Medication Vacation

11 days ago I had an appointment with Brent.  I expressed my urge to quit taking Latuda.  He seemed alarmed and asked if I was still agreeable to taking it.  I said yes, because none of the alternatives will be any better.  He asked if I thought anything needed changed and I said, “I can’t think of anything that will help” (unspoken bit: “that you’ll be willing to do”) and he made no changes and told me to come back in 2 months.

I came home and wrote pages in my journal about how miserable it is to only have lows now.  A few days later I turned it into a letter to Brent, and had a receptionist put it in his mailbox.  I guess I hoped he’d have someone call and set up another appointment so we could sort things out, but I haven’t heard anything.  The letter:

Dear Brent,

At my last appointment you commented that Latuda “levels out the peaks and valleys”. It reminded me of a song from Next to Normal, a musical about a woman with bipolar disorder. From the lyrics: “But I miss the mountains / I miss the dizzy heights / all the manic, magic days / and the dark depressing nights”. All I have left are valleys. They may not always be as deep as they used to be, but I feel like I range from apathetic to depressed.

I used to have good times to sustain me through the bad ones. Sometimes I got to be full of energy and creativity and joy. Sometimes I got to accomplish things like learning a whole programming language in 2 weeks. Sometimes I got to start half a dozen knitting projects and actually finish a few, as opposed to starting one and not being finished a year later.

When I was first diagnosed with bipolar disorder, my best friend said she had always thought of me as a bubbly person who happened to get depressed sometimes. She never thought of the peaks as pathological. I know they are, but I never realized that every bit of the energy, creativity, and motivation was just a symptom of hypomania and would be erased with medication. I thought some of it was part of my personality. It turns out I really am just an anxious, paranoid, pessimist who can’t find enjoyment in anything.

I can think of things that ought to be fun, but either I manage to do them and don’t really have fun, or I can’t motivate myself to do them in the first place. On the rare occasions I do have fun, I can’t seem to sustain the feeling.

Things don’t look so bad from the outside. I’m doing my job and being praised for doing it well. I’m doing my minimum required household chores. I manage to shower and style my hair and put on makeup before I leave home. I show up for group and individual therapy, and any other appointments I schedule. I even agree to go along with my mom to things I don’t really feel like going to. I’m not on the brink of suicide.

However, I don’t really know how long I can live this way. At least when I was severely depressed I knew medication should be able to help and that I should have hope. Now I don’t see any hope for things ever feeling good again. Like the song says, I miss the mountains. I know going off medication is not an option, but it’s always going to be a temptation.

At the same time, I often think my diagnosis is one giant mistake. My mother accused me of telling everyone exactly what they needed to hear to make that diagnosis, as though anything I said was untrue. It’s not, and yet I still feel like a fraud. Like my experiences weren’t really outside the realm of normal, and that anyone who really has bipolar would laugh me out of the room. I know this is a case of past events not looking so bad after getting some distance, but it certainly doesn’t help me want to take my medication.

Regards,

Donna

After dropping off this letter, I still couldn’t stop dwelling on how much I hate taking the Latuda.  I should point out that I took it for about 4 months, complained about how it made me feel and switched to Abilify, then after a few months I started taking the leftover Latuda without permission.  I talked it over with Brent and we switched back to the Latuda.  I was accepting of the side effects of having to go to bed early and sleep half of every day.  I thought the fact that I felt better during the other 12 hours was worth losing half of my time to sleep.

Now I just want to be hypomanic again, just for a while.  I want to feel joy, to remind myself that things aren’t always all bad.  5 days ago I skipped the Latuda one night.  Not only could I stay up late, but I felt motivated again.  So I kept skipping it, and I feel great.  Next time I see Sadie it will be a whole week of Latuda I’ve missed, and I’m dreading the part where she sees that noted on my diary card.  I’ve even thought about lying on the diary card so she won’t know and won’t be able to tattle to Brent.  Then I realized it’s not something I can keep a secret forever.  What happens in 2 months when I’m due to see Brent again?  Can I really pretend I’m still following his instructions?

I know I’m doing the wrong thing.  I texted with a friend while this was still just in the thinking stage and she was trying to convince me that I’ll get used to my new baseline mood and experience joy again.  She tried to convince me that I do have creativity that is not all part of the hypomania.  She told me she’d gone off meds several times and it twice landed her in the hospital.  I just can’t seem to make myself do what I know is right, because this feels so much better than I’ve felt in a long time.

I’m engaging in my hobbies again.  I’m communicating more with others.  I’m reading more books more effectively.  I feel excited about my job and ready to go above and beyond the call of duty.  How can Brent possibly think that keeping me slightly depressed is fine so long as I don’t off myself?  There has to be a better way.

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4 thoughts on “Medication Vacation

  1. That’s awful to feel that way, when I was only being treated for depression, those meds made me lose every ounce of creativity. After the bp2 diagnosis and med change, my pdoc is being careful about not overmedicating because she said it’s important that bp patients don’t lose that aspect of themselves.

    Like

    • After skipping the Latuda for a week, I found that it was doing something useful. Maybe the dose is just too high. I agreed to see the psych APRN as soon as I can get in (not until August 13th) and discuss options, and I have tentatively agreed to take the Latuda right before bed. Even if it’s less effective that way, it should keep me from getting too manic. *fingers crossed* But I can’t promise I will take it every day…2 weeks is a long time.

      I don’t know what the solution is. Lower the dose? Switch to a different AAP? Switch to an anticonvulsant mood stabilizer? I feel like the psych APRN won’t like any of the options.

      Liked by 1 person

  2. Pingback: Blog Award Extravaganza | Strong Enough to Break

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