beware of the perigee - or is it the apogee? [1]

[baratron]

Currently having incredibly rapid-cycling mood swings. Up and down like a freaking yoyo. Case in point: yesterday at 3.30 pm I was lying in bed, feeling miserable and confused from bad dreams, and in a lot of pain from thrashing around in my sleep. Yesterday at 7.30 pm I was bouncing around the room to loud music, too hysterically crazy to do anything useful. Then I crashed in a giddy, exhausted heap. 

Some kind of mood regulation system would be nice. I believe that normal people are fitted with one by default. Somehow I missed out on that, along with several other features which most of you can take for granted. It wouldn't be so bad if I could get any of my own work done - if the downs weren't so low that I can't function mentally or physically, and the ups weren't so high that I might as well be drunk. But the couple of hours of relative normality seem to fit with the couple of hours when I have to see students, and by the time I'm done with them I'm so very hyper that I can't sit still or concentrate.

I have decided to increase the amount of carbamazepine I take to 400 mg per day. This is what I was supposed to be working up to, anyway, although I seem to remember the instructions involved getting to 400 mg of CBZ and then starting to reduce the venlafaxine. Ah ha ha, like that's a possibility in my current state of anxiety. I'm sure that the week-long migraine and brain freezes would help tremendously with exam revision. I'm already losing words every couple of sentences.

[1] I know what both those words mean. But I'm not sure which is more scary: the lowest low or the highest high. They're both terrifying for different reasons. Wheeeeee *splat*.

Comments

[baratron.livejournal.com]

I agree totally with the concept of coming off venlafaxine for mood control purposes. It's known to be particularly "bad" for inducing rapid cycling (and in fact I had those symptoms freaking 10 years ago when someone gave me the tablets instead of the extended release capsules by mistake - I wish that the concept of hourly mood shifts being a possible bipolar symptom had been known then, rather than their obsession with a couple of mood episodes per year). However, I have exams in under a month, and venlafaxine withdrawal syndrome really is awful - when I say "week-long migraine and brain freezes" I am not, in fact, exaggerating. Just missing a pill by a few hours gives me the headache plus weird electrical buzzy feelings in random nerves. Going through that at the same time as trying to revise...

Another problem is that venlafaxine is prescribed if anything more as an anxiety drug than as an antidepressant these days. My anxiety is off the scale, and I don't think mood stabilisers do a thing for anxiety. Again, dealing with that this side of exams is not sensible.

[tirnoney.livejournal.com]

It's not something that's supported by any good evidence, but that's because largely the research is still waiting to be done, but the spectrum of depression and anxiety is clearly linked. The symptoms reported by most patients with bipolar disorder of both mood instability and anxiety improve with mood stabilisers, not just those of depression.

The difficulty is that no one has taken the time to look specifically at anxiety. Its also complicated greatly by the fact that in clinical practice, responses vary greatly to different mood stabilisers from person to person. Why do anticonvulsants work as mood stabilisers anyway? It suggests an underlying overactivity in certain regions of the brain which are being dampened by the drugs as that's essentially what they do in a rather blunt manner. There's some evidence that the mechanisms of anxiety are similar, it would just be a case of choosing the right anticonvulsant for the particular individual. Personally speaking, I kind a marked increase in anxiety levels if I reduce the dose of my mood stabiliser until I readjust to the level and vice-versa, with an overall long-term resetting that is favourable compared with not having the drug in my brain.

[meirion.livejournal.com]

My anxiety is off the scale, and I don't think mood stabilisers do a thing for anxiety. Again, dealing with that this side of exams is not sensible.

Olanzapine is supposed to work as a "quick fix" anti-anxiety drug for rapid cycling bipolar disorder with anxiety. It would probably be working for me had I not mislaid my passport — and since my intended solution to the anxiety problem was to emigrate, this isn't helpful! It is, however, making me sleep a bit better.