Happy happy joy joy
Well, I feel much better today, for no particular reason. I even made lunch, which is unusual. I haven't started the Lamictal yet--I kind of wanted to wait until the weekend so I could have one calm week--this week--of the other two medications at their usual dosage, since we've been screwing with the numbers so much lately. That, and if I have some kind of adverse reaction (which I can't imagine I would, at 25 mg) to the Lamictal, people will be home this weekend in case something happens. "The weekend" is kind of an arbitrary start date, just to feel like I'm imposing some kind of schedule on things.
While we're here, I feel like I should say something about the way I look at all this. The thing about talking about all of this on a public journal is that people do get very concerned for you and even protective of you, I think, and they end up trying to give you advice that's--well, not "unfounded," necessarily. Maybe more like "preaching to the choir." I don't know.
Here's the thing. I do think pharmaceutical companies encourage doctors to prescribe medications whether they're necessary or not. If you don't think a medication, in general or in particular, is right for you, you shouldn't take it. And you should tell them so. A pill is not the solution to every problem. But the thing is, I do think that a pill can be a solution to some problems. To wit:
I had sort of a phone-consultation appointment with my doctor on Monday, to discuss whether I wanted to change up my meds now that I'd had three weeks to think about it, and I told her some of the things y'all said. ("Where did you talk to these people?" "On... on my journal." "On the internet?" "Yes, but there were a lot of them!") Which is to say, I told her about some of the concerns that had been brought up, many of which she had already mentioned, and that by and far, Lamictal really did seem to work for a number of people, so I didn't feel quite as DO NOT WANT about it after I'd had time to mull it over. If nothing else, I felt better just in the sense that fifty-seven people didn't show up shrieking that Lamictal gave them third arms and green hair. No news is good news and all that.
I also told her about the hypomania ("I don't know if you mentioned this or not, but I did some reading that was totally not on the internet, shhhhh about it..."), and she agreed that it sounded like a component of the depression. She added that she'd gone back through the notes from our initial consultation eight thousand years ago, and signs of hypomania were present even back then. I then told her about this one time I wrote forty-two pages in one sitting--forty-two actual pieces of college-rule paper, in longhand, in pencil. I know, because I remember numbering them very excitedly. And then I told her the punchline: I was nine years old at the time. "What I'm saying is, it's always been like this. It's not something that just showed up when I was a teenager, or when I was in college. I've always been like this, no matter what you end up calling it. And I've always had these periods of inexplicable sadness--I'd go to my mother and say, 'I feel sad, but I don't know why,' and she'd just tell me to count my blessings. Because, you know, you don't expect an eight or nine-year-old or whatever to already have chronic depression. I'm just saying, if that makes a difference, in terms of medication--if it makes a difference that it's always been this way."
"Mm," she said. Which wasn't unusual, but it was a little eerie this time, just hearing a disembodied voice. You can't watch someone react on the phone, after all.
I also told her that I didn't want to medicate the hypomania, which I felt (in contrast to actual mania) to be a positive thing, into complete submission. I want it to hang around, but I accept that if you're going to medicate the deep trenches, you're probably going to take a little off the peaks as well. You have to figure out for yourself what each part is worth to you, what compromise you're willing to accept. And she agreed (I think. "Mm"), and said that she wasn't going to take me off either of the two antidepressants I've been on for several years now; she was just going to reduce the Wellbutrin (yes, I told her that I'd heard about possible seizures) and start me on very, very small increments of Lamictal--again, as previously described. I should be up to 100 mg after four or five weeks, but 100 (or even less) might be plenty, and I might not even need to go on up to 200. So I was glad that I wasn't giving up Zoloft or Wellbutrin, because I've had good experiences with them. When I'm on those two, I don't feel like I'm on drugs. When I was on Adderall, early on in college, I frickin' felt like I was on drugs. My scalp spent most of the day, every day, trying to crawl off my head, my heart would race, and I felt permanently caffeinated. When I'm on the other two, I just feel--I don't even feel "good"; I just feel like me. I feel like this great big wet fisherman's net has been pulled off me, and I don't have to drag it around with me all day. Once I first got that net off in college, as it were, I realized that I wasn't really shy at all--I wasn't Sandra Dee or anything, but I actually liked hanging out with people and doing poetry readings and going out dancing.
But since then, it's come back for weeks or months at a time. It's been really bad the last few months--probably as bad as it's been since my senior year of college. The fisherman's net may be a good metaphor, because you really do kind of feel cold all the time, in a figurative sense. Cold and wet and sometimes like you're drowning. We tried upping my Zoloft last month for that reason; and it turns out that while I feel kind of bad on 100 mg, I feel really fucking terrible on 200. A hundred and fifty really does seem to be the magic number on that one, and I feel a lot more capable at that level. Not "happy," necessarily; just "functional." Like I'm not drowning, basically.
I am going to have to say here that I do, in fact, think that a pill (or rather three low-dosage pills) is the solution to my problem.
My mother and I were talking about this at the kitchen table yesterday, about why I don't want to go back to therapy: "I spent years in therapy," I said. "I pretty much know what I'm doing wrong. It's just--you know how you'll watch a friend go out with someone who's really bad for her, but telling her that doesn't do any good? It's something she has to realize for herself? I know the things I'm doing to trip myself up--like pathological levels of procrastination, for example--but if I can't bring myself to do anything about it, well, talking's not going to change that. Or talking to someone else isn't, at least. Because there's nothing they can tell me, at this point, about these particular issues, that I don't already know. The thing is, I don't feel like it's fair--it's like going to therapy is setting myself up to fail, because I'm at a point where I'm not in control of a lot of things. I have to make a phone call to a stranger and I feel deep and abiding terror. It's not rational, but I do. That's why I think it's a medication problem. I just want to get to the right level of medication so that I can feel, you know, somewhat anxious about phone calls the way 'normal' people do. But a therapist says, 'I want you to make [whatever unpleasant business phone call] by the time I see you next week,' and if I'm too irrationally terrified to do it, well, now I'm an uncooperative patient or something. Or I'm 'not trying hard enough,' or 'not fully invested in this process.' Or they tell me that getting out and exercising would make me feel better, which would be great except for the fact that I can't even get out of bed. It just feels kind of pointless to set myself up for failure like that. I'm not saying I want medication to make me Supergirl; I'm just saying that I want to have the road repaved so that I can have the same ups and downs as everyone else, instead of hitting a pothole and spinning off into a ditch."
I think that was the metaphor that finally got her to understand what I was saying. That's not exactly how I phrased it, but in person it involved a lot of hand gestures ("I don't want to be up here, it's just that right now I'm down here and everyone else is up here in the middle [wavy up-and-down hands], and I just want to be able to not be down here") that I'm not sure I can reproduce coherently in a text format. Anyhoo, that's what I'm trying to say. I'm not taking medication because I want to put on Ren's happy helmet and not feel anything. I'm just trying to get the deeper trenches filled in so that I can at least have a shot at the same ups and downs as everyone else. Anxiety and irritation instead of soul-chilling fear and completely irrational rage ("CRANIUM? I FUCKING HATE CRANIUM!!"), if you will. I'm not asking for sunshine every day; I just want to be able to get out of bed and look out the window.
