Journey of My Bipolar Depression
I suppose I’ll begin chronicling my bipolar depression journey here rather than on my other blog, depression introspection.
Since August, my mood has been up and down with “down” being severely low. I was suicidal. I’ve been suicidal. And when news of Robin Williams’s death hit my ears, it hit my mood as well. I honestly began thinking, How could someone so vibrant and alive kill himself? How could someone so talented and loved by so many people commit suicide? Then I thought, I’m not as talented as he was. Maybe I should kill myself too. I’m certainly not as loved as he is. What’s the point of living? I should join him.
Somehow, I managed to hang on to see my psychiatrist and I told him that the death of Robin Williams had triggered persistent suicidal thoughts. I hadn’t attempted to kill myself, but I was seriously considering it. He suggested that I try taking lithium, which has a track record of reducing suicidal thoughts.
I’ve been reluctant to take lithium because it requires that you get your blood levels monitored every 6 months. But when you’re desperate, you’ll try just about anything. (Probably just short of eating cockroaches. I certainly don’t have the stomach for that.)
So on the lithium I went. First it was 600 mg. Blood test. Low levels. 900 mg. Blood test. Slightly higher but room for improvement. Then 1200 mg. Within therapeutic range but a little room to move up. Now 1500 mg. Therapeutic range and about as high as my psychiatrist will go.
Side effects that I’ve experienced so far? Loss of taste (things mostly taste OK or bad, rarely does food taste good), loose stools, and blurred vision when I take my entire dose at night (I now take 600 mg in the morning and 900 mg at night). Those are the significant side effects I’ve experienced so far.
As it stands, I’m currently on lithium, lamotrigine (Lamictal), aripiprazole (Abilify), and fluoxetine (Prozac). Four different psychiatric medications. This isn’t the life that I signed up for.
Regardless, my mood rebounded initially but kept dipping up and down. I haven’t experienced mania really, but alternate between feeling fine and feeling like I should be covered in crap. For the past 2-3 weeks now, I’ve felt consistently depressed. I’m barely functioning. Functioning but at a very low level. I isolate myself, rarely go out, and hunker down to work on any projects that keep me at the computer. Day and night. Night and day. I have not been able to work at the library. I have not been able to enjoy or take interest in things that normally, well, interest me, such as music, reading, and even working.
I saw my psychiatrist yesterday. He said instead of tweaking my meds, we’re at the point where we need to make drastic changes. So the lithium and fluoxetine dosages remain unchanged, but I’ve gone up to 200 mg of Lamictal (considered a therapeutic dose) and have cut down on the Abilify to 5 mg with the possible goal of cutting it altogether. If my mood doesn’t improve on the reduced Abilify dose, Abilify will be eliminated from my regimen and a newer drug, Latuda (lurasidone), for bipolar depression will be added. I asked about fluoxetine and the purpose that it serves. My psychiatrist said that he wants the fluoxetine to target my depression and that he’d go either one dose higher or eliminate the fluoxetine from my regimen. I asked why fluoxetine over, say, Zoloft (sertraline). Even he admitted (in different words, of course) that it was just a crapshoot and that the therapeutic effect of medications vary by individual.
My psychiatrist also mentioned other possible treatment options, such as electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS). I adamantly said no to ECT and had no opinion about TMS since I’ve never heard of it before. (But anything to directly mess with the brain like that makes me biased against it.)
As I sit and type right now, I’m okay. I’ve been okay throughout the day so far (and I’ve been up since 4 am). I’m not great. I’m not down. I’m just okay. I’m here, I’m surviving, I’m alive. And I guess that’s some improvement over the emotional rollercoaster I’ve been riding since August. Here’s hoping “okay” or better continues.