medicated

Yesterday I admitted it. I said out loud that I am not doing well. I told my psychiatrist, on a call at 7 AM. We had talked a few weeks ago, and he said my mood had drastically changed since then. I told him I had been lying, hiding from the truth, the reality of my darkness.

He prescribed me a new medication. I have not been on an antidepressant in years, about three and a half to be exact. When I was diagnosed with bipolar, I was told I could no longer take SSRIs, for the increase in serotonin could lead to a manic episode. Before the bipolar diagnosis, I had been on SSRIs for seven years. I tried many different dosages of both Prozac and Lexapro. They worked for those seven years, or at least I thought they did.

My old psych was, well, old. His name was Dr. McReynolds, and I never felt we clicked. First of all, he came from a different generation than me, perhaps two before me. Once I was “stable” we would have fifteen minute appointments every few months ago. I was part of the psychiatric machine. Doctors pump out as many patients as possible in a day, prescribing medications willy nilly, to get as many and the highest paychecks possible.

I never thought Dr. McReynolds listened to me. In fact I know he did not. Often times he forgot the details of my life, those that were important to prescribing me the right medication that would end the long time suffering I had been subjected to by my own mind. When I was diagnosed with major depressive disorder, it made sense. I recently asked my new psych and new therapist how they knew the diagnosis was true. Is psychiatry not just one big guessing game? Dr. P, my new psych, did not appreciate this, but conceded that there was some guessing to be done.

After my first manic episode, when my life came crashing down beneath and over me, we knew it was time to switch doctors. I do not know how we find Dr. P, but I attribute to him the saving of my life. The first time we met, we were scheduled for a forty five minute appointment. I ended up staying around two hours. I sat in his office, spewing such nonsense that he could not even follow my story. Bipolar he said, textbook symptoms. He was the one who emphasized the dangers of SSRIs.

That day I was prescribed a mood stabilizer, Lamotrogine. A drug that would keep the highs from being too high, and the lows from being too low. While it did make me feel better, my mind was still racing far too fast. He added an anti psychotic called Vraylar on top. Something that scared me, but also thrilled me. I was delusional enough to enjoy the idea of being psychotic, to enjoy that I was “crazy.”

I have only been on these two medications since January of 2020. I take Xanax and a sedative called Trazodone occasionally, when needed. Or I do now. At the beginning, I could not sleep with out them. Granted I pushed for the Xanax prescription, telling him I had tried it with my friends and it felt like it worked. I would pass out so hard that I would awake in the night unable to feel my whole left side. I enjoyed sleeping like this, a total relief from everything. Just darkness and rest.

In the beginning of 2021, I started to abuse the Xanax. Taking it when I went out became regular. It was fun to get so fucked up that my legs became noodles and my mind became mush. I pushed the limits of what was safe and what was not. But quickly it became no fun. I began making a fool of myself, but having no recollection of these totally embarrassing moments. The story of my recreational drug use is for another time, but I stopped taking the Xanax almost entirely. I still take it on planes and occasionally when I cannot sleep, but for the most part I cut it out of my life.

In the past year, I have played with the dosages of the anti psychotic and mood stabilizer. I have solely increased them, as my mind drifted and the previous dosages were not enough. I have had a manic leaning brain since the first manic episode, often going through short hypomanic states.

I felt comfortable on these meds, they were what I had known for years. That was until this bout of depression started. After confessing to my psychiatrist that I felt like I was drowning, he offered Wellbutrin, an anti depressant that is not an SSRI (not actually sure what class of drug it is lol.) As I said earlier, SSRIs can be dangerous in patients with bipolar, because they increase the possibility of a manic episode.

Dr. P said most of his bipolar patients take Wellbutrin. He had never prescribed it to me, because since he met me, I had only been showing signs of mania. I was hesitant at first; adding another drug felt overwhelming. Was my mind just in one big chemically altered state? Am I not able to control my thoughts, feelings, emotions, on my own? But, I surrendered, unable to bear the thought of feeling like this anymore.

I did some research on Wellbutrin, and found that it is also used for smoking cessation. I have a nasty nicotine addiction, and was excited at the prospect of something making me quit. When I told my therapist this, she laughed. “You have to have the intent to quit, you have to be trying. It won’t just work like magic.” This I have found to be true, since on my third week, my nicotine usage has not waned one bit.

I started writing this right after I started the Wellbutrin. I still wasn’t feeling any better. Dr. P said I would feel some energy return pretty quickly, which I did in the first few days. By now, my mood has shifted almost completely. I have not cried in a week, whereas I was crying multiple times a day before that. My parents have even noticed an elevation in my mood.

It’s too soon to say I am feeling good, but it is safe to say I am feeling better. I still feel weird about being on so many different medications, but as I have been told a million times, if it was a physical problem, I would have no qualms taking the drugs. One day, when I am in a place where my life isn’t constantly uncertain and changing, I’ll work on getting off of them. But for now, a chemically stable brain it is.