Whenever the rainbow appears in the clouds, I will see it and remember the everlasting covenant between God and all living creatures of every kind on the earth." Genesis 9:13

Monday, April 20, 2009

Thinking: Bipolar is a lot of responsibility

This may sound like a scary post, and it's not meant to be. I'm totally safe, and not actually considering munching on handfuls of pills. This is more intended to be about how absurd life can be with bipolar.

Along with other meds I take a relatively small dose of a tricyclic antidepressant, imipramine (Trofanil). It's actually the oldest of the tricyclics and considered the gold-standard of antidepressants. (Gold standards are my favorite meds; they say the same about lithium). Tricyclics have more side effects that SSRIs and other newer drugs, but I blew through all other options many years ago. SSRIs make me extremely manic, Wellbutrin makes me manic AND sick, Remeron worked for a long time then sent my blood pressure sky-rocketing, Effexor only worked a few weeks, etc. I've been on nearly everything. This was a last shot that happened to work.

At the dose I take there really aren't side effects. My doctor thinks I have some urine retention which explains my frequent UTIs, I have to play with the dose to get it right between manic and depressed, it makes me constipated (as does everything), but mainly it's not a drug I am bothered much by.

I knew tricyclics were potentially lethal drugs in an overdose. For the years I was sickest I only got them in monthly supplies. But I haven't had a suicidal episode in years, so I'm now allowed to get them from mail-order, with the caveat that if I start feeling I have too many I give them away to be doled out in smaller numbers. No big deal. Even if I were suicidal, having survived lithium toxicity I wouldn't turn to meds. I don't ever want to feel like that again, and even the RISK that I could not kill myself and make myself sick is enough to deter those thoughts.

But recently I took a CEU course that discussed how lethal tricyclics are. And now I'm scared. I don't know why. I take 7 of them every night, and no more. I have no desire to take more. I'm used to having lethal doses of lithium laying around. But the fact that I could kill myself and probably half my town with the contents of that bottle (or that bottle plus the lithium bottle) just amazes me.

It just is weird.

1 comment:

Emilija said...

You are very responsible! And it is scary. I was on MAOI's for a few years (until they stopped working). I once realized that I had accidently eaten cheese, and I took myself to the ER! I'm glad that high dose Effexor works just as well, and it is much safer. Why is this all trial and error? Shouldn't psychiatry have progressed beyond this by now?