Tag Archives: depression

Bipolar and mixed states.

Sometimes it is hard to know how you can control the next mood change.  At present it feels as if I am getting symptoms of both depression and hypomania.   My psychiatrist, over two weeks ago, increased my dose of sertraline to 200 mg, the maximum dosage.  So since then I have undertaken new projects as my mind started racing.  I intend to write a book that is semi-autobiographical and I have done over 3000 words so far.   It is about parts of my life but some bits will be fictitious,  as I pretend to have discovered the greatest melody ever written .  I have for a long time, since I was about twenty (I am now 37), pondered on the idea that mathematics could present a formula to enable me to find the best tune of all time.

During a recent hypomanic episode, this March/April, I purchased as many text books, the ‘…for Dummies’ ones, about maths and science as I could.  I feverishly worked my way through the first few books and exercise ones as well, thinking I was nearing a point where I could finally solve this musical riddle.  My doctor spotted the hypomania when I saw her in April and increased my dose of quetiapine to 600 mg daily.  This stopped the hypomania dead in its tracks and I was fairly level for a few weeks, until May 8th, the day after the General Election that I stayed up all night to watch.  When the result became clear and the Tories had a majority I cried my eyes out which is something I hadn’t done for a while (I feel that the medication blunts emotions like crying, and hysteria but that is something I just have to live with yet I used to love crying to beautiful music as a way of releasing pent up emotions) and almost immediately my mood plummeted.

Between May 8th to 29th June I was in the grasp of a serious depression and I thought longingly about ending my life, which was constantly going through my head.  There is nothing more disturbing than a human brain planning, or instructing its occupying mind to terminate itself.  Why would it do that?  I feel sad every time I read about people  committing suicide as it defies logic.  Are aim on this planet and during this life is to fight and endeavour to survive, have a safe place to live, be kind to others, and the most obvious, reproducing.  I reached a stage where I had made plans to commit suicide and written notes for my wife and children.  Yet, thankfully I saw the psychiatrist and my care co-ordinator at just the right time.  Seeing as there was room to maneuver with my medications I could take onboard the increase in sertaline.  This has rid me of the suicidal thoughts but like I wrote earlier I think it has tipped me into a mixed state.

In a mixed state you can have racing thoughts and wonderful ideas yet you feel utterly miserable and irritable.  I don’t think I have had a mixed state before, probably have but just didn’t recognise it.  I remember, many years ago, I saw a young doctor who was under the wings of the main psychiatrist, he prescribed me sertraline.  Well I remember my mood rocketing into happy hypomania.  I would stay up late writing and illustrating a comic book about a character I had created (loosely based on an old friend of mine, who actually read it and quite enjoyed it) called The Brizz.   This went on night after night and was long before I was taking lithium.  Also, this period also led to borrowing lots of money and getting into serious debt.   The same thing happened when I was started on citalopram, I was taking 10 mg a day and my mood shot up, which I recognised this time but I had little joy when I tried to explain it to a Community Psychiatric Nurse.

Since taking lithium I have found that it controls the impulses that hypomania brings, but I still get breakthrough symptoms which is what I think I am experiencing at present.  A part of hypomania is aiding me to write this blog post as I couldn’t muster any will to produce if I am in a period of low mood.  This current mixed phase has also led me to play the piano for several hours each day.  I play until sweat is dripping down my face and back.  I imagine I am performing in a concert yet get utterly frustrated when I can’t play a certain passage as well as I could.  At the moment I am devouring JS Bach and his son CPE Bach.  Their compositions are divine and I find myself constantly repeating the most beautiful passages over and over again.  There is a Toccata by JS Bach, that is in E minor BWV 914, the first three movements are full of intertwining wonder but it is the fugue that completes the piece that I listen in awe to.  I can nearly play it, but not quite as well as the humming Glenn Gould.  Sometimes I don’t have the patience to practice tricky passages and get annoyed.  I just want to play perfectly each time, and chastise myself when I get it wrong.

My music tastes vary like my moods do.  I am solidly transfixed by JS Bach and his son at the moment but over time I will venture towards slightly more modern pieces.  This is when Muzio Clementi re-enters my playing life.  I have nearly all of his piano sonatas and while they are fairly difficult I find them a pleasure to play.  Then of course Clementi’s contemporaries Beethoven and Schubert get invested into my playing schedule.  But I love playing and researching (Spotify is the greatest invention of the modern world for finding pieces by lesser known composers) music by ‘minor’ composers such as Dussek and Hummel.  They are worthy of higher esteem but were always in the shadow of Beethoven.

Along with my idea about a most tuneful tune I also wonder if it is impossible to witness our own death.  This all goes back to an American scientist named Hugh Everett III.  He had an interpretation of quantum mechanics that was named the ‘Many Worlds Interpretation’.  As this idea evolved and other scientists latched onto the idea, especially the Swedish physicist Max Tegmark, they said that for every decision you make like going right instead of left and vice versa another ‘you’ in another Universe goes the other way.  So what about the idea of not witnessing your own death?  Well, I am not a qualified scientist but I thought back to all the times I should have died but didn’t.  In a different Universe I did of course, but for some obvious reason we always chose life over death.  I remember driving a Taxi to Woking one Sunday morning.  I had had a good night’s sleep and was looking forward to a simple run around the M25 for which I would earn about fifty quid (after fuel of course).  I was taking an elderly couple home from their holiday on a cruise ship and when we reached the destination the gentlemen thanked me for the journey but handed me five pounds so I could get a coffee on the way home.  Apparently I had been dozing off at the wheel.   So in another Universe that would have ended in tragedy, yet somehow in this one we survived.   This happened quite a lot as during the summer months as the M20 was my second home and I used to get hallucinations from the constant motorway driving, along with persistent micro sleeps.  My dad, also a taxi driver, had once seen a boat go across a motorway bridge because he had been doing so much motorway travelling.  Now I don’t drive and have surrendered my driving license back to the DVLA.  This was because I started to have panic attacks at the wheel which terrified me.  I think about all the miles I used to drive as a taxi driver and now I am crippled when it comes to motoring.  I am not sure what caused this but it may have all the criticism I used to get at work for my driving.

I am probably completely wrong about all of the above, but it is a conjecture that sticks in my unqualified mind.  It’s like the vast amounts of cider and vodka I used to consume from 2005 to 2011, yet my liver is perfectly healthy and there was the time I tried to strangle myself in my dad’s garage, I was 19, yet failed to die as I wanted to.  That is a grim memory from a passage of my life that I would rather forget.  Yet as I was suffocating I saw images of people I knew.  If we do witness out own death then I would imagine it to be like being under a general anaesthetic when you don’t dream, and know nothing.  I suppose I am more worried about how I might die rather than death itself.  Yet is would be nice if Many Worlds interpretation is correct, although you would have to have a demise eventually.

So I thank the sertraline for giving me a small portion of hypomania to be able to compose this rather morbid blog, yet I am a fairly open to writing about these things.  It shouldn’t be a taboo anymore, along with mental illness not being a stigma or a block to stop people progressing in their careers or passions.   When manic I want to take on the world with my ideas and thoughts.  Which is why mental health should be taken as equally important as physical ailments.  I don’t know if this country will ever achieve that as mental health wards are being shut across the county of Kent at least.  I have come across a lot of prejudice when people have found out I am mentally ill.  One ex-colleague in my last job was scared that I would attack him with a chainsaw, which of course I would never do.  But that is the mood set of some people if they have never experienced first hand mental health issues.  I just hope for the day when it won’t be shameful to be open about mental illness.

Aripiprazole

Nearly two weeks ago I was prescribed aripiprazole, which is an anti-psychotic, (see here) and is being used as an adjunct to the antidepressants in my case.  I’m only on 5 mg at present but increase to 10 mg this Friday.  I can say that I am pleased with the results so far.  It has lifted me from a suicidal depression to a level where I can cope, even maybe causing a slight bit of hypomania as I am finding it easier to talk to people.  I have gotten a little irritable and for some reason my mood dipped yesterday for no reason but overall I am pleased and wonder what the 10 mg dose will be like.

Aripiprazole is another medication on my never ending quest for some holy grail of drug combinations to stabilise a stubborn recurrent depression that has plagued me since the mid 1990s.  I have though become more pragmatic about this illness and realise I am probably stuck with it but I do wonder if it is progressive as I have started having mild psychotic symptoms.  Hearing things  is one and paranoia of which it is suspected that I have paranoid personality disorder.  At first I thought that was incorrect but the more I think about it the more it makes sense.  I have always mentioned being paranoid to psychiatrists but it has mainly fell on deaf ears.  I was paranoid that they didn’t believe me which I suppose is ironic.  I do though now feel as though I am getting somewhere and close to finding the light switch to illuminate a correct diagnosis.

This new medication, Abilify is the brand name, has also made me very focused and able to solve problems more efficiently.  Maybe this is due to the stimulant effects it has (it has to be taken in the morning) plus the antidepressant qualities.  Side-effects I have had include restlessness, and sometimes difficulty remembering things quickly (like spelling or recalling names) but that is about it really.  Being more focused led me to work out how to put the scores of music to the tracks on You Tube videos.  This means I can have my music follow the score.  I had wondered for years how it was done then just figured it out, somehow.

So overall I am moderately impressed with the effects of aripiprazole, but I must say these is just my experiences.  I am in no way a qualified health care professional so don’t take my words as correct medical facts.  See a doctor if symptoms are the same as mine.

Venlafaxine withdrawal

It has been a while since I last posted.  My mood has gone down and down and I have found everything an effort but I want to start a mini journal on here about venlafaxine withdrawal.  I saw a consultant psychiatrist last Wednesday and it was decided that I taper off olanzapine and venlafaxine with a view to starting sertraline instead.  Olanzapine withdrawal isn’t too much of a problem because it has a long half life, as opposed to venlafaxine which has a very short half life.  The psychiatrist told me venlafaxine is the hardest to come off and he listed all the symptoms I may get, like sickness, dizziness, electric shocks in the head like brain zaps, feeling tired, aches and pains, it is not a nice drug to withdraw from.  So he gave me a plan.  I was to drop down to 300 mg from 375 mg for a week then get in touch with my caseworker.  If I am struggling he will prescribe some diazepam, if not then I can drop from 300 mg to 150 mg.

I am feeling bad after just three days at a lower dose.  My head feels like it is stuffed with cotton wool and I can’t keep still.  I am irritable, and fidgety also.  I don’t know if I could put up with this for six weeks without some kind of help.  Just see what happens.

Is recurrent depression a degenerative disorder?

I want to make it clear from the start that I am a patient and not a professional and all views are mine unless otherwise stated.  I am merely using my own experiences to form a conclusion about recurrent depression.  Please seek professional advice if your symptoms are the same.

At the age of eighteen I was first diagnosed with depression and was prescribed lofepramine by my GP.  I was also physically healthy, weight wise, but depressed and anxious.  I look at myself now, overweight, cumbersome, bad back, full of aches and pains and wonder how much the depression has contributed to this.  Of course it could be said that it is my fault.  I’m the one who chose to eat.  Yes, but the depression took away the motivation to remain healthy.

Recurrent depression, as the name suggests, ebbs and flows throughout your life.  For weeks even months you can be fine and tick over in life, but you are never far away from another episode.  Sometimes it can be triggered, events in life get too stressful and it is your bodies way of saying ‘get out of there!’.  Just like you wouldn’t keep your hand on a hot surface for very long.  Or, episodes can occur for seemingly no reason.  These usually hit you slowly, you feel yourself go down hill.  Getting a good night’s sleep in more difficult with constant awakenings, and then a feeling of tiredness all day.  Motivation levels drops and you experience less pleasure from activities you used to enjoy.  Then along comes irritation.  I have started to shout at people who annoy me in the street or supermarket.  This, for me, happens over about two, three weeks, then the worst part of depression hits: self harm, suicidal ideation, and feelings of despair and hopelessness.  This is coupled with strong feelings of doom and anxiety.  All this while still taking all the medications.  Depression is like Japanese Knotweed; it will find a way through any barriers.

So it is dealing with these issues.  The correct port of call is the GP or mental health clinic.  Yet you have to wonder that there is not a lot they can do apart from juggle your meds about again.  That in itself could make the problem worse and take weeks if not months.  You have to taper off one before starting another and then you have the suicidal thoughts before the new drug kicks in.  I don’t think I want to go through that again.  The wrong way of coping is drink and drugs.  Drink has always been my problem.  I like a drink sometimes but it was a problem over seven years ago.  I blotted out the pain by drinking every night.  Thankfully, I haven’t done my body too much harm, my liver is OK, but it made me put on weight.  Obesity is going to lead to diabetes (I am borderline diabetes) and heart problems.

So the depression has indirectly lead me to have a unhealthy disposition.  I am nearly thirty six and dread to think what I will be like in ten, fifteen years. Of course I need to just snap out it.  I thought I could do that ten years ago but I couldn’t without the crutches of alcohol, tobacco (given that up, thankfully), sugar, and a high fat diet.  Also what does an episode of depression do to the brain itself?  The very organ that is keeping you alive and functioning is consuming itself.  Is there real physical damage done to brain cells.  For one thing I can have a terrible short term memory, forgetting things very quickly.  Long term is generally ok, but has the depression caused irreversible damage to the brain’s ability to store short term memories.  Maybe not I don’t know.  Perhaps all the medications are harm full in the long term, but they could be the one thing that is keeping you alive.

In conclusion, I decided to drink and over eat yet depression has to take some of the blame.  I wish I could blame something concrete because then I may be able to reverse it.  If it was that easy depression wouldn’t be the terrible problem it is for millions of people.

Depression

The black dog made a prolonged visit to my shoulder last week and has left residual puppies stranded there in his wake.  I don’t know why it keep happening, I take enough pills to combat it, I exercise, and try to be careful with what I eat.  This is an ongoing thing, though, as I remember mentioning this to a psychiatric nurse.  All he could say was it was the nature of the illness.  Which made me think that the best you can ever hope for is to reach remission.  Depression can flash back in an instant.  Although it is a slower process for me.  First comes the sleep problems, always waking and lucid dreams, then I get more irritable and annoyed with people, then the feelings of everything is futile, then suicidal thoughts and self harm.

It comes in that nice little package.  I’m sick of going to doctors all the time.  Having to explain myself over and over.  Not being taken seriously is also something that seems to occur yet I null this with the thought they wouldn’t put me on all these meds for nothing.  What is prevalent though is the negative ideals.  I cancel and simplify things down to ‘everything is pointless’.  Just like this post.  Utterly ridiculous.

Every now and then certain newspapers run stories about the amount of people taking psychiatric drugs.  I can’t understand why they do that, you never see articles about how many people take clonidine for high blood pressure.  There is something that bothers that section of society, people on antidepressants are ill just like anyone else, why the nasty write ups.  It also winds me up when they call antidepressants ‘happy pills’, they don’t make you happy they remove the symptoms of melancholy.  There is a subtle but important difference.

Anyway, I’ll leave it at that and wallow in my own self pity a bit more.

Argument from ignorance.

I had a bust up with some religious people on facebook yesterday, in a depression group.  All I said was is it necessary for people to keep posting religious mantra all the time, not helping anyone.  I got a backlash of how I should respect other people’s feelings and belief.  So what, am I not allowed to have an opinion then?

Religios (people who can’t go five minutes without praising the lord) seem to think they should be immune from criticism and we should just put up with it.  But if I wanted immunity from believing the blue ghost in the kettle I would get laughed at, and rightly so.  They are predominantly right wingers, the Religios, when they are on the offensive, but as soon as you upset them they become all left wing and liberal.  They get all upset and feel victimised, well surely it is about time they did after the hell they have put humanity through over the last two millenniums.

Anyhow, I got told by one member that I was pissing too many people off.  Which quite knocked me back a bit.  I never singled anyone out, yet made valid points about the necessity of some members to constantly bring god into every post.  I wouldn’t go to a god page and start mentioning science all the time.  It is frustrating, but you just have to accept there will always be people like that.  I don’t mind an argument, but I prefer a debate, which that wasn’t, so I perhaps should rethink belonging to a group that is so soft so as to not upset any one.  I’m upset all the time, but that’s just me.

You see the Religios are arguing from ignorance.  They have no facts, no knowledge, and a head brimming with cognitive dissonance.  Everything from them contradicts itself.  If god is so loving and great then why has he given you a mental illness?  That’s not very nice of him.  Argument from ignorance you see, because scientists have a good idea what causes depression, so that is requires no supernatural being in any shape or form to intervene. The contradictions go on forever, but remember never to upset Religios, they have feelings too.

 

Depression, Delusions and the new 111 service

Something had to give yesterday, and it did.  Thankfully for me it gave in the right manner by my trying to get help through the replacement to NHS Direct, the 111 service.  I got through quickly and was handled by a very competent and helpful lady who took all my details and promised someone would ring back.  Which they did.  A clinician phoned and took note of my symptoms, put me on hold a couple of times before asking if I could get to A and E to be assessed.  This was a very good idea, trouble was the nearest one is twenty three miles away and I couldn’t get there.  So I didn’t really progress very far because I had been thinking about presenting at A and E previous to this.  Any, I took my meds and went to bed making sure to myself that I would ring my GP in the morning.

Waking up felt like pushing a tonne of cotton wool of off me.  That is the residual effects of olanzapine and mirtazapine.  I could’ve stay in bed all day but it is a very heavy sleep and I had phone calls to make.  So I got a call from my GP, told her the symptoms and she referred me back to the mental health clinic I was discharged from recently, plus increasing my olanzapine to 15 mg a day.  This was what I needed.  I can hopefully take 5 mg in the day and the 10 mg at night.  That should stop the delusions.

I think people are plotting against me, or spying on me.  I have managed to cope somewhat but it has got too much, hence all of the above.  I always worry when suicidal thoughts enter my mind.  I really thought I had got over the worst but depression/mental illness always makes sure your life revolves around it.