Changing the time I take my Meds

The past several days have been a bit awkward because I decided to change the time I take my meds. As you can see within my “Bio” section on the right-hand side of the page, I take Effexor, Zyprexa, Welbutrin, and Clonezapam for BPD and depression. For the past 10 years I’ve taken the medicine upon arising in the morning. Then, a couple hours later (with a few exceptions on really busy days) I inevitably returned to bed for a long nap, because I felt very depressed and sleepy. I was getting “tired” (no pun intended 🙂 ) of sleeping for part of the day and decided it would make sense to take my meds at night when I’m supposed to feel tired.

So far, the change hasn’t exactly produced the dramatic effects I thought it would. On one hand, I’ve noticed that the combination of taking my meds at night plus my nightly Clonezapam does get me to sleep sooner than before. Instead of tossing and turning in bed or staring at the wall, I now get to sleep within an hour, opposed to up to 2.5 hours previously. This is a welcomed change and it definitely means the “efficiency” of my nighttime rest has improved.

On the other hand, however, I still find myself creeping into my room for an afternoon nap; a habit which I thought would be eliminated by taking my meds at night. During the initial days of the change, I’d fall asleep in the afternoon for a shorter period of time, but would have nightmares and fitful sleep. I would wake up a little confused and would remember my nightmarish dreams as if they happened in real time. My mind was straddled between two worlds: reality and my sub-conscious (or wherever dreams emanate from). Although it is certainly better to have a shorter nap, the trade off of waking up “dazed and confused” makes me wonder whether or not my decision was prudent.

Another side effect is a much longer nighttime sleep cycle. This is to be expected since I’m combining all the meds plus my clonezpam at once. Now, I usually fall asleep by 3:30 AM – 4:00 AM and wake up late at 1:00 PM or even 2:30 PM. Yes, I get my “8 hours” of rest, but I completely erase the morning from my day. My cat sits at my door and starts to cry at 11:00 AM because that’s when she used to get her morning food and playtime. Now she has to wait another two hours; and she’s not very happy about that 🙁 .

During the past three or four days, some of the daytime nightmares have passed. Unfortunately, they have been replaced with longer periods of sleep and depression after waking up.

It probably sounds crazy to most people: I wake up at 12 or 1 PM, work for about 2 hours, return to my bed for a nap by 4 PM, then get back up about 7 PM and continue with the rest of my day. My productivity is strongest between 7 PM and 2 AM, however that time period includes an hour of TV to wind down after highly concentrated work at my computer for a few hours straight. My dinnertime is 9 PM and lasts about 30 minutes.

My psychiatrist used to say that some people are “wired” to operate better in the evening to late night hours. I definitely agree this is true and I can use myself as an example. Unfortunately, 90% of the world doesn’t operate on this schedule: the post office, banks, and most supermarkets where I am open early and close by 9 or 10 PM at night, just when I’m hitting my stride working at the computer.

As an aside, if nighttime productivity is an inherited behavior, I wonder what on earth my relatives did during the days when electricity didn’t exist. Did they just try to sleep at night and tough out the daytime? Maybe that process resulted in greater need for sleep and emotional tension? If I suddenly had to return to a 9 AM to 5 PM lifestyle, it would be EXTREMELY difficult and I’d no doubt start nodding off to sleep at 3 in the afternoon after lunch.

The only mitigating factor that I can think of in this complex balancing act – aside from taking my meds at night – is my Type 1 diabetes. Blood sugar naturally rises after meals, and this usually produces sleepy moods in most people, diabetic or not. Observe a 2 PM college class just after lunch and you’ll see that nearly half the class is dozing off to sleep. Speaking personally, I also notice that my mood changes with my blood sugar. High blood sugar produces depression and sleepiness, while low blood sugar produces drunken behavior, angst, and agitation. Perhaps I should monitor my blood sugar more closely and see if it is indeed throwing a wrench in the works?

I wouldn’t suggest changing the time you take your meds unless you consult a medical professional first. The only reason I did it rather spontaneously is because I see my USA psychiatrist once a year and don’t have the luxury of weekly appointments to discuss my progress and symptoms. That’s why I unilaterally decided to try this experiment.

Has anyone else altered their med schedule? What happed? I’d be very curious to know…

You just saw someone have a BPD rage: What do you think now?

I’ve had a few horrible rages over the course of my struggle with Borderline Personality Disorder. Most of them were directed inward towards myself, although some of the more poignant outbursts were directed towards those around me. When I blew up in front of family, they already knew I had mental illness and pretty much just distanced themselves emotionally and physically from me. When I blew up in front of complete strangers in a public setting, most of the onlookers stopped dead in their tracks – mouths agape – wondering “…What the f*ck is wrong with that guy?”. I know this look because I got many of these reactions after my first real BPD outburst in college that happened in the student center. People never thought of me as “the same” after that: it was as if part of my face had suddenly become disfigured, too grotesque to look at.

This blog, however, is directed at the bystanders and victims of BPD rages. While I was flipping out I know people were shocked; but what did they think after they were able to process the incident? Was I having a nervous breakdown? Was my anger drug induced? Was I suicidal? Why would I ever be allowed to be around us “normal” people?

Here are my caricatures of random people that witnessed my first outburst in college (or anyone else’s first major outburst in public). The following thoughts are purely speculation, based on my assessment of their reaction and probable conclusions about the incident. Do you think these profiles are accurate? Drop me a comment…

1. Disgusted Stranger – You saw me punch the wall, smash a bottle, and then curse out everyone around me with extremely vulgar language. You feared for your safety while watching the incident, thinking that I’d turn on you at any moment. You thought I needed to be restrained by security immediately, possibly even tasered. The next day, you recounted my outburst to friends and thought I should be immediately expelled from school, regardless of what the root cause of my anger was. Such people shouldn’t be allowed on college campuses because they pose a risk to others. If you saw me weeks after the outburst you looked away when I walked by or started to snicker with your friends.

2. Trying-to-be-a-hero Guy or Girl – After watching me go ballistic, you decided it was time for action. Someone needed to step in and calm me down, even if you didn’t even know who I was. After I started my profanity laced tirade, you came up to me and said “Hey…man… let’s calm down and talk about this. Don’t be this way…”. When I heard that I replied, “F*ck you, I’m tired of being calm. I’m pissed!!!” Later that night you thought about the incident and wondered if you did the right thing. You thought someone needed to step up and get this guy under control. Unfortunately, your efforts didn’t work. If you see me again, you might say a polite “Hi”, but you mostly feel sorry for me in an overly sympathetic manner.

3. The Angry Onlooker Who Fights Back – You started to hear me coming around the corner yelling loudly and acting violent. Now, you suddenly feel threatened and angry. Who the hell is this guy? What’s his problem? More importantly, why is he threatening my personal safety with his tantrum? Unlike the “Trying-to-be-a-hero Guy or Girl”, you react with impatience and anger. Fight fire with fire. You start yelling back at me, pushing me around and attempting to restrain me. Ultimately your efforts fail because I’m out of control, and you really could care less. The next day you and your friends talk about that “nut” in the student center freaking out. Your conclusion is that I should be institutionalized. How dare I threaten YOU in public!

4. Sympathetic Bystander Who Feels Sorry for Me – Maybe you know me from class, from a music performance, or from a school club. When you hear me yelling and acting out, your reaction is sadness. You wonder what could be wrong with me. Why is this guy doing this? Is he OK? Did something horrible happen to him? Maybe someone in his family died? Wow, I always thought this guy was kind of shy – what’s making him so crazy? I don’t direct any of my angry words at you, but you follow me from a distance all the same, wondering what will happen in the end. When an ambulance pulls up and takes me away, you feel sorry for me and your impression of who you *thought* I was has changed forever. You don’t really gossip about the incident with others and choose instead to think quietly about it, pondering why some people fly off the handle. What triggers such a scene? What will happen to this guy now? Does he deserve to be punished or administered medication? (Or both?)

5. Authority Figure With the Job of Getting Me Under Control – Wow, you think, I’ve seen that guy running around campus with the track team. What is going on here? Is this guy going to lash out at strangers or me? Is he armed? Should I call backup? In the end, you follow me closely to keep me corralled, but not quite in submission – yet. After a few minutes of witnessing my anger, you call for assistance and steer me outside, away from others. Then, you and your partner force me to the ground and hold me there until the ambulance arrives. Once in the ambulance, you restrain me to the gurney and are in complete disbelief as it pulls away: what was that all about? Has he done this before? Was this the result of pure evil intent or mental illness? Will we have to monitor this guy if he shows up on campus again?

So those are my thoughts about five different types of people and their potential reaction to my BPD rage. No doubt, if you have BPD too, you have probably come across the same types of people during your rages. Are these accurate portrayals? Are there more types of people I didn’t include?

I suppose I forgot to mention “The Turncoat”: the school official that feigns kindness but later stabs me in the back in private. I actually experienced this type of person in real life, but I didn’t include it above because it was only from one person, not the majority of those around me.

Victims of BPD Rages: I’m not trying to justify or condone BPD rages. They are awful and upsetting. They probably make you think twice about the person flipping out, perhaps changing your impression forever. Although I can make no excuse for my rages, all I can say is that I was not – and still might not be – emotionally healthy.

BPD rages are explosions of emotion, a supernova of sorts that cares little for what it destroys in its midst. My hope is that anyone who witnesses a BPD rage thinks carefully about the incident, considering that fact that mental illness, profound sorrow, emptiness, and loneliness might be contributing factors to the situation.

All the same, I’m sorry for all my outbursts and if given a second chance would never choose to react in such a dramatic way again.