To medicate or not to medicate.....

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So I was officially dx'ed with classic autism when I was three...I'm sort of self-diagnosed with PDD-NOS, because as an adult I also do not meet the all the criteria for or autism. I do not care about updating my diagnosis..when I tried to, one psychiatrist even told me a few years ago I probably didn't even have autism as a child (despite not speaking until the age of 5), and I just had probably child onset bipolar, ADHD, and OCD...and maybe hyperlexia or a even traumatic childhood to explain the speech delay. He said it was just a trendy diagnosis....um...in 1985 autism was "trendy." Whatever....

I am not doubting though that I am most likely bipolar. Actually I have a diagnosis of Bipolar I Disorder....I'm more prone to mania than depression, and my manias are more severe than my depressions are.

Anyway...I've been off an on meds for this since I was a teenager (more off then on actually). I can function pretty well when I'm hypomanic....actually I'm more functional than my "normal." I act less autistic and more NT when I'm hypomanic. I'm more socially outgoing, I have more motivation. I get more creative, and I'm in a generally good mood, even slightly euphoric. What comes next is a decreased need for sleep and an increase urge to spend silly amounts money and go on spontaneous vacations. Then comes a brief psychosis....hallucinations, derealization...but never delusions. It can be uncomfortable, and sometimes downright terrifying, but it doesn't last long...and I have a good vacation policy at work (screaming, yelling, and disorganized speech isn't very professional).

The mania has heavily influenced my performance at work. During hypomania I become very motivated, task orientated, and creative....which helps me a lot in my job as a cosmetic formulation scientist. I get a good four months a year of hypomania, and the rest of the year I'm either full blown manic and not functioning (lasts only a couple weeks at a time), or depressed, and barely functioning, but getting by.

When I do medicate, my superiors at work can tell that the hypomania is gone. It becomes harder to be motivated and I'm not the least bit creative....the meds sort of make me numb and stupid (or they make me break out in rashes, give me partial seizures, or have a paradoxical effect and make me psychotic). My boss notices a decrease in my performance.....

So anyway. I'm hypomanic, verging on manic right now....I've been on the verge of full blown mania for about a month. I have some hypomanic days, some mixed days, and some really manic ones (usually correlated to the amount of sleep I get). but I am able to function at work for the time being.

I saw a psychiatrist last night and he agreed I'm manic, but not psychotic yet (despite the hallucinations). I was expecting a prescription for yet another atypical antipsychotic, but he said that they often cause worse side effects in people with autism since our brains are wired differently (hence the seizures and stuff).

He gave me a prescription for Trileptal (oxcarbazepine), an anticonvulsant that works as a mood stabilizer by it's action as a sodium channel inhibitor. Although it seems like the least scary drug I've been prescribed for this problem...I'm still not sure I want to fill it....

While I have my reasons for sometimes wanting to be hypomanic, I know the mania is slowly damaging my brain with each episode. I end up doing insane things when I'm manic, losing my driver's licence for going 129mph in a 55mph zone, running up $20K of credit card debt in a week, , and otherwise engaging in reckless and self destructive behavior that damages my relationships and could damage my career....not to mention what the sleep deprivation can do physically....

So I have reasons to medicate, and reasons not to......I'm a bit torn....

It's a hard choice. I agree its really hard.

I decided not to. I took some DBT classes that really helped me with impulse control. (Dialectical Behavioral Therapy). It helped for me to not act on manic impulses. I don't have the dx as bipolar, but I have gone ten days without sleep and and have been wa y manic.

But I decided not to medicate. If I do it is ONLY at the times I "need" it. It makes no sense to medicate 365 days a yar when I might it for only 2 weeks out of a year.

Antipsychotics have been shown to take off at average 26 years from life. THat is not a good benefit/risk ratio.

It is only a very good profit for the complanies.

It take wisdom! I know you will make a good choice for you. Just do't be bullied by any shrink .

I also like the idea of only taking medication when I need it....maybe like letting the hypomania go until I notice I'm sleeping less then 5 hours a night, on average, and occasionally skipping nights and still feeling okay... Then I'll start using natural sleep aids like melatonin, Valerian root, etc...until those stop working and I'm back to less than 5 hours a night...then maybe it's time to medicate....just to prevent the onset of acute full blown mania and the psychosis that comes with it.

I really am only severely manic for maybe two weeks out of an entire year. I do experience depression and antipsychotics have only made me sleep more, and did nothing whatsoever for anhedonia, or apathy. I can't take SSRI's or SSNRI's because the risk of psychotic mania is too high (actually for me it's inevitable). But my little blue LED light box from Apollo can almost totally prevent a depression...and possibly induce mania if I'm not careful to limit my exposure and only use it when there is less than 10.5 hours of daylight per day. Mania is much harder to prevent for me than the depression is....

I've been able to induce a crash from mania by using darkness to force my internal clock to reset itself. It worked, but it wasn't a smooth transition and it led to some funky rapid cycling and mixedness until the time I usually naturally crash in two months later in July. It was torture to be locked in a dark room with nothing but your racing and disorganized thoughts, no TV, no phone, no I-pod....

So maybe that is the time of year to medicate....only from April to July.....with a mood stabilizer....not an antipsychotic. I will never take another antipsychotic again.

So last night I took a natural sleep aid I got at a health food store that contained Valarian Root, Tryptophan and Melatonin. Well it did make me fall asleep, and pretty fast too, but I woke up 3 hours later with my mind racing yet again....so I've been up since 2:30am....not that it's not normal for me...but I can't help but think how unnatural and possibly damaging to my brain it is to be able to function on 3 hours of sleep a night (or even less) for months at a time.

I need some help to convince me not to fill the prescription......

NO MEDS!! convinced?

Not very convincing.....

Well one reason is that I'll be hard pressed to find a therapist who will work with me if I'm not medicated, as I have obvious signs of psychosis.....like disorganized speech and hallucinations and whatnot. Another is that sometimes I really just hate the feeling of being manic....mind racing, internal restleness, extreme distractibility, getting so lost in your own thoughts it takes you three hours to make a peanut butter and jelly sandwich......

haha, dude I've been at the lowest of lows and the highest of highs. (and yeah going nuts is not fun, I was close to it) No other person can fix you, come on, you need to dig deep and find the cause and stop thinking about everything, I learned the hard way, burning out, crashing, passing out started twitching like a fish.

Take my advice just relax, like right now...

I have a thing that I do, when I noticed I've thought to much about the world and EVERY f*****g THING I tell myself, what do I want right now and then I think about something that I wanna do.

We think entirely way to much about other things and other people to consider ourselves for just 1 sec...

It's not really that I think too much, it's just that my mind races so fast I get a flight of ideas that I can't keep track of. My main train of though speeds up. Then there's the other train of thought suggesting I get on a plane and fly to Paris, or telling me I really need those $600 shoes in three colors, or I need to break up with my fiance and find a new random guy, and well ...you know.....Then there is the pictures flashing in my mind of places I need to be...right now. And the constant music playing 24/7, and constantly hearing my name being called, or my phone ringing, and seeing those shadow people.....

My mind is a very loud and confusing place sometimes.