Tuesday, July 26, 2016

Medication: A Love/Hate Relationship

Yes, it's another entry about medication.  This stuff is really important though, and worth another discussion.  
I am going to start this post with a disclaimer: I am not a psychiatrist, nor am I any sort of doctor.  I can’t give medical advice other than to say that if you have any sort of issue with psych meds, speak to your psychiatrist, or medical practitioner.  If you are experiencing a psychiatric emergency, go to your nearest emergency room, or dial your local emergency number.  
Having both worked in mental health and being a mental health patient myself, I have a lot of experience with psychiatric medications.  Additionally, I take medication for my Cerebral Palsy.  I have had my fair share of patients tell me they were having trouble getting their mind around having to take a medication every day for the rest of their life.  I heard this sentiment more often from younger clients, but certainly from people of all different stages of adulthood.  My favorite one was during a group at my job at the state hospital.  I'd been facilitating this group for about six months, so the participants knew me, and each other, well.  They knew that I don't do pity parties, and that I am big on personal responsibility and accountability.  The group got into a fairly heated discussion about psychiatric medications.  A person released from the state hospital can, under certain circumstances, be returned to the hospital even after earning release if he or she stops taking their prescribed psychiatric medications.  This is a bone of contention for many of the patients, especially the ones who are back at the hospital for this very reason.  So, during this particular group, the new member attempted to play upon my sympathies by saying to me, “(my name), you have no idea what this feels like though.  I am going to have to take a pill every single day for the rest of my life just to function!”  I could hear the other guys in the group start snickering.  I cocked my head, looked at him, and stood up on my good leg, allowing my bad arm to dangle.  I almost never let my patients see me like that, but this instance called for it.
“Really?” I asked.  “Care to repeat that?”  The man stammered out an apology, and stopped talking.  
It’s a pretty big head trip to know I need medications just to get through my day.  People with both physical and psychiatric diagnoses have even more medications to manage.  I have Cerebral Palsy, Depression, and Anxiety.  Each is medicated a little differently.  I take medications which work together to give me better results.  It means carrying a lot of pills with me when I travel.  I go to the pharmacy multiple times in a given month because of course, they’re not all on the same refill cycle.  In a way it’s good though, because I’d never be able to afford all of them at once.  I tell you this not for pity nor sympathy.  I certainly don’t say it to be an inspiration!  I want someone else facing this to know that I get it, and you’re not alone.
When I had a patient come back into the hospital after having gone off of medications, I always sat down and talked with them as soon as they were stabilized to figure out why?  The answer was frequently this: The patient started feeling good.  This happens when the meds are right, and it’s a wonderful thing!  He or she started thinking, “What if I skip a day?  What’s the worst that could happen?”  Then they notice they don’t have the side effects anymore.  Some people who experience a lesser degree of Mania called Hypomania enjoy the slightly euphoric feeling, and the productivity that comes with it.  But then the symptoms start interfering with their ability to get things done.  They started skipping required meetings and appointments, which raised red flags.  Hopefully, their county worker caught up with them before any more damage was done, like say, a crime.  Hopefully.  The next thing they knew, they had a direct ticket back to inpatient treatment.  Do not pass go, do not collect 200 dollars.
What I hope to drive home is that this can be any of us.  I have written about side effects before, but it is worth repeating: If the side effects are unmanageable, talk to the prescribing doctor right away.  Pay attention to warning labels.  If you start to experience dangerous side effects, seek emergency treatment, please!  
I believe that feeling apathetic, indifferent, or just plain blah (technical term) about medications is a normal part of coming to terms with our need for them.  I used to ask my patients this: If you had Diabetes and needed insulin, would you take it?  If you had Cancer and needed chemotherapy, would you do it?  They would always answer, “Yes.”  
Mental health affects our well being as much as physical health.  To imply otherwise, or outright deny it, is cruel to the patient, and negates all the work that they do to deal with symptoms.  Medication is a large part of successful management of a mental illness, but it’s only a starting point.  It helps us to get our thinking back to where we can do everything else we need to do to feel our best.  If all I do is take my meds but don’t take care of everything else that makes me who I am, I am existing, but not living.  My hope for you is that you are able to get as much out of life as you can.  We don’t live our lives in spite of our diagnoses.  They are part of us.  It’s what we do with them and about them that defines us and our character.

Be well.

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