(Previous in the therapy thread: Psychiatrist session - Better living through chemistry)
Therapy session #4 started with me discussing the experiences I had in the last week with Abilify. I told them briefly about my visit with the psychiatrist and the plan he explained to me. I was careful to read only the major warnings with the drug at first because I didn’t want it to develop side effects just because I was aware of them. I don’t know if I’m a hypochondriac in anyway, and I want this experience to be as “scientific” as possible. The next day after taking it, I start to get “flu” like symptoms and I detailed how those progressed over the weekend. All the research I had done over the weekend on how Abilify worked.
I also talked about working “sick” through Monday. On Tuesday with the “flu” fog gone I was even more certain the changes I experienced while on the drug for the short period I was on it. I explained my thought processes before, during and now after being off for 48 hours. I could feel my thoughts getting noisier and I had to deal with many more at once than I cared to. My therapist had me explain more in detail if and how I can get all my thought processes focused on one goal.
I told them that I meditate for a few minutes, do the diaphragmatic breathing exercises, or if I can put on my headphones and listen to something with a good repeating beat or “tonal” music. Techno, some ambient (genre) or most electronica music can really get me into the “groove,” that is, get all my thoughts going on one task at once. Once that happens, I will go heads down and work on the problem or task. I have to be careful not to get distracted while in the groove, or it’ll break down and I’ll no longer have all my thoughts working on one thing. The other thing that will get all my thought processes on one task is if I get myself into “fight or flight” mode. Then everything is in focus and I can get some stuff accomplished. (I really hate to use this method, because it can really throw me into depression so easily.)
My therapist advised me that I should avoid putting myself into “fight or flight” mode. I agreed, and told them I don’t like doing that. Sometimes, in the past it has been the only way to break a dead lock inside my head. They told me for the next while they wanted me every day to try my hardest to keep all my thought processes focused. At first I didn’t see where they were coming from with this request. I am tired, I’ve been doing that for all these years already and I know exactly what it will do for me. I’ll be exhausted, and have zero personal time. Everything will be dedicated to work and there will be nothing left for me. This is why I’m going to therapy, to resolve these things. So, I asked the obvious question, “Why? Why are you asking me to do this experiment again?”
They said they understood I was tired and I have been doing this exact same focusing task for a long time. They wanted to me to try my best, while on the medication, so we could see what was possible. Ah ha! I now understood. You see, when they asked me the first time to spend the time and energy to keep everything on track, they were speaking from as if I was on medication. Currently, for the past 48 hours I hadn’t been on Abilify. My psychiatrist had asked me to stop for a couple days. I was already starting to revert to my “normal” un-medicated state. So, to me, I was thinking the therapist was asking me to redo an “experiment” under the exact same conditions I had been living under for so long. This wasn’t the case at all. They were asking me to doing this experiment while I go through this next phase of finding the right drugs and dosage. They explained that if I understood what was possible with me trying my hardest to keep everything in check, as I had for so many years, the dosages for the drugs might be different. (I would know where my boundaries were, I’d be kicking the tires, checking the fences.)
This made so much sense to me; I was sold, totally on board. I needed no other convincing. I was already planning to do this exact same experiment anyway. I had been thinking about my current state and not my future state. It made me feel good inside, I could really see that my future self is going to be so much better off.
Earlier in the session, I had brought up the question if I should continue with weekly therapy while I’m in the “figuring out” phase with my medication. They told me that evidence has shown that therapy is helpful to that process and suggested that I do continue with therapy during this next phase I’ll be undergoing. Now after this last bit of insight from the therapist, I could see I would really benefit from therapy while figuring out my drugs and dosages. I could use my therapist as a bouncing board of how I’m doing and they could give me tips on how to best test and push things to the limits.
My session ended, and I really felt good inside. I had so much hope, and could really see another benefit of therapy; having another pair of eyes to catch the things I miss. It is like “pair programming” in the computer programming world. Hmm, I wonder if I should write my test cases up front, like in test-driven development. Hahaha. That is great. (Actually, I already have mentally thought through many tests that I did “run” while I started Abilify.)
That night, Thursday, again I didn’t take an Abilify. I needed to get the ok from my psychiatrist first. Friday during the day while I was at work, my wife contacted the psychiatrist and after hearing what I had prompted her to tell him, he suggested I give it another try. This time though, I’m going to switch to taking it in the morning. I had read online that the morning schedule works well for those that experienced insomnia from it.
Saturday morning I woke up and started taking my half pill again. Later that afternoon I started to feel hot again, as if I had a slight fever. That night I slept fairly well, at least no insomnia. I was able to go to sleep within 2 hours, and slept a more normal rest pattern though-out the night. I did have very vivid dreams though, not nightmares or delirious, just that I dreamed many times that night. In fact, that one thing has stayed with me so far. I dream every night. I used to go though weeks or months without dreaming, then go for a few weeks of dreaming. I’m curious to see, given enough time if I’ll still have a cycle like that, or if I’ll be dreaming every night. I don’t mind, I enjoy dreaming, as long as it doesn’t turn into nightmares.
All weekend I’d experience hot flashes through-out the days, and always had a slight low grade fever. It would get slightly worse at times and then back off a bit. On that Wednesday, I had my next appointment with my psychiatrist. I was still suffering from being hot, and fever though-out the days. In addition, I still get dizzy and lightheaded 6-10 times a day, and also get these weird sensations that I have a slight pressure in my head. It is exactly the sensation I get when I have an adrenaline rush. Like when I’m playing a video game or playing Poker and I have a really good hand, I get this rush in my head and feel a bit dizzy. I’ve always had this, but now with Abilify I get it randomly in the day. (I didn’t put this last part together until after I left his office, I might have to mention it to him)
The psychiatrist told me that he wasn’t going to change anything in our plan yet. I had only been on Abilify consistently since Saturday, and wanted to see how I was in two more weeks. This news was just fine with me; in fact, I really like my psychiatrist. He is always suggesting and doing what I would want him to do, but without me having to express it; it’s really nice.
So, that’s where I’m at so far with Abilify. Still the same three side effects and my thinking is quieter. I don’t feel much different other than that, and that is ok. Having my thought processes down to 2-4 instead of 6-8 is such a relief overall.
(Next up – Psychologist Session 5)
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