This is going to come out in one big sloppy brain dump because I’m exhausted. I’m exhausted not due to medication (directly) but thanks to a cold that kept me up all night with congestion and neck pain.
So, after last semester ended, mid December, I went to the M.D. and asked for Concerta. I had been taking Ritalin, to great effect, but the issue was the duration of the effect. I previously wrote at length about the wonderfully positive effect of Ritalin and it’s steep drop off. I started on 10mg twice a day, which lasted a little over two hours for each pill. The doc recommended then 20mg in the a.m. and 10mg four hours later, then 20/20, but taking 20 made me manic, unable to slow down, so I altered it to 10mg every three hours or so.
I went for my appointment, and the doc agreed that Concerta would be better, but was concerned that my blood pressure was elevated. I’ve always had borderline hypertension, and I suffer from “lab-coat syndrome”; getting nervous in the doctor’s office, which elevates my BP.
He prescribed me 37mg Concerta which is supposed to last 12 hours and recommended I get my BP checked elsewhere and call it in. This recommendation set in motion a mental Rube-Goldberg contraption that made me sit on my problems for a month.
You see, the 37mg Concerta was not enough. The next level is 54mg, and I had never taken that much. The 37mg level, paired with the nebulous nature of my life during the holiday break (no classes, no meetings, lots of plans to get stuff done, daytime routine shot to hell) meant that I got into a funk.
Not a big enough funk for people to intervene, but a big enough funk to set the circular thinking in motion:
I want the higher level of Concerta, but I have to go get my BP checked somewhere first. I really should get my own machine, but then I should get the doctor to write me a prescription for one so I can get the insurance to pay for it. Of course, as soon as I call the doctor, he’ll want to know my BP. Maybe I should just go buy one, but they’re expensive and I haven’t balanced the checkbook this month or checked the budget. I’ll just keep taking this stuff until we get through Christmas, New Years’ oh crap I’m almost out!!!
I couldn’t tell if my funk was due to the wrong dosage, or to the environment working against me. The solution to this problem ended up being simple. Got me a BP machine at the pharmacy. Cost the whole sum of thirty-nine bucks. In the meantime, I tried the old, non-time-release Ritalin that I had leftover for a couple of days and remembered what the good feeling I had felt like.
So I took my reading (borderline, not high) and called in and asked for the new dosage. The nurse said the doc was out of the office for a week, but someone else would refill the med, but probably would not do the higher dose. Damn, I thought. I had a trip out of town planned with my son and hoped I could have the higher meds to help me along.
Well the nurse turned out to be wrong, and later that night I came home with the 54s in my pocket. I started one on Saturday, and packed for our trip clearly and efficiently. Yeah!
But there I was again in a new setting, going out to dinner with my autistic son, sleeping over at my parents’ house (where I don’t sleep so well), fighting the beginnings of a cold, all things that work against me. But I got through it feeling better, woke up on Sunday, popped another, and got some work done while everyone loitered around the house (usually I loiter too).
So we drove home through fog and mist on Sunday night, and my cold set in. Damn. Missed a day of work yesterday, slept a lot, kids home with a snow day, again the environment working against me. Then I took my Concerta way too late in the day and took meds for my headache and was up until 3:00 this morning, and had to be to work at 9:00 (and get the kids off to school too).
My Concerta, though, is keeping me on task. I got good work done, but I am waiting for some kind of normalcy to return to the external life, the things I have no control over (like the four snow days the kids have had this month) so I can see the Concerta in action. I’m waiting for the new normal.
What this past month has taught me/reminded me is how precarious mood is, how much I am affected by mood, and how very little mood has to do with “will power,” how much of what we’ve constructed around our experiences in the world in terms of morality or discipline or whatever has more to do with brain chemistry than anything else.
By the way, this is the sort of thing one looks at on the internet at 3:00 in the morning: