Thursday, June 25, 2009

Hot and Cold

Physical symptoms of withdrawal have been coming and going over the past couple of days. Right now I have that hot and cold at the same time thing going on again. I had goosebumps but I'm sticky at the same time. My feet are freezing.

I had to change my coffee to decaf, unfortunately. A cup of regular coffee the other day triggered a symptom attack, so I bowed to the inevitable. The decaf isn't that bad, it's better than tea, anyway.

I spent the day on the sofa today, just too tired to do anything else. But my mood is holding up well, so I didn't mind. Yesterday I found that my energy level went up in the evening, and that seems to be holding true today as well.

The really good news is that I read a book! I don't know how many years it has been since I read a work of fiction, 4 or 5 maybe. I've been reading the occasional self-help book now and then, but I gave up on fiction, it just didn't hold my interest. I watched the Andrew Davies adaptation of Northanger Abbey on DVD the other day, and it made me want to read the book to see how it compared. I was able to read it easily, with no problems with concentration or attention. So that is a major breakthrough. I am thinking of looking into the rest of Jane Austen's works, I have not read them since school, I think.

My appetite has been all over the map also. Today it took me all day to eat a small dinner roll with cheese, I had no appetite. You will recall that a few days ago I was starving all the time. Fortunately, I was able to control that with the Total Amino Solutions (TAS). Things are tasting a little odd too.

I adjusted my taper off Risperdal to make it a little more gradual. I noticed when studying my charts on the Truehope website that my withdrawal symptoms really didn't start until my Wellbutrin went to zero. Just that last step from 75 mg to 0 mg seemed to be a big one. Rather than heap more insult onto my body by ending the Risperdal right away I decided to cut the tablet into eighths, a 0.375 mg dose. I will take that for 4 nights total. It seemed to me that going from 0.75 mg to 0 mg would have been another big step that might cause problems, so I feel better about this.

I have been reading Wikipedia about withdrawal from benzodiazepines and SSRIs. There is a lot of interesting information there. I am very grateful that I'm not dependent on benzos and going through that aspect of withdrawal. I dodged a big bullet there. I took Ativan for a few years until it just stopped working. I switched to Klonopin, but it never really did much for me so I just sort of drifted away from it. No withdrawal, no big deal. Thank goodness!

One of the things emphasized in the Wikipedia article on benzo withdrawal is that a very slow taper off the drugs has the best success rate and the fewest symptoms. They are talking about a 6 month taper. It made me wonder about Truehope's strategy, which is much quicker than that. One of the consequences of a fast taper is said in the article to be more severe symptoms during protracted withdrawal, which is the period of time after you've finished taking medications when you are still getting symptoms. I wonder if the severe symptoms many Truehope participants complain of during protracted withdrawal could be partly due to the rapidity of the taper. It makes me wonder if a gradual introduction of Empowerplus and a six month taper might actually be kinder. Food for thought. It's too late for me though.

Tuesday, June 23, 2009

Feeling Good

Well, all the symptoms I was having seem to have gone away. My body temperature is back to normal, my mood has stabilized and I'm feeling positive once again. My hunger levels are back to normal. Things are going great. I'm holding steady at 15 Empowerplus capsules a day, and I'm down to .75 mg of Risperdal. Two more days of that and I'm done all together! I'm already finished with the Wellbutrin. I'm not even taking the Total Amino Solutions today.

And the best news of all (almost) is that I've had a couple of cups of coffee without any trouble. The tea just did not cut it. I guess it is more than just a hot drink for me, it is the taste of the coffee as well. I will probably cut back from 3 cups a day to 1 or 2, but I don't know about decaf. It seems I am fussier about my coffee than I had thought. If the withdrawal symptoms come back I may avoid coffee for a few days, but otherwise it seems to be ok.

I am lucky I know. Who would have thought withdrawal from years of psychiatric medications could be so easy? When I compare this experience to the last time I quit Risperdal the difference is night and day. My mood is very positive. There are longer standing issues to get over, like my motivation problems, but for now, things are going very well.

Monday, June 22, 2009


Ok, I've had this title up two or three times already, but I always end up talking about something else. Motivation is a real demon for me.

Lack of motivation is pretty common among people with depression or other mental illness. It can be hard just to do the basic necessities of life, like cooking, cleaning, personal care. I have been pretty seriously unmotivated for 9 years now, since I went on disability. It is easy to understand why I don't do things I don't like doing, like cleaning, but I've had a hard time coming to grips with why I don't do things I ostensibly like to do, like my crafts.

I love crafts. I knit, needlepoint, cross stitch, embroider and quilt, to name the main ones. I love working with colour, I love the different textures of threads, fabrics and yarns, I love pattern. I enjoy the meditative, repetitive nature of many crafts. I love planning and starting new projects, and I love the finished products. I love my crafts. But in 9 years, I have shockingly little done.

This has been a source of much anguish to me. My dream has always been to be retired and free to pursue my crafts all day. There appears to be nothing stopping me from living the dream right now. I have a basement full of materials ready to go. But most of the time I don't do them. Does this mean my dream is wrong, misguided in some way? Maybe I don't really like crafts as much as I think. I have the feeling that I am having the experience of living my dream, only to find it was not what I wanted. Why am I not doing something I supposedly love so much? It is painful to feel that I don't know my own mind.

Thinking about this topic for the past few days I have been coming to the conclusion that it is the depression that is causing a lack of motivation, even for something that I enjoy. It is hard to accept that depression could take away something so basic to me, that it can take away my dreams like that.

I used to measure my days by how much crafting I got done. I felt good if it was a productive day, and I beat myself up if I didn't do anything. Recently I have stopped beating myself up. I had achieved a certain amount of acceptance with sitting on the couch, and I was more peaceful. Now, though, after writing all this, I am wondering. I have questions for the future. Many people on the Truehope program do get their motivation back. What will happen to me? Will I pick up my crafts and be happy? What if I do not like crafts anymore? What will my dream be then?

Sunday, June 21, 2009

Oh no! No more coffee!?!

One of the limiting factors that can reduce the effectiveness of Truehope's Empowerplus supplements is caffeine. There are lots of limiting factors, and I have a lot of them, so it was kind of hard to take them seriously. So even though I knew coffee was sort of a no no, I went ahead with my 3 cups a day anyway. And that worked fine, up until yesterday. I started yesterday with the Total Amino Solutions, to keep control of that hunger and my mood, and I don't know if that had anything to do with it, but when I had my first cup of coffee that afternoon I soon started to feel strung out. I was hot and cold at the same time, sort of clammy. My usual pattern is to have a cup of coffee if I am feeling unwell, so I had another cup. Things got even worse. It was clear that the coffee was not the right thing anymore.

So today I have not had any coffee, and I'm feeling it. I guess I have to go to the store and try to find some herbal tea. I've been reading about people giving up coffee, and I think for me the main thing is the ritual of making and drinking a nice hot drink, rather than the taste so much, or the caffeine. At least, that's my story and I'm sticking with it.

The worst thing is that I still have this hot and cold feeling -- it's summer and my feet are freezing while the rest of me is sticky. My feet have been cold for days now, very unusual for me, it must be another side effect of the withdrawal.

My mood is more volatile as well, although mainly it is disturbing me rather than those around me. I really value my peace of mind, so it is annoying to be getting angry over small slights. I seem to be in a more reasonable frame of mind now, though, so hopefully that will continue.

Actually, I wonder if there is some cinnamon tea still in the house? It seems like a sorry compromise, but maybe I will like it!

Friday, June 19, 2009

Symptoms Increasing

Yesterday I was a little hypomanic. I snapped at my mother on two separate occasions, just way overreacting to what she was doing, which is very unlike me normally. It was weird to be so out of control, for the first time in a long time. And then, the confirmation, I didn't sleep for hours last night. No racing thoughts or anything, just wide awake. But it looks like it's over now.

Today's problem has been more of that hunger. I was ravenous all afternoon. I spoke to Truehope support again today about the hypomania, and they recommended that I start the Total Amino Solution (TAS) supplements that I've had sitting around here since the beginning. After eating everything in sight it finally occurred to me that the TAS might help with the hunger, if it is indeed a symptom of withdrawal. I took two, and now, 3 hours later the hunger seems under control. This is good news indeed, because I understand I can take quite a lot of TAS without side effects, so hopefully I will not be plagued by this hunger any more.

It has really made me see, however, how strong that hunger side effect is. No wonder I gained all that weight! It has all become clear today. I had thought a large part of the weight gain was due to the depression, but now I can really see that it's the drugs that did it. Wow. They should warn people.

Thursday, June 18, 2009


I just realized last night that I probably am having some withdrawal effects. I'm hungry! It feels the same as previous experiences with drug-induced hunger. I'm just hungry all night, nothing is satisfying, I eat one thing after another, mainly carbs. During the day I'm ok, but at night, look out!

I've had this for a few weeks now, but it didn't really occur to me that it was withdrawal until last night. It figures that this would be the withdrawal symptom that I have. I have a history with weight gain from my medications. When I started Depakote (Epival in Canada) I gained 100 lbs from that and the depression. I was on Depakote for migraines actually. I was getting at least 15 days of migraines a month, and I was desperate, but I still wonder if the doctor had told me I would gain 100 lbs if I would have started it. I met a guy in a Bipolar support group who also gained over 100 lbs on Depakote, but he lost it all when they switched him to Topamax. I went off Depakote and I managed to lose 40 lbs, but then I started Celexa and gained another 25. I quit Celexa last winter and I've managed to lose 15, but I'm still carrying 70 extra pounds compared to my weight when I had my breakdown.

So my secret hope is that I will lose weight with the Empowerplus supplements. I've read of others with big weight losses on the program. Hopefully this constant hunger will be temporary.

I'm also noticing a little variability with my sleep patterns. In my second and third weeks on the program I was sleeping less soundly, I think because my dose of Risperdal was being reduced. Risperdal always knocked me out at night. But this past week I've been sleeping more deeply, even though the dose of Risperdal is even smaller. Hopefully I am getting into a healthier sleep pattern.

I'm considering speeding up my taper off the Risperdal, to maybe get through this hungry period a little faster. I'm thinking it's probably my version of being overmedicated. I've been stretching out the taper of Risperdal to 6 weeks, because I was taking a fairly high dose. Truehope support thought 4 weeks would be enough, but I was cautious.

Yes, I just got off the phone with Truehope and they agree that I could be tapering off Risperdal more quickly. I will do one more night at 1.5 mg, and then do 4 nights at .75 mg, and then I'll be done with it!

Tuesday, June 16, 2009

Not Sad, Depressed.

I just took my dose of Risperdal for the evening and I felt a little twinge of glee. I am down to 1/2 a tablet, from 1 1/2 tablets. I can't believe that this tiny bit is all I am taking now, and I feel good! Wow, it's amazing.

My situation is a little different I think than many people's, because I don't feel sad, and I wasn't feeling sad even before I started Empowerplus. I have been thinking today, after yesterday's revelation with the symptoms of depression, that there are many ways that depression manifests. Feeling sad is only one of them, and I think I have done a good job training myself to always reach for the better-feeling thought, so that I have talked my way into a fairly mellow place. I will say that five years of therapy helped a great deal as well -- I have all my childhood issues well sorted and totally reconciled. I have an excellent relationship with my parents now.

I am straying from my topic, but as an aside I recommend therapy for anyone who can afford it. Interview different therapists until you find one you click with. I had two primary therapists, one in California and one when I moved back to Canada. In California I had insurance to cover the cost but I paid out of pocket for my Canadian therapist, it was well worth it. Both my therapists were women. I did have some sessions with men, but I found there was more of an unspoken understanding with the women. I would expect that a man would find a better connection with a man too. Both my therapists had a Ph.D. in psychology, I found the higher level of education did make a difference. I had sessions with a psychiatrist too, who was well-respected, and I liked him, but in my opinion I don't think he was as interested in the process of therapy as my psychologists were. I went into therapy with a determination to be totally honest with my therapist and with myself, and it really paid off for me.

Ok, off my soapbox. My point is that despite all this good psychological help I've had, I'm still probably depressed. Not sad, depressed. The symptoms yesterday show that -- trouble concentrating, avoiding people, low energy and the rest. It is interesting that these symptoms persist even though the sadness is gone.

Arrgh, I don't even know where I'm going with this anymore. Concentration still an issue, clearly. I'll just post it and let the chips fall where they may.

Monday, June 15, 2009

Symptoms Evaluation

It's a lot of responsibility, having a blog. I keep starting and stopping today, trying different titles, looking for inspiration I guess. It really makes you evaluate your thinking.

For instance, in a previous version I was all set to tell you how I skip right over the "symptoms" part of the Truehope Symptom Evaluation Form, which I have been doing. I looked up the form to give you examples of symptoms that I don't have. But today, in all conscience, I can't really say that I have zero symptoms. I rescheduled an appointment to take my car in for service -- so there's "avoiding people." I've started this blog post several times today -- there's "hard to concentrate or decide." I think I can lay claim to "loss of energy" and "loss of interest in hobbies and activities" too.

But at the same time, I woke up feeling that lighter feeling again today. I'm not unhappy. In fact, if I didn't have things to do I never would have noticed that I have symptoms at all. There's the rub, as they say. If only we didn't have things to do.

Saturday, June 13, 2009

My Love/Hate Relationship with Drugs

Do you remember when Tom Cruise came out against Brooke Shields for taking medications for her post-partum depression? He said mental illness could be cured with vitamins. I thought he was a wacko. I thought everyone was seriously misinformed who didn't realize that mental illness was a serious physical condition that required serious drugs. And now here I am on the vitamins bandwagon! Life is funny.

Back when I lived in San Francisco I ran across a journalist who was against antidepressants because people were taking them for minor complaints, and they were losing their capacity to feel deep emotions. He felt that the ability to feel the darker emotions was essential to him as a writer, for example. I felt that he was totally missing the experience of those like me with serious mental illness, who had a surfeit of darker emotions. I felt, and I knew others who felt the same, that psychiatric medications had saved my life.

But life is full of irony. Once I was a little more stable, taking Risperdal, I was out of the woods as far as major depression was concerned, but I was dissatisfied. I was still feeling depressed, and I started to suspect that I was missing the fun and good feelings of my hypomanias. Such a typically bipolar thing to think. People with bipolar disorder are notorious for non-compliance on their medications for just this reason. I wanted to take less Risperdal, not stop it completely, just to open the window for a little hypomania now and then. But what happened instead is that I got more depressed and more fatigued than when I was taking it.

And then I got even more depressed, and we added Wellbutrin to the mix, and eventually Celexa. We raised the dose of Risperdal even higher. Now I wasn't depressed, but I still wasn't satisfied. I got interested in the positive psychology self help movement that is going on today, but for the life of me I couldn't muster a happy feeling. I started hearing that the psychiatric medications do indeed do that -- they inhibit the happy feelings along with the sad ones. Good grief, that journalist was right!

So for the past two years I've been trying to find ways to go off my medications. I tried other natural remedies. St. John's Wort hadn't helped me before my breakdown, so I didn't try that again. I phased out Celexa and added tryptophan, that worked successfully. SAMe was a big disaster, the stomach pain I had from that was tremendous. I tried bioidentical hormone replacement, thinking my mood problems could be hormonally related. I felt good on that for 6 weeks and then the migraines started. The migraines wiped out any benefit from the hormone replacement, so I had to give it up. Encouraged by my success with the tryptophan I tried lowering my dose of Risperdal again, but just a small reduction of that left me listless and more depressed. Just after that attempt I heard about Truehope.

Now I am taking way less Risperdal, in two days I will be done with Wellbutrin all together, and I feel better than I did before I started the Truehope Empowerplus. Can happy feelings be far behind? I hope not.

Social Phobia

One of the problems I was facing that motivated me to start the Truehope program was a growing social phobia. I am surprised to see on the Truehope message boards that it is actually not that uncommon.

Back before my breakdown I did personality tests at work that showed that my natural state is extroverted. It is almost ten years since my breakdown now, and the first five of that were spent trying to stabilize my depression. I tried every drug on the market before I settled on Risperdal, Wellbutrin and eventually Celexa as well. These left me not depressed, per se, but with a growing social phobia.

What do I mean by that? Well, for me it means that going out is a real trial. Things that people take forgranted like showering and putting on something other than stretchy pants are big challenges and require advance planning. So the cards have to be right there. Then there is the travelling to the outing. When I go downtown I take the train, so I have to be on time for that. Otherwise I'll drive. Now, I love driving as a rule, but when I am going out I have to worry about the weather, parking, traffic, and they all seem like big challenges when I am contemplating that on top of showering and getting dressed. It is like a long chain of things that all have to go right.

Once I am actually out with my friends I always have a good time, I guess my extroverted nature finally is released, and I try to remember this beforehand, but I still take a long time between outings summoning my reserves. I see my friends rarely these days.

Now I think a doctor would say this is all a symptom of depression, and maybe it is. What I do know is that the drugs I was on weren't doing anything to help it, and in fact it was getting progressively worse. I was looking at a bleak future of sitting on my sofa, well, lying on the sofa, afraid to leave the house. So, while getting off my medications and lowering my blood sugar levels is my primary goal, getting out of the house a little more often would be a nice bonus.

Thursday, June 11, 2009

A Quiet Mind

Yesterday, actually, I had an interesting development in my mental health recovery that has motivated me to start writing this blog. It's hard to describe. It's like there's been a constant noise in my head all this time that suddenly stopped. Like a source of pressure has been released. It's subtle, yet I think the ramifications are huge. I think part of the reason things in my life stress me out so much is because I've always had this pressure in my head, taking away my flexibility to deal with other things. With that pressure gone, my whole relationship to life could change!!

Ok, well that was yesterday, and it seems like it may be back a little today, but now I see what's possible.

I am 3 1/2 weeks into the Truehope Empowerplus micronutrient program for mental health. My diagnosis is Bipolar II, with my main problem being depression. I take 15 Empowerplus capsules a day. I am in the process of tapering down my psychiatric medications. I'm down to 2.25 mg of Risperdal, or 1/2 my original dose. I also take 75 mg of Wellbutrin, down from my original dose of 300 mg.

So far I have not had any withdrawal symptoms. This is not my first time tapering off Risperdal. I went off it several years ago when I developed a really annoying tremor in my jaw and tongue, which was brought on by a period of extreme stress. Last time I tapered off Risperdal the withdrawal was extreme, a terrible black suicidal depression. So I began my taper this time with a great deal of trepidation, but things are going swimmingly. This Truehope Empowerplus is great stuff!!

Not only am I not experiencing withdrawal, I am in fact seeing improvement in my symptoms of depression and anxiety. The Truehope website has a Symptoms Evaluation Form that users fill in daily, and you can view your charts to see your progress. I thought I was doing pretty well when I filled in my baseline charts before I started Empowerplus, but even there I have improved.

I think my doctor would have said that I was pretty well controlled on the Risperdal and Wellbutrin. I didn't have any big depressions or hypomanias. But I was still getting little depressions, as well as a seasonal malaise that is probably Seasonal Affective Disorder (SAD). I was dreadfully fatigued, developing more and more of a social phobia, and unable to work. I was staring down the barrel of spending the rest of my life on disability, sitting on my couch all day. I had no quality of life. So that is why I decided to risk a difficult withdrawal period and start the Truehope program.

Once I started researching Truehope I learned other reasons to get off my psychiatric medications. My last blood test showed that my blood sugar is at pre-diabetic levels, and I was shocked to learn that the Risperdal could have caused this. My hormones are also all screwed up, with elevated prolactin, also caused by the Risperdal. I don't have the mental fortitude to be taking blood samples several times a day, so diabetes is to be avoided at all cost. I have suspected all along that my psychiatric medications were shortening my life, now I am sure of it.

You may ask why I stuck with Risperdal all this time. The fact is that it took me 5 years to get as stabilized as I was, after trying every medication on the market. I had immediate side effects from almost everything, from dopeyness to migraines. Even Topamax, which was initially marketed for migraines, gave me terrible migraines. Risperdal was the only thing that even partially worked. But as I said, there's lots of room for improvement, and I'm not risking diabetes.

So this was a long post as I gave you all my background. I'm looking forward to lots of good news posts from here on in. The Truehope documentation says that recovery on the Truehope program is a long haul. In addition to the potential for withdrawal and what they call protracted withdrawal, when your body releases over the period of several months the psychiatric medications that have been stored in your tissues, there is also a period of adaptation to a new and healthy mental landscape. That is part of what I glimpsed yesterday with that momentary release of pressure in my head. It's more than just "feeling better," I'm hoping it will be a real shift in how I think.