Mystery Potion

I never, never want to change my psych meds. The overwhelming urge is to leave them alone, because I’ve found a regimen that has a minimum of side effects. Problem is…they’re not doing the job right now. I’ve had a consistent pattern of frequent hypomania for months, and the symptoms are starting to impact my life more. My rapid and disjointed speech is sometimes noticeable to others. Sleep is worse than my already-bad levels. I am hypercreative, but unable to settle to one project or get anything on paper. The urge to self-medicate with overeating is strong, and I’m not always able to resist it. So, it’s time for me to open my mind to a change. The last change I did was just a slight increase in the med I was already taking, but this one is adding something new.

Imagine you’ve been handed a magic potion in an opaque flask. You know you need to drink it, but you have no idea what it’s going to do to you…caught between the misery of the moment and your fear of the unknown, you raise it to your lips and swallow. And then you wait.

The next day, you feel sick. And the day after that. Or you’re semiconscious, or your mouth is so dry you can barely speak, or you can’t have sex anymore, or you’re heart-poundingly anxious, or you have sudden self-destructive thoughts, or you’re dizzy…but you continue to drink the potion, because you’ve been told all this is normal and will pass soon. But when will I feel better? you plead with the wizard. In six to eight weeks we’ll see, is the common reply.

Yes, though there are a few “big guns” of psych meds that have immediate effect, such as tranquilizers and antipsychotics, most others manifest side effects long before any therapeutic effect is felt. Which is why the popular misconception of popping an antidepressant to lift one’s mood is a pile of crap.

After an eternal couple of months, it’s time to assess whether the new med seems to be helping–and if not, it’s time to start over again with the next candidate, beginning the cycle of side effects all over again. Anyone who thinks psych meds are a crutch used by people who want to avoid the pain of life is invited to ride this merry-go-round a few times, until they understand it’s not the easy way out. It sucks, and we wouldn’t do it if we weren’t convinced it was our best bet for being more present and useful to the world and the people we love.

Blankets Kill

I hear a lot of blanket statements about mental health care these days. The people making them usually mean well, and do not realize the harm they are causing.

In recent years, there has been growing awareness about the overprescription of psych meds, the irresponsible assigning of diagnoses and other toxic aspects of the domination of Western medicine perspectives. This is a good thing.

Unfortunately, however, it is getting translated into a common and frequently aired attitude that ALL psych meds are bad and anyone taking them is some kind of a) ignorant victim in need of enlightenment or b) lazy, compliant sheep unwilling to face their feelings without some kind of crutch.

Blanket statements about ANY group of people are dangerous. When the group of people is at constant risk for serious to fatal behaviors, blanket statements can kill. They can kill by increasing stigma and decreasing the tendency to get help.

Anyone managing a mental health issue has been on the receiving end of so much stigma and judgment already that your words have incredible power.

So you’ve got opinions about this issue. So you think Big Pharma is evil and out for money. Fine. But quit with the black and white thinking and admit you don’t understand the contents of everyone’s skull. Open your mind to the idea that there can be people who have tried many things and found a responsibly managed meds regimen to be the least of evils. People, like me, who choose it because it allows them to be more present in the world, to help their families and others, to stick around instead of hurting themselves. People who find it a useful tool to add to the psychological and emotional work they ARE doing.

You want to help? Advocate for making competent help available to all, so people aren’t getting these meds from unqualified doctors. Advocate for making competent psychotherapy and counseling available to the non-wealthy, since we know that with or without meds this is a huge need. Advocate for a general decrease of stigma.

And stop judging us. Somebody, somewhere, committed suicide today because they were caught in a web of shame and saw no road out. Blankets kill.

Just Sick Enough

When you have a psychiatric diagnosis, there are times when it’s obvious you need help. Other times, it might not be as obvious.

I had to jump through some hoops recently to get seen by a psychiatrist with my new insurance. Among these hoops were multiple rounds of the same questions about the nature and severity of my symptoms.  As I tried to answer as patiently and honestly as possible, I was aware of feeling anxiety about whether I would be deemed “sick enough” to be worthy of care.

You see, although I have been under some form of care for many years, it’s been seven years since the last time I was in a hospital outpatient program and nine years since the last time I was hospitalized outright. I’m only on one relatively benign mood stabilizer.

In recent years, I have been aware of how lucky I am to be where I am. I work hard not to throw this good luck away by falling back into addiction or other self-destructive behavior. But should “doing well” mean I don’t need help any more? Especially with bipolar, where patients are quite likely to float out the door while in a happy place, stop their meds, and wind up in the ER?

So it’s a dance. Be sure to appear “sick enough” to be taken seriously, without appearing so ill that you get a level of intervention you don’t need or want. Be eloquent enough about what goes on in your head to make sure someone knows you aren’t “fixed.”

Why? Why not just have enjoy having fewer appointments and one less thing on your current record? My reason is simple: my condition means that matter how well I am doing, it is possible for me to have a serious episode and need more help. Having a psychiatrist of record means having someone to call for an urgent meds adjustment. In the event of dire need, it means I have a name to give the ER staff.

It’s regrettable that people like me must defend our need to be responsible and prepared for trouble.