In the beginning

About two months ago, I started a head first dive into a deep depression. It was deep enough, and serious enough, that I made an appointment with the doctor. It began on the weekend. I had a tough time sleeping--which isn't unusual, in and of itself, but it was unusually bad as far as not being able to sleep hardly at all.

Sunday night I think I ended up going to sleep, finally, around 4am. I slept for about 5 hours and then called into work sick. I simply did not have it in me. My wife, of course, was quite alarmed and began to worry about whether my life was in danger. I have had suicidal thoughts since I was a teen. Lately, those thoughts and feelings have been a lot stronger and more difficult to break.

I made an appointment with my primary care physician and my wife made an appointment with a psychiatrist. Getting in to see my primary care physician was not difficult and I saw her the next day. She indicated that she thought I had bipolar disorder and prescribed Depakote for me. She also wrote a release from work for me that day.

Unfortunately, getting in to see a psychiatrist in Asheville is not so easy. The earliest I could get in to see the psychiatrist was at the end of the month.

When I did get in to see my psychiatrist, she seconded the opinion regarding the bipolar diagnosis (Type I) and the script. However, she felt the level of Depakote was too low and doubled that. She also prescribed Seroquel as a second tier drug. And thus begins my challenge of finding the right medication mix that will work in battling this illness.

To put it bluntly, the Seroquel was a miserable experience. From what I understand, the Seroquel was to help in leveling off the mania that comes with bipolar.

One of the biggest challenges I've had in fighting this episode(s) of illness is getting my sleep regulated. Prior to seeing my psychiatrist and actually since it was not uncommon for me to be unable to get to sleep before 3am or 4am. This was not due to my not trying to get to sleep prior to then. In fact, it is quite the opposite. There is nothing quite so aggravating knowing that my body should be exhausted but having sleep be so far away. I know that I will drive my wife crazy with my constant tossing and turning as I struggle with the frustration of being awake but wanting to be asleep, so I have been in the habit of getting up and vegging or doing some minor tasks around the house. Many a night I've gotten most of the laundry done or did the dishes. ;-)

Anyway, the Seroquel was to help me moderate my sleep. My psychiatrist recommended that I start off slowly and work myself up to full strength. Well, that first night I took the Seroquel I ended up sleeping--too well. I didn't wake up for 14 hours--around 1:30pm. This was even more aggravating than not being able to sleep. At least when I wasn't sleeping I was getting some things done!

The next night I took half a pill. (The prescribed amount that I was aiming for was to take 2 pills.) This time was better than the first but I still felt like a zombie the next day. Needless to say, I hope, this wasn't doing much for the severe depression that I was struggling to climb out of. Between my psychiatrist and psychotherapist that I was beginning to see I came to the conclusion that I would try to continue on the Depakote and let the Seroquel go. (I even went down to 1/4 pill with still experiencing the side effects of drowsiness.)

This is not to say that I wasn't still having difficulty moderating my sleeping schedule. I was still having a terrible time getting to sleep. But I also knew that getting the medication mix down can take time. I won't get to it in this post, but it took my younger brother David years to get a medication that helped him to stabilize. On that respect, at least, I was ready for the long haul.

I have now seen my psychiatrist three times and I think I've found a medication mix that works OK for me. I'm now taking Geodon which, so far, is not causing the drowsiness side effects.

I'm not out of the woods yet, but I'm beginning to see some hope. Depression still strikes from out of nowhere and knocks me on my backside. I would describe it as having the rug pulled out from me. I go from a standing position to on my backside desperately clawing to get back on my feet but it's from a deep hole with no walls to grasp. This can be triggered by the most innocuous thing--a bill, a phone call, a conversation.

I'm thinking one of the great challenges of recovering from this episode is learning the coping mechanisms I need in order to live a healthy life--not unlike learning to deal with the diabetes that I'm also having to contend with. In fact, having to come face-to-face with the diabetes has helped me in some ways to deal with the challenges of bipolar disorder.