I went back to the psychiatrist on Monday morning during my planning period. Boy was that fun tearing out of the parking lot and racing there and back in an hour. Worth it, but not fun.
She agreed that I'm still struggling and we discussed medication options. She heard what I was saying about any of the stronger/more effective medications that can potentially cause weight gain and blood sugar changes. I told her I am not okay with weight gain. Not okay. About 10 years ago I gained 15 pounds in 2 weeks when I started taking Depakote. Oh, and also there was the nausea and lying on the tile floor of my bathroom. No, it's not worse than death, but I've worked so hard and I don't want to have to choose between being healthy mentally and carrying around extra weight and potentially risking heart disease, etc. Oh, and I gave away all my bigger clothes. And I'm vain. Beyond that, and on the side of things that are not negotiable is that fact that diabetes is an issue in my family. I really, really, really don't want to deal with that.
So... we talked about lithium. I took that years ago and there are various pros and cons. Not good for babies is the biggest con right now, not that I'm healthy enough to consider babies. She wants me to taper off the Trileptal and take Lamictal. It's what she would have given me a few weeks ago except that it takes a few weeks to work and we didn't have a few weeks to wait around. I am now taking 600mg of Trileptal twice daily and 25mg Lamictal at night. It seems okay. I'm still struggling, but what can you expect? None of this is instant.
In the meantime, I am still going back and forth between depression and feeling manic. "Mixed state" is what she called it. So, basically, my poor husband is being kind and for his own good should probably move to another county. I am lucky that he hasn't. I'm trying to stay calm and not smash all the dishes when they don't fit into the dishwasher.