Sleep: 8 hours! Only woke up twice! (this is unheard of for me; I will get into what changed)
No elevated mood
So, it’s been 2 weeks since my meltdown over my psychiatric care. Since then I’ve met with my therapist twice and with her help was able to come up with a plan.
In my area, I called several IOP facilities, to reasonably explore the option. But, I’ve found out that an IOP dealing with mental health is difficult to come by. They are mostly geared towards substance abuse and overcoming that. I couldn’t find a location to help with my mental health needs.
My therapist was able to refer me to someone within her practice. After a quick 15 minute rundown of my history and current symptoms, she felt confident she could successfully manage my medication, without using IOP. She felt that the medication should not, even under an outpatient program, be tapered up any quicker than what she would do. I was entirely functional and most of my symptoms were recognized by myself only.
Yesterday, I met with her for my initial evaluation. It was long! An hour and a half, to be exact. It is harder than you may think. This is now my fifth time going through this and it’s hard to continue to relive and rehash what happening. It is embarrassing to admit to all the things you did when you were manic. I am still struggling with accepting how I acted during that week. It gets me choked up a bit to think I could be so out of control. But, I need to accept that this is an illness I didn’t know about and therefore could control. I’ve done everything in my power to get better and fight this head on since I have known. This is a chemical imbalance, as real as diabetes or any other disease that isn’t due to something I could control.
Anyway, she went through all my symptoms, asked about overall health and other symptoms and did a complete look at my overall mental health. She ruled out specifically borderline personality disorder and schizoaffective disorder, as those could mimic bipolar. She said that I didn’t have the significant mood changes in an instant back and forth over a short time (like a day) that would come with borderline personality disorder and I didn’t have the psychotic symptoms, like hallucinations and hearing voices, that would come with schizoaffective disorder. From her standpoint, I had a true manic episode and a subsequent depressive episode that is therefore bipolar 1 disorder, due to the length of time of each of this episodes.
My mood fluctuations could be described as slight hypomania, but can easily be attributed to my body balancing out from the new medications and getting to a therapeutic dose to really keep my symptoms at bay.
She felt confident that I can be managed through her and together, we’d work to get my medication cocktail right and therapeutic. She was very into my comfort in doing the changes and what I thought of the medications and what sounded right for my body.
First, we talked about the Lexapro. It is most likely what caused my manic episode. Bipolar disorder was always inside me, manifesting itself in the depression episodes I often felt. But, when I started this anti-depressant, it suppressed the depression so much that it allowed the mania to come and allow me to be diagnosed correctly. I had wondered since being diagnosed why I would still be on this if that’s what caused my manic episode. I was told that I still had depressive symptoms and the Lamictal would keep the mania at bay. She disagreed with this and thought I should taper off the Lexapro. I was more than happy to do that. I will be doing 10mg for one week and then 5mg for another week and then stopping altogether. I wanted to do the withdrawal a bit slower, just so that I could experience as least side effects as possible. She was more than happy to go slower. I should be off it in 2 weeks.
Then, we discussed the Lamictal and the Seroquel. She described that these both would be used for mood stabilizing properties for me. Previously, I was prescribed Seroquel to help with sleep and anxiety, with the added benefit of helping with the mania side of my mood. She recommends doing something altogether for sleep and using Lamictal and Seroquel together for my mood. The Lamictal helps more with the depression side and the Seroquel helps more with the manic side. Together they work well as maintenance drugs; they keep me on a balanced path and lengthen the time between episodes. We are increasing the Lamictal to 100mg starting this weekend. I chose to start on the weekend as last time I was extremely exhausted and think it’s best I let my body get used to it when I can be home. I will stick with the 25mg of Seroquel, though we can revisit that dosage as my other medications stabilize.
Lastly, we discussed my sleeping and how I don’t sleep without taking something. I mentioned I didn’t think the Seroquel was working for that and she didn’t like using it for the purposes of sleep. She started me on a customizable dosage of Hydroxyzine. It is similar to Benadryl, in that it is an antihistamine. However, it is approved for anxiety, as it affects serotonin levels as well. It is often prescribed for its sedative properties for sleep before surgery or anxiety induced insomnia, which is what I have. I can take up to 100mg and I can adjust as I see necessary, in increments of 25 mg. Last night, I took 50mg and it worked so well! To fall asleep at 10AM and only wake up twice during the night, is AMAZING for me. I am looking forward to having this really regulate my sleep and helping wit the anxiety, as I can also take it for my sudden panic attacks.
Given that I felt comfortable with her and the plan we are on, I officially terminated my sessions with my other psychiatrist. She was happy I found someone that is working with me on a more regular scheduled and can regulate my medication. And I am happy too.
I feel as though I’ve been sort of “normal” lately. I’ve been pretty even and calm during most of the day. I think that my confidence is low and that I feel people can see through me and tell something is wrong. It is causing me to take things more personal and having that affect my mood, bringing it down mostly. A little more irritable, a bit defensive in what I’m doing and over justifying myself. I am still adjusting to a lot of changes. Doctors, therapists, medications. It is a lot. So, I know I need to be patient and allow this to play out. Sometimes it just is harder than it sounds. I just want to be like everyone else.
I hope that everyone is sticking in there and finds people that can be their circle. I’ve certain been closed off lately and know that I have ruined some friendships with my behavior during my mania. But I’ve also found so much in knowing I have a rock in my best friend and my boyfriend. A few other friends that wont judge me for what I’m going through. I really hope that people in a similar situation, or any situation, find their group. It might be small, mine sure is, but it truly is the quality in that small group that counts the most!
Anyway, that’s all for my update. Next post will be on my go-to makeup products currently and I’ll follow that up with a post on my Self-Care Sunday routine.
Suicide Prevention Hotline Website: https://suicidepreventionlifeline.org/
Phone Number: 1-800-273-8255
My email is email@example.com.
Who is in your support circle?
Stay well everyone xx