Just Take Your Medicine
My bipolar depression was getting out of control and I didn’t know anything that could be done about it. Bipolar depression (BPD) is no different than major depressive disorder (MDD) in the way one experiences depression. As one ages, depression becomes the predominant symptom of BPD and it can be very serious. The depressive stage of this disease is a killer of many. But more often it’s a killer of the joy of living.
How to describe depression is difficult, as I can’t imagine there is a word in the language to do it justice. If you have it, you know what I mean. If you don’t, praise all that’s holy and get on with your life.
I guess the closest thing to a description of serious depression is hopelessness. It makes one feel completely hopeless. Not everyone becomes suicidal. Most of us wouldn’t do such a thing if we were in our right minds even a little bit. Most of us don’t want to die — leaving our parents, mate, or children, wondering how we could cause such hurt and damage to them. No, most of us suffer rather than end it and hurt our loved ones. In the midst of depression, maybe we don’t care if we die, but we won’t do anything to cause our own deaths. Sometimes we even wish for death, so the effort it takes for us to live can end. But because we are not insane, only depressed, we do not act upon our wishes.
My own depression had been worsening and the consequence was my inability to do much of anything anything. I couldn’t get up and accomplish the simplest tasks. It was hard to get up to go to the bathroom. Sometimes my presence would be required at my mom’s house or somewhere, and I’d have to get up and dress. Oh, what an onerous task that was. Dressing alone was exhausting and the truth is that I’d worry all day before some necessary outing if I could get up at all. Taking a shower was the worst. I felt a little better once I’d had a shower, but getting myself in there was the catch.
Basically, I felt like a fat, lazy, aching, crying blob and I was already on three antidepressants and an anti anxiety drug.
My anxiety was up most of the spring and summer. I’d been having spells of panic/anxiety shortness of breath so often; if I even thought about my breathing, it suddenly became hard to get air in and out. For 20 years the panic attacks sometime get so bad I have to take clonazepam, and doing that makes me even lazier and more energyless than before. I was having panic attacks much more often than usual.
My arms and legs felt as if they each weighed about two-hundred pounds and I couldn’t use them. Just the effort to lift my arms to wash my hair and face took more strength than I felt I could muster. I had to put a chair in the shower so I could sit down, as it was too difficult to stand for the duration of my shower. My balance is also off when I’m badly depressed. Partially from lack of exercise — but it’s a weird symptom that just seems to go along with my deep depression. I’m always clumsy, but in the depths of depression, I can barely keep my balance to walk.
Some of you may have noticed I haven’t written much lately. The bottomed-out period started early in the spring when my big yellow lab died and just got worse from there. The loss of my constant and loyal companion seemed to trigger it and I just couldn’t snap out of it. It worsened as time went by, despite the fact I was taking my prescribed medicines as directed.
Thankfully, I had my three month appointment for medicine check and, of course, my psychiatrist noticed I was hanging on my last knot and had already fallen dangerously close to the bottom. She suggested I add a dose of aripiprazole (Abilify )to my repertoire of drugs. I was already taking a big dose of Bupropion (Wellbutrin) and Duloxetine (Cymbalta) along with Topomax (better known as “dopamax” for the dumbing down affect it has on most people) and Clonazepam (Klonopin)as needed for anxiety. I’ve never taken Clonazepam daily and I think it would just make me more sluggish and unmotivated. I take about 3–6 tablets per month for extreme panic attacks and breathlessness.
I’m not about to take Aripiprazole!
I thought she was crazy (sorry, Dr. Das) and I think I actually asked if she was familiar with the side effects since I’ve heard them on television commercials. They’re terrifying. And as if I wasn’t already taking enough psych drugs. No, I said, I didn’t want to take Abilify. I’m fat enough and everything I’d ever heard about it included weight gain, usually significant. It also is not recommended, I thought, for old people like me (69 this month). But she said she thought it would help me and urged me to try it. I said okay, but I didn’t intend to take it.
That was back in March, I think.
Then I went back for the 3-month med evaluation at the end of that three months severe depression despite my handsful of antidepressants — and what I’m not taking is nothing compared to how many I’ve tried.
She insisted on giving me a prescription for a tiny dose of Abilify. I checked it with the pharmacist who said it would cost about $178 per month. Damn! Well, I was afraid to take it in the first place, so I didn’t fill the script.
Fast forward to the next evaluation and Dr. Das was gone. I go to a teaching hospital and see psychiatrist-interns working under another psychiatrist until they complete the period — whatever it is. There are advantages to this as they are always up to date on the newest treatments and as the field of psychiatry moves so fast, they seem to have remedies older doctors don’t yet use.
But Abilify? No. Was not going to take it.
The new doctor, Dr. Brett Shaw, wasn’t happy that I had decided not to take a prescribed medicine that he said could potentially help me. I told him it cost too much, and he found a pharmacy that discounts it to just a few dollars and wrote the prescription and sent it to them. Moreover, he reminded me the dosage prescribed was tiny and it was only meant to get my other psych meds working better. Dr. Clovis, his supervisor, came in and said I needed to give Aripiprazole a try. He told me there was a very small likelihood of me experiencing any of the serious side effects on such a small dose. He told me many of his patients had no side effects of all, but that the drug was a kick in the butt to Wellbutrin and Duloxetine and might get them working better for me. He was persuasiveand I decided to fill the prescription.
My doctors also took me off Topomax, which seemed to help slow me down and made it hard to think of the word I wanted to use when I could normally pluck them out of the air by the dozens. He said he calls Topomax, dopomax, because of it’s potential to make people feel drugged and slow. I was glad to be given instructions to quit Topomax. I had always felt it slowed me down and contributed to my depression.
I looked at the side effects on the Aripizole with dread. Oh, me. I did not want to take it even though it was only a tiny 2 mg. But I did. I sure did.
And wow! At first it made my stomach feel just a bit quesy. Not throwing up sick or anything, just sort of unsettled. I decided that was going to have to go away if I was to keep taking it. But at least, I thought, I wouldn’t have to worry about gaining weight, another side effect, since it killed my appetite. Right off the bat I lost a few pounds. They’ve stayed off since I’m on my second month of the drug. I think I’m actually losing more because I am so much more active.
It began lessening my depression almost immediately. I started getting up in the morning and even taking regular showers again. Pretty soon I started painting the staircase I’ve been putting off for three years. Then I got out the “good” vacuum cleaner, the monstrous Rainbow that is a PITA to put together. And I actually used it! Next I noticed all the dust on the surfaces of my home and started dusting. Boy, I liked that dusting. It’s satisfying as hell and I was loving it. The sense of accomplishment and the pleasure of living in a cleaner space helped me continue to rise farther out of the deep depression.
More active; but not mania.
Yes, it could be making me a little manic…but in a good way. I’m only mildly manic — if at all — and by 11 p.m. I’m too tired to stay up all night (like a normal person). The night owl stuff has stopped. I’m not experiencing this as mania. I’m still cautious with money and haven’t gotten a boyfriend or bought a BMW or anything, so I think I’m ok. Even if I am a little manic, it feels so much better than being horribly, hopelessly depressed. If I’m manic, it’s not in the crazy way of the out-of-control mania of BPD. That kind has sabotaged my life so many times that I know it well. This is not that. This is being more active than usual and maybe being more interested in the world around me. It is an end to the agoraphobia I was well on my way to developing.
Even though I said I wouldn’t take Abilify and refused to take it for three months, I’m glad my psychiatrist encouraged me to try it and emphasized the small dose wouldn’t hurt me. It isn’t hurting me any that I can tell, but it is certainly helping me in a myriad of ways.
I still get angry sometimes, but I don’t rage. I still get sad, but I don’t have to go to bed over it. I may talk too fast sometimes, but I don’t have ideas rushing by, bumping into each other that is typical of mania. Those make me into a whirlwind bordering on being a tornado that nevertheless accomplished nothing but chaos.
I urge everyone who battles any kind of mental illness to try what your doctor suggests. There’s not much to be lost by trying it and if I hadn’t, I’d still be in bed about 20 hours a day. My objections to taking it were pretty strong, but I’m grateful I have a psychiatrist persistent enough to get me to take it. I’m enjoying the best mental health I’ve had in years.
Hard to believe it’s due to a tiny little 2 mg pill. But it is. Once again, there’s proof that mental illness is a real organic disease and not a failure of character. It’s as real as diabetes or cancer, and needs to be treated just as urgently. Some conditions even counseling won’t ease enough to allow one to live a full life.
Just take your medicine.
Don’t be like me and spend more months than you must in crippling depression. See your doctor and then, when she prescribes medicine, take it. No arguments or excuses. Just take your medicine. A full life is waiting.