I have an appointment with a new psychiatrist tomorrow. I’m nervous about this. The last time I saw a psychiatrist was about eight months ago. He was a complete asshole who pronounced me borderline, histrionic, and narcissistic after watching through a two-way mirror as a medical student interviewed me for about forty minutes and only speaking briefly with me himself. (By the way, the last mental health professionals who had dealt with me, who saw me nearly every day for seven weeks, had said that I definitely do not have any personality disorders.)

When I asked him why he thought I probably had these three personality disorders, he said it was because I showed no emotion whatsoever and denied the fact that I even had emotions. This is patently untrue, as I am pretty much the exact opposite. (And although I also don’t have histrionic personality disorder, I’d still like to point out that “shows no emotions” certainly doesn’t describe a histrionic, either.) He said that he could tell I had personality disorders because I didn’t talk about my feelings, just about things like the dates that certain things happened to me, and about every medications I had ever taken and at what dosages. Um, the reason I was talking about those things was that I was answering the questions the med student asked me. I thought a lot of them were tedious myself and I would have preferred to talk about other things, so why the hell was he basing my diagnosis on his dislike of the student’s interviewing style?

He didn’t have access to my previous files, in which my diagnosis of bipolar disorder is confirmed by multiple doctors, but I’m sure it would have made no difference to him if he had.

He also said some other bizarre things, like that I should tell my mother that I hate her. I don’t hate her, so I don’t know what purpose that would serve, but when I asked him why I should tell her I hate her, all he would say was that I should tell her I hate her and he wouldn’t give me any actual reason. He said that it wouldn’t kill her or anything if I told her I hated her, and I said, “Yeah, I know that. I’ve gotten angry at my mother plenty of times and it didn’t kill her, but I don’t see why I should tell her I hate her when I don’t.”

Who died and made him Freud?

He said that the best thing for me would be “fairness focused therapy” or something like that. I don’t remember the exact term, but it involved the words “fairness” and “therapy.” I haven’t really done extensive searching on the topic, but I have tried doing some Google searches and some journal searches, and as of yet, I have seen nothing that would indicate that this particular type of therapy even exists, let alone that it would be the best treatment for me. He told me I should go to some “fairness” program at the hospital three times a week, and when I asked if it were possible for a person to attend that program and still hold down a job, he seemed to think this was a completely unimportant consideration, despite the fact that I was stable at the time and there was nothing else that would prevent me from working.

So I figured he could fuck off and die. I didn’t say that to him, though. I was polite and decided never to go back to that hospital again because whatever crazy shit he must have written about me in my chart would totally bias anybody there against me.

I am seeing a shrink elsewhere tomorrow, not at the hospital, but you can see why I’m nervous. At least I think I’m seeing a shrink. My GP referred me to a shrink and I’ve got an appointment at a mental health centre, but I don’t know if I actually get to see the shrink tomorrow or if I see a social worker first or what.

In addition to being mega-nervous about this appointment in general, I’m also worried about my recent eating-disordered behaviour. To the best of my knowledge, I’ve never been officially diagnosed with an eating disorder. This is mainly because I am — okay, I want to say “a big fat liar,” but that is so not appropriate here. Let’s just say that I’m a liar, okay? And a really good, sneaky, convincing one, as far as eating disorders are concerned. The other reason is that whenever I do come clean about my eating-disordered behaviour, it’s always about things I’ve done in the past and never anything I’m currently doing.

“Officially” diagnosed or not, however, in the past I have met full criteria for anorexia nervosa. This would have been in 2001, when I lost over 20% of my body weight, had a BMI of 15.2, and still managed to convince most people that I wasn’t doing it on purpose. I didn’t fool my mom, but I fooled everyone else. I started losing weight when I was in the hospital in December 2000, following my suicide attempt, because I was physically weak after the overdose and hospital food sucked, and after that I just kept losing weight on purpose, because starving yourself is a more socially acceptable form of self-injury than cutting, I was manic so it was easy to lose weight, and I think I had developed a weird addiction to it.

I’ve never been overweight. I’ve always been thin. I have the extreme good luck to not even gain any weight when on anticonvulsants and atypical antipsychotics. I do not think my appearance would be improved if I lost weight. I know it actually makes me look worse. Eating-disordered behaviour is purely a form of self-injury for me. Well, eating disorders have all sorts of complex causes, but I can assure you, mine has nothing to do with me wanting to look pretty. (I know a lot of other people’s don’t, either, but I know it is a factor in some people’s EDs.)

Anyway, I’ve been restricting my food intake way too much lately (and since I’m naturally thin, any time that I restrict my food intake at all instead of eating whatever I damn well please is a sign of disordered eating for me) and worrying about my weight. For about the past two months, I hadn’t been feeling as hungry as usual… so a few weeks ago, I just sort of took that fact and ran with it. The less I ate, the less I decided I should eat. Now I’m purposely restricting instead of just eating less because I haven’t been hungry. I know I’ve lost a bit of weight. I’ve been eating one meal a day, but now I’ve even started worrying about exactly what that one meal contains, counting calories and all of that.

It was in 2002 that I may have met full criteria for bulimia nervosa. Maybe not, though. I’m not sure I binged enough for that, but I sure as hell threw up a lot. Binged and threw up, ate normally and threw up, restricted and threw up. Most of the weight that I had lost previously, I gained back in late 2001, and then lost it again in 2002. Purged once or twice a day, got nosebleeds from throwing up so much. If your eating disorder is mainly a means of self-injury, then you love the immediacy of bulimia. Binge right now, then purge a few minutes later! Relief right now, or self-torture right now, or both, whichever you want, but right now! No waiting like there is when you’re starving yourself, instant results! It’s mercurial and intense and appeals to short attention spans.

I’m managing to stay away from it now, though. It might have even been years since I’ve purged. I’m tempted lately, but I’m not vomiting and I’m not taking laxatives (yeah, I did that, too, although mostly back in 1999). Maybe my self-control has gotten better. Heck, maybe it’s gotten a little bit too good, what with the restricting.

I have had food issues, mostly in an ED-NOS sort of way, on and off for at least eight years, probably longer. It never lasts very long. Never more than six months at a really serious level, anyway. It always goes away, but then it always comes back. Socially sanctioned self-destruction. Eating-disordered behaviour is always the last card I have up my sleeve when everything else is gone, and I keep playing it again and again and again.

And I’m getting fucking sick of it. I’d thought I was better, because it had been away for so long this time. I thought it wasn’t coming back. I thought it could just go away on its own without me working to fix it, because I thought it wasn’t really serious, you know, not like eating disorders that other people have. That other people have real problems and deserve real help and I don’t.

This time, I would kind of like to tell somebody about it so I can start working on this for the first time in my life and make some real progress on it. But I’m scared that people will think I’m just making a big deal out of nothing. So I’ve been on an unnecessary diet for a few weeks, so what? Haven’t most people been at one time or another? Don’t I have enough real issues to deal with, without getting all bent out of shape over this? I really am scared that no one will take me seriously if I ask for help with this.

Also, at the same time, I kind of don’t want to get better.

Just out of curiosity, I recently looked up information online about the nearest eating disorders clinic. It’s not really near at all and I know my problem isn’t severe enough that I’d need the programme there, but having been in a partial hospitalization programme last year, I just had an idle curiosity about such things. I noticed when I read the referral criteria that even if I wanted to participate in the programme, I couldn’t, because my current BMI is lower than the minimum allowed (they want participants to be at a healthy weight before they work on their psychological issues). This pleased me.

I am seriously sick in the head.

Ruth at Off-Label wrote a post titled A stigma wrapped in a history inside another stigma - that will probably never make it onto a t-shirt, about the stigma of the borderline personality disorder label within the c/s/x movement, and since my worrying about being an attention whore helped trigger it, I thought I’d talk about it. On and on and on about it. My post might not make much sense if you don’t read hers first, so you should read hers first. Some of this I first posted as a comment on her blog, but when I realized how long it was getting, I decided I’d take it over here:

Oh, don’t worry. It’s already made it onto a T-shirt. If I believed I had BPD, I would be perfectly willing to wear that shirt to any place that I would be willing to wear my “BIPOLAR PRINCESS” shirt.

I don’t think I have BPD, but I am well aware that I have some BPD traits, namely that I have mood swings, I used to cut myself, I am sometimes impulsive, and occasionally psychotic and dissociative. Although I think these are better explained by my diagnoses of bipolar disorder and PTSD, I’m open to the idea that maybe I could have BPD, or am possibly a recovered borderline still exhibiting some traits, or that DBT skills might help me regardless of diagnosis. I’ve got two volumes of Linehan and a copy of Get Me Out of Here by Rachel Reiland sitting in a pile of books on my floor, that’s how seriously I take these ideas.

I often wonder if BPD is a useful diagnosis at all… but I’ve met people both in real life and online who were diagnosed with BPD, who agreed with this diagnosis, and who are wonderful people. Because they feel that BPD is a useful construct for explaining some of their feelings and behaviours, and because some of them have received treatment for BPD that they feel has been effective, I don’t feel qualified in saying it must be purely complex PTSD, or it must be purely a different form of bipolar disorder, or it must be ONLY a label docs slap on women they don’t like. Since I don’t identify myself as having BPD, who am I to invalidate the experiences of people who do identify as such?

I couldn’t say whether the stigma of being an attention whore is greater than the stigma of being bipolar in the general population, but there’s definitely a stigma in the c/s/x community against borderline personality disorder. I don’t think, however, that this is usually because those of us in the c/s/x community actually look down upon people who have been diagnosed with BPD or who we perceive to be attention whores (note the “or” there: I’m not saying that these people are one and the same). In some cases, I’d say this is true, but honestly, I think most of us, including myself, are terrified of ourselves being misdiagnosed, or even correctly diagnosed, with BPD because we know that most mental health “professionals” will see it as a license to treat us like crap.

Last year I had the particular misfortune of being seen by doctors who didn’t seem to think it was possible to suffer from personality disorders and Axis I disorders at the same time. I’ve got no problem with someone dx’ing me borderline as long as they also are willing to treat my other issues, because there are some things that are big problems for me, mainly bipolar disorder and PTSD. The first half of 2006 was so traumatic for me that so far in this blog, I’ve just skirted around every mention of it. Well, it’s partly how traumatic it was, and partly because I know I’ll have to write some long, detailed posts about it, and I’ll have to set aside time for that.

Really, I don’t think most of us who are mentally interesting are prejudiced against people with BPD, we just desperately want to avoid the diagnosis ourselves, and with good reason, since the diagnosis virtually guarantees we’ll be insulted and mistreated by some of the “professionals” who are supposed to help us. This has the unfortunate side effect of making people with BPD feel like pariahs, since we so badly want to avoid either having BPD or being told that we do. I guess we should stop crowing about how glad we are that we haven’t been diagnosed with BPD if we don’t want to make other people feel like crap. Although I don’t really mean “we” there — I’m young, female, and a former self-injurer; of course there were some speculations that I have BPD.

And okay, if I ever decide that I agree with that suggestion and I am borderline, I will wear one of those T-shirts. No, I’m not kidding.

I might be less tolerant than I should of people whom I believe to be willfully manipulative, but I have thought that about very few people I know, and none of them carried a borderline diagnosis. I guess there are some borderlines who do fit the stereotype of being purposely manipulative, but I think most are just coping in the best ways they know how and other people misinterpret their actions. People who do have contempt for anybody with a BPD diagnosis — well, they shouldn’t. It’s disgusting to look down upon people with a different psychiatric label from yours, and it doesn’t help anybody.

Honestly, the part of my shirt I was so worried about? “PRINCESS.” Because if you’re going to go to the trouble of making a shirt that says you’re mentally ill, is it right to be so damn frivolous about it? It would be nice to make a shirt with a slogan that is serious and stigma-busting and actually wear it in public and actually teach people something. But I haven’t thought of one yet, and “BIPOLAR PRINCESS” amused me. (I couldn’t afford to buy enough packages of letters for “MANIC DEPRESSION HAS ITS UPS AND DOWNS.” That has six s’s and there were only two to a package.) The word “PRINCESS” just by itself could seem snobby and spoiled, which I’m not. Don’t get me wrong — I still don’t know if I’d ever wear a shirt that says “BIPOLAR” in public, but my “attention whore” comment referred more to the “PRINCESS” part. I don’t think it’s attention-whore-y when people make LJ icons that say “BIPOLAR PRINCESS,” so I don’t know if I worried about this because it was something I did offline, or just because it was me.

I also have very different standards for myself than I do for other people. I am very shy and usually try to avoid being the centre of attention. In the past, I have been accused of attention-seeking behaviour when I was doing nothing of the sort, and it really upset me. I also hate asking for help from anyone, even though I know that my frequent refusal to do so is just another weakness.

The really odd thing is that as I am sitting here typing this, I am wearing a T-shirt that says “WHAT WOULD FREUD DO?” on it. (It was a gift from a friend. I swear I don’t have a whole stack of psych-related T-shirts, just these two. No, wait, three. I’ve got one from a university psych department pub crawl.) I can guarantee you that most things Sigmund Freud would do, I would not do… but I wore this T-shirt in public today with absolutely no qualms about it.

Some brief thoughts, most about the Virginia Tech shootings. Most are interrelated, but some kind of aren’t.

• Postmortem diagnosis of someone you’ve never met is stupid and pointless. This doesn’t mean that I’m entirely uninterested in it (hey, I have a copy of Touched with Fire, too), but I doubt its usefulness.
• I’m a good Canadian girl and I like gun control. I am not very interested in discussing this point any further in general, and I’m certainly not interested in doing so right now.
• I am shocked and appalled that Virginia Tech didn’t lock down campus and cancel classes after the first shooting incident at 7 a.m. I have a hard time imagining that a university wouldn’t do that. It’s terrible. I know the police thought they had apprehended the perpetrator, but shouldn’t the university have done something more just in case there was more than one shooter or the police had the wrong guy, which just so happened to be the case? I disagree with a lot of things that one of the universities I attended has done, but I’m positive they would have cancelled classes and done a better job of warning people.
• It is fucking hard to be mentally ill in university, but I think that might have had surprisingly little to do with the Virginia Tech shootings. I’m crazy, I was really ill in university, and most of the treatment I received only made me worse. But I’ve never killed anyone. My mom thinks that better mental health treatment for university students could prevent further mass murders; I don’t necessarily agree. I do think that mental health on campus is a very serious problem, though, and solutions like threatening to kick me out of residence for cutting myself superficially don’t help anyone.
• People have talked about how the people around Cho should have reached out to him. It seems, though, that some people did reach out to Cho while he was at university. He merely ignored and brushed off any attempt at friendliness. It was pretty nice of people to try to talk to him at all, since he scared the shit out of plenty of other people. I like to think I’m a generally nice person, but if there was some guy who followed girls around and repeatedly sent them emails or whatever after they’d asked him to stop, and surreptitiously took photos of girls and blamed it on other guys, and ignored people who spoke to him, well, I don’t see that there’s any problem with me being too scared of him to try to “reach out” to him. (As a side note, one of the guys who raped me, I later found out, had a previous history of stalking other girls when he took classes at the local university. This was not at the same university I have referred to previously, we were not on campus when he raped me, and he was not even a student when he raped me… but he did later get a part time job on that campus, despite the previous complaints that he was a stalker.)
• I do think, however, that Cho really could have used some compassion when he was younger. Maybe if his peers and other people had been kinder to him in high school, or junior high school, or elementary school, it would have helped him and he wouldn’t have become the twisted person he eventually did become.
• Since I’m very fond of freedom of speech and freedom of expression, it doesn’t bother me that Cho Seung-Hui’s plays were violent, profane, and bizarre. It bothers me that they were poorly-written and pointless as well as being violent, profane, and bizarre. This is not me poking fun at bad writing; this is me writing badly myself as I fail utterly in my explanation of why I do agree that they were somewhat disturbing. Mainly I guess, they seemed like the kind of thing that someone who’s 23 should have moved way beyond.
• In theory, I have absolutely nothing against the idea of briefly hospitalizing someone involuntarily if she is judged to be in imminent danger of harming herself or others. In theory, I am all for this. In practice, sometimes it even saves lives… but other times it’s extremely damaging. I could go on and on about this, but since it wouldn’t fit into point form, I’ll have to get back to it another day.
• People are responsible for their actions unless they are so completely psychotic that they honestly can’t tell right from wrong. You know, the legal definition of insanity. This doesn’t happen all that often. I have been that way only once, and this one time where I had zero chance of controlling myself lasted only for minutes. I had been psychotic nearly constantly for several months at that point, but the actual insanity lasted only minutes.
• At that point, I snapped back to being 99% out of control. And at 99% out of control rather than 100%, you are responsible for your actions. At that point, it’s extremely difficult to talk yourself out of things you’re about to do, but it’s not impossible. At that point, psychosis is an explanation for your actions, but it’s not an excuse.
• I am generally harder on myself than I am on anyone else. Additionally, not being in anyone else’s head, I don’t know how I’d judge whether they were 99% or 100% out of control. But if I did have a way to judge that, I’d hold other people to the same standards of responsibility to which I hold myself.

Last night I started crying for no reason at all. Just suddenly got depressed, not triggered by anything that I could think of, and everything in the world seemed terrible and pointless. I’m feeling considerably better today. I know how lucky I am lately. I used to feel much worse than that for months at a time, so intense, inexplicable emotional anguish for one night is practically nothing.

This is going to sound sick, but sometimes it’s comforting when something like that happens. I’ve been feeling really well for months, and when I’m stable for a long time I start to worry that much of the past decade — the hospitalizations, the essays I handed in late, the crying, the cutting, the not sleeping, a million other things and how bloody awful I felt most of the time — were my fault, that I always should have been strong enough to deal with everything and the fact that it’s not so hard for me to deal with stuff now proves I should have been stronger all along.

Getting depressed again out of the blue from time to time blows that theory out of the water, though. This may or may not be logical, but it’s good enough for me.

And I am stable now. I can tell you exactly where I was one year ago today, though, because that was the day I started attending a partial hospitalization programme. I was at the psychiatric hospital from about nine to three, four days a week, for seven weeks. Last year I probably wrote a journal entry about that first day, but right now all I can remember about it is that when we had break time, I locked myself into a bathroom stall and cried. One of the other patients came to talk to me and she told me that I should come into the lounge and talk to everyone else if I really wanted to get better instead of hiding and crying, and I was surprised that she gave a fuck. I didn’t go off on my own because I didn’t want to get better. I was hiding because I thought it would be terrible for anyone to see me cry, because they might think I wanted them to help me or pay attention to me, when really I hated the idea of bothering anyone.

If you want to know what I particularly remember about the second day of the program, it was spraining my wrist playing volleyball during exercise period. I’m not going to forget that anytime soon.

I’m just mentioning that this Associated Press article exists: Benefits trump risks for children taking antidepressants: study. I don’t remember reading about it before.

The authors of a new comprehensive analysis of antidepressants for children and teenagers say the benefits of treatment trump the small risk of increasing some patients’ chances of having suicidal thoughts and behaviours.

The risk they found is lower than the one the U.S. Food and Drug Administration identified in 2004, the year the agency warned the public about the drugs’ risks for children.

After the warning, U.S. youth suicides increased and some mental health experts said reluctance to try antidepressants might be to blame.

The new analysis includes data from seven studies that were not part of the FDA analysis…

The abstract of the actual journal article is here, but I don’t think I can read the whole thing for free and don’t really feel like commenting on the study results without having read it.

Anyway, more from the AP article:

“The medications are safe and effective and should be considered as an important part of treatment,” said study co-author Dr. David Brent of the University of Pittsburgh School of Medicine. “The benefits seem favourable compared to the small risk of suicidal thoughts and behaviour.”

Effective, when only Prozac worked better than placebo in depressed children under twelve, and none of the other antidepressants in the studies did? When overall, 61 per cent of depressed kids and teens in the studies improved on antidepressants and 50 per cent on placebo? (The data are better for OCD and other anxiety disorders, which I think we already knew, but I’m less personally interested in anxiety disorders.) I know that research-wise, you can define this as “effective,” but as a patient, it’s not good enough for me. So I at least appreciate that the article mentions the need for careful monitoring of the effects that antidepressants have on children and teens taking them:

Dr. John March, chief of child and adolescent psychiatry at Duke University Medical Center, welcomed the study as “the most comprehensive analysis of the data yet put together.”

He said the suicidal behaviour risk, although lower than that found by the FDA, demands that doctors and families watch for warning signs…

If I thought antidepressants were completely evil, I wouldn’t be taking them. I’ve taken them since I was a teenager. I have found them beneficial at times. I’m finding Zoloft beneficial now. But I think that even if this study is accurate and antidepressants will cause suicidality in only one out of 101 kids who take them (and I’m not saying it is accurate; I haven’t even read the thing), that’s still a cause for concern. And so do the parents of kids who are suicidal or dead because of antidepressants.

Is it wrong for me to be amused that one of the co-authors of the study has the same name as the incompetent boss from The Office? Probably, but hey, if it’s wrong, I don’t want to be right. No offense meant to Dr. Brent, I swear.

There’s a post at Furious Seasons today commenting on the Portland Identification and Early Referral programme in Portland, Maine and an Associated Press article about the program. My personal favourite part of the programme’s web site is the line “Mental disorders are diagnosed in the same way as asthma, diabetes and cancer.”

Ah, so mental disorders are diagnosed with a pulmonary function test? No? A blood glucose test? No? A biopsy? No? Is there any type of biological test that can conclusively prove someone’s particular psychiatric diagnosis? Again, NO.

I was in an early psychosis programme when I was nineteen. The psychiatrist I was seeing for depression when I was eighteen thought I might be schizophrenic, so she prescribed me Risperdal, only saying that it would “help my concentration” and not bothering to tell me that she thought I had schizophrenia. Six months later, she moved away and my GP referred me to the psychosis prevention programme based on whatever was in my file. The next summer, another psychiatrist I saw told me that my file said the first shrink thought I might be schizophrenic because I had told her that I was bullied in junior high school and sometimes I still worried that people might not like me. That was the basis upon which she had prescribed me an antipsychotic: she somehow mistook my occasional worries caused by past trauma for delusional paranoia. The best part is that the bullying was something I had mainly worked through and it bothered me so little at that point in my life that I didn’t even remember mentioning it to her. It was just something I’d said in passing.

During the psychosis prevention programme itself, I saw a psychiatrist and a psychiatric nurse and talked to them about my depression. I knew the programme had something to do with psychosis, but didn’t know why I was in it. Nobody told me that my previous psychiatrist thought I was psychotic. Nobody told me I wasn’t psychotic. Nobody told me they thought I might become psychotic. Nobody provided me with any education about psychotic disorders. Nobody thought they should take me off my Risperdal, so I stayed on it (and my Zoloft, which has been nearly ever-present in my life for the past eight years). I think I just quit seeing the psychiatrist and the psychiatric nurse on my own without them referring me elsewhere; I think my psychologist eventually referred me to my next shrink.

So I wound up in a psychosis prevention programme because I made an offhand remark about sometimes worrying that people might not like me. Even before I was in the programme, I wound up on an atypical antipsychotic because of that same remark. I was not schizophrenic then, and I’m not now, although I was tentatively diagnosed as such at the time. I was not psychotic then, nor was I showing any signs of psychosis. I didn’t get psychotic until years later. My worst psychotic episode was when I’d been off all of my medications for months, but I’ve been more mildly psychotic while on antipsychotics, too. I was misdiagnosed, unnecessarily prescribed heavy-duty medications, and kept in the dark about everything. I don’t believe AAPs caused my eventual psychosis (although such a thing is not impossible), but I sure wish I hadn’t been taking drugs with such serious side effects for years before there was ever any real sign that I might need them. In the long run, being prescribed antipsychotics at eighteen didn’t stop me from getting psychotic at twenty-one or twenty-two. I’ve also been off AAPs for over a year and a half without having any serious episodes of psychosis in that time.

Years later, I reread some old journal entries from the three weeks I was taking Zoloft but hadn’t yet started taking Risperdal. I seem pretty damn hypomanic in them, which I didn’t realize at the time. Although my behaviour shortly before being prescribed Risperdal wasn’t entirely normal, it appears that the only rationale for the prescription that my psychiatrist actually bothered to write down was that one comment I had made. Either that was her entire basis for considering me a possible schizophrenic, or she mistook my hypomania for schizophrenia and did a really sloppy job documenting it.

P.S. I should have knocked on wood while I was writing yesterday’s post. I didn’t sleep very well last night.

In the past few days, I’ve rediscovered what it feels like to get a lot of sleep. I’ve always had trouble sleeping, and although I’ve had the type of insomnia where you keep waking up in the middle of the night and the type where you wake up really early in the morning although you’re tired, usually I have sleep-onset insomnia, which means that it takes me hours after I’ve gone to bed to actually fall asleep. When I was a small child, I usually wanted to get up around 4 a.m. because I felt ready to start my day at that point (my parents did not think this was a good idea), but at some point in elementary school, I started having problems falling asleep.

The insomnia comes and goes, and it’s been present again for the past few months, but I haven’t found it very bothersome, partly because I’ve had much worse trouble sleeping at other times, and partly because I know that my chronic exhaustion and hypersomnia while on Topamax and Zyprexa were a lot harder on me than mild to moderate insomnia is.

The past few days I’ve slept considerably later than usual and I really haven’t wanted to get out of bed. I know it was a holiday weekend, but still, I slept a lot. Usually, not wanting to get out of bed means I’m depressed, but my mood was fine, so I only wondered very briefly if I might be getting depressed before dismissing that thought. Then I wondered if maybe I was anxious about the job interviews I have coming up and trying to avoid preparing for them… but I have been preparing for them when I do get up, and I don’t feel unreasonably nervous about them. (I’m allowed to be a little bit nervous. They are job interviews, after all.) My interview prep and increased sleep have also left me with little time to blog lately.

My conclusion: I am just enjoying this rare joy of eight, nine, or ten hours of sleep per night to the fullest, because who knows when it’ll happen again?

Holy crap, this is a boring post. Maybe it’ll have a soporific effect on someone else, though, and do some good that way.

Currently I take 50 mg of Zoloft and 500 mg of Epival (that’s Depakote to those of you not in Canada) per day. Actually, I have very little money and no drug plan and take generics rather than brand name drugs, but it’s easier to say “Zoloft” and “Epival” than “sertraline hydrochloride” and “divalproex sodium.” This is the least amount of medication I’ve been on in eight years, barring the times when I’d decide I’d be much better without the drugs and would stop taking them all.

I used to take 200 mg of Zoloft a day, not 50 mg. I was on antipsychotics for about six years. For about a year and a half, I took an antidepressant, a mood stabilizer, an antipsychotic, and an antianxiety med every day, some of them multiple times a day. I haven’t been on a lot of different medications (only eight) because usually when something didn’t work, my doctors would just increase my dosage rather than try something new.

The side effects from all these drugs were bad, particularly from Dope-a-max Topamax and the antipsychotics. I was lucky enough to be one of the few people who didn’t gain any weight from antipsychotics, but the pills made me completely exhausted every day for years. That is no way to live your life. So a few times I stopped taking my pills, things would go all right for a brief period, and then the really bad episodes would come. It’s not as if the medication ever really stopped my mood swings completely, but at least it made me less likely to be severely suicidal or psychotically manic.

For a long time, I thought, as a lot of people think, that my only choices were being out of control or being a zombie. But these low dosages of medication are actually helping me without making me tired and confused all the time. Five hundred milligrams of Epival isn’t even supposed to be effective for bipolar disorder, but it’s helping. I’m a bit hypomanic right now; I get that way in the spring. So far, though, it’s hypomanic in a good way, and I’m keeping a close eye on the way I’m feeling and acting. If I start feeling hypomanic in a bad way, I’ll call my family doctor and/or my therapist. I don’t have a psychiatrist right now, but that’s a post for another day, or probably several posts for several other days.

I’m not saying that drugs are all I need to stay healthy. Oh, HELL no. There are a lot of things I need to do. Plus, I’ve been taking these pills at these dosages for less than four months, so I don’t know if they’re going to keep helping me for a long time or just suddenly stop working. But for now, it’s good.