love to--get to know you

[erika]

Psychiatrist (saw him today):

• Agrees that the "Adderall crash" I'm experiencing is too much. Suggests spreading out the dosage so that I take 30 mg to get me going in the mornings and then 15 mg in the afternoon and 15 at night so that any "crash" happens after I'm asleep. (Can't believe I didn't think of that. Guess that's what they pay him for.)


• Prescription Added: 150mgs of Wellbutrin for "residual" depression symptoms*; agrees my anti-depressant is just not effective enough despite what we currently have added to it. *(my "residual" symptoms even with all this medication are still enough to get me a diagnosis of severe depression according to the Goldberg inventory)


• Will happily fill out paperwork for me and doesn't think I should feel guilty for asking.


• Is not angry with me for not responding adequately to treatment.


• Appreciated my sleep and mood-tracking charts; strongly encourages me to continue tracking both. (Currently tracking via https://tracker.facingus.org/ for the mood chart, http://yawnlog.com for the sleep chart)


• Suggests strongly I limit myself to 9 hours or less of sleep a night, concurring with therapist.


• Does not believe I have any symptoms of mania; suggests I may have a naturally impulsive personality when I am feeling better; agrees that I seem to have moved from "severe depression" to "dysthymic" rather than from "normal" to "hypomanic" on the mood chart. Agrees that vigilance for bipolar disorder is always necessary in depressed patients, but does not feel I am or have ever showed signs of mania or hypomania—says "to some degree, what could be called "cyclothemia" or mood changes is not pathological, it is a natural human condition." Thinks I have a naturally reactive mood and am somewhat impulsive, but not to a detrimental degree.


• Prescribes also an additional 30 minutes of SAD-lamp light in the afternoons.

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Sleep chart! (Blue line is sleep, large dots mark the days when I'm feeling better. Notice a FREAKING OBVIOUS pattern?)


Mood chart! (I made it myself. I think it's pretty, okay?)


Note: I usually hover in the blue to dark blue range without meds, with meds I'm somewhere in the blue-green to green range. Like so:

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Therapist (saw her on Wednesday so my notes are a little less than complete):

• It is better to try than to give up. Even if you do a shitty job, that can be improved upon. Not trying gives you nothing to start improving on.


• Try to sleep just 8 hours, make sure you GET OUT OF BED when you get out of bed in the mornings—ideally, leave my room (and my precious computer, sadness) so that I am not tempted to get back into bed, at least for the first half hour or so. Set alarm for 8 1/2 hours after I get into bed. (She also suggests going to bed at the same time every night, yeah, I'll... work on that.)


• Go through the motions, even if I don't feel like it. The effect, not the motivation, is what is necessary. The motivation would be nice. Maybe it'll come. Maybe it won't.


• Add/encourage structure to my day as it seems to improve my mood.


• Does not believe I have any symptoms of mania. Eventually, after some discussion, actually said "absolutely not." (If you know therapists at all... or anything about them really... you know that getting a direct answer like that is REALLY rare.)