I don’t know if I believe in demons, but I feel like I’ve been fighting three this week: mania, depression and rapid cycling.
I suspect my low levels of lithium combined with an increase in the amount of Zolft I take has caused a bit of rapid cycling. Within seven days I’ve experienced the high of hypo-mania and lows of depression. Technically, I don’t think I’ve met the DSM IV’s definition of rapid cycling because my hypo-mania didn’t last for at least four days.
For the purposes of this blog, lets just say in the last week my moods have changed more dramatically than Mitt Romney’s stance on political issues.
It all started a few months months ago when I decided to decrease my dose of Lithium from 1200 mg a day to 900 mg a day because I was afraid of dehydration during the ridiculous Kansas summer heat. I ran this past my primary care physician who was all, “Cool, whatever.”
Note to readers: Do not adjust your own doses without consulting an actual psychiatrist. Your primary care physician, pharmacist, or husband is no substitute for your actual psychiatrist. This is true even if your husband is a primary care physician or pharmacist.
When my lithium levels came back low I told my doctor’s nurse that I was comfortable with that and reminded her of the dehydration scare I had experienced the previous summer.
I was, and am, comfortable with 900 mg a day. So comfortable, in fact that four weeks ago I decided to decrease my dosage down to 600 mg a day. Why not? I eventually want to get off of lithium all together so what’s the worst that can happen by tapering down on my own?
Note to readers: DO NOT DO THIS!
For this tweak, I knew better than to tell my husband, who is in fact a pharmacist. I felt fine, better than ever. And that lasted for a couple of weeks. I noticed mood swings that spiraled toward depression two weeks ago. I bounced back from the mini-depressive episode and I as I did my energy increased and my thoughts grew faster.
I brushed off any signs that this could lead to hypo-mania. I am in the midst of a very busy season at my job, so of course I have a constant stream of thoughts, I told my self. If I didn’t things would fall through the cracks.
A week ago Sunday I realized that my rapid thoughts had crossed into the danger zone when I found myself doing dishes, practicing a standup comedy routine and going through my client’s wellness calenders. All of these tasks occurred simultaneously and later two occurred in my head.
“I should really try to get a stand up act going,” I thought. “I’m really funny.”
And that’s when I knew I needed to slow things down.
That night at dinner I asked Logan if I had seemed a bit flighty lately and confessed that I had reduced my dosage of Lithium.
He told me to get back on the dose my doctor had prescribed and I made an appointment with my psychiatrist and therapist the next day.
I have only had one full blown manic episode in my life, but it was in enough to scare me into compliance with my doctor. Anytime I experience anything that I think resembles hypomania or could cause me to become manic I go straight to my therapist and doctor. I can’t risk becoming crazy again, and that humbles me to get help.
Depression, on the other hand, is a demon all its own. And in the darkness of depression I don’t reach out for help as often. I fear that mania would cause me to lose everything I love. But when I’m depressed I don’t feel like I love anything at all. I feel like I have nothing to lose because it’s already gone.
My week that started off so high and full of my grand comedic ambitions ended with me crying my self to sleep, longing for something to numb my pain. This emotional roller coaster is the beast I call rapid cycling.
Sometimes depression reaches a level where you can’t pull yourself out of it, where you can’t even find the strength to get out of bed. I’m not at that level. So I woke up today, took a shower, went to church, and prayed for traveling mercies as I continue on my journey with this disease.
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