#all i know is since stopping the buspar but keeping up with the lamictal my anxiety hasnt worsened at least

[theboardwalkbody]

My mental health journey LOL

Note: Not exact quotes, but the general idea lol

Me, watching psych videos, taking psychology courses, going though psychiatric nursing in the nursing program, reading the DSM-V, and taking psychological assessments for fun: hmmm, I think I might be bipolar.

My 1st psychiatrist: So you mentioned bipolar but I think it may just be major depressive disorder and generalized anxiety with panic disorder. lets try wellbutrin.

Wellbutrin: *almost kills me*

My 1st psychiatrist: Oops! Lets try lexapro and buspar and ativan 1mg 3x a day for your depression and anxiety. Also, ADHD is a possibility but the meds might not be good for you due to the anxiety so lets wait.

Lexapro: *Makes mood fluctuations worse - now going from happy to depressed to pissed off to giddy to severely depressed all in one day*

My 1st psychiatrist: Weird. But lexapro can do that. Here's some Lamictal, it stabilizes mood.

Lamictal: *Helps*

My mental health: *stable but not great*

Me: I don't think these do much, I'm gonna stop.

My 2nd psychiatrist: So based on your history I think we should restart all your meds.

Me: Do you think maybe it's bipolar?

My 2nd psychiatrist: Nah, let's stick with your previous med combo.

Me: OK sure, maybe they did help.

My mental health: *no better than the 1st time*

Me: Nah, I think I'm gonna stop this isnt it.

My 3rd psychiatrist: Hi, first of all - who let you take 3mg of Ativan for years? That's not good. We're not gonna do that. Oh, you're off all your meds? That's fine - let me see how you are baseline.

*months later*

Me: Hey, do you think it could be bipolar or ADHD?

My 3rd psychiatrist: Could be ADHD but I think if we went with stimulants your anxiety would be horrible again and you do have mood fluctuations but they could just be based on your situation. Do you want meds to help? You can always stop them later. We can try the lexapro and buspar again and once your anxiety is under control we can talk about meds for that.

Me: Nah, I'm ok I don't want meds. Besides the lexapro by itself made my mood swings so bad I felt like I was loosing my mind.

My 3rd psychiatrist: That's cool, if you change your mind lemme know.

Me: K.

My 3rd psychiatrist: Hey, so I'm leaving and you're gonna have a new doc.

Me: :(

My 4th psychiatrist, after one session: Right, so you're bipolar.

Me:

My 4th psychiatrist: So your mood got worse on lexapro alone? SSRIs do that with bipolar. Your anxiety is likely a symptom of your bipolar which is why the buspar didn't really help. The ativan was what was calming it because it was basically sedating you to a degree. You say you think it's situational but going through your file you report continued mood fluctuations despite what's going on in your life. You don't adapt to change well, which is also a bipolar symptom. So we should try Vraylar.

Me: That's brand name only, my insurance won't approve it. I'm already fighting them for Taltz, which is also brand name only, so I don't want to throw another thing at them that could distract from that. Besides, I don't want meds in general, let alone anti-psychotics.

My 4th psychiatrist: Anti-psychotics don't mean I think you're psychotic, it's just the type of medication class. We could always try quietipine, that's the same type of med but a generic.

Me: I don't want meds. Especially not that type because I know all the side effects and they scare me.

My 4th psychiatrist: Then why are you here?

Me: I need to have a psychiatrist to approve therapy.

My 4th psychiatrist: OK, we will revisit this.

Me, out of curiosity: *checks after visit notes, sees diagnosis of bipolar, unspecified and adjustment disorder with mixed disturbance of emotions and conduct*

Me: That sounds fucking rude. >:(

Me, to my therapist: They said I'm bipolar >:(

My therapist: Hear them out...

Me: Do you think maybe possibly it could be bipolar personality disorder?

My therapist: I remember you mentioning that when we first started our sessions together, I can't diagnose so you should bring it up with your psychiatrist.

Me, to myself: Nah, not gonna do that.

My 4th psychiatrist: So, meds?

Me: Fine, but I only want to go back on Lamictal because I don't want to take antipsychotics.

My 4th psychiatrist: What side effect is the one making you feel that way?

Me: Tardive Dyskinesia.

My 4th psychiatrist: That's such a rare thing that really only happens to people on high doses for years and years. Mostly seen with schizophrenia, in my experience, due to the high doses needed. You'd be on 25mg.

Me: Nope. Lamictal or I walk.

My 4th psychiatrist: -__- fine.

Me: Also could we do the buspar again? My anxiety sucks.

My 4th psychiatrist: No. It'll make it worse because your anxiety is a symptom and adding buspar is gonna mess with your existing chemical imbalance and make the lamictal not fight it as well.

Me: >:( I'm pretty sure my anxiety is it's own thing.

My 4th psychiatrist: We'll see.

Me: *back on lamictal. dose started at 50mg and is currently up to 150mg. I was taking buspar as prescribed by my primary doc and I have stopped taking that after switching to 150mg of lamictal*

My 4th psychiatrist: So, how we doin?

Me: I feel better, but I think it's the weather change and the sun being out longer.

My 4th psychiatrist: I'm glad it's working. Let's keep going and I'll check in after a month.

Me: K

Me: *out of curiosity, checks after visit notes: sees diagnosis of bipolar, unspecified, and the adjustment disorder with mixed disturbance of emotions and conduct* Ok, I mean that's what it said last time. And maybe the meds are working and it's not just the change of seasons.

Me: .... wait a minute. *Sees it also now says Bipolar personality Disorder*

Me:

Apparently the moral of the story is only *I* am allowed to suggest I am bipolar and shit and no one else is even though the reason I ever started looking for mental health help in the first place was to figure out what is wrong with my head and fix it.

[ninetiescat]

story of my medications

This is my response to the message I received on my sarahah (@illusionarium), reading,

May be a bit personal, but I want to know your story behind all of your medication. Your social medias are phenomenal which raises my curiosity as to why you have to take so much.

This is going to be way more information than what you asked for. I haven’t proofread this but I tried to write carefully. Potential trigger warning beyond this point.

I’ll start at the very beginning, getting to the more-than-you-asked-for right away.

How I got on meds in the first place:

In January 2012, the night of day 1 of the second semester of my freshman year of high school, so roughly five and a half years ago, I was involuntarily put under mandatory 72-hour hold in a psychiatric ward for threatening to kill myself. I was in there until the afternoon of day 3 of the semester. This is pertinent because I wanted and somehow proceeded to achieve straight A’s and knew that staying in longer meant I was missing more class-time and putting that at risk it took a month to catch up on those three days I shit you not. (For the full hospital story, see this post.) While being held there, I did my best to abide by the rules the hospital operated by—i.e. rules none of us were directly informed of, rules we had to be informed of by our fellow inmates let’s be honest, it was essentially a prison who were there before us and learned the hard way so we didn’t have to—but those rules were just things to check legal boxes, they didn’t make any real sense, and they weren’t consistent, so despite my genuine best efforts, it became very clear very quickly that they wouldn’t release me after 72 hours (72 hours is only the minimum) if I didn’t sell my soul to the devil. I always swore I would never take psychiatric medications—I just didn’t believe in it, if I was doomed to be sad then so be it, I didn’t have anything against other people taking meds but I didn’t want it for myself under any circumstances—but I couldn’t afford to be held longer than the bare minimum basically if I took a breath one second later than expected, Staff would threaten to hold me for an extra week, a threat that was said to me five times, so I agreed to be medicated to check one of their damn boxes needed for an on-time release. Then, when released (about 24-hours after agreeing to take meds and taking the first dose), I was told that if I stopped taking the meds I would be readmitted. I assumed, despite Staff being heartless assholes for the most part, that they—medical professionals (well, sort of)—wouldn’t flat out lie to me, so I reluctantly continued taking the meds. I cried, I went to the doctor they referred me to every month and a half, I sold my soul and gave up what I stood for, I took my shit as prescribed, I was a good girl, and I hated every second of it, but I hated it less than I hated hospitalization. It wasn’t until a year and a half later that I cried to that doctor (who was very nice; I quite enjoyed seeing her) about hating being on meds and wanting to stop but knowing I can’t without being readmitted, and she, surprised by my statement, informed me that that was a lie, I was never required to keep taking them, they could not readmit me for that, period end of story, I had been blatantly lied to. Unfortunately, by then I had gotten in too deep (I’ll explain why), so despite still hating being on meds, I carried on.

Why I stayed on them:

I grew up depressed, anxious, and with insomnia; it’s all I’ve ever known, so I couldn’t complain too much having never known better I mean I complain all the time, talked about suicide etc., but I wasn’t fighting for better because I didn’t know what to fight for and didn’t have the motivation too. A year and a half into bouncing from medication to medication (I’ll elaborate later), I had had no success with improving my depression or anxiety, but after about a year of that, I found a sleeping medication that worked, and holy fucking shit. Over the course of my life, my sleep had been getting progressively worse; for instance, at age 14.5, Night 2 in the psych ward, bedtime from 10pm through 7am, I took over an hour to fall asleep and woke up eight times I remember because Staff yelled at me about this the next morning. That was quite normal for me, I wasn’t accustomed to anything better, but getting a night of what normal sleep should be for the first time…was just something I couldn’t pass up. It was like a brand new world. The medicine that did the trick was an atypical antidepressant prescribed to me for insomnia by that point my doc had gone off-label, as I was already failing to respond to traditional treatments, so I said fuck it and kept on making my way down Big Pharma’s product list trying to treat all my issues for the heck of it. Note however that I had also been diagnosed with ADHD, a problem I wasn’t previously aware of, and medication for it worked also, but I could’ve accepted pre-ADHD-med life more than pre-insomnia-med life.

Since then:

My insurance dropped that first doctor not technically a doctor, psychiatric mental health nurse practitioner, PMHNP, didn’t know that for a long time, didn’t know there was an important difference at the year and a half mark, so I switched to doc #2 not a doctor, advanced practice registered nurse, APRN, who quit and was replaced by #3 some kind of nurse practitioner who quit and was replaced by #4 APRN whom I hated, so I switched to #5 family nurse practitioner, FNP, who was great, but I really needed a psychiatrist. So now I’m seeing #6, a psychiatrist! A PhD! An MD! At last! My therapist of five years said I needed an actual psychiatrist and advised I try to get off of my meds (four total at the time), which is a main reason I took medical withdrawal from college in March. This doctor is fab and is trying so hard to get me the best treatment possible. We tried weaning off slowly, but the withdrawal symptoms were too bad to handle alone, so we’ve tried substituting new meds with them to ease the withdrawals (elaborated on later). Because of how that is going, he wants me to seek a second opinion technically an eighth if we include the psych ward, five NPs, my therapist of five years, and himself from an accredited institution if we can find one that will see me because my “case has advanced beyond what conventional medical treatments can help” and I have “suffered too long,” and if a re-evaluation shows that my diagnoses are correct, I could benefit possibly from experimental treatments or clinical trials since my shit is so treatment resistant.

How that’s going—what I’m diagnosed with and what all I’ve tried:

Chronologically, I’ve been diagnosed with major depressive disorder, generalized anxiety disorder, insomnia, ADHD, and panic disorder, with anorexia nervosa present but left undiagnosed. In trying to treat my five diagnoses in the last five and a half years, I’ve had my system pumped with twenty-five different psychotropic medications. Of the 25, I’ve only had any success with/positive reaction to 8. I’m currently on 6 daily. Let’s list them out chronologically with more info than you asked for for shits and giggles shall we—“[medication class] prescribed for [whatever, usually off-label], italicized means it worked, bolded means I’m currently on it:

Zoloft/Sertraline—(from the hospital) antidepressant for depression & anxiety

Xanax/Alprazolam—sedative for anxiety

Trazodone—weird antidepressant for insomnia

Tranxene/Clorazepate—benzodiazepine for insomnia

Ambien/Zolpidem—hypnotic for insomnia

Prozac/Fluoxetine—antidepressant for depression

Elavil/Amitriptyline—idk it treats everything and was prescribed for idk I can’t remember tbh

Remeron/Mirtazapine—atypical antidepressant for insomnia (worked for a year, stopped, immediately replaced by Seroquel)

Adderall XR and IR—stimulant for ADHD (XR extremely effective but couldn’t tolerate ingesting it, IR ineffective)

Buspar/Buspirone—anxiolytic for anxiety

Inderal/Propranolol—beta blocker for anxiety/depression

Seroquel/Quetiapine—atypical antipsychotic for insomnia

Lamictal/Lamotrigine—anticonvulsant for depression (under slow withdrawal at the moment)

Daytrana/Methylphenidate—stimulant for ADHD

Klonopin/Clonazepam—benzodiazepine for anxiety

Valium/Diazepam—benzodiazepine for anxiety then insomnia

Lexapro/Escitalopram—antidepressant for depression

Wellbutrin/Bupropion—antidepressant for suicidal thoughts (it helped a bit)

Atarax/Hydroxyzine HCl—antihistamine for insomnia

Phenergan/Promethazine—antihistamine for insomnia

Clonidine HCl—alpha blocker for insomnia & high blood pressure/elevated heart rate

Trileptal/Oxcarbazepine—anticonvulsant for depression/to ease Lamictal withdrawals

Vyvanse/Lisdexamfetamine—stimulant for ADHD

Dexedrine/Dextroamphetamine—stimulant for ADHD

Evekeo/Amphetamine—stimulant for ADHD

So I’m currently on Seroquel, Lamictal, Valium, Clonidine, Trileptal, and Evekeo—three for insomnia, two for depression, and one for ADHD. I am incapable of sleeping without sleeping medications; I go about 36 hours wide awake, then go from wired to unconscious note that sleep is not an unconscious state for about half an hour, then snap back awake as if nothing has ever happened until I take the next dose. I have extreme difficulty reading, comprehending, writing, and understanding information without ADHD medication, one of the main two reasons I’m taking a second semester off from school. My anxiety is debilitating and currently only being treated through therapy, which is undoubtedly beneficial but not the same; I used to take Valium to stop my panic attacks (it would calm down the physical symptoms so I could use what I’ve learned in therapy to calm the mental symptoms), but when I started taking it for sleep it stopped working for panic, so I just have to ride it out. I started Clonidine as a substitute for Valium for falling asleep, but it makes me so damn sleepy during the day that I’ve been slow to let go of the Valium and raise the Clonidine. I’m not addicted to any of it, simply terrified to not sleep. A sleepless night is a nightmare few people understand; yeah no one likes a sleepless night, but it’s fucking torture when you get more suicidal with every second you’re awake. I get in bed every night terrified that this will be the night I stop sleeping; Seroquel, for the first four years, worked effortlessly for making me fall and stay asleep for roughly eight hours and wake up on my own with no drowsiness, then all of a sudden it stopped helping me fall asleep and out of desperation I added on Valium because it was my only option and I knew it had hypnotic properties. Since it’s not healthy to be on it super long term, my doc wanted me to trade it for something safer, like Clonidine. I was put on Lamictal after going through rounds of antidepressants that failed; Lamictal treats seizure disorders and bipolar disorder and is related to Trileptal but carries a greater risk of a deadly side effect. Seroquel is an antipsychotic that also treats bipolar disorder; it seems the medications that work best for me with the fewest side effects are the ones that treat bipolar disorder, for which I have not been diagnosed (technically I am down as bipolar in my files for insurance reasons, as my insurance could request my files, see the depression diagnosis, and refuse to pay for Seroquel and Lamictal because they are not approved to treat unipolar depression), which I find interesting. Trileptal has shown very little evidence on efficacy at treating mood disorders and is in no way approved for their treatment, but I have responded to so few medications that my latest doc thought hey, why not. Fun, isn’t it?

And at last,

why I have to take so much:

My shit, aka an intricately intertwined clusterfuck, is just so damn treatment resistant that 1. no one medicine can treat any one problem well enough to suffice on its own 2. everything is so bad that even if one worked really well and wiped out one problem altogether the others really can’t go untreated yet. There are only two instances in which I am okay with being alive—on stage performing or in an airport. I’m not lucky/privileged enough anymore for the former occasion (bonus: my sleeping meds contain antihistamine properties and I’ve watched as my voice has deteriorated over the past four years, escalating in the last four with the addition of Clonidine) and not rich enough for the latter to occur as often as I’d like, so I spend virtually every day wishing I was dead. It’s so normal to me now. It’s been twenty years. I can smile and laugh and dance around for a few minutes, but that’s all I get; it doesn’t last. My favourite singer can release a new song and I’ll cry with happiness as I sing at the top of my lungs for hours or see some aesthetically pleasing decoration in a store and take a hundred pictures of it and that’ll make my day, but it simply doesn’t last. I’ve only managed to live this long because my anxiety is severe in just the right ways to keep me incapable of going through with any method of suicide. I’ve become accustomed to coasting by; I often wonder how many people can tell I’ve got issues or can tell what kind of issues I have without being informed first. I wonder too what I’m like beneath the medications, if I would even be recognizable; I thought I would find that out over the summer, but that will have to wait until the weaning is all done I suppose my psychiatrist estimated the process would take 3.5 years when I started seeing him.

Soooo…I hope that answered your question and makes some sort of sense. Feel free to inquire further; I’ve spent the past six months doing nothing but researching and focusing heavily on all of this so I know it well and have a lot to say about it.