questions about meds

This will be a little long. My apologies for those who don't enjoy these kinds of looking-for-answers posts. Hopefully a few of you will care to read it all and give advice if you have any.
Over the past few years my doctor has suggested I was bipolar many time but I've always refused to admit it as a possibility. Even though I fit the description of this disorder right on, there's a part of me that's very suspicious of medication that alters the chemical balance in the brain, especially since I've yet to find one pharmaceutical company that has claimed anything else than "we think this works because" instead of "we know this works because". Basically, all psychotropic meds rest on theoretical reasoning, and as a political scientist myself I need the proof to really accept anything as true. For the last 7 years I've also been doing a psychoanalysis, and although I'm also suspicious of this discipline's suggestions as to why people act the way they do, their arguments makes a lot more sense to me because I'M the one that's at the root of all the havock in my life. I NEED to be responsible. It's not some exterior malevolent force, it's not some brain chemistry imbalance, it's that I somehow overlearned some defense mechanisms as a child (result of abuse and neglect) and that in turn I've become stuck in a negative behavioural spiral where no matter what I do, what I take, I will be the way I am until I address the behaviour I don't want to talk about. In other words, you can take anti-depressants all you want they're just be a temporary bandage covering up something larger, within you. Or, in my case, I can take mood stabilizers but unless I'm willing to dig deeper I'm never going to fix this for good.
My psychoanalyst has never suggested I not take medication, in fact she does think I should be taking what the doctor prescribes. You see, it's not as black and white as I make it out to be, the doctor is supportive of the analysis, and the analyst is supportive of the doctor. But in my head I guess I somehow believe they're both at least a little wrong, and that the answer to acheiving any happyness at all (I have been miserable most of the time, for the last 12 years) is within me, if only I could work harder at trying to untangle the knot. But I can't, and not for lack of trying. I understand myself better than most people do because of the intense therapy I've gone through. I see many of the links, I understand that irrational things I do have a totally rational begining. But the ups and downs never go away. One minute I'm moving to the best school in France to complete my masters, the next I'm just this useless person that had no talent or intelligence and if I'm where I am, if I've always had A's or professors eager to work with me it's just because of luck, it's just because I'm good at fooling them. Eventually, earlier this year, I had a breakdown, or what was later labelled a psychotic episode during which I destroyed religious symbols in my house, burned the bible, and started screaming it was God. I came out of the hospital, went straight to my doctor's office and told him, ok, I'll take them. I'll take the meds. But because in the past I've had so many close-calls with anti-depressants (suicide attempts, this reaction to ADs was actually one of the reasons the doc thought bipolar) my doctor has been very careful about increasing the dose. I see him once every two weeks now, and after 4 months of taking these meds (he also had me on xyprexa but those knocked me out cold and I refused to take them) I'm still at only at half the dose I'm apparantly supposed to be taking. Specifically, I'm at 500mg of epival (depakoke). My question about meds, as this post implied I had, is the following: I've started charting my ups and down and they seem to be getting more and more frequent. I remember when it used to be a few weeks up, a few months down. Now its up and down in the same day. I mean, intense I-shouldn't-be-alive downs and intense I-will-rule-the-world ups. I am so confused. I write things one day and I can't remember why I ever would have thought what I wrote the next. I go see my friends one day and tell them how great I feel and how my life is all a rainbow of colour, and the next I won't answer the phone, I'll withdraw completely to the darkness of my home. I study like a nut one day, and the next I can't focus on anything for more than 10 minutes. Often these mood shifts occur in the same day, so example I can study in the morning but I get fidgety by afternoon and can't do anything anymore. Usually I start the day up, around noon I start going down, later in the afternoon I go up again, and I end the day down. Not always like that, but often. Shouldn't this epival be treating those ups and downs, or is the dose I'm at still too low to have any effect. Should I be pressing my doctor to up the meds? If I ask this I'm admitting I have this disorder and I still so do not want to. I'm at a complete loss as to what to do. I am so nervous all the time, I can't stay put, I feel like there's something inside me that has taken over control and is just doing everything in its power to sabotage my life. Then I switch out of that line of thinking and tell myself that I just WANT to believe that, but it's not actually true. I don't have anything. I've just had a rough childhood and as a consequence I'm having a rough adult life. This turned out to be a post not much about questions on meds but more about a monologue to myself. I'm sorry. I'm sort of freaking out. I'm willing to accept that I have this, but it's very hard. Maybe because I'm so convinced I don't have any brain chem imbalance issues I'm causing a sort of reverse placebo effect on the drugs. I'm going to stop writing now because I feel what I'm saying is ridiculous. I'm clicking submit and holding my breath. Please, if you do respond, don't attack my reasoning. I hear it all the time from friends that think I push things too far into the extremes. I just need advice from people that actually have what I have, if I indeed have bipolar.
n.

mm sounsd like u dont believe in meds at least because they've never worked for you. im still in a place where i feel i can handle myself - just afraid of the mania really. i dont know what im waiting for but someday ill probably end up trying meds. from all the stories ive heard, an important part of meds is to not giv up on them. once u start it can take a long time to find the right prescription for you, and even then u still may be coping with symptoms on top of the drugs'.
since you are on depakote, im no doctor but id recommend trying the recommended dosage. i mean, wont know till you try, right? at least youll get a taste of what 'normal' is for you.
its very rational to blame all problems on oneself, i do the same but IMHO the brain is as susceptible to problems as any other organ inside u, if not more so. i think if you find the right medication, perhaps you will still hav problems to confront but you would be better prepared to handle them.

-matt

I am taking them, I'm just confused as to why I'm still going up and down so much. When I wrote that first message I ended up taking an appointment early with doc to see what was going on. He prescribed clonazepan (valium like) to calm me but did not increase the dose of epival (I'm on 500 and he says the minimum I should be at as 1000 or 1500). I took the clonazepan and it depressed me. Later in the evening I decided to get beer (when I'm really down I tend to always do that) to calm me, but instead I became more agitated and popped a few more pills. I took a razor blade and started cutting my thigh (I've cut before). The next morning I woke up on my couch (no idea how I got there) and had just enough time to take a cab and get myself to school for my final exam (which odly enough I did good on). Then I went to the hospital and was bawling, affraid of what I might do to myself next (numerous suicide attempts in past) and I feel like I can't control it. They had me wait 6 hours in the waiting room with all these other people. I finally just left because I started thinking they were going to take me in and God I don't want to see the insides of a psych ward again. So I left. After my exam I was supposed to take a bus to go see my mother in Ontario, but I left her a message that I felt so awful I was actually going to go to the hospital. When I came back (having never seen the psychiatrist) I told her everythign was fine and I'd be leaving this morning (bus leaves at 7h30). I'll stay the week-end and I know nothing will happen to me there. But haven't you ever been affraid of yourself. How do you pass from suicidal ideation to oh its all ok. I'm so tired of it. Anyway have to go. Thanks for answering.

Short attention span. Didn't read your whole first post. Hope this helps.

At one point, a pdoc wanted me to try a med, and I was very scared. For me, I know 'resistance to change' just comes naturally. The easiest way for me to understand it, was that my therapist told me to think of a psychiatrist as a "brain chemist". That gave me strength to try it, and I survived! Maybe scarey, but I had to have 'blind faith' in him, and it worked. Ofcourse we had a very good working relationship, which helped alot.

"But haven't you ever been affraid of yourself."

Yes I have, and it is very scarey. Once, I had to leave work, and 'ran' straight to the dr's office! Another time, I took a firearm to a trusted friend, and went home, where I felt safer. He then contacted the husband, who came to check up on me.

Whatever it takes, do what you need to, to stay safe. If that means the ER or a hospital stay, it's better than the alternative.

Communication is very important with your pdoc. If the meds aren't working, or doing weird things, it is so important to get ahold of them, and let them know, so they can makes adjustments, or changes.

I wish you well & best of luck,

Flyer

Yeah, it's scary. I've had a few close calls and each time it was really spontaneous. That's what I'm affraid of. I'll decide pretty much spur of the moment that today's the day to screw my life up. It's been really bad lately, and I know I'm a danger to myself. I have so many scars from razor blades. I just want it to stop. I want the ideas of death to stop coming. Why aren't they always there. That's the f-ed up part. If I was always down and suicidal at least I might be labelled as depressed. The other day, I think after writing the first post in this thread, I went to the hospital of my own free will. I said to myself this is enough, I need to check myself in and be somewhere safe where perhaps I'll actually get help. I had self-mutilated the day before on my leg. I didn't show the doctor I had to see before seeing the psychiatrist. I heard him in the hall say "she isn't suicidal". He spoke to me perhaps a whole 2 minutes. I was put back in the waiting room where I tried to calm myself down between the crying spells. I waited there 6 hours and then I left. Hospitals are like that, no one cares. Last week my doc had given me a prescription for pills against anxiety. He prescribed 40, I told him he really shouldn't do that. Just prescribe a few so I don't take them all as I have often done in the past when I've had pills available to take. So he prescribed 10. I was out of them in three days. For three days I just took these pills to knock myself out. They make me sleep. Hours of life disapear and I don't have to deal with anything. This week I've been thinking quite a lot about the end. I was thinking of going to the doc again (have appointments weekly, but I'd call to get an appointment sooner) and tell him, if you don't help me, if you don't get me hospitalized, I will go to another doctor and get more of those anxiety pills, and I will then take that razor blade and instead of mutilating I will cut exactly where I know it will kill me. I know where that vein is. I only need to take 2 pills to be knocked out for 2 hours, and I think 2 hours is ample time for me to bleed out. I HAVE THESE IDEAS. I want them to go away. I don't want to suffer like this anymore. If I do something to myself now the only purpose is to end the pain, not my life. But my life will leave along with the pain. I need help but it seems like no matter where I turn the door is shut in my face. I will read this post tomorrow and there is a high likelyhood that I won't feel the way I do right now, and that I'll feel stupid for writing. But then there will be an aftertomorrow and I'll be suicidal again. I'm definately afraid of myself, but I don't know what to do anymore. I notice that epival, like antidepressants also lists suicide ideation as rare side-effect. Everytime I did something I was on anti-depressants. Will these drugs be the end of me? Is it just in my mind? Oh, and I should just shut up. Click submit and duck for impact.
Sorry for making you guys/gals go through this.
n.

Just to bore you more.

I haven't felt this suicidal since the last time I was hospitalized some 8 years ago. It's about 2 weeks now that I think about it on and off. I've felt very very down, but it was always withing my control to not think about my own death. Today, I'm not scared about it. I think it would be a $#%^ thing to do to the people around me, that's the only thing that stops me. No one in my family has any clue how I feel, and it's been too many years for me to start telling them. No one has any clue about possible bipolar or possible major depression. And there's too many other things happening. Other people are sick and have to be tended to. Other people have issues. I don't want to impose. I want them to know but the world doesn't revolve around me. I have until september 6th to snap out of it, after which the new semester starts. My master's advisor thinks I'm so bright. He's so wrong. I don't know anything. I don't know anything that I knew when I first impressed him a few months ago. I can't keep this up anymore. What's the point of writing here. I should be talking to real people. You are real people but you're not here and you can't help me. I find it impossible to be with real people. Real people are noise. I want it to stop.
I want it to stop.
I want it to stop.
I want it to stop without me having to stop it myself with draconian measures.
I'm sorry for this.
n.