2012

Call me a cynic, but I don’t know if 2012 will be much kinder to me than 2011 was. I hope so, but I’m starting off with depression.  Whether it’s just the post-holiday blues or something more sinister remains to be seen.  I picked up my last round of medications on the 31st and two of them were free.  Geodon is not free.  It’s a brand-name.  This means I met my maximum out of pocket for the year.  That’s $8,000 in medical expenses. It was nearly that in 2010.  If I lose my job, I lose health coverage – then where will I be?

I was thinking yesterday about my situation.  I have been out of work on disability for 6 months now.  What have I done with that time?  Did I find a new job? No. Did I read? No. Did I do any of my favorite hobbies? No. Did I study my field in order to keep my brain active? No. Did I even write? Not really. Only these sporadic posts. I sat on my ass and watched TV.  I did a lot of worrying. Fought depression and anxiety with mostly losing results. I got my brain (somewhat) in order, I had my gallbladder removed, my left wrist mostly healed, and I let them operate on my right elbow.  I went to a lot of doctor’s appointments and physical therapy.  I paid a lot of money in medical and I’ve got a lot more yet to pay.

Today I tried to take stock of our finances.  It’s depressing to see how much we spend on things.  Yes, I have disposable income.  The sad part is how much of it I dispose of.  I spend when I’m manic/hypomanic, I spend when I’m depressed, I spend when I’m bored or stressed, and then I have horrible buyers remorse afterwards. I try to rationalize: It was a good deal, it was only 5/10/20/50 dollars, etc. But those small numbers add up.  And someday that may mean the difference between paying the water bill or not.

By the way, did I mention my house needs repairs & updating?  I hate home ownership.

I hate harping on finances, but I am really scared.  I’m scared of losing my job, even if I don’t like it.  I’m afraid of what losing my job would do to me psychologically.  Last time, I almost committed suicide. If I lose this job, what will happen to me this time?

Ah well, time to take a Klonopin and toast the new year.  May 2012 be a kinder, gentler year for all of us.


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Bipolar 1.5

I saw my psychiatrist yesterday.  It was my 3 week checkup on the new Geodon dose.  She asked how the Celexa was doing, but I said I didn’t think I could adequately answer that question since it’s only been a week since I titrated off the Paxil and onto it.  So another followup in 2 weeks to check on the Celexa.  I think this “medication soup”, as I called it, is bringing my moods into line.  But I wonder… how much control do I really want?  Will I never get excited about things?  Will I never experience sadness again?  Yes, I want to feel better but I don’t want to lose myself in the process.

So we talked about a lot of things, and my time even went over by 10 minutes.  I love talking to her.  I feel completely respected, almost as if we are equals, but at the same time master and student.  We talked about panic disorder and Generalized Anxiety Disorder (GAD).  She read snippets from the DSMV-IV.  We agreed that since my anxiety problems are not something that happens more often than half a week, and usually stem from specific events or situations, I do not suffer from GAD.  (I do have OCD.) We talked about medications and we talked about bipolar.

Then I asked her the question: do you think I am bipolar type I or type II or NOS? I was originally diagnosed NOS, but I’m not sure that has much meaning to it. She took a moment to collect her thoughts and then she said, I think your symptoms resemble bipolar type I more so than type II… but it’s really a spectrum… She pulled out a copy of Stahl’s Essential Psychopharmacology where he describes the bipolar spectrum and read some of the classifications to me.  But at that point, my brain had stopped listening.  I had the answer to a question that’s plagued me for a long time, but I’m not sure I really wanted it answered.

My first reaction to the call was to make light of it and say, “Well, if you’re going to do it, you may as well go all the way!” This is not meant as a slight to any BP IIs out there, it’s more of a statement as to my coping mechanisms.  I affectionately refer to my time in outpatient therapy as Daycare for Psychos.  I have my chill pill (Klonopin), my crazy pill (Lamictal), and now I need good names for Geodon and my antidepressant.  I once introduced myself to a pair of interns at the neurologist’s office with, “Hi! I’m crazy.”  (The neurologist politely corrected me saying that I wasn’t crazy but rather bipolar.)  Labeling myself, my medications, my experiences with these terms somehow lessens the emotional blow.

Yes, this is the same woman who won’t tell her best friends that she is bipolar.

Because I don’t trust them or because I don’t trust myself?  I don’t know.  Silence is a burden, but it is better than ridicule or pity.  I don’t want to be known as the bipolar friend.  One of my friends already has a bipolar friend and I hear about her every so often.  All the crazy things this woman thinks and does.  When we bought our house, our realator wouldn’t shut up about her crazy ex-daughter-in-law who was bipolar.  I think I wrap myself with twisted humor as a shield against the true face of stigma.

While my brain and my soul are still wrapping themselves around the idea of being bipolar I or perhaps bipolar 1.5 might be a better description, I still have to contend with my impending surgery.  I will try to post a little something tomorrow as it is my last day of two-handedness for a while, but if I can’t eek out the time, I guess I’ll report in when I can get the iPad to cooperate with WordPress.  (It ate half of my original post.)  Good thoughts requested for Thursday AM! 🙂

Dear Paxil

Dear Paxil,

What happened?  We used to be such good friends.  We were happy together.  I know we haven’t seen each other since 2004, but are you holding a grudge?  You need not make me anxious just to prove a point.

Perhaps you are angry because I have let Geodon into our family.  Please, it’s not personal… well, OK it is, but I was hoping you would understand.  You make me happy – too happy – we just can’t be left alone together.  Geodon is our chaperone.  I swear, it is nothing more than that.

We were united twice before – once in 1997 and once in 2003.  You didn’t treat me like this those times.  Or is my memory just hazy from the beauty of mania we have shared?

Please Paxil, I beg of you, send your side effects away.  I wish to be friends, good friends, but not BFFs as we once were.  I need you to do this for me, because Klonopin does not play well with Geodon, so he must be used sparingly.

I plead my case.

Thank you,

Monday

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4 am

It’s 4am and I’m blogging.  I’m blogging because I can’t sleep.  Why can’t I sleep? No clue.  Well, maybe I have a cue, but it’s a bit tenuous.

I suspect it has something to do with Geodon.  Geodon must be taken with food.  Apparently it doesn’t work right unless you take it with a meal that contains at least 500 calories.  Granted, I can reach 500 calories with two candy bars, but that doesn’t appear to be the correct method.  The correct method would be 500 calories worth of steak, potatoes & vegetables.

But maybe I don’t always each the right kind of 500 calories because Geodon affects me differently on different days.  Some days it makes me loopy and I can’t think after about 2 hours. Other times it does nothing.  Like tonight.  I took my Lyrica, nothing. Geodon, nothing. Klonipin, nothing.  Nothing put me to sleep.  (Although I have to admit this second bit of Klonipin seems to be helping. Don’t worry, it’s shrink-approved.)

If this lack of Geodon side effects is really related to the right kind of food eaten, then probably it is also related to how you take it.  Be sure and take it right after you have finished eating, not just before you eat, nor 30 minutes after you have eaten.  It doesn’t matter if you are still full, you will need more food.  But at that point, it’s really just too late.

So here I find myself, blogging at 4am.  Oops, make that 5am.

Hmm, I think I’ll try that sleep thing again.

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Geodon

Oh Geodon, what have you done to me?

The Depression Train was coming for me. It was. I want it to veer off, but it won’t and I can’t move off the tracks. It not only does it run you down, but it grasps you and takes you for a ride. Flinging you into a pit of despair when it’s done with you.

Geodon has slowed the train for me.  It’s still there, the blaring headlight blinding me into submission, the great black steel body intimidating me into compliance.  And it will catch up.  I know it will.  It’s smokey tendrils have already grabbed a hold of my ankle and are trying to knock me off balance.

But can this powerful drug save me? Not completely, not at 40mg, it seems.  And there are other trade offs as well.

Pros:

1) Geodon appears to work.

2) It has not caused any weight gain.

3) Blood sugar levels remain within normal range.

Cons:

1) It makes me dizzy/sleepy so that I have to go to bed within a couple of hours.

2) It has to be taken with a full meal.  (minimum 500 calories)

3) It works best taken twice a day because its half-life is 7 hours.

4) Low levels of Geodon cause anxiety.

Taking it twice a day is impossible because of con #1, 2, & 4.  Let’s start with con #1 –  I need to be a functional individual.  I took 80mg the second night (as prescribed) and I could not move for 14 hours! (2 half-lifes!) So now I take 40mg at night.  Sounds like a good plan, right?  Except that by mid-afternoon, I am a total ADD/manic-depressed nutcase.  No, seriously.  This stuff doesn’t just cause anxiety, this creates mayhem!  So by my rough calculations, this means that there is approximately 10mg of medication in my system leading us to #4.  The problem with #2 is that the only time I eat a total and complete meal is at dinner.  I rarely have more than 200 calories for breakfast.  The other problem is that if I have to travel for work (conferences, etc.) I can’t control when I am able to eat.  It might be 6pm or 9pm, then I would have to be up by 6am the next morning.  And I only get ~2hrs (sometimes 3) between taking the pill and getting knocked off my ass with side effects.  How is that going to work if I have to wine & dine a colleague?

So what’s a girl to do?  All the anti-psychotics cause weight gain and/or blood sugar issues.  Most docs would say, well, I’ll just give you some Metformin and be on our way.  No.  I did not work for a year to lose 40lbs and bring my glucose under control just to take a medication that will kill off more pancreatic cells.  I would rather be crazy.

Plan of Action:  I am going to try to take 80mg at night until I see my p-doc on Monday.  (Don’t worry, this plan is doctor approved.)  Hopefully, this will give me enough data points to draw a conclusion regarding the tapering off.  Can I wake up after 6-7 hours of sleep and be functional?  Does it keep that damn locomotive at bay later in the day?  Otherwise, what’s left for me?  Abilify, with a 30% chance of weight gain at $10 a pill, or lithium.

By the way, has anyone out there ever taken lithium?  Would you be willing to share your experience?

Update: I have found that higher doses of Geodon help so that I am not running into the really low does at the end of the day. Klonopin also seems to help with the anxiety.

© Manic Monday (manicmonday123). Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Manic Monday (manicmonday123) with appropriate and specific direction to the original content.