Here are a few pictures that capture my life …
I want a new drug
One that won’t make me sick
One that won’t make me crash my car
Or make me feel three feet thick
I want a new drug
One that does what it should
One that won’t make me feel too bad
One that won’t make me feel too good
– Huey Lewis and the News
I’ve been taking this new drug Vraylar for over 2 months now with good results. I have had very little depression since increasing the dosage last month. I feel like I’m right on the edge of being a little hypo most of the time. Maybe that’s how “normal” people feel all the time: positive, capable, resilient, and alive.
I’m a little unsure of how to take this new feeling. Only time will tell, but for a change I feel a little bit of optimism about my treatment. I’m apprehensive in thinking that I’ve really found a solution, and that it will last. I wonder if I have become so accustomed to depression that I simply accept it as how my brain is wired without having hope that things can change.
Unfortunately, this drug is under patent and is expensive. Under my prescription plan, a 30-day supply would have cost me over $300. The manufacturer has copay cards which cover that cost for a limited time, so I paid very little for now. However, my plan’s maximum annual out-of-pocket is about $1000, which is a lot to pay when the discount card runs out.
It sucks that a drug this effective is out of reach financially for many people, but I’ve finally found a combination that works. I understand that the drug companies spend many millions developing new drugs, but they make huge profits when a drug is successful. Maybe that covers the costs of the unsuccessful drugs, but when company executives make tens of millions of dollars per year it seems hard to justify that level of profit. I don’t know what the solution to that problem is.
What’s the old saying? When one door closes, it hits you in the ass, then you’re stuck in a dark room and you’ve misplaced the key? That’s how my life feels now.
I didn’t get the job I was hoping for, but I’m not really too shattered about it. My hopes were tempered significantly a few days ago based on a conversation I had at the office with a former coworker. He told me some behind-the-scenes info which made it pretty clear the hiring manager was looking for someone from the field to fill the job. At least I know for sure now, and I can stop thinking about it.
But then another door opens. A new job posting appeared on the job board, one which I am definitely qualified for. I’m not sure if I actually want the job, but I am looking for a change; I can’t continue with what I’m doing for another 15 years. There would be a modest pay increase and more responsibility. It might be another bang-your-head-on-the-wall type of job, but it would be a different and more lucrative wall than the one I am banging on now. Maybe it will have padding. Maybe I belong in a rubber room without doors. That remains to be seen.
Speaking of mental health, we finally have a psychiatrist appointment for my daughter. Now I just have to get her out of bed and get her to the office for the appointment. She understands now that she is totally empty on meds and I can’t give her any more of mine. I’ve cut back a little on my lamictal for two weeks now to be able to give her enough to wean her slowly off the drug rather than have nasty withdrawal symptoms. I’m feeling a little funny, nothing serious, but I need my full dosage again, and she gets it now.
Everyone needs things from me. Fuck I get tired of doing things for other people all the time. I don’t mind helping people, but the steady stream is wearing me down at work and at home. I took my little vacation in May all for myself, and it was wonderful. Unfortunately I can’t do another getaway right now. Instead, I eat my feelings.
I need to remind myself of things I am thankful for and be grateful for what I have. Maybe my attitude will be a little better if I can do that. The bipolar depression doesn’t help in this regard, but it’s something I can work toward.
Finally: I have a therapy appointment looming, and he wants to work through a mindfulness exercise with me. I’m still skeptical, but we’ll see how it goes. Update to follow.
I’m not talking about blood-sucking arthropods, but the little movements and rituals that are the major symptom of OCD or maybe Tourette’s. I’ve had little tics and quirks since I can remember, but usually they were only present during stressful times. The rest of the time, they didn’t have control over me and I could ignore them.
During the most recent manic episode brought on by taking Latuda, I started having uncontrollable “tic seizures” where I would be lost for seconds to minutes at a time, then only by force of will could I stop them for a few moments. I could maintain calm stillness if I really concentrated (which is the opposite of being calm), but eventually I would surrender to the urge.
I tap or flick things repeatedly with my fingers. I blink my eyes forcefully, way more than necessary. I blow air on my fingers. I tap my mouse on the desk over and over. I click my teeth. I scratch my chin or my head. I wiggle my feet or my toes. All of this is fueled by the need to “get it right” – the right sound, the right amount of force, the right number of times, or the right rhythm. If I don’t get it right, I feel like I have to keep doing it until I succeed, and I never do. These rituals are not involuntary, I’m doing them purposefully and I’m fully aware I’m doing them.
I quit taking Latuda two weeks ago, and my psychiatrist tells me it should take no more than a week for the drug to wash out of my system, but the tics remain worse than ever before. I find them in control much of the day, every day, and only when my brain is fully occupied can I really prevent them from happening. I have had difficulty with concentration and focus over the past year or so, and when my mind is spinning or drifting, the tics are more difficult to control. They get worse with stress, and my anxiety is feeding them. They get worse with caffeine, which is bad because I need my coffee in the morning.
Between the manic episode and the increasing control of the tics, It has been mentally exhausting for the past three weeks or so. My work is suffering, and because I am working remotely it is too easy to take time away from the computer to try to relax. It has been difficult to work a full day every day, I am taking too long on projects, and I am struggling to meet deadlines. After work I just want to drink myself to sleep, but I have (mostly) avoided that so far.
My p-doc wants to put me on Klonopin or Ativan to calm down a little and hopefully reduce the tics, but my employer’s safety requirements and drug policy might be a problem. We are randomly tested to federal standards for opioids, marijuana, PCP, cocaine, and heroin. In addition, I’m not supposed to take any drug which might affect my “ability to perform” safety-related tasks. Klonopin is on that list, so if I do take it, I have to demonstrate to the safety police that it doesn’t affect me during work hours. Hopefully I can work with the company on this problem. I won’t ask my p-doc to be untruthful, but I wonder what will happen when they find out I have bipolar and anxiety disorders.
I don’t know if the manic episode or the Latuda triggered something in my defective brain, but something has changed, and I hope the effects are not permanent. I’m actually concerned for my future because of this. I am worried that my mental health problems will cost me the best job I’ve ever had, and send me into an uncertain future of trying to find a new job at my age. I’m not that old, and I can do good work when things are under control, but age discrimination still exists. I hope I’m just overthinking everything.
In the meantime, I’m exhausted, and I’m struggling.
Latuda is marketed as a treatment for bipolar depression, but they don’t tell you that it prevents depression by placing you into a constant manic or mixed state. I had to stop taking it last week because I had been manic for about three weeks.
The withdrawal symptoms of Latuda are significant and apparently long-lasting. I got more sleep last night, but I’m still waking up in the middle of the night for extended periods. In addition, my brain is still restless even though my body is tired. I sat all day yesterday and fidgeted because I wanted to do something, but I didn’t know what to do and I couldn’t concentrate on anything. Finally, the akathisia effects continue; the “twitchyness” is still causing me to blink my eyes and tap on things with my fingers repeatedly and shake my feet almost constantly. I’m hoping these symptoms will decrease this week.
Several years ago I had bad luck coming off a high dose of Effexor, but those effects were completely different: auditory hallucinations, nausea, and dizziness. I’m not having any of those now.
I took a short break from posting. I wrote a lot of words in a short time, most during the middle of the night, but the train stopped when I started getting sleep again. Of course now I’m up again at 2:30, so there you go.
I don’t think I can take Latuda anymore. I think it is responsible for the manic spell, and it made me nauseous every time I took the 80 mg dose. I was also extremely tired after taking it, as I was falling asleep within one hour after taking it (then not sleeping well when I needed to sleep). The 40 mg dose didn’t have these effects, but it also wasn’t relieving the depression. I see my psychiatrist Monday, so I’ll let him know the side effects are too much for me. Maybe I will go with just Wellbutrin and my old friend Lamictal and see what happens. By the way, my psychiatrist made a special appointment time for me after hours, which I really appreciate.
The other news is about my bad back. Nearly two weeks ago I was getting in my car when I felt something move in my spine, and I thought, “that’s not good.” I could hardly get out of the car when I returned due to the knife-like pain in my left side and lower back. I have been to my chiropractor twice, and each time the adjustment only lasted for about a day before the pain returned. He said I may have to return to the decompression table, aka the stretching rack. Whatever works, man. I’ll see him Monday as well, but in the meantime I’m alternating heat and ice.
I was happy to see the inauguration went off without problems. I don’t think there was ever a plan to create a disaster on Wednesday; I think the premeditated plot was for Congress to be stopped and for a hostage situation to ensue during the riot on the 6th. Chilling stories are surfacing in court documents about how some of the mob weren’t rioting, but moving purposefully around the capitol searching for a way to get to the legislators. Someone with inside information and detailed knowledge of the building (an “unnamed sender,” said the FBI) was sending messages on Facebook telling the hunters exactly where everyone was located. Speculation about one congresswoman had been rampant, but if the FBI knows anything, they aren’t revealing it yet. I think the true story of the riot will come out, eventually, and hopefully people go to prison for a long time.
Finally, someone recorded 200+ hits on my blog Thursday. Either someone really appreciates my posts, or a bot crawled my site. I don’t know how WordPress’ stats work when the bots come to visit, so I can’t explain the spike. I only have 57 posts, so I don’t see why a human would generate that many hits. If you did, however, say hi.
Over and out.
I finally decided to make the effort to get an early appointment with my psychiatrist. I let him know my depression has worsened and is persistent, and I wanted off Abilify due to the weight gain. He listened to me (for which I am thankful), and suggested we try Latuda for the bipolar depression. It is an atypical antipsychotic but it works differently than Lamictal (that’s the limit of my knowledge at the moment).
I agreed to try it, despite the known side effects of nausea and possible vomiting. When I read the pamphlet, it said a small percentage of people have weight gain, as opposed to Abilify where everyone blows up. I can’t do any worse at this point.
I am still taking Wellbutrin for depression, but we will probably wean off that as soon as we know if the Latuda will work for me (and if I can afford it).
As I’ve said before, the bipolar changes and fluctuates over time, and stability is a moving target for me. That’s why I don’t believe anyone who says you can “recover” from bipolar. You can’t stop it, you can only hope to contain it.
This is the depression that never ends, yes it goes on and on my friends. I can pretend to be in a good place for everybody – family, work, psychiatrist – but I can’t fool myself. I can’t concentrate on work, I don’t enjoy anything, I don’t go anywhere, and all I do is eat comfort food. I don’t do anything for my own physical or mental health except keep popping pills. It sucks right now, and It. Is. Always. There.
I don’t want to tell my psychiatrist, because I’m afraid he would put me on more medication. I want fewer pills, not more. With his recommendation I slowly weaned myself from Topamax; I immediately gained 10 pounds, and I feel like a goddamn bloated walrus, but my brain is a little clearer and not as foggy. Next I would like to decrease the Abilify, which is the reason I can’t lose weight.
I would consider another drug if it would relieve the depression. I want to keep the Lamictal (my wonder drug) to prevent cycling, keep or add to the Wellbutrin for depression, and slowly wean from the Abilify. If my psych wants to replace Abilify with something else I might do it. Fuck it, better living through chemistry.