I saw my psychiatrist, Dr. M, yesterday for my routine 3 month check in. I typically see him every 3 months for a med review, symptom review, and med refill. Invariably he also mentions, briefly, ECT. This takes up the first 10 minutes of the appointment. The second 10 minutes is spent chatting about my job (nursery nurse) and life in general. My scripts are sent and I make an appoint for 3 months to do it all over again. Last year we were also discussing TMS as I was going through it. But this is pretty much how things go.
Not yesterday though. If you've been keeping up with my blog then you know that I've been pretty darn depressed again and wanting a change (not ECT). I think I need a med change. While the med combo I'm on has kept me the most stable, it's falling short with my depression. I had some ideas of what we could do, but I wanted to hear what Dr. M had to say before I offered up suggestions. He is, after all, the MD.
I think he could tell something was wrong when I walked in. Just something about my aura maybe . . . or my resting bitch face and over sized hoodie in June. He asked how I was doing. Not good. He looked at me a moment, leaned back in his chair and asked what was up. I told him about how my depression is getting progressively worse, how I feel so empty and dead inside. How I've been doing maintenance TMS and how it's not really helping. My lip trembled. I need something different. He folded his hands in his lap and - of course - asked if I had given any thought to trying ECT again. I told him yes I had but because of the memory issues I already have, I'm worried about them getting worse and me not being able to do my job. He nodded and said he'd review my meds and history.
I sat forward in my chair, wringing my hands with anxiety. See, I came here knowing that I would be firing Dr. M. I've tried getting a med change with him before and met with resistance. He always only offers ECT. And I don't want ECT. That would be an absolute last resort. An I-know-I-will-kill-myself-if-I-don't type of thing.
He looked over at me, his glasses hanging precariously off the end of his nose. "Cami, you've been on almost everything. All of the powerhouses we use for bipolar . . . you've been on them. And then some." He leaned back. "One med I don't see that you've been on is Wellbutrin. It's an antidepressant that works differently than the Prestiq you're currently on. We could try adding that to your current regimen and see if that helps bring you up."
I thought a minute and slowly nodded my head.
"It's our best bet without doing a complete upheaval of you regimen. I'd prefer not to do that as you've been the most stable on it."
I nodded again. "Okay. I'll try it." I was surprised really. I wasn't expecting him to offer up a medication for me to try. I was a little dumbfounded.
Dr. M discussed how the titration up would go and that I would need to see him again in a month for a follow up to see how I was doing on it. I nodded and thanked him. We still had time to talk about delivering babies, which grosses him out, but I think secretly fascinates him.
I guess I don't have to fire him yet after all.
In other news, last night I took my first Wellbutrin, 150mg. I take 150mg nightly for 10 days and then go up to 300mg nightly. This morning I felt groggy (drowsiness is a side effect) and I've been sluggish all day. I'm hoping after my body gets used to it this will go away. We'll see.
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