Wednesday, April 4, 2012

It wasn't hypomania

I did not sleep much last night. And I didn't feel sleepy today. Instead, I felt very awake. I felt my emotions were very strong, my thoughts were very loud, and a little racy. My anxiety was up, and increased over the course of the day.

Oh great, I thought. I am getting hypomanic. And it isn't a nice one. My doctor is right, I really do need to go on lithium... I even broke down and took a quarter milligram of klonopin.

And then I got home, and saw my bottle of Zyprexa on the table. I had forgot to put my Zyprexa in with my nighttime meds when I "did my meds" for the week. I was off Zyprexa. That was all.

And because I didn't know that's what it was, it brought out all my fears. A part of me even started to think, maybe I haven't seen the last of the inside of a locked hospital ward. Which is really something I wouldn't like- because they would just want to give me antipsychotics, no doubt, and that is what I am trying to get off.

I blame insurance companies and psych hospitals in part for the increased use of antipsychotics for non-schizophrenics. There was a time when they would keep you 3 or 4 weeks for a depressive or manic episode- enough time for an antidepressant or mood stabilizer to have a chance of kicking in. Now they want you out the door as fast as you come in. And the only way to do that, if you are very distressed or agitated, is to put you on an antipsychotic, perhaps in addition to an antidepressant or a mood stabilizer. But as soon as you are calmer- "stablized" is the term they use- they kick you out the door. And then your outpatient doctor is afraid to take you off the meds that got you "stable," especially as an outpatient, so you are now on the antipsychotic, for a very long time if not for life.

And then if they do try to take you off of it- or if you try to go off of it yourself, you might get withdrawal symptoms, which will be interpreted as illness progression, or proof that you need the drug. And so there are studies that show people who stop taking their meds relapse sooner. That doesn't prove they should be on them, or that they improve long-term outcomes. If you take an addict off of cocaine, a good number of them are going to have symptoms of mental illness for a while- it doesn't mean they should take it for life.

I am trying to get off of Zyprexa without relapsing. My therapist- who I think I will continue to see for a while- actually had an interesting suggesting. I was telling her that I don't know how to do this while working as many hours a week as I do, and having to function at a very high level. She suggested taking a medical leave to try to get off of the last bit of it.

It is an interesting idea, and one that deserves consideration. Most people go on leaves to go on meds, not off of them! But if you no longer need a medication, if it is bad for your health, and you can't get off of it... why wouldn't this be appropriate?

But not now. And not without trying to taper down some more.

My psychiatrist had the idea of going on klonopin to get off of Zyprexa, and then tapering off of the klonopin. And I actually found the blog of someone else who did that. But I think I would be too impaired to function at work if I was taking that much klonopin. I'm not worried about getting off of klonopin- I have had to taper down from large dosages twice, and it was never that difficult as long as I did it at my own pace. The last half milligram, that was the only hard part, but I did it.

Someday I will be writing about something other than meds again in the blog!

I don't think my therapist believes me when I tell her that I wasn't like this a year ago. Since I have known her, I have been questioning. I always questioned the Zyprexa, but I didn't even know how bad it was- I thought it was just weight gain and tardive dyskinisia (as if that isn't enough!). But there has been all this new research out about what the antipsychotics do to your brains- and the longer you are on them, the more brain volumn you lose.

Granted, this research wasn't there when I was first put on the antipsychotics. And in fact, I was also told that the risk of TD with the atypicals was minimal. But I wonder if what people are being told today has changed.

And now I am questioning, not just Zyprexa, but meds in general. This is new to me. Sure, when they weren't working, and obviously making me worse, I questioned. I assumed my psychiatrist was just an idiot! But antidepressants have pulled me out of some very, very deep depressions that I thought I could never emerge from, when I didn't even think that something as simple as a pill could ever fix. In fact, sometimes I got mad when a pill made me better. All that suffering! I thought it meant something! And it was just some biochemical hiccup that some pill can fix! I was mad, but grateful too. I kept taking my pills.

This is the year I discovered Robert Whitaker's work, and that there is more to the anti-medication movement than crazy scientologists. There are a lot of research studies out there in peer reviewed journals whose finding have huge implications for mental health treatment, and yet no one is talking about them- well, no one in the main stream media or main steam medical community.

So I need to figure out what to do about these findings, I need to figure out what all this new information means for me. What do I do? I don't trust that my psychiatrist is going to be able to have all the answers for me. But I want to hear his perspective.

1 comment:

ashmc2 said...

What I hated the most about the psych ward was the rigid incessant control. Lights-out at 9:oopm is patranizing in the least for an insomniac. And, oh yea, the freakin' crazy people! Klonopin used to put me in a stupor. You seem to have a plan. That means a ton why you work your meds against your neurons. Go slow, so if you pass that fine line, you still aren't too far from being regulated. Better than a full-on collapse, ending in a month of turmoil and risk as you get your doses back to therapeudic level. Just stick to your good plan and I will be wishing you sucess.