Archive for the ‘ meds ’ Category

The Freelancer’s Margaritaville

Day One of my unemployment. I’m freelance, working usually 7 weeks to 6 months at a stretch. Then it’s out into the jungle again to look for work. It’s exhausting, and has made me wonder whether I was smart when I chose my profession. Back then I didn’t know this bipolar time bomb lay in wait for me. It came late, which caused me to question its authenticity, but of course there have been enough stacks of examples, reams of examples of my bipolar behavior published in the family scrapbook of everyones’ familial memory. Most of which I’d love to erase.

So — now this blog is being given over not to just one guy’s occasional posts that get a little abstract, annoying and pretentious, but to a periodical on my job hunt and how it toys with my little different mind.

I’m already up to 2 milligrams of klonopin, and it’s only 1:00pm. Margaritaville!

Depression without sadness

Once again, doing nothing with myself. I think I’m depressed. Not emotionally, but intellectually. I’m apathetic, deeply apathetic. Is it possible to be depressed without the emotional component? For me, it’s all about getting something done – I’m off work this week, and rather than starting a staycation, I’m sitting around, staring at the computer, doing nothing. I should be writing, reading, watching good movies and TV, going out to explore the city, but I’m not. I don’t want to do any of those things, and I nearly don’t care if I don’t. The couch calls out to me for naps. I wake up early, raring to go – but go where, and do what then? Motivation is something the meds do not provide. They’ve got my sadness, loneliness, hopelessness covered very well. Those horrible emotions are squashed. But the get up and go? Nowhere, nothing.

I think real depression, the keep-you-in-bed-weeping kind, when it leaves, leaves you with some bad habits of mind. In my case, it’s a torpor. My previous therapist could only say, “just do it,” not realizing that he was quoting the Nike ads. He almost uttered the phrase, “baby steps.” I could tell he wanted to say it.

I know what the solution is. Take on one small project per day, give myself a gold star for doing it, then move on to the next day, and the next, and before I know it, I’ll be moving and doing. But the initial inertia is so difficult, the habit of mind so ingrained, I don’t care about making the first step.

Perhaps a sunny self-help book? First, I gotta get up the motivation to go to the book store and read the fucking thing…

I Fought the Law

My grandmother was an irritable, chain smoking, sleeping pill popper until she died. My mother and her two sisters are on at least one anti-depressant each, maybe one or two of the anti-psychotics thrown in there too. My father’s side had a true-life hermit (my great-uncle) who lived off the land in Louisiana’s Mississippi swamps. My father is beginning to resemble a hermit himself, though not a hoarding hermit, PTL. Am I trying to stitch together a pro-medication flag to fly over this blog?

Yes. You so rarely hear someone talk about what they’re taking (when they’re not close friends), but in fact we have progressed to the point, at least, of admitting in a vague way that taking anti-depressants, anti-anxiety and anti-psychotic medication helps many people avoid terrible plights — or helps to avoid becoming hermits vying with nature every day instead of interacting with other human beings.

I’ve been off and on anti-depressants for about 10 years now, and during roughly half that time I was a miserable wreck. Wrong pills. I wasted a lot of time and money on Effexor and Paxil back when one of my old docs thought I had garden variety depression. Right before I stopped seeing him, he suggested I might be bipolar. My next doctor put me on the Effexor, which made me a little manic and was hell discontinuing (I had the brain zaps intensely for six months, and still will have one every once in a while, like a bad acid flashback). She too suggested bipolar right before I left her. A pattern? Maybe they were trying to hang onto a client (fodder for another post on another day, the dread feeling that they’re just trying to maintain their client list) by offering me a “sexier” diagnosis.

After Dr. Effexor I went cold turkey on medications and therapy for about a year and a half, and started spiraling three months into the experiment. I did not make the connection between discontinuing therapy and meds and my swinging moods, so strong was the feeling that they were a natural part of my life. I thought of myself as fucked up, but not in need of medication because nothing had helped before. I’d taken one anti-psychotic briefly — Geodon — but it made me fall asleep on the subway and tempted me to lie down anywhere (on the sidewalk, why not?) for a little nap.

I was fighting the law that states that those with mental illness must get on some pills, pronto. There’s no talking cure in the world that’ll break through the genetics, neurochemical imbalances and just plain crazy of bipolar. Others disagree, but they protest too much, don’t you think? They’re often like people who brag about not owning a TV. Get over yourselves and take a little something to make the crazy go away. Stop fighting nature so damn hard, like a hermit in the swamps, and come back to civilization.

I believe kids are over medicated, but the rest of the population is under medicated. That psycho boss, partner, mother? Medicate them. My grandfather’s grief over my grandmother’s death that lasted years and reduced him to a shell of a person? Well, he should have been medicated because that was grief turned psychotic.

I finally knew I had to see a doctor when the spirals got so bad that I experienced them in the mornings, too. One morning I looked out my kitchen window and saw, hanging on the next-door neighbors covered patio, two or three plastic clothes hangers. Suddenly and without any prior rumination on this, I was hammered with sadness. I mourned the fact that I could not turn the prosaic vision of those clothes hangers into art, the way, say, Andy Warhol would have done. The thought burst in like a message from God, no ignoring it. And so, before breakfast, I was comparing myself to Warhol and crying. I believe I had to skip work that day. I skipped a few days during that season of crazy, putting truth to the statistic that mental illness causes decreased worker productivity.

Then the paranoia started. People were talking about me. When someone on the street looked at me, it was because they were reading my mind and seeing how miserably crazy I was. Talk about no privacy. I was deathly afraid of seeing my reflection. Like a reverse vampire, I saw my refection everywhere: glass fronts of buildings, shiny metal street vendor carts, and those hellish restaurants that think that putting mirrors up all over the place is chic, or at least makes the place look larger. And don’t even talk to me about getting my hair cut. I still hate it, sitting in front of a mirror and being pressured into making small talk. The craziest thing about the reflection situation is that I was often wrong; it wasn’t me I was terrified of seeing — many times it was just some dude walking or standing next to me. When the vague reflection in a car window moved independently of me I was thoroughly relieved to know it had not been me. I wanted to disappear.

I found another doctor, a guy with a heavy hand on the prescription pad, and my life has taken off since then. I started with Abilify to snuff out the paranoia, then moved up slowly to 300 milligrams of Lamictal (more on what that was like in a later post). Wellbutrin — check. Celexa, most recently. So, a slew of pills, each with its own little job to do, like brain elves. They have not disappointed.

Tongue-tied and witless

Bipolar seems to have this way of robbing you, when you’re not manic, of decent conversational skills. One day you’re doing fine, talking to everyone you know, having a fucking ball, then the next you’re barely able to smile when you’re supposed to. The people around you get that particular rhythm in their conversation — they pause, ever so imperceptibly, for something from you. And of course it never comes from you, because it can’t come from you because you’re feeling like this, so incapable of speech.

My doctor calls it self-censorship, but I think he’s wrong again and think it’s something deeper. I think there’s a biological component to this lack of speech; verbal portions of the brain are shut down during depressive bipolar attacks. People talking circles around you, stunning you not so much with their wit as with their capacity to access phrases, and even words, at the right time and pace. No amount of milligrams seems to have protected me against this deficit. This is where the drugs have let me down the most.

Tweaking the medications?

How do you know what’s working is working in the highest degree possible? You can’t know absolutely that the medication you’re taking for major depression or bipolar disorder is the best for you, and that drives me nuts. Whenever I’m feeling better — right now, for instance — I tend to get greedy: But I could be feeling so much better than this, I reason. Because getting better always involves a gaining of perspective, it invariably follows that, getting better, you look around yourself, see the devastation that the disease has caused, and think, I have to run from this as fast as possible. That’s when you start questioning your medication choices. Are they doing enough? How happy am I supposed to be? What’s my baseline? Am I getting better quickly enough to gain some ground, to gain some momentum to get me over the next hurdle? Because getting better isn’t good enough. What’s well? Greedy thoughts again. It can only be measured by time, how much time you get to feel better. Quality of life questions come into play — is my life so much better than when I was depressed, or am I just fooling myself into feeling better about things? I tend to forget about stressful questions, like how I’m going to do my taxes now that I’ve set myself up as an LLC, and just begin to float, so thankful that I’ve Gotten Better. It’s like a vacation: don’t bother me with the tricky stuff, I’m feeling better and I’m going to hold onto this sensation for as long as possible. Sensation. That’s what it feels like, like a strange sensation, a rare emotion, this smoothness of mood, and I’m so sensitive to it that it only takes a good morning to make me think — hope — that it’s going to be the way I’m going to feel for the rest of my life, or at least for the rest of the day. And I start to wonder, again, is this the best I can possibly be? I make resolutions, plans, for how to maximize my time feeling this way. I’m going to start this and that good habit, I’m going to be like a better person from now on, I’m going to show myself a better time. Better and better. I suppose this is hypomania expressing itself again, or I’ve drunk just the right amount of coffee this morning, who can tell? I just want more. Now I’m thinking that I should be more self-sufficient. Wait — that’s not the word. I’m just thinking that I shouldn’t be mentally challenged, mentally ill, whatever you want to call it. I’m just tired of it, so I’m not going to be that way today. I’m going to be well today, and get some work done and be happy, or at least normal, average, level, sane.

Targeted medication

An interesting thought from McManamy:


All our current psychiatric meds are the result of serendipitous discovery, based on old technologies. They get some of the people somewhat better some of the time, and we have no idea why. The drug industry made vast sums of money essentially putting old pills in new bottles. That era is just about over.

The new era would involve finding the precise illness pathways that cause specific mental illness symptoms and figuring out which gene variations are involved. Forget about a treatment for all of depression. Rather, it might be more productive to uncover the underlying mechanisms to, say, lack of motivation. Maybe only a small percentage of depressions involve lack of motivation. But maybe such a drug would get a lot of these people a lot better a lot of the time.

I wonder whether this dovetails with brain enhancement drugs such as Progivil and Adderall, because those two drugs certainly treat “lack of motivation,” although not sustainably. In any case, an intriguing idea about the future of medication. I suspect, however, that we’ll remain in the Dark Ages of “serendipitous discovery” for a little while longer…

“Coffee is a great power in my life; I have observed its effects on an epic scale.”

So begins Balzac’s “The Pleasures and Pains of Coffee,” a brilliant essay on coffee consumption – consumption working in both directions, against boredom and sloth and against the user’s stomach and ability to leave the house.

Highly recommended reading for the bipolar who still hasn’t quit the bean.

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Clonazepam dangers? Anti-Anxiety Drugs Raise New Fears

This from the blog Bipolarblast


Drug addicts can be made..they need not seek…they only have to find YOU who tell them the drugs are safe.

This is in response to an article in The Washington Post:


Critics say benzodiazepines are broadly over-prescribed and can have serious side effects. Some patients find themselves on high dosages after a few years because their bodies need more of the drug to get the same effect, according to health experts.


Unfortunately, there’s not a single mention of actual dosage amounts in the article. What are “high dosages?” 2 milligrams per day? 10 milligrams? Or does the dose intensity depend on the patient, in which case only a patient’s retelling of the experience of taking the drug can help determine whether the dose is high or not.


John Steinberg, a physician and former medical director of the chemical dependency program at the Greater Baltimore Medical Center, estimates that 10 to 20 percent of those taking the drugs for extended periods will have problems with dose escalation and physical dependence. “For a serious side effect, that’s a fairly large, significant number,” he said. “It is, after all, a devastating and debilitating adverse effect for those who experience it.”

Increasing the dose is clearly the doctor’s purview, but the patient bears some responsibility in the matter. Facts on benzos are just a Google search away. Increasing the dose to get the same effect is a massive warning sign that something’s going wrong, and the treatment should take a turn for the better. The problem, in addition to doctors who don’t seem to care how much of a particular benzo their patient is taking, seems to lie with the patients’ ignorance of the drugs they are taking. Today, it is beholden on all people to do research on their own for every drug they are prescribed.

Again, from the Washington Post:


Robert DuPont, former director of the National Institute on Drug Abuse, who has written several books on addiction and anxiety and maintains a psychiatric practice in Rockville, said the drugs are widely successful in treating panic and anxiety. He said that 90 percent of his patients have no difficulty taking the medicine, and those with problems are most likely to be people who’ve had issues with addiction in the past.

“The typical patient that I see with anxiety is taking [benzodiazepines] well within the green-light zone,” he said. Addiction is an entirely different issue, having to do with a person “essentially falling in love with a chemical high,” he said. “For those people, they’re booze in the form of a pill.”

Again, it comes down to the patient being honest with themselves and with their doctors. Correct dosage of benzos relies almost entirely on a patient’s ability to understand what the drug is doing for them. Is it knocking them out hard, blurring out the world and making all their anxieties go away? Then the dose may be too high. Is it helping in some small way while the patient keeps in mind the addictive qualities of the drug? Then things will be all right.

Research the drugs you take. I wish every patient taking meds for psychiatric illnesses had the opportunity or the knowledge to do their own research. These are still the dark ages, and P-docs are shooting their arrows in that dark. They don’t know what dose will work until the patient tells them so, and of course doctors who are not the best will leave you on the pills so long as they seem to be working and YOU continue to say they’re working. Addiction to medication is a two-way street, to use a tired old cliche, and it’s time patients took greater control of their mood-altering drugs.

Pristiq – Awesome name for newish med

It’s my understanding that this is just an altered form of Effexor that doesn’t require slow titration up. I just needed to post a link to the site, which is awesome in both its name and the wind-up doll metaphor. Puppets, dolls, wooden blocks… we all feel that way from time to time! Er, dPicture 1.pngon’t we?

Free Clonazepam

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I am nowhere near the top of Google’s results for the search for “clonazepam,” yet that’s the search term that sends me all my (meagre) traffic. Where are people finding this link? How many pages of Google results must they be paging through to find this page?

It’s the post called “A little something” and it’s burning up the charts, relatively speaking. I get at least a couple of hits on that post per day. Lot of people out there looking for clonazepam. Go to a doctor, that’s the easiest way, people.