There haven’t been many developments in my life since my last update. I’ve been cycling up and down, depending on the day usually. My psychiatrist put me on a steady course of antidepressants a couple months ago, where I had been taking them PRN (as needed) previously. This consisted of taking them for 3-7 days at a time after feeling flat depression for at least 3 days, then stopping them for no fewer than 2-3 days before taking them again if needed.
My mood disorder is bipolar, so taking a steady course of antidepressants is risky, as antidepressants tend to make people with bipolar cycle. My PRN dosage of Cymbalta was 30mg, so we increased my lithium (mood stabilizer) from 300mg to 450mg and added in 20mg of Cymbalta. Lithium, while primarily being a mood stabilizer, also has antidepressant qualities, so it is typically fairly effective in treating bipolar 2 – but with my CKD, we can’t increase my lithium enough to be a standalone solution. So my med regiment included 20mg of Cymbalta and 450mg of lithium, to help stabilize my mood with a regular antidepressant added, daily.
This led to me feeling… okay, I guess? I didn’t feel bad, which was an improvement. But I didn’t really feel good. Which is fine, honestly, I’d be okay with just not feeling bad all the time. But my motivation, drive, and mental energy were still nonexistent, and I was spending most of my time napping still. Some days I was able to pursue an activity for a couple hours, but I quickly got tired or lost focus and had to nap again. So we decided to switch from Cymbalta to a brand-new antidepressant called Auvelity, about three weeks ago.
There’s currently only one dosage of Auvelity available. Typically, a patient starts by taking one pill daily for, I think, a week, and then they take two pills daily. We decided that maybe if I just stuck to taking one pill daily, it might not cause my mood to cycle while still getting the benefits.
Auvelity is, essentially, cough syrup combined with another drug called bupropion (Wellbutrin). I believe basically the way it works is one of them causes the other to be absorbed more effectively, and this in turn works as an antidepressant trifecta of sorts, affecting all of serotonin, dopamine, and norepinephrine, three of the most significant brain chemicals in treating depression. It is a brand-new drug just released to the market, but it is an antidepressant, not FDA-approved to treat bipolar. So of course we didn’t know if it would be too much and cause me to cycle or not. But we wanted to do something. So we stopped Cymbalta and started Auvelity.
We could have kept me on Cymbalta while starting Auvelity, in cause the latter didn’t have an effect. However, with me having bipolar, taking two antidepressants would be risky – it could cause me to enter a mania which, according to my psychiatrist, is harder to treat than a depression. Therefore, we stopped Cymbalta and started Auvelity. Unfortunately, it did cause me to start rapid cycling, where I would jump from moderately depressed to borderline hypomanic a few times a day. It’s been worse in the past, but any cycling is bad, as it will always, always get worse. I called my psychiatrist last week, and he told me to stop all antidepressants so we can hopefully have a stable me to work with at our next appointment tomorrow.
At this point, I don’t know if I want to try adding other antidepressants. I’m not happy, but I don’t want to cycle anymore. And I’m sick of taking a bunch of pills.
I went to my evaluations with the state’s doctors, both the physical and mental ones. I think they went well, but it’s hard to tell. I don’t see how a doctor who talks to me for half an hour about my complicated mental and emotional states and life can possibly give a better evaluation of me than my treating psychiatrist. She was very nice, which only makes me suspicious. I cried three times, which probably didn’t help my case, probably partly because I tried to hold it back so it might have even looked forced. But it’s over, so now I get to just wait for my hearing date, which probably won’t be until next spring. They tell you the hearing date 90 days before it, I think – something like that, might be 60 or 30 days, but whatever it is, I’ll still have at least a month to wait even after they give me the date. I’ll be lucky if I’ve heard a decision on the case by this time next year.
On the bright side, my boy problems have finally resolved, so that extra depressing stressor is now null. My boyfriend is understanding and supportive, and my dog loves him.
I’m currently very conflicted about the idea of working. Thanks to society and the SSA and some people in my life, I’m questioning if I’m actually sick, if maybe I am just lazy, if maybe I could handle a job after all. These thoughts drive me insane because I’m quite aware that I’m being gaslit, and it’s even worse because it’s working. I’m speaking to my attorney, my therapist, and my psychiatrist this week to get their thoughts on it. I mean, I know I’m sick. But at the same time, maybe it’s all in my head after all…?
Rory's Write Place 