In my first post I said that I would come back around to the topic of medication, and well, folks, today is that day.
I’m going to lead off with a blanket statement: if you seriously think that medicating for mental illnesses is “tHe ReAl PrObLeM” or that maybe I should just do more yoga, I’m going to ask you to just keep that to yourself and have a seat over there because this is not a place where I will tolerate med shaming.
Let’s start with some basic concepts. Mental health challenges are not just “feelings” or something that you can just overcome by sheer force. (Trust me, if this was the case, I wouldn’t be here writing this post today). What are they?
Mental illnesses are health conditions involving changes in emotion, thinking or behavior (or a combination of these). Mental illnesses are associated with distress and/or problems functioning in social, work or family activities. (source)
Key point here? They are health conditions. Full. stop.
Using this as a baseline, this is why I’m not here for people shaming folks for taking meds for mental health stuff. You wouldn’t tell a diabetic to not take medication and do yoga in hopes their pancreas decides to produce more insulin. Or tell someone dealing with cancer to they shouldn’t do a round of chemo. Or someone with asthma they shouldn’t use an inhaler to breath. Or someone with arthritis they don’t need meds to handle pain and discomfort.
Now, does this mean you shouldn’t also do other basic self-care things? Nope. Because as with many illnesses, taking care of your body will help you manage symptoms. If you are sleeping enough, eating well, and drinking water, your body will have the resources it needs to do what it can, in conjunction with medication, to help manage things. When I’m not sleeping well, my anxiety will be worse and my ADHD symptoms will be more noticeable. Same for if I don’t eat or stay hydrated. “Hanger” is a thing because lack of fuel impacts your body – and for someone with mental illnesses, there are just additional things it messes with. It’s not an either/or, it’s a both/and.
I’ve been on medication for my anxiety and depression off and on since high school. I used to be ashamed of this fact, and thought that it was a weakness. I actually stopped taking medications in college because I thought I didn’t need them any more. In hindsight, I wish that I not only stayed on them, but also had a more complete care team to help me manage my medications and make sure I was taking the right dose and the right kind. This is a missing piece for many people since there is a shortage of psychiatrists in this country, and the wait times and other barriers make it not a resource easily available to folks. There’s also the insurance mess, and barriers with certain meds since they are scheduled drugs by the DEA which brings up other issues.
It is also important to remember that your care team should be that – a team. I have a therapist, psychiatrist, and primary care doc that work together to provide me with supports and advice to help me manage my symptoms. I think without this trio, I wouldn’t be where I am today. They all bring an expertise to the table based on their education and experience that help give me the tools I need to manage symptoms and keep this chronic condition under control as much as possible.
So what do I take?
I take Prozac for my anxiety, Adderall XR for my ADHD, along with Vitamin D and E each day and Ativan as needed for anxiety spikes/panic attacks/PMDD. I was on Zoloft for a long time, but we found that the Prozac actually did a lot better at managing my anxiety, and I’m glad I made this switch.
However, unlike other types of illnesses, there isn’t a quick and easy blood test to know if the doseage is right. I have to become aware of my symptoms and how they change from day to day. I have to note what it feels like when everything is managed well, and hope I notice a difference when things aren’t to know that I need to change something to get back into balance. This is not easy. Like I said in an earlier post – when I’m in a bad place with my anxeity, it’s the only thing I know and I can’t think of a time I wasn’t in that place. So, since this seems like “normal” it sometimes means you miss kinda obvious signs that you need to use your toolbox to get stuff better managed.
This is definitely a place I found myself in recently. I’m thankful for the people that helped me see this and continue to provide support and guidance when I struggle and give me props when I’m on my A game. People that let me flail and ramble and be vulnerable because I’m just needing to get thoughts out of my head. Folks that distract me with memes and other things. For those that are honest with me, even though they know it may cause me some stress and anxiety short term, but will lead to longer term benefits. For the people that let me be me, the real me, without having to hide my symptoms for fear of being judged or hated. Having a sapce where I feel comfortable and safe is not something I take for granted, and I’m thankful for those that help create this for me – whether they realize it or not.
So how does all of this relate to medication? Since I’ve been focused a lot on symptom tracking and management, when I realize that something is off, I can then use the skills I have to try to get back to “normal”. (I put normal in quotes becuase my normal is not the same as anyone elses. . .and there will always be impacts of my chronic conditions on my day to day). Recently, I’ve realized that my normal tools weren’t getting me back into balance, so I had to do a hard, yet needed thing, which was talk to my care team about changing or adding medications. After conversations (thank cheesus for telemedicine – I was able to have many of these conversations via “email” and not have to make phone calls), I established a game plan, with additional steps in case this didn’t work well, to try to get symptoms better managed.
This is harder than you’d think. Because when my anxiety is out to play and my concentration is shot, the act of remembering to make an appointment and being in a place where you can be honest and open about your current status is harder than you think. You want to just pretend that you are on top of everything and that if you just try harder, things will be ok. (spoiler alert: they won’t be – and some of the stuff you are doing is not helpful) But earlier today I overcame this and talked to my psychiatrist about changing the dosage of my Prozac both to combat the overall increase in anxiety I’ve been dealing with for the past few months (thanks COVID and the general state of the world!) and also the PMDD anxiety spikes. We had a good convesation about when I’d start to feel changes and will check in again in a month to see how things are and then go from there.
This is a huge relief in many ways. Mainly, I hope I can get my symptoms better managed and get back to my “normal” self. I hope that the increased anxiety can gtfo so I can stop dealing with the physical symptoms that get in the way of so much. It also showed me that I am strong enough to deal with this, and I can get through this rough patch. I’ll get through this day and the next and the next. Every day won’t be perfect, but I can handle things. Even it it means laying low and catching up on sleep, I can handle this.
I’m sure I’ll come back to this topic again in the future. And to be honest, it’s kind of scary to have laid this out here like this, but if sharing my reality can help someone, then it’s worth it. And if you want to hate or judge me for dealing with a chronic condition, that says more about you than it does about me.