In my last post, I discussed my realization that I was experiencing hypomania. I met with my psychiatrist, who put me on Vraylar (antipsychotic that doubles as a mood stabilizer) and began lowering my Lamictal (mood stabilizer that has proven ineffective for me). He also slightly increased my lithium dose as a short-term accommodation until we see how I react to Vraylar.
Shortly after meeting with my psychiatrist, I took a planned vacation trip to New York with my mom for a concert. He seemed to think it was fine for me to travel despite being in the midst of an episode, which I am grateful for. I noticed that I was coming down from the high within the first couple days of the trip, which was for 10 days total.
For those first couple days, I was relatively stable. Not too high, not depressed, clear-headed. I had planned most of this trip and was navigating (voluntarily and gladly) my mom and myself, getting us where we needed to go on public transit and making plans that were financially viable. We played some Pokemon GO, explored Central Park, went to the Bronx Zoo, went on a buffet dinner cruise (which many others dressed up for–I was wearing an oversized capybara shirt), walked around Rockefeller Park and Battery Park, went to the Paradise Fears concert, and ate some good food including Italian food and cheesecake. We had a couple lazy days too, especially since my last day’s plans to drive to Connecticut fell through and I ended up staying in the city with my mom.
During this time, aside from to and from the airport and from the pier at night, we exclusively used public transit, primarily the subway. Note that neither of us has used public transit much–this was my first time ever except for following my friend onto a bus in Seattle a couple times in 2017. So with that in mind, it’s debatable as to how serious this next part is.
From the start, I navigated us on the trains nearly flawlessly. I felt clear-headed like usual, and the only thing that confused me was choosing which exit to take at times, as my sense of direction understandably got very screwy after moving so much underground. I often felt like the trains were going in the wrong direction when we got on them, so I’m glad I understood the difference between “uptown” and “downtown.” But on day 6 or 7, I started feeling some brain fog. This affected my ability to efficiently lead us where we wanted to go. And as brain fog will do, I started being unable to find words, the images I saw occasionally didn’t make sense, and I just felt out of it. My mom commented on it, so it was clear enough, at least to someone who knows me and is paying attention. I got us going the wrong direction at one point, at another couple I couldn’t even figure out how to get to the station from my map spelling it out to me.
Luckily there were no severe consequences. However, this brain fog has only continued to get worse. I have trouble walking in a straight line, and it takes a long time for things to make sense in my head. Usually when I’m looking at something, it looks like it’s moving–if the image even makes sense at all. Sometimes the shapes will just be swirling, and I can’t quite tell what they’re supposed to be.
This brain fog, which is the worst brain fog I’ve experienced so far (though it may just have been more noticeable in an unfamiliar place), may be caused by three things, I believe: the Vraylar, Lamictal withdrawal, or the increased lithium dose with not enough water in my system, as I have not been drinking all my water while on vacation. There are simply not enough public bathrooms in NYC for me to drink that much water every day when I’m out and about.
I see my psychiatrist again on Wednesday, so I’ll be able to talk to him about this then and see what he thinks. I don’t believe I can live with brain fog this severe, so if it doesn’t clear up then I may be unable to take Vraylar, and we’re back to struggling to manage my mood enough for me to be considered truly stable. We will see…
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