Living with treatment resistant bipolar disorder can be really frustrating, not just for me but also for those around me. With symptoms that have responded atypically (either worsening or not resolving and accompanied by outrageous side effects) to the traditional route of pharmaceuticals normally used to treat bipolar disorder I have to shift all of my focus onto using skills to help keep me calm and rational.
Even doing everything I have encountered; things like meditation, dialectical behavioral therapy skills, living openly about my illness and asking for help when I can, paying close attention to my diet, sleep, and exercise, -that bipolar spark in my brain remains elusive and unchecked. Under the right conditions, my big mood shifts can happen in whatever direction they choose and I find myself along for the ride.
Lately I’ve been seeing that frustration growing in my healthcare team. In the last two months I’ve been taking a significant shift into depression, enough that both my therapist and new psychiatrist (of about 6 months) have become edgy. My therapist let slip that, “well you would think something should be helping by now!” and my psychiatrist sat, horror-stricken, when I replied to her question about what we should do about my depression with, “well the past few years nothing has worked so we typically watch and wait, requiring hospitalization as necessary until the episode ends.”
Maybe so, but it is my life. As much as I dislike being subject to frequent mood swings and psychosis I have reached the point of feeling some form of acceptance over my situation. I can’t throw a fit (though sometimes I do) every time a new treatment option doesn’t go my way, but the slightly pissy attitudes of my healthcare team the past few weeks has initiated something of a domino effect kicking people into gear.
On one hand, it feels nice to know that my psychiatrist feels inspired to do everything she can to try to help me. On the other, after a constant barrage of negative outcomes from medication after medication the past few years I am pretty familiar with how it can feel to be a guinea pig. I’m not saying I am opposed to new options, quite the opposite. I want to keep trying, I want to move toward a life that is stable and more functional, I just need to find a balance where I can do that and not have to be pulled along in the wake of each drug that’s had a negative effect without being able to take a break. When psychiatrists take me on it can be easy for them to look at me as a sort of challenge and they feel eager to throw everything at me they can think of right away without giving me time to recover. It has tended to make me both more physically and mentally sick while this is occurring, so it is important that I can balance pursuing new treatment options and living some of the life I am working to improve.
After how hard it was cycling through medications the last go around (2010-2015) I have been floating around using my cognitive skills and sitting tight taking Lithium that isn’t helping. I have actually been doing better without the barrage of new drugs constantly eroding my mental and physical health, so I have just kind of been waiting for the right doctor, or something new to come on the market, or for things to get rough enough to push me back into feeling willing to roll the dice again.
I wouldn’t normally consider my current state of depression severe enough to make me desperate enough to move back into that place of uncertainty, but last week my boyfriend was gone for 8 days and I was really concerned about being home alone that whole time and having the added stress of taking care of our sick dog on my own.
My new psychiatrist is focusing on making tiny changes in medications (hoping that my big reactions to regular doses might be mitigated by tiny doses) and trying things that have a low chance for making my overall health worse.
We started with a huge increase in my fish oil consumption, up to 2400 mg daily of highly concentrated oil (with a bunch of other specific properties I can’t quite recall). I couldn’t tell if it was helping while my boyfriend was out of town, but I didn’t feel worse, so for depression that was causing me to steadily deteriorate that may have been enough to give me a more level playing field last week.
If the fish oil was helping keep me from sliding further into depression, the plan went to hell a little bit when my boyfriend came home from his trip with a broken shoulder. The immediate jump in stress level left me plummeting and I was frantic this week trying to take care of him, and the sick dog, AND me.
I found myself in a situation where I can’t really afford to be screaming at my neighbors or paranoid out of my mind at the grocery store so I called my psychiatrist and agreed to try an antidepressant again.
I tried Zoloft a few years ago in a similar situation and was manic within a couple days. My boyfriend found me feeling high out of my mind in our apartment jumping around uncontrollably and he thankfully had the frame of mind to point out to me that I was acting a little strange.
Naturally, the idea of taking an antidepressant isn’t one I’m too keen on (I’ve had several mixed or manic reactions over the years to them) but I find my psychiatrist’s theory about trying the tiniest little bit to be intriguing, mostly because I’ve had the same thought myself and anytime I’ve brought it up to a doctor before (or my sensitivities to medications) they always just prescribed a regular dose anyway.
Yesterday I tried 1/8 the dosage of Zoloft as I did the first time around. 12.5 mg, half of a 25 mg pill that is so small I keep losing them. I was able to sleep (which is a good sign) so I expect to keep this up and see if anything happens.
In the meantime I’ll be here doing the best I can.