DepressionFilter: I'm on meds and am in talk therapy. However, I tend to fall apart on weekends and at night. What coping strategies might I try in order to help with the downness that comes with nights and weekends? [More info, including potential factors and meds schedule, inside.]
#1: Medication and therapy history:
I've been on meds and going to one-on-one talk therapy for almost 8 months.
My current med slate is: 100mg Lamictal/ + 1000 IU Vitamin D supplement + birth control pill (generic Seasonale) in the morning, with 600mg Seroquel XR + 1mg clonazepam + varying doses of diphenhydramine (I'm currently in the midst of cutting down my daily usage of diphenhydramine on advice of my pdoc and am currently taking 150mg nightly.
) at night.
The Lamictal/Seroquel/clonazepam/vitamin D dosages have remained unchanged since early January. I've been on the same birth control pill since around 2003-2004.
Blood tests have shown that my vitamin D supplementing has brought those levels into a 'normal' range. I had Lamictal levels done as well and they were at the bottom range of being effective.
Medications that have been previously tried, but rejected are: Abilify (made me jittery, wasn't helping), Cogentin (in an attempt to deal with the Abilify jitters turned my nearsightedness into far sightedness), Paxil (seemed to help a bit at 40mg, but pdoc said it wasn't doing enough), and Wellbutrin (turned me into a constant sobbing mess). The pdoc has said that SSRIs are likely off the table completely due to my seriously bad reaction to Wellbutrin. The pdoc and shrink are pleased with the effects of the current slate of medication.
Therapy is a mixed bag. I do talk a lot but sometimes I feel like I'm just telling random stories of my life, with intermittent crying spells. The shrink does recommend books and is trying to get me to rethink about situations around my folks (which hasn't much changed from here
* except for the fact that pops basically bought a condo for me because with the numbers, buying was cheaper than renting for my situation and I found a part-time job which I love). I think it's helping a tiny bit and the pdoc agrees. I see the shrink one day a week and have just gone to monthly appointments with the pdoc (instead of every 2 weeks).
#2: Diagnos(es) and psych testing
Right now there isn't a solid diagnosis (as far as I've heard) but some flavors of things being tossed around are: major depression (with and without psychotic features), ADD, some flavor of a nonverbal learning disorder, PTSD, dysthymic disorder, generalized anxiety disorder, social anxiety, cyclothymia, and/or possibly bipolar 2.
The frontrunner right now is major depression (which might or might not have psychotic features).
I had psych testing done about a month ago which showed that there really wasn't anything seriously going on there (except for some issues with numbers, but that's been a known factor) and passed me off with a perfectly normal IQ.
#3: Current schedule
My schedule is fairly fixed at the moment. I work part-time Sunday-Thursday. I go to the gym once a week and have a (DVD-led at home) bellydance practice once a week. I volunteer every other Friday. I'm getting between 9-11 hours of sleep per night and am working on eating more fruits and veggies. I'm also in grad school for Master's degree #2, part-time.
#4: Some things I've found to help a bit
I've found that I feel better when I have achieved something or feel competent. Sunshine helps a bit. Exercise helps a bit. Sometimes food helps.
#5: Factors to consider
I have a really hard time in crowds, meeting new people, running into people who are angry with me (which is a problem where I live because I pissed off the condo board president) and general social interaction. I do have a car, but not much money (due to paying for school out of pocket and treatment). There's a park across the street from where I live that looks interesting, but see above about social situations. I do not have any close friends that live nearby and my family is a raging pucker of assholes*. I've read damn near every AskMe about depression/anxiety/therapy/etc and have done some research in PubMed, but haven't come up with anything conclusive.
#5: Possible ideas?
Some potential ideas I have: adding in more exercise (weight lifting, more elliptical, adding dance sessions), eating better (work in progress), getting out more (that social thing is a bitch), increasing Lamictal or taking some in the morning and some at night...
As of late, I've been having occasional 'okay' days (I use a mood tracker daily) with the hint of potential 'good' days. However, these tend to only be during the week (Monday-Thursday morning) and sometimes those nights aren't problematic, but 'weekend' nights for me (Thursday night-Sunday night) put me back into the hole (which I refer to as cratering).
The pdoc and shrink both know about this problem, but they said the okay/almost good days are a promising sign (and to me it sounds like they think the rest of the time will fall in line, eventually). I've thought about adding more activities to my schedule, but I'm afraid of overwhelming myself. (I'm a baby steps kind of person.)
The question, if you've made it this far:
What can I try to do to either alleviate this cratering or eliminate it entirely?
(Other advice about dealing with down days while in treatment is welcomed as well.)
Thanks in advance.
* The current plan to deal with the folks is that I'm going to finish my degree (expected to be done by November/early December) and hopefully find a better job (I want one preferably in this area but the shrink says taking one that's waaaaaay far away may be better) in that time so I can fully support myself. (There are some issues that are going to be sticky about this, but that's the general plan for right now.)