Dr: “You’re unlikely to experience pleasure in life”

captain 1911Just read the report from my psychological evaluation that I had done last week. The line I can’t let go, “His personality is such that he may have only a small capacity to experience pleasure in life.”

It feels and sounds true. Yet, reading it, so damning, part of me is devastated. A little of the hope I still have just died.

Below is a section of my psychological evaluation:

Psychological Functioning: The patient completed the MMPI-2, an empirically based measure of personality and psychopathology. His responses suggest that he cooperated with the evaluation enough to provide useful interpretive information and the resulting profile is considered an adequate indication of his present personality functioning.

The patient’s profile was developed using the D (depression), Pt (psychasthenia – fear, anxiety, tension, depression, intruding thoughts, and obsessive-compulsive symptoms); and, Pd (psychopathic deviant – rebellious, non-‐conforming; family problems; impulsive, angry, irritable, and dissatisfied) scales. Patients with this pattern tend to exhibit a pattern of chronic psychological maladjustment.

The patient appears to be quite anxious and depressed at this time. He may be feeling some tension and somatic distress along with his psychological problems. He endorsed several items related to suicidal ideation and should be monitored for risk. He indicated a history of impulsive acting-out and substance abuse for which he expressed guilt and remorse.

His personality is such that he may have only a small capacity to experience pleasure in life and tends to be pessimistic in outlook. It appears he is experiencing disturbed interpersonal relationships. Patients with this profile are prone to substance use and abuse disorders and all treatments involving medication should be carefully monitored.

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Dr: “You’re unlikely to experience pleasure in life”

My Bipolar Medication Cocktail

wonderHaving been diagnosed with Bipolar disorder six months ago and actively seeking treatment for three and half months, I’ve tried a litany of medications.

Below I detail my experience with the medications that worked. I plan on making another post detailing the medications that didn’t work for me.

Effective Medications: Vyvanse 20mg, Prozac 30mg, Seroquel XR 600mg
Uneffective Medications: Gabapentin 1800mg, Strattera 80mg, Lamictal 200mg,

  • Vyvanse 20mg
    • Started: started three days ago
    • Purpose: to aid in energy and focus to help me breakthrough crippling apathy
    • Impact: So far Vyvanse has been very effective at helping me to return to more normal functioning. Its impact on my mood has been mixed, although I can now do things which is nice, underneath there is still a layer of boredom.
    • Side Effects: Mild and fleeting anxiety about three hours after taking and again as it wears off in the evening
    • Future: Very effective, I hope to increase my dose to 30mg and stay there. I think that would be the ideal dose for aiding me in breaking through my boredom.
  • Prozac 30mg
    • Started: two weeks
    • Purpose: By this point my mood had largely stabilized, no more severe depressive lows. However, my mood stabilized at a mild level of sadness.
    • Impact: It has had a moderate impact on mood. Having been on SSRIs previously, they usually hit on day five, or so for me. It brought my mood up, apathy was replaced by boredom. I could now force myself to accomplish minor tasks, nothing interested me, my mood was flat. I found nothing engaging.
    • Side Effects: Decreased labito and possibly worse, difficulty maintaining an erection. Sigh, mental health or sex, decisions, decisions.
    • Future: SSRIs have helped for periods of time in the past, I plan to stay on Prozac.
  • Seroquel XR 600mg
    • Started: three months ago
    • Purpose: Started taking immediately after stopping Adderall (abused Adderall, over 100mg daily for several months before seeking help). Meant to help with the depression I was masking with Adderall and aid in falling asleep.
    • Impact: I started at 50mg immediate release and increased my dose to 600mg XR within weeks. Seroquel was effective in helping me fall asleep. Seroquel did help with my anxiety, I was in a constant state of low-level panic. I do not believe it had any impact on my mood.
    • Side Effects: Several side effects, hives, weight gain and constantly tired. I wrote a blog about the hives, they coated my body. I ended up getting an epinephrine shot and a steroid shot, the hives never came back after that. Also, dealing with significant weight gain, I gained twenty pounds in two months.  My weight hadn’t changed much since high school. Also, drowsiness throughout the day. Oh, and one more, it substantially increased the amount I slept each night. Regularly sleeping twelve to sixteen hours a day.
    • Future: I plan to attempt to slowly tapper down to 300mg XR and possibly off entirely. The sleepiness throughout the day impacts my mood in a negative way.
My Bipolar Medication Cocktail

Wait, Wait, Finally Happy!!!

singin-intherain-suit-auction-postponed_12-9-2013_129617_lGod. I feel alright. Like, actually alright.

Right now I am sitting at my computer. I haven’t sat at a computer for more then twenty minutes since I stopped Adderall, two months and ten days ago. And I am a computer person, like so much. I built the computer I am currently using, it has a window in the case and leds inside to help show off my fancy video card.

Fuck. It is so nice to want to sit a computer.

How did this happen? This is Strattera, definitely.

I’ve been taking 36mg in the morning and 18mg at 4:30pm, when I get home from work. Yesterday and now today I started to feel alright around 6:30. I asked my doctor if we could increase the dose to the 80mg max. It takes a month for this med to fully get into your system.

If I can be this person, I’d be alright. I have my doubts. I do feel a bit manic, but I am not fully, it is like 10% manic. This is a happy place for me, please let me keep it. I have desires, wants, a bit of energy, maybe this is normal.

Maybe this can be normal.

Please.

Current Meds: Lamictal 200mg, Effexor XR 75mg, Seroquel XR 600mg, Gabapentin 300 – 600mg, Strattera 36mg morning & 16mg at 4pm, Caffeine Pill 400mg

Wait, Wait, Finally Happy!!!

What does normal feel like?

scene_from_leave_it_to_beaver_1958Is this normal?

How the hell do crazy people know if they feel normal or not?

Seroquel XR is still a god send. I am now taking 600mg three hours before bed and I take up to three 25mg IR tablets as needed throughout the day.

Still, I am largely apathetic. My mood is stable, but there is little range. Okay, blah, fine and that is about all my mood does.

Towards the end of a dose, when the drug has built up in my body, I get a boost of energy. The apathy disappears and I feel capable. It feels normal with a push in the right direction.

Manic? Maybe. Maybe it is like 10 or 20 percent manic. As Seroquel builds up over the next several weeks I wonder what my normal will be.

I hope normal is 10% manic. But I feel normal is the apathetic dull mood I bear every morning.

What is normal?

What does normal feel like?

Which me is me?

640px-dr_jekyll_and_mr_hyde_poster_edit2This morning I woke up to a fourth of my normal Adderall dose. Prescription far too quickly. But for so long, it has been the only tool I have had between planning my suicide, or not. And it is a blunt and shitty tool.

Thankfully, over the past week Lamictal has become more noticeable, I am three days shy of six-weeks. Coming down from Adderall is always a disaster, heavy drinking became the solution to that problem. Two years ago I drank once or twice a month, not anymore. Now that Lamictal has built up in my body, coming off Adderall lost its terror.

Instead, the decent from Adderall leaves me calm, even relaxed, and a bit tired. It is nice. It is also easier to see Adderall’s awful side effects. And this article, god, me, this is exactly me:

After (people with Bipolar disorder) taking the drug chronically, rather than feeling happy while under the influence, patients report that they instead feel surly and paranoid while high.

Paranoid, yes. Surly yes. And panic inducing. As I swore in my last post, Adderall was poison and I was done. Well, now I am not so sure. Haha.

Adderall is bad. And can be terrible. I didn’t take a normal dose until 2pm today. Nothing really worried me. Doctor appointment ran late, called out for the rest of the day. Dropped off my prescription and headed home for an hour. I’d get the pills, eventually, but home sounded nice. As apposed to my normal routine of handing the prescription, asking them to get it ready as quickly as possible, then pacing back and forth in front of the counter until they call my name.

So, yeah, this morning was nice. I didn’t exactly get much done. Or anything, but I didn’t care to. Now on a dose of Adderall, the energy and focus is nice. There is no anxiety, not like it was producing, just a bit of a bump into productivity. I’m definitely not hypomanic, again, still very calm. But calm with an ability to focus and accomplish tasks.

Now what? Which me is me? I like this me, but is it the me doctors will let me have? Or am I to be the calm sedatited unproductive me? That is still incredible compared to the me who only thinks of suicide. Or are there even more version of me? Each pill probably giving a slightly end result.

I missed my first appointment with the new psychiatrist, an expert on adults with ADHD and Major Depressive Disorder and Bipolar — an expert on me. My first appointment is now a week or so off. I wonder, which me will she allow me to be?

Are any of them me?

 

Which me is me?

Twelve hours to live

It has been a few days since I last posted. My posts are full of cheer, I didn’t want to post on a bad day. Every word of that last sentence is a lie. 

Posts are desperate pleadings into the void. Posts are prays to the universe to solve my problems, no one else can. Well, a gun can. We don’t own any. We don’t because I’m fucking crazy. 

One of my favorite thoughts is taking that handgun, pushing it to the back of my throat, firing a bullet into my brain stem and painting the white wall behind me. Leaving that wall as my final statement on the value of existence.

At this point I should say that today is a good day. Yes, good. Taking 200mg of Lamictal (Lamotrigine) is a god send. I’ve been at 200mg for a week and a half. 

On Lamictal I never wonder if I’m crashing, I do not fear my mood, I’m not held hostage by self-hate. The most incredible part, it is easy to fend off those bouts of depression. 

Not on Lamictal (Lamotrigine) I try to focus my mind on particular tasks. I’ll try not to think about the pointlessness of existing. Attempting to not dwell on the fact that the bulk of humanity’s only contribution to this earth is our carbon footprint. 

Censorship doesn’t work. Trying to avoid thinking about a topic, frustrating. I get furious with myself. As a thirtyish adult I can’t stop myself from thinking of suicide. And when I attempt to, I preservate on planning my demise. 

During the twelve hours that Lamictal protects me, zero hours are spent fighting my thoughts. Zero. Fucking zero. Those thoughts are gone. Vanished. Absent. Never did I dream such a state possible. It is incredible. I am fully aware that constantly wishing to die is an abnormal thought. My emotions control me but if I could be a bit stronger, maybe I’d stop desiring death.

Knowing that all of those suicidal thoughts aren’t actually me, instead assigning the thought to this disorder, god. Liberation.

Why can’t I have it all the time? I got off work excited to come home and build a computer, all the parts finally had arrived. Around 5:30 frustration set in. By 7:00 I gave up, I felt apathetic towards my new toy. 

I proceed to lay down and hammer out the first few paragraphs of this blog. Then I started crying. It dawned on me that I took Lamictal at 6:37am, the reason the last couple hours were so difficult? I was fending for myself. Battling on my own, the darkest parts of my mind always win.

Do you know the last time I experienced excitement? I don’t. Honestly, no idea. Or joy? Or mild contentment? Or… I started to ball. I missed that feeling of excitement I got to experience just a few hours prior.

Why does my shitty mind need drugs to experience that? It is so neat to be excited about something. It is wonderful to look forward to a task, to desire to do something. None of that has been present in my life for years.

Why do I only get to feel human for twelve hours a day? Yes, I’m greedy. Two weeks ago I needed a break. I was overjoyed by the prospect of day with far too much Adderall because it’d be a day without me fucking tearing myself apart. Now I get twelve hours on a regular basis, at least for the last three days, but that isn’t enough.

It is, I guess. But why don’t I get it all the time? Why do I have to fucking hate my pathetic bitching pointless fat piece of shit self for four or five hours a day? The difference between Lamictal “normal” and non-medicated me has become more stark. I’m clueless as to how I didn’t hang myself three months ago.

This is all still shit. But at least I can take a hand full of sleeping pills in thirty minutes and wake up to twelve hours of, of, of contentment? Well, of not wanting to paint my living room wall with a pistol and the insides of my skull.

Morning can’t come soon enough.

Twelve hours to live