The trouble with some illnesses, such as bipolar disorder, is that the medications and dosages required to keep you well can change over time.
Finding the correct dosage can be tricky and when you do find that magic prescription you certainly don’t want to mess with it.
From my experience with bipolar disorder every psychiatrist has his or her own opinion about what medications work best and how you need to tapper off of, or alter, medications as needed.
I have been seeing a resident psychiatrist. Every visit I would see the resident and the he would tell me his thoughts on my medication and then an attending physician would come in and tell me what he or she thought. Most visits I would have the same resident, but the attending, who had the final say on my treatment plan, always changed. And so did my treatment plan. This became worrisome when I decided that I wanted to get off of my medications to try and conceive.
Some docs prefer a more conservative approach while others shrug off the idea of getting off my meds for pregnancy as no biggie. Typically the doctors I saw who were more easy going about getting off my meds were new male residents.
I knew I needed to find an experienced psychiatrists who was female. I thought I female doctor would take my concerns about pregnancy more serious than a male doctor. I realize just how sexists that sounds. And I acknowledge it is in fact sexists.
I’m okay with my sexism because I know that a female doctor works best for me. Trying to have a baby is a complex, emotional issue. Particularly if you have health problems that stand in the way. I admire people who can just get pregnant on a whim without thought to how it will play out. I am not one of those women. Even if I didn’t have bipolar disorder I would not be one of those women. It’s just not my personality.
For over seven years I relied solely on lithium to manage my moods. It worked great, but a several months ago my anxiety and depression seemed to need more than lithium. I got on 50 mg of Zoloft, which seemed to do the trick for a while.
After a few months on the 50 mg, my depression started to creep back and seemed to be even worse than before. I felt on edge at work and drained when I came home, crying at the drop of a hat.
The resident I saw during this bout increased my dose of Zoloft to 100 mg. This complemented the 900 mg of lithium I took daily.
The extra Zoloft made me feel happy, really happy. Soon I felt elated and decided that I should get off the antidepressant. After all, it would be one less thing to worry about when I decided to get off all of my medications to conceive.
I tapered off of the Zoloft in about week. A day after my last dosage, I felt amazing. My therapist classified me as hypomanic but warned me that coming off of the Zoloft could have side effects.
Two days later my mental state completely collapsed. Nothing could motivate me and I couldn’t stop crying. It seemed as though I had dove head first into a deep depression.
After only three days of this depressive state I found myself in a dry heave style of crying. I had put out calls to my doctor, but they weren’t returned. I decided to go back on the Zolft at 50 mg (and get another doctor).
Within a day I felt like myself again, not depressed or elated, just myself.
I never realized what dramatic impacts such subtle shifts in my medications can cause. Now that I am back to myself I’m hesitant to change my medications again. I know I will have to before I can conceive, but I will never again take for granted the power of these pills.
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