This is Me...This is My Brain on Psychiatric Drugs...Any Questions?

I think a big question that plagues many people who take antidepressants, antipsychotics, and other types of psychiatric drugs is, how much do these drugs change your personality?  And, how much does that matter?

Obviously, if you're taking some sort of mood-altering drug, it's because your mood is interfering with your life, presumably in a negative way.  You're depressed, psychotic, anxious, or have some other undesirable problem that you've sought treatment for.  The only problem is, often times, the drugs you get to help you through the original issue cause other undesirable issues that may or may not be worse than the original problem.  For example, I wrote a few weeks ago about the mountains of Seroquel I'm taking and how they make me blunted and tired.  Add that to my ECT treatment from yesterday, and I've slept the better part of the last day and a half.  I'm lucky I have a babysitter so that I can sleep as much as I need, but I still feel like the world's laziest person.

Another issue I've noticed being on a higher dose of Seroquel in addition to ECT treatments is that I just kind of feel stupid.  My reaction times are slower, I can't think of words or phrases as quickly as I usually do; I can't flesh out ideas like I usually can.  While I don't think I'm a particularly great artist or crafter, I feel like my normal pool of creativity is definitely shallower than it used to be.  When it comes down to it, those things are small prices to pay to be a functioning member of my family and society.  It's more irritating than anything, to have a half-formed idea hanging in your brain and lack the ability to give it structure and substance, but it's irritating, nonetheless.

One last complaint (let's face it, this is just one big rant) I have is that I just don't care about most things.  My weight, cleaning the house, getting out and doing stuff, setting up fun, structured activities for the kids -- I just can't be bothered.  It's as if my mantra is, "Whatever." I did manage to get my girls signed up for ballet and theater classes, and I made the giant step in managing my weight of buying a bunch of Lean Cuisines.  Maybe just the fact that they're in my freezer will rub off on my other food and make all of it low-cal, tasteless and cardboardlike.  I can only hope, because that's about as far as I've got.

Even entertainment-type stuff has less appeal.  I can hardly sit through a whole television show anymore; I just don't care.  I've been reading the same book for three weeks.  And it's a good book!  I just can't get that interested.  Even knitting and crocheting hold less appeal for me; I feel like just about everything I do turns out crappy and I just can't get excited about anything.  I flip through lists of projects in my head and nothing grabs me.  It's so frustrating.

So, to sum up, I'm going through that unavoidable existential crisis that most people who are on mood-altering drugs go through at some point.  If I think, therefore I am, what am I if I think slower, or less sharply?   If I think differently, or less?  If I think, but I just don't care?

ECT Update, and Why I Hate Seroquel

No, I haven't fallen off the face of the earth.  Like most people, I got distracted by Christmas and haven't updated in a little while.  Here's hoping you and yours had a lovely holiday and are getting some much needed rest and relaxation.

I am now in the "maintenance" phase of my ECT treatments.  I finished up my "acute" phase last week on Friday, with my sixth treatment.  Now I'm on to one treatment a week for a month, which is much less of a hassle, especially considering the treatment facility is 40 minutes away.  The bad news, though, is that while I was pretty sure the treatments were helping the first week or two, now I'm not so sure -- I seem to have slipped back into a funk and am generally intolerable to be around.  I'm trying to tell myself that maybe it's just the stress of the holiday (like I wrote last week, it's hard to determine what ups and downs are due to having bipolar disorder and what are due to general life stress).  I hate the thought that I may have to go back to 3 ECT treatments a week for another few weeks to try to stave off a heavier depression, but if I do, so be it.

I'm also tired -- very, very tired.  And I'm not sure if it's a side effect of the ECT, or the increased dosage of Seroquel I'm on.  When I was hospitalized in early December, the doctor increased my Seroquel and decreased my lithium in anticipation of starting ECT treatments, because lithium and ECT don't play well together.  I went from 50 - 75 mgs of Seroquel daily to 450+ mgs daily.  I think it does what it's supposed to do, which is even out my moods and make me a little less irritable and raw -- but it also makes me really sluggish.  Add the ECT treatments (and anesthesia) I'm undergoing, and I'm pretty worthless. 

It's so irritating to me that I have to make a choice between being an ugly-acting, depressed witch and being an exhausted, useless sloth.  I guess I should just be grateful that there are drugs that do help depression (more or less), and just look at the side effects as a small price to pay for the benefits they provide.  But it's still frustrating.  Ultimately, though, there's not much I can do about it -- just hope for a speedy end to the ECT treatments so I can get back up on a therapeutic level of lithium and leave the Seroquel behind.  Here's to hoping!

Back to the point, part 2

In my last post I started detailing the issues I've had during pregnancy with getting mental health care, which is the whole reason I started this blog in the first place.  I will continue the story with this post.

In late October/early November, I went to my general practitioner because my mood had started getting really bad since going off my meds (Seroquel and Lamictal) in August.  After talking to me, -- which involved a lot of crying on my part-- looking at my medical history, and looking at the cuts I had made on my arms, he put me back on a low dose of Seroquel.  For about a week, I felt not great, but functional, but then things continued back on their downhill spiral.  I was crying all the time, just wanting to sleep, having anxiety attacks, and doing a lot of cutting.  I called my GP back and talked to a nurse, who in turn talked to the doctor, who increased my Seroquel dosage. 

The increase in Seroquel didn't seem to make much difference, other than to make me more tired (something not particularly desirable when you're trying to chase a four-year-old and a two-year-old).  I called my ob/gyn's office to see if she could help out at all.  She put me on Vistaril as needed, which is pretty much just an antihistamine but can kind of mellow you out at the same time. Both my ob/gyn and my GP suggested strongly that I see a psychiatrist, but not wanting to go back to my prior psychiatrist, and with nobody recommending a new one, I was sort of at a loss for who to see.  If you've ever tried to get psychiatric help in Dayton, Ohio, you understand what I'm talking about.  There aren't too many psychiatrists, and those that there are often have a 3-6 month waiting list just to schedule an initial appointment.

In early December, after a few more weeks of generally decreasing mood and functionality, I called my family doctor again and the nurse recommended I go to Kettering Behavioral Health Center, a facility located in Centerville (I think) that has both inpatient and outpatient care.  They also offer walk-in assessments.  I drove myself over there and talked to the admitting nurse for about a half hour.  I explained I was about 21 weeks pregnant (in case she couldn't tell), was cutting myself daily, crying all the time, and generally feeling like utter crap.  I was worried that my mood was hurting the baby, and I needed psychiatric help to look over and manage my medications. She asked the $64,000 question:  "Are you suicidal?  Do you have specific plans?"  I told her that I frequently thought about suicide, but didn't have a specific plan to follow.  I thought about taking pills or slitting my wrists, but hadn't written a suicide note or anything.

At this point she assured me that the facility had an ethical responsibility to help me out, since I was a danger to myself and my baby, based on my suicidal thoughts and cutting behavior.  They wouldn't just send me home and tell me good luck.  She asked me to step out while she called the psychiatrist on duty and talked to him about what to do next.  My sense of relief was tangible -- finally, someone was going to help me.

She came out to the waiting room a few minutes later and told me that the psychiatrist wanted to admit me to try to regulate my medications.  I didn't particularly want to be admitted -- it was close to Christmas, and I wanted to be home.  But, I knew I needed help, so I agreed.  She went back to her office to talk to the admissions people to get the process started.

About 15 minutes later, she called me back in to her office.  As it turns out, they couldn't admit me to their facility, because I was more than 20 weeks pregnant, and they didn't have the medical facilities to help me in out in case of a problem (they are not on the same grounds as the actual hospital).  What they could do is prescribe Klonopin for me, a powerful anti-anxiety drug, increase my Seroquel again, and suggest if I was still having problems to either call my old psychiatrist or go to Miami Valley Hospital's ER.

And with that, despite their "ethical obligations," they sent me on my way.

Next post:  a new psychiatrist and the ER.