3 Months in [Update to "1 week after BD2 DX"]

Original post: https://lemmy.world/post/48009634

I wanted to share my experience so far three months in. I couldn't get motivated to do a 1mo or 2mo update before this. I'll try to keep the same basic format.

Lamotrigine side-effects:
I am currently at 200mg. Each titration (25 > 50 > 100 > 150 > 200) came with side effects. As happened with my first dose (25mg), each increase in dosage has brought:

• headaches
• lethargy
• brain fog
• loss for words
• reduced spatial awareness
• reduced coordination
• difficulty sleeping
• dry mouth / wake up with bad taste in mouth

These symptoms usually last less than 3 or 4 days with the exception of the brain fog. That has persisted.

After my second dosage increase, I curb-rashed my wheels twice in two days after spending $1k to refurbish them four months ago, so I decided not to drive anymore after an increase. I get too confident while my reactions are "blurry" at best.

I am still having issues forgetting what I am doing at any time, not just when increasing dosage. Go someplace to do a specific thing, forget what it was before I even get there. Talking with someone and I think of a thing to say. I think of my opener, like, "That reminds me," but that's all I remember to say. The idea itself is gone.

I lose my glasses a few times a day, when I never used to do that. Ever.

Effect on mood: Not really sure, TBH. My wife and my pDoc both say I am still hypo, but I don't see it. However, that's how I got here. Others noticing what I would never think was out of the ordinary. My Dx was updated to include mixed features and rapid cycling, but that second one is based on historical anecdotal evidence from my wife to our (shared) pDoc. I don't really have much to add to that yet, as identifying my state is extremely difficult and new to me. If you ask me, I'm like I always am, but my wife tells me a few times a week how I am showing symptoms, and I can't argue with her.

I can say this: In the past two weeks, I've slept less than three hours only four times. Then again, I am forcing myself to sleep with xanax. If I don't, I'll gladly stay awake for 28-40 hours before my body starts getting really mad at me.

Also, I think I have been experiencing more depressive episodes than about two months ago. I guess that speaks to the validity of mixed/rapid cycling? I thought it was a hopeful sign that I was no longer hypo, but my pDoc and wife both kindly corrected me with facts.

I am still doing three or more things at once. I am playing piano (which only requires spinning my computer chair 90-degrees to the left) around six hours a day as opposed to double or more. I still feel as though my piano skills are improving hugely, but I expect an outside observer would say it's normal. I am still reacting highly (read: irrationally) emotionally at the barest notion of feelings. Things that most people wouldn't react at all to, or make them say, "aww," make me cry. Music gives me chills, all the time.

Lastly, symptom-wise, my anxiety attacks are more frequent and more pronounced lately. One book I read warned that people with some symptoms under control without meds may suddenly have relapse of those symptoms when Lamotrigine basically "changes brain pathways" and we need to re-learn how to brain properly.

Reconciling my past:
So much of my life makes more sense now. Even more than I mentioned before. It isn't unlike when an addict working on sobriety has to come to term with the negative effects on those around them. So many times I hurt myself and others around me. Criminal behavior, promiscuity, excessive drug use, quitting jobs on a whim.

On the other hand, a lot of my negative life experiences are more comforting in light of my Dx. It gives me a new understanding and allows me to give myself grace that I never have done before. Now I realize that work project that I worked 22hrs/day on for four weeks before suddenly crashing was likely a hypo episode that lead into a depressive episode. Getting chastised for no progress during my depressive times, and praised for the times of extremely high productivity. Now I know it was pretty textbook. I can forgive myself for some of my past choices.

Family:
I decided not to tell any more family and friends about my diagnosis. It hasn't helped them or me, but it has created many situations where I am explaining what is and is not my disorder. I expected my immediate family to want descriptions and want me to tell my story. Instead, they seem to want to tell when in the past they think I was hypo, or another symptom. On the other end of the spectrum are those who responded with a simple grunt. "Hmm."

Where do I go from here?
I'm not actually sure. My wife thinks I need more Lamotrigine, but I and my pDoc want to keep me at 200mg for at least the next two months. I don't see when I am or am not hypo yet. I need to learn that kind of awareness. Not knowing, I have to trust what I can see (not much) and what others tell me.

I'm still happy that I am treating my BD. I feel a lot more like I "belong" as a member of the BD community now. Before, I really had convinced myself that I was faking it, or seeing things that weren't there. Now I am more at ease with my Dx.

As far as my wife being someone to talk to,she and I had a warmed (not heated?) discussion where I pointed out that she was gate-keeping BD from me. I would explain something I was experiencing, or (this really got her incensed) something I read in a BD book, and she didn't even let me finish before dismissing me. She learned about BD in the early 00's, and a lot has changed since then. Things like the 'spectrum of bipolarity' aren't "real" to her, and subject to ridicule. I have had to show the journal publications to prove the doctor isn't a hack. Once I confronted her, it all stopped. She was sorry when she realized she was doing it.

I think this will be at least a few years-long process. I need to learn and become fluent in the language of my moods first. I am glad to be undergoing treatment. If I'm being 100% honest, I'm not aware of any difference. I'm not even sure I would notice the difference, but both my doc and wife tell me I should notice when it starts working. I think I may need some more guidance on how to know that. I keep reading books recommended by the various BD and MH groups I am part of, and those recommended by those authors. It is pretty cool knowing more about "sodium pumps" and how Lamotrigine works on them.

That's all I can think of. Feel free to ask Q's and I will hopefully respond in under 48hrs.