didn't need sleep and could get lots done - all the stuff I didn't have the energy to do most days.  When I first met with my psychiatrist I asked her why I would want to give those up when they're so great.  She told me they cause brain damage.  Oh.  Okay.  I'll give them up.

As I researched Lamictal I read that it can often have the side effect of also helping depression.  I held a tiny spark of hope that this would happen, but not much.  I've tried so many meds for depression over the years and had so much therapy, but none of it took away the depression for good.  The meds didn't work at all or made me suicidal.  And the therapy could sometimes get me through a tough moment if my appointment happened to hit during an episode.  But usually the black dog (as depression is referred to by those who suffer) would just come out of nowhere and pin me to the ground.  And I just tried to survive until he let me up again.  I couldn't fight him off.  I just had to wait until he was done with me and moved on.

Since I have been on the Lamictal I have not been pinned to the ground by the black dog.  Not once.  He's chewed on my leg on several occasions, but I haven't gone completely dark at all.  There was one time when I'd say he knocked me to the ground pretty hard, but that was situational, and I recovered from it much more quickly than I normally would have.

So here's the deal.  And I hate to say it for fear of jinxing it.  But I believe the Lamictal is helping with my depression.  For real.  And it's kind of amazing.

Just as my psychiatrist said it should work, I have ups and downs, but they aren't as high or as deep as they were before.

And there's still a part of me waiting for it to come back and hit me in the head.  I've sometimes gone through long periods without depression before, only to be dragged down again; what if this is just one of those?  Depression has been a part of my life since I was a teenager.  The idea that it could finally be under control is something that's difficult for me to wrap my brain around.  I feel like it's an "I feel better so far, but we'll see how it plays out" thing.

And there's a part of me that doesn't want it to completely work.  Depression is part of my self-definition.  It's part of who I am.  If it works, I will have to learn to be me all over again.

My Consciences

Remember Disney's Pinocchio?  Cute, sweet, little wooden boy?  All he wanted was to be a real boy.  But he didn't have a conscience, so Jiminy Cricket volunteered.  He followed him around and helped him make difficult choices.  And sometimes, as we all do, Pinocchio blew off his conscience and did whatever he wanted regardless of the consequences.

Pinocchio was so lucky.  He only had one conscience.  I have several.

I have the one I came with.  It's standard with the human model; we all have one.  Some function better than others.  Mine works pretty well most of the time.  But there are times when it fails.  Or at least, others in my life think it does.

The first external consciences I remember were my parents.  When I was griping about someone, they were always quick to point out that I didn't know what kind of a life that person had experienced.  I didn't know what kind of trials they were going through.  I didn't know the intent of their heart. 

Okay, I can accept this.  I learned a lot from them.  We'll call them training wheels for my conscience.

Sometimes my husband tries to fill this role.  Guess how well that goes over.  Now, he's learned a lot over the years.  He doesn't do this as much as he used to.  But every once in a while when my PMS is particularly bad I get a little . . . how to describe it . . . let's say snarky.  A little testy.  A little short-tempered.  A little less kind.  With a lot less compassion (which I don't have an abundance of to begin with, but that's another post).

During this time one of my children will push a button.  One of my buttons.  One of my bite-your-head-off buttons.  And since they pushed the button I all too often oblige.  This is when he steps in.  Sometimes it's a look.  Sometimes it's, "I don't think that was very nice."  Sometimes it's even, "Hey!  You're out of line."

Do I appreciate this?  Am I grateful for his protection of these beautiful children I claim to love?  Um . . . no.  Usually he will get his head bitten off as well.  This is when I start to realize that maybe my buttons are a little too sensitive right now and I should probably go to my room.  Time outs aren't just for children, you know.

But the ones that bug me, that I truly value the most, are my children.  I have great kids.  I'm not sure where they came from, but they are awesome!  Yes, I want to beat them at times -- I'm not afraid to admit it.  But usually they rock.

Occasionally I will not be at the top of my game as far as behavior.  I wish I could say this only happens when I am PMSing, but it doesn't.  Sometimes I get catty.  Sometimes I talk behind someone's back.  And sometimes my kids are there when I do it.  Yes, I am ashamed.  But it doesn't seem to stop me from doing it again.

Or sometimes my husband will deliberately try to irritate me.  You may think that he doesn't actually do it deliberately.  If you think this, then you obviously don't know my husband.  Yes, he does.  He thinks it's funny to watch me try not to lose it.  I think he likes watching my face turn that particular shade of red, while the blood drips from the tongue I'm biting (yes, my own).  Look!  I think her head is really going to explode this time.  I've had it and I swear at him.

If one of these things happens in front of my children you can be sure that I will hear about it, sometimes with scripture to back it up.

Do I know that what I am doing is wrong?  Yes.  Do I care?  In that moment, no.  But then my daughter gently says that it makes her sad when I talk that way.  She looks at me with disappointment.  I am two inches tall.

And I am proud. 

As much as they irritate me, I am proud that my children have the courage to stand up for their convictions.  I am proud that they love me enough to care about my behavior.  I am proud that they are mine.

So I guess I am really the lucky one.  Pinocchio only had one conscience.  I have many.  And I am grateful for them all.

A Peek Inside My Cave

I blog for myself.  I write because I need to write.  But I do so knowing that others will read it.  This has created somewhat of a dilemma for me.

Sometimes I have considered blogging about things that may bother others.  Things that may be a little too heavy psychologically.  I have avoided this in the past.  I do not want to make anyone uncomfortable.  But tonight I need to write truly for me.  And you may not even believe anything I tell you.

So.  This is a more serious warning than in the past.  I see this blog entry as serving no purpose for others except perhaps to help them understand me better.  If that is not your desire, skip it this time.

Also.  There may be "female" words used.  While I anticipate that they will be used scientifically, they are still uncomfortable to some.  If you can't handle them, skip it this time.

Now.  I have given you plenty of warning.  I begin.

Several years ago I was diagnosed with a condition known as PMDD (Premenstrual Dysphoric Disorder).  It's a condition recognized by the mental health field in the DSM IV (diagnostics manual).  It's estimated to affect about 5% of mentstruating women.  It's a severe form of PMS.  Although its cause is believed to be physical/bio-chemical, most of the repercussions are emotional/mental.  The closest thing I can compare it to that you might understand is being bipolar, but that's not what it is.  It's just kind of like that.  Being in flux.  Extreme ups and downs.

This is a condition that has gotten more severe for me over the years.  I have had PMS since my first period at age fourteen.  I have had episodes of depression and suicidality many times over the years, among other difficult and frustrating symptoms. 

What started out as a day or two of depression and irritability before my period has become 10 to 14 days of a multitude of symptoms, with little relief when menstruation starts.  My symptoms are not the same each month.  Some of the possibilities:  depression, suicidal ideation, anger, anxiety, panic attacks, insomnia, fatigue, food cravings, apathy, difficulty concentrating, bloating, sensitivity to touch.

During this time I become very sensitive to touch.  If you touch me, it hurts.  I become irritable.  I know that I have no reason to be angry with you, but that doesn't stop it.  I can not think clearly.  Making decisions and having conversations can be physically painful for me.  It's difficult to function at all and is very hard on relationships.

I know it doesn't make sense.  It doesn't make sense to me either.

And my willpower is almost non-existent during this time.  If I am going to eat an entire bag of potato chips, a whole coconut cream pie, and drink an entire two-liter bottle of Diet Coke by myself in a matter of hours, it will be during this time.  If I am going to swear up a storm, it will be at this time.  If I am going to be hurtful and not care, it will be during this time. 

I have tried many things to treat it.  Hormones.  Diet.  Exercise.  Therapy.  Spirituality.  Vitamins.  Anti-depressants.  Nothing seems to do the job.

And I do not believe that struggling with this gives me liberty to treat others however I feel like treating them.  But I have difficulty controlling it.

So during this time, I isolate myself as much as possible.  I call it being "in my cave."  I go to my room.  I don't return phone calls.  I don't answer the door.  I kind of just disappear from society for a week or two.  And if I have to be out, I try to keep my mouth shut to minimize the damage I can do.

But it does hurt.  It hurts my family.  It hurts my friends.  It hurts me.

If you can't find me, I'm probably in my cave.