MCAS vs. PMDD vs. Bipolar I Disorder

My guardian during depressive evenings.

I went three months and nearly two weeks with no epipen (!!!!!!) which was a huge milestone for me. Avoided it twice in that time by taking a certain med during what I call pre-anaphylaxis, but tonight's attack descended hard and fast. I almost thought I'd need the second pen.

Now is when I'll own up to the weird depression I've had for a week - and you'll see why in a moment. A particularly rough two weeks of PMDD came and went, I was good and active for about five or six days, and then the paralyzing fog knocked me out again. Finally called psych doc so that she knows and we are not adjusting meds yet for various reasons, all of which I agree with.

One of these is that one of the symptoms of MCAS can actually be depression (and anxiety) due to all those mast cells mucking things up in that blood/brain barrier. This means that if I'm having an inflamatory response the depression could be a side effect of that. Furthermore, stress exacerbates both depression in someone that suffers from it already AND the inflammatory response. The fact that I've had a week of weird depression plus some stressors that culminated in my first pen in months is not clinically insignificant.

It's important here to mention that, while depression and anxiety are accepted symptoms of MCAS, the things I experience as a result of bipolar disorder are not. I have a long history of mood and behavioral patterns that a) match the criteria for bipolar I diagnosis, and b) are being increasingly controlled by mood stabilizers and antipsychotics. If anything, the depression and anxiety that are involved with MCAS may have been what made my psych diagnosis and treatment over the years that much more convoluted.

So what now? It's been about two and a half hours since pen but I'm not physically ready to take Summer out yet. I did just manage to take food, though. Looks like tomorrow is a rest day.