Friday, May 29, 2009

Hormones & the medication issue

Vickie asked on my last post whatever happened with my meds. She observed that I seem to be going up & down a lot. And she's right. I am going up & down a lot. I thought rather than just posting a response to her blog, I'd write a post here b/c I want all y'alls feedback.

So here's the recent history with my meds. I had gone up to 300 mg of wellbutrin last winter when my SAD kicked in. Turns out, that's a dose that causes severe anxiety in some people, & I am one of those people. My doctor knew exactly why I was so anxious 2 months after upping my dose, & I was relieved I wasn't suffering from a more significant mental issue.

I got off the 300 mg, started lexapro, took that for a week, the anxiety went away, but then I freaked myself out by reading story after story online about people gaining weight on lexapro. And I slapped myself upside the head and went "DOH!" (my favorite Homer Simpson quote). I gain weight on lexapro. & so I asked myself, What the hell am I doing taking it again?!

So I called my doctor & spoke with the nurse & said I'm stopping the lexapro, starting wellbutrin 150 again, and they were fine with it. I didn't have any withdrawal symptoms. & I started feeling much better, pretty quickly. It didn't hurt that it was mid-March by then and the sun was showing up more & more often.

And before you suggest or ask, yes I have a SAD light. No, I do not make time to sit under it every morning in the winter. Yes, I know I need to. No, unfortunately I do not have room at my cubicle to bring it to work. Yes, I know it sounds like I'm making excuses. Yes, I will try to do better next winter & get up earlier & sit under the darn thing.

OK. Moving on.

If you've been reading me long you can probably guess from my word choices today that I'm feeling better. Much much better. Much much much better. In a mere span of 2 days.

I do track my moods & when I'm feeling bad/better, on the spreadsheet that I have been tracking everything on for the past two years--my weight, my exercise, my running miles, my periods, my moods, my family's illnesses, my family's crises, holidays, birthdays, binges, successes, new diets started or stopped, you name it, it's on my spreadsheet.

And what I know very well about myself is that I am severely hit by hormones when I ovulate. & again right before I start my period. The ovulation hormone swing is much much worse, & usually lasts 3-5 days. I often go from feeling completely normal to being in the pit of despair (cue the Albino from "The Princess Bride") within 24 hours. It. Sucks.

My husband asked me Wednesday what was wrong with me. He'd been asking me since Sunday if I was okay. I kept telling him I was fine. He's pretty tuned in to my emotional frequency & can tell when there's something wrong. I finally just told him Wednesday it's my hormones. He asked a question along the lines that Vickie did--do I need medicine for this?

Honestly, I don't know. I don't know what the doctor would put me on to fix it, without me gaining weight. I refuse to take any antidepressants other than wellbutrin. I know for a fact my body gains weight when I'm on anything but wellbutrin, & trust me, a 40 pound weight gain would make me depressed & hormonal 30 days a month instead of a mere 5.

I don't think I need anything resembling a bipolar disorder med. I don't go into severe highs or lows. I'm not detailing the kitchen sink when I feel good; I'm not stuck in bed immobile when I'm down. Plus, I hear those can cause weight gain too. Again, completely 100% not an option.

I have xanax for when things are unbearable. I take xanax every day when I'm hormonal. It gives me a nice mellow feeling when the kids or my husband or the cat and/or dog are driving me insane. I'm sure there is more than one mom out there who has xanax to thank for not ending up on the Evening News.

I exercise when I'm hormonal. It helps, but it is by no means a cure. I feel better during & immediately after, but the emotional malaise creeps back quickly. Exercise endorphins must have a short half-life.

I have never been an even-keel person. I've always had emotional ups & downs, even as a kid I remember being very happy some days, very sad others. My mom is an even-keel person; she wouldn't know a mood swing if it bit her in the ass. My dad, on the other hand, has a history of depression & bad moods (& good moods, where he spends money on things he can't afford, & gets depressed again--this was a common theme in my childhood). I know what even-keel looks like; I know I get my brain functionality honestly.

Perhaps I do have a touch of bipolar disorder. I don't know. And if I didn't already have (literally) tens of thousands of dollars in medical costs already for me, my husband, & my daughter, I might go to a psychologist & find out. But, for now, I'm not willing to spend the time or money. I guess you could say the pain is not great enough for me to fix it. I will, someday, perhaps work on it. It's not that I think I'm not worth it--I am. It's that I'm, well, like many people, just doing the best I can with what I have.

So, that's the long drawn out story of my hormones. I don't have an answer, other than I know the feelings are temporary, & I do the best I can to maneuver through them.

I have a sneaking suspicion I am far from alone in this hormonal disorder. & I'm wondering if it will get worse as I get older. Probably. It seems most things do.

Thank God I have this free therapy called blogging.
In specific weight-related news--Who'd have thunk it, calorie counting works. I started logging my food 2 days ago (this is day 3) & already I'm down 2.4 pounds (a lot of water weight, but still). Totally old-schooling it--paper journal & a pen & a calculator (b/c I can't add up all those numbers in my head... I was an English Lit major, you know, & I don't do numbers.)
After Vickie called me on the carpet with her wise, tough-love comment, I looked online & found some information about bipolar disorder that doesn't have mania associated with it. There's a lot to read, & I've bookmarked the page. But at first blush, it looks like Vickie could be right. Shit. I need to go see a psychiatrist. I just wrote this long post rationalizing how I didn't need to see one. Oh well. No more burying my head in the sand. As Cindy says, more will be revealed.


Vickie said...

PsychiaTRIST is what you need to square your meds - and it would not take much $$$ if it is a good one - because you would only be there for meds - not for talk help.

And I think it is silly not to go - because all this is impacting your family and yourself.

You are just saying that you don't want to go and don't want to spend the $$$ because it is YOU. If it were any of the 3 of them - you would take them if they needed it. AND YOU NEED IT.

When I started with mine, he saw me once a month for the first few months and now it is once a quarter. Could be twice a year if I wanted - but I don't - I need the security of once a quarter.

And it probably is some form of bipolar - you just have a middle of the road swing - not a huge swing from up and down.

I think it is best for every single one of us on any psych meds to get them through a psychiatrist and NEVER a GP - because it is just too complex a diagnosis.

And I am very glad you are charting - good idea.

Helen said...

I'm not an expert on anti-depressants as the only one I've ever personally taken was wellbutrin when I was quitting smoking. Lots of people have trouble with it, but I didn't. In fact, I kept my weight down beautifully while on it...only started to gain when I went off it. (I'm not saying that to scare you -- we are all very individual and react differently to different meds.) I have plenty of friends (including my sister) who struggle with depression and the meds that constantly seem to need changing. From my experience with them, I know it is totally worth the time and money to get them balanced. Hope you get to see a psychiatrist soon. ;-)

Vickie said...

There are a lot of them here - but the one I see - is said - by ALL - to be the best - so literally - when we started asking around - everyone said HIM.

And I will call HIM Monday and see if he knows a very good one in your area.

You already have a lot of the work done - because you know ones that do NOT work.

And I am not on an antiD - I am on a med that was originally for epilepsy and then found to help with bipolar. I do not have typical bipolar - but respond to this medication well. I am still on a very low dose - and he sees no immediate need to increase. He said I am NOT someone that should be on multiples - because I react strongly (remember it took 6-7 tries and I had side effects to all of them).

it can take two-three years to get people on the right conbination - he straightened me out in less than a year.

And it straightened out other weird things that I thought were non-related - but it turned out somehow were related. And my sleep too.

Vickie said...

If you do not need a referal for your insurance - there is no need to go through your doctor IF you think he will argue or hassle you about this.

debby said...

Hey, Laura. I'm definitely not an expert in this area. But I would say a couple of things. Why wouldn't you take the xanax more freely when you need it if it helps? And second, I am not a huge believer in psych stuff, and I have thought in the past that bipolar was an over-used diagnosis. But the longer I am around, the more I can see it in quite a few people, sometimes to a very mild extent, so much so that it could just be part of being 'normal' whatever that is. I do think that there are so many drugs out there, that it is unneeded for anyone to spend time being in pain, either mentally or physically.

In other words, I think I agree with Vickie!

And this should be covered under your health insurance, shouldn't it?

Jill said...

I think Vickie may be right. And if you already have a gazillion dollars in medical bills, a couple hundred more aren't going to make much difference. Go see someone - take care of YOU! :)

Jodie said...

Thanks for this post. It's great that you're journaling everything...that really helps figure out triggers, if there are any.

Lexapro was the best for me, but your right, the weight gain sucks. I'm back on Welbutrin now, as well, only because we want to try for another baby soon, and lexapro isn't on the good list.

Hopefully the summer will help out. that and getting your training set up...something to get you focused on yourself, plus the exercise always helps.

Thanks - like always - for trusting us with your personal information...we want you to be happy.

Have a great weekend, girl.

Heather said...

hormones are definitely tricky. I turn into a nasty crazy person right before TOM. There is nothing I can do to stop it and I hate it, but I just have to live with it and try not to destroy anyone in my path who pisses me off even a little bit.

congrats on your loss! thats the good thing about sticking to something - it always works.