This time, it is for medication management.
My Psychiatrist works at a teaching hospital. So, I see her each visit and often I see a new student, too. My Psychiatrist asks if I mind them being a part of my session. She always asks me in the waiting room or in the hall leading to her office. She never asks me in front of the student. I appreciate that. I always say that it is OK if they are a part of my appointment. As we enter her office, she introduces the “doctor in training” and then we begin.
As we begin, the student has an opportunity to ask me questions.
My overseeing Psychiatrist will listen for a few minutes and then always joins the conversation. From there, it often becomes a dialogue between me and her, often to the exclusion of the doctor in training.
I know that I will get to say what is on my mind. I will get to share how I am tolerating the medication. She always asks questions from things I said during the previous visit. She is very smart, and I appreciate her looking at the big picture. She has my history in front of her and knows what changes we have made to my medication in the 20 months since I was hospitalized with Major Depressive Disorder.
Although these appointments are not designed to be talk therapy, I still feel the focus is on my wellbeing, not just that my medication is working without major side effects.
And we worked through a major side effect with my Prozac.
I could not get going in the morning. I was fighting with myself just to get out of bed. This mental sparring could last for minutes or even hours. The very act of getting out of bed and putting my two feet on the bedroom floor was a major achievement. Standing up and walking to the closet to put on my flip flops and a T-shirt was the next step.
Next, it was a stop in the bathroom, where I took 40 MG of Prozac.
In the hospital, I had been prescribed 20 mg. Later, in a discussion with my previous Psychiatrist, I shared how this was no longer helping to clear my mind. We decided that doubling my dose would have a more pronounced effect and might help give me my life back, without the debilitating outcomes depression was heaping on me.
Now back to my morning routine, it became a waiting game.
It would be one to three hours before my head would begin to clear up from a morning fog. Until then, whatever I did was generally muscle memory. I would go through the motions, without emotion. And the cloud would tag along as I began whatever activities I was required to perform.
If it were a workday, I would comply.
But that did not mean I was motivated. However, I was and still can switch gears when I arrive at work. I pride myself in my ability to NOT bring my personal life into work. And I almost always succeed. Now I know there have been days where others could tell I was “off my game,” but this has been the exception, never the rule.
And leaving work, the switch goes off, and my thoughts turn back to whatever I was mentally working on before I walked into the door at work.
After over five months of saying “something is not right, I cannot get started in the morning,” I finally got someone to listen. I had said it in group sessions at On Our Own, I had said it to my therapist, and most importantly, I had said it to my Psychiatrist three times in medication management sessions over the course of five months.
It took me finding a new Psychiatrist before I was heard.
And with “out if the box thinking,” we discussed several alternatives before choosing my current program. We added 150 MG of Wellbutrin XL and kept me on 20 mg of Prozac for 30 days. Then we ended the Prozac. I must tell you I was more than a little anxious about stopping the Prozac.
I guess it was the monster you know kind of relationship.
I was unsure of life without Prozac. But I survived the 30 days. And my perceived withdrawal was only felt in days two and four. After that, my body did not seem to notice that I had stopped taking Prozac. And my depression started abating.
Even more remarkable, I was not having problems getting out of bed.
And the cloud that would follow me each morning suddenly was no where to be seen, I was a new man, able to start the day without having to first run out the clock. The one to three hours I was dull and unclear was gone.
Several months into my 150 MG of Wellbutrin, I began to regress.
Not that I went back to not being able to get out of bed, but the progress I was making stopped. I felt like I could be more balanced. At my next Psychiatrist appointment, we discussed my situation and the alternatives. Having choices, I feel in control. And having a Psychiatrist who gives me options, has worked for me.
We discussed adding Abilify, and we talked about increasing my Wellbutrin XL.
In the end, we changed my dose to 300 MG daily of Wellbutrin XL. This was months ago, and my life has been much more balanced as a result. I am not expecting rainbows and unicorns, but just a day-to-day life that allows me the ability to experience my core emotions.
I do not foresee any changes to my medication when we meet Wednesday.
But I will share how I am doing. There are core emotions I spend a lot of time with; sadness, fear, and sometimes a bit of anger. I want to spend time with; joy and excitement. I am not asking for my medication to provide that for me. But I am asking that my medication allows me to experience these core emotions.
In my therapy session, we spend a lot of time with the change triangle. Here, I can plot where I am. There are many times when I am using a defense to avoid core emotions. Some I use often are; working too much, over-eating, joking, and negative thinking.
I want my medication to continue to let me work through these defenses, allowing me to move to core emotions.
Before each medication management visit, I always have a list of things I want to touch on. This written list keeps me on track and makes sure I do not forget to ask something. During this visit, I will ask about the Covid 19 vaccination and my current Wellbutrin prescription. Will I have any side effects or complications if I get the vaccination?