Tuesday, November 27, 2007

Questionable Medicine

I woke up at 3PM today, in time to make it to my psychiatry appointment at AIDS Health Project at 4 by cab, (which KD had left a little extra cash specifically for).

We all agree, everyone who has witnessed me over time, that without sleep regulation the rest of my life comes undone. Low-dose Ambien does the trick every time - except when I take higher doses of Geodon, (an antipsychotic/mood-stabalizer which can be paradoxically and unpredictably sedating and stimulating - and very helpful with overwhelmingly confused thinking.) (This kind of writing here, for whatever reasons, is also very helpful with organizing and grounding overwhelmingly confused thinking.)

I told him, my psychiatrist, that I wasn't sleeping and that I had upped the Geodon (for a number of reasons). But rather than advising me to reduce it, he advised increasing it significantly, but taking it only in the morning. Which is fine if I stay home all day.

I trust him implicitly, therapeutically, but I don't always trust him chemically.

So we'll see. Maybe I'll take it temporarily, maybe I won't. What is essential though, is that I force myself to sleep at night, and that when I wake feeling depressed in a way that feels irremediable, (which is every waking these recent days), I force myself to get up anyway, just enough to take the rest of my morning medicine. Then if I allow myself unconsciousness, I wake up clear, soon after. Not high - just not plowed under.

I told him it helped that I've found other people online who have difficulties and complications and questions about amounts of medications prescribed. And he said, "Are they my patients?"

I said, "Why? Do you prescribe more than most?" He said, "I am freer about it."

He did say, "You are smart," - which I didn't understand - "You know you tend to crumble when people leave. You need to sleep. I don't like seeing you this way. I don't think you like being this way. Please try to take care of yourself. Please don't drink. [New studies show drinking is more detrimental to immune function than psychiatric and street drugs.] Please sleep at night. "

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