So...

I haven't done a personal post in a while.  It's mostly because there is nothing to say about me or my life...at least nothing that relates to my mental illness issues.  Since this blog is dedicated to that, I don't want to ramble on and on about my friends or pets or family.

I had a checkup with my doctor on September 20.  It was one of those med review things.  I'm at a difficult point in my "recovery/fight/struggle".  My meds work.  I don't feel bad and have more good days than bad days.  Life in my head is starting to even out some and is less chaotic and I generally know what to expect.  But, I still have bad days.  And I still struggle.  And there are still times that my depression stops me from doing things.

This is a difficult point because I am topped out dosage-wise on my Zoloft.  It cannot be increased anymore.  According to the dr. the med he would usually add on would be Wellbutrin but that doesn't work for me, in fact, it makes things worse.  With Zoloft he doesn't really like the other combos.  So, we would be looking into trying a new med and dropping the Zoloft.

That scares me.  In a way, my Zoloft is a security blanket.  I know what it does for me and how it affects me.  I know which side effects I usually see.  We know each other and are friends.  A new med is starting over.  A new med is potential success or failure.

Because I have been dealing with this for 17 years and have been treating it with medication for 14 years, there are several drugs I have tried that didn't work for me.  Most of those are now offered in generic form.  I still do not have health insurance or a job so we have to budget.  And generic drugs are generally affordable.  If we bump up into the non-generic drugs, things get pricey.  Yes, there are programs available that can offer some help.  And, yes, there is the potential that I can get free samples from the doctor.  But...

I do know that I'm going to do what is best for me.  Even if that means the expensive meds.  Me getting better and leading the best life I can, despite my depression and anxiety, is the priority.

So the dr. and I talked.  He asked me what I wanted to do.  I told him I would like to stay on my current meds.  I want to do this because I feel like I'm finally even and predictable/stable and want to see if that is the kind of existence that I can enjoy.  I need to figure out how to "do me" in my current situation and see if it enough. 

I go back in 6 months and we go from there. 

Non-update update

I've passed the three week mark since my latest med change.  Nothing to report.  No noticeable change.  No random observations from family or friends.  But, I felt the need to at least chime in with the current results.  I guess nothing is better than getting worse.  However, nothing is not the way I want to go.  I want to get better. 

One less chemical

As of today, at least for now, I am no longer taking Wellbutrin.  As I've said before, I am very hopeful that everything will be improving.  I know nothing is guaranteed but I'm doing my best to maintain a positive outlook.

My husband believes he's seeing an improvement in my lately just with the decreased amount of Wellbutrin.  In this post, I briefly hit upon the craziness I elected to take on last week.  I didn't add the additional insanity that encompassed the weekend - 2 huge rituals.  I survived and didn't totally lose it once.  I didn't break down and I didn't flip into bitch mode.  I did require some extra recoup time in the form of sleep and solitude, but nothing more than usual.  Hubby pointed out that he didn't think I could have handled the five days of crazy as little as a week ago and I have to agree.  So either the decrease in Wellbutrin or just adjustments in life are making a difference.  Woot!

So, another day and one more moment to get life to where I want to be...where I know I can be. 

Half

I'm on my second day of the decreased Wellbutrin dosage of 75 mg.  Eight more days to go until I get to stop taking it completely.  And that's it. 

The next step, medication-wise

I was able to speak to my doctor today.  Well, not really.  I called and spoke to his nurse.  She relayed the message to him, checked over the notes and dictation and then called me back.  I'm cleared to stop the Wellbutrin.  Apparently Wellbutrin is not one of the medications that you just stop taking.  I'm supposed to take half a tab (75 mg) for 10 days before I stop taking it completely.  Since my meds are set up through Saturday, I will just start the new dosage on Sunday.  On May 1, I will be done with taking the Wellbutrin. 

I'm curious to see how this will affect me.  My hope, obviously, is that I'm going to get through this foggy feeling that so isn't working for me.  Will definitely be tracking this.

Other than that, nothing much here.  I did let my two main/interactive pagan groups (online) that I would be taking a hiatus.  Lots of support offered up and a great deal of understanding.  I mentioned that I would more than likely still be around but really couldn't be counted on to commit to much - chats, projects, work, etc.  It also snowed and I love snow. 

Prescription plan

Late next week or early the week after, I will be contacting the doctor.  The meds aren't really making much of a difference one way or the other.  The only noticeable improvement since September was the first prescription when I went from not being on meds to being on them.  Adding the Wellbutrin seemed to make things a little bit worse - my good days were fewer and my bad days were more common.  It wasn't a huge difference or dramatic or in need of reporting. 

Since the current cocktail isn't helping me to be where I want to be and to where I know I can be, I'm curious about the next step.  I'm maxed out on the Zoloft and have at least 2 bumps available on the Wellbutrin.  It would make sense to bump up the Wellbutrin.  Or add a third medication, fourth actually if you include the "as needed" Ativan. 

I want to ask to drop the Wellbutrin and see how I do without it.  Since I feel that it might be doing more harm than good, it's a logical step to me.  Besides, the less medication I am on, the better in my opinion.  I have no clue if this will be an option but I'm going to ask. 

Cost of Wellbutrin is up to $32.89 for 30 tabs.  That is more than double the price of my last refill.  I just don't get it.  My Zoloft price remained the same at $22.90 for 60 tabs.  Both are still less than the market price for someone without insurance and/or a prescription card.  I'll take it. 

Hmm...

I don't have much to write about.  The meds aren't really helping.  Well, they are helping but I'm not to the point that I both need and want to be in my battle with mental illness.  I need them to boost me some. 

Still rather apathetic about most of life.  I'm experiencing emotions freely so that is still a good thing.  I'm not sad.  I'm not happy.  I just am.  Floating.  Flat-lining but not in the sense of the heart stopping and death.  Just a monotone beep that doesn't change for the good or for the bad.  It's a rather sucky way to live life but I could deal with it.  It is, at least, better than the alternative: the life I was experiencing prior to September and first getting back on my meds. 

I am taking better care of myself spiritually.  I meditate, write "morning pages", pray, and observe nature.  I do this daily.  It gives me a sense of peace.  I don't know if it is having any effect on my mental issues but it is helping my overall mood and general sense of contentment.  I also started a new class (Ritualist training) recently and am continuing with my other class (Feri book circle/class). 

On Sundays, I look at the classified for a job.  I want to work and need to work.  But the process isn't going very well.  I haven't really found a job that I'm qualified for or interested in or able to do.  I've yet to apply.  At the same time, the search brings on anxiety and I've worked myself out of a number of panic attacks.  I'm unsure if this means I'm not ready or just afraid or something completely different and/or totally irrelevant.  But I'm trying.  That's at least something.

Am I still spiraling?  I don't know.  If I am, it is even slower than it was nearly a month ago. 

I will keep on the 200 mg of Zoloft until March 27.  That will be three weeks.  Because it is already in my system, the increase should be working by them.  If there is no change, I have no clue what will be next to come. 

Tracking

As of today, I have been on 200 mg of Zoloft for one week.  Dr. S said we should be able to tell if it is working or not within two or three weeks.  So far, I really don't feel anything one way or the other.  I have been in a little bit of a better mood but nothing really noticeable.  I've been very tired.  I've cut back on Ativan (none this past week) and haven't used my Blu ecig very much either (not daily and maybe one or two puffs a day when I do use it.)

Then again, I wasn't using Ativan nearly as much anyway so it isn't an improvement per say.  Cutting back on the Blu ecig was something new and noticeable.  I guess I will just keep trucking. 

I'll take Zoloft for 200 mg, Alex

After just over thirty days, I finally called the doctor to tell him that Zoloft at 150 mg wasn't doing anything for me.  I actually spoke with his nurse and she called back some time later.  The next step is to up my Zoloft dosage to 200 mg.  The Wellbutrin is staying at 150 mg and my Ativan is the same.  Like the last time, I'm supposed to give the new dosage some time and then call the doctor to report if there is any change.  I will probably call back in mid-March.

I really don't understand how my insurance works.  The Zoloft (60 100 mg tablets) cost $22.90.  Any little bit helps and clearly I cannot budget for my meds based on any previous month.  Crazy stuff.

Absolutely nothing else to write about beyond this. 

What if the new dosages don't do it?

Since I'm on a new dosage of Zoloft and back to my original dosage of Wellbutrin, I have been wondering what will happen if this doesn't do what we are hoping it will.  To the best of my recollection, Dr. S and I didn't make a plan beyond where we are now.  He did once again mention that we can max out on Zoloft by getting to 200 mg.  I would guess that would be the next step if I'm not feeling where I want to be and having some motivation.

But what if I don't improve and the side effects of an increased Zoloft dosage show up?  I'm most concerned about the idea of getting numbed out and not being able to experience my emotions fully.  I'm also worried about the weight gain and sexual side effects.  If that happens, I would guess we wouldn't again up the dosage.

So where does that leave me?

I'm full of all sorts of "what ifs?" that are starting to drive me just a little bit bonkers.  I know it does me absolutely no good at all to worry about something that hasn't happened yet and might not even happen.  I also know that being apprehensive about all these potential problems only makes me more prone to panic attacks.

It is difficult, but I'm trying to direct my thoughts towards the positive.  I and trying to remember that my doctor knows what he is doing and knows what my needs are.  I keep pushing myself to recall that there are multiple methods for alleviating my mental illness issues.

One step at a time, I guess.  And do what I can to keep Mr. Worry at bay.

Price of happiness (change #5)

So, with the dosages going down on Wellbutrin and up on Zoloft, we have yet a different price on meds.  Woot! 

Zoloft is now $7.35 (a prescription and a half = 45 pills).
Wellbutrin is now $15.90 for the 30 150mg tablets (last time I filled for just 30 it was $32.89).

It's a bit strange how the prices keep changing.  I'm not complaining because they keep getting less expensive for me but I'm curious as to why they are going down in cost. 

One thought is that the prescription discount card works differently all the time.  Since I don't really know how the discount card works, I don't know if this is due to the current cost of the medications or what discounts are being offered by the manufacturer or if it is just luck of the draw.  I'm fine as long as we don't increase a great deal since we budget for my meds.

Another thought is that it has to do with Patient Protection and Affordable Care Act (PPACA) which is often called Obama Care.  To be honest, I really don't know what PPACA will and won't do for me so I cannot say if lowering the cost of prescription medication is something it is meant to help.  If it is, then I am incredibly grateful for that.  As someone who currently doesn't have health insurance, every little bit of help in regards to my medical needs is appreciated. 

Medication roulette

January 23 marked the day that I'd been on the upped dosage of Wellbutrin for two weeks.  I tried to get in touch with Dr. S that day but it was his day off.  I was unable to leave a message because:

1. The Clinic has obviously never heard of something called voicemail.
2. The live person I spoke with clearly had never heard of taking a pen in hand and writing a message on a piece of paper.

Ridiculous!

I was finally able to speak with his nurse today and relayed that I wasn't seeing any difference on the new dosage of Wellbutrin.  She asked what the doctor had planned for me so I told her what I could remember.  The nurse said she would check his dictation and speak with him directly and get back to me.  When I still hadn't received a phone call by 6:00 pm, I was pretty sure that I wouldn't be hearing back from them that day.  Shortly before 7:00 pm, his nurse called.

Our new "plan" is what Dr. S had discussed with me on my last visit.  I will bump my Wellbutrin back to 150 mg a day and will increase my Zoloft from 100 mg to 150 mg per day.  I am to call the doctor back in two weeks to report how things are going.  This means I need to call on Friday, February 8.

The nurse went ahead and called in the changed prescription.  I don't need refills yet but I'm getting them since I got a text message notification from my pharmacy informing me that I have two prescriptions ready to be picked up.  Guess I will be doing that tomorrow.

I'm hopeful that this tweak in my medication will be the one we've been hoping for.  You know, the one where the clouds part and a glorious ray of sunshine beams down upon me.  I am optimistic even though my past screams to be a pessimist.  Only time will tell.  

No change...yet?

I've been taking 300 mg of Wellbutrin for one week now.  To be honest, I don't feel one bit different.  I have had a few bursts of some really happy and great moments, nothing I would consider as mania so no fears there.  My panic/anxiety has neither increased nor decreased.  I really don't think it is doing much of anything.

In one week I will call Dr. S to report how I'm doing so there is still time for it to kick in and show some improvement.  From what I can recall, if we aren't seeing an improvement from the increased dosage, We will take it back down to 150 mg and increase my Zoloft.  But I'm not 100% sure if that was the plan or not.

Overall, I just want something to work.  I want to feel better and have some motivation.  I'd like my anxiety to decrease immensely.  But I still want to feel my emotions.  I need to feel my emotions.

My husband and I had a talk the other morning about how important it is for me to be able to experience my emotions.  While I had never thought about it beyond that I just know I need to feel and express my emotions, my husband pointed out that he feels the experiencing of emotions is an important and necessary part of who I am.  I need to experience those feelings so I can process them and get past them. It is a part of my process and a key to my well-being

He really does know me well.  And I am so very lucky for that. 

Price of happiness, again

My husband picked up my new Wellbutrin prescription and my Zoloft prescription.  I was concerned that the Wellbutrin would cost around $60.00 since it was double the amount of pills.  I was even more afraid that it would be difficult, if not impossible, for us to afford that on a monthly basis.  In fact, I had even considered going back to the doctor and letting him know that the increased dosage on the Wellbutrin was just not an option for us. 

I certainly was surprised when he returned from the pharmacy.

The two, 30-count bottles of Wellbutrin somehow cost less than the last time I filled the prescription for just one, 30-count bottle.  Instead of $32.89 it was $30.30.  The Zoloft was also cheaper.  Usually it is $13.30 but this time it was only $5.40.  Very happy about that.

Since my prescription card is a discount card, I have to wonder if said discount can be different each time.  I hope that is not the case because our budget demands that we be aware or how much our recurring bills are.  Perhaps it is because of Obama-care.  Honestly, it doesn't matter why my meds were cheaper.  They were and that is what matters.

It is a huge relief that the meds were not as pricey as I had thought they would be.  I am happy that I will be able to follow my doctor's orders.  Now I can actually feel hopeful that this new med regime might be the right combo to get to the place I want and need to be.

Day two on 300 mg

It is day number two since my Wellbutrin was upped from 150 mg to 300 mg daily.  So far, I'm not feeling anything one way or the other...and it's not that I thought I would so soon.  I am being hyper-vigilant about keeping an eye on my anxiety because that seems to be the area to worry about.  Every other change that this increase could cause should be for the better.  

I'm hopeful that this adjustment to my medication regime will give me the boost I need to really feel as though I'm getting better.  I just need some oomph and motivation.  It would also be nice to take the edge off the depression and the anxiety.  Hell, it would be great if it all just went away and I could move on with my life.  I know that is a pipe dream since there isn't a cure for depression.  But I can hope and there's nothing wrong with hoping.

In other news, I had a massive panic attack just a little bit ago.  It stemmed from an argument I had with my father.  A lot of past issues were dredged up and the topic of my little sister became a partial focus.  There were tears and some harsh words spoken.  Towards the end of the call, I just didn't have it in my anymore.  I couldn't argue and I couldn't fight.  Since he needed to end the phone call anyway, I cut him off and said I'd talk to him later before ending the call.  I feel a bit bad about how it ended but am glad that it did.  There is a strong chance that he will call back later.  I really don't want to talk to him anymore today and it is honestly for the best if we don't.  I think we both need to calm down and get some breathing room before we chat again.

To me, the panic attack had nothing to do with the increase on the Wellbutrin.  I did want to note it though. 

Doctor knows best, right?

Well, I'm not overly happy with our next move.  By "our" I mean me and Dr. S.  But doctor knows best, right?  Today was the three month med check since I started on Wellbutrin. 

We chatted and I told him that I wasn't feeling any different at all in the three months since I've been taking the Wellbutrin.  I informed him that I'm taking Ativan more than I did the last time I was on meds.  He presented me with two options.  One option was to increase my Zoloft from 100 mg to 150 mg daily and leave the Wellbutrin at the same dosage of 150 mg.  Option two was to increase my Wellbutrin to 300 mg a day and leave my Zoloft at 100 mg.  He also mentioned that we could go up to 300 mg on the Zoloft and up to 450 mg on the Wellbutrin.

Out of the two options, he felt that option two was the best choice for our first step.  The problem is that Wellbutrin isn't like Zoloft in that it does nothing for the anxiety part of my illness.  In some people, it can even increase the anxiety.  I could be one of those people.  If that is the case, we will go back to 150 mg of Wellbutrin and then try upping the Zoloft.

Since the medicine is already in my system, I should notice any change within two weeks.  I'm to call Dr. S in two weeks to let him know how it is going.  If I see adverse effects from the increased dosage, I am to call as soon as I can.  If the Wellbutrin increase isn't the answer, he will then decrease the Wellbutrin back to 150 mg and increase the Zoloft to 150 mg.

I'm not happy because I really do not feel as though the Wellbutrin is working for me so I don't understand the dosage increase.  Yes, I understand that I might need a higher dosage to see a change.  But if it is doing nothing for me and then the increase either does nothing or increases the anxiety, why have me stay on it?

Dr. S said he selected this option because Wellbutrin doesn't have as many adverse side effects as Zoloft.  In fact, it can help combat the potential Zoloft side effects of sexual problems and weight gain.  However, I'm not experiencing those problems.  My sex life is fine and has improved since I started back on my meds.  And I've actually lost weight since September when I first went back to the doctor. 

If the Wellbutrin increase doesn't work and we then reduce it and increase the Zoloft, I'm back to giving it a try and then calling him two weeks after we start with that med change. (I'm mostly adding that part so I remember.)

Once we get the meds adjusted to a place that works for me, Dr. S said we could wait three to six months before my next office visit.  Just another turn and loop on my roller coaster life. 

Tell the doctor on the next visit

I just created a label of things I need to tell my doctor when I have my next visit.  My rationale is that it will help save me time reading through my entire blog before every visit/med check.  Seemed like a smart move to me.

I have my three month visit on Tuesday.  Here are some things I need to share with him:

• Wellbutrin - not feeling anything different than when I wasn't taking it. There are some days that I feel a little something but it is barely worth the notice.  Regardless, most of the time I feel the same as before when I was just on Zoloft and Ativan as needed.
• Ativan - will need refills once I'm done with what I have.  I also find that I'm taking them more often than the last time they were prescribed for me.  
• The other moments that are labeled in previous blog posts.

As usual, I'm already feeling a bit apprehensive about the visit.  I know I will be fine but it will still be something I will have to work through in the next several days. 

Alcohol reactions

I don't drink very often anymore.  I will occasionally have a drink or take a sip of something but I generally elect to avoid alcohol.  No real reason except that I really don't enjoy drinking or getting drunk.  Alcoholism also runs in my family.

On my meds, it is recommended that you don't drink.  But I was curious how alcohol would affect me so I had a few mimosas on Christmas day morning.  My husband and I have started a tradition of having French toast, bacon or sausage and mimosas for breakfast on that day.  Since I wanted to know how alcohol might affect me, I decided it was a good time to give it a try since we didn't have any plans for the day and it would just be the two of us at home.

And I will not be drinking again, or at least as long as I am on my meds.

Initially I was fine and had a slight buzz from the champagne.  As time progressed, I got dizzy and felt exceptionally hot.  My brain function was not good.  I couldn't concentrate and was having problems selecting the right words and my memory was shot. 

It was not a good feeling. 

Chalking it up to experience and I'm glad to know that I should avoid alcohol. 

Price of happiness, revisited

I had to get my Ativan refilled so this was the first time it was applied to the discount card.  I ended up saving $6.37 on that prescription alone.  So here's the current cost of keeping Shanda medicated and generally happy:

• Bupropion HCL (generic form of Wellbutrin) 150 mg XL tablet -- $38.08 $32.89 for thirty tablets, saving $5.19
• Sertraline (generic form of Zoloft) 100 mg tablet --$19.72 $13.20 for thirty tablets, saving $6.52
• Lorazepam (generic form of Ativan) 0.5 mg tablet -- $16.84 $10.47 for sixty tablets, saving $6.37

 I'm saving $18.06 on my meds.  It's help. 

Three months/two months

It's the time again.  Time for the check in with how my meds are helping or not.  As of today, I have been on the Zoloft (and Ativan as needed) for three months and the Wellbutrin for two months.  And...

In some ways I feel like I'm sliding backwards which really sucks.  I can deal with standing still for the time being and would love to be making improvement but getting worse, no matter how slight, is not acceptable.  It's not getting bad or even overly noticeable but it is apparent to me and to my husband.  In less than a month I will see Dr. S again and see what he thinks.