Tag Archives: Mood

Increase in My Antidepressant Dose: Is It Working?

Tomorrow, I will see my psychiatrist for a medication review. Last month, the dose of my citalopram, an SSRI antidepressant, was increased. Do I truly feel it helps?

When I started on the higher dose of citalopram, I had no idea what to expect. I’d originally been prescribed this medication in September of 2010 and had never had its effecacy evaluated. I seem to remember I was put on citalopram after the dose of my Abilify had been increased twice in a few months’ time and I was still very irritable. Abilify is an atypical antipsychotic commonly used for irritability and emotional dysregulation of all kinds. Citalopram is primarily used for depression and anxiety, but it can also help with emotional dysregulation, or so I seem to remember my psychiatrist having said.

Even before I started on my higher dose of citalopram, my mood started to lift a little, possibly because of anticipation. Once I started on the higher dose, my mood remained relatively good for a short time. Things were looking up in the day activities department, so that also helped.

One thing I have clearly been noticing, is that I’m more active. I have less need for sleep during the day. I am also a little more motivated and inspired to get things done. Though I obviously did’t complete the #AtoZChallenge, I did write far more regularly on this blog last month than i’d done in almost two years before.

Another positive that I’ve noticed is that I am more able to keep myself from engaging in self-destructive behavior. I do still have urges, but I’m more able to reach out for help first.

Though these are all very positive changes, I must say that if I’m truly honest, my depressed mood is still the same if not worse. Same for my irritability. I still experience this feeling as though a heavy weight is on my shoulders. I still get agitated very easily. I still experience suicidal thoughts.

Then again, these are most likely more symptoms of emotional regulation issues rather than major depression. Unfortunately, there’s no medication that targets these specifically. I won’t have my first appointment with my new treatment coordinator till the 17th, and I assume we won’t be diving back into dialetical behavior therapy right then. I try to use the skills I’m learning through self-help groups and apps, but it’s all rather hard.

Rays of Sunlight – April 2018

It’s been months since I last posted a list of things I’ve liked and loved, otherwise known as my Rays of Sunlight post. In fact, it’s been over a year, although I did post some positive posts more recently.

April 2018 was really a mixed bag. I’ve been struggling a lot, but there were also lots of positives. Today, I’m sharing these positives.

1. The beautiful weather. Today is a cloudy day, but last week, I was actually able to wear a skirt for the first time this year. It was over 25 degrees Celsius and sunny. I loved it!

2. My mood improving. I mentioned this in my gratitude post as part of the #AtoZChallenge already. Now that I’ve been on the increased dose of my antidepressant for over three weeks, I think I can sincerely say it’s helping some. I am not over the moon happy, but then again I didn’t believe I’d be. Instead, I feel calmer and a little more able to handle stressors such as my husband being home late from work. It’s still hard, but I’m less likely to engage in self-destructive behaviors. Yesterday, for example, hubby wasn’t home till 8:30PM and I felt quite stressed. However, instead of doing something self-destructive, I called the on-call nurse at the mental hospital.

3. Cuddling with my stuffed animals. I have five stuffed animals in our bed. Until recently, I didn’t know how to arrange them cofortably and still have space for myself and my husband to sleep. Now I seem to have figured it out. I love to cuddle with my stuffies just before going to sleep.

4. Nice wax melt scents. I rediscovered my wax melts on Wednesday. I don’t know which I have in my warmer right now, as I opened it when my husband was at work so couldn’t ask him to read the packaging. I love the scent though.

5. Beautiful music. Thanks to My Inner MishMash, I rediscovered Cara Dillon. She is an Irish singer and I just love her music. It’s so relaxing.

6. Kindle. On Saturday, I had a meltdown because Adobe Digial Editions, which I use for reading eBooks from Kobo, was once again crashing on an eBook I had just bought. I tried out Kindle with some free eBooks then. Amazon only accepts credit cards as payment, which I don’t have, but my husband has said I can use his if I can make Kindle work. With my version of JAWS, my main screen reader software, it isn’t working that well, but with NVDA, a free screen reader, it is. Kindle also works on the iPhone. I am loving the free children’s stories I downloaded. I may write a full review soon.

A Cornish Mum

Grateful: Three Things I’m Grateful For Right Now #AtoZChallenge

Welcome to day 7 in the #AoZChallenge. For my letter G post, I once again chose a prompt from the 397 journal writing prompts and ideas. This prompt is “Grateful”. Today, I am listing some things I am grateful for right now.

1. Sunny weather. Today marked the first warm day of the year with the temperature rising to about 21 degrees Celsius. I love the sunshine, even though I don’t usually go outside on my own. That being said, my husband put an enclosure in my room in which I can put our cat Barry for a while should I want to sit in the garden. Barry in fact loves his enclosure and lies in it a lot even though I haven’t yet put him in there.

Today, my husband and I drove to Kleve across the German border to go for a walk and eat some croissants. My husband used to live there for a year about eight or nine years ago. It was interesting to see how much the city had changed.

2. Nice food. I ate some lovely food today. Croissants are one of my favorite types of bread. Once we got home, my husband microwaved a bapao for me. By this time, it was already almost 6PM, so we decided not to have a full dinner. Instead, we drove to the supermarket and bought a salad. Mine was Mexican chicken and it was great.

3. My mood improving. I’m telling myself it cannot yet be the increase in my antidepressant dose, but my mood is definitely better than it used to be. It helps that I have something to commit to, ie. the #AtoZChallenge. However, with my depressed mood of the past few months, I wouldn’t have been able to stay committed. It’s not easy now either, but it’s doable.

Other than the fact that I’m more active, I’m also generally more positive. My irritability is still the same, but I’m having a more upbeat outlook on life. For example, two weeks ago I was pretty sure I couldn’t cope with independent living at all. Now I am looking at the prospect of possibly moving out of area, which might get me less care, with a relatively positive attitude.

What are you grateful for right now?

Changes

This week has been rather eventful and yet, nothing really did happen. A lot of changes are on the horizon for me, yet nothing has really changed yet.

First, I found out a few weeks ago that next week, my primary day activities staff will be leaving the day center. It is great for her, as she’ll embark on a new and challenging path in her career. For me though, it’s quite hard. Some of my other staff and family have been askign whether I mind at all, since I’ve been struggling at day activities and she was the one who filed the incident report that led to my day activities hours being cut. Yes, I do mind, since despite this, I like this staff a lot.

Then on Thursday, I found out that my CPN is leaving too. It’s also to embark on a new and challenging path in her career, but it’s sad nonetheless. My CPN and I have had quite a few misunderstandings over the ten months so far that we’ve worked together. However, I’ve noticed that I did make progress. It seems odd, since both my husband and my psychiatrist have been commenting on how I didn’t get far on the DBT course yet and it’s apparently my CPN’s fautl. Apparently, she should be limiting my bringing up only indirectly related topics.

I know the nurse practitioner who will be replacing her already from my intake interview last year. It is a slight disadvantage that he’s male, but other than that, I think I could get along with him just fine. However, it’s still a bit stressful that so many people are leaving at the same time. After all, my nurse will also be taken off my case. We’re not yet 100% sure who will be replacing her.

On Friday, I had a meeting with my psychiatrist. We discussed my progress on the DBT course, my medication and I mentioned I’ve been rather depressed lately. I did say it’s been going on for half a year already, so if I can hold it together for that long, it must not be that bad. She ignored this comment and proposed to increase the dose of my citalopram from 20 to 30mg. It’s a bit scary, since I’ve been on 20mg ever since 2010 with no med review whatsoever and I didn’t even know why I’d been prescribed it. IN this sense, I like it that my psychiatrist did ask to see me in a month’s time for an evaluation. I really do hope the med increase will help with mood improvement.

Considering Getting a Psychiatrist’s Appointment on My Depressed Mood

Tomorrow, I have an appointment with my community psychiatric nurse (CPN). Part of our appointment will likely be about where to go from here regarding day activities. My CPN already E-mailed me that she’d contacted the Center for Consultation and Expertise. They will hopefully take on my case and help me and my staff assess my needs. That will hopefully help us find a new place or get me the right support at my current place.

I also intend to ask her to get me an appointment with my psychiatrist. I feel too embarrassed to schedule one through the secretary. It’s been 3 1/2 months since my last appointment, so in that sense I could request one just for a catch-up. However, I want to discuss something specific with the psychiatrist and I feel incredibly ashamed of it. I’m finally coming to the conclusion that my depression symptoms are getting worse and to a point where I don’t know how to handle them anymore.

I was more or less by chance diagnosed with major depression last year. This came to light when I had my autism-related independent assessment. I had to fill out a screening tool for depression as part of the intake procedure. I scored as severe on that one. I was then evaluated further and was diagnosed with recurrent moderate depression. Because this was an independent assessment, my psychiatrist isn’t affiliated with this hospital and doesn’t need to take over the diagnosis. I don’t know whether she has.

I do take an antidepressant and have since 2010. Same medication, same dose all these years with no med review whatsoever. I don’t even know for sure why I was put on this medication, except that my Abilify (an antipsychotic) had been increased twice in a few months and I was still irritable.

This is the main reason I feel embarrassed about asking my psychiatrist to evaluate my mood. I mean, irritability bothers other people and ttat’s always been the main reason I was in care. Like, in 2007, when I was admitted to the mental hospital, it was really because of suicidal ideation but my staff always said it was because I’d been having public meltdowns.

I don’t know whether I truly believe that psychiatry’s job is to keep people, or me specifically, from being a pain in other people’s asses. I don’t think it should be. However, I’m rather afraid that my psychiatrist thinks so at least in my case. I’m not exactly sure why, as so far she’s been pretty understanding. I guess they may be left over feelings from all these years being treated like a cumbersome waste of resources.

Keep Calm and Carry On Linking Sunday

Mood #WotW

The past few weeks have been rather hectic. I started out last week in a creative, elated and slightly impulsive mood. I spent days and nights finally reading a book I’ve been wanting to read for a while. I hardly slept at all. Needless to say, after four or five days of this mood, I was exhausted and crashed. I spent some days in bed being a bit depressed and not having much energy for anything.

Then on Tuesday I had an utter meltdown and started spiraling down into crisis. I wanted to quit my antipsychotic because, I believed, it made me dull. At that point, however, I was quite irritable. I ended up self-injuring on early Friday morning after a sleepless night. At that point, I realized this pattern of mood lability is very common for me, repeating itself roughly once a month.

I had asked the staff to schedule an appointment with my psych doctor because of my wanting to quit my antipsychotic. However, between me asking to get an appointmnet and the actual appointment, I had this realization I described above. I decided to discuss this with my doctor and she suggested I enlist the help of my named nurse in adapting my crisis prevention plan to acknowledge this longer-lasting pattern. The current version has it look like I melt down out of the blue. She also suggested I may’ve done just a little too much during that four to five days of increased productivity. Many people with mood disorders and borderline personality disorder cope with their affective lability by acting opposite to how they feel. For example, when depressed, they drag themselves out of bed and do something. When they feel elated, on the other hand, it’s time to wind down.

Because I also have a very poor sleep/wake cycle, the doctor suggested I try a sleeping pill for a bit to help me get to sleep at night. Of course, this means I do need to stay up during the day as well. I have now gotten Restoril, a benzodiazepine sleeping pill, as-needed for a week, to be evaluated next week. I tend to develop tolerance to benzos very rapidly. To get me back in sync, I agreed with my named nurse that I’d be taking the medication for three nights and see how I do on Monday. Last night, I got okay but not great sleep.

I hope I will be back to stable soon. I hope this state of stable means I still have some of the creativity I have during my elated moments.

Because I am not too inspired to blog lately, I decided to participate in Word of the Week again. I contemplated for a bit what word to choose for this week, and I’m settling on “mood”. After all, this refers to my affective lability as well as my realization of it.

The Reading Residence
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