Anticonvulsants

For the first time since getting my first prescription, I forgot to take my meds.

This was Thursday; my first day at the convention, after a day of driving and a late night hotel check-in. My memory is crap. I have an alarm set set on my phone so I won’t forget my pill time. It goes off, it plays some music, and I remember I need to dig the tiny pill bottle I got at REI out of my backpack and down 50mg of Lamictal (lamotrigine, actually, since I’m on the Generic Train). I try to keep a sense of humor about the fact that I’m now taking psychiatric medication, so I chose my crazy-pill alarm sound carefully. Every morning at 9 a.m. EST, I hear the music from this scene of Paprika:

One day as my alarm went off, I marched down the steps, waving my arms back and forth, into the living room. Erin joined in on my pill parade, pretending to be the swaying refrigerator. I digress.

When the music started on Thursday, I just had to tell Brent all about my hilarious choice of crazy music. I was so excited, I never got around to actually taking the damn pills. Off we went to the convention, to nerd-shopping, to playing five hours of Dungeons & Dragons. It wasn’t until I was walking out of the Regency Ballroom at the Hyatt (D&D gets the big room, because no one screws with Hasbro) that it hit me. OMG I never took my meds I never took them I’m going to seizure to death!

I don’t take an antidepressant. While it’s the depression that usually scares bipolar folks into getting help, that’s not the whole of the problem. Taking antidepressants on their own will certainly take care of the Sadface, but in doing so can push you into Crazy Time Manic Land. Anyone diagnosed bipolar or cyclothymic is either not prescribed an antidepressant, or is given it in conjunction with some kind of mood stabilizer. The antidepressant keeps you from falling over. The stabilizer brackets your moods so you don’t go flying off into the upper atmosphere. Because my depressions have been short and relatively less severe, my psychiatrist started me with a mood stabilizer only. Specifically, he gave me an anticonvulsant.

Whatever is going on in the brains of the bipolar is not entirely unlike what happens in epilepsy. Your neurons twitch and you flip into a mood that isn’t your own. Anticonvulsants (also known as antiepileptics) dampen those neuron twitches. My drug, Lamictal/lamotrigine, is one of the most effective anticonvulsants for treating Bipolar II and Cyclothymia because it acts as a very slight antidepressant in addition to grounding all that neural heat lightning. The downside of an anticonvulsant is that sudden discontinuation can potentially cause exactly what it was made to prevent: seizures.

Look, I’m on a really low dose. Dropping off of 50mg of Lamictal for a day isn’t going to do anything. That fact has nothing to do with how you feel the first time you miss a dose. I panicked, calmed down, panicked again, got in line for dinner, panicked, ordered dinner, and panicked enough to use my first lifeline: phoning a friend. I just realized I missed my dose. I’m going to be ok, right? Which, of course, I was. I was even within a safe window to take a half dose and make myself feel less vulnerable to whatever crazypants nonsense I thought I was going to happen to me.

Two months into being medicated, I feel safe saying it’s changed my life. Though I still get occasional, light emotional flips (I had a mild two day reminder of what I’m keeping at bay over Memorial Day weekend), the last two months have been the most even, productive and normal period I’ve had in at least two years. That doesn’t mean it’s all cake and roses. Psychiatric medication isn’t meant to be skipped or taken inconsistently. I know my memory; keeping from missing doses is a matter of planning and more planning. I keep a few pills stashed in my desk at work in case the ones in my backpack get left on my dining room table. I was running low and had very little leeway before my next psychiatrist appointment, so I took only the pills I needed to the convention; if my backpack was stolen I’d still have enough in my medicine cabinet to get me through to my refill. I have an alarm on my phone, and I’m already thinking about how to make sure I don’t screw up the next time I’m way out of time zone (say, in England for the Doctor Who 50th Anniversary).

Medication only takes up a few seconds a day, but it’s an important few seconds and I can’t afford to be casual about it. I missed a role playing game I really wanted to try in order to get back to my room and take my half dose. Was that half dose necessary? Probably not, but it was my way of telling myself that the next time I was on vacation, I needed to be careful. A self-imposed wrist slap to remind Eric of the Future to talk about his cool alarm music after he takes his meds.

read to be read at yeahwrite.me

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31 Responses to Anticonvulsants

  1. Mel says:

    I occasionally forget to take my meds a few days in a row. I’m on cymbalta, which is an SNRI, so I get discontinuation syndrome http://en.wikipedia.org/wiki/SSRI_discontinuation_syndrome…I find it INCREDIBLY ANNOYING that for a day or two after I am back on the regular med schedule, the brain zaps continue. But my mood stuff and my migraines haven’t been affected by a day or three off meds. Just remember to follow the directions on the bottle about missed doses. You’ll be okay <3

  2. Mel says:

    also, you put me on your phone-a-friend list, y’hear?

  3. Renee says:

    Ah, yes, the challenge of the meds. Glad to hear yours are working well – it can really change your life!

    One thing to check – most insurance plans will allow for a limited amount of extra meds for vacations – so you can take some medication with you and not worry about running out in the middle of a trip, or losing some.

  4. Saismaat says:

    so, almost 20 years ago, I was on my way to my reading group, on the bus with a dear friend. She had had a bad bipolar episode and was on some new medication. I have a family history of bipolar disorder, so I can’t say I *knew* much, but I could sympathize. One of the side effects of the drug was tremors, she told me.

    A few hours later, there was an earthquake in Seattle. We were at a very nice, but oldish, house with big windows. All these educated women, we just freeze. Finally, our hostess (who helps run Clarion West and WHO ONCE ACCEPTED AN AWARD ON BEHALF OF NEIL GAIMAN) snaps into action and gets us away from the window.

    My buddy thought it was a side effect. And me, having just a titch of overactive empathy, did too.

    Anyhoo. Probably not a helpful story. But it’s what I’ve got.

  5. Eric says:

    @Mels – There are instructions on the bottles? (Kidding, kidding, I read the instruction sheets about thirty times when I first got this prescribed.) Other than the risk of seizure (which I’m certain I’d need to be at a far higher dose to actually be at risk of) there’s some research that Lamictal does have a discontinuation syndrome similar to an SSRI, but so far that’s inconclusive.

    @Renee – I’d never heard of that, re: vacation meds. Would I start at my doctor for that, I guess? I’m still a bit lost in the woods on this stuff.

    @Saismaat – First, any story that has a sidebar like *this person once accepted an award on behalf of Neil Gaiman* absolutely must be told. *Must* be. Even without that, I loved this story. Honestly, I’ve found a lot of comfort in these kinds of funny little oddities of medicated life. It makes it all more real, more silly, more grounded and down to earth. A story about thinking that someone’s shaking is a crazymed side effect and not an earthquake somehow takes the edge off of these things. Thank you very much for sharing it.

  6. Hey, another Bipolar II in the house! I took Lamictal for years but am on something else now. I forgot my meds entirely when I went to Blissdom this spring and my husband had to overnight them, early delivery, for like seventy-five bucks. I’m on a cocktail much bigger than yours, and it messed me up for days. SO glad you got the right diagnosis and the meds are working for you. They can be truly life-changing, as we navigate this chronic illness-for-life. ~ Cindy

  7. Amber says:

    That is always a scary feeling. I was once on an old school med that a crazy psychiatrist gave me that caused the shakes when you stopped taking it. Then I went away for the weekend and forgot the bottle.

    And guess what, the doc wouldn’t send me another prescription.

    It was the worst wedding weekend ever.

  8. Delilah says:

    Hey Hey Hey, I ride the crazy train too! I took Lamictal for quite awhile after my journey to crazy town with postpartum psychosis. It worked well for me. I’m currently med-free. Translated: Bringing back crazy, one day at a time.

  9. Eric says:

    @Cindy – It’s always wonderful to meet another card carrying certifiable. This transition from I’m Fine->I’m Not Fine So Alone Ahhh!->I’m Going to Be Fine And Not Alone has been difficult at times, but reaching the point of seeing how many other people are struggling, fighting and making it through is so helpful. I’m glad your husband was able to get it to you so quickly (if expensively, yikes!), at least. I’ll probably just straight lose it with pointless fear, what with my thankfully tiny tiny dose of medication.

    @Amber – I cannot believe he wouldn’t send another prescription! I hope you kicked that doctor to the curb. Did he have any good reason at all?

    @Delilah – How did you know when to stop taking the medication? I’ll be honest: seeing how well it’s working, I’m a little afraid of going off of it at some point, having a relapse, and it losing its efficacy.

  10. Carrie says:

    Oh wow, that would have been scary. Risk of seizure is nothing to scoff about. I was on a slew of different meds for my anxiety for many years. When I decided to have kids I needed to stop taking them – obviously. My anxiety came back ten fold and ironically it wasn’t until facing my last child’s potentially life threatening heart defect that I was able to deal effectively with my anxiety without meds. That being said I understand that a change in thought processes won’t help someone whose bipolar! So i’m glad that you remembered to take your meds and I hope the dose your doc has you on helps you enough that you don’t need to up your dose or try something different!

    Thanks for sharing :)

  11. I love the fact that you picked that music. I am even more glad that you had a scare without having a problem.

  12. Mayor Gia says:

    Ugh, forgetting to take your meds does NOT sound fun.

  13. Eric says:

    @Carrie – It’s hard to say with Bipolar and how long you’ll be medicated. Some people are on it for their entire life. Some people improve. There’s research showing that anticonvulsants actually allow the damage caused by bipolar episodes to repair itself, so that’s hopeful. I might be on meds forever. I might not. That said, I think it’s *incredible* that you found your way off of yours, and found a way of living where you didn’t need them anymore, especially through the hardship of a child’s illness. That’s awesome in every way.

    @thedoseofreality – Nothing like making yourself feel *so clever* by way of your medication alarm, right?

    @Mayor Gia – I’m lucky in that I have more leeway than my crazy paranoia was letting me believe. People who are on a mix of drugs really have to be careful and can have far more adverse effects. Mostly it was a Kicking Myself A Lot moment.

  14. Carri says:

    My mom was diagnosed with bipolar disorder when I was 12 – over 20 years ago. She’s never taken medication consistently.
    Now that I’m past my “angry” phase, I’m interested in what a person with bipolar is thinking. Thank you for writing this.

  15. Shosh M says:

    Reading this post was like reading a page out of my own life. My alarm goes off everyday at 9 PM. It says HP for, you guessed it, Happy Pills. I have generalized anxiety disorder stemming from Post Postpartum Depression. My doc keeps upping my meds; however, she keeps warning me that I might have a manic episode because my mom and my sister are bi-polar. Awsome. Just freaking awesome.
    It’s so refreshing to read someone else being open! Thank you for this post.

  16. JUST YESTERDAY my husband told me to set the alarm on my phone to take my Lithium (I’m a bit more advanced than you. Cyclothymia is a thing of the past and I’m just Bipolar II and everytime they check my blood I’m low and they up my dose – oy). If I take it at dinner as prescribed I drink my way through the evening because it makes me thirsty and I get up 6 times at night and become physically ill from lack of sleep. I don’t always lunch at the same time so Joe wants me to set the alarm for breakfast. I get it.

  17. Jamie says:

    My Babe takes meds for anxiety and depression. They matter. On time and consistently. They matter.

  18. Kerstin says:

    I have never been on those type of meds and where I come from people don’t like to talk about it. I am so glad that it seems to be different here – or maybe it’s just the blogoshpere?
    I have to very dear friends who have been on different medications, like Abilify and they have had very good experiences with it. And just like you, they said that taking it regularly and on time is key!
    Glad it’s working for you!

  19. When I switch back to birth control pills I’m definitely going to need to set a reminder for myself every day. I watched that Paprika clip– craziness! My boyfriend walked in and was very confused :)

  20. hey there–

    you are most definitely not alone and you have lots of neighbors in Crazy Town. I’m one of them. I am taking Cymbalta and Klonopin for depression & anxiety. I definitely notice things when I miss a few days—those brain flashes are the worst. I’m so glad you felt comfortable sharing this here b/c lots of people need to read this. About to go share on twitter.

    Found you through Yeah Write & am happy I did. If you manage to make it to my post, you won’t see anything, at least not right now b/c my blog is down. Which is making me all crazy and anxious. Oh well.

    @ErinMargolin

  21. Eric says:

    @Carri – I’m sorry to hear about your mom. I’ve got bipolar in my family, too, but no one I lived with, and I didn’t know about their condition until I was researching my own. I hope you stick around; I plan on talking a bit about what it felt like, because I think that a lot of the internet material is too focused on clinical diagnosis and not what the experience, in the moment, is really like. It makes it so much harder to accept what’s going on. My archfrenemy, Mere, wrote an excellent post about what her bipolar depression is like here: Dear Lizardhead.

    @Shosh M – The reminder thing is kind of tough to deal with, isn’t it? You almost have to find some fun in it, because the fact is, you are now tethered to a time, and a pill, and not sticking to the schedule can cause problems. If you ever want to talk about warning signs of a manic episode, let me know. If it turns out that bipolar is in the mix and not just depression, all it means is a different treatment. Nothing more, nothing less. Just a different treatment. Please let me know if I can help.

    @Kim @The G is Silent – Did you start as a cyclo and get worse? This has always been my fear, and why I pushed *so hard* to get treatment quickly. If I was catching it before it progressed too far, I was determined to do everything I could to stop it. I don’t know if that will work long term, but I have to feel like I’ve got some control. Have you used anything other than Lithium, or has that always been your first line treatment?

    @Jamie – Word.

    @Kerstin – I think talking about mental healthy issues can be difficult because it feels like admitting weakness and asking for judgment. Unlike an obvious, physical disease where you can go LOOK I HAVE OPEN SORES! there’s always the worry that people will think you’re not sick, just weak, and that can be hard to take. I try to talk about it so people know that you can be strong, together, focused…and still have a mental illness that needs treatment.

    @Alexandra the Tsaritsa – Isn’t that clip just grand? The whole movie is a head trip. I love it.

    @erin margolin – I’m so glad you found me, and thank you for sharing! As I learned about my own problems, I was helped by friends who made sure I knew that a mental illness is no different than diabetes or the flu, and there’s no shame in medicating it. I figure if I’m up to talking about it, it’s my responsibility to do so, and since friends helped me, I kinda *have* to pass that along. I can’t wait to see your blog once it’s back up!

  22. Amanda says:

    Thank you so much for writing this. Just, thank you!

  23. Kathy Kramer says:

    I have to put my anti-depressants and my ADD medication in a day of the week pill box or I will forget to take them. It’s gotten better since I’ve been on the ADD meds, but I still have to set an alarm to remember to take them and have the pill box so if I’m not sure I took them, I have a visual reminder on whether I did or I forgot. I have an anxiety disorder, which is also treated by the anti-depressants. Earlier in March, I started having panic attacks because I forgot to take my meds.

    I know what that’s like being on the medication train.

  24. I’m glad I found your blog. You show so much insight and depth, but in a plain-spoken manner. Also, the humor ain’t bad. (“D&D gets the big room, because no one screws with Hasbro”=giggles)

  25. jamieywrites says:

    Eric, love the clean layout of your blog! Anyways, nothing in life should be taken lightly ;) xx

  26. TriGirl says:

    I think there might be nothing worse than feeling out of control because you have not done what you need to stay in control…a bad downward spiral. Glad it all worked out ok! I don’t know any D&D terminology (aside from a 12-sided die) so, “Live long and prosper”?

  27. Ado says:

    I have a lot (a LOT) of friends who take meds for depression and it helps, like you – it has changed their lives. I’m always so happy to hear it when people find the right medication for them so they can be “normal” and not feel depressed. Congrats on the past two months! (-:

  28. That must have been so worrying! Hopefully as you continue to develop the routine it will be less and less easy to forget. Stay well!

  29. I applaud you, your success, your balanced mood, and your dedication to taking your medication. It is not easy. I grew up with a bipolar father. I am very specifically saying bipolar father and not a father with bipolar disorder. Bipolar was who he was, and it controlled his life (and mine). When things got too tough in life, he would purposely go off of his meds to escape. And then things would get tougher for us all.

    I’m glad things are going well for you and I know it takes more work than just popping a pill. Ellen

  30. Eric says:

    @Amanda – If my mouthing off about the things I’m going through helps in any way, I’m happy to do it. I mean, ok, I’d probably mouth off anyway (I can’t exactly stop myself) but I’m really glad to hear if it meant something.

    @Kathy Kramer – The day may come when I need to use one of those day pill boxes. I keep putting it off (I can manage one pill a day! I don’t need no help!) but if I miss any more days, I may not have a choice.

    @Liz @ShiftlessMommie – Glad you found your way here, too! I loved your entry this week on the challenge board and laaaaughed, so if I gave someone so witty a giggle, I consider my work done. I’m telling my boss I’m going home for the day.

    @jamieywrites – What was that Doctor Who quote? “900 years of time and space and I’ve never met anyone that wasn’t important.” Something like that, only it’s more like nothing is unimportant. But if I didn’t laugh at some of it, I’d probably be crippled by the ennui of it all. ;)

    @TriGirl – Dude, 12-sided die? That’s some beyond-novice D&D knowledge. Most people would go for 20-sided. Win! Sadly we don’t have terminology beyond, “Where’s the Mountain Dew, damn it?!” I’ll take Vulcan-speak any day.

    @Ado – Thank you for the congrats! It’s been a massive relief. Now it’s just a matter of maintaining, of training myself that being healthy is a process and it doesn’t so much end so long as your body and mind keep going.

    @Michelle Longo – I’m a massive over-worrier as it is, so this was a perfect excuse for my mind to go loony-tunes on me. I was getting too comfortable about it, probably. If it happens again, I’ll break down and get a day pill box and give my wife a cattle prod.

    @Sisterhood of the Sensible Moms – I am so, so sorry to hear that, Ellen. Mental illness is so tough in so many ways, and it might be worst in the ways it can affect loved ones. I know that living in those conditions must have been terrible, and left you feeling at the whim of *his* moods and *his* choice to go off of his meds. More than anything else, the thing that woke me up to needing help was seeing the way it was worrying my wife. She got the worst of my mood swings – I could hide from the world, but not from her – and she deserved and deserves better than that. Someday, maybe soon, I’m going to hit a rough patch, and I’m taking to heart your story to use as a reminder of what not to do, and how it could hurt the people about whom I care to forget it’s not just me the pills and therapy are meant to help.

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