Saturday, January 2, 2010

Breakthrough Depression

Earlier this week, I struggled with some breakthrough depression.  It lasted about 3 days, but in that time, it laid me pretty low.  I didn't want to get out of bed.  Were it not for the fact I had to take my Aunt somewhere, I would have stayed there.  I only started feeling better yesterday.  It's a strange thing to have happen.  Everything is going along status quo, and then out of the blue, BAM!  You're on your ass.  I guess that's just how strong mental illness is.  Not even modern chemistry can completely control it.

It frightens me to think that one day, that could just happen and stay that way.  My medication could just stop working altogether.  It happens.  Then again, it could just keep working.  I am comforted by my therapist's story.  As I have mentioned before, he is bipolar and has been episode free for 25 years.  He has been on the same medication for the entire time.

Rather than looking at the episode I had in a negative light, I am seeing it differently.  Many people with "controlled" bipolar still have cycling symptoms.  These are the people who keep mood charts.  I've read about it, but never quite understood why they kept them.  I've read about people who kept mood journals, and how the illness was very predictable so they knew when they were about to have a down day and how to plan for it.  It seemed so alien to me.  Well, looking at it now I realize it's because my moods are stable.  I don't vary widely in how I feel from one day to the next, one week to the next, etc.  I can be easily irritated sometimes, but that doesn't mean I woke up irritable (it usually is a cumulative thing).  I don't have days where I'm extra buoyant, and aside from the aberrant depression I had earlier this week, nor do I have days where I am just blue or down in the dumps.  Sundays produce some anxiety for me, but I know why that happens.  So, it stands to reason that my mood stabilizers are doing their job.  (Ya think, genius?)  I guess this is successful treatment on one level and I just never saw it.

The depression has been tricky.  It's been stubborn and hard to lift, as anyone who has read this blog for more than a post or two knows.  I had a really good day last week where I actually felt happy.  Yesterday, I was out of that sudden depressed state, and guess what?  I felt happy again.  This morning, I feel pretty fucking good, too.  I swear if I wasn't already crazy, this illness would drive me nuts.  It makes no sense.

When I got sick, my family was upset and concerned for me.  I agreed to let them call Dr. Tween.  I didn't want to feel that way any more than they wanted me to feel that way.  Since I see her this coming Friday, normally I would have just toughed it out until I saw her.   This time, I acquiesed but did not speak to her.  She told my husband that she was considering changing one of my anti-depressants to Cymbalta or Effexor.  I am not interested in taking either.  I researched both, and there are side effects with one or the other that I don't want to risk experiencing.  I've only been at the current dose of Wellbutrin for 30 days, so maybe I just haven't given it enough time.  I don't know.  I do know that I haven't been doing as much as I can for myself, as much as I should be doing for myself.  I need to do that before I move on to something else.  I can't solely rely on medication--no matter which medication it is--or it will never happen.

So, while I am not a "Resolutioner" as I mentioned in my last post, I do have to create a new structure for myself.  I am cheered at the prospect of building one because order and predictability are a bipolar person's best friend.  I feel good. I feel strong enough to devise and implement a solid plan.  The kids go back to school next week, so my normal routine will be back in place.  That should also help me stay on board.  Setting up a schedule is going to feel a lot like making a resolution.  It has that fresh start appeal; all the excitement of a new beginning.  Then again, I always have had a weakness for a blank piece of paper, too.  I like new stuff.  I think that's a bipolar thing.  Anyway, just because it feels like a resolution doesn't mean it IS one.  What am I obsessing about, anyhow?  Nobody gives a shit whether or not I've made a resolution!  They aren't thinking about me.  They're probably too busy trying to achieve their own resolutions.

So, my mood is stable overall.  In the grand scheme of things, I started feeling, and right now feel, better than I did before the depressive episode.  I feel better than not sad.  I feel reasonably happy.  I think between the medication and a full routine/solid structure, I will achieve the level of mental well-being for which we have been aiming.  That's what I'm telling Dr. Tween, anyway.