Sunday, December 02, 2007

Doped Up and Ready to Rock

Well, after a fashion. Slowly but surely, I'm coming out of my last, awful bout of dysphoria. I'm hooked up with more Seroquel and a new therapist who is absolutely fantastic. It may seem as if I've been doing the right thing in my pursuit to manage my disorder all along, but one thing that has finally hit home: I need the talk therapy, especially right now. It's enormously important and helpful. Someone truly objective, who listens.

Sue asked some very good questions: Does it matter which types of medications you are subscribed? Do some work and others not? And does it make a difference if you see a regular medical doctor or a psychiatrist?

Um, yes to all. There are a number of medications out on the market for manic depressives: Lithium, the first real medication for the disorder, Tegretol, Seroquel, Lamictil, Depokote, Abilify, Klonopin. These are the most commonly prescribed. Does it matter what you take? No, if it works. And yes, some help more than others, depending upon your individual physiology. Often, it takes time to find the right mix. But you have to be commited to finding that mix and to try what you need to try.

And then, some people never get enough relief from medication. It's a sad truth, but one that must be faced. There are cases of manic depression that are so bad, not much helps. Some bipolars often would rather self-medicate with alcohol, blow, heroin, and whatever than face up to the reality that their health is in their hands. It takes a hell of a lot less energy to do the illicit or the Liquor Store Shuffle than get yourself into a proper care program. It also takes an epiphany about your illness, something that may or may not happen.

Often, medications don't "work" because the bipolar doesn't take them according to directions, stops them as soon as they feel better. We've all been guilty of this, including me. "Oh, I feel great! Don't need no steenking pills." Wrong. My epiphany continues to this day. The first epiphany was in 1995, when I accepted my disorder for what it was. When I understood that my healing must come from within and that there is a higher power than my ego, I was able to submit to the treatment I needed, including admitting to things I had done when manic, much of which I was ashamed of. The second epiphany came when I understood that I will have to take medication for the rest of my life for this. Big deal. As my mother pointed out, look at all the pills she has to take at 84. As ever, she was the voice of reason that I needed to hear. Along with my pdoc's

Seeing a medical doctor, such as your primary care physician, and hoping that's all you need to do is foolish. First of all, most responsible MDs will refer you to a psychiatrist or a behavioral clinic. Psychiatrists understand all the ramifications of psychotropic drugs. MDs can help you with your upper respiratory infection. You wouldn't see a shrink for your chest congestion, would you? Or your bad back? You'd see an orthopedist or chiropractor for that.

Is there hope? Absolutely. Every day, more and more is learned about this disorder. It affects so many people--an estimated 5+ million Americans suffer from it.


Audrey said...

We're still trying to decide (family MD for 30++ years) whether I have an anxiety/depressive disorder or if I am bipolar. My depressions are much deeper than the mania. I don't "act out" as much. I do overspend, talk fast and have brain fog, racing thoughts and unreasonable expectations of my capabilities. I'm also post menopausal but have had these highs and lows my whole life. Just worse at times. I've been on Paxil, Pamelor and Effexor in the past. Stopped them all because "I no longer needed them" and the withdrawls were hellish. Recently, Wellbutrin has gotten me out of the deep dark hole and Librium helps the anxiety but I'm not sure if I am on an even keel or not. I get nasty, aggressive and verbally mean. Maybe that's my underlying personality? I do have rages and usually totally inappropriate to the situation. Lack of coping skills? I am married to a veteran being treated for PTSD and I know we probably play into each other's troubled psyches. Psychiatrists are few and very far between out here in the sticks. To see a reputable one, I'd have to travel nearly 100 miles. I'm a nurse, so I know you are right, but right now I'm in an argument with myself and when that happens I never win! Thanks again for providing a place to discuss subjects that are scary, shameful and very, very private, in a public forum with others who understand.

Marilyn said...

Audrey, I have very similar symptoms, which is why I talk about dysphoria. Dysphoria is a form of mania. It has all the bad behavioral stuff of euphoric mania without the happy feet feeling. True depression, as explained to me by my pdoc once, means you're having trouble getting up and doing things, you can't function. I can function when dysphoric but yes--there's an anger that bobs to the surface way too often, an anger that is not proportional to the situation.

As my boss says, she can tell when I'm dysphoric because I get "snippy" about minor things. Knowing that your anger is inappropriate should make you stop and think before you engage your mouth. Sometimes, that's tough. But when I feel myself getting aggravated over nothing, I take myself away from the situation and let myself rant and rage in solitude before I blow up in public. That usually defuses me.

Arguing with yourself is counterproductive because as you say, there's no winner. Be good to yourself and it will help you be good to others. As far as finding a pdoc, if it's difficult to find one locally, perhaps it would be worthwhile to make that 100-mile trip once or twice so that you can get an informed opinion. The psychiatrist can work with your MD then in helping with a diagnosis, via phone or email. Second opinions are always worth the effor.

Molly Bloom said...

My department has finally realized (today, after four years of fighting) that something is not right. All is not right in my head.

So there's a plan afoot to make the last six months never officially, acedemically, have happened.

It is, incidentally, very hard to explain to a very famous in his field, very unsympathetic, prof that you only get up for about three hours a day because you can't move the rest.

Audrey said...

Molly, tie a rope and hang on. Get the help like MAR says. I have just been through the third ring of hell trying to locate and make an appt. with a pdoc. Actually, the insurance folks were the easiest hoop. Unless I was prepared to harm myself or someone else, most couldn't work me in until APRIL!! I did find a nice fella who will see me in January and my family doc upped some doses that are getting me over the hump. Don't give up, keep pushing for those three hours you are able to crawl out of the fetal position and fight for your right to get the help you need and deserve!!