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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Vitamin L : Medication Adventures

Lamictal.  The one drug that I can say that we’ve all been on at one point or another in our adventures with medication.

Pardon me, my aphasia is showing with a little dash of emotional flattening.

I’m having difficultly remembering how to spell things.  You wouldn’t know it, because there is a such thing as spell check just for this purpose (but not solely).  My emotions are at such a level that I don’t actually feel.  It’s closer to a favorite pair of jeans where the dye has just completely washed out.  The jeans still look good, but they are faded and muted.  That’s me.  Faded and muted.

I can’t write intelligently like I did before.  Everything just comes pouring out like word vomit, because I can’t hang on to a thought for longer than a moment.  It’s a miracle that I can put anything coherent together.

The landscape of my technicolor world washed away into an old movie reel.  It’s so surreal.  Once, I was the flowing turquoise waters of the seas, ever changing, always in motion.  Now, I am the cracked earth, immobile and silent.  And ever so slowly, I am drying up and eroding, existing without life rooted in me.  Only the empty air whistles in my mind, catching a faint tune here and there, only to carry it away.

Moments come in flashes.  I am engrossed and deeply engaged for just a few seconds before I am distracted by something nonsensical.

Stop.  Sip of coffee.  What was I doing again?  I reread my last passage, and I am stumped, because it seems futile to even continue.  What is the point I am trying to convey with such vague and poorly worded imagery?

That was my world for the last month, prior to the last couple of weeks.  That is my life today, a translucent figure shrouded by shadows, discontent with such a shackled self.

That was not my life over the past couple of days.  That is how I narrowed down what medicine was doing this to me.  I was starting to run out of Lamictal, my Vitamin L as it’s commonly called in the mental health community (not to be confused with the Vitamin L of Lithium).  I lowered my dose from 300 mg to 200 mg in order to make it through successfully.

Except, there was no success to be had.  I went straight back into the same mixed episode I’ve been a slave to for more than nine months.  It was almost as bad as before, sans the psychosis.  I referred to it as Energetically Sad.  The story of my life.  I went into several crying fits a day, panicked and shouting the same phrase again and again,

“I can’t do this!!!  I can’t do this!!!”

Not again.  Not again.  Not again.

I can’t do this again.

Ultimately, I grabbed my precious medicine and dosed. The distress was immeasurable. I needed relief from that hell, the one I had endured for far too long.

But, I realized I’m not experiencing relief. I’m experiencing escape. My mind goes into a state of partial shutdown, leaving me no real clarity in any aspect. My consciousness is jagged, disjointed, and blurry, at best.

I experience slow motion waves of hollow, but shallow depression. Futility is found at every turn. The shadows seem deeper and more defined, like menacing sillouttes in the distance. I can’t shake them, but they can’t seem to touch me. They nip at my heels, and send ripples of darkness through me, infecting every molecule. And in a few moments, it passes, the poison having been purged.

At first, I thought it was just me. It felt like a new state altogether, like anxiety masked by a tight cloth, rustling, deperately seeking an outlet. It had the face of depression, leaving me dispondent and uninspired. But no true symptoms existed. Not in the desperate, deep dark places I’ve been. I stood in a parellel existence unlike anything I’ve ever known.

And then I thought, “Is this what it’s like to be better?” Dullness and mild discontent.

It’s not.

It’s the medication.

So, that leaves me with two very undesirable states. Perpetual distress or muted depression and anxiety. One zaps my everything, making me too medicated to function. The other disrupts my life with meltdowns, only making me partially functional.

One little pill is what makes the world of difference. My vitamin L.

Liquid Courage and Tablet Saviors : 30 Days of Truth

Day 20 : Your views on drugs and alcohol.

“Drugs are bad, m’kay?”

Or are they?

There is this long, Nancy Reagan-induced diatribe about the dangers and evil of illegal drugsSay no to drugs.  This is your brain on drugs.  The war on drugs.  Above the influence.  Don’t drink and drive.  Prom promise.  Those of us that are Reagan babies and older, through the boomers, are well aware of the presence and negative consequences of drugs and alcohol.   And despite the heavy dialogue, many people have personally experienced their own battle with substance abuse and dependence.

Alcohol had torn my life apart at the seams.  As with any addiction, it starts off as a recreational activity.  It’s a part of popular culture, especially in the younger age groups.  In my youth, drinking was cool.  Truthfully, it was a fun escape from the drudgery of daily life.  That was at seventeen.  Within a year, I started to find solace at the bottom of a bottle.  Coincidentally, that was the same year Smile Empty Soul sang:

I do it for the drugs.

I do it just to feel alive.

I do it for the love that I get from the bottom of a bottle.

Bottom of a Bottle – Smile Empty Soul

By the time I was in college, I was seeking out opportunities and excuses to drink.  A set of rules existed which meant to separate alcoholics, the loathsome bunch that we perceived people like our own parents to be, and recreational drinkers.

  1. Never drink before 5PM.
  2. Never drink alone.
  3. Never drink without occasion.
  4. Don’t drink before or during work or school.

As I gained my own freedom with my own apartment, the rules started to change.  In private, I could do what I liked.  I could deny everything and anything when I failed to be under the limelight of public scrutiny.  I began to use alcohol as more than a crutch; I started to abuse it completely as a coping mechanism.  That’s when alcohol and I started our sordid love affair.

The environment in my private life began to change.  I have spoken about it many times in various posts like Decent into Hell where I described my addiction as:

The last days of that relationship are blurry; my memories are obscured by the drugs and alcohol intoxicating my mind.  The days blended together in a ritualistic, self-medicated loop, work.drink.sleep.work.drink.sleep.sleep.drink.sleep… suspended in agonizing slow motion.  The silence was deafening in the deep, dark hours of night, still, cold, indifferent.

I had become a functional alcoholic.  I never drank before 5PM.  There was always an occasion, even if it was a day ending in “Y”.  And I certainly was not without company to share in my intoxicated merriment.  But there is a solid difference.  Every waking moment I did not spend at work was with a glass or a bottle in my fist.  I had gone far beyond the point of mixers, and mostly beyond the need for glasses.  It was me, a bottle of Bacardi 151 sans the filter, and a bottle of Gatorade to chase.

I wrote in Love the Way You Lie:

At that point, the seeds of alcoholism were taking root.  I violated my own rules of drinking.  It’s 5 o’clock somewhere!  I’m not drinking alone if I’m drinking with my boyfriend.  Hair of the dog, best way to cure a hangover.  If I’m still managing to get to school and hold an honor’s average, I’m not drinking too much.

Liquid courage and comfortingly numb.

It has always been my vice, and holds the looming, unending threat to assume control and ruin my life. In another 30 Days of Truth piece entitled, Control, or Lack Thereof, I went into a full exploration of recent recreational alcohol use and the negative impact it created in my life.

Flip that coin.

Drugs have revolutionized my life.

People neglect to realize that they are consuming legal drugs daily.  It becomes painfully obvious when you sigh over exorbitant copays at the pharmacy counter, like many people with mental health disorders often do.  But, instead of calling them “drugs”, we call them “medications”.  Did you know that Wellbutrin technically has the same chemical composition of a methamphetamine?  And that benzodiazepines work on the same receptors in the brain as alcohol?

So here I am, with my uppers to wake me in the morning, and my downers to put me to bed at night.  It would be illegal and detestable if I were using meth and boozing away.  Instead, it’s under the supervision of a doctor, as a controlled substance, in a convenient little pill.  Don’t get the wrong idea.  I am only likening the effects.  The supervision of the doctor is safer, and the medications are regulated by the FDA.  And as a result, I have most of my functioning back.

And I wouldn’t have it any other way.

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.

Up For Some Blog Tag?

I don’t know about some of you guys, but I’ve been coming up short in the writing arena lately.  Not because I don’t have anything to complain about (I don’t), but the Abilify is making my head unusually empty.  So, I’d like to toss around a game of tag!  Enjoy!

Da Rules:

Write ten facts about yourself, all true, and then pass it on to ten people.

Da Facts:

  1. I don’t like red meat.  I really don’t.  I am not a big fan of meat in general.  Except cheeseburgers.  I love cheeseburgers.  They are my downfall every time I attempt vegetarianism.
  2. I sleep in my contacts.  I’m so vain.  No, just kidding.  I just really love waking up and not fishing for a pair of glasses.  There’s something beautiful about waking up and being able to see the world without some plastic foreign object on your face.
  3. I live in Pittsburgh.  For those of you that might not know, I live in the City of Champions.  Most livable city in the US.  Six Superbowl Rings.  Four Stanley Cups (that I know of).  Jaywalking is a birthright.  The most disgusting rivers you will ever see, all three of them.  So bad that Bruce Willis said he will never, ever go in them again.  Most cloudy days of any major US city.  And more sets of stairs than San Francisco, believe that or not.  This city is the best.
  4. I was not born in Pittsburgh.  Unlike the rest of the natives, I was not born at Magee Women’s Hospital.  I wasn’t even born in this city.  I was actually born in a little town outside of Atlanta, GA.  I was raised there for several years and then hauled to Pittsburgh.
  5. I occasionally have a southern accent.  If I am drunk enough, surrounded by southerners, or actually in the south, I will slip into a southern accent.  The more time I spend in the south, the harder it is for me to get rid of.  I went down for a week for my honeymoon, and couldn’t get rid of it for three weeks, much to my husband’s disgust.  He’s one to talk; he has a mix of a Pittsburgh accent and a Brooklyn accent.
  6. I speak three languages.  Good English.  Bad English.  And Pittsburghese.  Look it up, it’s a real thing.
  7. I play more than one instruments.  I play most instruments in the woodwind family, and some in the percussion family.  I do not play any strings or brass.  It’s just not in me.
  8. My hair is naturally blonde.  Just not as blonde as I dye it!
  9. My son has Autism Spectrum Disorder.  I know I don’t talk about it often, but my son was diagnosed with Pervasive Development Disorder – Not Otherwise Specified in May 2011.  My brother has classical autism, so it was a hard diagnosis to take in.  I couldn’t help but think to myself, “Not again, God, I can’t handle this my whole life.”  The good news is that he’s coming along just fine, though he’s still delayed.
  10. I am on five psychiatric medications.  Lamictal, Abilify, Xanax, Wellbutrin, and Temazepam.  I hear that’s actually pretty tame in comparison.

Now, here’s the tagging.  If you come upon this, then TAG, YOU’RE IT!  I mean, if you really want.  I’m just not going out of my way to tag others today.