Up, Up, and Away

After making my last post, I worked a 3 pm to 11:30 pm shift at work.  I talked non-stop to my coworkers, in epic oversharing mode.  I clocked out at 11:30 and drove home at 30% over the speed limit.  My excess energy was spilling out of my left hand with its flapping and finger-tapping.  I walked in the house and instantly wanted to leave.  The urge to go wandering took me to Taco Bell, where I went through the drivethrough (something I’m normally anxious about doing).  I came home with my snack and sat down to watch television as I ate.  Hours later I dragged myself into bed, then got up early and went shopping for a sugar binge.

Yesterday the energy dissipated.  I guess it was the crash from all the sugar and caffeine, but I became so physically exhausted that I took a nap before supper, another nap after supper, and then when I finally set the sleep timer on my Fitbit I ended up with over 13 hours of additional sleep.

I walked into Sadie’s office this afternoon and suggested that we skip therapy and go to Dairy Queen for Miracle Treat Day.  She thought at first that I was saying I’d already been, and that’s why I was so hyper.  Then she looked at my diary card and saw all the notes of “skipped Latuda”.  I honestly had no idea that there was an obvious change in my behavior, but she could tell.  She said she was having trouble following what I was saying.  She was ticking off the hypomanic symptoms as I talked.  Concerned, she asked about some things that are often symptoms (drinking, drugs, overspending) and I assured her those things do not happen for me.  Well, maybe a little with the overspending, but I would never get a credit card and go out spending money I don’t have.

I talked about work.  There’s a potential change coming up that I think may not be the best idea (or at least I think not all the consequences have been considered).  I had e-mailed Joan, the employment specialist, for advice on how to present these thoughts to my supervisor and instead of helping she discouraged me from saying anything.  Sadie pointed out “goal-oriented behavior” and I think she was just being polite when she failed to mention “grandiose”.

She asked me about my usual mood cycles.  All she has seen is the okay-to-severely-depressed range, so she really has no idea what it’s like to experience my mood being way up.  I tried to explain that there are multiple overlapping cycles, but the one that is most independent from external triggers is the alternating months of hypomania and depression.  I can still see these cycles taking place despite medication.  The moods have been less extreme lately, but I still notice things like irritability, grandiosity, and lack of insight.  Hearing that it tends to alternate months had her concerned, especially when I said that my next appointment with Brent isn’t due until mid-September.  In that case, it’s likely I’m going to crash into depression before seeing him.  She said she’d be notifying him of the fact that I’d stopped taking the Latuda, and encouraged me to schedule an appointment as soon as possible.

She said she was worried, and for the first time ever I believed she meant that.  I didn’t have that voice in my head arguing that she has to pretend she cares.  I felt like she actually did.  She said she doesn’t want me to end up back in inpatient, and doesn’t think Brent would want that either.  I can third that sentiment.  I do not want to jeopardize the job that I’m finally starting to like.

I scheduled the appointment with Brent on the way out of Sadie’s office.  The first available appointment was exactly 2 weeks away, down to the minute.  I can’t decide what to do in the meantime.  I can continue skipping the Latuda, so it will be up to 3 weeks without it by the time I see him.  I can take it as prescribed and go to bed super early and sleep long hours and be less motivated again.  I can take it right before bed, so it will be about half as effective and maybe that will be tolerable enough.  I don’t want to take it.  I love the way I’ve been feeling, but I’m also really scared of how things could go bad fast.

I came home and asked mom if she had noticed anything odd about me in the past week.  It took until I confessed to skipping the Latuda – and explained why – that she mentioned noticing that I was sleeping less.  So now she’s worried, but not totally understanding of the situation.  She wanted to know what good it would do to see Brent, since it’s not like he can force me to take the Latuda.  Um, no, but he can change my medication to something that might be an improvement.  Even if he’s determined to go with the atypical antipsychotics, there are plenty of choices that don’t require 350 calories and thus could be taken right before bed, which may diminish the horrible feeling of losing half my life to sedation.  I think I’d be fine with a very small dose of whatever he chooses – just enough to keep me from going totally off the rails.

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