I spoke to my new psychiatrist for the first time today. He was assigned to me because the old one is too busy and needed to decrease her caseload. At first I was pretty pissed that I’d been assigned a new psychiatrist without prior notice – I only found out when I asked my old one a question about medication. Then on Monday I heard from a nurse that the new one’s Dutch is pretty poor, so I was like: how in the world does someone who doesn’t speak a country’s primary language earn a doctorate?
Fortunately, the psychiatrist’s Dutch is better than I expected. He uses a lot of medical jargon and sometiems has trouble coming up with the right lay term. In that sense it’s good that I studied college-level psychology.
I can’t remember all that he said. My question was for a review of my PRN medication and maybe my antipsychotic. In the end, nothign was changed. He explained about the PRN meds that even with effective drugs, 50% of effectiveness is still placebo. That made it understandable that I don’t notice much effect even from the non-addictive promethazine (Phenergan) after a while. He asked which drugs I’d tried before, and I mentioned having been on most benzodiazepines. For a while, he contemplated prescribing a very low dose of Seroquel XR for sedation, but when I said I was already sleeping a lot, he decided against this. In the end, he advised against meds but recommended I exercise more, sleep less and get a better day-to-day structure. I’m not too sure this will work but it appeals to me. I am not too much in favor of tranquilization, especially since it’s usually the first thing a nurse will suggest when I’m irritable even when other strategies work better. Maybe I’d have had a different attitude had my experience with tranquilizers been positive.
Many years ago, I read an article on Suite101 or About.com or the like that discussed similarities between Asperger’s Syndrome and bipolar disorder. The parent who wrote the article described her son’s mood swings from elated to depressed. However, she realized that these mood swings were related to whether the son could engage in some special interest.
I find the same thing happen to me, but in my case, it also ties in with the dissociative or emotion dysregulation symptoms. I find that when I’m in a particular personality state, I engage in a certain special interest a lot more than when I’m in another state. For example, Clarissa is my blogger part, who is behind most of the posts on this blog. Annemiek is my crafter. And I at this point can’t think of anyone else.
Getting back to mood swings, I must say that I get very elated when I engage in a particular interest for a certain period of time. I uttered the phrase that I would’ve been manic if I experienced this (mania) at all. In a way, this is extremely inappropriate and comparable to when a currently mentally healthy person talks about “going all OCD”. I in no way want to say I suffer from bipolar (hypo)mania, but these mood swings do get problematic at times.
For example, last night I didn’t sleep at all. I spent around $80 on useless online services without even bothering to read the not-so-fine print that clearly said these services would not be working for me. I actually took a PRN Phenergan at 2:00 AM, before I went ont he shopping spree, but swung right through it. Phenergan, for those not familiar with it, is a strong tranquilizer or low-potency neuroleptic. I’m now relatively calm again, so again I in no way mean to compare myself to people who have these experiences for weeks on end, but I do see actually how this could become a problem.
So, should autism parents limit their children’s special interests in order to prvent this from happening. I don’t think this is universally the case, but parents must teach their children about time and money management. I, having been pretty stingy as a child and teen, never really had to learn about this. I always had enough money on my hands anyway. I actually must say I have no clue about budgeting, and really don’t know whether I need to learn it yet. I guess so.