Tag Archives: medication

On using psych meds

… that Sarah Silverman tweet got me thinking…

There’s so much info and support out there for people taking meds, but nothing for people who react badly to meds.

I’m not sure I ever really talked in detail about my struggles with psych meds.

I tried them briefly in college, but came off of them after a short time (can’t remember why, or how long I was actually on them). Then, 4-6 years later, I was convinced to try them again. It was against my better judgement, but my therapist at the time was adamant that I needed them. I wanted to trust that she had a less biased view of things than I did, and that she was more knowledgeable about it all than I was. I battled her about it for several sessions before I caved and agreed to try them once again.

I had trouble finding a psychiatrist I felt comfortable working with. I must have cycled through 5 or 6 before I found one who I felt listened & cared (read: didn’t try to push the same meds I reported as having not worked when I tried them; wasn’t cold or condescending; sat with me for more than 3 minutes before handing me a prescription). Sadly, she moved out of state after about 3 months, and my search began again.

I really don’t remember much of the details at this moment, but I do know at one point I was taking roughly 15 different meds up to 4 times a day. It started with one med, then another med to combat side effects, and another to augment the first, then another to help with side effects from the one helping with the original side effects, and so on.

The meds didn’t work for me. I kept getting more depressed, more anxious, and more suicidal. I cycled in and out of hospitals. Each time, they added meds, or switched them out, or increased doses, or all of the above. None seemed to help.

They started blaming me for complaining about the side effects. I was called willful and resistant to treatment. I was told I was being manipulative; that I didn’t actually want to be helped; that I was enjoying the depression; that I was not trying hard enough to get better. I was told I would never be able to live without medication; that I needed to accept it as a part of life… at one point, doctors told me that I would never be able to survive on my own because of my level of self-sabotage.

I was seriouslly depressed, constantly anxious, extremely impulsive, and actively suicidal 90% of the time, not to mention my mounting ptsd symptoms (an enormous difference from my demeanor when not on meds, but few people had seen me prior to starting them by this point. Even I was mostly convinced that I would certainly die without meds (which was honestly part of what prompted me wanting to stop them. At least if I managed to kill myself, the pain would end)).

During one of my last dozen hospitalizations, it was strongly suggested that I not be released back to my home, but rather permanently be sent to a residential facility, as I was an inherent danger to myself. The doctors were shocked that I had survived this long. Even less believable to them was that I had a successful life and career prior to my most recent hospitalizations. I had held down a full-time supervisory position, as well as 3 other part-time jobs up until that final year on meds. I would be hospitalized one week, then return to work as soon as I was released. I attended intensive therapy programs during first shift hours, and worked in the afternoons. I taught trauma informed care workshops. I attended professional trainings. I was very high functioning professionally even as I was crashing personally…

I was lucky enough to have family and friends on my side backing my insistence to receive more intensive treatment (mind you, this was 4 years after I started meds, and roughly 40 hospitalizations in by that time). I knew I was metaphorically drowning. I knew the treatment I was getting wasn’t sufficient (most psych units, even in psych hospitals, don’t offer therapy so much as physical containment), but I did not totally know what might actually help. Dr C was a great resource. She helped me figure out that a specialized trauma program would likely be beneficial. She’d also advocated strongly with the doctors at the local hospital to send me to a more intensive program. Between her, my family, and my own insistence, I was finally admitted to a trauma clinic, The Center at PIW.

There, I finally found some meaningful & intensive help. Despite reading my recent history, the psychiatrist agreed to help me come off all the meds. By the time I left there 2 weeks later, I had tapered off most of the meds. Those last ones I was able to come off of with the help of the psychiatrist at the day program I attended following my discharge from The Center.

The first day back to the IOP, the staff commented that I was doing the best they had seen since I first attended there 4 years ago. They said I seemed clear-headed, articulate, calmer… they asked what changed. When I mentioned I was tapering off the last 2 meds, they seemed incredulous. After all, how could the person who was so debilitated for so long be better not taking the thing they believed was her biggest hope at normalcy? Initially, the psychiatrist was ready to refuse treatment because I was refusing to take medication again, but upon seeing how differently I presented, I was allowed to stay in the program. I was, however, requested not to mention that I was no longer taking any regular psych meds. They claimed it was to avoid compliance problems with other patients in the program. I guess I was seen as an oddity.

After my shortest time “completing” the program (3 weeks or so), I was deemed stable enough to graduate. I returned to only doing individual therapy & the trauma group with Dr C.

Since that time (2011), I’ve only tried psych meds 3 times. Each time I noticed the impulsive drive to kill myself return in less than a week’s time. They faded just as quickly once I stopped taking the pills. The depression still hits hard, but suicide is no longer my first and only thought on how to deal with it. I’m also better able to avoid cutting (actually, I rarely think about using it as a coping tool these days).

Doctors still react with shock and disbelief when I deny being on psych meds despite my diagnoses. I’m pretty sure most believe I’m lying when I tell them I only take something for asthma and stomach issues. Even the neurologist did a side-eye when I mentioned the only 2 meds I take aside of the pot.

In a society where pharmaceuticals run the medical industry, and they are the be-all & end-all of mental health treatment, not taking meds is seen as going against medical advice. Hell, we take away people’s basic human rights when they say meds don’t work so they’d rather not take any. They are deemed an immenant danger to themselves, and not competent enough to make rational decisions… all because something we are indoctrinated into thinking is the only way to treat mental health issues harms some people more than it will ever help them.

I can’t tell you how much I loathe the phrases “you just need to find the right meds or combinations),” and “the benefits outweigh the side effects.” Sometimes there is no right combination, and the benefits definitely do not outweigh the side effects (because for some, there are no benefits). I wish medicine understood this…

Maybe we need to start another movement; that sometimes meds do more harm than good, and there’s nothing wrong with choosing not to take them. There are several notations in my records that insist I’ll die within 6 months max if I were allowed to stop all psych meds, yet here I am, 7 years later, more stable than I ever was on the meds. Oh, and check it out, I’m still alive! Who knew that was possible?! 🤔

It’s time we stop forcing everyone with mental health challenges into a medication routine. They can definitely be helpful for some, but we also need to acknowledge that they can be detrimental to others.

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Different treatments for depression with different origins

I came across an interesting article on the differences in treatment efficacy for depressed individuals with trauma history vs. ones without a trauma history. The article suggests that an early trauma history lends itself to a better response to CBT and talk therapy, whereas depression without an early trauma history responds better to medication (thought to be because of trauma’s impact on hippocampal development)… this would make sense when depression is thought of as an “allergic reaction” to certain situations. If depression is something like a fever (generic healing response which kicks in for several stimuli), then it would make sense that different reasons for depression need different treatment options. This is definitely something I’d like to look into further. I hope they do more research on both of these topics. I hope it also stimulates more reasearch about treatment efficacy for other mental illness. I keep hearing professionals claim they understand one treatment does not fit everyone, but I have yet to experience that open-mindedness. SO much of treatment is dictated by insurance and “empirically proven treatment models”, yet they ignore that not everyone responds to it the same way.

One fear I have around this research is that they will categorize people in one of two ways: either those that can be treated with meds, or those that can be treated with therapy. I would hate to see them again restrict treatment options based solely on this. The one thing we know about mental health is that we know VERY little about it.


Apologies

I took a muscle relaxer least night after my back went into spasms (was trying to get up to go to the bathroom around 3 am and realized I couldn’t move without excruciating pain). I’m so glad I kept the pills from a few years ago. The first time, L was giving me a massage. When I tried to stand up after she was done, I realized I couldn’t move. Ended up needing to call an ambulance because I couldn’t even flip over to put my top back on. Poor L refuses to give me any more massages… anyway, I had some left over from that time, and it saved me from having to call paramedics last night. It did however kick my ass. I was pretty much comatose till about 1pm. I was ready to pass out again by 6. I have such a low tolerance for meds if I don’t take them often…

Today was a wash for anything productive thanks to the pain killer. I had intended to work more on a journal page I started last night, but I’m still pretty foggy. As it stands, it’s just a background. I have a plan for it, but that wasn’t going to happen today. Maybe tomorrow.

Yesterday, I had called De’s agency to find out if I could get services there again. I was there so long with De, they doubt it, but will leave it up to the clinical supervisor. I think even if she makes an exception, I will decline. I don’t like being an exception… I doubt she will anyway.

I’m still waiting on a call from someone at TL’s agency. I think they assign people in their Wednesday meetings, so maybe I’ll have someone by the end of the week. I really wish I had the insurance or the cash to get someone more experienced. I guess that will have to wait though. If this fails, I suppose I could check into the agency through which I saw D. Their sliding scale was a tad higher, but at least they are an option. I’m getting tired of having to keep starting fresh with someone every few months… oh well. Guess that’s life at the moment.


fog

yesterday’s appointment with TL was much better than the first.  There was a ton of anxiety leading up to it, but I sat it through and met with her (albeit about 30 minutes late because there was a miscommunication amongst office staff).  I was able to give her the stuff I had meant to read her that first time around, and then we talked about some more history (specifically, the brief, cliff-notes version of the stories behind the flashbacks).  She was able to make me feel a bit more comfortable in sitting with her.  I can see her being a bit intense at times, but hopefully we will fall into a balance there.  She was quick to tell me that we didn’t have to talk about what it was that was bothering me, but I found my voice enough to ask for a few more minutes to build up to talking. She seemed to take it in stride.

The hour went by too quickly again, but I let her keep the list.  I hope it helps some. We also switched up the schedule some.  I was going to ask if she had anything earlier in the day (because waiting all day builds too much anxiety), and she was hoping for something earlier also, and on a different day.  We settled on middle-of-the-day Thursday, though that will mean a week and a half between session at a time I should be asking for shorter times between session… Oh well.

I left there emotionally raw and super tired.  I came home with enough energy to fix the bed (had started washing the sheets earlier in the day) and collapse into it.  I took something to help me calm down and sleep, and I am still feeling the effects at 1:30 the next afternoon… I guess this is ok for now.  I guess being drugged-up and only partially feeling the flashbacks is better than the alternative of full-on flashbacks all day… I really need things to change though.  I really need something helpful to get me through all this because it’s exhausting in so many ways…


hearing voices: a sane reaction to insane circumstances