Saturday, August 26, 2006

Mood Watch - 3

I'm back from vacation. In general I had a great time with some terrific people, but about midway through I could begin to feel my spirits slip. It's almost impossible to pinpoint a significant change in mood within a day or two, because it takes time for the pattern to become obvious. But by the weekend I definitely felt out of sorts, and for most of this week I've been so low that I've had little energy or interest in anything.

In some ways I've come to regard such times as no different from having a bad chest cold. You don't beat yourself up about having a cold and you give yourself permission to be ill. But in others I still retain a gut-level feeling that this is something to be ashamed of, or at least hidden discreetly away. It's only now that my spirits are improving that I can nerve myself to compose this post.

Coincidentally I saw my psychiatrist today. I have an appointment with her about every other month, mostly just to manage my medication. There's a small arsenal of meds available to deal with bipolar disorder -- both the underlying illness and its symptoms -- but the two principal ones are 1) a prophylactic against manic episodes (typically lithium carbonate or, in my case, depakote), and 2) an antidepressant, for obvious reasons. The depakote works fine for me but in two decades I've never yet found an antidepressant that did any good. I've tried at least a dozen at various dosages and so far, no dice.

The latest candidate is Lamictal. Like any drug it has potential side effects, the worst of which, in this case, is a horrible death, to wit: "severe and/or life-threatening rashes and hypersensitivity reactions." For that reason you begin by taking a 25-day starter regimen that builds up the dosage very gradually so that if you're one of the unfortunate small minority who develops "skin rash; fever; hives; swelling of the lips, tongue, or face; sores in the mouth or around the eyes; or swollen lymph glands," you can discontinue the drug in time to avert the worst.

The fact that anyone would even fool with this should give some indication of just how bad these depressions can be. Actually, it's not how bad they are per se; it's how unrelenting they are.

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