Long story short: Aggressively supplementing the vitamins that birth control depletes has helped non-insignificantly with my depression, but the fact that it cancels out the mental benefits (namely: executive function) of my ADHD medication remains.
I called my OBGYN about the birth control side of it, and his response was more or less what I expected: In short, 'stop taking the birth control immediately, and go consult your GP about the depression'.
I tried to explain that I'm wary of just stopping the birth control, because going back to insane PMDD + completely disabling levels of pain is just another form of hell. My period has been trying to kill me since I was 14, and I have no reason to suspect that it'll suddenly be resolved once I'm off the pill now. I want to know what the game plan is for that point.
And he admits he doesn't know what to do. I'm on the gentlest form of the lowest possible dose of BC on the market, and he's actually stunned and confused that I'm having this experience at all. There isn't a weaker form of it to move to from here, and I'm 'supposed to be hormonally stable and not really experiencing any fluctuations at all'.
(And like... yeah! I haven't felt mood-swing-y or unstable. I've been feeling consistently, very stable-y, catastrophically depressed lmao?!)
He says to focus on the depression first, and when / if menstrual shit gets bad again, to come to him.
I said 'alright', but I don't know what I'm supposed to expect. Obviously, birth control outright isn't an option, now. Obviously, he's not going to put me on a stronger dose, as that's not going to help anything.
He might send me for another ultrasound, but odds are we're just going to find the same cysts -- the ones where the go-to treatment to shrink them is the very birth control I'm on and can't tolerate.
My best prediction for what he'll suggest -- because let's be real, nobody's going to entertain a hysterectomy for a 'healthy' unmarried woman* under 50 with no children -- is extremely strong prescription painkillers again and a suggestion that I go to my GP for antidepressants.
Thing is, even if I was comfortable with taking extremely powerful painkillers for a week out of every month for the rest of my bleeding life (I am not), and wasn't wary of antidepressants (I am),
my GP isn't able to prescribe antidepressants, himself. He'd have to refer me to a specialist who would take far, far too long to see, and cost far more than I have.
So!
What I'm going to do for now is remain on the BC pill, a little longer.
My job hours are really picking up now that school is out and the mall I work at is really busy. I work retail at a place that sells swimsuits, and we're going through what's effectively Christmas-in-July, so it's crazy for a while, and I cannot have that pay fucked up for me by two weeks of trying to throw myself off a bridge and incapacitating pain!
I have an appointment with my ADHD doctors in two weeks, and I'll consult them on all this and see if they have any insight... though I think all they'll be capable of offering is the suggestion to bump up my dose by 5mg and see if that breaks through the BC cancellation factor.
(It's worth a shot, but I can't help but worry, since I haven't fully adjusted to 20mg yet. I'm extremely sensitive to stimulants and do experience some mild-but-worrying-at-times side-effects as is, so I'm open to trying anything but I can't help but be wary of just Throwing More Drug At Problem, if it can be helped otherwise)
Once that's all said and done, though, I guess all I can do is stop the pill and just... see what happens. Based on my life experiences + having forgotten to take the pill one day and feeling borderline high compared to the norm, I have to expect that the depression will vanish into thin air, my Adderall will have me functioning in peak form, but the menstrual issues will all return with a vengeance.
Then I'll go waste my time at the OBGYN. lmao. I don't know...
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