Saturday, October 10, 2009

Clonazepam is amazing

Benzodiazepines rock. Or, at least, Clonazepam does. I've been feeling anxious all week. It was weird, it felt different from my regular sense of anxiety. I felt very taxed, very preoccupied, like I couldn't catch my breath, except I didn't actually have shortness of breath. When I was heading out to start my day on Wednesday, I just sat and listened to podcasts and played solitaire on my Palm Centro.

Ordinarily, when I feel anxious, I feel a sense of fear about all sorts of things in my life, "I'm inauthentic", "I'm afraid of paying bills", "What if I run out of money?", "I'm not a good grad student", "God doesn't like me". It's normally a pretty cerebral experience, but, hey, I'm a pretty cerebral kind of guy. Of course, there are physical effects, too, I tend to oversleep to cope, that's the big thing. I'm less attentive, I'm more likely to goof off at Photobomb than to actually do my job.

Exercise helps a lot. I love going for half an hour on an elliptical machine, then doing some weight training. However, this takes a lot of time, I need to get into gym clothes and pack soap and a towel, if I want to exercise in the middle of the day. I haven't been to the gym in a couple of months. I take a lot of walks, now; whenever I need to burn off steam, I can wander by the pond for fifteen minutes and get back to work. Half an hour of walking a day is way better than two hours at the gym once every two weeks.

The anxiety I've felt this week has been different. I grind my teeth. I can assess how anxious I've been over the past couple of days based on how large of a lesion I've worn in my right cheek. My cheek had been healthy for the last month or two. This week, the lesion was huger than it had been in maybe a year or two. I felt very physically tense, a lot of tightness in my belly and I was getting tension headaches. I was twitchy. I always carry Silly Putty for if I get fidgety, I was using it a lot this week. I would wake up an hour before I had set my alarm, and have trouble falling back asleep, I was tossing and turning. This is all very unusual for me; anxiety is normal for me, but this felt like a more basic, physical anxiety.

I've been taking Lamotrigene for two weeks now; it's a mood stabilizer, and it's the first thing I'm trying to manage my bipolar disorder. One of the potential side effects is anxiety. I was wondering if it could have been the cause of the anxiety this week. I had been on 25 mg for the first two weeks, which is, in the words of my psychiatrist, Dr Regan, "practically homeopathic". Dr Regan is gradually increasing my dose; the Lamotrigene won't do anything useful for another six weeks, or so. The dose is being increased very gradually because the medicine can cause all of my skin to "slough off" if I'm allergic to it, which would lead to "death".

I had an appointment with Dr Regan yesterday, Friday, but I was feeling so bad on Thursday that I tried to call him anyway, to see if I should back off on the Lamotrigene. I knew that it was unlikely that it was making me anxious, but the anxiety felt so different from my normal anxiety that I wanted to make sure. I couldn't get in contact with Dr Regan, so I called my primary care physician, Dr Murthy.

Let me digress. I would like to say that I'm wildly enthusiastic about all of my doctors that are helping me. Dr Murthy has been my doctor for about two years. She's not chit-chatty, but she's very compassionate. Also, she's a vegetarian, and so am I, so she can help me make sure my diet isn't troubling me. She works in Glen Burnie, but is so good that I think she's worth the drive. I can get you her contact info if you're looking for a doctor.

At any rate, Dr Murthy suggested that I skip the dose on Thursday night, just in case, and talk to the psychiatrist on Friday.

In our regular appointment, Dr Regan said that there was no way that the Lamotrigene was causing the anxiety. He proscribed clonazepam, which is an anti-convulsant. Most benzodiazepines are pretty addictive and can cultivate dependency, so they should only be used in emergencies. Clonazepam is great because it's long lasting, but with no euphoric high. It's safe to take long-term. I can't drink, now, though, because alcohol interferes with it very strongly. I enjoy wine, so, hopefully, when the Lamotrigene kicks in, I won't need the Clonazepam.

The Clonazepam is amazing. I was having trouble not being panicky yesterday, but, today, I feel calm and serene. I sleep ten hours last night, but I had been pretty tired, so I'm not sure if it's the meds or what.

For the past week or two, my anxiety and depression had been pretty tough for me. Curiously, I could concentrate very well doing my job. That concentration blocked out the pain. I reckon that I've worked 57 hours this week, which is a lot more than normal for me. Whenever I wasn't actively talking with people or writing code or grading papers, I felt terrible, not because I felt compelled to do these things, but because it was only when I was concentrating, flowing, that I could feel free from the anxiety and depression. This isn't healthy, long-term, I want to work because I love work, not because I hate doing anything else, but there are worse coping mechanisms than advancing human knowledge and helping train the next generation of engineers.

I'm still confused as to why anxiety felt so different for me this week.

Lexapro broke me of a lot of the negative thought patterns that I had. I normally have very cerebral experiences of anxiety, depression, and hypomania. This got so bad on Lexapro, I had to learn how to just feel terrible, instead of feeling terrible and thinking terrible, too. I've been listening to a lot of Zencast lately. I don't have a regular meditation practice, or anything, but I've been learning to cultivate mindfulness, learning to be more embodied. I used to have anxious thoughts. Now I ask myself, "What does it feel like to be anxious?" and I observe how I feel in my body, tightness in my belly, soreness in my limbs, whirling energy, and so on. I wouldn't put a lot of money on this, but I wonder if mindfulness practice has helped me change my experience of my psych problems, and maybe that's why anxiety felt so different this week.

I feel so not-stressed now, thanks to the clonazepam, that I feel like I'm on vacation. I'm sitting at an outdoor table at Panera with a cup of coffee and a bagel. I'm looking at a parking lot. When I feel okay, though, I can take a vacation to a parking lot.

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