Apartment Shopping, Hay Fever, and Antipsychotics

It’s that time again in Madison, time to shop for apartments. And that’s about all I have been doing in the past two days is looking at different apartments. I saw 12 in one day and over all nearly 25. It’s a lot of walking and the weather hasn’t been the greatest for it either. All wet and now slightly cold. Cold, that is, by comparison to the 85 degree heat we had previously. Thankfully though, that is all settled and the time to fill out applications is at hand. We have two, one we want and a backup, so we should be good no matter what. Hurray.

The other difficulty that has arisen is very early hay fever. I’ve been sluggish and feeling slightly ill for a few days now and it never really occurred to me that it was allergies. It wasn’t until today, where I slept in late and did nothing all day that I suddenly started sneezing after leaving the house. Allergy season has arrived and it’s not that pleasant. But, this is different from past years. Before, I used to pretty much get sick with allergies. My nose would run all the time and I would be completely out of it. When they say “fever” it’s very much like one. However, this year all that it’s done is made me sneeze, given me a small headache, and made me lethargic. My allergies have seemingly disappeared for all intents and purposes. This also goes for my dog allergies and my cat allergies (and I used to be very allergic to cats). They just vanished into thin air.

There’s a very good reason for this. Antipsychotics. Most antipsychotics, like seroquel, rispridone, abilify, and zyprexa, all act in some way on the histamine receptors, primarily H1 receptors (although some act on more). This often causes them to make you sleepy, just like benadryl does, but it’s the same mechanism of action for every antihistamine out there. This includes claritin and zyrtec. Everything acts on that receptor as its mechanism. So, while zyprexa is clearing the hallucinations from my mind, it’s also doing a fairly good job on taking care of my allergies. Actually, it’s better than just about anything else I’ve taken, far better than claritin and it’s a good margin better than zyrtec. I still have allergies, but a little sneezing and lethargy is better than being completely out of the game.

With all that said, since I’m definitely going to get hits by people who have allergies, I wouldn’t recommend taking an antipsychotic for allergies. For starters, seroquel and risperidone will knock you out cold, as in, you can’t walk after taking them until you adapt to it. And abilify, while everyone has their own experiences, it’s a drug that has a lot of phases and none of them are very pleasant. It took me a solid 5 weeks to fully adapt to it. Then there’s zyprexa. Which is fast acting, short half life, and can remove your emotions very quickly. It has the power, even at low doses, to stop a full psychotic episode in its tracks within 2 hours. I also know that there is a growing market for antipsychotics on a lot of off label uses, but these are heavy duty drugs that do a lot more than just attack your allergies. They can really mess you up and I fight tooth and nail with my psychiatrist every time she wants to raise my dose of zyprexa. I’m content with it being at 2.5mg, but not happy. It’s a necessary evil in my life that I would easily give up and go back to having allergies. The only reason that I’m thrilled is because I have to be on this drug, so it’s a perk that I get to enjoy.

Trending Up!

Oh boy, it’s coming, my secondary cycle is kicking in and it’s on the rise. I think I’ve written about this before, but I have a primary cycle, which is several days long and can be lengthened by some antipsychotics like abilify, and then I have a secondary cycle on top of all of that. My secondary cycle controls just how low the lows get and how high the highs get. It’s like taking a sine wave and shifting it up and down. Also, if my primary cycle is short, like it is now, then my secondary cycle will be over a month or two, but if it is longer, then the secondary cycle is longer. I don’t know how common this is, and it took a solid 3 months of mood journaling to detect it, but it’s there for me. And in keeping with my normal mood cycle returning, I guess it’s time for my secondary cycle to kick in.

Now, looking back, I see that I was in a low dip among other things and my primary cycle just never got that high. I didn’t get the giddy hypomanic states. I only got a few productive days here and there. But that’s all changing. Last night I could not sit still or stop talking. I had far too much energy for my own good. It’s the highest I’ve been in quite a while. It also fit into the way that I usually start to become hypomanic for days; first I’m up for half a day and then it keeps growing in duration.

I’m keeping an eye out though. Though a hypomania feels like a breath of fresh air, I have to make sure that it doesn’t get out of hand. So I’m keeping with my rhythm and making sure I get 8 hours of sleep and eating properly. I’m also making a very concerted effort to take time to calm down and do chores as needed. If a place gets too messy, I start to go full manic and clean everything. I’ve also had the fortunate chance to kill my caffeine intake by running out of coffee beans and switching to tea. I’m also staying away from bookstores. Bookstores are deadly areas for buying tons of books I don’t need. And once I get that high from buying something, I’ll buy another thing, and another… you wouldn’t believe how many books I’ve bought in a day. Finally, alcohol is going away. I’ve been letting myself get a little more lax with drinking 2 drinks over the course of an entire evening. No more. I have only two Kalamazoo Stouts left and those are getting paced out because if I’m manic, I’ll drink a rugby player under the table (and have done so).

Obviously, I’m doing this so I don’t provoke a mania. I’m on a heap of lithium (1800mg) with a blood level of 1.24 mmol/L, but I’m not going to bet that it’ll work 100% of the time. I need to do my end to and try to keep the triggers to a minimum. It’s going to be hard, I already am salivating over buying books to read, but I’m stopping it this time. Despite this, I still expect to trend upwards and reach several days of hypomania. That’s fine, and welcome. Hopefully, if I can keep it contained to some extent, I can channel this into some creative work and reading. Something that is impossible if I get too loopy.

Off Zyprexa… Emotions Are Full Force

Zyprexa has by now been completely eliminated from my system. What it’s done is bring back my emotional states. It’s nice to finally feel sad and happy again, also enjoy things or despise things. It’s been really interesting that even negative emotions are at the same time interesting and I’m curious about how they feel.

For instance, last night I found out that I didn’t get into a food co op that I had previously been a member of. It brought back a lot of feelings of rejection and loneliness. I felt friendless and a little betrayed. After my parents went to bed, I couldn’t hold it in any longer and I started tearing up and felt awful. I wanted a beer. But at the same time, I didn’t want to numb the pain at all. I cried on my birthday, but it was this odd crying without a really sad emotional state supporting it. Now I finally had an emotional state that I lacked for a long time. I was entirely curious about it. Part of me didn’t want to shut it off, but wanted to experience it.

And that desire to experience emotion has crept into every facet of my life. I feel emotions from everything and I love music that produces actual changes in my emotions. It doesn’t really matter what emotion it is, it just matters that I emote. I’m in love with experiencing moods again. Another curious aspect is that the emotions feel more intense than I ever remember them being. It’s almost difficult to concentrate at times because it is so intense. I’m going to make a guess and say that it’s from not experiencing emotional states for the better part of a month and now I’m hypersensitive to them. That would explain the curiosity and the intensity.

The only down side is that I feel naive about emotions. I haven’t had to deal with them for a while. And now that they’re so intense, I feel that I don’t know what to do with them. I don’t know how fast they should change, or how sensitive they should be. I also don’t know if I will stay in this hypersensitive state indefinitely. I’m not adverse to that, the world just feels beautiful and wondrous right now. And it’s not even a manic state, I’m inclined to keep this and I’ll learn how to deal with the emotions later as I experience more of them.

But any which way it’s sliced, the result is a peculiar side effect. I would have never guessed that this would have happened. Yet, it did and I’m not sorry for it. It’s wonderful to experience the hight of my moods again. I’ve missed them terribly. I don’t know how I went without them for so long and didn’t notice them. This drug holiday has given me back so much of what I’ve missed. It’s incredible. It’s probably the best decision that I’ve made all year.

Thinking back, I spent the better part of last year on antipsychotics. Numbing me to my emotional states. I now wonder what sort of damage abilify did to them. I was kind flat on that compared to this. And so long as the random suicidal ideation stays away, along with the suspicious thinking and paranoia, I’m not going on antipsychotics unless I must. And that would only be for psychotic episodes. As terrifying as they are, I’m banking on lithium to control the moods and prevent those blackened manias from happening again. But even if I have one here or there, I think I’ll take them in exchange for having my emotions back. This decision is bolstered by the fact that I know that I have an antipsychotic combo waiting to take care of any psychotic moods. And that’s in keeping with the interesting way that my psychiatrist is handling depressions as well. That’s a whole different piece though, I’ll probably write one up later.

Happy Holidays!

The Incredible Journey of Going Off Zyprexa

It’s time for an incredible journey of going off of zyprexa after being overmedicated on it!

I’ll catch up new readers first. So you can skip this paragraph if you want. But the basics are that I was medicated at 10mg of zyprexa and that turned out to have disastrous side effects. One of which, a big one, was akathisia, which is a form of restlessness. The second one I only recently discovered, which was flattened affect. In terms of restlessness, it means that you constantly need to move about. I couldn’t sit still for long without getting up or just twitching, it drove me nuts. Flattened affect means that I experience no ups or downs of any kind. Life is unenjoyable and boring. What this did to me was prevent me from really recharging from relaxing. The boredom and twitchiness just wore me down more and more.

And today is my first day on 5mg after lowering the dose and switching to taking it at night. The results have been incredible. I slept very well after switching it to night. But the today has been much different than normal. On the good news front, my concentration is coming back. It’s been glorious to be able to read for an hour straight without zoning out or forgetting what was just read. And I enjoy it. It’s been too long for my memory since I last enjoyed reading. And this morning, I was able to really deeply reflect on my medication situation. I felt sad afterwards. But now that I’ve swung around, I’ve realized that I haven’t felt sad either. My emotions are back. And this will probably only get better as the serum level keeps dropping over the next few days. I must have been right at the cusp because early morning me was feeling flattened, but as today has progressed I’ve become more like my old self.

I also have been able to recharge emotionally. Which has been sadly lacking since I first attempted my mental health holiday. I thought I was going to relax and maybe that would get me back to normal, but it hasn’t until the zyprexa was tapered off that I started feeling better. I must metabolize zyprexa like there’s not tomorrow to see these side effects.

It might seem strange that these changes can happen so quickly, but zyprexa has a half life of 30 hours on average. This is different from another drug that I was on, Abilify, which has a half life of 74-90 hours. Seeing such a rapid response, I’m inclined to think that I probably metabolize it a little quicker than average.

That’s the good news. The bad news is that there is some withdrawal that I’m noticing. I’ve got some weakness in the legs going on. They shake when exercising like I have low blood sugar. I’ve got muscle weakness in general if my exercise regimin is accurate. I also have hot flashes and cannot find a good temperature to work in. It is either too hot to be comfortable or too cold. So while the need to move is gone, it has been replaced be a need to shift to get warmer or colder. But this is easily managed with layering.

The journey of going off of zyprexa is hardly over, but the second day off seems to show that I was just at the edge of being over medicated. And now that I have part of myself back, it’s just in time for an interview at a food co op (not a job, but for membership).

Do I Like Being Medicated?

I thought I’d touch on something today that I’ve heard from my girlfriend. She has accused me of liking medication and being medicated. I believe that what she means is that I rely on medication to take care of everything and don’t just ride the wave of my emotions.

To some extent, I think that she has a point. I dive head first into every new medication, allowing my doctors to ramp up my dose if needed, and I get impatient when it takes too long. I’m also diving head first into a pool of drugs that have some rather unpleasant side effects. With lamictal, there was a risk (a small one) of developing a deadly rash, and going off of it risks seizure if it is done too quickly. Antipsychotics have some of the most powerful side effects that I’ve come across. Seroquel introduced me to my first psychotic symptoms. Risperidone and Seroquel knocked me out every night (which I’m sure she wasn’t thrilled about), abilify required me to go to my parents to wade through the symptoms. And all of the above decreased my sex drive. Now I’m on lithium and zyprexa, risking my kidneys and thyroid and needing monthly blood tests, also there are extra pyramidal side effects that might arise from the zyprexa. Right now I have akathisia from it. So for the past year I’ve been dealing with side effects of one sort or another in addition to bipolar disorder. And I keep going back to the well of pharmaceuticals for more.

So she has a point, I do seem to embrace pharmaceuticals very readily. And her accusation is really born out of wanting the person she knew before my depression and diagnosis of bipolar disorder. I know how she feels, I want the old me back too.

What she sees is a person who has been medicated to the teeth and someone who was better before the medication. I survived for years without medication and was fun loving and out going. But now that I’m medicated, all that I’ve done is become worse. It must be incredibly frustrating on her part to see me sink down further and further, all while medicated. And it would definitely seem that medication isn’t working for me if I continually got worse while on it.

If I could go back, I’d change some of what I did. I would have ridden the bipolar wave. At the time, I didn’t exhibit psychotic symptoms and I shouldn’t have been on so many medications. I should have waited to develop psychotic symptoms to present before going on antipsychotics. My summer would have probably been a lot better if I wasn’t dealing with seroquel and risperidone. But I was looking to get rid of my symptoms and go back in time to before the depression. I was also trying to hold down the rapid cycling, but I probably could have made it through that.

But on the other side of that, I now know that I have dysphoric manias with psychotic symptoms. I probably wouldn’t be on zyprexa and getting over it so quickly. I would have done the seroquel/risperidone first and discovered they didn’t work, letting the mania progress further. I also would have been inpatient without risperidone sedating the hell out of me when I was suicidal and rapid cycling every few minutes after being kicked out of the co op. I also know that I can’t ride the bipolar wave any more, it ends in psychosis.

So I’m not sure what to say to her, she’s right and she’s wrong. I embraced medication when I shouldn’t have, but if I didn’t I’d be a world of hurt right now. I would be trading off medications that didn’t work and waiting until I get to zyprexa. So I made some mistakes along the way in aggressively pursuing medication that I might not need, and probably wouldn’t recommend anyone else do the same as I did. I just turned out to be incredibly lucky in needing the heavier medication.

And now I’m also with a doctor who is far less free with with medication. My new goal with Dr. M is to only be on lithium and maybe add back in lamictal if depressions get too bad or add back in zyprexa if I start to experience psychotic episodes again. It’s getting back to square one because I’ve been so medicated through this past episode that it’s hard to tell where normal is. So in that respect, my girlfriend is right, I’ve been over medicated recently and embraced every drug as a way out of the episode. But I’m taking some of her advice along with my doctor’s approach, I’m getting back to a minimal drug plan to find the new normal for me. Because now, I’m not nearly as terrified of the diagnosis and I have an arsenal that I can fall back on in case things get rough. And hopefully, my new normal is like the old me.

Losing My Mind a Second at a Time

The title says it all, I’m supposed to start feeling normal, but all I am is bored. Boredom like I’ve never experienced it before. I’m not buzzing about with energy, but I’m starting to get the hang of the lithium dip in my day. The key has been to exercise in the mornings, then I only have about 30-45 minutes of drowsiness. Today, it was an hour long walk to get my blood tests. I think I forgot my medication last night, so they might be botched. Great. But if not, then I’ll hear how things are going tomorrow when I see Dr. M.

But in the mean time, I’m bored. Very very bored. Everything is boring. I pick up something, read it for 20 minutes, and then get distracted. I’m looking for that hyper focus that I can get from time to time. The one where I just lock in and unload all my mental batteries on a subject ready to be devoured. But instead, I’m just getting nothing. I was able to lock into two books by Phillip K Dick, but that’s partly because of how readable he is. The one by Nabakov, I liked, but I don’t remember much. I don’t remember much of anything from any of the novels. My brain is swirling around in my head with no proper short term memory.

I think that it’s the abilify that’s doing some of the leg work, but it’s also occurred to me, maybe this is how I am when stabilized. A highly distractible bored individual. And it’s not just distractibility in terms of subject matters that I’m reading. I have a hard time following conversations. I’m like a ping pong ball being bounced around and can’t remember where I started at. I’m also zoning out after about 10-20 minutes in any subject. I can’t even properly read comic books anymore because I just zone out after picking it up. I’m a bored, zoned out zombie. And getting all the details right in my head is also next to impossible. I was bad with details before all this began, but now I can’t get the details right to save my life.

It’s just entirely frustrating to feel my mind not working properly. It’s always been a battle for the details and attention, but now it is 5 times worse. I don’t know what’s wrong with me. I’ll need Dr. M’s advice on what might be the problem. I hope it isn’t lithium, it was one of the last drugs they hadn’t put me on. And I can’t double up on zyprexa with another antipsychotic, zyprexa seems to be stabilizing me. In fact, out of this whole ordeal, I feel very normal in terms of my mood. There is no up or down, day or night. I’m flat. I should be rejoicing. But instead, I have done next to nothing because I can’t seem to be what ever I need to be to find things interesting.

It’s also not purgatory, the mood where it’s neither here nor there nor up or down. One where you spend your existence craving for some sort of emotional state. No, I rather like the flatlined me in some respect, it’s just boring. I honestly cannot take this waiting-for-something-interesting state of being. Maybe it’s the emotional fall out of pushing so hard for so long that my mind doesn’t know what to do in a normal state of mind. Or maybe it’s the aftermath of weeks of stress and suicidal ideation that has finally settled. It could be any number of things doing this to me and that’s driving me even crazier thinking about it because I simply don’t know and I hate not knowing.

So I guess the moral of this post is that I’m bored, I don’t know why, I’ve tried everything from reading to playing music and nothing holds my attention long enough. Even writing this post is an odd exercise where I’ll start a sentence and stop half way through without knowing what should come next. Editing this will be right out, so I apologize if it’s disconnected and rambling. But by now you get the picture, I’m very very bored and find nothing of interest in the world. Somehow though, I don’t want to kill myself.