In my last personal update, I was waiting to talk to my psychiatrist about my relapsing of symptoms. Last month, my psychiatrist put me back on duloxetine (an antidepressant also known as Cymbalta). I took it earlier in the year too and had satisfactory results, but it would cause my mood to cycle, so he lowered the dose this time. I had an appointment with him last week now, where we decided to increase the duloxetine and my mood stabilizer lamictal, which should help prevent me from cycling throughout what we assume is a partly seasonal depression. He says it’s common for people with bipolar to have seasonal depression, so that isn’t unusual.
I don’t need a high dose of antidepressants. While I am very depressed a lot of the time, my diagnosis is bipolar, meaning mood stabilizers are the most effective treatment–sometimes a combination of mood stabilizers and antidepressants. This is because with bipolar, your mood naturally cycles. On antidepressants, your mood is prone to artificial cycling while mood stabilizers flatten and stabilize your mood, which is the ultimate goal with bipolar. So even with Bipolar 2, which will have lower depressions and hypomanias rather than full-blown manias, mood stabilizers are the primary treatment with antidepressants being a possible addition as needed, oftentimes at a relatively low dose.
I saw an improvement after restarting the duloxetine last month. I was still very, very low on motivation and drive, so it still took a long time to get ready to work out, and I was rarely writing. I wasn’t even recording gaming videos as often as I wanted to. The thing is I did want to do these things–but I physically couldn’t. It sounds stupid if you haven’t experienced–think, “Why don’t you just move?” or the like. But I only had enough willpower to, say, sit up in bed. Then I would just sit there for a few minutes, looking at my work-out shoes. Then I would think about how dang comfortable I was in that bed. And I would lie down again for a while. This would repeat for hours, literally. That is a symptom of depression, a majorly debilitating one. Total, absolute lack of motivation. By the time I would manage to make myself work out, it would be too late in the day to get anything else done.
But the thing there is that my mood was good and stable. I wasn’t depressed while this was going on. I just could not make myself get out of bed. It was a really strange feeling to me, having that lack of motivation without having the depressed feeling. And trust me, I am very, very familiar with that feeling as well as lack of motivation–just not separately.
I managed to keep working out until just last week, when I saw my psychiatrist again. I’ve lost about 15 pounds total so far, which I largely attribute to dieting with just a touch of working out. Not that I’m a nutritionist, nor have I spoken to one, so I really wouldn’t know what’s helped the most. Anyway.
My psychiatrist increased my duloxetine, as I said, and increased the lamictal as well to help counteract any impending cycling from the antidepressant. One of the first warning signs that I’m starting to cycle is irritability, so when I notice that, I have to immediately stop the duloxetine. He likes to ultimately leave a patient’s treatment in their own hands, which I really like. It means he holds his patients to the standards of knowing themselves and their illnesses so they can make informed decisions and keep themselves safe. He provides his expert opinion and knowledge of illnesses and drugs, and he will even look up supplements and the like that might benefit your side effects, if you elect to stay on the offending drug.
My lithium, we believe, is causing me to experience a fair bit of confusion and memory issues. It’s almost like the beginnings of dementia, if you ask the people around me. This apparently can be a side effect of lithium, so he recommended a cognitive-enhancing supplement. The only reason he didn’t recommend a specific one was that he had to look them up and didn’t have time to read about all of them and their reviews before the end of my appointment. Vitamin D is a pretty simple vitamin to take, but he recommended a specific brand from a specific place because it has a good combination of vitamin D and vitamin K2, which apparently helps the vitamin D do its thing. Again, I’m not a doctor.
If you follow any of my writing, you’ll see that I managed to write again this morning after a month hiatus–which was immediately preceeded by a longer hiatus. This morning, I attributed it to the neat dream I had last night, inspiring me to write. Now I think it was a combination of this and my medication balancing out. I mean, here I am writing a blog post, which I rarely do these days. I didn’t work out this last week, but I’m hoping that it will be easier to again starting next week. Either way, it seems I am on an upward swing right now.
I know that, at some point, I will crash again and have trouble doing things. That is an inevitable part of my illness, I think, and unfortunately it is something I have to learn to live with. As far as I’m concerned, that just means I have to enjoy this while it lasts and milk it for what it’s worth.