The summer of 2018 went fine. Tommy, my 13-year-old son, was enrolled in several summer camps, which he enjoyed; we had no discernible immediate family issues, and I was in a complete bipolar remission. It felt good to feel good.
But then, the school year rolled around, and I got stressed out. I was teaching two writing courses at a local college, and I noticed a big difference between the calm I’d felt over the summer and the tension that going back to work brought on. There were classes to plan and papers to grade. There were names and faces to learn and personalities to try to understand.
Pretty soon, I found myself a little hypomanic. I couldn’t sleep, and I felt myself living on the edge of reality, which was a feeling I hated; the ideas of reference were returning. Ideas of reference are when a person believes that small, random incidents have important personal meaning.
To compensate for this abnormal rise in my mood, I took myself off the 20mg of Cymbalta which I’d been taking for about a year and a half. My ex-psychiatrist, who had recently retired and who I’d trusted with my very life, had given me “permission” to do this whenever I felt myself get too high. All I had to do was call his office and tell him that I was going off the med, and his nurse would record the change in my file. I discussed my prior medication change process with my new psychiatrist, and he was completely on board with it.
OK, so all was fine and dandy. I quickly came down off my hypomanic high and returned to normal. I felt like myself again. My sleep patterns resumed their optimal pattern. The ideas of reference quickly disappeared.
But then, I felt myself drifting down, getting depressed. Soon, I was deeply sad, and it was extremely hard to function. All I wanted to do then was sleep. Yes, going off the anti-depressant was even more destabilizing than the hypomania had been.
I waited the depression out for about a month, and then, I had no choice, but to go back on the 20mg of anti-depressant.
But it took forever to kick in. I held onto my daily life “by my fingernails.” I was grouchy. The whole household was grouchy, especially my son Tommy. When I was depressed, Tommy was also depressed. No one was feeling any joy. I contacted my new psychiatrist. I asked him to increase the Cymbalta, but he was afraid to do it because he thought it would make me hypomanic again, and the whole cycle would start all over. So I waited it out.
I’ve now been back on Cymbalta for three weeks. It’s finally starting to work. How do I know this?
Today, out of a clear blue sky, Tommy remarked, “I’m happy, Mommy.” He said this before he got on the bus for school.
As I said, his moods mimic mine. I must be feeling better because he’s happy again.
Also, today, I find myself writing. I hadn’t written at all during all of these turbulent months. But when I’m writing, I’m at my “normal” disposition.
As a bipolar individual, I am sometimes at the mercy of my medications. Sometimes, they work too well, and sometimes, not well enough.
One thing I know, a medication change is hell. Medications should ideally remain stable. Going off and back on them is very hard on a person. When you find a medication cocktail that keeps you sane, you should stick with it.
Maybe I made a mistake going off the Cymbalta in the first place. Maybe if I would have ridden the hypomania out, it would have disappeared as I got more and more comfortable with school.
The upshot of the whole experience is I’m going to be slower to change my meds than I’ve ever been before. I’m going to leave the ultimate decision up to my new psychiatrist. He said if this happens again, he may add more anti-anxiety medication instead of reducing the anti-depressant. He sounds as though he’ll be much better at tinkering with medications than I was.
Is this a lesson in trust? I think so. I’m learning to trust a new doctor and switch over to his methods. I miss my old doctor, but it’s time to move on.
One thing is for sure: I’m no psychopharmacologist.
Live and learn.