Adventures with Psychiatry pt2

So it’s been a few days since I began taking the full 300mg dose of the bupropion. And so far, the patterns that seemed to be emerging before are consistent:

  • Increased irritability. It’s stuck around, but I think I’m starting to get the hang of handling it.
  • Much lower scores on the Burns check list: the highest this week has been a 12, with four different instances of a 9 representing the low. In fact, my weekly average dropped from a 14 to a 10 (technically a 9.8, but close enough).
  • An easier time actually getting going. Four days in a row of paid work (all successfully done) is a good testament to that.

The only difference I have noticed is something I was warned about: if I take the second dose too late, the 6 hour jolt of energy is enough to make it difficult for me to get to sleep. Mostly, this is a problem when I wake up late (ie, 1 or 2pm), rather than the drug acting in some weird way. The other thing I have noticed has been an increase in headaches; but that could simply be attributed to general lack of sleep. In fact, that’s probably what it is; headaches are a fairly common result when I get less than four hours of sleep in a night.

All told, I’m mostly liking the bupropion so far. I’m thinking of doing one more part to this series after a few weeks on the full dose when I’ve gotten a better picture of how it’s affecting me.

Adventures with Psychiatry pt1

Following in Ziya’s lead, I also recently had a psychiatric appointment. I made it the same date as zir appointment, and it was supposed to be for the day after zir appointment. But of course, things happen, and five days later (the 5th), I had an appointment with the same psychiatrist that Ziya had so many problems with the last time.

My appointment thankfully went much smoother, and since I’ve been doing the Burns depression checklist every night for the past three weeks or so, I had a pretty good sense of what my symptoms really are. This made his choice of medication easy: the generic of Wellbutrin (bupropion). This post (and the next few parts) will consequently track how I’m feeling on the medicine as I ramp up to the full dose and beyond.

So far, I’m a little more than halfway through the ramp up period; I have two more days of just one 150mg pill a day, then I progress onto two. And so far, it seems to be helping with my main symptom: the incredibly low energy (as well as the motivational problems that follow from that). Prior to starting it on Wednesday, my typical score on the Burns was in the 17-26 range; basically, the upper end of mild with the occasional break into low moderate. Since I’ve been taking the bupropion, the highest I’ve gone is a 13, and I’ve seen my second 9 in several weeks. So while I may still hit the low end of mild, I’m seeming to stay more towards normal but unhappy.

I feel significantly more energized and capable of actually getting things done. This is a huge improvement.

But I’m also finding myself more susceptible to distractions (for example, people talking near me or Ziya humming a song or thinking aloud). And those distractions are definitely hurting my ability to focus. I’m also finding that, so far, I’ve been becoming more prone to irritability. Little things that didn’t use to bother me are starting to and with an ease I haven’t felt in awhile. It is possible that the latter issue is (at least in part) due to having the energy to actually feel those emotions again. But I’m not sure if the bupropion is the cause of the former, and I’m hesitant to look at the side-effects; I don’t want my brain to get any ideas. I’m hoping that the former will become easier to deal with; I like this new energy far too much to want to try some other random drug.

Maybe things will shift when I start taking the full dose next Tuesday. Part two will probably go up after a few days on that dose.

Prescription by Dr. Ziya

WARNING: This is a (potentially risky) decision I have made for myself. It does not take the place of medical advice by a qualified mental health professional.

Today I had a conversation with 2 friends that confirmed a few thoughts I’ve been having:

  1. I will not go back to Psychiatrist B under any circumstances.
  2. I need to stop taking my current medications.
  3. Listening to music daily will improve my mood and possibly also my brain’s functioning.
  4. I need to be honest and talk about my disorder more often.

Psychiatrist B didn’t take my thoughts about harming myself and even committing suicide seriously, despite the fact that the drug he was prescribing me can cause such thoughts. He also needed assurance from me that it was worth gaining weight to have the possibility of recovering from a disabling disorder; that my mental health is more important than my appearance! (He also made the typical assumption that fat = ugly, which I have no desire to perpetuate.) As one of my friends put it, there’s a significant risk that if I keep going to this doctor, his problems will have a negative impact on my well-being. It also certainly doesn’t bode well that the “clinic” hasn’t made any attempts to contact me about rescheduling the follow-up appointment I canceled nearly a month ago.

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long-white-pillsRegarding my medications, the bottom line is: they’re not providing the relief I need. Regardless of whether they’re helping “somewhat,” the fact remains that they are not helping enough. And there’s the possibility that they are causing or contributing to some of my more disturbing symptoms. I haven’t been taking them for the past few days and to be honest it’s been a very rocky road. At this point I’m unsure whether I should hold my ground until they’re completely out of my system – or start taking them again in smaller and smaller doses until it’s safer to stop completely (or I run out). Everyone seems to think it’s better to wean myself off them slowly, but I’m concerned about what might happen if my levels spike again after being so low for the past couple days. It’s also a lot easier to just not take them than to try to figure out what doses would be appropriate and remember to take them regularly.

It’s recently come to my attention that I’ve been doing my readers and the companies that make certain brand-name drugs a disservice. I’ve been taking generic “equivalents” of Zoloft and BuSpar (sertraline HCl and buspirone HCl, respectively); prior to beginning this blog I was taking bupropion in place of Wellbutrin. Anyone reading my blog would think I was taking the brand-name drugs and that they were causing or contributing to the undesirable effects I’ve described. This is most certainly not the case. In Generic Versus Brand: What’s In That Pill? Part 1, Disorderly Chickadee sheds light on how generic formulations of brand-name drugs often are not as effective as the brand-name version; in some cases the difference in functioning one experiences can be “like a brain transplant.”

Most notably, there is a huge difference between Wellbutrin and generic bupropion, enough so that one generic formulation was recalled. It’s not the one I was taking, but it still raises some suspicion that I might have done a lot better if I’d taken actual Wellbutrin instead. I’m also wondering whether brand-name Zoloft and BuSpar would be more effective (and safer!) than the generic sertraline HCl and buspirone HCl I’ve been taking.

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bob marleyI don’t usually listen to music, unless you count the background stuff in Oblivion – which either alerts me to the presence of enemies or puts me to sleep. Yesterday I had the very pleasant experience of listening to some of the more upbeat tracks on a CD of instrumental Celtic music. The bass and percussion were very grounding and calming, helping me to feel safe … while the foregound instruments were lively and played complex melodies in compound meter.

MeterI had a lot of fun listening to the music, felt calmer and happier, and thought it was having a desirable effect on my brain. It required enough of my attention that there was little to no room left for disturbing thoughts, and it seemed to help organize my brain. My hypothesis is that the regular firing of neurons involved in listening to the music (which are located throughout the brain) may have provided the stimulation, serotonin, dopamine, and information pathways my brain needed to function more effectively. I might need to experiment a bit to figure out how many times per day and for how long I should listen to music, as well as what types of music will provide the best effects … but overall I’m optimistic that listening to music regularly will help – a lot!

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meep-and-lolz-cropFinally, it felt really good to be honest about what I’ve been struggling with and have my friends accept my reality. They listened and shared their own related experiences, which helped me feel less alone in my struggles. They offered advice – some of which I found helpful – but more importantly demonstrated that they support me in my efforts to take care of myself. “You know you can call any of us any time you need to talk, right?” Yeah, I do; I just need a reminder that there are people who want me to reach out to them in my times of greatest need, when I feel like I’d be doing everyone a favor if I just ceased to exist.