Depressed once again

My depressive episodes are back. My antidepressant is back. And me? I feel like I'm back to zero.

I really thought (and believed!) that I was already getting better. My former psychiatrist thought so too, and that was why I've been off my antidepressant since January. I'm still taking my antipsychotic (Quetiapine) and anti-epileptic (Lamotrigine) on 300mg and 150mg doses, respectively, to help stabilize my mood. For six months, I believed I was getting better. But yesterday, I broke down.

It's because of my insecurities. Yesterday, during my therapy session, I was doing great. I was sharing with her what I wrote on my thought journal in the past three weeks. I was talking about my anxiety triggers. Everything was fine. But when we came across my entry about something that triggered my feelings of being insecure, I cried, and we dwelt on that during the rest of the session.

My psychiatrist wanted to make sure if I'm taking the right combination of meds. I stopped taking my antidepressant at 10mg. She was thinking that if we push my antidepressant a bit more---if I'd take 15mg instead of 10mg---I might get better. It might work. "I know it's an added cost," she said. "But let's try it."

Of course, I agreed. I am under her care, and she knows what's best for me. I asked her, though, if what I really have is bipolar disorder. My psychiatrist told me that my former psych (a good friend of hers) had his reasons for giving me that diagnosis. But now, she wants to make sure that I'm taking the right combination of meds. She wants to see if I would respond better to a higher dosage of antidepressant combined with my two other medicines.

I'll see her again in two weeks. Meanwhile, I'll keep writing on my thought journal and take my medicines as prescribed. Thank God for medicine samples; I have enough antidepressant tablets to last me for two weeks.

Anxiety and my thought journal

My depressive episodes are no longer that frequent. But it's anxiety that plagues me now. My mind is racing most of the time, as if it's flipping through pages of a book very quickly. Sometimes, my thoughts shift so fast I can't quite keep up. This is why I now have the habit of listing everything down. It's an expanded to do list, which includes not only my tasks at work but also personal ones like buying bread, milk, and toiletries at the supermarket; buying my medicines; getting rid of clutter in my cubicle; and organizing some things, among others. I even list down websites to visit when I have free time so I won't forget them.

I've been to three CBT (Cognitive Behavioral Therapy) sessions, and so far, I think I'm doing fine. My depression index score has decreased significantly from 16 to 4 (a score of 15 and above indicates depression) after one and a half month. I don't feel so insecure anymore (although I still feel insecure at times, but no longer as frequent as before). 

My third session last July, I think, is the start of the therapy proper. My last two sessions had been all about establishing the context in which all my personal issues stem from. On my third session two weeks ago, my psychiatrist started discussing with me how different people react to different situations, because different people see things differently. We ended the session on this note, and she gave me my first homework: to create an automatic thought journal where in I would write about a situation, my mood during that situation, and what I was feeling before that situation. This is the format I will follow in writing my entries. 

I've been expecting this kind of homework, because during my first session, when I told my psychiatrist that I maintain a personal journal, she said I would have one in therapy, but there would be a specific format. I bring my therapy journal everywhere (I gave my personal journal a break in the meantime). I write even the smallest of things that changed my mood, like how a girl took my seat during lunch and how a Facebook post affected me, among others. I write almost anywhere, even inside a movie theater while the show has not yet started. 

My entries, so far, have been all about anxiety attacks---how worried I am over some things, how I easily got irritated over something that set me off, and how I feel there are swords dangling above my head whenever I want certain things done during situations I have no control over. But I guess, anxiety can also be managed. I just have to be equipped with the right coping skills. Hence the importance of these therapy sessions.