I called and made an appointment to see pdoc tomorrow at 9am...
Better not mess around with this.

You were right, it was a good idea to go in.
I am escalating again. And today is worse than yesterday.

The plan is to increase the pm dose from 400-600mg, with an "as needed" daytime dose of 50-150mg, as tolerated.

Pdoc said that most of her patients do well with just a higher pm dose, but some do need to add a dose during the day.
I have an appointment with her next Wednesday. In the meantime, she's giving me the leeway to try and figure out which category I fall into.
And I can always return to the office if I have to.

I was still agitated and psychotic when I was almost maxed out on Abilify. Life is certainly imperfect at the moment, but at least I'm only exhibiting symptoms of hypomania. I'm not in the middle of a mixed/manic event anymore. And I'm not delusional.

Despite the escalation, I'm still encouraged because there's room to adjust the dosage. And I think the adjustments she made today are aggressive enough to make a difference.

Kay

Kay, I agree with mymorgy- definitely see your psychiatrist face to face.

I have no direct experience of Seroquel but when I was a voluntary patient in a private psychiatric hospital it was handed out PRN with no follow-up. This concerned me.

I hope that your psychiatrist can help.

All the best.

My husband can tell that I'm much better than I was yesterday, and better than I was when I was when I was on Lithium, but he can't help me with the gray areas.

It's rather an arbitrary thing to wake up in the morning and know whether you're feeling like yourself or not (and I bet most people can trust their own judgement)...
But for 7-8yrs on Lithium I was either hypomanic, depressed, or flat and
I don't know exactly what I'm looking for now.
It's frustrating.

Last night taking 600 vs. 400mg made a huge difference.
I still have med to play with (650 today, I can take up to 750, max is 800mg).

I don't know now if I should have taken that 50mg prn dose earlier than I did today (I took it at 3) or at all because it made me tired. I felt better before I took it... But was it a healthy kind of better? And how much energy is too much energy?

Tomorrow's plan: No plan. Fly by the seat of my pants per usual.

Hi Kay,

You are doing well. One sign of this is the amount of insight you have into yourself and into your daily life right now.

Simply asking the questions you are asking shows insight.

It makes sense that you are not sure of what you are looking for as an emotional "norm," the target you are trying to define and trying to achieve.

Medical conditions, as well as the effects of medications, can, over time, cause us to loose a sense of what feels "normal" for ourselves. We can also lose self-confidence and no longer trust ourselves, our own perceptions.

I like how your doctor is handling allowing you to find the doses and times of daytime meds which suit you best. I feel she is showing confidence in you, in your judgment and is helping to restore your self-confidence.

You are very highly motivated to bring your life into balance. It's inspiring to witness someone so motivated!

I believe you will have an increasingly accurate sense of what's just fine for you, as for energy levels, goal-directed behaviors, and more.

Self-compassion and patience help us so much in our finding balance in our lives.

You are working hard to heal, Kay. Not everyone works so hard at this. I have a lot of faith you will find the balance which serves you best.

You are truly doing an amazing job of caring for yourself.



DejaVu

Yes,

You are right, DejaVu,

What makes these things especially
hard is that we have to ignore our own self-perceptions /self-trust.

We have to trust that we made the right decisions about the process-- finding a doc, getting on the meds, . . .
And we have to accept that we are not in control because we handed control over to the meds.


M

Thank you both so much!

I still have the same pdoc I was bitching about 2mo ago. I think she's a hero now. Two major changes: 1) I became more proactive in my care 2) I became much more insightful after I discontinued Lithium.

I suffer from a general lack of self confidence. I question everything. Why should this be any different? I certainly have good reason. For example: am I questioning the 50mg prn dose because I over-medicated? could it have been s/e of the drug? or is it because I am really only missing the energy/productivity?

At some point last night, I remembered I have MS
Sure, meds are going to effect me differently at different times. But I guess that's where the prn's will really come in handy.

In a perfect world I'd like to get away from prn-dosing, but I realize that might not be a realistic goal. Thank you, Mari, for letting me know that it's okay. I grateful to have the option, instead of having a pdoc insist on snowing me 24/7.

Kay

Kay

Keep up the good work.

Donna

Seriously, I lost my post.
It was the most beautiful and thought full post I have ever written.

Kay,

Even someone like me who has been in the bipolar game since 1988 and who is mostly depressed now both due to side effects and to lack of sleep, has to adjust pills during the days sometimes and weekly via the pill minder.

You daily plan/system will eventually settle into something more of a routine.
It might feel like hard work right now. I can promise you that it gets easier because you and the meds / amounts / times will get used to each other.

Take good care.

Mari

Mari,

I am sorry you lost your post.
I enjoy your writing so much! You clearly hit the nails directly on the heads whenever you write. I am always very enlightened by your written offerings.


DejaVu