I want to say at the outset that I consider myself to be well. I am no longer: depressed, in tears for no reason, sleeping all the time, wanting and planning to die, wallowing in despair, hopeless, irritable for no reason. I am happy and I am living my life from a place of peace and well-being.
I take medicine. It has taken time but I have found the right cocktail and lifestyle to support my mental health. I live in a way that supports my well-being.
I’m sharing my experience intending to help someone, in some small way. I offer it up to everyone who struggles with their own mental health, in hopes of raising their hopes. Please know, things can get better.
Here’s my story.
After a thorough assessment which took over 4 hours over 2 weeks, my psychiatrist diagnosed me definitively with Bipolar 2 and Social Anxiety. He said I have had them all my life.
I have always had anxiety, it runs in my family. I don’t have a single childhood memory without an underpinning of anxiety in it. I was an exceptionally shy child. I vividly recall hiding behind my mother’s legs and refusing to go to Kindergarten. My anxiety and grew steadily worse over the years, with a marked increase when I became a mother. Anxiety has been a consistent thread running throughout my life. It still is, but now it’s manageable.
I first experienced depression in puberty, around age 11. It lasted until I was 14. I can pretty much pin its origin to the day that I began menstruating. How I made it through middle school I have no idea. I was miserable and sad and eventually suicidal. I turned to drugs and alcohol during this time, a common dynamic for depressed/anxious people. It was through the intervention for alcohol and drug use that my depression and anxiety lifted. I was in rehab for 5 weeks and came out a new person.
I was happy and a basically well-adjusted person for years.
I experienced situational depression a few times throughout my twenties and early thirties, always triggered by a major life event. I was able to overcome these depressive periods in time with the help of psychotherapy twice and love from others.
Beginning with the birth of my second son, I have experienced more severe mood swings, depression, and anxiety. The differences between the births of my two children are notable – I see them as key factors that morphed my symptoms into those consistent with Bipolar disorder. One difference was that I was 4 years older, 37 – “advanced maternal age” is the medical term for it. A second difference was that I was diagnosed with hypothyroidism during my second pregnancy – a known contributor to depression, anxiety, and mood issues. Third, the trauma of the delivery with my second son, that I reference in my “Spiraling Downward” post, was a significant difference, and the one I believe to be the primary cause of my Bipolar. Regardless of the reasons, my mental health deteriorated significantly.
As I describe in that post, I eventually went to my primary care doctor who prescribed me an SSRI called Sertraline (brand name Zoloft). Once it kicked in, my mood shifted. I noticed a state of euphoria almost immediately. I seemed to be happy for some period during this time, but after a year or so, my mood became erratic. I would get irritable in the afternoons and for lack of a better word, “odd” acting (according to my husband). At the time, we were having my son evaluated for ADHD. To our surprise, not only did he have ADHD, he had Bipolar – the more severe kind – Bipolar 1. (I wrote about this in a previous post.) Needless to say, this was a major stressor. With this information and given my mood swings, sleep disturbances, and behavior, I thought it prudent to have myself evaluated.
Once diagnosed I was put on Aripiprazole (brand name Abilify) – a psychotropic medicine used as a mood stabilizer and Lamotrigine (brand name Lamictal), an anti-seizure medicine used as a mood-stabilizer, while still remaining on Zoloft. I was also prescribed Clonazepam (brand name Klonopin), to help with sleep and restlessness, a side-effect of Abilify. I was shocked at the amount of medicine my version of crazy required.
It was a long and painful process to get my treatment right. As I understand it, this is typical. We had to tinker with dosages and manage side-effects for a long while. I felt worse before I felt better. This lasted several months.
Along the way, I struggled mightily to fully accept that I had Bipolar and needed all this medicine. Once I started feeling better, I felt that I no longer needed all the medicine I was taking. I decided to reduce the dose of my Abilify – the one I minded the most (it had weight gain as a potential side-effect and was a powerhouse medicine for crazy people after all, unlike the Lamical which could be used for people with seizures, not just crazies). Knowing nothing about the process – because I didn’t think it necessary to talk to my doctor or even do some research – I thought it perfectly fine to reduce the dose within a couple of days. Surely this was sufficient. Wrong.
Within the week, I slammed into a wall of major depression. It happened in a distinct moment in time and overcame me physically. I actually collapsed on the bed. Sadness, hopelessness and despair settled in, sapping all of my energy and joy. I don’t remember how long I allowed myself to feel this way, but I know it felt like an eternity. During that time I cried all the time, became suicidal, and began researching ways to kill myself.
Somehow, through Divine intervention I believe, I was able to find my way to my doctor. I told him what I had done with my meds and how I was feeling. He immediately increased both my dosage of Abilify and Lamictal, at the same time. (Looking back I should have insisted he pick one to increase and if needed, adjust the other later . But I was barely able to get through the meeting without completely falling apart so just went with it.)
Within a week or so I began to feel better again. I stayed with these levels of medication for a good long while, a couple years I think. The depressive episode had scared the shit out of me.
I did play doctor a couple times after that, again with the Abilify, always to my own detriment. Eventually, the on-again, off-again caught up with me and I began to gain weight. I came to find out that’s what can happen with constant starting and stopping of a drug like Abilify. I had been fortunate enough to escape the weight gain until that point. (At the same time, I discovered that my thyroid condition had become unstable and that treatment was being tinkered with.) The combination was the perfect storm for weight gain.
I could never shake the feeling that I was over-medicated. From a stable, sound state of mind I decided to listen to my intuition and go off the Zoloft – I knew enough to very slowly wean myself of this medicine – over at least two months. Thankfully, it had absolutely no effect on my mood or my anxiety level.
I eventually surrendered to the diagnosis and the need for medicine, probably about 5 years in. However, I never fully accepted the need to take Abilify. I just had a sense it was dulling me and stifling my creativity. And I hated its effect on my weight. For years I asked my doctor at every check-up to go off of it and every time he said no.
Something changed in October of last year. I decided that I would insist on removing the Abilify. I felt confident that the Lamictal was strong enough support my mood. After all, the doctor had maximized its dose at the same time he increased my Abilify way back when. I never forgot that.
I did a lot of research this time and knew that a very slow withdrawal over a period of months was necessary given how long I had been on this drug. This time, I didn’t give my doctor the option to say no. I stated my case and asked him to help me wean off. He reluctantly agreed. I tapered even slower than he prescribed just in case. (I had read that psychiatrists are known to minimize the need to taper as slowly as is actually necessary. If the weaning process is insufficient, the withdrawals mimic the depressive/mood symptoms though they may not be a sign of the need for the drug.) I was advocating for my mental health. I was listening to my intuition. It was a risk yes, but it felt right.
It’s now 6 months later and I have never felt better. I am more engaged and have more energy. My creativity has flourished. I am happy and stable. My appetite is back to normal and my weight is down some.
In addition to medicine, I have discovered that my lifestyle needs to support my wellness. Particularly important for me is regular exercise. I notice a change within a day of a missed workout. I lose energy and my outlook narrows. For me, my activity level is directly proportional to the quality of my mood and my ability to cope with stress.
Because of its powerful impact staying active is the only advice I am comfortable giving. As Tony Robbins says: “Emotion comes from motion!” It’s totally true for me.
I realize that my ups and downs may seem ridiculous and over the top given all the adjusting I did with my medicine. It may seem irresponsible and ignorant. You may even say I was stupid and caused my own misery. At best, you may be confused and just not get it. It’s none of my business what you think of me. This was my path to recovery – no two paths are the same. But there is hope no matter what path you are on.