For those of us who need meds, getting on them is almost as difficult--sometimes more--than finding a good therapist. For one thing, medication culture has made it harder to find a good prescribing doc. For another, meds take time to work and are fraught with possible side effects.
Let's start with finding a prescribing doc, since, obviously, meds can't happen without one of those. The safest way, I've found, to find a psychiatrist, is to ask your therapist for recommendations. She will usually know of someone safe and good.
What makes a prescribing doc safe and good?
1. One who listens to you. Appointments are generally fifteen minutes long. About five to ten of those should be spent talking about how you're feeling.
And--this--is a really important note: you HAVE to be honest with your prescribing doc. If you're just feeling "not suicidal" but you tell her you're "fine," she doesn't know any better. She can't read your mind.
But if you DO say "fine" and she doesn't press, doesn't ask questions about, say, sleep patterns and enjoyment of regular activities? Find another doc. Depressives are taught by society not to express themselves. Any doctor should know that's a self-protective measure.
2. One who explains things. You're NOT a doctor. You don't know what one drug does as opposed to the next. It's your doctor's responsibility to explain that to you, and to make sure your questions are answered.
3. One who gives you choices. You're the person who has to go on these meds. If you're doc is telling you something is imperative, i.e., "this is the only med that will work for you," something is hinky. Instead you're doctor should say, "there are a couple of routes we can go, here are the pros and cons of each," and leave the final decision up to you. It's rare that there's only one treatment option, this is not an exact science.
Let's assume you've found a doctor who fulfills all those prerequisites, now what?
Well, first of all, it's going to take about six weeks for the meds to kick in if this is your first go around. Do not freak out if nothing happens--that just means you need to try something else. Alternatively, also do not freak out if what happens is you stop sleeping and/or start gaining crazy amounts of weight, or some other serious side effect. Again, this probably just means you need to try something else.
TALK to your doctor about all these things. Tell her what's bothering you about it, what's working about it. Meds can be tweaked time and again--and need to be. I've had to change meds seven to eight times in the last seven years due either to them ceasing to be effective, or having counter-indications, or just side-effects that I couldn't stand. For instance, when I first when on Prozac, I stopped sleeping. Like, at all.
Sometimes, it takes a combo. I'm currently on a cocktail of Welbutrin, Lexapro, AND Abilify. There are side effects. There are going to be side effects with almost any of these drugs. It's a matter of whether you can handle them, or if they are worth the trade-off of not being suicidal and never wanting to get out of bed. For me, Lexapro and Abilify cause weight gain, something that is hard, because I have body dysmorphia. It's another reason why I exercise so much. But I make myself handle it in order to enjoy daily things like writing and spending time with my pets.
Medication is NOT for everyone, but if you've spent significant chunks of your life feeling hopeless and wanting to just close your eyes and sleep forever? It's definitely worth a shot.
I was amazed to find, when I first got on meds that worked for me, that there was someone underneath all that pressing, obliterating hopelessness, someone I actually found pretty interesting and diverse. There might be someone inside of you who you want to meet. It really is worth a shot.
Showing posts with label Prozac. Show all posts
Showing posts with label Prozac. Show all posts
Saturday, December 6, 2014
Sunday, October 12, 2014
It's Not a Happy Pill, It's an Anti-Depressant
In 2007, I went on anti-depressants. This is notable, because I was diagnosed as needing to be on medication in 1999.
Why the eight-year hesitation? A few things:
1. Anti-depressants have a HUGE stigma to them. The term "happy pills" in an of itself is an issue, it suggests that people who need--not want, NEED--to be on these kinds of medications are in fact just looking for an easy out. It's as if we're somehow just going to our doctor instead of down the street to score some illegal substance that makes us feel better for a few hours.
To illustrate, here is a comment once directed at me by a family member. A family member, who, by the way, is nominally in the health industry: "Yeah, anti-depressants are great in the wake of, say, a tragedy. I took some [when my father died] and they helped me to get through it. But you can't live your life on a pill just to make everything easier."
In other words: stop being weak. The rest of us are just fine without pills to help us get through the day.
2. Anti-depressants come with side-effects. One of the most common is significant weight gain, which isn't fun for anyone, but for a woman--and, in my case, a woman who already has societally-induced body dysmorphia--that can be devastating.
On one of them, I stopped sleeping. On another, I was so nauseated that even basic toast wanted to come back up.
Additionally, they can have counter-indications. I was on Prozac long enough that it started CAUSING suicidal ideation, rather than alleviating it. They also cause long-term liver damage, which means they essentially shorten the lifespan of almost anyone on them.
To sum up: they are not fun and are terrible on your body.
3. For me, I was terrified. What if I went on them and they didn't work, and this was what life was like for the rest of it, a very possible seventy or more years? More importantly, what if I went on them and they didn't work because there was nothing wrong with me other than being lazy and pessimistic and a bad person?
In the end, though, I had to try. Because, honestly, things couldn't get worse, and the hope, however small, that they might get better was impossible to turn away from. My medication history has been full of ups and downs. It took several tries to find the right medication the first time, but I will never, not if I live to one million and three, forget the feeling I had when the right one--Lexapro, at that time--kicked in.
It wasn't sudden, it was slow, but there was one day when I got home from work and the gym, and wanted to do something that wasn't sleep. I had the feeling tomorrow might be a pretty good day. I felt like ticking a few things off my to-do list. And I thought, "Huh, look at that. There's a person in there."
And then I cried. Because for the first time since I could remember, I could feel something that wasn't soul-numbing hopelessness. Even if it was sadness that I'd waited so long to go on the meds, it was real, an emotion, not just a blanket of brain chemical malfunction. And, as it turned out, when on meds that work, I'm actually pretty chill about a lot of things, even things that objectively suck.
Now, let me be clear: when I am on anti-depressants that work, not everything is easy. Life is still life. It is still stressful, and I still have to accept that I am not going to get a lot of things I want or wish for. People can still be hurtful, and loss still occurs.
The difference is, my brain's default reaction to all of this is not, "What's the point? Why should I bother with this anymore?" or, at the worst, "Everything and everyone would be so much better off if I just sat down with a bottle of pills and disappeared."
That's not a happy pill. I've never taken any hardcore street drugs, but from what I have been told by people who have, it's a COMPLETELY different sensation. What's more, it's ephemeral. You come down from it.
Anti-depressants don't cause happiness. They cause the brain to work the way it's supposed to.
Here's the truth: being on anti-depressants is a pain in the ass. Forget all the stuff I mentioned above, okay? Your body gets used to them. And you slip back into depression. And sometimes the best they can manage is to keep you from living in a haze of suicidal ideation. Sometimes it takes years to find the right combo, because just having that much help makes it feel like they're working. And, to some extent they are.
I have changed meds seven times since 2007. Every time is a gamble. And for years at a time, I have been willing to accept, "not actively suicidal" as "meds are working."
I'm lucky right now. I'm on the one-two-three punch of Welbutrin, Lexapro, and Abilify and it WORKS. It works in the way where, when I have free time, I actually want to read or write or watch some television, instead of sleep. It works where I can do things like plan ahead: go to the grocery store with an actual list, and come home and make meals for the week. It sounds simple. It's not. It's the difference between a life that is just made up of days of forcing myself out of bed and to do every little thing that has to be done until I can get back in bed, and days where my life is actually happening, and I'm an active participant in it. And because they actually work, instead of just providing base-stabilization, it's the first time since 2011, which was the last time I was on a combo that fully worked, that I can remember who I'm like as a person underneath the depression.
Right now, my insurance is refusing to support the Abilify, which means I'm going to have to appeal and try and figure out another way if they still refuse, since it is $830/month, which is, you know, outside my ability to afford. I'm still underemployed, and still have been for over two years. My rabbit has an ear infection that will not go away, and my dog vomited directly where I sleep on my bed while I was dancing Friday night. And you know what? It's all okay. I'll find a way to afford the drug, because I need it, and I have always figured out ways before. My rabbit is almost nine years old and this is her first ear infection, which is a near miracle. The puking forced me to clean my mattress, which really needed it. And I'm in the process of interviewing for a job I might get. If I don't, well, back to the drawing board.
I cannot emphasize enough: these drugs aren't happy pills. They do not blind me to the things that I'd rather NOT happen in my life. They don't give me moments of ecstasy. They allow me to COPE and to live my life without the constant specter of suicide.
If you or someone you know is avoiding medication because of stigma or fear, I cannot stress enough that neither of those are good enough reasons to continue being miserable. Please, please try, or get them to try, talking to a prescribing doctor. Maybe meds aren't for you. But maybe they are. And maybe underneath how terrible everything is, there's a person, screaming that zie just needs a little help, just a shove in the right direction. Get yourself, or try to help the person you love get that shove.
Why the eight-year hesitation? A few things:
1. Anti-depressants have a HUGE stigma to them. The term "happy pills" in an of itself is an issue, it suggests that people who need--not want, NEED--to be on these kinds of medications are in fact just looking for an easy out. It's as if we're somehow just going to our doctor instead of down the street to score some illegal substance that makes us feel better for a few hours.
To illustrate, here is a comment once directed at me by a family member. A family member, who, by the way, is nominally in the health industry: "Yeah, anti-depressants are great in the wake of, say, a tragedy. I took some [when my father died] and they helped me to get through it. But you can't live your life on a pill just to make everything easier."
In other words: stop being weak. The rest of us are just fine without pills to help us get through the day.
2. Anti-depressants come with side-effects. One of the most common is significant weight gain, which isn't fun for anyone, but for a woman--and, in my case, a woman who already has societally-induced body dysmorphia--that can be devastating.
On one of them, I stopped sleeping. On another, I was so nauseated that even basic toast wanted to come back up.
Additionally, they can have counter-indications. I was on Prozac long enough that it started CAUSING suicidal ideation, rather than alleviating it. They also cause long-term liver damage, which means they essentially shorten the lifespan of almost anyone on them.
To sum up: they are not fun and are terrible on your body.
3. For me, I was terrified. What if I went on them and they didn't work, and this was what life was like for the rest of it, a very possible seventy or more years? More importantly, what if I went on them and they didn't work because there was nothing wrong with me other than being lazy and pessimistic and a bad person?
In the end, though, I had to try. Because, honestly, things couldn't get worse, and the hope, however small, that they might get better was impossible to turn away from. My medication history has been full of ups and downs. It took several tries to find the right medication the first time, but I will never, not if I live to one million and three, forget the feeling I had when the right one--Lexapro, at that time--kicked in.
It wasn't sudden, it was slow, but there was one day when I got home from work and the gym, and wanted to do something that wasn't sleep. I had the feeling tomorrow might be a pretty good day. I felt like ticking a few things off my to-do list. And I thought, "Huh, look at that. There's a person in there."
And then I cried. Because for the first time since I could remember, I could feel something that wasn't soul-numbing hopelessness. Even if it was sadness that I'd waited so long to go on the meds, it was real, an emotion, not just a blanket of brain chemical malfunction. And, as it turned out, when on meds that work, I'm actually pretty chill about a lot of things, even things that objectively suck.
Now, let me be clear: when I am on anti-depressants that work, not everything is easy. Life is still life. It is still stressful, and I still have to accept that I am not going to get a lot of things I want or wish for. People can still be hurtful, and loss still occurs.
The difference is, my brain's default reaction to all of this is not, "What's the point? Why should I bother with this anymore?" or, at the worst, "Everything and everyone would be so much better off if I just sat down with a bottle of pills and disappeared."
That's not a happy pill. I've never taken any hardcore street drugs, but from what I have been told by people who have, it's a COMPLETELY different sensation. What's more, it's ephemeral. You come down from it.
Anti-depressants don't cause happiness. They cause the brain to work the way it's supposed to.
Here's the truth: being on anti-depressants is a pain in the ass. Forget all the stuff I mentioned above, okay? Your body gets used to them. And you slip back into depression. And sometimes the best they can manage is to keep you from living in a haze of suicidal ideation. Sometimes it takes years to find the right combo, because just having that much help makes it feel like they're working. And, to some extent they are.
I have changed meds seven times since 2007. Every time is a gamble. And for years at a time, I have been willing to accept, "not actively suicidal" as "meds are working."
I'm lucky right now. I'm on the one-two-three punch of Welbutrin, Lexapro, and Abilify and it WORKS. It works in the way where, when I have free time, I actually want to read or write or watch some television, instead of sleep. It works where I can do things like plan ahead: go to the grocery store with an actual list, and come home and make meals for the week. It sounds simple. It's not. It's the difference between a life that is just made up of days of forcing myself out of bed and to do every little thing that has to be done until I can get back in bed, and days where my life is actually happening, and I'm an active participant in it. And because they actually work, instead of just providing base-stabilization, it's the first time since 2011, which was the last time I was on a combo that fully worked, that I can remember who I'm like as a person underneath the depression.
Right now, my insurance is refusing to support the Abilify, which means I'm going to have to appeal and try and figure out another way if they still refuse, since it is $830/month, which is, you know, outside my ability to afford. I'm still underemployed, and still have been for over two years. My rabbit has an ear infection that will not go away, and my dog vomited directly where I sleep on my bed while I was dancing Friday night. And you know what? It's all okay. I'll find a way to afford the drug, because I need it, and I have always figured out ways before. My rabbit is almost nine years old and this is her first ear infection, which is a near miracle. The puking forced me to clean my mattress, which really needed it. And I'm in the process of interviewing for a job I might get. If I don't, well, back to the drawing board.
I cannot emphasize enough: these drugs aren't happy pills. They do not blind me to the things that I'd rather NOT happen in my life. They don't give me moments of ecstasy. They allow me to COPE and to live my life without the constant specter of suicide.
If you or someone you know is avoiding medication because of stigma or fear, I cannot stress enough that neither of those are good enough reasons to continue being miserable. Please, please try, or get them to try, talking to a prescribing doctor. Maybe meds aren't for you. But maybe they are. And maybe underneath how terrible everything is, there's a person, screaming that zie just needs a little help, just a shove in the right direction. Get yourself, or try to help the person you love get that shove.
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