Friday, October 2, 2009

Psych update

I've not written much about my psychiatric problems since about mid-August. I finished taking Lexapro, an SSRI that I was proscribed for anxiety, on July 31. If you've read most of the stuff I've written so far, skip down to New Stuff. Otherwise, here's a

Handy Review

The first few weeks on Lexapro, in late June, I had become very depressed, anxious, and sleepy. But, after the first few weeks, I started having delusions and feeling very up. I describe some of this in Bad Lexapro.

I was brought to the point of realizing that I have depression in addition to anxiety while I was on the Lexapro. In How psychologically healthy Lexapro made me, I describe how this realization happened: Lexapro made all of my regular problems, depression, anxiety, and a whole slew of negative and harmful thoughts, it made them huge, so I was forced to admit that they bothered me. I don't know if I was in denial about having depression, or if I just didn't know what it felt like, to have an undepressed mind, but my depression became so bad while on Lexapro it made the depression the rest of the time seem more obvious to me. I decided to get help for this problem, too.

In Anhedonia, I describe still feeling very affected by the Lexapro, a month later. In fact, I don't feel like I landed until about a week ago. I feel more normal now, but not totally normal; I feel very affected, mentally. Frankly, I feel scared.

New Stuff

At the end of August, I decided to get counseling help. At UMBC, there is free counseling offered by the University Counseling Services. I now have been to two intake sessions and one regular counseling session with Dr Wick. Dr Wick is a new counselor with UCS, but she has twenty years of experience, including three at Goucher. I feel like she has a good understanding of the context my life is in as a grad student; heck, she's been one herself!

I was initially reluctant to ask for counseling help. I could write a whole post on just the bad thought process in that, but I didn't want to admit that I have trouble just knowing how to manage my emotions, at a thought level. I'm a smart person, I'm working on a PhD, I get good grades, I read smart books, but that doesn't mean that I am as good as I'd like to be at telling when the things I'm thinking about myself and my feelings are reasonable or harmful.

Wednesday of last week, I went to Dr Regan with UCS; Dr Wick had referred me to him, he's a psychiatrist. Dr Regan is one of the coolest doctors I've ever been helped by, he reminds me of Tom Gammill, smart and pleasantly sardonic. He diagnosed me with bipolar disorder. I didn't believe it at first, because I've never, say, raced my car along country roads at 4 in the morning, or spent a week rearranging furniture.

As I understand it now, I fit the bill perfectly for bipolar II. Bipolar I is the really tough bipolar disorder, with the wild mania and deep depression. Bipolar II never hits the DSM's definition of manic; my experience from mid-July to mid-September or so does count as hypomania. Bipolar II is tricky to diagnose, because a patient could complain of the doctor, never have had a hypomanic episode, be proscribed an anti-depressant, and then get shot high. Antidepressants like Lexapro are great for depression, but without a mood stabilizer, are terrible for people with bipolar disorder.

My terrible experience with Lexapro is the classic litmus test for bipolar II. I'm so glad to have a concrete diagnosis now. It'll be a while before I can look at getting medicated for anxiety specifically, but that might be treated along the road with mood stabilizers and antidepressants.

Dr Regan proscribed Lamotrigene, a mood stabilizer with few side effects, except for a deadly rash that could result in "the outer layer of my skin sloughing off". That doesn't sound too bad, compared to hypomania. I've been on it for a week now. I have to gradually increase the dose, so it'll be a while before I feel any effects.

1 comment:

  1. Alex, I want to let you know that when your skin sloughs off, there will probably be market for your pelt. The price would have been higher before you excised Rudolfo, but that was so a wise decision that any resultant profit losses can be excused.

    Also, I am glad that you seem to have made some more progress in this area. I'm one of those stick in the muds who doesn't like medicine or doctors sometimes for probably completely irrational reasons, but how can I not be happy for you?