When Medications Go Wrong

For years, I’ve pretty much been medicating myself.  I take my scripts home and medicate how I see fit for my situation.  I realize that makes me medication non-compliant.  The trouble I come to is my trust in doctors.  I have been burned so badly before that I find I have a lack of faith in them to know how they are really treating me.

When I was in my teens, and being treated for Major Depressive Disorder (misdiagnosis – strike one), I was put on high doses over a slew of medications for years with little result (overmedication – strike two).  I suffered extreme side effects, with little done to relieve them.  I took Zoloft in increasing doses over a three year period.  I continued to complain of extreme fatigue, anxiety, motion sickness, and periods of flu-like symptoms.

The doctor’s answer?  More medication.  It came to a head when I found that if I sat still for too long, I would drift off to sleep.  Sitting in school became impossible, and I was sleeping fourteen to sixteen hours a day.  Eventually, I was put on 300 mg of Zoloft with Provigil to combat narcoleptic symptoms.

It was at the doctor’s suggestion that I continue to exceed maximum dose and go to 350 mg that my mother finally put her foot down.  “Put her on something else.  We’ve put three years into this, and it clearly isn’t working.”  And much to my doctor’s chagrin, I was switched to Lexapro.

Wrong answer.

Immediately, I started to have dissociative symptoms.  I recall laying in my room, laying on the floor, and staring at my ceiling in the dark.  My mother stood in my doorway, just observing me.

“What are you doing?” she asked.

“Nothing,” I answered blankly.

Yes, I was finally awake.  But, every moment was torturous.  I lost my sense of self, and started to drift away.  My memory began to fragment, and I sunk into a deep, desperate depression.  I was frantic and crazed, while feeling numb and blank at the same time.  I became paranoid, and started to assert that everyone was doing things against me.  They were intending to harm me, and I started to give meaning to harmless comments and phrases.

I attempted suicide several times in the first month.  The cutting became so bad that I was doing it in rather public places.  I was caught one time at my boyfriend’s house, and I had a dull exacto set ripped off of me and immediately chucked into the local creek.

We were unaware of all of the side effects at the time, because all of the medications I was placed on were brand new.  When a pharmaceutical representative left her office prior to my visit one day, it became clear that I had become an experiment to brand new medications.  I was taking expensive, largely untested medications for her financial benefit.  Strike three.

I had gained thirty-five pounds over a six month period.  I was 4’11” and 165lbs.  That put me at a BMI of 33.3, and in the obese range.  And despite all of my best, and even worst, and unhealthy efforts, I still couldn’t manage to get my weight below 145lbs.  I was starving myself on 900 calories a day, and I still hovered around obesity.

I couldn’t afford my medication once I was kicked off of my parent’s insurance, and I just decided that since it failed to ease my symptoms, I would stop taking the medication entirely.  They failed to mention that if I attempted to stop the medication cold, then I would be stricken with the worst withdrawal I had ever known.  It was a good thing my parents had been through this before with my father, because they knew how to ween me off.

It took me years to get the rest of that weight off.  But, by then, the medication had already done long lasting damage far worse than just weight.  I had begun to develop a drinking problem.  I had engaged in risky sexual behavior due to hypomania.  And it sent me walking with bad eating habits.

After that, I distrusted doctors and medication entirely.  I had lost faith in mental health treatment.  I was left with a feeling that I didn’t have a disorder at all, and instead, it was just me.  I was convinced that I wasn’t treatable.

It took a lot to make me realize that I was in desperate need of treatment.  I had taken psychology courses and was suggested by several psychologists in my college to have bipolar disorder.  I knew my behavior wasn’t “normal”, just as I had always suspected.  It took the my marriage, my depleting mental health of my husband, and the birth of my son to encourage me to start treatment again.

Three years, four doctors, and a another slew of medications later, and here I am, again the victim of overmedication and bad medication choices.

Recently, I stopped my Abilify.  Admittedly, it was because I noticed an interaction between the Abilify and my weekend consumption of alcohol.  I started to find that I would fall asleep soon after taking it on Friday’s while we drank.  I decided that I would just stop over the weekend, and continue during the weekdays as normal.  But, eventually, I just forgot to take it at all.  And soon, I started to notice an improvement in my worsening condition.

Suddenly, I was able to think again.  I started to feel more like myself.  I became more aware of what I was thinking and feeling, and I finally started actually living in the world around me.  It actually felt like living again.  And that’s when I noticed the weight I had put on.  I had fell victim to Abilify’s weight gain, among other things.

I can blame the dissociative symptoms on Abilify.  It had created an emotional flattening, and I started to dissociate from myself and my world.  It had robbed me of my ability to write and care for my family appropriately.  I wasn’t feeling, so I wasn’t caring.

The anxiety?  Well, I recently started to run out of a supply of Wellbutrin I can’t really afford right now.  I started to cut back to make ends meet, and I discovered that was starting to subside.  Other than rebound depressive symptoms, I was feeling better.  It didn’t matter to me anyway.  I was still going through crying jags, whether I was taking the Wellbutrin or not.  The difference was between whether they were loaded with distressful urgency to cut or not.  I decided that I would prefer to keep my near streak of four months without cutting.

I don’t blame my doctor.  He’s an old school doctor who works off of the biological model and treats symptoms.  I have declined therapy several times, though my requests to be seen since have not been honored.  All of my symptoms point to mild psychosis in general, aggravated by extreme life stressors.

I blame myself for not listening to myself and taking action sooner.  Treatment happens on both ends, and I have not been holding up my end of the bargain.  I have not been mood charting, and I have not been notating subtle symptoms.  It has become abundantly clear to me since my extreme meltdown and psychotic break during the summer that I had been probably Bipolar 1.5 all along.

Though I don’t experience full on mania, I do experience mild psychosis, practically all of the time.  I have not been pressing the issue about invasive thoughts, paranoia, “The Voice”, or any of the mild hallucinations that I experience.  Only when I had my break did I bring it to my doctor’s full attention.  And I was met with extreme medication.

Personally, I’m at a loss as to what to do.  I’m damned if I do, and I’m damned if I don’t.  I noticed last night that “The Voice” has returned, even if it’s benign (right now).  I don’t want to be overmedicated, and I can’t risk gaining anymore weight.  The weight is worse for my mental health than anything else.

And it completely screws up my bodily function.  Now, I’m experiencing weight related problems again.  My knees and back hurt.  I have acid reflux near to the point of anorexia again.  Sexual dysfunction is destroying my sex life, my self-esteem, and hurting my marriage.  And I’m back to full on social anxiety, because I’m too self-conscious to function.

But, at the same time, I’m aware that I need some kind of medication.  While, for now, I’m better off without it, the day will come where I am asked to step up, and perform at a higher function.  My family, including Finn, has been very great about my general lower function and picking up a lot of the slack for me.  However, this won’t last forever.

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With or Without You : 30 Days of Truth

Day 15 : Something or someone you couldn’t live without, because you’ve tried living without it.

Most people would prefer to choose a certain special someone or an object to contain all of their affections.  Though my relationship with this is troubled, I have found it to be impossible to live without it.  Even if it’s so hard to live with it.

Medication.

I have made the attempt several times in my life to live without psychiatric medication.  My first was a psychiatric evaluation when I was thirteen, and I refused treatment.  What thirteen year old has the intense desire for repeated therapy visits and pesky medicine?  As a direct result, my symptoms progressed, and I wound up my own cutting board.  When it became concerning, no one was willing to take me back for actual treatment.  Instead, I unnecessarily suffered until I humiliatingly revealed myself and my wounds to an outsider.

The next time was in my late teens.  After being medicated for nearly five years with no result, I was ready to give up on $60 co-pays for a medication that just gave me heroin-like withdrawal symptoms when I forgot to take it.  (That was also the first time I became strongly inclined to start carrying medication on me in clever, cute containers).  I spent a gratuitous amount of time on weekends in a different county, an hour away from my home.  The bus services were shoddy at best, and if I forgot to take my medicine on Friday, then by Sunday morning, I was violently shaking and vomiting in front of my relatively new boyfriend.

This new boyfriend, Avi, convinced me that there was absolutely nothing wrong with me.  The medication was doing more damage to me than good.  It was a waste of time and money.  Psychiatry was a joke and a con for cash.  It would be in my best interest to get off of the medication.

The funniest thing about that was the fact that I became irreconcilably depressed when I weaned myself from the Lexapro, an SSRI.  I required way more than my typical six hours of sleep.  I could no longer party until dawn.  And mostly, my only desire was to scream and cry my eyes out.  After you’ve been hypomanic for so many years, having a crash like that was epic.  Coincidentally, it coincided with the very first cliff fall in our torturous relationship.

And resulting in that choice, I developed functional alcoholism prior to the legal drinking age in the United States.  It took several abusers, victimization, abject poverty, and becoming an abuser to take me down into the depths of a bottle.

I found that I had even given up on self-medication.  When Xan and I got together, it became obvious that he suspected I suffered from addiction.  Though our relationship was certainly not new, our courtship was brand new.  In order to not put him off, and make a show of my own self-control, I slowly ditched the bottle.  I was so addicted that I found I had to be intoxicated to make love to him.  At least a little.

A few years later, I started treatment.  I had managed to remain sober, however, I had completely lost control of myself.  Several months into treatment, I ran into every medicated person’s greatest fear.  My medical coverage was eliminated.  Every pharmacy reported the same thing; Lamictal costs a fortune, and if I can’t afford COBRA, then I sure as hell cannot pay for it from pocket.  I found myself soliciting every pharmacy within a 10 mile radius for assistance.  Finally, one came through for me.  But, not before I suffered cruel withdrawal symptoms.

A similar withdrawal happened over a holiday.  I was unable to see my Pdoc before Christmas, and he had taken vacation through the New Year.  The office had a policy not to call in medications, so I had to make an appointment to go in.  Catch 22.  For four days, I laid there writhing in bed.  Xan took charge, and I had a refill that same day.

The very last time was one of my own poor choices.  That is exactly what mania does – it gets your hooks into you and tells you dirty little lies.  I had decided to attempt to wean myself from medication slowly so that I could prepare to attempt pregnancy.  I did so alone.  Instead of consulting a doctor, I went ahead.  And instead of getting off of medications, I had psychotic breaks the likes of which I have never been remotely acquainted with.  The result was more medication and a lesser likelihood of having a second child.

I have been without by force, by accident, by coercion, and of my own volition.  Like it or not, I cannot live without medication.