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tamagotchi

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    imitation of life

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  1. I continue to take 600mg and I think it is still good... what's weird is that I almost feel like I am not taking Wellbutrin at all, because I no longer have all the side effects I had at lower doses. It just feels like I am taking nothing, except that I get the antidepressant effect.
  2. At least in animal breeding... sometimes undesirable genetic traits end up being linked/correlated with positive traits, so when you eliminate an undesirable trait, you may unwittingly eliminate something positive too.
  3. OK, so obviously your doc is being stupid by equating pole dancing with doing something "wild and crazy." However your doc is also being stupid by equating "thinking about something" with actually having a bipolar episode. Let's suppose you were thinking about something that actually wouldn't be very reasonable, such as running away from your family and going camping in Yosemite for a long while. Just imagining this doesn't mean you are hypomanic. It is understandable. Non-bipolar mothers imagine things like this all the time. On the other hand, a person having a hypomanic episode becomes totally full of enthusiasm about this idea, thinks about it constantly. Buying camping equipment becomes more important than everything else, and the person stays up until 4 am every night reading online reviews, or gets excited and can't sleep at all. They actually start spending money on all the coolest best rated camping equipment, rationalizing this because they can also be considered to be "emergency preparation" in case the family has to evacuate the area quickly in a disaster. And they start taking advanced wilderness first aid courses. And so on. All of this seems like a really, really good idea and super important. (Maybe you can guess who actually did this.....) So, in a nutshell: Normal = thinking about and imagining something unreasonable. Hypomanic episode = overwhelming all-consuming enthusiasm for the unreasonable idea, being convinced that this is the best idea ever, vast amounts of energy devoted to thinking and planning, and typically also buying stuff and doing stuff.
  4. Everyone's insurance is different, but it really is a perfectly normal lab test and yes, the test was covered by my insurance with no question. What you want to measure is the trough level-- The lowest level it ever gets to. So, have the blood drawn just before you take your wellbutrin dose (or the first one of the day if you take it multiple times). Then if it is low, you can try various things to get the trough level higher-- taking it multiple times per day may help, or raising the dose.
  5. Recent study below: Therapeutic drug monitoring of bupropion for depression (2013​) http://www.europsy-journal.com/article/S0924-9338(13)76150-9/abstract Results Patients who were very much improved according to CGI had significantly (p=0.042) higher hydroxybupropion serum levels than patients with moderate or minimal improvement (mean±SD, 1113±576ng/ml, 825±398ng/ml and 475±331ng/ml, respectively). Receiver operating characteristics analysis revealed significant predictive properties of hydroxybupropion serum levels (p=0.002) for improvement with a lower threshold level of 858ng/ml. Women attained significantly higher serum levels than men and also exhibited a better therapeutic effect (p=0.018), though they did not receive significantly higher doses. Conclusions Measurement of hydroxybupropion plasma levels can be used to optimize the therapeutic outcome of patients treated with bupropion. Plasma levels between 850 and 1500ng/ml can be regarded as optimal. Potential sex differences in bupropion pharmacokinetics, probably due to differential activities of CYP2B6, should be taken into account. Upon reading this, we tested my levels and hydroxybupropion was significantly below therapeutic levels as determined in the study (bupropion was low too) even though I was taking 450mg. Raised to 600mg XL (I split it into 300 am/pm) and I am quite a lot better on that, with fewer side effects (?!?). I hope this lasts... but at least for now, it is really a lot better than 450mg ever was. Getting insurance to approve 600 mg is a pain, though. There can be huge individual differences in how people metabolize bupropion so you really don't know how much you have floating around in your blood unless you do a test. The lab test is called "bupropion and its metabolites" and you will get both bupropion and hydroxybupropion levels. Worth a try anyway. If anyone else here does this test... I would be really curious what results you get!
  6. For migraine, you definitely have more options than ibuprofen. Prescription meds I have tried have been Fioricet and Imitrex, and now I take take Midrin. I think all of those are worth trying. I never heard of Midrin until I switched neurologists and she suggested it. Midrin has the least side effects for me, it just works on the headache, sort of like taking ibuprofen except that it works better.
  7. I will agree with that. Not only that it's hard to complete projects when depressed or whatever... in my experience it can also be way too stimulating to get really excited about a project and work extremely long hours or pull all-nighters. Another big problem with project-based work is that you are liable to have some big successes when you are feeling super great, and then people (including yourself) expect you to perform at that level all the time.
  8. My mom wears earbuds at night, tuned to NPR on low volume, I guess that is her version of white noise! It distracts her from ruminating thoughts so that she can fall asleep, and I guess the sound is soothing during the night. It's really hard to say if the med itself is or isn't for you. Wellbutrin can be a great drug for many people if you have the right dosage and dosage form, but you might have to experiment. It's too bad you can't call your pdoc and tell you how you are feeling. Are you sure you can't talk to anyone until the 30th?
  9. I take the XL version also, I couldn't tolerate the IR or SR (which was worse for me than IR)
  10. That sounds great! It doesn't matter if you are taking 1 pill or 10 pills. The bottom line is that you feel better. It sounds like you have been on this combination of meds for less than a month? If this combination is keeping you stable and confident, with minimal side effects, I don't think there is an immediate reason to change anything. In the longer term you could think about tapering meds, but right now, the meds are working! I agree with sylvan's advice above, the thing you need to concentrate on is stability.
  11. It can be really scary to think about getting better. There are a lot of perfectly rational reasons to be afraid of getting better-- such as, being afraid of losing your therapist, seeing pdoc less, getting less care and sympathy from others, having to take on more responsibility in your life, and generally having to move forward and build a life that isn't centered around therapy and treatment. It's not weird AT ALL, it is perfectly normal and reasonable, I think most people have those feelings! Even if you really want to get better, you still might have those feelings at the same time. Right now though, it sounds to me that your therapist was just pointing out your progress. Which is great! She didn't say that she wanted to reduce the frequency of appointments. If this is the first time anyone has said you were making progress, you probably have plenty more things to work on with her. Probably you would not need to reduce frequency until you are truly ready for that. I would suggest talking to her about these worries, it can be a very helpful conversation on many levels!
  12. If you are having trouble sleeping, you might want to ask your pdoc about getting something to help you sleep, while you adjust to the Wellbutrin. Not getting enough sleep can definitely contribute to feeling bad, emotional and depressed. Whenever I restart Wellbutrin or raise the dose, I always feel terrible for a while. It can make me a little speedy so that I have more of the depressed and anxious thoughts, faster. And it can keep me up at night. The first night after the dose adjustment I often can't sleep and feel extremely suicidal with all the bad thoughts. I actually expect and plan for this, it's that predictable. It can take a week to get back to where I was, then these effects go away and feel better and sleep better.
  13. Great suggestions! thanks! I think maybe I will try to put them in my glasses case. I do always put my glasses away in the case, so I would not be able to avoid the pills that way. It might be a challenge remembering to put them IN the glasses case but maybe I can think of a system for that! Unfortunately, I don't have a nightstand and I don't sleep in a consistent location... I often go to sleep in one of the kids' beds. And we don't have dinner at a consistent time, and we don't set the table... it's a bit chaotic here...
  14. I have never been able to consistently remember to take evening meds on time. I always have to adjust everything to take once in the morning because I am so incredibly bad at this. If I take meds in the evening they need to be taken within a 2-3 hour window consistently. This is a huge problem. I usually remember the night meds for a few days on time... then I slip up and take them late.... then I fall asleep forgetting about them, and wake up in the early morning and take them.... then I end up forgetting them all the way until the next morning. For the life of me, I can't remember them consistently for more than a week. Yes, I use a pill box (otherwise I would have trouble with my morning meds too). Things I have seen suggested / tried: Setting an alarm / pill reminder on my phone.... that would be a good idea, except that about 1/2 of the time the phone has no power because I forget to charge it up. Linking it to something else I do in the evening.... unfortunately, I don't do anything consistently at bedtime except sleep, because I forget everything and have never been able to establish habits. For example I can never remember to brush my teeth, etc. Half of the time, I even forget to take my clothes off!! Asking my husband to remind me... unfortunately, he can't remember this any better than I can. Please help!!!!
  15. In all of my DBT classes we had some people who had trouble feeling emotions. It's not uncommon at all. Personally I have a lot of trouble with numbness, avoidance, and overwhelming anxiety that I'm often not even aware of feeling (or deny it). Even people with very powerful emotional responses also frequently have trouble feeling some emotions that are painful, that they are afraid to experience, or that they "shouldn't" have. There are a lot of other components to emotion. Not just subjective experience of feeling the emotion... there are also physical symptoms, urges, behavior, and thoughts. Someone might for example have thoughts and urges that are influenced by the emotion of anger, even while feeling "cold" and not subjectively angry. Or someone might subjectively feel very angry, but have difficulty feeling the sadness or fear that may also be occurring along with the anger. In the emotions part of DBT you spend time learning to recognize, name, and work with your emotions, whether you feel them very strongly, or when you have trouble feeling them. Mindfulness exercises can also seem really stupid, frustrating, irritating or boring. Experiencing the present moment can be uncomfortable and distressing. Lots of people feel that, as you say, "the present moment sucks and I don't want to be there." That's super common for people in DBT because generally, people do DBT because their life sucks in lots of ways. But in order to make life suck less, you have to turn towards it, experience the uncomfortable present moment, and be mindful of reality. That's necessary in order to effectively work with it. Not all skills apply to everyone... No one finds all skills equally helpful. Most people, though, will discover some skills that are especially helpful, and the only way to find that out is to try using the skills. That's why you have homework. Some skills seem really simplistic or annoying or impossible, and then turn out to be great skills for you. And often people experience skills really differently when they go through the skills curriculum a second time. DBT can be incredibly useful for many people. It's worth giving it a really, really good try, and sticking with it through the whole curriculum.
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