Obecalp

About 2 weeks ago, my doc upped my Welbutrin dose from 300mgs to 450mgs because we’re trying to stay on top of my depression and this was the only compromise medication-wise that I’d make because I didn’t wanna change any of my other meds or add new ones.

Welbutrin (bupropion) is kind of a neat drug. It tends to give me a little extra energy and it prevents me from smoking (mostly). Other people sometimes find it helpful for issues like weight management and sexual dysfunction. I think John Oliver once referred to it as the “happy, horny, skinny drug,” though he was mostly lampooning its off-label overuse. Including my dad before he died, all of my immediate family members have been on Welbutrin at one time or another, all for different reasons related to depression. I know I mentioned in the LBD that antidepressants are usually ineffective in treating bipolar depression and can even have some hazardous effects, but that’s not always the case. Partly ’cause everyone responds to meds a little differently and partly because, at least in my case, combining Welbutrin with a mood stabilizer and anxiety meds seems to be a workable balance. The Welbutrin handles the grogginess I experience with my other meds and my other meds seem to keep the Welbutrin from making me hypomanic. (It’s more nuanced than that, but I’m not getting into it.)

So when my doc offered to increase my Welbutrin as a means of handling my worsening depression, I went for it because I wasn’t comfortable with my other medication options. Increasing my olanzapine makes me really tired and I oversleep. I was not keen on introducing Depakote – an anti-seizure med which also works as a mood stabilizer – either because the last couple of times I took anti-seizure meds, they made me stupid. That’s really my biggest fear. Some medications make you a little slow. One of the notable side effects of many psych meds is having difficulty finding the word you’re looking for when you’re speaking or writing. This is a really big deal to me because I’m not good at most things. Language is kind of all I have and there’s an easily roused part of me that would rather be sick than stupid.

Last week, during therapy, after I’d been on the increased dose for about 5 days, my doctor mentioned that a newly documented side effect of Welbutrin is that hard to find words thing. I asked her if it was one of those side effects that tend to go away as you adjust or if it’s just part of the nature of the drug. She said it was likely the latter and I told her I wished she hadn’t shared that with me ’cause now I’m hyperaware of everything I say and write, constantly checking things to make sure my vocabulary didn’t shrink.

The annoying thing about this situation is that it doesn’t matter if my lingual capabilities are taking a hit or not, I just assume they are. It’s this reverse placebo type thing…or just the power of suggestion and and I’m suggestible. We bipolar folk are notoriously hard to medicate and it’s not just for one reason. This is a complicated illness.

I think a lot of us have this warped notion of losing ourselves to wellness. At least for me, I see such a radical difference between myself as I am untreated vs. myself with a fairly controlled mental illness, I naturally assume that getting from the former to the latter requires a deep sacrifice on a fundamental level. Instinctively, I always assume the thing I’m sacrificing is of value, I almost never think of this shit as shedding symptoms of my illness via modern medicine. I also cling to fears that are irrational because the idea that everything is gonna be OK consistently strikes me as completely ludicrous.

There are some parts of my life that are a bit too black and white. If I can’t do something I deem important perfectly, I’d rather not do it at all. I take the adage, “anything worth doing is worth doing well” and stretch into a preposterous shape. I’ve been like that since I was a kid. I understand that I’m frequently my own roadblock. I contemplate this nonsense as I’m constructing yet more roadblocks. If I can’t write good songs, I shouldn’t even play instruments. If I can’t write good stories, I should turn off my computer. I also have a very strained relationship with mascara ’cause my eyelashes are like a foot long so if I accidentally clump my enviable fringes, I wash that eye off and start over. I will do this even if I’m running late. These things are a shitty combination of obsession and self-defeatism. It’s gross. I hate it.

My doctor asked me to give it about a month before I make any decisions about changing my medication dosage. So that’s like, a little over 2 more weeks. I don’t get dizzy anymore. I’m starting to adjust. It’s easier. But I’m still paranoid. I’ve been reading over some of my older posts and thinking, “Why don’t I write like that anymore?” when there’s no real discernible difference between the talents I had last October and the ones I have now (’cause they’re the fucking same, Laura).

Even if I operate a little differently at the moment, my first assumption is that my meds are messing with me, not the more likely scenario that it’s super fucking hard to do things when you’re depressed. Why is that? Why am I like that? Why do I have such a complicated relationship with help?

So, fine, I’ll stick out out mistrustfully for the next ~2 weeks. If I’m still in this big, dumb depression, if it stays the same or gets bigger and dumber, then I’m gonna have to revisit this Welbutrin thing with my doc. No sense in being sad and stupid.

-LB

Tagged: bipolar disorder, depression, help, language, meds, mental health, off-label, paranoia, self-esteem, vanity, wellness

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