Lithium vs Dysphoria?

Hi! This is a medication topic, I hope it is fine under Anti-Depressants, even if I am diagnosed with schizoaffective disorder since 2007 (I am 53 now). So I got a bit of everything, depression included. But my current problem is dysphoria. I am currently on Valproate 1000 mg and Amisulpride (Solian) 2x 400 mg.

And I have been stable for about 3 years now. But recently I get this terrible state of irritation, distress and unease twice a day - in the morning and in the afternoon. I do not want to bore you with the details - those who know do not need much explanation here I guess

It feels as if I am decompensating. But it only lasts for about two hours. I stop everything I do, sit down and wait until it is over, trying not to think too much nonsense, trying to relax, trying to avoid the dark funnel that is about to suck me in. And then it stops and I do no longer understand what happened to me. I do not find a reason. If I would not know it will only last about 2 hours I would go to the psych ward. But as it is, I just wait until it stops.

Now, not only that I will get into trouble with my employer (sure, I call them, I apologize, I go there same day as soon as I am better), but it costs me 4 hours of my precious time, and today I decided I just do not want to stand that any longer in silent resignation.

So I made a date with my psychiatrist. I am quite sure he will want to change my medication, as he already offered last year. I have not talked to him more-in-depth since then, only came for my recipes and a sick note now and then.

He will offer me to switch from Valproate to Lithium. In fact it looks like the anti psychotic isn’t the problem. It is the mood stabilizer which is not sufficient. It is a mood problem.

Experience with Lithium therapy anyone? Seems a bit last century, eh?

Update… every day is an adventure now for me. Cant wait to see Doctor „Make-it-so“. Checked my meds again, because I know I have to control the situation and what I am going to talk him into. Found my mood stabilizer is meant to be 20 mg per kg body mass. So I am very low with it (1000 mg and 80 kilos, calculate it yourself, lol)
Changed my mind. Do not want the Lithium in the first place. He should allow me to rise my dose of Valproate. I wonder why I ask him even, instead of just doing it.
Going to clean the toilet now.

I am afraid my psychiatrist will not understand. I should try to get my appointment much earlier than the 6th of April, on the other hand I am afraid I will mess it up. I need more preparation. I need to find the key words he will react to. It will be all over within 20 minutes. The doctor does a brisk business…
I have seen so many MDs and psychologists by now. He is not the worst. It is like watching western movies - when you have seen one, you know them all.

Maybe I am silly to hope there is a medication to do away with the state I slip in every day. I wish I could go there and just tell him I am dysphoric and that would be enough. In my dream he would nod and say, „okay, I get it, let us try the following…“ (Instead of: „that is something you have to accept and live with, you do not have your chronic disease for nothing“)

You know, it is very discouraging to look up the term „Dysphoria“ in the german wikipedia. They state it is mostly a „banal everyday displeasure without pathological significance“. I feel derided when I read this.

Yes, it is „a profound state of unease or dissatisfaction“ causing „emotional distress; in some cases, even physical distress is seen“. Yes, it is. Not, seen, but felt. My solar plexus is a cramped knot. Thank you wp.en. I love you.

Oh my goodness, I hate lachrymosity! Do I have to wallow in self-pity to be heard and treated? My superego kicks in and tries to silence me - but I have learned that is just an intrusion. Let’s go on.

I need a result. Unease. Anguish. Desperation. I do not know how long I will be able to control my actions. I am not able to force me to do something that would distract me. Paralyzed. I am not able to relax. No wonder, I sleep as much as possible, to avoid and delay this state of mind. And that is easy, because I am exhausted when I return from work every day.

I am agitated, achy awake. I am sitting on an ice floe of resignation that is melting away. I am in the mood to pull my hair out if I had any.

It will last some hours and disappear. My mate will come home and distract me. We will talk, we will eat. I will get tired. I will be able to sleep. I will be able to get up and do my job. I will be exhausted from 11 am on (be it so, ready to live with that), call it a day at 1.15 pm, bike home and sleep until 5 pm… slip into this state again like every day now since about 8 weeks.

I looked it up. Mania does not fit. Mixed state does not fit. Depression does not really fit. I tried the Beck Depression Inventory. They ask whether I feel sad! lol. I am not sad. I am so unhappy that I can not stand it. And I think I have good reasons… It does not fit.

Maybe it is because i am maxed out on anti-psychotics. I have no weird „ideas“. My mind is empty. These questions are just silly. I do not know whether the future can become better. I am afraid. I do not have the feeling to be a loser - i have a disorder… I do not feel guilty… i do not feel punished (by whom? What nonsense!)… I do not hate myself… I do not want to commit suicide… ah, here, yes, maybe it would be good to cry, but I can not… and yes, I am no longer upset, I just do no longer care… other people - i do not know… decisions… yes, I am ugly, so what… yes, I have to force me to do anything… exhaustion, yes… appetite is okay… yes, imagine, I am worried about my health… I lost every interest in sex. Who cares.

It does not fit.

Anyway, my mate came home… enough for today. Anyone cares to give me feedback?