So it's come to this. Docpan's seeing a shrink.
Why? Because I've become an alcohol-abusing, drug-using, manic-depressive, caffeine-fueled rage machine. Yes, worse than ever. I've surpassed MY limit, which is pretty fucking high.
The doctor's diagnosis is that I'm suffering from bi-polar disorder, I inherited it from my parents, and certain conditions in my life right now have pushed me over the edge. The best I can describe it is that I will feel literally invincible at times, followed by some zoning out, followed by rage/sadness/isolation. This continues in an endless cycle every day, and I've been suffering from anxiety attacks. Essentially, the walls feel like they're closing in on me and I have to BAIL OUT at that moment at any cost. There's no rhyme or reason to my rationality anymore, and I break a lot of shit.
I've always enjoyed getting plastered, but as of late I've been using it to self-medicate, and just like everything else I take it to the extreme. I got physically chucked out of a bar last weekend for being a belligerent asshole (someone called me 'gay' for fist pumping and I flipped shit, refusing to let it go. Not proud of it, let's just say tables were upended).
So I don't know what the fuck is going to happen. I have an appointment next week to talk about medication. From what I read, a lot of bi-polar meds have the side effect of weight gain. If that's the case, I may as well not even go, because I would sooner flush them and turn into a shit-flinging maniac then risk gaining flab.
People get a kick out of reading about my antics, but it's starting to get out of hand. I'm only in control of myself half the time. It's time to take care of this shit.
Two questions for the rest of you pill-poppers:
1) Will it affect my sexual performance?
and
2) Can I still take a hella shitload of caffeine and bodybuilding supplements?
Okay, the chance to give psychiatric advice to Docpan makes this all worth it. Also, this is a genuine service to society at large. I'm going to take these good vibes and just write like crazy!
So, okay, seeing a shrink sounds like a great idea. What you describe sounds a LOT like the classical picture of bipolar disorder. Congratulations! Welcome to the world of mental illness. The relationship between alcohol or drug abuse and any form of mental illness is impressive - the popular theory is that psych patients like to self-medicate. Nicotine and alcohol are the most popular mood-regulators, but you'll find a mix of everything from caffeine to heroin. And if you abuse one substance, chances are you abuse another. I'd drop some science on you, but let's get right to the questions!
1.) Maybe. Sexual side-effects are common with psych medications. Some are worse than others. They're getting better at managing this. Wellbutrin has low sexual side effects and is even given in addition to other drugs to alleviate sexual side effects. Be frank with your doctor about your concern. It will probably help steer initial treatment recommendations.
2.) I wouldn't. I'm looking at the relationship between caffeine and depression RIGHT NOW, so you're in luck. I'm rapidly becoming an expert. First of all, if you take a ton of caffeine, coming off of it can give you symptoms of both depression and anxiety. On the other hand, consumption of large amounts of caffeine leads to something called "caffeinism,' which, surprisingly has exactly the same effects. So how does that make sense? As it turns out, we understand caffeine really well, and it's pretty simple, pharmacologically. Caffeine blocks adenosine A1 and A2A receptors. Adenosine builds up when you're awake and, acting on A2A receptors, makes you sleepy. So block the receptor and you don't feel sleepy. The problem is that A1 and A2A receptors have the exact opposite effects. So depending on your dose of adenosine/caffeine, you can get opposite effects.
So caffeine obviously affects mood. Does adenosine signalling have something to do with depression? Yes! But, it's complicated, which is why there aren't any specific adenosine receptor drugs for psychiatric conditions...yet. If you just give rats adenosine, it has an antidepressant effect. Unless, of course, it makes them depressed, which some other researchers have reported.
A2A blockers might make good antidepressants and, a few months ago, there was a report that drugs that specifically STIMULATE A1 receptors may make good antidepressants. There's all this complex reaction with glutamate, GABA, opioids, dopamine, serotonin - it's a mess. That's why this was all hot shit until about 2004, when all the interest seems to have dried up. Give it another ten years.
Side note - tricyclics bind to adenosine receptors which may explain why they can hurt your heart - aside from caffeine, adenosine is famous as one of the drugs you shoot into people who are dying from specific heart problems.
Drugs like soma also affect your adenosine levels, which may explain why they help with pain, but that's a mess too.
Anyway, alcohol + caffeine is a bad idea. That's known for sure. Basically, adenosine receptors help your body tell when you're reaching toxic levels of alcohol and you need to puke and shut down. Block the receptors with caffeine and your body thinks things are great and you die of alcohol poisoning. You see this in the ER quite commonly, apparently.
As to your other supplements? I'm guessing we're not talking about FDA-approved substances? Then, we could at least look up known interactions. As it is, it's a crapshoot if you're taking some crazy supplement. You could end up with serotonin syndrome and die, so that's no good. Or you could block metabolism of your meds and they could build up to toxic levels and kill you.
Take a list of EVERYTHING you're taking to your doctor. He or she will probably be horrified and tell you to back off of just about everything.
Here's a good cautionary tale: everyone was gung-ho on vitamin E as this amazing cure-all that would extend your life. So people took massive doses and planned to live forever. But, oops, it turns out taking vitamin E supplements is associated with INCREASED mortality. The science just isn't in for most supplements, even things like vitamins that you'd figure we'd have sorted out by now.
Are you going to gain weight? Possibly. If you keep working out, probably not. Most people with psychiatric conditions are pretty sedentary, so that's your baseline when looking at side effects. Some drugs will make you crazy hungry OR make you not want to eat. Again, tell your doctor your concerns and they'll tailor your treatment, hopefully.
I hope that was both boring and helpful. If nothing else, that brain dump on adenosine was good for ME.
You can ask me about specific drugs and I can look them up, tell you what I know. I'll bill your insurance.
Back to work!