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.

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.

Motivation

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?

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!

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.

Hungry!

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!

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.