In case I forget.

Sex? What sex? The drugs they give me for depression destroy my libido. The drugs they give me for seizures mean I can’t take the only drug for depression that is less likely to destroy my libido. The seizures are directly linked to the depression. So it’s all circular.

Then, there is Ritalin. Hmm. Or rather, Hmmmmmmmmmmmmmmmmmmmmm. That’s what my doctor wrote when I sent him an email about considering me using this drug. There is some evidence that it boosts the effectiveness of anti-depressants. There is some evidence that it can kick start a person’s libido that has been made dormant by other drugs. And of course there is a lot of evidence that it can improve energy levels and executive functioning. So I sent this email to my PCP:

Quick question. Is it worth our time for me to make an appointment to come in to talk with you about the possibility of Ritalin to address the total lack of libido in our home (Well, on the left side of the bed, anyway. The right side of the bed is doing just fine, if you don’t count frustration intense enough to cause a man to chew paint.)  thanks to these pretty little “take these so you won’t kill yourself” pills, or would you just tell me to shut up because you’re laughing to hard you’re going to pee your pants and you don’t have a spare pair at the office?

To which he replied:

hmmm.  I’ve never seen anyone use Ritalin for countering the decreased libido issue.  I’ve only heard of changing doses and adding Wellbutrin (which will worsen seizures, which would be a bad thing for you).  I wouldn’t want to cut down the dose because of what we’ve been talking about.  hmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm.   I dunno.  If you want to start Ritalin, you have to come in because it is a SUPER controlled prescription requiring a SPECIAL prescription paper to fill it.

The hmmmmmmmmmmmmmmmmmmmmmmmm cracked me up because I could just hear him doing it. He does it all the time when I’m in his office and he’s thinking. The thing is, when I sent him this email I included an article by a physician who is a Professor of Psychiatry, University of Pittsburgh Medical Center and Chief, Division of Adult Academic Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania called “Sex and Antidepressants” where he discusses many possible “remedies” to address the problem and one of them is Ritalin. I did some research on all the drugs he mentioned and this was the one that best fits my problem and would give me the fewest side effects. The point of this whole thing is that I know there are many doctors who would react negatively to a patient doing something like this but my Dr. PCP is open to all sorts of things and, as you can tell from his email, doesn’t out of hand dismiss something just because he hasn’t encountered it before.

In the mean time, I’m due to see Dr. Neuro B in two weeks. At 600mg Lamictal I have returned to a manageable but still every day seizure pattern. I’m both looking forward to this appointment and dreading it. Looking forward because I’m sick of standing still, which is what I feel like I’ve been doing for about a year, and dreading it because my lack of success with Topomax will be my official 4th “failed” drug. Last time I saw him he said “alternatives” are our only next option with a 4th failed drug if I am still having seizure activity. So I’m both happy and nervous about all of that. It’s a good thing and a terrifying thing, too. Fingers crossed for an update in two weeks. All fingers. And toes, too.

At the same time, Counselor A says she thinks I don’t cry enough. I was in her office and she started talking about how she doesn’t think I talk to the people who love me about all the stress and pain I still have from this accident, and how hard it still is for me and always will be. I saw her the day after the 3rd anniversary of the accident and we talked about that. It made me cry so hard. I told her I didn’t want to do that – to sit in her office and cry about the anniversary and all the things it brings up in my head. She asked why I hadn’t talked with my husband about the anniversary and all the feelings it brought out. I told her that it’s just another day for everyone else, that it’s only an important day for me. She doesn’t think that’s true. I don’t go on and on about all this stuff with my family because geez you know they’ve got to be tired of listening to it.

It’s been three years – it shouldn’t be this big gorilla in my life anymore. Other people get hurt and they get on with it. So she thinks I should cry more – by that she means I should talk with my husband and friends about all this and she knows that if I did that I would blubber like a whale, but she thinks that would be a good thing. I have just never been a person to dump on other people. I explained to her that when I was hurt and physically unable to do for myself I had no problem asking for help. If your leg is broken you can’t get up and reach the top shelf of a cabinet or scrub your own feet. But just because I’m sad doesn’t me I’m going to dump on people. Everybody goes through hard stuff and I’ve gone through a lot of it in my life. A few months ago I was in Dr. PCP’s office and he started talking about something close to this and I waved him off. I told him that if he kept talking about it I would cry and I didn’t want to do that. He said he thought maybe I should. So two of the people who know more about what is in my head that anyone else in the world think I should just dump on my husband and my friends and sit around crying my heart out and feeling sorry for myself. I’m just not like that.