It's not clinical depression.
It's Bipolar Disorder.
Goodbye Celexa, Trazodone, and Klonopin - Hello Depakote, Wellbutrin and Zyprexa: this afternoon my doctor diagnosed me as Bipolar Type I.
Talk about racing thoughts!
I don't know where to begin. Why Bipolar I? I run to this site's Diagnosis links and read the diagnostic criteria. It's hard to believe that someone like me, who has such a dark history of depression, could have ever had even the single major manic episode required for diagnosis of Bipolar I - but as I read, I recognize it. A long time ago - but it happened. I was cast in a play, and I flew through the rehearsals, the performances, the cast parties, on two to five hours sleep a night, working my ten-hour a day job without missing a beat ... until I crashed into a serious illness from burning myself out.
But that WAS a long time ago! I didn't continue to behave that way - couldn't it have been just the excitement of the event?
Well, I hardly need to look at the definition of a major depressive episode - those have been common in my life. And hypomania sounds just like major mania until you compare the fine print ... it's a matter of being less severe. I guess some periods of my life fit this description.
But the one thing that fits - that seems right - is the phrase "racing thoughts." The noise in my head that is a combination of one or two pieces or phrases of music or song, repeating over and over, plus a repetitive rhythm that is almost as if my brain was a soft drum, plus words in strings, phrases, gibberish. (I have sometimes tried meditation exercises that start with "clear your mind" - IMPOSSIBLE!)
History
Just under five years ago someone called me "the poster child for Prozac." I had gone from a paralytic depression, so serious that my employment was in jeopardy due to poor job performance, to having incredible, vibrant confidence. It was a glorious period in my life!
"But it didn't last," said my new doctor, as if he knew the answer.
No, it didn't. Over the next four and a half years I had broad, slow mood cycling while taking more Prozac, and then Prozac and Trazodone. And gaining weight. About 30 pounds.
Then last November I quit smoking, and over the winter two things happened. One, I went into another nearly paralytic depression (still taking Prozac and Trazodone). Two, my weight increased more rapidly.
On the internet I found disturbing information about SSRIs and weight gain. But I did nothing - then. The depression was in control. I thought probably I was suffering from Seasonal Affective Disorder and hoped I would improve when the weather improved. (Later someone pointed out to me that quitting smoking is in itself powerfully depressive.)
But when my total weight gain (from the time I started taking Prozac) hit 40 pounds, I did do something. I asked my G.P. if I could try Serzone instead of Prozac. I had heard that you could lose weight on this medication.
Well, Serzone was a disaster for me. For several weeks I went around feeling as if my brain was trailing behind me just a little. Diarrhea became common. Yet as spring wore on, I did pull out of the depression, as has happened every year for the past few winters.
Finally, some common sense weighed in, and I looked for a psychiatrist.
A Winner!
There was a lot of good information on finding a therapist on this website (see sidebar). I was fortunate to find a psychiatrist who, among other things, specializes in sleep disorders - a problem for me since my teenage years.
Dr. Meyer listened carefully to all I had to tell him, including the facts that my dreams were so active, vivid and detailed that in spite of sleeping eight to ten hours a night I seldom felt rested, and that I had been diagnosed some years earlier as suffering from fibromyalgia and inadequate delta sleep. He then prescribed a "diet" of Celexa, Klonopin and Trazodone.
At the two-week follow-up, I was feeling a great deal better. But some issues arose by the time of the six-week follow-up visit.
For one thing, I felt like I was turning into a Judy Garland - taking pills to go to sleep and pills to wake up. I was sleeping well, but waking up earlier and earlier, no longer getting enough sleep. Second, my mother made me realize that I was responding to a stressful situation by getting extremely grouchy - I hadn't noticed until she mentioned it. And then, on the day of the visit, somebody hurt my feelings - and I found myself crying uncontrollably - for half an hour.
This had not happened in a long time, and it shook me. Why hadn't Celexa prevented it? I realized then that my good mood had started to feel artificial.
