Introduction - Part 2

Lithium is known as the 'Gold Standard' of mood stabilizers for bipolar disorder. I've been on it for virtually all of my 10 years.

However, there is one big catch - you can develop kidney or thyroid problems. Regular blood tests keep an eye on that.

My blood tests were always perfect, until about a month ago I received a call from my psychiatrist.

I had developed hypothyroidism.

Now at first this sounded terrifying - I have even more shit wrong with me that need medication for?!  Not something temporary, but another lifelong condition?!

In the end, it's not that scary. Anybody can develop hypothyroidism, and the medication (Synthroid) is side effect free. I learned how it just means my thyroid is under active - which explained my mysterious weight gain I had been experiencing for over a year. (Hyperthyroidism, in contrast, means you have an over active thyroid. Can lead to anxiety, weight loss instead of weight gain, etc)

I made peace with my new additional medial condition over time. My weight started to go back to normal.

However, my psychiatrist reacted dramatically. She started to slowly taper me off the Lithium, while trying new medications like Abilify.

At first this went fine - I had annoying (not terrible) side effects from Abilify, so we moved on to trying Tegretol.

This continued to be more of an annoyance than a terror - I was fidgety, wakeful while sleeping, but overall okay. However, the Lithium was still in my system in lower doses.

Almost immediately after stopping Lithium completely (staying only on Tegretol), things started to feel wrong. I was starting to have trouble breathing, with a physical feeling of panic often.

I gave it a week, and that proved useless. I just ended up having mini panic attacks 24/7. Hooray!

My psychiatrist reacted by raising my current medication, the Tegretol, to a higher level. I at first was pushing for a lower dosage level due to fear of side effects.  Plus I felt that sense of invincibility mentioned in my first post.

And, well, raising it did introduce some terrible side effects. I felt completely drugged, woozy, and uncoordinated. Just walking on the sidewalk, I tripped and fell flat on my chest like a feeble old man.  I got into a car accident (fender bender) that cost me $1,800. Exercising just felt weird. Not to mention the worst sexual side effects I had ever experienced (hey, can you really get too TMI in an anonymous blog?)

And on top of all of that, I was still having a mini panic attack 24/7.

At this point I was a mess. I'm a freelancer, I was in between jobs, and my car was in the shop. My days devolved into me watching Netflix all day, trying desperately to make the terrible feelings of panic, shortness of breath, etc to just go away. My body felt like it was in revolt.

Oddly enough, now whenever someone mentions Orange is the New Black or House of Cards (Netflix shows I watched), that panic starts to come back for a second. Almost like a strange mild form of PTSD (Post Traumatic Stress Disorder)

At this point me and my family lost faith in my psychiatrist. My parents, both mental health professionals, found me the very best psychiatrist they could find in New York to give me his second opinion. Expensive as hell, but they split the cost with me.

This new psychiatrist recommended I get back on my Lithium immediately. He never would have taken me off of it the way my psychiatrist had, bouncing me around between medications.

You would think, at this point, things would get better, right?

Nope.

Not at all.

I was segued back to Lithium, now free from the Tegretol side effects, but my terrible panic remained. Plus now I was starting to feel nausea in addition to the panic. At first mild nausea, nothing serious, but it just got worse. Much worse. I felt in a permanent state of being about to violently throw up, as if a small creature in my stomach was pushing my innards around. My mom joked I was going into labor.

Over time, the nausea invaded my sleep. I'd go to sleep to only wake up 30 minutes later, nauseous and panicked.

Finally, one night, this culminated into the grand symphony that landed me in the Emergency Room mentioned in my previous post. The nausea, the panic, the insomnia - they all finally left me a twitching mess.

The doctors in the ER found nothing obviously wrong with me, deemed my situation psychiatric in nature, and hooked me up to an IV of powerful anti nausea medication. At least that afforded me an hour of two of sleep throughout the long night at the ER. (I was released at around 7:00am)

Finally, at this point, things turned around. In addition to the Lithium, I was newly prescribed Seroquel, another mood stabilizer that is very sedating. Normally I'd avoid something that powerful (and am still nervous about it in my system), but it worked.

My nausea went away, and I was able to sleep. My new job at the time kept my mind off of everything.

I am now writing this after my job finished. My sleep has gotten worse again, but I've switched from Seroquel's XR (Extended Release) to Immediate Release on a higher dose (200mg from 100mg). It ain't perfect - takes about 90 minutes to 2 hours to fall into a wakeful sleep - but the panic/nausea is still gone, which I'm very thankful for.

The thing is, once I feel ready, I'm going to need to get rid of the Seroquel. It's too powerful, and has its own run of potential long term side effects. I don't trust my current psychiatrist to guide me through that, but the high profile expert is expensive, with limited office hours.

If I improperly take myself off of the Seroquel, I could suffer withdrawal symptoms that would be just as bad as all of my previous nightmarish experiences.

But, for now, I patiently wait to get back to a solid night's sleep.