News Day Tuesday: New drug for PTSD!

a cure for what ails you, medication, News Day Tuesday, ptsd, three hopeful thoughts

News on mental illness (aside from the usual stories about police brutality and the fact that mental illness physically alters your brain) has been somewhat scarce lately, readers. However, I did manage to scare up an article about a new drug for PTSD called TNX 102 SL, which is absorbed sublingually (under the tongue, like lorazepam and other anti-anxiety meds) and reportedly helps with some of the more disruptive symptoms of PTSD, like arousal/startle response, anxiety, and negative thoughts.

The drug is related to a muscle relaxant called Flexeril. I’ve heard of muscle relaxants being used to treat startle response in the past, but I’ve never tried anything of the sort before. I typically rely on lorazepam to control acute symptoms, like when I’m out in a crowded public space and begin to feel the good old irritability and hypersensitivity to sound kick in.

I’m pretty excited that new treatments are even being tested for PTSD, honestly. The startle response is definitely the worst symptom for me–any sudden noise, no matter how small, can provoke an ear-piercing shriek and a huge bump in my heart rate. And because I have chronic pelvic pain that’s partially caused by trigger points, the instinctive tensing makes the pain multiply, which makes me more miserable, and it becomes this whole endless cycle that’s really hard to break.

I’m also hopeful that some new treatments that help with sleep but don’t leave me a groggy mess the next day will pop up. I sleep very lightly now and have a hard time falling asleep. I usually use either lorazepam (if the insomnia’s not too bad, though I need at least two milligrams to get a good night’s rest) or quetiapine/Seroquel if I’m really sleep-deprived. However, even though those drugs work in the short-term, I end up sleeping way longer than intended and am basically a zombie the next day.

Readers, what do you think of this drug, given what limited information we have so far? Would you try it? What do you use to cope, either medically or psychologically?

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This week has an been a wild ride!

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

This story actually starts at the beginning of July, about a week after we moved to Baltimore. I applied for Medicaid through the healthcare marketplace, as did my fella. Since we listed each other on our applications (not knowing any better) and he filed after me, his app bumped mine out. I was never informed (oops), so I sat around for over a month wondering why I couldn’t get coverage and going through the frustration of weekly phone calls to check on my application, to no avail.

So that brings us to this week, when I finally ran out of my carefully-rationed venlafaxine. I’m supposed to take 75 mg a day, and had been taking 32.5 every other day to make sure I could stretch it because I had no other options. I took my last dose on Monday, and it took about a day and a half for the symptoms to start up. And man, did they come back with a vengeance.

I had two nearly-sleepless nights because of the brain zaps and headaches. My application had been received, Medicaid promised on Tuesday, but I had to give them more time to get me an ID number. Meanwhile, the depressive symptoms, combined with the stress of the whole unfortunate situation, snowballed into something truly awful.

The little sleep I did get this week was plagued by night terrors, involuntary twitching, and (so I’ve been told) a lot of whimpering in my sleep, some of which woke me up. I finally got my scripts filled today, after a bit of a fight regarding the dates on the prescriptions, then came home and promptly collapsed after taking one of my newly-procured venlafaxine.

Moral of the story: Withdrawal is exhausting. It’s hard on the patient, and it’s hard on the patient’s loved ones. Fortunately, my brain immediately grabbed that medication and held onto it ferociously, and I woke up feeling much better (perhaps because I slept like the dead for two hours).

This week was a test of my will to fight and my mindfulness skills. I didn’t cope as well as I had hoped–little things sent me into tears, and I was generally irritable the entire time. I didn’t like being around myself. I was plagued by guilt. I felt, for the first time in years, trapped in my body and helpless to fight my invisible tormentor–the bipolar disorder that had, once again, taken hold despite my best efforts to fix the situation.

The good news is that I’m on the mend. I now have insurance, so I can start shopping for a good psychiatrist/therapist/every other kind of doctor I have to see because my body’s kind of a wreck and I have a bunch of chronic illnesses that tend to require a lot of maintenance.

Have any of you had to detox against your will? I hope not, but from what I’ve been reading, it’s frighteningly common. Stay safe, readers. Hang in there–it’s finally the weekend, and I hope all have a lovely one. 🙂

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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?

Manic Depression: A Brief Explanation

authoress in motion, explanations, major depression, medication, rapid-cycle bipolar disorder, self-harm, stigma

I finally got around to editing the explanation video on bipolar disorder/manic depression (I prefer the latter term as I feel it’s more descriptive).

In the video, I talk about the different categories of bipolar disorder, what each phase (from depression to mania and mixed states) is and what it feels like, and tips for dealing with a mixed episode.

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?

Could have gone mad.

major depression, medication, ptsd, rapid-cycle bipolar disorder, stigma

The depression has felt different the last week or so; now that I’m off the risperidone, my hands aren’t shaking anymore but I’m not sleeping as well. I sleep too much, but it’s fitful, and I’ve found myself prone to hysterical crying the last couple of days. But hey, at least my mood isn’t any worse.

I’m worrying, as I frequently do when I go through these periods of agitation (without the depression lifting one bit, mind you) that I’m popping manic symptoms. My mother is bipolar, so I’ve always been vigilant about monitoring myself for signs that I’m swinging from major depression to bipolar disorder as well. I don’t think that’s the case, but thankfully, I see my psychiatrist on Wednesday.

I know one thing for sure: this medication is not working. Not one bit. But even though I’m clearly ill and not doing that well, at least others tell me I’m still fun to be around. When I’m around others, I try extra-hard to be vivacious and entertaining because you know who likes being around me when all I can do is lie on the floor and cry? Nobody, that’s who. Not even the cats.

I’m beginning to wonder if the forced gaiety is doing more harm than good.

The worst part is the emotions. I seem to have so many of them, and yet I can’t put anything into words effectively, which is frustrating because goddamnit, I’m a writer.

All I can do is hope that therapy tonight helps a little and that I will finally, finally, finally discover the magical combination on Wednesday that will make me feel okay. In the meantime, I’m doing more of that charming but potentially destructive “Whatever gets you through the night” living.

How have you guys been lately?