A few days after deciding to start lithium again and writing ‘The hard decision of putting off growing our family’ blog, things changed quite rapidly. Within a week I went from severe depression, to suddenly stable, to the beginning of a hypomanic episode.
When I really thought about it, what I was experiencing was similar to what I felt like in Rarotonga a few weeks earlier. I was excitable, feeling ultra-productive, super creative, overly confident, and in a constant state of busyness with an urgency to get everything done as soon as possible. I was also not sleeping well. At the time I put it down to the excitement of the holiday, but I think it was more than that.
As quickly as my depression lifted, the hypomania came on, and while I was so grateful to finally be out of depression after desperately trying to rid it for months, I was a little worried about how quickly my mood had changed yet again. On the whole I did things to help myself. I got in touch with my psychiatrist, I started taking my olanzapine every day, and I did things to try and slow my mind and body down. But part of hypomania for me is enjoyable, particularly the increased productivity, creativity and confidence, so I took advantage of my decreased need for sleep and used this time to squeeze more into my day.
At this point my husband and I were fighting, as he was trying to help me the only way he knows how, and at the best of times I don’t like being told what to do. I was in the spare room so I didn’t disturb my husband with my strange sleep patterns, but also so I wouldn’t be forced to try and sleep when I didn’t feel I could. But as I’ve learned in the past, going into my own room doesn’t always help me as my hypomanic brain prioritises everything else over sleep. I was blogging and creating content, online shopping and dreaming of up big plans until late at night, then waking up really early full of energy. I was physically tired, but my brain just didn’t want to rest.
When it got to a point I was only getting 4-6 hours of sleep, I knew I needed help so I went back to the mental health team.They advised I up my olanzapine dose to 1.75mg in the morning and 2.5mg at night, and prescribed a sleeping pill. I fought the urge to keep doing things at night, and with these new medications on board I was able to get my sleep back on track.
It’s been a few weeks since I would consider myself stable. I’m still feeling productive and an urge to keep busy, but I am being realistic and pacing myself with how much I achieve in a day, and doing things to improve my sleep hygiene. I’m actually tired by the end of the day, and sometimes even falling asleep on the couch after a long day of teaching and parenting. I’m still in regular contact with my psychiatrist.
About a week ago I went for an in-person appointment (a lot of our contact is over the phone. We discussed my symptoms, behaviour and the ups and downs of this year at length.) He told me about rapid-cycling, which is classified by at least 4 bipolar episodes in a year, which he said applies to me. Rapid-cycling doesn’t feel like a big diagnosis, it’s just a part of this mental illness I carry with me always. It actually helps, because it gives me a name for increased amount of episodes I’ve had in one of the hardest years I can remember. It makes a lot of sense.
Doctor Gary changed my medication somewhat. We decreased my anti-depressant (because when you’re not depressed it can actually push you into a hypomanic state), increased my lamotrigine (mood stabiliser), and kept the olanzapine on board for a few more weeks until I’m satisfied that I’m not hypomanic at all. It’s an absolute science getting your medications right, and while I’m pretty much a qualified pharmacist with all my experience, I’m so grateful to the experts for their knowledge and support.
When I last posted about changes in my medications I talked about starting lithium and how we’d have to put off trying for another baby. I am thrilled to say that all the medications I’m currently on are safe to take during pregnancy, so I don’t have to give up my dream of growing our family. But like my last pregnancy, I would like to reduce my medications as much as I can while still being in a good place mentally. I definitely want to focus on being stable right now, and the baby-making can wait. It’s daunting for me, but it’s exciting, and I’m sure it will happen when the time is right.
