Daily Archives: February 6, 2015

Concluding Hormonal Treatment; Pushing the Bipolar Button

My second jaunt down Hormone Road this week ended relatively the same as the first (two-three weeks ago). By day six I was experiencing so much anhedonia I couldn’t eat or sleep. I had become completely engulfed in a tidal wave of pointlessness and self harm fantasies, so much so I could be seen walking up and down the street in the rain like a zombie, frowning for no real apparent reason.

Honestly, I pretty much expected this (since it already happened once two weeks ago) but I was holding on to some faint hope that I might be able to avoid surgery for the odd and still somewhat unknown abdominal problems I have developed. I’ve never had surgery (well, just a wisdom tooth extraction), and never even stitches, so the idea of anyone slicing me open (even a little slice) makes me exceedingly nervous.

Despite my inability to talk with the nurse over the phone in a polite or straightforward manner I am pretty proud of myself. She suggested I see the surgeon the same day I was calling to let her know about my reaction to the hormones, but somewhere in the back of my mind a little voice reminded me that I couldn’t figure out how to use the shower the day before (the same shower I have been using for the last six moths). If I couldn’t figure out how to make hot water come out of a tap (with only two options, left and right) it might not be the best idea for me to talk with a surgeon and make important decisions about the most invasive procedure I will have ever had up to this point. I told her it would be better to meet with him next week, and I am glad I did because it would be another 24 hours before I could smile for the first time in days.

One thing I have found relatively interesting from this whole hormonal excursion is that the first round (on a higher dosage of hormones; desogen) triggered an extremely agitated mixed state where I was depressed, but also very aggressive (not unlike my experiences triggered by corticosteroids). The second round (lower dosage, microgestin) provided a straight-up triggering of intense hopeless depression. Even after I stopped taking the drug (after waking up completely depressed) the depression worsened for 48 hours before the symptoms began to recede.

As usual, I feel compelled to point out that my body (for whatever reason) has become extremely sensitive to pretty much any and all medications I’ve tried, usually with some very poor results. Though it is probably not typical for people to have these sorts of reactions to hormones, it irks me somewhat that most bloggers and internet articles have now taken the stance that hormones never cause mood issues. Of course, this was also the stance of the first nurse who ever gave me hormonal birth control (when I was 18) -which promptly landed me in a psychiatric facility because of a sudden intense mixed episode.

Do hormones cause people to have mood problems? Maybe not most people, but I believe that anyone making broad sweeping generalizations about how safe and effective a treatment is (hormones never cause mood problems, vitamin supplements never cause side effects) are usually trying to sell you something. The truth is that even though hormones might not cause mood problems in most people, nobody ever mentioned them potentially triggering episodes for people who already have abnormally behaving moods.

Frankly, going into this second round of hormones I guessed (with probably 90% certainty) that I would not be able to tolerate them. This guess was not based on anything I read on the internet, but based on my own experience with hormonal treatments I previously encountered (prior hospitalizations, prior depression triggered by hormones, etc.). Having tried a multitude of medications in the past few years (and finding myself reacting to them in unusual ways) has taught me that the best thing anyone can do when starting a new kind of treatment is pay attention. Get to know what is typical for you; a typical headache, a typical bipolar episode, even your typical aches and pains. Without knowing how my body and mind normally act, it becomes incredibly confusing and maddening trying to discern side effects from the normal mood cycles I experience.

And most of all? Don’t forget about your doctor. If something is feeling off, or if I feel much more miserable more quickly than I normally would (like this week)… that’s when it is time to say something. I know that I tend to get incredibly anxious about contacting my doctors after starting a new treatment because I don’t want to appear to be a hypochondriac, but working with people I trust has meant that they also trust my judgment, and I know they want the best for me.

As frightening as surgery sounds to me, after 7-8 months of extreme pain I am ready for this issue to be addressed… and if hormones are not going to be the way to do that, I am ready to take whatever steps I need to in order to improve this situation. Though I can rule out episodes triggered by hormonal therapies at this point, the pain I have been experiencing is significant enough to trigger episodes as well. In the end, all of the healthcare I have been seeking is ultimately tied to improving my mental health as well, less pain -> less stress/distress -> more sleep -> more stable mood. I am hoping that if I can get my body to a relatively happy place, my mind might follow suit.