To P or not to P

When you're dealing with depression (or sleep deprivation - BTDT too), even little questions become huge.

Tonight's big question: do I take my meds (Prozac) or not?

The uncomplicated answer is a big, fat DUH!

But my case is complicated. Three years of medication management has demonstrated beyond a doubt that I function best on what the experts call a "sub-clinical dose." That is, a lower dose than doctors would normally prescribe, probably because I'm so sensitive to medication.

Prozac comes in 10mg pills. That's the smallest dosage made. My "therapeutic dose" (where I function best) is generally at 5mg per day. Due to all sorts of logistical reasons that would bore you to tears, two years ago we decided that I'd be best served by taking one 10mg pill every other day.

But sometimes, for reasons that are unclear, I need a bit of a boost, and I was given the go-ahead to take one 10mg pill every day for up to two weeks, then bring it back down to every other day.

I can't stay at 10mg/day for too long or it interrupts my sleep and I run a greater risk of triggering a manic episode.

Don't get me wrong. I love my "normal" manic episodes. I feel good, I'm cheery and happy and I get a lot done. I'm the best volunteer anyone has ever seen! But if it goes too far, it can be detrimental, and I don't want to go there.

I'm in one of those slumps now, and so I wonder, do I bump it up for a week or not? I'm already having problems sleeping, not getting to sleep until 3 or 4 in the morning, and having to get up with my children, one of whom is too young for school.

Even now, thinking about tomorrow, I'm feeling overwhelmed, and I don't have to be anywhere except home! Yet dealing with e-mail that needs answering and planning a child's birthday party and some of the other volunteer activities I've taken on... they're just so hugely overwhelming that all I want to do is curl up in bed and cry.

So I guess the answer is to P after all.