This is a story about the rise and rise of mental illness...
I used to be a Sea Scout. The motto of the Scouts is "Be Prepared".
When I suspected that I was becoming mentally unwell, I read every book, website, academic paper and journal that I could find that I felt related to my mental health and its potential treatment. I educated myself.
I'm an educated patient. Because I'm an educated patient, I avoided being medicated with a Selective Serotonin Re-uptake Inhibitor (SSRI) which would have caused greater mood instability than I was already suffering with.
SSRIs are also linked to emotional blunting and the destruction of the sex lives and relationships of many couples. My relationship was already on the rocks, hence going to the doctor to see if there were some magic beans or a silver bullet, that could cure my ills.
Fundamentally, I believe that some mental health issues are risk not destiny. There don't seem to be any genes that are clearly faulty in individuals who suffer from Unipolar Depression and Bipolar Disorder. They are complex spectrum disorders. Some people are really dysfunctional when they are unwell, and others find ways of coping, sometimes to the point that people around them don't even know they are suffering.
However, out of desperation, I have tried the following medications, prescribed to me:
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Mirtazepine
This was well tolerated (no nasty side effects that made me want to stop taking it). It certainly seemed to reduce my stress levels and get some sleep. I think I might have rebounded though and started to go hypomanic fairly quickly.
Quetiapine
Unless you like weight gain, constipation, dry mouth and feeling like a drugged zombie for the few hours that you are awake, before your next dose knocks you out and you start the whole miserable 24 hour cycle all over again... I can't say this medication gives much quality of life beyond dribbling at daytime TV.
Aripiprazole
This is useful to see if your head is held straight. If your head is leaning to the left, then you will dribble out of the left side of your mouth. If your head is leaning to the right, then you will dribble out of the right side of your mouth. If you are holding your head perfectly straight, then you will dribble out of both sides of your mouth.
Lithium
This is hardcore. You need to have regular blood tests. It will shorten your life. Avoid if you can tolerate other meds or manage without.
Sodium Valproate & Depakote
Do you plan on working again? In an office? 9 to 5? Not really compatible with going back to work full time. If you're not completely manic (psychotic) then best avoided.
Lamotrogine
Just takes so damn long to get up to a therapeutic dose, you go through another hypomanic episode, decide that you're fine, and then stop taking your medication anyway. It's pretty subtle. Apparently it improves REM sleep. I dream a lot anyway. My sleep quality is more a function of good sleep hygiene.
Olanzapine
Fast acting. Good to calm you down if you're having an unmanageable moment. Makes you sleepy though... couldn't really work 9 to 5 on it.
Bupropion
Fast acting. Incredible antidepressant. It did give me a panic attack once though. Also stokes my hypomania pretty bad. Although it's a nicotinergic agonist, it actually shares many characteristics of stimulants like caffeine and amphetamine. Makes you pretty horny. Helps you quit smoking too (I don't smoke though).
Diazepam
Mother's little helpers (Valium). This powerful long-acting GABA agonist is an amazing anxiolytic. You could literally stand in the middle of a highway and not give a sh1t about the cars whizzing past you at 70mph. Super addictive. Horrible to taper off.
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Fundamentally, do any of these medications work? Well, I can vouch for Bupropion, Olanzapine, Mirtazepine and Diazepam for their short term efficacy. However, the body soon gets used to the effects and builds tolerance, which means you forever need to increase the dose to get the same therapeutic effect... welcome to homestasis, b1tches!
In my anecdotal experience, it's better to tough out the storm and not mess with the ridiculously complex organ that is a brain. When the psychopharmacologists imagined how Prozac (Fluoxetine) was having its antidepressant effect they expected to see higher serotonin levels in spinal fluids. They told the world that depressed people had "low serotonin". They just guessed and they guessed wrong.
Type I Bi-Polar Disorder was also known as Manic Depression. This is a serious illness that requires serious treatment. It's not my place to comment on whether medication plays a part in that. I'm no expert on Type I BPD.
Type II Bipolar means that you have hypomanic episodes, not fully blown mania. That means risk taking, spending money, hypersexuality, racing thoughts and pressured speech... amongst other symptoms, such as reduced need for sleep & food, and intolerance of slow-witted fools.
I'm Type II. I think it's a very important distinction. If I can control my mood disorder with good diet, good routine, good sleep and abstinence from alcohol & drugs (including prescribed drugs) then my brain has the best possible chance of finding homeostasis.
If I can remove unnecessary stress in my life, caused by complete ass-hats, and I'm empowered to just get the f**k on with my life, then my symptoms will abate. It's as simple as that.
This was the first time that Frankie had ever seen snow. His brain adapted to the change in environment (December 2010)
Tags: #bipolar #mentalhealth #depression #suicide #sex #drugs #frankie