Lost It, Again

I lost it in the office at the psych's. Completely, utterly broke down. Shaking, sobbing. I think I used half his tissue box. I couldn't stop. And he just sat there and let me cry, which made me feel stupid and dumb and broken. I admitted I hadn't been med compliant and that I couldn't keep up with the hydration on the Lithium to offset the side effects. And when he suggested Abilify, I had to shoot that down because I'd been on it and gained 50lbs. And that's when my last psychiatrist suggested bariatric surgery rather than meds. What the fuck?

So I'm out in the parking lot outside the office, calling Jb, because I suddenly realize what day it is and that he's not getting paid 'til next Friday, and I blew all our foodstamps on food for, like, 4-5 days and a bunch of crap, and we've a whole other week we need groceries for. So I fucked up. And I'm bawling on the phone to him about that. And I can't stop. I can't stop crying. Up and down, up and down, up and down. Fucking roller coaster, and I want off. But no, the psych says, "That seems to be symptomatic of your illness." So it's official: I'm a rapid cycler.

Anway, prescription changes: off the Lithium. Still on the Lamictal and Klonopin. Wellbutrin is now gone. Zoloft has been up from 50 to 100MG.

You Are What You Eat

So, now that I've a cocktail of five drugs, I'm interested about what, exactly, I'm putting in my body. I mean, what's the difference between the three sets of anti-depressants I'm on?

According to Crazy Meds, Wellbutrin XL is a multiple reuptake inhibitor, which means:

These drugs affect more than one neurotransmitter, usually serotonin and norepinephrine. Serotonin, norepinephrine and dopamine are the big three neurotransmitters responsible for a lot of depression issues. My wild-ass guess / rule of thumb is that imbalances of one or more of these three are responsible for 80% of the depression issues people suffer from. It's all just a matter of figuring out exactly the extent of the tweaking and what neurotransmitters you exactly need to tweak.

As for Remeron, it's a tricyclic anti-depressant. According to McMan, that means:

They work by preventing two neurotransmitters - norepinephrine and serotonin - from being absorbed by the brain cell's receptors, and can be a life-saver where other medications have failed. Some experts contend that because these meds have strong action on two neurotransmitters, they may be more effective than the newer generation of antidepressants, which largely zero in on only one. But owing to the fact that tricyclics are imprecise weapons that take out unintended targets such as opioid receptors and histamine receptors, patients are at risk for a range of unwanted side effects. Overdoses can be fatal.

Yay for fatal overdoses.

So, now, what's the Zoloft for? Apparently, it's an SSRI, or a selective serotonin reuptake inhibitor. Nice to know that the three are at least three different kinds of anti-depressant. Still, here's what Crazy Meds says:

These drugs don't make you produce more serotonin, rather they make your neurons soak for a longer period of time in the serotonin you already produce.

But is that the same thing?

That depends on the person and the sensitivity of your 5HT receptors. Sometimes it's the same effect, sometimes not. When not it could be sub-par (to the point of being useless) or too much.

These days serotonin is the first line of attack in conquering depression, and the most likely neurotransmitter to really mess you up if your problem is actually bipolar and not unipolar depression. While these are not happy pills, for unipolar depression they are often quite effective at keeping depression at bay. In addition to depression, SSRIs are frequently good for panic/anxiety disorders and some are good for OCD as well. SSRIs are sometimes good for the more common forms of premenstrual dysphoric disorder (PMDD).

Basically, the psych nurse is trying to cover all bases, it seems. I don't know how I feel about that. Wellbutrin and Remeron are in my system and have been for a while now. The Zoloft is the one that'll take nearly a month before I can possibly see any benefit.

I'm not even ready to touch the debate about anti-depressants and bipolar disorder. Maybe it means I don't have it. Maybe the fact I'm not having an adverse reaction means I've something else: major depression, unipolar depression, what have you. Sometimes, I think I'm drug resistant. Because I've been on Zoloft, on Effexor, Prozac, Cymalta, Trazadone, and one or two more I can't remember because it was long ago. They either seemed to help, then pooped out, or didn't help at all, or made me suicidal. Now I'm on nearly every type of anti-depressant, except an MAO inhibitor, which no one uses anymore, and a mood stabilizer.

It makes you think: if this doesn't work, what the hell will?

Psych Check-In

I haven't felt like writing here much. I had a good bout of depression going last week. Slept until 2:30 one day, got up for a few, then went back to sleep until Jb came home. Couple fights put me so low that I was thinking about the hospital and suicide again. It passed, though, which is good. I did make up an excuse to not see my therapist last Friday. Jb'll have a fit when he reads this, as I told him I was sick, which I was, just not in a way he could understand. Or so I felt.

There's other little things. I haven't cooked in a week or so. Haven't made a grocery list yet for this two weeks. Haven't done dishes in a week. Let the apartment go to hell. Jb helped me clean up this weekend (i.e. Jb mostly cleaned up. I've yet to do the dishes). On a side note, I did apply for unemployment today, and we'll see how that goes given the obnoxiously ridiculous situation that was my work's request for a voluntary resignation and then an unpaid LOA without any documentation whatsoever. I finally just quit, and I'll probably have to explain that.

Did see the psych, or rather, the nurse practitioner, who I like better anyway. She still considers me unstable and has put me on yet another medication, Zoloft. So that's what? Five psych drugs. You've got to be kidding me. I'm really unhappy with this. I'm almost to the point where I'm ready to throw up my hands, throw out all the fucking meds, and just try to work through things with this therapist, who I'm liking quite a bit. I mean, seriously, five fucking meds:

Remeron 30 MG 1x a day (Sedative/Anti-depressant)
Lamictal 150 MG 2x a day (300 MG total) (Mood Stabilizer)
Klonopin 1MG 3x a day (Anti-Anxiety)
Wellbutrin XL 300 MG 1x a day (Anti-depressant)
Zoloft 50 MG 1x a day (Anti-depressant)

Plus the Benicar, the Levsin, and the Protonix that I'm always on for hypertension and IBS. I honestly need a pill organizer at this point. A quarter of the time, I forget to take my meds. Maybe not so much. But I'm not daily compliant. I don't remember until too late in the morning, or I totally forget at night. Maybe an organizer would help. I don't know.

Feeling increasingly frustrated.