To medicate, or not to medicate…my thoughts on drugs

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Earlier this month I was asked to contribute to the “Talk About Your Medicines” awareness campaign established by the American Recall Center.  The ARC Center provides drug and medical device recall information alongside practical healthcare information and support.  Their aim is to make information about medications and medical devices easily accessible to the consumer, mine is to share my own experiences and opinions about taking medications.  My point of view is one of a dual-diagnosis alcoholic in recovery who takes psych drugs to treat Post Traumatic Stress Disorder and chronic depression.

I know that this can be a controversial subject, I’ve been to AA meetings where discussions about this have gotten pretty heated.  So, I want to stress that I am not a doctor or therapist, and I am not being compensated for this post.  I don’t claim to know or have insight into what will work for others regarding medications.  I only know what has and hasn’t worked for me.  That is my disclaimer.  I hope that no matter which side of the fence you are on about taking medications, you will continue reading and let me know what you think.

I grew up in a household that used over the counter medications for things like headaches and allergies, and prescription medicine when antibiotics were recommended by the doctor.  Aside from that, I never really took anything.  It was during the 70′s and 80′s, before everyone was on an anti-depressant and anti-anxiety drugs were handed out like candy.  While I was a kid, I never knew anyone on psych meds except my Aunt who my mom thought was crazy because, as my mom said, “she was strung out on Valium.”  Looking back, my Aunt probably took her Valium as prescribed for anxiety, but it was unusual to know someone who did that, so it had to be crazy.

I never thought that I would grow up and have to be on medication for psychiatric conditions myself.  Nor did  I think that I would become an alcoholic.  Little did I know, those two things often go hand in hand.  I believe that I have suffered from PTSD since I was raped as a teenager.  My condition was exacerbated when I suffered physical abuse from my ex-husband.  Although I went through a few bouts of adolescent depression, I think my real, chronic depression started when I got close to thirty years old.  My conditions remained undiagnosed though, until after I went to treatment for alcoholism the first time.  That’s where the ‘hand in hand’ thing came into play.  I never considered the fact that I might need some psychiatric help, I just self-medicated with alcohol.  Again and again.  And it worked at first.  And then it didn’t.

When I got to treatment and had to go see a psychiatrist while I was there, I wasn’t quite sure why.  I knew that I had some issues – I was in rehab, for Pete’s sake – but I didn’t think they were psychiatric.  I thought that all of my issues were caused by my alcoholism, not the other way around.  So when the psychiatrist said that I needed Zoloft and Abilify for depression, I balked.  My primary care physician had prescribed Lexapro for me a couple of years prior when I was going through a divorce, and that had made me feel crazier, almost suicidal, and I didn’t want to go through that again.  I didn’t know at the time that suicidal thoughts and ideations can be a side effect of anti-depressants, so I just thought they didn’t work for me.  Still, while I was in treatment I agreed to try the Zoloft, but adding the Abilify was just too much for me to accept, so I refused it.  I left treatment with a bunch of new tools for dealing with sobriety, but not properly treated for my psych condition.  I didn’t want to be on medication, to be ‘strung-out’, or to be reliant on something (drugs) for my mental health.

Guess what happened?

Yep. You’ve got it…I drank again.

When my psych conditions showed up again, I went back to the thing that worked before – booze.  But it really no longer worked, it made things much, much worse – but that’s a post for another day.  I found myself trying to self-medicate with no success, so I made a second trip to treatment.  This time I was, as they say in AA, ready to go to any lengths for my sobriety.  And that included being honest with, and listening to, the suggestions from the psychiatrist.   This time I went in with an open mind when it came to medication (and other treatments, including intensive childhood work in therapy), and I decided that I would try what was recommended and see what happened.  This time, as the Zoloft didn’t seem to be working and Lexapro had made me feel suicidal, Effexor was prescribed.  That’s when I learned that for some forms of depression and PTSD,  SNRI’s (which Effexor is) work more effectively than SSRI’s do (which Zoloft and Lexapro are).  SNRI’s, or selective serotonin-norepinephrine reuptake inhibitors, work with serotonin and norepinephrine, while SSRI’s only affect serotonin levels.  This small difference made all the difference for me.  Within a short amount of time, I could tell that I was feeling better.

I was also prescribed Seroquel to take at night to help stabilize my mood.  Seroquel is an antipsychotic medicine, it works by changing the actions of chemicals in the brain.  It is often used to treat schizophrenia and bipolar disorder,  which scared me a little, because I don’t have either of those.  But it is also used together with antidepressant medications to treat major depressive disorders.  The Effexor/Seroquel combination has been, and still is, working for me for the last two years.  I haven’t had the desire or the urge to drink to self-medicate.  I know that it is not the work of the medication alone that has kept me sober, it has taken a lot of self-awareness and step-work and therapy also, but once the medication helped balance my brain chemically, the other things became more and more effective and long-lasting.

So, my thoughts on taking psychiatric medications:

Do I think that medication, as a rule, is over-prescribed in the United States?  Yes.

Do I think that there is a stigma attached to taking psych meds?  Yes.

Do I think that taking medication is, or can be, a substitution for a healthy lifestyle?  No.

Do I think that taking medications, as prescribed, in addition to doing other healthy things (therapy, eating healthy, exercise, etc.), can greatly improve quality of life?  Yes.

Am I very careful that I don’t take medications that are not recommended for people in recovery (opiates, benzos, etc)?  YES!!!  Every doctor that I go to is aware that I am in recovery.  I will not take medication that jeopardizes my sobriety.

Do I want to continue to take medication for the rest of my life?  Not really, but I will if I need to.

I guess what it boils down to for me is this:  If I was diabetic, I would take insulin.  If I had cancer, I would do chemotherapy.  If I had epilepsy, I would take anti-seizure medication.  I do have PTSD and depression, why shouldn’t I take medication to help those illnesses?  I know that taking medication isn’t for everyone, nor should it be, but for me, at this point, it’s working, and I want it to keep working.  It is no longer something over which I feel ashamed or embarrassed.  It’s just a part of my physical make-up; something I do to take care of myself.  It took a little while to find what worked best for me, but it’s been so worth it!  No more self-medicating, and such a happier life.

I’m interested to know what you all think about this.  I would love to hear your comments.

 

 

 

 

 

The Secret Keepers

jamilynaz:

I am happy to reblog this for my friend Karen at Mended Musings. As a survivor of rape as a child myself, this definitely hits home for me. Please read and share.

Originally posted on Mended Musings:

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I’m going to do something I’ve never done before. I’m going to ask you to share this post. Reblog it, share it on Facebook, tweet it. Someone out there needs to hear this message today. Even if you think you don’t know anyone who has been abused. Even if you don’t read the entire post.

About a month ago I was asked by Dawn at WTF words, thoughts, feelings to contribute an essay for an anthology that she and Joyelle are creating for parents who are survivors of childhood sexual and physical abuse (learn more at https://www.facebook.com/TriggerPointsAnthology).

I submitted my essay but I also want to shine a bigger spotlight on this project because I fear that they may not get many submissions. Not because it’s not a worthy cause or because there aren’t enough people out there to contribute but because survivors of abuse are secret…

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Healthy Habit #11 – A month of do-overs

Try aagain

 

I tried.  I really did.  But October was a horrible, awful, emotional, depressing month.  I wrote about it here, if you would like to see why.  I didn’t even make it a week with my Healthy Habit #10.  I think I worked on physical activity for about 3 days, and then it went kaput, and I was back to laying on the couch, or, on particularly bad days, in bed, watching countless hours of mediocre TV shows to distract myself from the blues I was feeling.  The only silver-lining in the whole ordeal was that this time, as opposed to times in the past, I knew that the depression would pass.  I knew that I just had to be patient, to talk about the things that were bothering me, and to take comfort in knowing that I wouldn’t always feel sad and down.  I took it easy on myself, did the things that I had to (like earn a paycheck, and shower daily…or almost daily), and waited.  And finally, this last week, I started to feel better.  I noticed that I didn’t feel as sad, and that my smiling and laughing was, once again, genuine.  Last Monday was the first day that I felt I was able to stay mindful, the first day that I felt like myself again.  The remainder of the week has gotten better and better.

So, all of that being said, I have decided that November will be a month of do-overs.  I want to redo HH #10, and try to get my sedentary self moving.  That is first and foremost.  I know that I will feel better physically and emotionally if I do it.

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I also want to revisit some other Healthy Habits that I enjoyed, but didn’t quite stick to.  Meditation is one of them.  I have been using meditation on and off since I first tried it, but it hasn’t been a regular practice as of late.  So I will again make time for it, and see how it goes.  I would  also like to add consistency back to writing gratitude lists.  My mind has been pretty well-trained to look for the good in every situation these days, even when it’s hard, or when all I can find is the tiniest of slivers of gratitude, I know that I can find something for which to be grateful.  Unfortunately, if I don’t take the time to really think about it, or write it down, then the gratitude stays in my head, and never really reaches my heart.  In other words, I know what I have to be thankful for, I just don’t know how to feel gratitude for it.   Writing it down helped me before, so I am going to do what I know works.  I am going to add listing the things that I am grateful for to my journal writing that I do every morning.

I feel positive and hopeful.  I was going to add “about….”  to that sentence, but as I typed it, I realized that it said enough.  I feel positive and hopeful.  And that’s good.  :)

 

Healthy Habit #10 – A Month of Getting Moving

Get Moving

Here we are in October, so it’s time for a new Healthy Habit.  I have put this one off as long as I could, being the sedentary person that I am.  It’s time though.

I can’t wait any longer.

I’ve got to get moving!

Since I did a month of yoga back in March, I haven’t done any real exercise. I’ve done a yoga class here and there, and I’ve done yoga at home from time to time, but that’s it.  So this month is going to be the month of getting moving.  In my last post, I talked about how difficult the coming months are for me.  I’ve been down and sluggish and not at all active.  My inclination is to go to work and then come home and lay around…doing nothing.   I am hopeful that adding a little bit of activity will not only improve my physical health, but also my mental health.

Here’s my plan: there is no real plan.  I don’t do so well with plans that are set in stone…I get bored and then I quit.  What I am going to work toward is doing something physical every day.  I have a little fitness center just across the parking lot from my apartment, I can go use the treadmill or the elliptical.  I have yoga DVDs that I can do at home.  I can walk around the lake at the park that is less than half a mile away.  I can use the weights that have been collecting dust beside my sofa.  The weather has cooled off here in the desert, so hiking on the weekends is an option.  Whatever it is that I do each day, I know that something is better than nothing.  :)

I’ll see how it goes, and hopefully I’ll be healthier and happier.

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Update on brown bagging it:  Taking my lunch to work every day, along with making sure that I take a real lunch break away from my desk (Healthy Habit #8), have definitely become a habit.  I haven’t eaten at my desk more than a couple of times in the last two months, and I haven’t ordered out or gotten Subway or pizza for over a month.  I find that I look forward to my lunches, and that I feel refreshed and more motivated in the afternoon.  Success!!

October

It’s been a while since I’ve written a post.  I’m not completely sure why, I just haven’t felt much like writing, or doing anything else for that matter.  I am sober and everything is alright.  But everything is also not alright.  I am a depressive, recovering alcoholic and I’ve just been feeling down. Nothing bad has happened, nothing of real consequence anyway.  I just feel down and unmotivated for no real particular reason.

Except that it’s October.  The beginning of fall and winter is right around the corner.

This is not my favorite time of year.  At all.  I’ve known that for the last few years, but I’ve blamed it my birthday and the anniversary of ending a pregnancy seven years ago.

But now, I think, there may be other reasons…

Have you ever heard a song, or smelled a scent, or felt something that triggered a specific memory?  Like whenever I hear Billy Idol sing Mony, Mony, I am transported back to my very first concert when I was fourteen.  Or  when I smell cinnamon rolls, memories of my first real job at a bakery come flooding back.

It was like that the other morning.  I got up early, about 4:30, as I usually do.  I went to sit outside on the patio and have some coffee in my usual morning attire – a pair of Austin’s boxers and a t-shirt, and I realized that I was cold.  I later heard on the news that it was our coolest night since last Spring.  Anyway, I had to go inside and put on a robe to be comfortable outside.  As I sat there, in the cool morning air, memories started filling my head.  These weren’t great memories like concerts and cinnamon rolls, these were memories of bad things.  Bad things that have happened to me, and bad things that I have caused.  Something about the weather triggered an onslaught of scenarios of the past, and filled my heart with feelings of regret and sadness.  At first I didn’t understand it.  But as I wrote in my journal about these things, it became clear to me.  Many, many of the negative things I’ve been through have happened in the fall and winter.  Actually, as I’ve really thought about it, almost everything that I would consider “bad” has happened between October and February.  It’s when I did much of my active drinking and when most of my bad behavior happened.  It’s when I suffered rape as a teenager, it’s when I went off the rails and ended up in the looney-bin, it’s when I’ve been sick enough to go to rehab….twice.

So, is it really the time of year that is to blame for my depression?  I don’t know for sure, but it makes sense to me.  If a song can trigger a feeling, then why not the weather?

Austin and I talked a lot about it, and after he thought about it, he agreed that this may be the reason.  He talked about his feelings of fall and winter which are quite the opposite of mine.  He has many, happy memories that are triggered by the beginning of fall, it’s when he feels the most hopeful and happy.  So if it affects him in a positive way, then I guess it stands to reason that it can affect me in a negative way.

But now, what to do with this new-found realization that I’ve had about my third-quarter depression?  I’m still working on that.  I know that lying around watching every old episode of Monarch of the Glen hasn’t really helped much.  What is working (a little) is telling myself the truth: the past is over, I can’t change it, and I am a different, healthier person today.  I tell myself that my expectations that this time of year is going to be sad and hopeless, are really unfounded.  The time of year may bring up old stuff, but my attitude and how I deal with it is really the key to me backing away from the ledge of despair.  I don’t have to succumb to my emotions…I can put one foot in front of the other and keep doing the things that I need to.  And I can do so happily.  Knowing this now, I can, and do, find joy in each day no matter what the weatherman forecasts.

It’s still early in the season, we will have to see how things eventuate for me, but knowing now why it is that I get sad at this time of year will help me to combat the blues.  There is power in knowing.

October

Time for confession

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Step 5 of the twelve steps of Alcoholics Anonymous says:

“Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.”

Although it’s been a while since I posted about the steps, I am still working them with my sponsor as we both agreed at the beginning of the year that it would be a good idea.  I’m up to my 5th step which is all about confessing our wrongs to God, to ourselves, and to someone else.

When I started trying to get sober and attending AA meetings, this step was by far the most daunting to me.  I wasn’t anywhere close to the state of mental health that made telling all of my secrets seem like a good idea.  As I’ve written about before, I come from a family that clings tightly to presenting a good face, while secrets upon secrets live just under the skin where no one can see.  I simply couldn’t see how admitting my wrongs to another person was going to make anything better.

I think I understood the psychology of being honest with oneself and acknowledging, to myself, that I had done many, many things wrong and that I had caused a lot of pain to others.  I figured that it was important to understand where I was and what got me there in order to not repeat my past mistakes, and that meant getting honest with myself and acknowledging those things that I had struggled to hide away from my consciousness.  I got that.  I had to do that.  It made sense.

It also made sense that I had to confess my wrongdoings to God.  When I first attempted a fifth step, I was still a very new Christian.  I knew about God’s grace, forgiveness, and unconditional love, but I had yet to feel it.  It was still kind of an abstract idea to me; something that I wanted, and that I knew was out there, but I didn’t yet know how to accept for myself.  Consequently, when I did my fifth step and sat down to present it to God, it went something like this:  “Dear God, I have done so many things wrong.  I could list them all, but you already know what they all are, because you are all-knowing.  I am doing my best not to repeat those mistakes and I need your help.  Thank you.”  Over and out.  That was it.  Not quite explaining the “exact nature” of my wrongs, but it was a start.  At that time, talking to God felt appealing, yet still uncomfortable and new at that time, like a pair of beautiful new shoes, pleasing to the eye, but not broken in and therefore a little pinchy to the toes.  I had a feeling that at some point I would get comfortable talking to God, that I would be able to slip into it like I slip on my favorite pair of worn out black heels, but I wasn’t there yet. That was okay though, I had made a first attempt.

What didn’t make sense at the time, was why I had to tell all of my closely held secrets to another person.  How exactly was that going to help me?  Unless I presented my story to a therapist that was prepared to offer advice, or to a minister that was going to offer me God’s absolution, and I wasn’t going to do either of those, then what was the point?  Wasn’t I just opening myself up to fear and judgment and giving myself more ammunition to continue on with my self-loathing and low self-worth?  I knew deep down that if I ever told anyone everything about myself and what I had done, that I would lose my relationship with them.  How could they remain in my life when they knew the real me?  So, armed with those feelings and beliefs, when I sat down to do my fifth step with my first sponsor, I left a lot out.  I talked about some of my bad behavior while drinking, and I talked a lot about feelings of powerlessness and unmanageability, but when I look back at that conversation, I can see that it was very, very incomplete.  I told just enough that I thought my sponsor would believe that I understood that I was an alcoholic and that I wanted to get better.  But I didn’t tell her the things that I thought would make her look at me with disgust and drop me like a hot potato.  I was still holding on to secrets and trying to save face.  It’s no wonder that I ended up drinking again shortly after that.

After I went to treatment the second time, and really started to get honest with people other than myself, I began to understand the importance of admitting my wrongs – telling my story, honestly and completely.  I had a new sponsor, a new level of surrender, and I think a new willingness to do whatever it took to get better.  So when I sat down to do my fifth step again, I didn’t leave anything out.  Nothing.  It was a long, tiring, telling of my relationship with alcohol and everything that I was using the booze to get away from.  I think that conversation was a turning point for me.  As I told my story, my sponsor interjected from time to time telling me how her own story was similar to mine.  She related her own tales of bad behavior and insanity.  She smiled and affirmed me, she quietly and without many words let me know that I was not alone.  And you know what?  She didn’t judge me.  I never once saw a look of disgust on her face.  I never once felt like she wasn’t going to like me when I got to the end of my story.  And when I was done, I didn’t feel like I thought I would.  I had imagined feeling embarrassed and vulnerable and maybe a little bit like one would feel if she was required to run through the halls of high school  completely naked.  But I didn’t.  I felt good.  I felt lighter.  I felt like I had finally been completely honest with another person and she didn’t hate me!  In fact, she hugged me and thanked me for trusting her.  What a wonderful feeling.

Over the years, I have gotten so much better at admitting my wrongs.  I know that I have done really thorough fifth steps, and I know the feeling that comes with being able to share my story with others.  It’s so liberating.  It takes a lot out of a person to try to hold on to old secrets and keep up appearances.  I have found that it takes far less energy to be honest and open.  And the rewards of doing that are exponentially better.

So if you are at a point in your recovery where you are going to be doing a 5th step, find someone who you trust and relate to, and put it all out there.  Chances are, the person hearing your story will identify and affirm and love you unconditionally.  Accept it as a gift of sobriety and Alcoholics Anonymous.

 

 

Healthy Habit #9 – A month of brown bagging it

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I know I’m a little late on this post, it’s already the 6th of the month, but for the month of September my Healthy Habit is taking my lunch to work instead of buying fast food every day.  It goes hand in hand with my healthy habit from last month, which was to actually take a lunch break away from my desk at work.  That, by the way, has been a great success.  I’ve enjoyed my lunch breaks and getting away from my desk, and I’ve noticed that my afternoons go faster and I am actually more productive.  So the time that I was “saving” by eating at my desk wasn’t really time saved after all.

Back to this month’s plan, though.  The idea is to take my lunch to work and not run to the Subway next door or the pizza place at the end of the complex.  Those two places have become my solution to being lazy in the morning and not wanting to fix a lunch before I leave for work.  It’s relatively cheap and it’s very convenient.  That said, I know that I consume more calories than I should and I know that fast food can’t be that great for me.  So if I take my own healthy lunches I can avoid those negatives.  All of that sounds great, right?  But there is a drawback.  And for me, it’s kind of a big one.  This whole taking my lunch every day is going to require some planning on my part.  I’m not so great at this planning stuff.  I tend to more of a fly-by-the-seat-of-my-pants kind of girl when it comes to planning those kinds of things.  But, I’m going to do my best to prepare the night before and pack my brown bag each day.

If this healthy habit is successful I might just feel better and lose a little bit of weight…sounds good to me!