My Doctor Recommended Wellbutrin, but I’m not sure I want to.

“I am bipolar 1. I was diagnosed at 30 years of age. I have been on Lithium for 20 years and am taking Cipralex. I am considering taking Wellbutrin recommended by my doctor. I am looking to get away from the numbness of my life. I used to be a real go-getter and after a cancer diagnosis 6 years ago, I can’t seem to get back to my old self. I feel lost and a shadow of my former self.”

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I am so sorry to hear about your cancer diagnosis.  I can only imagine how that would get you in a hole that is hard to come out of.  Take away the cancer diagnosis and insert going through a divorce and I would think that you were an extension of myself though!  I too feel like I’m a shadow of my former self.  I am not bipolar 1, but am bipolar 2, so my ups don’t get quite as high as yours, but when it comes to every day life being a “go-getter” does not depend on the intensity of our bipolar.  I also was always a “go-getter” and on the move, packing my schedule with either work activities or events with friends and family, I was rarely just sitting around or lacking any type of motivation, except for two periods in my life; back in 2006 when I had my first crash leading to my bipolar diagnosis and this most recent one, last year January that I still have yet to recover from.

I have been on Lithium since my diagnosis in 2006 and found that to be the best mood stabilizer for me.  I’ve tried increasing my dosage and had trouble with side effects so my doctor then tried adding other medications TO my Lithium during periods of extremely rapid cycling to slow the cycles, and thankfully, the additional medications helped tremendously to slow down the extreme rapid cycling, then when I’m back to a stable place,we take away the additional meds and the Lithium continues to keep me stabilized.  I have been fortunate to have very few side effects from the lithium as well, and it sounds like you have found success with Lithium as well since you have remained on it for such a long period of time.  Why the story about the Lithium?  Well,  lets take a look at your concern with Wellbutrin and you will see! 🙂

Your Cipralex is an anti-depressant which targets your seratonin levels.  Now, I’m sure you probably already know this, but in case you don’t (or for the sake of anyone that is reading this that doesn’t), depression can be a result of an imbalance of the neurotransmitters in your brain.  It can be just one that’s affected, or multiple neurotransmitters in any combination that will cause you to feel depressed.  The three neurotransmitters usually affected are serotonin, norepinephrine, and dopamine.  You didn’t mention when you started your Cipralex, so I don’t know if that is something that was previously working and now just isn’t cutting it anymore, or if this is a new medication you are trying and it’s not doing the job.  I had been on one antidepressant for almost 6 years, and at the highest dose, and then it just wasn’t cutting it because my body became so used to it and I had to start playing the “test out different meds game” myself.   The first antidepressant they tried me out on was Wellbutrin.

Research has shown that while Wellbutrin can be used to help people stop smoking, it can also be used in addition to another anti-depressant that is targeting serotonin to give that antidepressant, or your serotonin levels, an extra boost. Just like when I was taking my Lithium, and it wasn’t fully doing its job at certain times, so the doctor gave me another mood stabilizer to take WITH my Lithium until the really rapid cycling got back to normal,  that’s kind of how doctors can use Wellbutrin, only on a more consistent, daily basis.

Yes, Wellbutrin does have its risks.  All medications do.  The reason I was never kept on it for very long was because if you have a history of eating disorders or seizures, this medication is not recommended because it has the potential to cause seizures.  I have a history of eating disorders (and purging was part of it) and the act of purging could induce a seizure while on Wellbutrin.  However, I have taken the medication and not had any seizures, and know of a lot of people who have had nothing but good things to say about Wellbutrin.  While I did not have any seizures, I did experience other side effects (it was causing my serotonin levels to be too high and serotonin was not one of the neurotransmitters that needed to be adjusted for me) so I did not continue taking it.  If you are already taking a medication that is adjusting your serotonin though and you are not feeling any difference, then you might need the extra boost that Wellbutrin can give.  What are your trepidations for NOT trying it?  If you do try it and it helps, then FANTASTIC!  You can start getting back on track again.  If it doesn’t change anything after giving it some time, then maybe you and your doctor need to discuss other options, perhaps the dosages are not strong enough, maybe your system is used to the Cipralex and you need to try something completely different etc.

There are so many different possibilities when it comes to medications and getting your drive back.  Some of them may not be anything that can be treated with medication.  Many discussions with my doctor have led me to the conclusion that my situational factors are a huge contributor to my depression and no amount of medication is going to get me out.  To get out of my funk, it’s going to require a change in circumstances and a few other possible changes, such as trying to implement Mindfulness (a part of DBT-Dialectical Behavioral Therapy) into my treatment plan, NOT meditation (although it is a form of meditation, but it really is NOT meditation) he just means being able to streamline my thoughts.  My major issues were my job loss and my divorce, both major changes in my life.  Your cancer diagnosis is a HUGE change in your life.  It’s quite possible that medication alone may not be able to get you out of this hole and back to being a “go-getter” again.  There may have to be some additional therapy sessions or even different kinds of therapy, like my doctor suggested because of the life changes, or situational changes.

I know how debilitating the feeling of losing the “go-getter” mentality and attitude can be.  I ask myself everyday why it won’t come back no matter what I do or how hard I try. BUT I have come to the conclusion that the reason it isn’t coming back is because I am dwelling on the fact that it is no longer there!!  My continued ruminations about it not being there and why it won’t come back, and when will it just go away, are not helping me get it back, but are instead just reinforcing the absence.  My doctor was right!  I need to change the way I look at it and think about it and while it is ok for me to be upset about the things I have lost and the way my life has changed, I need to think about what I can do to make my life better using what I have RIGHT NOW.  I may not have my full 100% “go-getter” attitude right now, but I have the idea in my head that I want it back and I want to bring it back.  From your email, t sounds like you WANT IT BACK too!  That is the biggest step, changing your perspective from dwelling on the fact that you lost it and that its gone and never going to get it back again, to I WANT IT BACK!   I want to bring it back and be back to myself again!  No more shadow of myself.  You have already laid the foundation for bringing it back though by recognizing that its gone but you want it back again!

I don’t have the answers to if you should take the Wellbutrin or not.  I can’t tell you it will work wonders and bring you back to your old self.  I wish I could, but unfortunately, when it comes to medicine and medication, everybody is so different that no one can predict 100% what anyone’s reaction to the Wellbutrin will be.  I can’t tell you with any certainty how to bring back your “go-getter” attitude, but I can give you some tips.  The rest is up to your body’s biology and your willingness and attitude to try doing things that you haven’t tried yet.  I kept trying the same things over and over and kept wondering why I wasn’t making any progress.  Well, I wasn’t making any progress because I was trying the wrong things and getting the same results over and over.

I can definitely see that you truly want to get back to your old self, and many people, once they are diagnosed with cancer, never adopt that attitude unfortunately.  Talk with your doctor, about EVERYTHING.  Look up Wellbutrin and read over the information and the warnings and decide for yourself if that is something you would want to try.  (I suggest drugs.com)  Only YOU can make the decision on if you want to try the medication or not.  It’s your body after all.  You can try it and if it doesn’t work, try other options.  Or, before trying Wellbutrin, ask your doctor if there ARE other alternatives.  My doctor is great about giving me a few different options so that I can pick the one I feel the most comfortable with.  Ask him about any thing he would recommend that you could do NON MEDICATION wise to help you bring back that frame of mind.  If you want to learn about DBT and Mindfulness, I have several YouTube videos and worksheets to help you learn on my personal website and YouTube channel (www.bipolarhotmess.com).   The key is being open and honest with your doctor.  You have the desire and the will.  I have given you a few ideas and tips, but you are already on the right path, so its just a matter of keeping that mindset and running with it!  Try making a list of things you would LOVE to accomplish one day and then take that list out and pick one of them. Each day take one step toward achieving that accomplishment, then maybe a week or two later, try taking 2 steps each day, or pick out a second thing and do one step for each of your goals every day.  Starting small might help you get back to being goal oriented and excited about things again, and might just jump start the attitude also!

Good luck with all of  your decisions.  I have the highest hopes that you are going to get that spark back!!!!

In the meantime, if you have any questions, feel free to email me at christi@askabipolar.com.

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