Friday, 12 August 2011

Medication + Mental Illness

One of the biggest misconceptions about mental illness is medication. This isn't a psychiatry or pharmacology lecture, so I won't be detailing the physiological causes of mental illness, and I won't be discussing how it's believed that medication works - because unfortunately, we don't really know. Basically what scientists think is that there are chemical irregularities in the brain, and certain medications cause changes in the brain that counteract depression in about 2/3 people. But if you do want some kind of background, feel free to message me or inbox me on facebook, I'm fairly well researched in this topic.

In this blog I'm going to be talking about the antidepressant drugs I've been prescribed in the past and how they've worked for me. The thing is, I've already mentioned that my diagnosis was bipolar disorder, which is usually treated with mood stabilizers, NOT antidepressants. Unfortunately, no intelligent GP will prescribe these mood stabilizing drugs because the levels in the body have to be kept within a very specific range and require specialist supervision. . which is why I'm waiting for that psychiatrist appointment ! I'm just on antidepressants currently to take the edge off the negative symptoms I have, the 'downs' I mentioned in my last blog.

 The thing about antidepressants is, they are only really useful in people who have severe depression. People with mild to moderate depression are usually people who are experiencing some kind of traumatic event in life and benefit greatly from psychologists + counselors to help them deal with their problem. But for us 'chemically irregular' mentally ill folk, talking about our problems doesn't fix much - mostly because we don't know why we're sad or angry or demotivated or whatever is going on. Also, before I get started I just want to make a point of saying these drugs work differently for everyone, and I can only document my personal experiences with them. You could give someone else the same drug and it could have a completely different effect, so this isn't really a drug review per se.

ENDEP (AMITRIPTYLINE); I was prescribed this drug before I was actually diagnosed with anything. I just went to the doctor because the pain I experience and the insomnia I was experiencing were driving me CRAZY. So I was prescribed this drug to help me sleep, and boy did it work. Infact, it worked so well that staying awake soon became the problem. There were other side effects too - having a dry mouth half the time was fairly annoying but tolerable. However, the hunger was pretty irritating. And when I say hunger I don't mean 'I'll sit in front of the television with some BBQ shapes', I mean this kind of hunger where I was waiting for people to leave the room so I could gnaw on the furniture in peace. It was awful. I definitely gained a few kilograms in a few weeks. So my friendship with endep was short lived, however my emotional problems were becoming far worse, so I was off to the doctor again.

CYMBALTA (DULOEXTINE); My doctor diagnosed me with bipolar and prescribed me these drugs + regular visits to the psychologist. The psychologist was a lovely lady - but when you don't know why you feel the way you do, and external events have no impact on your internal thinking/moods/etc, then there wasn't a lot she could do. So it was just me and the drugs after that. Cymbalta is from a different class of antidepressant to endep, which is why it had very different side effects. The dry mouth was there, plus nausea and insomnia for the first few days. After that subsided, I had reduced appetite, so I lost weight really easily. It took away my physical pain and helped me sleep. Unfortunately, again I was sleeping too much. I persevered with drugs for about 6 months before I threw in the towel. They did take the edge off life so to speak - the sad days weren't as crippling, the ups were more frequent. . but the fatigue wasn't worth it. By now my doctor had entered some kind of unofficial semi-retirement so I found a new GP and she helped me taper down the dose. You never go off antidepressants cold turkey - and with good reason. Even with tapering down the dose slowly I felt like I had the flu for about 2 weeks, plus I was frequently experiencing this phenomena we in the industry call 'brain zaps'. Ever been really drunk and turned your head too fast, and you experienced 2 seconds of intense dizziness ? It's like that, plus this weird jolt feeling to your brain. They sound fun but they're awful, and they were happening every few minutes. Anyway, my doctor made me fill out this form with all these questions to calculate a depression+anxiety+etc. rating. I went back to see her a few weeks later + answered the same questions. Unfortunately my scores had doubled (=a bad thing) so I was put on new drugs.

EFFEXOR (VENLAFAXINE); Effexor is amazing, really. I had the whole nausea and insomnia thing to begin with, but then this really strange thing happened. I was sitting at work one night thinking about something really cute morgan did when we first started seeing each other, and I felt this weird feeling in my chest. My heart actually felt all warm and ticklish. I figured this must be what love feels like, and boy, it feels nice ! My mood improved quickly in the first fortnight, for the first time in a long time I felt really, really good. Unfortunately, like cymbalta + endep, the sleepiness was a problem. I had zero energy, and would mentally rate how good days were by how often / how long I could nap for. One time, I was so tired I couldn't even be bothered moving my tongue when I spoke. I went back to my GP and she said that unfortunately, we should move on to a new drug. I was quite sad, my friendship with effexor was over so soon, and it was so promising ! But at the end of the day, what's the point in being happy when you're only awake for less than 8 hours ? I was told 3 days cold turkey, and then onto the new drug. I felt like I had the flu again, but the brain zaps weren't so bad. However, I was an emotional wreck. I even yelled at my dad, which made me feel awful. . I never yell at my dad :C

LEXAPRO (ESCITALOPRAM OXALATE); This is the drug I've been taking for the past two days (just half the recommended dose to warm up). To be fair, that isn't really enough time to make an accurate assessment on how it's going to go, but already my sleepiness has reduced drastically. In fact, today I forced myself to take a nap because I got so bored ! I'm not used to being awake this much and I'm just starting to realise how many god damn hours there are in the day. . My mood is slightly better but still recovering from the whole cold turkey thing.

That basically brings us up to speed with my medication history ! It really frustrates me that people think antidepressants are just these happy pills for sooky people. They don't even work on non-depressed people, and the people who are sincerely depressed experience so many side effects and may not even end up happy. Sometimes these drugs just work to numb you, and then you have to decide what is worse - feeling sad most of the time or feeling nothing at all. They can help make you happy but that depends on the individuals brain chemistry, and it's also a matter of finding the right drug, which can put your body through hell and back. Some people don't agree with the use of antidepressants but at the end of the day, if you had a headache you'd take panadol, why wouldn't you treat major depression + other mental illnesses ? They're no different.

So to summarise !
a) kids, become public health system psychiatrists. WE NEED YOU.
b) antidepressants are recommended for the severely depressed only - they are ineffective on people with mild to moderate depression.
c) They're not just 'happy pills' - they have plenty of awful side effects and aren't just a quick fix.

Hopefully you enjoyed reading + learnt something new. I haven't really decided what my next blog will be on, but I'm thinking relationships + mental illness, just to highlight to everyone what my poor boyfriend puts up with + why I can be so hard to live with. If anyone has a request for a topic they'd like instead, let me know ! I'm doing it to provide information to you guys !


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