Lithium, Lamictal new psychiatric np

 I went on lithium a little over a month ago do to having suicidal thoughts. There was one night in particular that was pretty scary so that's why I went on the lithium. Things have been much better since then. I'm not sure if it's me or if it's the lithium. I only had those thoughts for the one night and I hadn't had them a couple nights before starting the lithium. However instead of going off of it I decided to stay on it another week or so so I could start the ketamine before I get off of it and hopefully not notice a difference.  

I increased my Lamictal from 250 to 300. This is supposed to help with depression. I'm not sure it's really doing anything. I'm doing better, but I think that's because of vacation. When I got back I started going a little downhill again. Not as bad as before I left, but it's still there. I have to take 150 twice a day and I keep forgetting if I already took it or not or how many times. Therefore I'm thinking I need to ask if I can just go back to taking it once a day, this twice a day thing is not working out too well for me I don't think. 

Last week I saw a new psychiatric nurse practitioner to hopefully get referrals for ketamine infusion therapy and TMS therapy. She said she couldn't diagnose me after just talking to me for an hour. What a relief.  Everyone else diagnoses me in that amount of time. She said she thinks I could have bipolar disorder but she also thinks it's possible I don't have bipolar disorder. She said what makes her wonder is that I was on SSRI's for multiple years before I ever had a manic episode. Often this is how they discover someone has bipolar disorder because it pushes them into Mania. She said having a manic episode can definitely make you not sleep for 2 weeks and feel like you don't need to eat. But it wasn't the manic episode that caused me to not sleep it was the sleep and the trauma that caused the manic episode. She also said my medications don't even tell her that I have bipolar disorder. She's prescribed Latuda and Lamictal to people with treatment resistant depression without bipolar. My insurance currently only covers TMS therapy for major depressive disorder. However this new psychiatric nurse practitioner thinks she can put up a good enough argument that I'll receive TMS therapy. She's just not going to put a diagnosis. She's going to put treatment resistant depression. I'm hoping this gets approved. 

I start ketamine therapy today. I'm pretty nervous. I think I'm most nervous that it won't work. And I really don't want to throw up. I'm nauseous pretty much every day anyway. I don't want this to make it worse. In addition the nurse told me to prepare to be there for at least two hours. That seems like a long time to just sit in a room. I'm hoping I don't realize the time while doing it. Ketamine is supposed to help rebuild connections that get lost due to prolonged depression and Trauma. So it helps with treatment resistant depression and PTSD. I will do two treatments a week for 3 weeks making a total of six treatments. After that maintenance is usually once a month. They can't say for how long everyone's different. I'll probably be at least halfway done with ketamine before I find out if TMS will be covered or not.

2nd ectopic and miscarriage

 Since the last time I wrote in this blog I had another ectopic pregnancy and now a miscarriage. I'm going in in a couple hours for a D&C (surgery) to clean out my uterus since I haven't yet miscarried on my own. It has been a very long week just waiting for it to happen. That's why I decided on the D&C so I wouldn't have to wait any longer. It's been consuming me. I found out a week ago yesterday that there was no heartbeat. I held on to it for a couple days hoping that the ultrasound was wrong, that they just missed it and everything would be okay. But it wasn't. It isn't. 

I was encouraged this time because we made it over the hurdle of getting the pregnancy in the uterus. But something still went wrong. I wonder if I'll ever be able to have another child and question how badly I really want one. A counselor thinks maybe I don't want any more because I may not be able to have one and it's my way of coping. Maybe in part, but I've questioned if i want another one for several years. I just decided I was getting older and I didn't want to regret not at least trying for another child. I think if I just never would've gotten pregnant again I could go on knowing I tried and give it up much easier. Having been pregnant now 3 more times and experiencing the roller coaster of emotions there are times when all I can think about is another child and I want nothing more than to have a healthy child. 

Doing better, productive

 It is now Friday. I woke up at 3:45, but since I first fell asleep at 8 last night i guess that isn't too bad.  Since starting the EnLyte prescription Tuesday night I feel better. My days have been far more productive than they have in a long time. I still don't necessarily feel like doing stuff. For instance I don't feel like cleaning the house. However,  I want it clean and my son wants Christmas decorations up, so I have been. Today I started an iron and Herb supplement. It's supposed to give me more energy. So we'll see. My blood work revealed an iron deficiency thus the reason for the supplement.

I had my third visit with my psychiatric nurse practitioner yesterday. We decided I'd try going from 100 mg of Latuda down to 80. She says the dose of Latuda is very high which is easy to believe seeing how they don't even make 100 mg tablet. The hope is that I can get down to 40 to 60 mg Latuda which is a more ideal dosage. She thinks either I'm on such a high dose of latuda it prevents all the anti depressants from pushing me to Mania or I don't have bipolar disorder. Generally they try not to put people with bipolar on any antidepressants yet I'm on 3. She wants me on the least amount of meds at the lowest affective dose. So we'll see what that ends up being.  I have a feeling this is going to be a long road.  However, I'm hopeful it won't be a hard one. 

Lamictal 150mg and EnLyte

 I have been on a reduced amount of Lamictal for nearly two weeks now. I was on 200mg for years. Now I'm on 150 mg. Thanksgiving was a good day. However the day before that and the days after it until yesterday I was feeling fairly down and hurt. I know the cause of the depression was the ectopic pregnancy, but I think the reduction in Lamictal made it even worse. I hadn't been down and stayed down for several days like that for awhile. My desire to take a shower was gone and I felt like crying even though I'm not much of a crier.

Last night I finally had the desire and energy to wash my hair in the shower. Last night was the first time I took EnLyte.  They say you won't feel the full effects of it for two weeks just like any other medication. However,  I tend to be very sensitive and notice things right away. Today is day two of taking EnLyte. I hope today is a good day and the days to follow are as well. It's an all natural prescription that's supposed to help improve my mood and give me more energy. I'm also waiting on an iron and Herb supplement that should help my energy as well. I'm hopeful these changes will be beneficial. I have a follow-up appointment with my psychiatric nurse practitioner tomorrow. Wondering what we'll do with my medication. Will we continue to go down on the Lamictal since the EnLyte seems to be working or will we stop where we're at since the decrease in Lamictal seemed to increase my depression and make me feel down. 

Today I'm just sitting here playing games on my phone so far. Trying to find the motivation to clean the house so I can get the Christmas stuff out. Still don't really have the motivation to do it, but I feel more willing than I did the last few days. I know I shouldn't go back to sleep at this point. We'll see what I do with this day. 

New providers

 I finally changed providers a week or two ago. Turns out it was long overdue. My new counselor helped me more in two sessions than my previous counselor did in over a year. I thought about either switching counselors or stopping going for awhile just didn't take the initiative cuz I wasn't doing terrible and I dread intakes. I actually look forward to my next appointment with my new counselor. 

I also found a new provider to manage my medications. She is a psychiatric nurse practitioner. This is the first time my main provider hasn't been a psychiatrist. Her approach is much different than anything I've experienced in the past. Time will tell if this is a good thing or not, but I'm hopeful and optimistic it will be. The first thing she did was go over my history and then she ordered genetic testing and more thorough blood work. My insurance covers it all which is a wonderful thing, but I'm frustrated given it's a covered benefit that no one has ever mentioned genetic testing to me before or try to do more thorough blood work. Supposedly the genetic testing will give my provider insight as to which medications and what doses may work best for me. I'm hopeful the results are accurate.

I thought I was on all the right medication until I started feeling better and having more energy and motivation. First I thought it was hypomania I was experiencing. However, now I think this is "normal" and before I was in a state of depression. Initially it was the right combination of meds I was on, but at some point that changed. Now the challenge is to figure out how to stay where I'm at and figure out a way to not feel so tired all the time.

This psych is a holistic provider and believes strongly in gut health and mental health being closely related. This is new to me, but I'm definitely open to learning and trying something new. Plus maybe it'll help me understand why my stomach is always hurting and make me feel better as a whole. 

After going over my mental health history my new psych mentioned she wasn't convinced that I have bipolar 1 disorder. She said I've experienced a lot of trauma and all my mental health concerns have been linked to that. She said that with depression you can experience psychosis. Manic episodes and psychosis have overlapping symptoms so it's hard to distinguish what your diagnosis should actually be. She also said depression can cause not sleeping. Since when I ended up in the hospital I hadn't slept for 12 days, she says anybody will be psychotic after that long with no sleep. I agree with that. For a long time I was in denial that I had bipolar 1 disorder because there were a lot of factors that went into why I ended up in the psych ward for nearly two weeks.  She said usually with bipolar disorder in childhood or adolescence you have a lot of ups and downs. I didn't experience any of that.  My problems other than depression didn't come to light until after I witnessed the suicide and acquired ptsd. Ptsd can cause a lot of problems too. She said she's going to keep my diagnosis as is, but she would like to get to know me better to see if it should be changed. 

This gives me mixed feelings. For years I was in denial that I had bipolar 1 disorder. Then I finally learned to accept it, even embrace it, live with the lifelong sentence, take my medication, and just roll with the punches. However hearing that it might not be bipolar disorder made me feel like maybe I was right all along and validated my feelings. 

12 hours sleep

 Last night I actually slept for 12 hours. I woke up just about every hour, but was able to fall back asleep fairly easily. I got out of bed about 5 a.m. I watch the Denver Nuggets highlights and then fell back to sleep. I ultimately got up at 8:06. I felt like I could have slept longer, but I had to get my son ready for school.

During the day I felt tired. It was easier to keep my eyes open, but I still felt tired. I don't feel like caffeine really does anything. I still feel tired regardless of how much I drink.

Since last Thursday when I started feeling better, I have taken a shower every morning. This is a far cry from what it was like previously. Today I feel tired, have slightly more energy than I used to, but not as much as the previous couple of days. Also I have motivation, but not as much as the previous couple of days. The past couple days I've thought about doing something and just did it. Today I have thought about doing something and then questioned if I really should or not/ hesitated.

Off on Halloween

 Today I woke up at 3:08 a.m. I slept about six and a half hours probably. My stomach hurts a little bit and I have a little bit of a headache, other than that I feel okay. I don't feel rested, but I also don't feel super tired. I already started cleaning the kitchen and I started the dishwasher. Usually when I'm up at this hour I'm writing, thinking, or playing games on my phone.  While I think it's perfectly fine,  having the energy or motivation to clean is out of the norm for me. 

Yesterday was Halloween. I was extremely tired after getting 8 hours of sleep the night before. At church I kept closing my eyes. Also during football I kept putting my head down. Even when looking at the screen, I probably only saw a handful of plays. It was hard for me to pay attention. My mind must have been somewhere else.

Around 4:45 I took my son and niece to trunk or treat at the church. Since it was so cold outside, the event took place inside. There were a lot of people in a small space and I kept having to herd two kids around to the right place. I felt very overwhelmed. When I first got there I told the kids to sit in their seat and not move while I went and got them ice cream bars.  I had went to get them chips,  but there was someone in the way talking.  I didn't have the patience to wait so I grabbed the ice cream bars instead. It was like I had to do that to keep my mind straight.

When we got back to my brother's house to go trick or treating I wanted to go right away. I felt like I needed to keep going. I started feeling off so I started trying to figure out how to work through it. I took a little walk with my husband. I thought maybe I couldn't stop moving or something. We were literally only gone like 2 or 3 minutes. When I got back to the house I figured I'd go to the bathroom thinking maybe that was it. That didn't help either so I tried sitting down. I put my head down and closed my eyes. I couldn't figure out what I needed to do to get past the off feeling. I still don't know what feeling off is. This time it started out with feeling overwhelmed. So maybe it is anxiety or at least triggered by anxiety. I hadn't felt off for at least a few days. Walking around with the kids trick-or-treating I felt alright. When we finally got home, I was super tired again and fell asleep around 8:30/9. The world series was on.  It was possibly the final game and I still couldn't stay awake/ didn't have the desire to watch it. Other than to go upstairs,  I didn't wake up at all.  Therefore,  I probably slept 6 straight hours.