Disturbing "mental event"--can you help me find the words to describe it?

Factual Questions
1

I’m going to ask this while it’s fresh in my mind, and hope it is as interesting to some as it is important to me.

Like many of you, I take medication; like some of you, some of my meds are for a fairly minor, but chronic, depressive ailment that I live with. (Don’t think “disabling sadness” or anything so grave: when I started taking these meds about 15 years ago, I regarded it as “life enhancement”–basically allowing me a richer “texture” of emotions.)

I normally take two such meds daily: Effexor and Depakote. They are by prescription, and I do NOT abuse. (My other meds are for blood pressure and cholesterol control.) I’m in quite good health over all, by the way.

For the usual boring reasons, I happened to be out of both, and my pharmacy is having some trouble getting my doctor’s office to get back to them with a refill authorization. I’ve been out of both for about three days now.

OK. Last night, during the first dream of the night, the “event” occurred. I doubt that the details of what was happening during the dream, at the precise instant in question, matter much…as this “event” has happened twice before over the years when I’ve missed more than 2 or 3 doses of Depakote, and in those times I was wide awake.

Now bear with me; my inability to put this into words is the essence of my question. I went INSTANTLY, without pause or build-up, right in the middle of the action, so to speak–from my normal, generally optimistic and positive view of … well, reality in general and my place therein-- to an entirely “other” mental state. It was a frightening and terrible “state” yet was NOT expressed with any of the concommittants one might expect in connection with those words. No agitation, no frenzied feeling, nothing that seemed like a “sensation of my body” (as when you taste something, or have an orgasm, or whatever). It was more like…(yikes)…the “sense” of having made a calm and dispassionate judgment that my life was not worth living and never would be, that all optimistic readings of how things will work out in the long run are (and have always been) utterly false, and that this is something I have always known (had I not chosen self-deception), and I will “feel this way” from now on.

Clarifications:

  1. Again, it was NOT “like” a sensation (as when one is sad or in pain or angry) but much more like a “dispassionate judgment” (and all the more “true”-seeming for that).
  2. The stuff I say above, the “as if” stuff, did NOT pass through my mind during the “event”, but came moments later after it was over, as I thought about it. And that’s part of why I’m stymied, because what exactly IS it that is a mental experience, yet is neither a sensation nor a cognitive-type judgment (ie, that is, at that moment, “about” something)–?
  3. I’m not suicidal; I think maybe I touched the very lowest of the 3 classical levels for, literally, about 10 seconds–and then THAT faded away.
  4. The event woke me up, and I experienced about a minute’s worth of what seems like an “anxiety attack”–heart pounding, agitation–and such anxiety attacks rarely happen to me. (Could this have been, somehow, what the first part of such an attack is “like”?)
  5. In this (re the dream) and the other two waking times, there was an element of my being involved in an entirely pleasant situation (finding a lost dog, spending Christmas with a friend) with this “event” spliced-in over the expected positive sensations without warning. As if my brain was getting a “feed” from someone in a rather opposite kind of situation (but, please, I’m not loking for “mystical” interpretations).

I want to communicate this event to my doctor, but without the long narrative. Am I missing a simple, direct way to describe this? (Just take my word, printing this out for the doctor to read, or a half-hour of semantical/metaphysical hand-waving, won’t “work” for my actual situation.)

Obviously, I’m not looking for a “diagnosis”–more like the fellow doper who wants to find a word that means “next” and “last”–if you see.

2

A “delusion”, I think – a worldview without any external basis.

That being said, I think telling your doctor the whole “long narrative” is probably the best thing to do.

3

You have a Bi-polar condition, dont you? The closest thing I have personally experienced is the anxiety attack. To me it felt like a very stressful kind of sensation with no apparent cause. You just feel “anxious”, the lack of reason causes paranoia and disorientation. It was brought on by medication that did not take too well with me.

As far as the “event”, that is about the most vivid recollection of the flip side of being happy I have ever seen written (or posted) The best description I can give is that you flipped off whatever switch humans use to be positive, optimistic, hopeful and happy. Kinda like running out of seretonin. Im pretty sure you remained relatively calm because you were in sleep mode. Being naturally sedated probably prevented any adverse effects the instant pumping of adrenalene did to you but it did wake you fast. If that were a waking event, there might have been fear, confusion, disorientation, paranoia, panic, dementia; you might have seriously hurt yourself.

Might I suggest you never skip your meds like that again. Your pharmacist shouldve known the serious implications of stopping dosage of those kind of drugs. He did not do you kindly. You sould also notify your doctor a week prior to finishing your meds so that he alerts the pharmacy way ahead of time. If you really have a problem expressing what you felt, print out this thread. I’m sure he’ll understand perfectly when he reads your post. Good luck.

4

Generally when the pharmacist knows you’re totally out of something, and there’s trouble contacting the doctor, they’ll give you 2-3 days’ worth to tide you over.

5

I know exactly the feeling. I used to take Depakote as well but now I take Lamictal. It’s almost like a reverse epiphany. It’s like your struck with a thought that life isn’t worth living but devoid of affect. It’s sort of like looking at the 3D drawing of a cube on paper and suddenly seeing it from the other perspective. Depakote has a very short halflife and a very thin blood-level range that is therapeutic. It’s not the Effexor, it’s the Depakote. Your pharmacy should give you a courtesy refill like ratatoskk said - certainly in the case of something like Depakote.

6

I am on the academic side of psychology not the clinical end, and as you said you do not want a diagnosis I will not dissect what you said too much.

I have heard some of the side effects of Depakote being Abnormal Dreams, the fact that you portray very lucidly what you thought after the dream tells me maybe it is time for a re-evaluation. I am sure you have had many evals, especially since you have been taking the drug for so many years. Having more than one family member suffering from manic depression I know how truely dark things can appear. Sometimes a simple drug switch is all that is needed. I know my sister got glorious results by switching from a psychiatrist to a behaviour therepist…it may be an option, but you seem to have things well under control.

This website offers a good clue as to why you may be feeling the way you are.

I would mention this when speaking to your doc. Good luck and check back soon…

7

To answer the question literally: I’d describe what you had as an epiphany, but not one of true revelation, rather a manifestation of sudden comprehension disjointed from reality. The conclusion may have been valid, but based on blurred input.

I hope I understood what you were asking for. Words, not psychobabble. Feel better,
W.

8

i once had an experience like that while on LSD during college it came on as you said suddenly just on. i think serotonin levels have something to do with it as LSD is know to affect them somehow.

9

These are all very helpful comments.

To clarify, BTW, I have not been diagnosed as bipolar, but rather “chronic dysthymia”, basically a “muting-down” of emotional responsiveness.

The pharmacy DID, as RatoskK mentions, provide a few-days supply last night, and it quite amazes me how palpable is the relief…like a sudden reassuring warm embrace. I’m always surprised that it happens literally within minutes, as I thought these SSRIs had to “build up” over long periods of time. Perhaps it’s different when the brain cells know what they’re missing!

“You sould also notify your doctor a week prior to finishing your meds so that he alerts the pharmacy way ahead of time.” Well–in the interest of general information–the sort of problem one deals with may not be apparent. Because I have a condition that actually causes me to make use of doctors and meds, I am literally uninsurable in the State of California. I have to rely on a special plan provided by the state government, through which I contract with, in this case, a company that “provides” private behavioral health services. The quotes are because they don’t actually “provide,” but rather authorize their members to go to doctors on their list. In this way I found my most-recently-former psychiatrist, who was “part” of the Behavior Health staff of (fictitious name) the Tommiman-Smith Medical Corporation. His name is on the board, his office is in the building, etc. One might assume he worked “for” that corporation, as an employee. But No! --I finally realize that these service-providers are all basically independent contractors who agree to various rules and regs, and in return get a reception counter, office, scheduling and billing services, and so on. Which means that if someone doesn’t bother to respond to messages or authorize refills in a timely manner, it’s not really the Corps’s problem.

Now all that is just find and often works well. The problem is that a given psychiatrist may only be there for a year or so, and then move up and on. Which is OK; but what happens when the client runs out of meds and needs a renewal before the new psychiatrist is in place? What has happened at TSMC is that they route requests for renewals (phoned in by the pharmacy) to the remaining psychiatrist designated to handle it; and if said psych only comes in once a week, or leaves on Christmas vacation, the message just sits there…even as the pharmacy dutifully calls over and over. (Meanwhile, the insurance won’t permit “early renewal”–there’s a fairly narrow window of a few days during which one can get a refill prior to running out…and alas, when one is taking a lot of pills, one doesn’t always remember the need for a refill until the container starts to rattle.)

KidCharl, it does seem we’ve had the same experience! Have you any cites re: side effects of Depakote withdrawal, or suitability of Lamictal? (–because, of course, I’m now scared to death of being without my Depakote!)

For the record, here is the difference in my experience when I go off my two SSRIs:

EFFEXOR: Downward drift of emotional responsiveness over a period of days; fatigue; “feeling of deadness,” sometimes mild confusion.

DEPAKOTE: Bizarro anti-epiphany as described; not much in common with the withdrawal effects of Effexor. (In fact, though I was out of both this time, it was the Depakote effect that seemed most striking.)

You folks are fantastic!

10

IANAD, but this is the first thought that crossed my mind. I also deal with a similar type of depression, and back when I used certain drugs (illegal drugs that is) I would get feelings that were similar. I came to the conclusion long ago that the chemical balance in my body had far more influence on my thought process than I had previously imagined. Personally I’d write that moment off to a temporary chemical imbalance unless it persists, but I also think it would be wise to print your very well written description for your doctor to read. Its rare that someone is able to communicate their inner thoughts so well.

11

You’re having withdrawal symptoms.

12

Bongmaster: Thanks for the compliment!

AHunter3: I suppose that’s literally true, but it seems like “You’re having withdrawal symptoms” is what the doctor would tell me, not what I would tell the doctor–in other words, it sounds more like a diagnosis, not info about the event upon which to base a diagnosis.

My “Pill Book” says basically nothing about Depakote and what happens if you go cold turkey. It is used to stabilize the “swings” of bipolars. As I am not bipolar, and it has a good effect, I gather it “centers” emotional swings of whatever kind or cause.

I always assumed that a negative affect disorder would feel like something “inside oneself”–like a bad mood or feeling of sadness. I find it quite remarkable that there are such things that present themselves as totally external–the same old self in a new (and awful) reality, so to speak. Or could this have more to do with the way I happen to look at myself, an individual reaction?

Very interested in other such “withdrawal effects” on SSRIs (not sure, though, if Depakote is classified that way…)

13

Hi Scott,

I don’t take Depakote, but I have been taking an anti-depressant and an anti-convulsant (for mania) for several years.

I have a bad habit of going to spend the weekend with friends or family & forgetting to pack my meds. I don’t take them for 2 or three nights & then return home. Often, after settling in back at home for awhile this mood would overtake where I’d feel like…my life wasn’t working out, how could I ever see happiness again, etc. And then it would occur to me, “Stupid, you cold-turkeyed on your meds & that’s what this is.”

So…I would agree with both
Bongmaster: “that the chemical balance in my body had far more influence on my thought process than I had previously imagined.”

and AHunter3: “You’re having withdrawal symptoms.”

My hypothesis is your mind’s processes have become used to having those chemicals. When you suddenly withdraw your mind from them for an extended period of time, your mind is going to hit a trough before it rebounds (to whatever extent).
Rubber band analogy: Your mind’s been stretched, you let go & it’s going to snap back in the other direction before it relaxes.
I wouldn’t call it an epiphany. When I’ve been merely manic, I have had every hour-on-the-hour “epiphanies” or “breakthroughs”. Those “epiphanies” or the “strong pervasive feeling” are your mind’s signal that your neurotransmitters have taken a sudden change.

IMO, your dream state was a direct result of you having not taken your meds. It was a withdrawal state your mind was experiencing: reactive and transitional as your mind jolted out of the substances that your body does not intrisically regulate, like hormones.

So how about:
"Doctor, I ran out of Depakote for a few days & had weird dreams & hit…

  • a disassociative med-withdrawal depression.
  • a sudden mood trough.
  • a reactive withdrawal state.
  • sudden withdrawal trough.

I don’t mean to be judging Scott; I just feel like I’ve been there.

I extrapolate that your experience in general doesn’t just occur with Depokote, but probably with sustained withdrawal from drugs of any kind that affect your mental state.

14

Yes, very well put.

15

Thanks, folks. No, I don’t feel at all “judged.”

16

It isn’t you who is to be judged, Scott, it’s the evil system of medical insurance, and the awkward substitute for it you desribed, that put you in this predicament. Makes me wonder how many people have already died because of such snafus. Why won’t this country provide adequate care for mental conditions the same as any other condition needing treatment?

17

My sister is bipolar, and she used to take Depakote but has switched again.

She gets a lot of good information from this forum as far as “what works for you?” type stuff. It’s possible someone there has experienced what you have, as well.

18

Thanks for ref to the forum, NinetyWt.

Jomo, thanks for the vote of empathy. What gets me is that in so many cases, the problem is easily foreseen, and the solution doesn’t seem to involve any Einsteinian paradigm-busting. Since most pharmacies now allow the patient to register his request for a refill electronically, by phone, I wonder why something similar couldn’t be used to throughput the request directly to the doctor’s office–showing up on the same screen used by the nice counter people when making appointments?

(Answer: From the point of view of the med insurance company, better the patient should drop dead than that they should pay for one milligram more medication than has been filtered through their careful “system,” in which delay and frustration are used as cost-control mechanisms.)