Posted by Tony P on September 18, 2007, at 21:56:45
In reply to Re: Cyclothymia mood stabilizers, posted by Cyclothymic on September 16, 2007, at 0:03:33
Wow, this thread has being going for over 8 years! Is that a record?
I am so pleased to see other people talking about cyclothymia ... when I used the term to my pdoc, he described it as obsolete, now it's all "ultra-rapid cycling bipolar" etc., but it perfectly describes what I've been going through in the past year or so, with a main cycle of a few days to a week or so.
The creative/artistic connection, mentioned way back in the thread, has been a big thing for me recently. After many years of writing almost no music, I started work a couple of months ago on a major classical choral piece for a concert later this month. I found I was staying up all night riding the high of composition, often for several nights in a row, then crashing and sleeping for as long as 36 hrs. at a stretch.
The most difficult thing is that I enjoy the highs, and they _have_ been productive -- I've written the one piece that I'm very proud of, and knocked off a few others that are quite OK. I also resurrected a number of pieces I wrote or left unfinished in my teens & early twenties (the pencil manuscripts were beginning to fade!), revised them & got them into the computer so I can print out readable copies. They somehow look much more impressive than handwritten MSS, so I get extra satisfaction out of seeing myself in print, as it were!
Trouble is of course the roller-coaster ride I've been on creates some major problems for me, not just the depressive side of the mood swings, but being out of synch with the rest of the world (up all night/asleep all day), not able to commit to a regular day job, and not even managing normal self-care because I'm either too high & concentrated on what I'm doing to care, or I'm too exhausted to have the energy to brush my teeth or even undress for bed - when I crash, I **crash**!
Browsing quickly through the thread has reminded me of a couple of med. approaches & other strategies I need to get on to, or back to. I do have a minor but significant S.A.D. component, & right about now is the time of year when it kicks in, so I've got out the hi-intensity light and I'll put it on a timer so it wakes me up whether I want to or not.
As far as meds go, my main A/D is Remeron 30 mg. at night. I also take Requip (ropinirole, a dopamine booster) & 1-2 mg/day clonazepam as I suffer a fair bit from social anxiety and even agrophobia. I've been a bit irregular with the Remeron lately: I skip it when I'm on an all-night high (because I don't _want_ to stop & sleep) then either take it in the AM and sleep the day away or add an extra half dose over the next two nights. It has at least kept me free from the near-suicidal level of depression I was cycling through six months ago. I've also been self-medicating with mild stimulants such as Modafinil, Adrafinil & good old coffee, which of course only make the hypo-manic highs higher, but lately they haven't been working to get me moving in the crash periods -- I can take a full dose of Adrafinil (600 mg) and then sleep for 10 hrs. So all in all I'm on a regime that's mostly activating -- no wonder I'm getting hypo-manic swings!
I was on a mood-stabiliser for a year or two, Lamictal, and in retrospect I may not have been having as much fun, but I sure wasn't swinging as wide. The main reason I haven't gone back on to it before now is the very slow dose build-up recommended versus not being entirely sure how helpful it will be. I haven't seen my pdoc for a couple of months or more, so it's time to discuss that with him again. I think it was working better for me than I credited at the time. I've also tried Neurontin, but it mostly makes me dopey without a lot of benefit that I can feel.
I need to hit the cognitive/behavioural side too, get more order & discipline back in my life (how I hate that d--- word!), but where does one start? Especially when my current crazy lifestyle has such good short-term rewards! Maybe a med change will help me kick-start a turn-around. But I know only too well I have to do some of the legwork as well: I've been through enough different med changes to know that there's no simple "magic bullet" for me.
Tony
poster:Tony P
thread:9730
URL: http://www.dr-bob.org/babble/20070911/msgs/783811.html