Sunday, February 26, 2006

Taking My Time

It's been a while since I posted an entry to this blog and to be honest, if it weren't for my friend Carol encouraging me to continue, I was seriously thinking about giving it up.

Why? Because there's something in me that says it's not all that healthy to write constantly about your illness. This could be interpreted two ways: First, as avoidance or second, as a sign of health. After all, if you're really mentally healthy, why would you want to keep dredging up the subject?

It would seem that a number of people have benefited by my discussion. And maybe I've benefited, too. So I'll keep writing, when the spirit moves me. It may not be on a regular basis but if nothing else, people use the links.

One of the last comments asked a few pertinent questions that I'll try to answer:

Mar tell us what it feels like when you take your meds. Does it makes you feel sedated? antsy? Why is it so common to stop taking them when a person does so much better on them. How long after you stop taking them do you begin to once again slip back into manic or depression. If you had a teenager would you sit on top of them until they took their medication for the day? Will you listen to someone telling you that you're not on your meds, or do you resent someone trying to direct your?

When I take the right combination of medication, I feel OK. When I went back on medication more than a year ago, it was a bitch. I had terrible tremors, I would fall asleep at any time, which made driving very dicey, and I couldn't focus on my work at all. It took a bit of doing and adjusting but now I'm fine. The anxiety is gone, the depression and mania are kept at bay, and I can still write, knit, spin, whatever.

People generally stop taking medication because they feel good. Duh. It's the medication that makes it so. I stopped my medication only once, in June of 2001. And it was not because I really wanted to or felt that I was "cured." It was a financial decision. My psychiatrist no longer took insurance at all, so I had to leave her. I couldn't afford the $180 a session. My primary care physician refused to continue my medication. So I went off meds. And stayed off for more than three years. During that time, my husband became ill and died, leaving me with no money and a big mortgage. I had to sell the house we built together and move. And still, I managed to stay balanced. I have no idea how.

However, in November of 2004, I again became extremely dysphoric, as is my tendency at this time in my life. Bad crying jags, extreme irritiblity accompanied by anxiety. It's sometimes hard to differentiate between dysphoria, a type of mania, and depression. However, with a true depression, it's very difficult to do anything. With dysphoria, you can still function, get up, go to work and so on. So back I went on meds. I was fortunate to find out that UMDNJ had a center not too far from my work that would take insurance. I didn't need anyone to tell me I needed to go back on meds. I know that better than anyone else.

Slipping back into depression or mania or both happen quickly or, in my case, slowly. It's a crapshoot. Everyone's different. The thing is, you are playing Russian Roulette if you go off your medication. Sure, you might not feel anything right away. But depression and mania are insidious and they can sneak up on ya before you know it.

As far as kids taking their meds, that's one I've never had to deal with. I think that rather than making medication a point of contention, I would work with my child so that they understood exactly how important medication is. And that's not easy either, especially with teenagers. The bottom line: You can't force anyone to take anything, be they adults or teenagers. It has to come from within. And if you force the issue, it becomes worse. Bipolar children are a special case, one that warrants specialized handling.

I do listen if someone says I need to be back on meds. Actually, I know it before it's apparent to my family. In fact, generally they don't have a clue because I tend to keep my behavior steady in public. It's in private that I don't do too well.

I think it's a good thing to feel someone out before suggesting that they need medication. Rather than say, "You need some drugs, your behavior is ridiculous," I think a better approach would be "Don't you think you'd feel better if you saw the doctor and see what s/he can do for you?" People with mental illness respond badly to demands, especially manic depressives.

However, everyone responds to love and caring. No matter how off the wall they are.


Christina said...

I take Cymbalta for depression and recently had to go on public assistance to receive my meds. It is a terrible experience for anyone with a mental disease to experience, because there are many times when you go to receive your meds (they only give you enough for a week at a time) that they tell you they don't have any, so you have to go 4-7 days without any meds. I get parasympathetic nerve buzzes that makes my heart pound, my head ache, and makes me very dizzy. I'm to the point where I might just stop taking the meds. In the past, when I had insurance, I'd go off of my meds because I thought I didn't need them. Now I might go off of them because I can't afford them.

Anonymous said...

Thanks Mar for blogging to my questions, I really appreciate it. You teach me how to help my family member. I tip my hat to my mom, she raised 3 good kids, worked like a man in the rubber factory and did all the housewife stuff. She was the only mom on our street who worked too. I grew up expecting women to have checking accounts (1950's) and make good money decisions without input from my dad. All the while she was manic depressive and without lithium. Looking back Iam amazed by her all the time.

Milinda said...

I work for a disability insurance & had an epiphany of a sort which was the result of my experience just getting the right meds.

I have some of the best insurance in the country. I have one of the best medical facilities in the State, certainly in the city. It still took me 6 months from the moment I made my 1st telephone call to when I felt like a normal, rational person. If it took me that long, I can only imagine what happens when someone is not so welll connected & protected.

I'm still hoping that the trembling will go away but that is a small price to pay for the sanity that I feel has returned to my life.

Marilyn said...

Six months isn't half bad, actually. It takes a huge amount of perserverence with medication.

A sorry tale, Christina. And unfortunately, all too common because of this country's non-existent public health insurance. I've been paying out of pocket for my meds the past few months and while lithium is cheap, antidepressants are not. You're talking $2-3 per pill in many cases.

Anon, your mom was amazing. I managed to raise two great kids, work full-time and sort of do housework but it was a continuous battle of me v. the illness. Too often, the disorder got the better of my housekeeping, that's for sure. And occasionally I would hugely lose my temper with the girls and with my husband. But you do the best you can and I know your mom did just that. Sounds like a woman to be admired.

Milinda, my tremors have dissipated a fair amount but they still show up now and then. I'm with you--it's a fair price to pay in exchange for relative wellness. Although it can be a pain in the ass when I'm trying to sley my loom.

Katherine said...

Any advice on how to find a therapist/psychiatrist? I'm not bipolar, "just" have depression and anxiety disorder and my current meds don't seem to be cutting it. For some reason I'm paralyzed here--it's very hard to find a psychiatrist who takes insurance, I think therapists are a little easier, but I'm having a hard time getting going on this. It's really scary--I'm very afraid whoever I find won't be good and then what? And yes, I know I can just find someone else, but it's really daunting.

Marilyn said...

It's tough, Katherine. I called my local hospital and they gave me names of psychiatrists. I totally lucked out with the one I picked. I decided upon a woman because I felt I could relate better. She took insurance at that time. Five years later, I had to leave her because she dropped the insurance.

You need a psychiatrist to prescribe the medication. Often, psychiatrists, psychologists and social workers work together to provide care. In groups such as these, your insurance is usually taken.

And you can't go by what a friend recommends, either. It's one thing to use the same dentist--that's a tangible service. Psychiatry and counseling is not.

So what I'm telling you is: It's a crapshoot. However, some help is better than none. Start with somebody and yes, if it doesn't work out, switch. That's the way it goes.

Matt said...

First I want to say that I love reading both your blogs, Marilyn. The one has inspired me in my knitting, and the other has been a great help in figuring out my own mental issues.

I've had my own ride on the med-go-round over the past year. My main issues are depression and anxiety, so not surprisingly my doctor started me on an SSRI (Zoloft). It worked for a few months, long enough for me to realize that I wasn't going to be happy until I got out of a bad work/living situation and moved across the country.

Unfortunately Zoloft crapped out about the time I finished moving, making starting a new job pretty difficult. My new psychiatrist decided I was somewhere on the mild end of the "bipolar spectrum." This makes sense now, since the Zoloft did make me what I'd call "hypo-hypomanic" -- I was sleeping fine, but I was spending too much money and starting numerous unfinishable projects. He put me on an anti-epileptic drug (Trileptal) that is working pretty well. Now the big hurdle is getting off of the Zoloft, since I happen to be very sensitive to the withdrawal symptoms. So, it's mg by mg, but I'm almost done. There's lots of great information on all this stuff at and crazymeds (both links I found on this blog).
I seem to have some things in common with those who are fully bipolar, but I'm having trouble finding information about anything besides bipolar types 1 or 2. Any ideas?