Daily Archives: June 18, 2012

Looking Into a Trileptal Mineshaft

I am pretty glad my psychiatrist’s office now has email capability (though I was getting to know the women who worked at the front desk pretty well over the phone). I just sent my psychiatrist an email about Trileptal, and unless he is able to pull a magic rabbit out of his hat, I am not expecting to continue taking it.

It is one thing to deal with headaches, nausea, dizziness, and fatigue, but I have definitely seen a severe and sudden change in my mood after starting Trileptal.

As a reminder, most people have an improvement in mood stability while taking Trileptal (oxcarbazepine), but I have seen an almost immediate downward shift into depression with cycling 2 or 3 times per day into an irritable/agitated mixed state and back into depression again. By yesterday it was bad enough that I had to take an antipsychotic before bed, and if I had the attention span to write the email out to my psychiatrist last night, I would have.

Obviously the major threat from this sort of mood change is suicidality, but the game changer for me is desperation.

Desperation is like suicidal thinking wrapped in a big bow made of justification.

If I am under a large amount of stress, or in a large amount of pain, desperation can make any form of escape feel justified, and all forms of escape feel welcome. That can mean anything from playing video games for days at a time, to being inebriated for long periods (or more frequently), or even fantasies of self-harm or suicide to escape the immediate situation. With depression it is easier for those fantasies to remain fantasies, but when I cross over into an irritable/agitated place where the negativity of depression lives hand-in-hand with the energy and impulsivity of hypomania (as I have the last few days),

shit gets tricky.

This moment of desperation is the only time I can think of where antipsychotics feel like a good idea, because I find being a zombie preferable to the agony of a mixed episode.

Personally, I find desperation to be one of the most dangerous places a person can be in, because someone who is cornered (in any part of life) is almost always more likely to do something irrational because they believe they have very few options. A wide view narrows to a small tunnel of vision, and a picture with 100 options becomes a picture with 5.

With depression I usually feel lethargic enough to withstand desperation, because giving in would mean doing something and I never quite feel like doing anything while depressed (at least, up to a certain point). I think this is kind of a nice fail-safe, though it really doesn’t feel like it when I’m there. This is something I can feel a bit good about, because I know desperation’s tactics; choose a course of action and take it immediately. 

When it is present, desperation chants repeatedly in my ear, “you have to do something! Do something, do something, do something!”

In the last few days this chant has come and gone like the tide rolling in and out again. This feeling works as something of a clear sign, and it says,

“This stared with the Trileptal…

…do the math.”

So there you have it.

I hope that my doctor will respond quickly and agrees with my reading of this sign, but I do also have a series of mood charts showing the change in behavior/activity and the overview, showing that this is the lowest point of depression I’ve had in three months. How unfortunate.