Posted by Christ_empowered on October 31, 2011, at 20:26:28
I haven't taken any Abilify today, but I'm considering it. I think the problems are that a) I was on an excessively high dose for too long, which made me dislike Abilify (which is the only AAP I can tolerate) and b) short-term, Abilify isn't that bad, especially at 15 (I have lots of 30 tabs, so I just take 1/2). However, over time, I start to feel kind of dull, apathetic, lethargic...tranquilized, basically. I'm also prone to depression anyway, and long term I don't think full-dose Abilify really helps in that department, and I suspect it may actually make the situation worse.
So, I don't really know what to do. My parents get generic Abilify from India (God bless the internet), so it wouldn't be too hard to order a stash of a lower dose. I'd need my doctor's approval though. They just ordered more 30 tabs, so I should probably work with those first. I was thinking about taking a 1/4 tab daily (roughly 7.5mgs) to see if that would be better than 15. I did read somewhere, in an article or something from the early-to-mid 200s, that 7.5mgs Abilify was roughly equivalent to 100ms Thorazine, which is apparently a good, small maintenance dose for those with psychotic "issues."
I don't think I need clozapine. I mean, I'm glad they're still using it, since it seems to help people who aren't adequately helped by other available options, but man--that is some rough stuff. Even if you ignore the potentially fatal side effects and hassle of doing blood work, you still have to admit that something that densely sedating (some people have a tendency to drool on it) probably isn't ideal, especially considering that I've become accustomed to Abilify.
As much as I hate reuptake inhibitors ("antidepressants"), I kind of think that a low dose of something relatively tolerable--celexa, for instance--might help with my problems. This time around, if I could get on an antidepressant, I'd probably also try to haggle with my doc to get a lower Abilify dose approved. Unfortunately for me, my doctor is convinced that an antidepressant would make things worse. She has a point--even people without a history of psychosis or mania can have problems with the reuptake inhibitors--but I think there's a lot of variability in response to these drugs, and in my own experience I sometimes benefit from them.
As for diagnosis...I have no idea. Auditory hallucinations that become more pronounced with very low or very high mood. No current sleep problems, except for a screwed up sleep schedule because of my bout with the flu. Anxiety and agitation have been minimized by the Lamictal 200, which to me would mean that the mood-elevating properties plus the anticonvulsant action (they have a "taming effect," at least on animals) really does the trick for me. I get agitated, psychotic depression (or whatever you call it) and my last "manic episode" lasted 5 months and involved paranoia, religious delusions, periods of euphoria, periods of dysphoria, lack of concentration, hyperkinesis, high blood pressure, a half-*ss*d suicide attempt, hostility, weight loss, high blood pressure, and dissociation.
I'd love to say "hey, its Bipolar with Psychotic Features," but I think maybe I'm one of those people who doesn't really fit into the DSM. Then again, I think shrinks have a tendency to *make* people fit into the DSM by emphasizing some problems and minimizing (or ignoring) others. My "manic episode" left me feeling as if my whole personality was disintegrating. I don't think that's terribly common in classic Bipolar I, but I don't know.
There have always been strong psychosocial and environmental factors in my "illness," most of which have now been minimized or rectified, which may explain why I'm able to do more with less medication. Or I could have outgrown an immature, self-absorbed personality.
What's strange is that, looking back, I feel as if my psychosocial and personality issues masked an underlying problem. On paper, it looks like I've gone from neurotic and disordered to straight up crazy as hell. The psychiatric symptoms are now more distinct and more easily treated. I kind of feel as if some of my so-called "defense mechanisms helped "hold back" severe psychotic issues. Now that those defense mechanisms have been destroyed, I'm left with more maturity, more insight, a better ability to engage in life and function, but I also have to contend with more severe mood and psychosis problems. Such is the price of progress, I suppose.
Sorry this was so long and rambling. Its just that I think my madness, and most people's madness, is so much more nuanced and complicated than just a "broken brain" that results in aberrant (or at least undesirable) behavior. Factor in the hot mess that is modern day psychiatry, and you have a recipe for Trouble (note the capital T).
Thanks, everyone, for taking an interest in my well-being. I can assure all of you that I'm not in denial or looking to land in a mental hospital; I'm just trying to figure out how to function without turning into a tranquilized zombie.
I think I'll go ahead and take some Abilify now. I have a fear of ending up in a mental hospital. Not only do those places suck for everybody, I seem to earn the contempt of the physicians and other staff of the hospitals I've been in. I think I'm a little too "spunky" for my own good, at least when it comes to inpatient "treatment." So, its probably wise to take 7.5-15 Abilify and keep myself out of psychiatry's more oppressive forms of "treatment."
poster:Christ_empowered
thread:1001368
URL: http://www.dr-bob.org/babble/20111027/msgs/1001368.html