Medication Maintenance: Too Much of a Good Thing?

About a month ago, I had a lot of anxiety-inducing events happening all around the same time. I strategized and planned how to deal with everything and figured, at the end of the day, I would just “get ‘er done.” But in the approaching weeks, I just didn’t feel like myself. I had assumed I would be super-hyper and anxious, perhaps a bit petulant, but not this. I was exhausted but couldn’t sleep through the night. I was punishing myself with food control and I noticed my internal thoughts were getting sharper, meaner, deeper. Still, I told myself it would pass.

I had a terrible social hangover for a few days after the main event. That was to be expected. But a week passed and I still felt like shit. I panicked and went to my psychiatrist. We decided to move my medication up. I felt like I was slowly falling and didn’t want to dip too low before it was too late to pull myself back up.

I already have side effects from this drug. (It’s my super drug – the one that pulled me out from my three-year chemical depressive slump.) Dry mouth, disturbed sleep, pee issues, hair issues, anxiety, memory loss, inability to find words. But once I went up, I started to notice other things. My current side effects got worse: my dry mouth has now created a metallic taste in my mouth. I can’t have disturbed sleep because I can’t even fall asleep – my brain can’t shut down. And new side effects have decided to join the others. I’ve started getting tremors, dizziness, and light-headedness. I don’t have any energy – when I start spinning, my legs feel like I’ve been at it for an hour already. I’m sweating more. The worst and most disconcerting component is that my anxiety has really increased. The same drug that in the past made me feel like I had a couple cups of coffee, is making me feel like a squirrel on coke. (Yeah, not sure why that metaphor, but it just seems right.)

And honestly, I could handle all this. I believe that side effects are just part of the package and you live with them. They suck, they’re annoying, but you chew gum, drink more water, put your hair up, take more meds during the day for your anxiety, and just wait out the light-headedness.

But I’m not feeling emotionally better. (After all, that’s the other part of the package deal.) It’s probably the anxiety, but I’m actually feeling worse. I’m thinking thoughts I haven’t had for almost a year now. I find myself fluctuating my mood multiple times in an hour, let alone in a day. It’s exhausting. I’m starting to get anxious about going into the supermarket and the gym – the people, the noise. Small things feel huge and unmanageable. I catastrophize more than usual and find myself falling into self-hate vortexes.

I’m terrified. I’m nauseous. I’m scared. Hopefully we will go back down on this med and I will be better. We might have to go on another drug expedition to deal with this sadness. That, I detest. But I don’t want to go back. I don’t want to cut. I don’t want to think about dying. I don’t want to wish I didn’t exist. I don’t want to go back.

Update: I spoke to my psychiatrist yesterday and I went back to my past dosage. Here’s hoping this post will soon be a distant memory.

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Self-Medicating: How Can Something So Right, Be So Wrong?

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Mental illness or not, we all do it. No, I’m not talking about masturbation – I’m talking about self-medicating.

Life is a stressful, complicated, big blob of fear, anxiety, and failure, wrapped in a bomb with an unknown time limit before explosion and death. It’s no wonder people need a way to relax.

For some, they go the way of meditation, aromatherapy, yoga, acupuncture, natural and prescribed medications, exercise, and healthy eating – and I am in no way knocking these things. In fact, I have tried, and am doing, the majority of them. But sometimes, it’s not enough. And especially if you working with the complexity of life and a mental illness, it can be too much to balance with breathing exercises and a downward dog. Besides, medications are expensive and as I mentioned in my last post, take time, are unreliable, and have major side effects.

So we try to self-medicate first. For me, it started with food. I could stuff myself with food and just before I thought I would throw up, stuff myself some more. Then, by the time I got to high school and was constantly trying to lose weight, it became anorexia – trying to see how little I could eat to see how much control I could gain. But there was also alcohol and drugs. And it’s not like someone was asking me if I was okay because everyone was doing it, it never impacted my grades, I never got busted, drank and drove, or made those mistakes that some Beliebers do.

In college, I would outdrink the guys next to me and then make out with a few – trying my best to convince myself I wasn’t the ugly, worthless piece of shit I knew I was. It never quite did the trick and since I was too much of a control freak to sleep around, I started to wonder how I was going to find my release.

Somewhere around sophomore year, I found cutting, or as some call it “self-mutilation.” It was the best of times; it was the worst of times. It was the point I realized I needed therapy but it was also when I finally found a self-medication that did what I needed. I’ve tried to explain cutting to many, and I’ve learned from others that like most things, it’s different depending on the person. But I can tell you what it gave me, and why to this day I still miss it. But more on that later.

I know people self-medicate in different ways that take them on much more intense addictive paths. These paths exacerbate their psychosis, and can lead to, for example, homelessness, violence, and abusive relationships. While I know that prescription medications are not a cure-all (I’ve been “unlucky in love” with most of mine,) I think the difference is that self-medication is a short-term fix while medication and therapy seek to find a long-term solution. And given how exhausting this process is, I think the latter is what we’re truly looking for on this journey.

Medication: A Complicated Balance

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It’s ironic that the next topic I wanted to discuss on this blog was medication, because the reason why I couldn’t sit down to type about it was because of my … medication. It’s a tricky thing – medication is intended to help you get back to your life; to quiet the demons so you are strong enough to get out of bed, get out of the house, try to have some sort of consistency or “life.” But it’s a balance because feeling better is a complicated mix, with some severe side effects that are both psychological and physiological.

I have been on prescription medication since college. With each medication came its’ own set of side effects including: dry mouth, akinesia, stomachaches, weight gain, (a pro-depressant if you ask me,) headaches, light-headedness, dizziness, sluggishness, wanting to rip my skin off, insomnia – pick an uncomfortable side effect, and I’ve had it. And sometimes you have to decide if the side effect is worth the effect you are receiving psychologically from the medication. This is a personal, complicated, and often difficult process (both in starting new meds and withdrawing from old).

Four months ago, I went on a medication and within two months, had gained 30 pounds without change in diet or exercise. At that point, I didn’t care if it made me feel like someone in an anti-depressant commercial, it wasn’t worth it. Getting off that medication was difficult with headaches, sluggishness, and stomachaches, (in other words – withdrawal,) and the weight still hasn’t come off. Two weeks ago, I went on another medication and developed akinesia. It was like having 18 cups of coffee on 2 hours of sleep. I couldn’t stop moving but every time I took a step, I wanted to lay down wherever I was – in the street, at the gym. I was spelling words incorrectly, having a hard time doing anything for more than 15 minutes, and having massive panic attacks. So yeah, I decided after two weeks that all that the negatives outweighed the positives on that one.

The medication I am still on makes it difficult to fall and stay asleep. So, I take medications to help decrease anxiety (both mentally and physically) and medication to not only help me fall asleep but ideally stay asleep. I know – you all of a sudden go from no meds to having five because the one you are taking needs four to compensate for the first one. But at the same time, I can see the positive changes psychologically the first medication is making and it makes the other four worth it. At this point in time, even with the sleep aggravation, it’s an aggravation worth dealing with because the benefits of this medication do outweigh the annoying disadvantages. And besides, if I’m taking one pill, what’s another four. :)

A large problem for people with bipolar or schizophrenia (or any other mental illness for that matter,) is that they go off their meds. They decide to either self-medicate or go cold turkey because they don’t like the side effects. On meds, they don’t feel like themselves – they’re cloudy, unable to concentrate, and feel like their creativity is suppressed. I cannot tell anyone what they should or should not do because making these sacrifices/decisions are personal. I will say that sometimes we either think we don’t need medications when we feel better, even though it’s the meds we are taking that are making us feel that way, or we don’t want to feel the side effects so we give up. Unfortunately, given the power of mental illness, I think sometimes we just have to honestly weigh how bad the side effects are in relation to the impact and effect the medication is having on our overall mental health and well-being.

Another reason I’m often tempted to go off meds is because I miss how I “normally” feel. Sometimes you are depressed or sick for so long, that being like that starts to feel like the norm. I’ve been feeling different since I was eight and with the meds, I sometimes feel like I’m faking this version of myself and that version lacks the sensitivity, passion, and creativity I used to have in handfuls with my depression. In fact, when I take medication and start to make plans and build up life, I feel this deep sadness. At first I thought it was the depression creeping back in but I think sometimes I’m mourning the loss of my sadness and mood swings.

It is in those extremes, I feel most “alive.” I am more impulsive, more creative, and less passive. I yell at people instead of being polite; I hate myself without the guilt of those around me telling me I shouldn’t; I hurt myself and no one can stop me, and in a way, it makes me feel powerful, in control, and “normal.” Life may not feel dulled like when on medication, but I realize the feelings I have that are “full,” are dark, foreboding, and negative. When I’m having a hypomanic episode, I feel effective and efficient, but tottering on a string, about to slip and fall into a large hole of deep, intense depression. And I realize that in the end, it’s all about about the long-game and every day survival.

I know, at least for me, I also don’t just take these medications for myself. I take them for my family and friends. Because without them, I know eventually I’ll become suicidal (shit, sometimes even with them,) so I have to keep trying. After all, I don’t want to hurt my mom who tries so hard to help, or my friends who have stood by me for so long. I don’t want my sister to have to explain to her children what happened to their aunt. Even if I can’t fully do it for myself because at the moment all I can see is that this dry mouth is really impacting making any conversation and my jaw hurts from chewing so much gum, I have seen the possibility in others of what my life could look like, and I recognize it just takes time – even though I detest that idea, no matter how true it is.

I mentioned that I’ve been on medications for over 10 years. And that’s because sometimes medications stop working. Or they re-diagnose you. Or your lifestyle changes and a side effect is no longer viable. (I can imagine for some sex drive might become a game-changer. Sadly, not for me at this time.) I can’t think of a metaphor for how frustrating and disheartening this process is. It also has personally given me trust issues – what if I go on something and it works and I build my life up and then it just stops working and everything comes crashing down. Then, after all that, you want me to try it again? Patience is a bitch.

But every so often, I’ve found myself in a good place with medication and so I know it’s possible. And while faith is not a strong part of who I am, I can’t seem to get rid of the hope that one day I’ll find something that works and won’t quit on me. And so, at least for now, I won’t quit on myself.