*Please note that any side effects from the specific drugs mentioned in this piece are from my own personal experience. It in no way indicates what you could expect from the same prescription. Drugs affect people in different ways. Also, make sure to discuss with your doctor any changes in your own medication.
One of the most confusing aspects of mental illness is treatment, and whether medication should be part of that treatment. While I can’t answer that for you, I can tell you about my own journey through the medicating process.
My first psychiatric drug was an antidepressant prescribed by my gynecologist after the birth of my first daughter. He prescribed Zoloft, primarily for prevention of the daily migraines I had begun having, but also for the severe postpartum depression that, though I did not say much to him about, he must have sensed from my demeanor. The “happy pills” worked their magic; my migraines decreased in frequency, and my depression lifted significantly. I do remember an embarrassing moment after taking the first pill. I was walking through Walmart a few hours later when suddenly I had a dire urge to go to the bathroom. Like, in a really bad way. I nearly didn’t make it to the toilet (I may have knocked a few people down as I ran through the aisles), and it was ghastly once I sat down! Loud and ghastly! I don’t think there was a soul left in that public restroom once I got through. Fortunately, this smelly little side effect only lasted a few days. I stayed on Zoloft for about three years, content with the results. I did notice that it lowered my libido a bit and heightened my irritability, but my husband was understanding (or scared of me) so it didn’t concern me too much.
Since Zoloft is considered safe during pregnancy, I remained on it while pregnant with my second daughter and also while I breastfed her for a year. I had never been happier, and I had a lot of energy. Nothing out of the ordinary until…
Things started to change. There was a definite shift, but I couldn’t pinpoint it then, and I certainly can’t now. I just knew I wasn’t “okay” anymore. The depression was back, yes, but sometimes I was really happy too. I was too happy, and the irritability was at an extreme. I was irritated that I was happy, and irritated at anyone and anything around me. I made an appointment with my primary doctor and told him I didn’t think my antidepressant was working anymore. I admitted to feeling depressed and irritable, but I didn’t mention the “too happy” feeling. I didn’t think it was relevant. He prescribed a different antidepressant, Lexapro. I don’t remember if a wean-off from the Zoloft was necessary; I just remember the Lexapro was the ultimate Turn Me Into a Royal Bitch drug for me. I didn’t even make it a week before my husband and I both decided that it was a mistake. If I had taken it longer, possibly the bitchiness would have subsided, but it was not a gamble we were willing to take.
My doctor tried me on a couple of other antidepressants, but they all produced the same effect. Finally, I told him about the other symptoms I was experiencing, and he referred me to a mental health clinic. At that point I just wanted relief, so I made an appointment to see an intake therapist at the clinic. After speaking with her (this time I was honest and didn’t leave out any symptoms), she gave me a preliminary diagnosis of bipolar disorder. I had read very little about the illness prior to this, but I had had my suspicions; still, it was a shock to be right. I was scheduled to meet with the psychiatrist, and she confirmed a diagnosis of bipolar disorder (it was later down the road when I was additionally diagnosed with obsessive-compulsive disorder, social anxiety, and panic attacks). And of course, her first course of action was to get out her prescription pad and start scribbling out drugs I had never even heard of before.
The first combo was Depakote and Effexor. I immediately hated the Depakote, as it made me gain 5 pounds a week and caused a lot of scary hallucinations. As far as I could tell, it did nothing to stabilize mood, so she switched my meds. And switched them again. And again. Along with each drug came new side effects; some annoying and some downright unbearable. Many made my symptoms worse rather than providing any form of relief. Finally I got fed up and *like an idiot* I just stopped taking any of it. Okay, maybe “idiot” is harsh, but I was definitely an uninformed individual about the potential dangers of abruptly stopping psychiatric medication. Besides making me dizzy and sick, it was most likely the main trigger of the biggest psychotic break I have thus experienced. Very bad things happened after that, and I will spare you the details since I have written about most of it before, but suffice it to say I went off the deep end and lost my family in the process. I’m not going to sit here and blame medication (or the lack of) for the things I did during that time period, but I do feel like the constant switches between medications (often with no reprieve in between) and then the complete absence of medication so abruptly did nothing to help my mental status. I made some very irrational decisions that seemed perfectly rational (to me, and only me) at the time. I was a mess, and it didn’t seem like I would ever get better. I was committed to a mental hospital on two separate occasions, and there were so many med changes I can’t even remember them all. The second hospital wanted to change my diagnosis to schizophrenia and so anti-psychotic medication got added to the pile. Those made me so groggy and zombie-like, I didn’t even feel alive. It led me to wonder, countless times, which is worse: the symptoms of my illness or the side effects of these drugs? I would get fed up with meds and go without them for a while. Then I would end up in such a mess that I would succumb to trying them again. This cycle repeated oh so many times. I really didn’t think there would ever be a “perfect cocktail” for me. I didn’t even want to try anymore. In the midst of this I had started drinking (something I had never done before), and my hair had started falling out. My marriage had fallen apart in the beginning of all of this, and my subsequent relationships fell apart as well. I still had joint custody of my daughters, but I wasn’t allowed to be with them without the supervision of another person. I had hit rock bottom, and even that bottom seemed to be crumbling underneath me.
Then, a breakthrough! Cymbalta and Lamictal did the trick for me, along with regular therapy. My moods stabilized, the more psychotic symptoms went away, and I was eventually able to hold a full time job. I found an apartment and was able to get my kids every other weekend like a “normal” parent. At some point I decided I was all better – cured! never had bipolar to start with! – and I weaned myself off the medication that had supposedly helped me so much. And, surprisingly, I actually did quite well without them. For about two years, in fact. I did have a suicide attempt at one point during that drug-free era, and now that I look back there were instances that hint at the fact that perhaps I wasn’t doing so great after all, at least not all of those two years. But I was able to keep my full time job – I even advanced to a management position – and I kept my inner demons at bay as much as I could while I was at work or any other public place. I was also trying desperately to keep it together at home, but my new marriage was not a happy one, and it added a lot of stress to me. I recognized that I needed more than just therapy to keep me afloat and I resumed the Cymbalta and Lamictal. Klonopin was eventually added to help with my anxiety. It became a regular occurrence for my husband to flip out on me and say “did you forget your meds today?” This wouldn’t just happen when I actually had an obvious bipolar symptom rear its ugly head. It was whenever I showed the least bit of emotion about anything. I really detested hearing that said to me, especially when I knew it was unwarranted. But sometimes (increasingly more often) I wondered if he was right. Sometimes I would double, even triple how many times I took my medication in a single day, in hopes that it would make me act “right” for him. But it didn’t fix my marriage, and it didn’t fix me. I started drinking again, and even more so after my dad passed away.
Thankfully, I had a good therapist at the time, and she helped get me through the death of my dad and another failed marriage, and I stopped relying on overdoses and drinking to get me through my life. I abruptly walked out of my job one morning, but I think I just needed a clean break from everything that had been weighing me down. It wasn’t a mature, or even sane, thing to do, but I was one step away from the breaking point at that time, smothered in stress and discontent, and I saw a window to fly out of. I moved out of my apartment and tried to move on with what little self-worth I had left. Things got better, and I began to unbury myself from the wreckage. I found another job and began a healthy relationship. I didn’t feel like I was breaking anymore.
I have went through med changes since then, and I have stopped/started many times too. It seems to be one of those lessons I never learn, though I am trying! Right now, my current medication is not doing so great for me and I am going to make an appointment to discuss what my next options are. It’s an overplayed scene, but I’m used to it. My bipolar is of the rapid-cycling variety, and it’s harder to treat. I accept this. Do I like it? Of course not! But I do what I have to in order to be the best I can be. Sometimes I actually do better without any meds at all, but sometimes they are a necessary part of my treatment. I’m never going to wake up and be cured from mental illness. I doubt I’ll ever be able to go drug-free for any lengthy amount of time, let alone forever, but who knows. It could happen. Some people do great without medication. Some don’t. Me? I don’t know if I’ll ever feel completely “fixed” either way.