Hormones got me like…

a cure for what ails you, bipolar disorder, endometriosis, medication, rapid-cycle bipolar disorder, Uncategorized

I had laparoscopic excision surgery earlier this month for endometriosis. It was loooong overdue and my surgeon was excellent, which means no more pain! Seriously, I haven’t had a single day without some form of pelvic pain or muscle tension in years, so this is incredible.

Anyway, he popped the hood and did a bunch of stuff. In addition to removing sheets of scar tissue that had formed after my last (unsuccessful) surgery seven years ago, he placed a Mirena IUD. I was always scared of having one placed because I’d heard it was so painful, but he assured me that he could do it while I was 100% out. And readers, I feel great and am so glad I did it!

I’d been on a pretty heavy dose of Megace for about a year and a half. Megace is a heavy hitter and is one of the strongest progesterone medications out there. It’s not really meant to be taken long-term, but the gynecologist who prescribed it back in the day didn’t tell me that. She also failed to mention that it wouldn’t actually treat my endometriosis–it just stopped my periods. I mean, that’s great and all, but I was under the illusion that I was actually treating it. Instead, I was just building up some heckin’ heavy uterine lining that my surgeon had to scrape out. Ew.

I stopped the Megace cold-turkey a few days before my surgery, with the blessing of my endocrinologist. (I have a lot of health stuff going on in addition to the bipolar disorder.) He ran a fasting cortisol panel to make sure the Megace wasn’t destroying my adrenal glands. Everything came back totally normal, so boom, no more Megace. And hello, Mirena!

But, as we all know, hormonal shifts can have huge implications for people with mood disorders. My bipolar disorder has been amazingly stable for years–you all may recall way back in the day when I was first diagnosed (2013!). I’d been on more or less the exact same doses of medication since then, with minor adjustments to my lithium and a change in the type of antidepressant (from SSRI to SNRI) when I first started taking meds. It’s pretty rare for a patient to not have adjustments within a five-year period, but I was one of the lucky ones.

I saw my psychiatrist yesterday and mentioned a few things I’ve noticed–tiny bits of hypomania peeking through and depression where it shouldn’t be. Fortunately, I’ve been very tuned-in to my body and my moods for years because I have to be in order to stay healthy and sane. Being in the mental health field has also helped, because I now have more precise language to describe what’s going on with my moods. My psychiatrist, who I initially had doubts about, has been pretty awesome the last few times and worked with me to determine what meds to adjust and how much. She seems to get that she has the medical knowledge and I have the experiential knowledge, so together, we’re a treatment powerhouse.

I’ve been sleeping a lot more than usual lately and my appetite has been really weird–up one day, then down for a couple days, and so on. I slept thirteen hours the other night and eleven-and-a-half last night. I would have slept later today, but the cats were staring at me when I woke up from my third alarm and I needed to get up and feed them. Groan.

Here are my current meds, for anyone who’s interested. Please bear in mind that these are my doses and that your needs may be different (either a little or a lot!). As always, work with your doctors and make sure everyone’s in the know, especially if you see a few different specialists regularly like I do. They’re part of your wellness team, so make sure they’re up to date!

I’ve dropped the 60mg of Megace and also my 5mcg of liothyronine (a T3 thyroid medication) so far this year! My current regimen sounds like a lot, but it’s actually the smallest amount of meds I’ve taken in years. Here we go!

  • 400mg lamotrigine/Lamictal
  • 88mcg levothyroxine (T4 thyroid medication)
  • 600mg lithium
  • 112.5mg venlafaxine/Effexor

And that’s it! No more birth control pills because Mirena’s got my back. Now that I’ve more or less adjusted (a few aches and pains similar to what I remember PMS being like) to it, I’m feeling pretty good. I still have some residual pelvic achiness from time to time, but my surgery was less than a month ago and things are still healing internally.

How are your meds going, readers? Or are some of you fighting the good fight without them? Summer can be rough for a lot of us mood-wise–hypomania and mania tend to spike, so we have to be extra vigilant. Let me know how you’re doing in the comments!

 

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Remission?

abuse, Authoress, endometriosis, medication, ptsd, rapid-cycle bipolar disorder, three hopeful thoughts

 

Also pictured: Beast-baby Dorian T. Catsby on his king-of-the-house perch

I can’t remember the last time I was sad. Granted, my memory’s not great, and there was a lot of crying last week because of all the trauma that was suddenly dragged to the surface, but now that I’ve made my peace with that—or at least, beaten the beast back into its cage, tucked safely away deep underground—I feel good. Not hypomanic- or manic-good, but balanced, settled. Things aren’t going the greatest right now, but at least I have the concrete knowledge that they’re going to get better sooner rather than later.

Current medications:

  • 200 mg lamotrigine (Lamictal) taken twice a day, once in the morning and once in the afternoon/at night (usually around 6:00 or so).
  • 1 mg tabs of lorazepam (Ativan), as needed. Since the myoclonic jerks I began experiencing when my Effexor dose was too high have begun to subside, I’m finding that I don’t need this as often.
  • 300 mg lithium taken three times a day, two in the morning and one at night
  • 125 mg venlafaxine (Effexor), taken in the morning
  • 50 mg hydroxizine for sleep, one to two capsules as needed

This regimen seems to be working well for me. I’m sort of scared that it’ll just stop working, which is what I’ve experienced in the past with psych meds as well as endometriosis treatments, but I’m trying to stay positive.

Speaking of endometriosis, I met my new pain doctor on Thursday; he and his PA are both excellent. She spent some time asking about the nature of my PTSD and then informed him, and he actually asked if it was okay if he examined me before inviting me to hop up on the table. That was a whole new experience for me, and while I don’t really like being treated that gingerly, it was obvious that he was making an effort to make me feel comfortable, and I appreciated that.

I had some trigger point injections done yesterday morning; the knot of muscle was located very low, well below the bikini line in my general pubic area, but I didn’t feel nervous about him touching the spot or doing the injections. Because of my initial impression of him, I found it very easy to trust him implicitly. First impressions matter.

Right now, I’m in quite a bit of pain…about a level 7, which isn’t fun but is something I can tough out. As D. has told me, I’m “a tough old broad, a bad motherfucker.” Several people have suggested I buy the Pulp Fiction wallet and after everything I’ve been through with the pain in the last few years, I just might. It feels like a cautery knife is running back and forth through my lower abdomen, but my mother assures me that this will subside in a few days.

In the meantime, I’m keeping busy—cross-stitching, reading Ruth Reichel’s food/bipolar mother memoirs, and bothering the beast-babies, as usual.

Readers, what do you use to distract yourselves?

A brief update.

authoress in motion, major depression, medication, rapid-cycle bipolar disorder, three hopeful thoughts

This is just a brief update on my current meds, treatment plan, and moods. If you’re into videos and want to see the authoress in motion, check it out. 🙂

Transition.

a cure for what ails you, major depression, medication, ptsd, rapid-cycle bipolar disorder, three hopeful thoughts

At this point, I can’t say that I’m cured or that my bipolar is in remission, but something feels different. My mood swings aren’t as intense as they were before, and “Flat/numb” has replaced “Depressed” as my default mood state. I still can’t remember the last time I felt truly happy without also feeling some underlying negative emotion, but I actually feel hopeful.

My PTSD is still pretty bad. There’s some parking lot construction going on right outside our apartment, and when I had to walk past it yesterday to get home, I flinched, jumped about a foot, and had to clamp my hands down over my ears to get through the unrelenting roar of construction equipment. I felt embarrassed and remember thinking, “Normal people don’t act like this.” But I’m trying not to judge my reactions and emotions. My therapists over the years have all encouraged me to just experience them without having a knee-jerk response and assigning a morality to everything.

My derealization/depersonalization is present, as always, and I’ve been having unnerving spikes in severity that have unusual triggers…if I have my head turned or tilted a certain way and I say something/something is said to me, for example, the detached feeling increases tenfold and sticks around until I finally go to sleep. It seems to only happen in the late afternoon/early evening, but I’m still not sure what to make of it. But in spite of this, I feel like I’m finally starting to recover. I’ll deal with the emotional bit first; then, I’ll try to tackle my dissociation.

Medications: Lorazepam, 1 mg tablets*, 37.5 mg Effexor, 400 mg lamotrigine/Lamictal.

* I think it’s important to note that I can’t remember the last time I actually needed one of these.

A change in the weather

a cure for what ails you, major depression, rapid-cycle bipolar disorder, suicidal ideation, three hopeful thoughts

I was out for a walk yesterday when it hit me: I haven’t felt actually depressed since Thursday. Occasionally anxious and agitated? Sure, but mostly in response to external stressors. I’m mostly flat/content, but have had a few moments of what I think is mild happiness. The climate in my head isn’t quite sunny and 75 yet, but it’s slowly improving.

The lamictal seems to be doing its job, but I’m still living in fear of the rash. Every time I feel itchy (which happens frequently, considering how much I’ve been outside lately and my allergies to tree pollen), I freak out and pop allergy pills and repeatedly ask D. to check and make sure I’m not getting blotchy. The actual rash doesn’t scare me—it’s the prospect of having the one thing that’s finally making me feel stable stripped away from me without warning.

Being outside, going for long walks around the pond (especially when D. works nights, when I get too anxious and lonely to sit in the apartment by myself) has been incredibly therapeutic. In Middleton, there are so many places to walk to, so many things to see. It’s not a large town, but it’s a step up from Cross Plains, which was tiny, and my hometown of Dubuque, which was not exactly what one might call “pedestrian-friendly.”

How do you all feel about being in nature? Does it help your mood to just get out, even if you’re alone?

Bipolar II, sans mania.

a cure for what ails you, major depression, medication, rapid-cycle bipolar disorder, stigma

After two hours of evaluation with my new psychiatrist, I received a new and totally different diagnosis: Bipolar II with mixed episodes, no actual mania. It was something D. and I had suspected for a while and had discussed extensively, but hearing it came as a bit of a shock.

And then I felt relief. The reason I’ve been feeling so shitty for the last six years is because antidepressants can make the bipolar cycling worse (my doctor also suspects I’m rapid-cycling), not because I had treatment-resistant depression.

My mother is bipolar. My uncle, who committed suicide years ago, may have been bipolar. And my grandfather’s alcoholism (self-medicating) and fits of temper could have been attributed to the disorder as well, according to my psychiatrist. There is very much a genetic component to the disease.

The game plan is to keep the 150 mg of Effexor in place for now while I continue climbing the lamotrigine ladder to 200 mg. Then, we’ll reevaluate at the end of the month and see how things are going.

I received the news less than an hour ago and am still sort of in shock, so I’m having a really weird mixture of emotions right now. I’m not quite sure how to feel about all this, though I’m glad I’ll finally be able to receive proper treatment. And, as I’ve told myself dozens of times over the last hour, it’s not like I’m a different person because I suddenly have a different diagnosis. It’s just that everything makes more sense.

I guess this was nothing to be afraid of after all.

Lamictal.

medication, ptsd, stigma, three hopeful thoughts

Supposedly, this is the drug that is going to make everything okay.

I met with my psychiatrist yesterday and learned that while it’s usually used as an anti-seizure medication, it works very well for the depressive portion of bipolar disorder. She’s hopeful that this will stabilize my moods and make everything feel less dismal, though I have to build up to the maintenance dosage slower than other patients because it can cause a nasty rash (I had a terrible full-body rash as a reaction to amoxicillin when I was a child, so she wants to be extra-careful).

She warned me that there’s a chance it could trigger a manic episode if I do, in fact, have undiagnosed bipolar disorder. I’m young, and it could be lying dormant for now–she said it wouldn’t be at all unusual if I remained in a depressive state for decades before experiencing mania for the first time.

I feel that, as an advocate for mental illness who tries to do something to fight the stigma every single day, it’s not great for me to say this…but I am secretly afraid that I’m bipolar. My mother is bipolar and when I was young, “You’re just like your mother!” was thrown at me whenever I was being difficult or acting out.

I’ve been educating myself on the disease, though, mostly through memoirs written by women with bipolar mothers. I know that it’s just another chemical imbalance and that I have nothing to fear, but at the same time, it seems like the proverbial big black dog, looming just out of sight. And there is a tremendous stigma surrounding bipolar individuals, which is awful. I am taking comfort in the knowledge that if I do indeed have the illness, I can do a lot of good work to help fight that stigma, too.

But is it so wrong for me to be terrified of being “just like my mother”? It’s not just the possibility of being bipolar that scares me–I was conditioned to fear and avoid any behavior that was even remotely reminiscent of the woman, though now I’m beginning to “take it back” by trying to take the positive aspects of her personality into myself–her carefree, fun-loving nature that I remember so well from her “good” days.

My relationship with my mother is a complicated one, so I’ll refrain from discussing it further in this post; I feel it deserves at least one post of its own, if not a series.

Did anyone else grow up with a mentally ill parent? How has it affected you?