Journey through Faerieland

Today I went to my neurologist. They took me on-time, no wait at all. However, I was in the appointment for over an hour. They tried to get the labs from my endocrinologist. The nurse practitioner was a bit annoying... She insisted I had low cortisol because I had low cortisol from my March 2012 lab. I have high cortisol according to the past couple of months. She said I couldn't have a pituitary tumor because none showed on my summer 2012 MRI. I asked the endocrinologist the same question and she said pituitary gland tumors don't show on those kinds of MRI's -- she has to do a "different, deep pituitary MRI." The nurse practitioner asked if I drove (no), if I worked (no), if I cooked (no), and then she asked "Well, what do you do?" to which I didn't answer. Because I've had 3 seizures (1 tonic-clonic in my sleep, 2 complex-partial) seizures since late November, that means my seizures aren't completely controlled (though it's certainly good enough for me), so the nurse practitioner wanted to add Keppra to my Topamax. At least if they had to add a drug I'm glad it would be that one. I've been on it before for Bipolar and I don't get "Keppra rage." The doctor disagreed, though, and just increased me to the maximum amount of Topamax. He also tested my blood levels of Topamax today (which I did right after the appointment, in the hospital). I guess they were also concerned that I was having more seizures than I was aware of; it is possible, given I had several seizures on my 24 hour eeg and I wasn't aware of any of them.

The nurse practitioner *did* say that if I have a pituitary gland tumor, she can't guarantee that after it's treated my seizures and migraines will go away. That's okay, but the fact that *maybe* they will is encouraging! The fact that once the hypothetical tumor is treated I might be much more emotionally stable is even more encouraging and exciting! And even if they don't find a tumor, I will still be treated to lower my prolactin, which should greatly help me emotionally. As for the cortisol, that's still all up in the air. I still think they are testing me for Cushings and I don't know how long that will go on for or what will happen if I have it. That's scarier territory. If I have it it's in the early stages, whereas my prolactinoma (tumor secreting tons of prolactin) might have been around since puberty, just getting worse and worse, adding more and more symptoms. One of the major symptoms is irregular periods, and my periods have been rare from the start. My bipolar, anxiety, and seizures (not tonic-clonic) began around age 19. My libido and ability to orgasm ended in early 2005. Sex became more painful in late 2008. I gained weight suddenly late 2011 and my depression worsened then. I attempted suicide spring 2012. My daily migraines, fainting, tachycardia, tonic-clonic seizures, and weakness began spring 2012. I gained more weight suddenly in late summer/early fall 2012. Sex became even more painful. My vision sometimes started getting more blurry and I started getting headaches sometimes, though not migraines. I grew more weak in 2013, back like how I was in the summer. Since going off my birth control pills in mid-February to test my hormones I have not gone back on it and have not had my period. That was another dumb question asked in the neuro's office "Why aren't you getting your period?" I'd already told them my prolactin is sky-high. My body thinks it's majorly pregnant and/or nursing!

These are all my problems a prolactinoma might account for:
-Depression
-Anxiety
-Hostility
-Irritability
-Suicidality
-Irregular periods/rare periods/amenorrhea
-Infertility (though I want to keep that! No babies for me, thanks!)
-Anorgasmia
-No libido
-Vaginal dryness
-Painful sex
-Vision problems
-Migraines
-Headaches, in general
-Hot flashes
-Cold sweats
-Seizures
-Memory problems
-Bad decision making
-Over-sensitivity
-Physical weakness
-Needing 12+ hours of sleep a day
-Fatigue
-Fainting
-Collapsing
-Dizziness
-Nausea attacks
-Weight gain
-Loss of body hair
-Joint pain, bone pain, and muscle pain
-Hypothyroidism

The one symptom I *don't* have, that my endocrinologist was shocked at, given my prolactin levels, was lactation. I have never lactated, which is partly why I was so shocked to find out my prolactin was so high and wreaking havoc on my mind and body. I remember getting the test order and seeing prolactin on it and thinking "Prolactin? Why is she testing *that?* This is dumb."

So any or all of these things might get better with my prolactin levels controlled! For all I know, I'm not even bipolar! I was stable as a rock, just very sensitive, until I hit 19 and everything fell to pieces!



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Just wanted to say, for the first time in over a month, I did not wake up with severe nausea! I hope it's because I'm back on only 25mg of Zoloft (the smallest starting dose, though I guess you could cut it in half and start with 12.5mg). I only took 25mg two nights ago, but still felt nauseated yesterday morning. I didn't need Zofran, though. Today there was no nausea. Hopefully this will continue and I can take Zofran very infrequently. And my depression is still just as under control. I increase the dose because it wasn't helping my anxiety, but at 50mg it still wasn't helping my anxiety. Then going on Neurontin almost completely controlled my anxiety. I sometimes had slight anxiety at night and took an extra Neurontin (or, in the case of last night, a Klonopin), but I haven't had free-floating anxiety. That leads me to sometimes forgetting to take my evening dose of Neurontin and taking it a bit late. And Klonopin greatly affected me and helped last night, which it hadn't been doing before because my body was so used to it. A 2+ week break from Klonopin and now it helps me again. I hope to take no more thank 1 Klonopin a week. Hopefully more like 1 every 2-3 weeks, like lately.

5-HTP worked many nights for me to decrease anxiety and depression, though it never helped my insomnia (but very few things help my insomnia). However, eventually it started giving me stomachaches. I ordered a large container of L-Tryptophan to start taking after I ran out of 5-HTP. I'm taking the larger recommended dose (which, comparatively, should be twice as strong as the dose of 5-HTP I was taking) and I haven't noticed any effect at all from the L-Tryptophan. However, I just read it should be taken on an empty stomach and, due to my psych meds schedule, I eat the most at night. L-Tryptophan is usually recommended to take at night to help insomnia, so I have been taking it at night. I also read taking it with fruit juice can help and I have no juice. After my mother returns from her vacation I will buy some (probably apple juice since it's so cheap). I just took 1000mg L-Tryptophan on an empty stomach with an orange (the closest thing I have to juice) and I think it is helping my anxiety! I also could try taking 1500mg L-Tryptophan if 1000mg doesn't work. If I can't get L-Tryptophan to work reliably I may go back to 5-HTP after I run out of L-Tryptophan. I'm not actually vomiting from the stomachaches so maybe I could deal with it.

Loving Someone with Bipolar Disorder made me start thinking about ways to improve my mental health. I never really considered how other symptoms like irritation or being quick to anger can be related to bipolar, even if you aren't currently in a serious mood episode. Also PTSD and OCD are very commonly comorbid with Bipolar and what I read recently is that nearly everyone with bipolar has anxiety problems. This kind of makes sense to me because all of my mental health issues started about the same time. I'd already gotten severe overload problems and meltdowns due to autism, but when I was put in a calmer environment I was fine. And I did get some sadness/anxiety at night, but nothing severe. My first bipolar episode was hypomania with started college and it lasted my first semester. I felt like my brain "switched" over winter break. Then I came back mildly anxious and mildly depressed, but then I ended up being stalked and fell into a severe depression (my first ever). Then a few months later it gradually turned into a bad, long mixed episode which is what I was in for my first psychometric testing.

I have already made goals of ways to improve my life, but here are some changes I'm going to try making specifically for my mental health:

1. Drink 3 bottles of water a day
2. Take my multivitamin and also vitamins of Omega-3 fatty acids
3. Eat (dark) chocolate occasionally (apparently it helps some people)
4. Try to eat a fruit a day
5. Eat peanut butter and yogurt for protein
6. Eat raw vegetables
7. Try to eat the amount of calories my psychiatrist (Eating Disorder specialist) thinks I should eat
8. Stretch daily and maybe try to do yoga (turning off outside stimuli and focusing on breathing)
9. Try to do meditation exercises at least when upset (preferably a daily thing, like stretching)
10. Try to do more strenuous exercise 3x a week (ballet exercises, stomach crunches, and push ups?)
11. Journal out all my problems, obsessions, and worries
12. Take Zyprexa daily and Klonopin as needed, as well as my medications for physical issues
13. Unless it's a special occasion, go to sleep by midnight
14. Have people who know me well watch for any signs that I'm beginning to enter a mood episode so I can do something about it
15. When behaving in unsafe or negative ways, have people close to me point them out and explain why they are problematic
16. Have people try not to argue with me rationally when I'm in a mood episode, but help me find ways to stop the mood episode and cope
17. Email one of my psychologists if I need to talk about something due to mental health problems
18. Page my psychiatrist if I am having problems and need a medication change/increase/decrease
19. Talk to a friend when I'm feeling depressed or lonely
20. Wait out angry feelings before doing anything drastic (write about my feelings and tell someone what I'm feeling and why, maybe having them point out why it would be a mistake to act on my feelings)
21. Do soothing activities when my mood is becoming problematic (art, reading comforting books, writing poems)

Today I woke up feeling okay, though I woke up a bit late and my cat Joey knocked one of my earrings off my nightstand and I can't find it:P I went over to April's apartment, but she was still sleeping and I went back home. I struggled to read more of my book (I'm still struggling to read it -- I will read a little more then read some Sailor Moon). I enjoyed my afternoon mostly talking to Maria online. I did wake up to two good surprises on Facebook:-) A message back from my first Catholic school friend to friend me on Facebook. Her oldest son is autistic. Amber also messaged me to apologize for not contacting me the past few days and that she's been sick for stress, which isn't good, but I'm pleased she has been thinking of me. I explained my recent panic attack over obsessions over our relationship and it didn't seem to bother her. I know she's had similar experiences. I became more anxious and depressed as night fell. I was worried about going out with April and Phil, as April mentioned they would come by my house. I didn't want to leave the house for fear of a panic attack. Ritalin really helps my anxiety... I hate when it wears off. Fortunately April and Phil just wanted to hang around my house so we talked while Little House on the Prairie played in the background. Now I'm watching Ever After with Drew Barrymore. I love her clothes! And I miss my long hair. I love this movie and just added it to my amazon.com wishlist. I'm hoping to cheer myself up and keep my anxiety under control. I'll read one more short story and then read Sailor Moon, which often helps me.

Today I woke up fairly early, but slept much better last night. I went bike riding with my mother, but it was really hot out and I'm in bad shape so it was exhausting. I decided not to get ice cream (which my mother usually buys for me on our bike rides). I just felt too nauseated and hot. I've felt nauseated consistently for the past couple of months, but a low-level nausea. I didn't want to take more Zofran (my nausea medication) because I just took 2 pills yesterday. I also think my nausea problems might be at least partly psycho-somatic, like a friend brought up yesterday. Every time I think of eating I immediately think of vomiting the food.:( We stopped at a deli so I could cool off and my mother ate a sandwich. There was a cute chocolate Labrador puppy outside:) When we got back home I took another shower and turned up the air-conditioning.

My bipolar and OCD workbooks came in today and I've started working on them. My mother made my psychiatrist appointment for July 29. I will call him Monday, when he's back, and talk to him about everything. I can't be on Zyprexa with that insane appetite and sleeping 13 hours a day. Especially if I can't get my Ritalin to curb my appetite. My psychiatrist said I could take it twice a day and told me to wait to get a refill, but by the time I needed it he was gone for two weeks! So I switched to Geodon, which so far has controlled my bipolar quite well. The problem is my anxiety. I did still have some anxiety on Zyprexa and took Klonopin and Klonopin still is usually working. There was that horrible night two nights ago, but that hasn't been the norm. Also I just started taking Geodon a little over 2 weeks ago, so maybe it's not working to the maximum yet. I know people take Zyprexa as needed sometimes, so maybe I can have a prescription for emergencies when I start to get a bit crazy or my moods start getting bad again. It works instantly for me. And I can just rely on the Klonopin for my anxiety. I took one today when I was feeling a bit depressed, but I think it was really more anxiety, because I feel quite well now.

The power went out due to a storm and usually that makes me very anxious because I always have to be doing things to keep my mind busy and it's hard to even find flashlights to read with. This time I stayed calm, just played Tori Amos with my computer's battery power and worked on my OCD workbook with a flashlight. I still don't know if I will make an appointment with my psychologist or not. I may wait a little while to see if my obsessions and anxiety get under control. I felt kind of bad when Amber told me I seemed so stable on my other medication (Zyprexa) and it was too bad I had to go off it, since now I was feeling "blah" and obsessive. The truth kind of hurts:-/ Though I wouldn't say I'm feeling "blah"... At least my moods are pretty good. I just have to get my anxiety symptoms under control. It's too bad antidepressants don't work on me.

I talked to my psychiatrist about my overeating while on Zyprexa, to the point of making myself very ill. I said how taking Ritalin LA in the early evening, as well as in the morning, controls my hunger and keeps me from overeating. His first idea was to decrease my Zyprexa dosage, but he doesn't have my file at home and I don't know if he realizes I've only been on this new dose for 2 1/2 months. It's true my mania and depression are under control, but I feel much better on this higher dose than I did even prior to my hypomania/severe depression cycle that occurred in March. I'm generally a lot happier and calmer now, and while that might not all be due to medication, I'm sure some of it is. I don't want to go back to struggling as I did on a lower dose of Zyprexa. Maybe after I'm stable for a longer period of time I can decrease it. So, in the meantime, I'm going to have a prescription for Ritalin LA in the morning and then in the early evening. I don't get any bad effects from it. On regular Ritalin it would wear off very suddenly and I'd get very anxious from suddenly feeling different. On Ritalin LA, though, I don't even notice when it wears off, aside from getting really hungry when my morning dose wears off. It helps my mood, attention span, and appetite.

Today I visited April and we walked to the comic book store (at least I got some exercise in!) and we watched Buffy the Vampire Slayer. They were actually episodes I was familiar with. I should watch more of the series someday. It was also fun just talking to April. It's nice to get out of the house and I usually feel better in the presence of other people. I've got her interested in The Happiness Project, too, now:-) I hope the book comes into the library before Michael comes over to my house. I got my dates confused and Michael is coming here on Friday and then the following Saturday is when we go to the zoo and then his house. That's fine, as long as I have his company! I'm not good by myself. I also ruminate way too much which can worsen my mood or make me focus on unpleasant things or even concoct long streams of vitriol I want to say to someone whom I feel has been cruel or selfish. I'm working on all of that. I'm going to try to be less critical of myself and of other people. I will try going through the motions and acting happy-ish to see if that can turn my mood around when I'm feeling rather negative. I'm going to keep making short-term goals for myself that lead to longer term goals. I'm feeling pretty hopeful and good today.

Getting out of the house helped my mood. Sometimes it helps, sometimes it doesn't. There have been many times I've started panicking over an obsession in public and just had to get home so I could be crazy in private. Being into a lot of activities and going to classes didn't help my dysphoric mania in college, either. So it's hard to know what to do often:-/ I'm more relaxed now and I'm going to read and then finish my painting. I hate putting on my painting clothes. I like things to be one-step, but getting ready for art takes many steps... That is why I haven't been painting more. I have to get back into the habit.

I'm feeling much more at peace after taking my medication. I made a mistake and it won't happen again. It hadn't happened, and I hadn't had the urge to peek, for many months. Overall my life has been really good lately and a lot of good things are happening. Michael is driving and will move in soon, I've got my art and writing, I'm on good terms with my friends (who don't trigger me at all), my mother and I usually get along, I'm learning more independent life skills, I don't hate my appearance as much as I used to (though I'm still uncomfortable with my weight often), I have doctors I really get along with and who respect me, I'm in better physical health than I used to be, my house keeps getting improvements to look nicer. Things will be okay. I have to let go of the bad things that happened.