Sometimes there are no words to express what is going on in my head, so I’ve made the executive decision to use animated gifs instead.
The last few weeks have been a shit hole of catastrophe in my brain.
When I started back to work after my lay up, Dr. H. was of the mind that since Concerta only seemed to work some time, I needed to try something else to find something that worked all the time. The following Monday, I went up to two Adderall XR in the morning, with no effect. Spoke with Dr. H. that evening and he moved me back to Concerta 36mg. Tuesday was fine. Wednesday, I was an idiot and accidentally took double my Concerta dosage in the morning, so instead of 36mg, I was high as a kite on 72mg. I immediately dosed myself with Klonopin to keep me more even and brought the bottle with me to work.
By mid-day Wednesday, I was quietly having a meltdown in my office. I was reading something about something and got so intensely frustrated, I wanted to start punching holes in the brick walls. I kept myself together by duct tape and string. Thursday, my dosage was normal but I was so tired, I broke my no-caffeine rule and drank a Coke that evening to just get over the hump. Friday was much the same as Thursday. Saturday, I was heading to MSU as a panelist at the MSU Comics Forum.
Even after taking my regular dosage and my lithium early on Saturday morning, I could not function. I had to drink a Coke to keep awake to drive to Lansing and by the time our panel came up, I was manic in my head. Kristin and I were supposed to head to Gizzard City for dinner but I felt so whacked out, I didn’t know if I could make the 1/2 hour drive to the restaurant eat, and then drive home. So I bailed and drove home on a wing and a prayer.
Sunday was glorious. I felt like my body had finally been reset. Monday, I spoke to Dr. H. and he was concerned about Concerta’s effects during the week so we’re going to try Adderall XR again except this time, we’re going to split the dose: half in early morning, second half later part of the morning. Makes sense. I’m on spring break, let’s give it a try.
Not only did the Adderall XR do nothing for me, but it turned me into this moody, depressed, state of an animal. I didn’t want to leave the house, I didn’t want to hang out with friends, I didn’t want to do things with my husband. I just wanted to wallow in bed and watch terrible TV. So the long ago set plans to do something on spring break week were all mostly broken. When I was feeling up to doing something, it was mostly writing and working on my cadre of websites. Except, there were massive problems on my host providers end and my website couldn’t stabilized all fucking week. 504 and 502 errors all over the place. Which wasn’t super helpful when this happened:
TheHusband wanted me to stop taking the Adderall XR and I refused. I had to see if I could finally metabolize the drug AND I had a phone appointment with Dr. H. on Friday (yesterday). I’ll be fine.
Except, I wasn’t.
During my phone consult on Friday evening, I was nearly hysterical. Dr. H. had no idea why this was happening because chemically, Adderall XR isn’t supposed to effect serotonin levels. But obviously something was happening because it was fucking mess in my brain.
Here is how it is supposed to work:
I take Lithium (1200 mg, half in the morning, half at night) as a mood stabilizer. With my mood stabilized (and I get blood drawn to check my Lithium levels every couple of weeks), the ADHD drugs work better. If I feel too amped up or I can’t sleep, I take Klonopin as needed. When the ADHD drugs don’t feel like they are working, then we ramp up the Lithium. Except now I’m at the therapeutic levels of Lithium (known via the blood tests) so I can’t amp that up, so we have to work on the ADHD drugs.
Or go on anti-depressants for more stabilization to make the ADHD drugs work better.
Which I’m rejecting.
A decade or so ago, I was seeing a medicating therapist when I lived in DC area, who decided to cycle me through almost all known (to her) permutations of various SSRIs/Anti-$whatevers in her drug book. So if X combination did not work, then, we’ll try something else! Then try something else! Then try something else!
The hitch in this giddy up is I metabolize drugs fairly quickly. For SSRIs, if it takes 14-21 days before the drug stabilizes on me, it could take as little as 7. Rather than up/down the dosage, she just changed me to something else. I was cycled through so much, over the course of six months, my life fell apart. Granted, the relationship I was in then was already on the rocks, but everything else that may have been okay such as job, professional and personal relationships were all hit hard by this. It was fucking terrible and a fucking nightmare
The other hitch is I’m one of the rare cases of people who get suicidal thoughts on anti-depressants. I’ve been on varying doses of:
XR or not, doesn’t matter. On or off Lithium, doesn’t matter. I start taking an anti-depressant, I want to kill myself.
When I went off the drugs a decade ago, I swore I would do whatever was necessary to stay OFF the drugs. Change diet, living, jobs, whatever, I’d do it. But DBT and yoga can only do so much; I recognized I needed to be more proactive in my mental health. But this last few weeks has shown me glimpses of what that life was like a decade ago, and it is NOT one I want to repeat. I have too much at stake to lose all of it due to my fucking terrible brain chemistry.
There was no fucking way I was going back on an anti-depressant.
So there I am, nearly hysterical on the phone with Dr. H, very emphatically without a goddamned moving an inch to my voice, that I will not get on anti-depressants. We agreed to keep me on the 1200mg of Lithium and go back to the Concerta 36mg, since I can tolerate that and it works somewhat. The rest is up for discussion when I see him in a few weeks.
My hysteria got worse when I got off the phone and was talking to TheHusband about the whole phone call ordeal, then my mood shifted in to self-protective mode where I did not want to be touched, stroked, talked to, or anything. I remember wrapping my arms around myself while TheHusband tried to sooth me during this depressive spike. I cried. A lot.
After I made the decision in October to start seeing Dr. P. again, he collated in later sessions the depression I was experiencing was more than likely stemming from the untreated ADHD which was creating a vicious circle of frustration and all the life changes that had happened in the last few years and were not dealt with. So, more normal life stuff rather than chemical.
This is how I knew what happened this week was different, even despite the chemical incredulousness of it, the mood shift down this week was caused by Adderall XR. This WAS chemical, and it was crippling, and it was debilitating. How fast I shifted during the day, before the phone, while on the phone, and then after the call was huge.
Today, I started the morning with half of my Lithium dose (the remaining dose will be later) and Concerta. I’m still feeling prickly, my eyes ache as if I had been crying for hours (though I haven’t), and I am still in my pajamas. But for the first time in a few weeks, that I feel okay.
And this is how I absolutely do know, it will be sunny one day.