The Medication Gamble

Medications offer a chance of improvement, but as most anyone who has tried a psychiatric medication can likely attest: it can be hard to find the right one for you. The process can take years and be disheartening at times. Taking medications is a gamble. We risk disappointment and side effects ranging from minor to severe in order to potentially reap the rewards that medication can offer. Medication is a critical tool in the management of mental illness for many people. However, the process of finding the right medication and complications that can arise from taking medications deter some of us from trying.

This morning I took my first dose of a new (to me) medication. I have tried over 15 psychiatric medications, among which very few have had the desired result without unbearable side effects. To say that this morning’s pill was a hard one to swallow, would be painfully accurate. I’m anxious. I’m trying my best not to read in to every little thing I’m perceiving in my body and mind. You know that feeling when someone says they have lice and you start itching your scalp? Reading the list of potential side effects of a medication can cause a similar sensation. In an effort to calm down, I’m trying to remember why I’m taking this risk, and I thought I’d share that with you.

Early this summer I stopped taking all of the daily medications I had been previously prescribed. I decided to reduce the dose of each of them, one at a time, in order to see if I felt any difference with or without them. The result seemed to be that none of the medications I was taking were having any positive effect on my mood. In one case, reducing and then eliminating one of my medications from my regimen seemed to pull me out of my brutal two-year-long depression. I had been prescribed all of the medications I was taking over a short period of time, so I hadn’t been able to isolate the impact of each medication. Starting back up from zero felt like the right decision. Once I was free from daily medications, I was faced with a choice: start trying a new medication or take a break. I took a break.

The break has been wonderful. It has given me the opportunity to rest my body – free from the side effects of medications and symptoms of beginning and ending medications. For two years I had felt like a guinea pig – constantly trialing something new and coming off of something else. Trying 15 medications in two years was taxing on my body and mind. I tend to be sensitive to changes in psychiatric medication, experiencing headaches, stomach upset, brain zaps, nausea and negative mood changes, among other side effects. In a couple of cases I have had to immediately stop taking a medication because of potentially severe side effects (a rash with Lamotrigine & a dramatic increase in suicidal ideation with Mirtazapine). I’ve had to stop taking Venlafaxine, Desvenlafaxine and Clonazepam, leading to horrible withdrawals. In all of this I’ve found one medication that works for me without any major side effects, the afore mentioned Clonazepam. While I’ve had to stop taking it daily due to concerns around dependency, I continue to use it infrequently on an as-needed basis to help manage my anxiety and panic. One medication, out of at least 15, has been helpful in a lasting way. Taking a break from trying new medications has given me the chance to escape from the pressures of trying medications, and the disappointment when the gamble doesn’t pay off.

I knew, of course, that I would have to make the choice between continuing to manage my illnesses without daily medication or trialing new medications again. Would I continue to avoid new medications and eliminate the possibility of finding a medication that helps? Or keep trying medications in spite of my terror of putting my body and mind through uncertain changes again? Ultimately, I know I don’t want to cut out the chance of finding a method of treatment that could make the weight of these illnesses easier to bear. Yesterday, when my psychiatrist again suggested I try Moclobemide, I agreed. She first suggested this medication to me months ago, and I’ve been giving one reason or another (with the prevailing reason being my anxiety about beginning medication trials again) for why I didn’t want to start taking it yet ever since. Now, in the beginning phases of a depressive episode, after months of rest, I decided it was time.

Moclobemide is an antidepressant in a different medication class than any I have taken to date. It tends to be weight-neutral (a major plus for me as I struggle with weight gain), low on side-effects and has been seen to improve social anxiety for some individuals who take it. I took my first pill this morning. It’s time to hold my breath and hope this gamble pays off.

Take care,

Fiona

Photo by rawpixel on Unsplash

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Psychiatric Medications: Our Bodies. Our Minds. Our Decisions.

Photo by rtdisoho on Pixabay

As someone with mental illnesses, the choices I make to take medication, change medications or not take medications are often met with strong reactions varying from support to criticism. I like to attribute these reactions to genuine concern on the part of people who care about my wellbeing. Nonetheless, it’s frustrating when it seems no matter what I choose to do I will inevitably be met with judgement.

Over the years I’ve heard it all…

“Medications are for real health problems, not emotions!”

“You’re too sick, you have to take medication!”

“Benzos will ruin your life!”

“You’ll feel better if you just smoke weed!”

“Mental illness is caused by a chemical imbalance in the brain. Taking medication is only thing that helps.”

“You’re kidding yourself by taking medication. Eat healthier, exercise more. Mental illnesses can be totally cured by lifestyle changes.”

I am not alone in having faced conflicting opinions, judgement and criticism over my medication choices. Many of us have been questioned, criticized, judged, demeaned and shamed for our decisions. We have been given opinions we never asked for from people with varying levels of understanding. We receive conflicting messages from family, friends, acquaintances, professionals, movies/TV and popular science articles. We have been instructed what to do as though we don’t have the authority on our own healthcare decisions. We have been told what drugs to take, what drugs not to take, not to take drugs, to take drugs, to change drugs, not to change drugs, etc. It’s dizzying. Some of us have been pressured in to decisions we don’t feel comfortable with. For many of us, the cycle of judgement seems to start again every time we make a new decision about psychiatric medications. This can all be isolating and overwhelming. Honestly, a lot of us are tired of it.

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Photo by stevepb on Pixabay

Are psychiatric medications the only solution that works or a scam? Are they helpful or harmful? Are we over medicating? Opinions differ on these and many other questions. Part of the discrepancy in opinions about medications can be explained by an overvaluing of individual experiences. Medications used to treat mental illness have varying levels of efficacy and side effects from person to person. Likewise, some people respond better to medications than others. Our personal experiences are important, but no one person’s experience can encapsulate the efficacy of a treatment. What is right for me isn’t necessarily right for you and vice versa. The information available to most people through popular science is also confusing. When we go looking for answers we often find more questions. It’s no wonder strong opinions form on an issue that is polarizing even amongst mental health professionals and advocates.

I have come to realize that the only people I want involved in decisions regarding my medications are myself, my medical team and anyone whose opinion I specifically ask for. Simply put, I am in the best place to judge what is right for me and my doctors are the only people whose authority I trust on medications. It isn’t that I don’t appreciate the concern of others. What I don’t appreciate is concern expressed in prying questions and unsolicited advice. My decisions around my mental health care treatment are my own. I should not have to defend them for fear of being judged. Nor should anyone else.

Please allow us the right to make our own decisions without judgement. We should be able to choose treatments that we feel comfortable with without fear of the reactions they will provoke. These choices are personal and they should be. Bottom line: when it concerns our bodies and our minds, it should be our decision.

Take care,

Fiona

Exciting news! (Mental health progress)

I have some exciting news to share – after two long years, the depression has finally lifted!
At first I hesitated to say anything, I thought perhaps I was just having a good hour, day, weekend, week, month… I didn’t want to jinx it by celebrating it. But heck, it’s been a long couple of years and I am going to enjoy this break from depression, no matter how short or long it ends up being.
For about a month now I have felt much more like myself. I have felt motivated, energetic and have enjoyed things again. Perhaps most excitingly, I have LAUGHED. Like real belly-busting, think-you’re-going-to-pee-yourself laughter. I have seen friends because I wanted to, I have smiled authentically. It has been such a relief after a very dark two years.
The best thing about my depression lifting is that it makes my anxiety easier to tolerate. If I am entering an anxiety provoking situation when I am depressed I am unlikely to be motivated to work through the anxiety, social phobia and agoraphobia because I won’t feel a benefit from it because I am mostly unable to enjoy things. When I’m not depressed, I feel compelled to stick out the anxiety provoking situation because I might enjoy myself. Likewise, not being depressed makes me more hopeful that I can make progress with my anxiety. Also, I have a much more optimistic view of the progress I have accomplished so far. The scale has tipped towards being more proud of how hard I have worked instead of feeling ashamed of how much ground I still have to cover.

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Enjoying dinner out at my favourite restaurant.

Because of this newfound happiness, motivation and energy I have been able to tackle a few major milestones. I went on a weekend trip with my husband Tom and we went out to several stores and restaurants within just a few days. Most excitingly, this past week I went to a gathering at a friend’s house, stayed the entire time and had a lot of fun (real honest to goodness fun!) in spite of how anxious I was for being outside of the house and in a group of people. My increased energy has also been great because I can do my fair share of households tasks and am able to do more than just sit on the couch all day.
I have lived with recurring episodes of major depression for many years, but usually it comes in waves of a month to a few months at a time. I think prior to this depressive period which spanned from about April 2016 to March 2018, my longest episode of depression was probably about 6 months long. I have become accustomed to the ebb and flow of my depression, and never before had I been so certain it wouldn’t eventually lift. I have been seeing a psychiatrist and a psychologist, participating in group therapy, completing workbooks at home, doing more intensive work during hospitalizations, practicing mindfulness and self care, etc. I felt that I was doing everything I could to no avail, which led to worse depression, self-harm and suicidal ideation. And yet, all of the sudden that all slid away.
So, what has brought on this change? It is hard to say anything for sure. But all roads lead to it being tied in to reducing the dose of my anti-depressant. I have already come off of several medications in the last few months to check whether or not they were effective but none of those medication changes had the slightest effect on my mood. So far I have done two phases of reducing my dose of Pristiq (desvenlafaxine), first from 150mg to 100mg per day, then to 100mg to 50mg per day. While I have been dealing with some dreadful symptoms of medication changes, my mood has been a lot better. I’ll just clarify quickly here though that the efficacy medications, particularly psychiatric medications, varies greatly from person to person – I’m just sharing my own personal experience.
There is no guarantee that this sudden change in mood will last but I have decided to embrace it while it is here rather than worry about loosing what I have gained. I am not under any illusions, I don’t think that I am cured of depression. I think that the medication I have been taking for about a year now was contributing to my depression and lack of energy. While I’m not looking forward to my next low, when I do feel it coming I am going to be a lot more certain that it won’t last for years on end. And that will make it infinitely easier to bear.
Take care,
Fiona