The mood chart's not been indicating good things lately. Things have been worse before, for sure. By far and for huge stretches of time. It's not like that, but...The problem is that I can't figure out what is causing it. Too many potential suspects for the latest shift.

Probably the two biggest possible causes, which started at much the same time...are switching to the generic Lamictal (the Teva lamotrigine) *and* job stress in the form of graveyard shifts (and the inherent split sleep patterns) and that the boss keeps changing the schedule and even the way the work days are referred to (will spare you). Long and short is that I often truly don't understand when I'm supposed to be working. As I'm one of those people who take work very seriously, this causes a LOT of stress. (Oh, and at best, I have huge problems perceiving time and what day it is, so you can imagine...) I do have one other factor, but that has remained a constant through the other changes, though it's not a positive, I'm sure.

I'd had such a nice stretch of overall good stability and now it's all over the place (but lower end of the chart) with extreme switches in short order. Generally in the form of instantaneous plummets or anxiety. And much more anxiety overall. Very frustrating. I tried to tell myself that it wasn't that different, but the mood chart says otherwise.

I've got an appt. in a week and a half and will bring it up, but in the meanwhile, it's hard to know how to think about it. None of the options I can see from here are appealing. Quit the job. As if. (Though I may concede to asking for non-graveyard...This sounds simple, yes? Not exactly. Day shift starts early, and I have a very hard time in those hours. Swing would make it so I'd rarely see my BF, who is my only person IRL, and a huge support element for me.) or go back to the brand med (about 7x as expensive and not exactly financially practical <understatement>). Will see what the PMHNP thinks of course, but in the meanwhile felt compelled to post about it, as it's the main BP thing going on for me atm.

Don't know that this needs any advice really, just felt like talking...

Edited to add that I've recently had the feeling that I'm on the edge of losing it. In what way? Dunno.

[PT52]

Hugs...wish I had some wise advice, but that's about it...hugs...

[PromisesToKeep]

to be filed under "for what its worth"

I started my career many, many moons ago (back in the days of cave paintings and T-Rex threats) in the medical field first as a EMT and then a pharmacy tech. Way back then, according to the FDA, the generic forms of the medications had to be identical to the brand names. Donning my suit of armor in academic pursuit, I will research this topic now and get back with you ASAP. I have taken Lamictal and Lamotrigine and they have had an identical effect on me.

In my humble opinion (also in the 'for what its worth' file), structure is a ABSOLUTE must to keep me healthy. There is no way in hell that I could work a swing shift or even switching around shifts to match scheduling priorities. The way that we maintain our health is by taking our medications on time, every day. How can that happen if you are working different hours? You MUST take your meds at the same time, every day, without fail, if you are to achieve and maintain recovery. Why? Each med that you take has a certain half life in which it degrades and you must maintain your medications in your blood serum level appropriately. For instance, I take zolpidiem (generic for Ambien) at one hour before bed time. I have to have a full eight hours for this to detox from my system. But I am also taking a NSAID, Relafen every 12 hours as I do with my lamotrigine. My clonazepam is dosed every 8 hours while my Effexor XR is dosed every 24 hours. I also take topamax every 12 hours and Soma every 8 hours. I also take phentermine with each meal to address the diabetes issue caused by Seroquel which I discontinued. Now I have to take metformin twice per day based on my food intake periods until the weight loss addresses the Diabetes II issue (I gained 30 lbs in under 2 months on Seroquel. At my top weight, I was 175 @ 5'7 and still came down with Diabetes. (It is a side effect of Seroquel and my Pdoc has stopped prescribing it for that reason. Too great of % of his patients have had to discontinue and go on diabetes meds.)

I have never shared my meds or their schedule in a public forum before but I do so now to make a point. Although my situation is admittedly complex, I am sure that you can understand the importance regarding my compliance regarding the timing of dosages. If you are switching your sleeping schedules and working schedules around, you will not be able to maintain your medication schedule. THIS, I propose, is the source of the angst that you are currently facing. You cannot maintain your blood serum levels if you are taking your meds at different times on different days and you cannot work safely under the influence of certain meds.

I STRONGLY encourage you to speak with your human resource representative and refer him/her to the Americans with Disabilities Act. Explain that you have a documented medical disability that requires regular medication throughout your lifespan that has to be taken on schedule each day. You can document your disability with a letter from your doctor withholding your diagnosis, just a confirmation of your disability requiring medication that would effect your job performance if your shifts were switched around. You can even back that up with a letter from your pharmacist stating the timing regarding the dosage of each medication and the cautions associated with such, redacting the prescription name. It is none of their business the nature of your disability or which medications you are required to take. If you really want to load your six shooter with teflon coated rounds, you can also leave them with the business card of a labor attorney that is willing to take on your litigation on a contingency basis. You would have one hell of a discrimination suit should you choose to file.
There. Do you feel better. You are not powerless and you are not backed into a corner. They have to make some concessions for you based on your disability, just as if you were in a wheelchair.
Now I will go look up the organic chem structure of the teva lamotrigine vs lamictictal. I shall return and then, I shall crash. Been up now over 48 hours but had to dispense the arguments.
hugs,
Colleen

[PromisesToKeep]

OH NO!!!! I just worked on a justification of how lamictal and teva lamotigine are, for all intents and purposes, identical, yet a wrong key stroke, and the whole essay was GONE. The structure, the molecular formula, the molecular weight, the plasma drug concentration as well as the extent of the drug dissolution statistically identical. Teva Latmotrigine earned an AB rating with the FDA which is about as high as you can get considering the variations that can occur during experimentation. Some of these can be human error, degree of equipment calibration, adherence to ensuring that the same pieces of equipment are used for each experiment, environment variation, batch sizes, quality control, bioavailability, in vivo/in vitro correlation rates.... etc. All of these studies must be performed several times, enough that it can be analyzed statistically. I am a particular fan of the t test. That being said, I admit to having banged my head on a lab bench for six months or longer because my data didn't match my previous studies. One time, it turned out that the temperature gauge in my refrigerated ultra-centrifuge was off by five degrees centigrade. Another time, a very small ant had taken up residence in the mouth of the hosing attached to the equipment that created my sucrose gradients. That little ant ruined an $18,000 experiment! Why couldn't he stick to that rubber tree plant?!?
IN CONCLUSION; Over ten years in the research labs gives me the experience to know that results can rarely be repeated identically, hence, the necessity for statistical analysis. Each organization allows for a certain error rate and in this case is a factorization of a logarithmic function. For our purpose of efficacy of treatment and consumer safety, lamictal and teva lamotrigine ARE THE SAME. All of the hype that you hear regarding the difference between the two is just that... hype. We are, admittedly, a hypersensitive population. It is much easier to point to the medications being wrong or ineffective, yet we forget when we point our finger, we have three fingers pointing back at ourselves. It is a far more difficult task to evaluate our own self, behavior, conditions, emotions, and conclusions objectively. This is why a therapist, recovery partner or both are invaluable for growing in recovery.
Well, its time for me to hang up my chainmaille and retire for the evening. I hope that I have been of help.
hugs,
Colleen

[blueoctober]

Sorry you are having a tough time Innerzone. Is the graveyard your structured shift or are you switching back and forth between days and nights. I do work shift work and it's not ideal, but I have been able to do it. I really enjoy my job, and I wasn't willing to give it up (I had my the job prior to my diagnosis).

If you like your job requesting a more suitable shift is definitely an option. If you don't like your job perhaps this just forces you to start looking for a job that you would enjoy more.

I hope you start feeling better soon.

[PromisesToKeep]

oops... just reread your post innerzone, that you don't need advice. Damn. There went three hours. Gotta pay attention to detail. I am having a bad weekend. Sorry for my posts, hope you aren't offended. It's just the mom coming out in me... I want to wrap everyone in bubble wrap and protect them from all the evils of the world.
night nite
Colleen

No worries, PTK! The thing is... someone may well have been wondering about the ins and outs of what you researched (and btw, WOW!) and there it is! (A lot of folks on here take Lamictal/lamotrigine after all...) Oh, and I sooooooo hear you on the keystroke of DOOM! When I first got a laptop...can't even tell you how many times that happened. It had something to do with the heels of my hands for crying aloud-- not even a keystroke(!) Very frustrating stuff. Between that and how many times sites have gone down *just* as I submit, I now compulsively save (control c) as I write, multiple times for more involved posts. (If only saving my cave paintings were as easy! Hehe, oh how many times a reference point is caught on the edge of the tongue, eh?... I'm 47-- still can't believe when it's said or written-- and just yesterday was extolling the virtues of the endless amusement that could be had with a typewriter.... No, really!)

So... I wasn't working graveyard before, but actually requested it (kind of crazy, but I had/have my reasons, mainly that it's the least stressful shift of this job. Considerably so, even to the point of serious boredom(!)) So yes, blueoctober, it's stable as of this point. Also, it's really not anything I feel in the least bit pressured about (free to request any or all shifts, no problem there). Small co., no HR, don't possess disabled status. Um... let's see... Do I *like* this job? Well, don't know if "like" would be the word exactly, but I don't hate it, as sooo many jobs of the past and to my total surprise. (Almost backed out before starting, such were my fears of it. Turns out I'm pretty dang good at it! It's sooooo not me, and yet I can do it. Very weird. Was just thinking-- tonight actually-- there's me-me, and there's work-me and usually I can manage to "do" whatever for a frame of time, unless me-me is completely overwhelmed, then work-me doesn't stand a chance. Does that make any sense?) So... anyway, I don't hate it (don't "like" it, but don't "hate" it), but here's the thing. The pay? OMG in relationship to my usual min. wage type stuff. And as a result, I have to work far fewer hours to manage. That's a VERY good thing, as I've ever (as in, 30 years!) only had one full time job, and it was seasonal. Full time was one of my biggest fears in having to head out into the Big Bad World. Oh. And you will also be glad to know that I'm quite good at taking my meds right around the same time every day. No matter what. Will admit that it helps enormously in currently having a very very simple routine. Did get a pillbox recently to help with the "what day of the week is it" and "did I take my meds this morning?" problems in one fell swoop.

Think I will ride it out a bit longer and see how it goes. The weirdest part of it is that most of the time, I'd say, "yeah, it's going pretty much the same". But there are times when I realize, no..., there have been some fairly disturbing and rapid plummets and anxiety bouts. More than there were before. I *am* keeping a new style of mood chart, and it certainly does reformat the experience(!) Still, there's just... something. These sneaking peeks of an impending "losing it". ....They come and go (of course. Sheesh, what doesn't?!) Like.... right now I'm fine. Better than fine. Ready to blow off sleeping and just go to bed early tonight. Couple hours of sleep in the past...24. Heading home from work, went grocery shopping. No list, but some fun stuff on the potential menu! Then just didn't really feel like going back to sleep (DID take my meds on time though! ) and here I am!

Ok. Here's a funny. Here I am grocery shopping. La-di-dah, la-di-dah and all of a sudden I thought... holy cow, did those packages of chicken just move?! Like they're... breathing???!!! Stood and stared. WTH?! Poked a few racks, watched when people took things out of the case, maybe it's just air pressure! (BF came by. Works there. I've been mixing up my words and said, "I've been standing here swearing at the chicken!". "I mean "staring"!) Couldn't figure what was going on. A little while later, was walking down an aisle when I saw the same thing among canned goods. Holy cow, am I losing it altogether?! More tired than I feel? Suddenly I realized. Just last week, I got progressive bifocals. Side to side (away from a computer screen, lol!) movement of my head made it look like things were moving on their own!!! LOLOLOLOLOL!!!! Which has nothing to do with anything, but it was funny, so had to share.

(Oh, and PTK! I've worked a fair bit of chainmaille, so got a kick out of your sign-off there! How'd you know?! )

p.s. Paragraphs are my friend. Also, wishing you all a big laugh from my grocery escapade. It's still cracking me up, a couple hours later... Humor is good.

[Grkgjohn]

Originally Posted by Innerzone

The mood chart's not been indicating good things lately. Things have been worse before, for sure. By far and for huge stretches of time. It's not like that, but...The problem is that I can't figure out what is causing it. Too many potential suspects for the latest shift.

Probably the two biggest possible causes, which started at much the same time...are switching to the generic Lamictal (the Teva lamotrigine) *and* job stress in the form of graveyard shifts (and the inherent split sleep patterns) and that the boss keeps changing the schedule and even the way the work days are referred to (will spare you). Long and short is that I often truly don't understand when I'm supposed to be working. As I'm one of those people who take work very seriously, this causes a LOT of stress. (Oh, and at best, I have huge problems perceiving time and what day it is, so you can imagine...) I do have one other factor, but that has remained a constant through the other changes, though it's not a positive, I'm sure.

I'd had such a nice stretch of overall good stability and now it's all over the place (but lower end of the chart) with extreme switches in short order. Generally in the form of instantaneous plummets or anxiety. And much more anxiety overall. Very frustrating. I tried to tell myself that it wasn't that different, but the mood chart says otherwise.

I've got an appt. in a week and a half and will bring it up, but in the meanwhile, it's hard to know how to think about it. None of the options I can see from here are appealing. Quit the job. As if. (Though I may concede to asking for non-graveyard...This sounds simple, yes? Not exactly. Day shift starts early, and I have a very hard time in those hours. Swing would make it so I'd rarely see my BF, who is my only person IRL, and a huge support element for me.) or go back to the brand med (about 7x as expensive and not exactly financially practical <understatement>). Will see what the PMHNP thinks of course, but in the meanwhile felt compelled to post about it, as it's the main BP thing going on for me atm.

Don't know that this needs any advice really, just felt like talking...

Edited to add that I've recently had the feeling that I'm on the edge of losing it. In what way? Dunno.

I can relate to almost everything you said. Speaking as a third shift worker i think your job may be more of a factor than you think. No matter how much sleep you get in the day your body needs sleep at n7ght and people like you and I should not be on graveyard but i have no choice right now.

[PromisesToKeep]

Originally Posted by Innerzone

No worries, PTK! The thing is... someone may well have been wondering about the ins and outs of what you researched (and btw, WOW!) and there it is! (A lot of folks on here take Lamictal/lamotrigine after all...) Oh, and I sooooooo hear you on the keystroke of DOOM! When I first got a laptop...can't even tell you how many times that happened. It had something to do with the heels of my hands for crying aloud-- not even a keystroke(!) Very frustrating stuff. Between that and how many times sites have gone down *just* as I submit, I now compulsively save (control c) as I write, multiple times for more involved posts. (If only saving my cave paintings were as easy! Hehe, oh how many times a reference point is caught on the edge of the tongue, eh?... I'm 47-- still can't believe when it's said or written-- and just yesterday was extolling the virtues of the endless amusement that could be had with a typewriter.... No, really!)

So... I wasn't working graveyard before, but actually requested it (kind of crazy, but I had/have my reasons, mainly that it's the least stressful shift of this job. Considerably so, even to the point of serious boredom(!)) So yes, blueoctober, it's stable as of this point. Also, it's really not anything I feel in the least bit pressured about (free to request any or all shifts, no problem there). Small co., no HR, don't possess disabled status. Um... let's see... Do I *like* this job? Well, don't know if "like" would be the word exactly, but I don't hate it, as sooo many jobs of the past and to my total surprise. (Almost backed out before starting, such were my fears of it. Turns out I'm pretty dang good at it! It's sooooo not me, and yet I can do it. Very weird. Was just thinking-- tonight actually-- there's me-me, and there's work-me and usually I can manage to "do" whatever for a frame of time, unless me-me is completely overwhelmed, then work-me doesn't stand a chance. Does that make any sense?) So... anyway, I don't hate it (don't "like" it, but don't "hate" it), but here's the thing. The pay? OMG in relationship to my usual min. wage type stuff. And as a result, I have to work far fewer hours to manage. That's a VERY good thing, as I've ever (as in, 30 years!) only had one full time job, and it was seasonal. Full time was one of my biggest fears in having to head out into the Big Bad World. Oh. And you will also be glad to know that I'm quite good at taking my meds right around the same time every day. No matter what. Will admit that it helps enormously in currently having a very very simple routine. Did get a pillbox recently to help with the "what day of the week is it" and "did I take my meds this morning?" problems in one fell swoop.

Think I will ride it out a bit longer and see how it goes. The weirdest part of it is that most of the time, I'd say, "yeah, it's going pretty much the same". But there are times when I realize, no..., there have been some fairly disturbing and rapid plummets and anxiety bouts. More than there were before. I *am* keeping a new style of mood chart, and it certainly does reformat the experience(!) Still, there's just... something. These sneaking peeks of an impending "losing it". ....They come and go (of course. Sheesh, what doesn't?!) Like.... right now I'm fine. Better than fine. Ready to blow off sleeping and just go to bed early tonight. Couple hours of sleep in the past...24. Heading home from work, went grocery shopping. No list, but some fun stuff on the potential menu! Then just didn't really feel like going back to sleep (DID take my meds on time though! ) and here I am!

Ok. Here's a funny. Here I am grocery shopping. La-di-dah, la-di-dah and all of a sudden I thought... holy cow, did those packages of chicken just move?! Like they're... breathing???!!! Stood and stared. WTH?! Poked a few racks, watched when people took things out of the case, maybe it's just air pressure! (BF came by. Works there. I've been mixing up my words and said, "I've been standing here swearing at the chicken!". "I mean "staring"!) Couldn't figure what was going on. A little while later, was walking down an aisle when I saw the same thing among canned goods. Holy cow, am I losing it altogether?! More tired than I feel? Suddenly I realized. Just last week, I got progressive bifocals. Side to side (away from a computer screen, lol!) movement of my head made it look like things were moving on their own!!! LOLOLOLOLOL!!!! Which has nothing to do with anything, but it was funny, so had to share.

(Oh, and PTK! I've worked a fair bit of chainmaille, so got a kick out of your sign-off there! How'd you know?! )

p.s. Paragraphs are my friend. Also, wishing you all a big laugh from my grocery escapade. It's still cracking me up, a couple hours later... Humor is good.

ROTFLM*O!!!!!!! Thank you soooo much! I needed some comic relief. As soon as you started talking about the canned goods, I KNEW the punchline! As each member of my family ages, I can hear them talking around the table at the holidays. Without fail, as each one graduates to the progressive bifocals, I hear the same story with a bit of variation. It must be a genetic thing. Are you sure we aren't related... bipolar, graduated bifocals, chainmaille (I am thoroughly impressed that you know what that is, we did have to use it back in my glory days when fighting over the boys from the round table) And you thought you were dating yourself with memories of the typewriter! HA!

Thank you for forgiving me for intellectualizing, researching and educating. It is so much easier for me to communicate this way. Posting about ME on the other hand.... OMG... I was worrying that I was having uncontrollable spastic side effect from a medication when writing the posts for the last two threads I wrote. That's why I have to keep writing, with practice comes confidence and with confidence, courage. And getting out of my comfort zone takes a LOT of courage but if I don't, I won't get better.

When my moods are off and I can't quite put my finger on the reason, I randomly brainstorm on a blank piece of paper all of the factors that weigh in on my daily life. Charting though is a really smart thing to do. I don't seem to be able to keep up with that. Best wishes in seeking THE elusive answer and if you happen to come across the meaning of life along the way, do tell!

hugs,
Colleen

[WendyAussie]

Innerzone, my hat is off to you. I can't even work now, let alone working different shifts. Geez. Unless I could co-ordinate when I can't sleep with a night shift!! lol

Always glad to provide comic relief! Was definitely feeling silly. Started in on the kitchen a bit and pondered starting some of that cooking I'd envisioned, but decided that sleep would not happen then. Posted here and hung out a bit. Went to sleep about 12:30 (afternoon). When BF came in I said, "oh, I've been asleep for an hour". He just laughed. It'd been 4. Got up for a couple hours and went back to bed. Slept for about 13 hours.

You know what one of the hardest things is? Trying to figure out "hours slept" on my mood chart! When was that? Does it count for this day or that? I even keep a little sheet by the bed to try to keep track and am still completely confused.

Grkgjohn, yeah, it's hard even on the "normals". My ex (who's worked shifts all over the clock for several years now) said, "so how do you like the sleep thing?" Eh, not so much. Am glad however that it's not constantly rotating around the clock. Couldn't deal with that for sure. Had a very short-lived job many years ago like that, and totally couldn't handle it (The job sucked too, so that didn't help. Quit after 6 weeks.)

Hey Wendy, you're onto something there! Though I seldom have trouble falling asleep (sometimes, but not that often), my sleep troubles seem to play out more that for spans of time, I wake up in the middle of night not being able to get back to sleep for 2-3 hours, mind just cascading with thoughts. No one would want me on the job then, though! Lol, unless that job were journalling, which happens a lot in those times.

There is a location change in the job coming up in a couple of weeks. As it will be a good time to put in for a change, I'll decide by then whether to ask for day shifts. Leaning towards a yes. I don't know whether this all is directly affecting my mood instability, but it is definitely messing with my mind, which is completely scrambled* most of the time now. That surely can't help the overall picture...

*Scrambled, as in even less idea where we are on the clock/calendar than usual, constantly mixing up words (and not realizing it), words eluding me, only being able to think of things that rhyme or are in the same general (VERY general) meaning vicinity, whereupon I'll set to thinking about it only to realize that the theatre is completely dark. BF has been boggled by the extent of it. Spaced out near-gibberish one minute, then suddenly perfectly lucid well-constructed sentences containing extensive vocabulary. (Posting in times of clarity still takes forever w/ typos, revisions etc...)
If only I could just stop "swearing" at chicken packages....

[laur88]

Switching meds + lots of stress + messed up sleep = yuckyuckyuck!

That really does suck but keep in mind that things will eventually even out! I can say truthfully that I know how you feel (college = VERY uneven sleeping and lots and lots of stress) Keep truckin' (or as Dory in Finding Nemo would say "Just keep swimming, just keep swimming! What do we do? We swimmmmm")!!

You can do it!!

Originally Posted by laur88

You can do it!!

Turns out I can't.

Which makes me tear up a little (just a little, don't worry). I really thought I could do it. Really hoped, because in many other ways, it's the ideal shift: night owl, the far less stress, no sun, barely having to interact with people (which virtually every job I'm qualified has required in abundance, the public no less.).

But oh how it is messing with my brain. The sleep probably being the biggest factor. I never feel rested no matter how much I sleep. Even days off I'm so blah I just don't give a flip and can't get anything done. So everything's piling up, increasing the stress level, causing mental overload and immobilization in that viscious circle way. More often than not, I don't even have the wherewithal to post/respond her (please know that I am thinking of you all though, want to respond, but just can't seem to). There are brief periods of being buzzy, vibrating and damned annoying, like...very short-lived manic bursts. Or swearing and very pissy getting ready for work, when I can't even seem to get clothes on right. There are brief, very brief, spells of almost normal (post then). Oh yeah, and the words. Not being able to find them and mixing them up badly resulting in weird speech. May not seem like much, but language skill is something I've always taken a degree of pride in. It's frustrating and chipping away at what little self esteem there was to start. Also, I have to stand by a loud machine all night. May seem just annoying, but in fact, it makes me hear things, like indistinct voices talking behind me and radio sounds. Even knowing they're not real, they sound so real that they make me jump and turn around. Not cool. Though I can reason that out sometimes, sometimes it's just too real.

Having spent so much of the last few years in severe depression and mixed, being a serious danger to myself, it's hard for me to recognize depression that comes short of being on the brink. If it's not unrelenting and all-consuming, but bouncing around, it's easier to deny in the upper parts of the bounces. Still, they're almost without exception, below the balanced zone.

Can't help but think there probably was a time where I might've been able to do it, but that the BP went untreated for so many years that there's just too much cumulative damage done. (It's not the only thing that has indicated this.)

So, long and short, I requested day shifts. The boss is working on switching the schedule around to accomodate this. Thank goodness, because I really really can't lose this job. (I just said, "It's messing with my brain more than I thought it would". Which is fine, because "normals" often have that too. Wasn't about to mention the voices. )

[PT52]

Looks like you are on the right track...hang in there, and don't forget we're here for you.