The Medicine Woes of Bipolar Disorder

I’m sorry I haven’t written for a while. I have been living in depressed-land. Don’t worry, I’m doing something about it. My p doc and I are trying to find me the right medicine combination which has been a “fun” adventure. This leads me to today’s post: the medicine woes of bipolar disorder.

One of the biggest things that people with bipolar disorder struggle with is noncompliance with their treatment program—or, in other words, people with bipolar disorder often have a problem with taking their medicine. This is a big deal considering 25% of people with untreated bipolar disorder will commit suicide. Yes, you read that correct. 1 out of every 4 people with the disorder who doesn’t get treated will die and yet a lot of people with the disorder are CHOOSING to not be treated. The idea that someone could know the risks yet choose to live untreated used to baffle me. Right now, I think I understand and so I will elaborate. I think the best way to do so is to tell my story.

When I was diagnosed with bipolar disorder, I was going through incredibly rapid mood swings. I could feel as high as a kite one minute and then ruminating on how I would kill myself the next. Obviously this is a bad thing so my doctor put me on the fastest acting thing he had, an anti-psychotic, Geodon. That drug had serious side-effects. For the first two days I was on it, I slept more than I was awake. I got tremors in my hands, especially when I was tired. I couldn’t think straight. But I was so grateful to not be cycling like that anymore I didn’t care about the side effects. I just was glad to have control over my emotions again. Because of Geodon’s severe side effects, my doctor only left me on Geodon as long as it took to transfer me to Lamictal. Lamictal is one of the top choices for bipolar disorder because it doesn’t have as many side effects, but you have to go onto it slowly or you could develop a rash that might possibly turn deadly. So I stayed on Geodon just long enough to get me onto a therapeutic dose of Lamictal. It’s a good thing too. Geodon seriously messed with me. It took quite a while for the tremors to go away, even after I stopped taking the drug. I’m glad I got off it when I did.

I thought I hit the jackpot with Lamictal. Really, it was my best friend. For over a year I was relatively balanced and happy. Life was good. I even went back to school and got a 4.0 my first semester. That was the first 4.0 of my life. I had a couple of bipolar friends who were very jealous of me because finding the ideal medicine that fast is rare for people with bipolar disorder. I didn’t appreciate how good those times were. I don’t know if it’s because I started taking more stressful classes or if it’s just the nature of the disorder, but I started getting unbalanced again. Nothing major, just a little bit, so my doctor (new one—I moved) raised my dose. All hell broke loose. Keep in mind, I’d been on this med for over a year so I was incredibly surprised when I woke up one morning with my eyes wacked out. I had bouncing vision and double vision every morning for a few hours after I took the medicine. I’m no baby. I knew from previous experience that sometimes once the body gets used to a medicine, side effects die down, so I held out as long as I could on that dose, but the crazy eyes didn’t die down. If anything, it got worse. We dropped me back down to my old dose and my eyes stopped going crazy every morning, but they never were the same. Literally. I had them checked and my eyes were perfectly healthy, but my vision had decreased during that time period and sometimes in the mornings I would feel little tremors behind my eyes.

Since upping my dose wasn’t an option and outside my crazy eye event Lamictal is such a good medicine to be on, my doctor and I decided that we’d try adding another medicine to the Lamictal to see if that would help. We tried Seroquel. It made me sleepy at night, but that’s about it. It didn’t help balance my moods and sometimes I got a bit snacky. We took me off that. I think we tried something else too at this point, but I can’t remember. We decided that we’d wait until the summer before playing with medicines again because I had a very stressful semester and we didn’t want to make it worse.

Summer came and I realized that without the stress of school the Lamictal was almost adequate. Playing with meds would have to be done during the school year, whether I liked it or not, if I wanted to actually find the medicine that helped me when I really needed it. This last semester has been the “play with meds” game. It’s been a nightmare. I have an incomplete as a result and I’m still not on the right med combo. We took me off Lamictal. We tried Abilify and it stabilized me right into a mild depression, the one I haven’t gotten out of. I was sleepy a lot on Abilify and I couldn’t focus at all. I LOVE reading, but it took me over 2 weeks to finish a book. I didn’t do a lot of my homework during this time, hence the reason for the incomplete.

My current medicine is Depakote. Depakote added a new piece to the adventure in the form of bloodwork. I’ve had to go three times to get my medicine. The first time, the Depakote, even though I’m at a low dose, was above the therapeutic level. I had to go again—if it stayed there, new medicine. It was a fluke and went down, but the second time my liver enzymes were high. Again, I had to go get it checked. If they remained too high, new medicine. I got the phone call today saying that once again, it was a fluke. Liver enzymes are normal. (Side note, I have an amazing doctor. She called me on a Saturday morning to let me know I was okay even though she wasn’t in the office. How many doctors do that?). Since everything is normal, for now I’m staying on Depakote.

The issue is I’m still depressed. I’m stable. My moods aren’t fluctuating. I’m not suicidal. I’m just depressed. My doctor prescribed Buspar, an antidepressant, to take on top of the Depakote. I’ve only been taking a partial dose and at a partial dose, it doesn’t seem to be doing much. I took the full dose one time and it made me all shaky and faint to the point I couldn’t stand straight. Today my doctor told me to spread it throughout the day and see if that helps. Hopefully it works. If not, back to the drawing board.

I’m so tired of trying to find the right medicine. If I didn’t have a firm support network, one that checks in on me regularly, one full of people I love, it would be so easy to just say “Screw this!” Luckily I have people I love who support me. That and the fact I’m ridiculously logical keep me going back to the doctor over and over. I’m optimistic, at least once you take out the depressed part of me. We’ll find the right drug combo someday. There are just too many medicines out there I haven’t tried for me to give up. I don’t want to even risk being part of the 25% who doesn’t make it, but I understand their reasoning. Some don’t take it because they think they can do it on their own. Some don’t take medicines because they like the highs too much. Most don’t take it because honestly it’s just easier to give up than go back to the drawing board one more time and try another medicine that might make you feel like crap.