What I learned from reducing my medication

My family went to Costa Rica a couple months ago and I forgot to take my medication with me.  Such a rookie move!  I took my bedtime dose the night before our trip and then forgot to put the container back in my bag.  I don’t have a great packing track record:  last year we went to Whistler and I forgot pants.

As I’ve written about before, the medication I take works fairly well as a mood stabilizer, but also causes a major reduction in my blood sodium level (called hyponatremia, a.k.a. what marathon runners get if they don’t drink Gatorade).  It’s very dangerous and I’ve been hospitalized because of it.  If you want immediate admission to an ER tell them, “My sodium level is 123.”  BAM!  You’ve got a room!

In order to prevent this from happening again, I take a massive amount of sodium via salt pills to maintain a safe sodium level.  I also have to be careful not to drink too many liquids, which I find really difficult to do.  I love the coffee, the Diet Coke, the water, the wine, the protein shakes… all of it.  What- you CAN’T drink 64 ounces of fluid by 10 am?  Weirdo.

After we got back from Costa Rica, I went in for a blood test and my sodium level was in the “normal” range for the first time in years.  Yay!  This was a direct result of being off my medication for a week. I decided to lower my dose of my mood stabilizer on my own.  (Warning bells should be going off right now.)  My psychiatrist was not thrilled with this decision.  She understood my frustration with the sodium issue and the constant monitoring, but was concerned about my moods becoming less stable.

From September to November, I slowly started to feel more agitated.  I exercised a lot to burn off nervous energy.  I had trouble sleeping.  My children’s voices became louder.  The house felt messier and more crowded.  My mind started running circles around the same questions over and over again.  Basically, I felt like I used to feel in my 20s and 30s before diagnosis or treatment.

I scheduled an appointment with a fancy, famous, expensive doctor because I thought maybe he would know about a new medication with fewer side effects.  Fancy doctor was not magic.  In fact, fancy doctor was kind of a jerk and suggested I switch to an older medication that causes extreme weight gain, kidney damage and potentially uncontrolled bleeding.  He brushed aside my concerns about such major physical problems and ushered me out the door.  So much for a magic doctor with a magic cure.

I went back to my regular psychiatrist.  We agreed that my current medication is my best option and that I should go back to my regular dose.  I did and I already feel better.  I have some headaches and tiredness, but the volume in my head feels turned back down to a more manageable volume.

This whole experience taught me a couple things.  

1.  First, this experience reminded me that bipolar disorder is incredibly real.

Mental illness is very obvious in times of crisis.  Nobody doubts that the guy on the corner talking to himself has a mental illness.  When I was diagnosed, I was in a very hypomanic state and was clearly experiencing a bipolar episode.  The diagnosis could not have been clearer.

As I’ve gotten my condition under control, though, it’s become far more subtle.  This is a good thing!  The whole POINT of treatment is to achieve a more normal mood state on a regular basis.  Taking my medication, trying to eat a healthy diet, attending support groups, journaling, exercising, reducing my stress, making sleep a priority, meditating…. THEY ALL WORK.  I stop feeling really bipolar when I do all the things, because all the things work.

Reducing my medication reminded me how quickly things can go downhill, though.  Bipolar disorder is kind of like diabetes, in that it can either kill you or it can just be an annoyance, depending on how well you manage it.  Some people die, but others live productive, normal lives because they take the disorder seriously and have the resources to do so.  Both outcomes are entirely possible.  In fact, my dad actually did die from unmanaged diabetes and a lifetime of unmanaged mental illness.  So, I got that memo.  Take it seriously.

2.  This experience reminded me how lucky I am.  

I may be unlucky in having bipolar disorder, but I’m very lucky in the tools I have to deal with it.  I’m lucky to have a compassionate, knowledgeable psychiatrist who I can afford and who provides me with great care.  I’ve lucky that I have medication that works and that doesn’t poison my body, even if it is annoying to deal with.  I’m lucky that I can afford childcare, which keeps life manageable.  I’m really lucky to have a supportive, wise and loving husband.  I’m lucky to have the time to take care of myself.  I’m lucky that I’m in otherwise good physical health.  I’m lucky to have a good support system of friends and family.

3.  This experience reminded me to have compassion for myself.

In a weird way, it’s actually really comforting to be reminded of the seriousness of bipolar disorder.  It reminds me that I’m not being self-indulgent or dramatic in taking good care of myself.  Self compassion changes my self-talk.  Instead of saying, “I’m an unemployed lawyer who can’t even take care of her own kids” (what I used to say), I say, “I’ve created a wonderful life with what I’ve been given”.  Yay, therapy!

All of this leads me to want to connect with and support others who deal with mental illness.  I do this by writing this blog, attending local support groups, listening to and reading mental health content online and in books, donating to mental health causes, being an active member of the mental health community and doing what I can to help reduce stigma.

I don’t know what the future holds for me, but for now I’m okay with being a mom, taking good care of myself and doing my best to shout out into the void, “Hey!  Over here!  I deal with this too, and you are not alone.”  Mental illness is real, it is everywhere, and there is no reason for anybody to go through it by themselves.

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