Wednesday, October 16, 2013

Adventures in Medicating

Skip this post if you're not interested in my ongoing medication/therapy/mental health roller coaster. THERE. You've been warned.

A little over a year ago, I started a new medication. It's one commonly used to treat bipolar disorder, but in my case it was being used for, as my doctor put it, "treatment-resistant depression." At first, this drug seemed to be doing the trick. I don't remember if I updated later, nor do I currently have the energy to look, but in any case the initial high that I seem to get with any new anti-depressant once again didn't last. I stayed on it, and felt like maybe I was just able to cope better than before, and thus it was certainly helpful, right?

At some point, my company switched insurance companies and the doctor who prescribed this medication didn't take the new stuff. Figures. I found a new place where they use nurse practitioners for the medication part of mental health wellness, and once again went through the intake process. She asked me questions about feeling manic, but since my answers were all negative, I didn't think anything of it. I didn't like this nurse much, so when she transferred offices and I was assigned someone new, I was happy. I did sort of a mini-intake with the new nurse, since she had the notes from the previous woman, and when she made mention of bipolar now and then, I simply thought she was being general or thorough about what this medication was for and could do - I didn't realize right away that she inferred by the prescription itself that someone, somewhere, had actually diagnosed me as bipolar.

Several months ago, we tried weaning me off the medication, but I had a bit of a breakdown so that decision was reversed. I went back on, but at a lower dosage, and added in anti-anxiety pills. By now, there's a girl at my pharmacy who knows me by sight. I'm not entirely sure how I feel about that, although I suppose it's kind of nice not to have to spell my last name every time anymore. If any of the other employees now recognize me and remember my name, they at least hide it.

Between these 2 drugs, I once again felt like I was, at least, capable of handling stress. It was better than before. But, sidebar, let's talk about my cat's health for a minute. This last year he was diagnosed with IBD, which is actually kind of a funny thing to say a cat is "diagnosed" with, because the loose translation of IBD in cats is "we don't actually know what's wrong, but it's definitely something with his digestive system." The treatment is quite similar to that of mental health treatment for people: try these drugs... see how it goes... maybe try these drugs with those drugs... how's that? no? okay, let's try these and maybe some of that... It goes on like this until you find the right cocktail. Guess and check.

The other similarity is the question, for the patient, of where to set the bar. With my cat, it's his poop. Yep, I managed to take this very serious post and put some shit in it. Awww, yeah! Now that's finesse. So IBD means my cat has un-good poos. With the various combinations of drugs and shots and supplements we've been going through, the poos have improved, but about a month ago I found myself wondering, where do I set the bar for quality of poo? It's better than it was, by far, but is it good enough? Can we do better?

And that's the big question, isn't it? Is this good enough?

In my cat's case, the answer was no. I went in to the vet and, no joke, asked him to look at my cat's poo and told him I needed to know where to set the poo bar. THE POO BAR. Yup, this is how I talk to professionals. And in the end, I'm glad I did, because his answer was, "we can do a LOT better" and now we're trying new cocktails of drugs for him.

And that's where I'm at now. Last week I had the kind of horrific breakdown that hurts everything about me, inside and out, and I even looked up the number for Hopeline on my phone as I sat in my car, sobbing and shivering. I ended up deciding I was entirely too cold, so I would call when I got home, and then when I got home, the aforementioned cat was loud and demanding and wanted food and attention RIGHT MEOW, and I thought, "welp. There it is: my reason to stay." But that night made me realize: this is not good enough.

I took the next day to work from home, cry fairly steadily, and think things over. Had the medications really helped? Sure, I felt like I was coping better... I could continue to function through the depression... but the depression was still there. It's kind of a constant fog in my life, from which I can sometimes emerge for a while - a day, a week, even a few weeks if I'm lucky - but it's always there, and it's always just one bad sleep, one rough day, one upset away from engulfing me again. The meds gave me the ability to remain standing and moving and getting through the basics of life, but the fog never went far from me.

After this breakdown, I decided that wasn't enough for me. The poo bar had been set way too low and I needed to address this.

Today I went back to my nurse practitioner and I told her all of this - "my base level of functioning seems to be depression. When you ask me if I'm doing okay and I say yes, it really just means 'I don't want to kill myself right now.'" She took all of this in carefully and thoughtfully. She mentioned something about bipolar and I interrupted, finally, to tell her that if anyone has ever diagnosed me as such, they didn't tell me. That I was on the current medication because of depression, not bipolar disorder. She looked surprised, and went back over her intake notes with me, and those of the nurse before her. After some quiet review, she turned to me and said, "you're right. There's no indication anywhere that you're symptomatic for bipolar." Funny how even though both women had asked me questions about it before, neither had then said, "you don't appear to show signs of bipolar disorder, so why are you on this medication?" Maybe they just thought that was a sign it was working! And I learned my lesson about speaking up with my doctors.

In the end, I'm adding yet another pill to my repertoire, with the plan that once it's in my system, I can ease off the others - again, like with my cat, "we don't want to make too many changes at once."

If anyone else is reading this, and struggling, and wondering if this is how everyone feels... ask yourself, is my poo bar set too low? One of my best friends told me once that being on medication for mental health is no different than needing glasses or contacts - there's no shame.


  1. I'm glad you write about your depression. One person I know with it has a hard time explaining what they're going through so you never really know what's happening.

    1. I hope it helps that person find words to articulate their feelings. I know it must be difficult for you to learn how to comfort and support if it's difficult to understand what's happening. That's something I've been working on with Boyfriend - figuring out what I need from him during the "dark times" and communicating that to him so he doesn't feel as helpless and frustrated, not knowing how to "make it better."