The Ultimate Guide To Taking Psychiatric Medication

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When you first start psychiatric medication, you honestly don’t know what you’re doing. I wish that there was a class on how to be a good and helpful patient that anyone could take for free when they get their first script, but instead, I will write out the things I believe are crucial in order to make significant progress aided by meds.

person holding white medication tablet

Patient Skills For a Lifetime

Although I am not a doctor or any sort of health professional, I do consider myself a “professional patient,” due to the past 13 years of dealing with bipolar disorder, major depressive disorder, and generalized anxiety disorder. All that time, I have been in treatment with psychiatrists, psychologists, therapists, general practitioners, and specialists in various fields. The following is what I’ve learned.

The Rules

  1. One psychiatric medication does not work the same on everyone. And if you’re already telling other people about your meds (what works for you and what doesn’t), then please read the disclaimer that needs to come before any advice you hand out.
  1. Sometimes a psych med has the effect of causing health problems, making things worse, or affecting you in a way opposite of its intended purpose. An example is that for some people, some antidepressants can cause suicidal ideation, and some antipsychotics can cause hallucinations. These effects happen to a small minority of people, so this doesn’t mean you shouldn’t try them. Because…
  1. Psychiatric medication can save your life. A med can bring you back from the brink. A med can improve you enough to be able to use coping skills, which is difficult in a nonfunctional place…
  1. Doctors are stabbing in the dark when you begin treatment. This means that you will probably have to try more than one medication before you find one that works. Once you find one that works, then you will need to…
  1. Adjust your dosage and time of the dose with the guidance of your doctor. Often, a medication that works for you a little bit can work for you a lot after you figure out what time(s) of the day make you feel best. This is often called “tweaking the dose.”
  1. To learn how the dose needs to be tweaked, you will need to KEEP NOTES. Print out a mood chart from the internet (search “mood chart”-it’s easy). Go to Kinko’s or the library if you don’t have access to a printer. I know some apps do the same thing, so look for those instead if you’re inclined. Or just keep a notebook. It doesn’t matter how you do it as long as you have the following information in an easy to read way:
    • Your daily mood status
    • What you are taking, what time and how much (you don’t need to write down the things that don’t change every day)
    • Your mental illness symptoms, especially anything severe or unusual for you
    • Other health problems
    • Any problem behaviors or events (like self-harm or episodes)
    • Any insight you notice about how you are being affected
  1. Bring your notes with you to the doctor. Some doctors’ appointments are as short as 10 minutes, so every sentence counts. Having all the information on hand eliminates the need for telling long, rambling stories full of irrelevant details. This is probably the most important thing to do in your relationship with your psychiatrist.

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How I Learned That Change Is Always On The Way (or Hope In Water)

 

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One time, about 5 years ago, I was on an antipsychotic medication that was known for being very safe and having few side effects. I will not name it here, because I don’t believe that telling others about my bad experiences with medication is safe or appropriate. This medicine helps millions of people; I was just in a minority of people who had horrible, devastating, contraindicative effects from it. This effect is possible because each medicine reacts uniquely in each person’s brain. A medication is prescribed based on the typical reaction it produces, but the typical reaction doesn’t happen to everybody. For me, this medication was very harmful, and it took several months for my doctor and me to connect the dots between my ever-worsening depression, insomnia, paranoia, delusions, hallucinations, and mixed-state bipolar episodes to that medicine.

I was on this medication for five months, growing progressively worse. Every time I got worse, my doctor increased my dosage. I stopped sleeping more than 4 hours a night and fell deeper and deeper into a dark hole that was filled with overwhelming sadness and psychosis. By the time I got to the point where I had felt sincere suicidal desires for about a week, I started making plans.

I did this most waking hours. Bread knife across the throat, hanging myself with an electrical cord from a tree in the park, strangling myself with duct tape, and buying a gun were all considered. I was hurting so badly that all I wanted was out. The breadknife across the throat was the most troubling because when I was lying awake at night with my soul on fire, that was a legitimate plan for exit; all I had to do was walk to the kitchen to end it. I remember literally “white-knuckling it,” clutching my bedding so hard that my hands cramped. Continue reading

How To Support To A Mentally Ill Loved One

One of the biggest worries of a mentally ill person is that they are a terrible burden on their friends and family. As an outsider, most of what you can contribute is verbal. Regularly remind your loved one that they are not a burden, they are not going to lose you, you love them, and that it’s okay to be upset. Physical contact is also very powerful: a hand on the back, a squeeze of the hand, or a hug can make an enormous difference in the current mental state of your loved one in crisis. If it’s appropriate to your relationship, lay with them and hold them, or let them put their head in your lap so that you can pet the side of their head. This sounds very basic and very infantile, but the difference you’ll make is enormous. Just being present with your sick loved one is powerful. Try to listen without judgment, and try not to give advice, only reassurance that they’re safe and loved. If your loved one is very sick and not making good choices, keep them at home. Even a trip to the grocery store could be catastrophic for their state of being. If they’re not making sense, do not let them cook or drive, and keep a close eye on them to keep them safe.

If your loved one is suicidal, take them immediately to the emergency room, because they’re going to need to Continue reading

The Disclaimer For Your Advice

Meeting Myself CCEach person is mostly like every other person, but not exactly. And the not exactly goes to varying degrees. Some people are sick. Of the people who are sick, there are many different body parts that can be sick. Of the people with one specific sickness in one specific body part, each will have different and varying degrees of the effects of the illness and the effectiveness of their treatment.

Every illness is like this. The world is full of different people; mostly all the same, but each with a personal experience that no one else gets to experience. My mental illnesses are different from yours. Mostly the same, but different.

Don’t assume you know what someone feels because you wear the same label that they do. I, for example, do not have happy mania. Continue reading

Practical Advice For Living Successfully With A Mental Illness

There is a multitude of things I had to learn to manage when I got sick. There are many practical, everyday tasks that must be fulfilled in order to stay in the game. In all of my trial-and-error learning, I’ve figured out some very crucial things. If you’re mentally ill, I hope you learn to do all of these things too.Above the Spiral CC

The first and biggest is managing medicine. You have to take every dose at the right time every day, or it’s not going to work for you. If you feel like your medicine isn’t helping, this may be the culprit. Even the perfect medication only works if you put it in your body on time, every single day, and that is a much bigger undertaking than one would assume. I strongly recommend putting alarms on your phone for every dose-time. When I started, I had to put a backup alarm on, too, for ten minutes after my dose-time, because I got used to hearing the alarm, turning it off, and then forgetting about it and not taking my medication. If your memory is impaired (as mine is), this will be even more challenging, but if you stick to this routine, you will eventually Continue reading

It Is Possible to Lose Weight While on Psychiatric Drugs, and I Believe in You!

Three years ago, I weighed 270 pounds and I was miserable. Now down to 155, I get terrified when I see fat people because I know I could go back to that weight if I’m not careful.

Medicine for psychiatric conditions makes weight control very difficult. It’s another one of those things about mental illness that’s not fair. On Seroquel, my first antipsychotic, I never felt full. Ever. I’d go to the school cafeteria and go back for seconds, thirds, dessert, and, of course, second dessert. My stomach would hurt badly, and I still didn’t feel full. It was like being hungry all the time for two years. Eventually, I leveled out on the Seroquel and could feel full again, but by then I’d put on a lot of weight. As a student at the time, exercise was not part of my routine. I was mostly in survival mode, just trying to keep my head above water.

Over the next few years, I continued to slowly and steadily put on weight. I wasn’t overeating the way I had been before, but I was making a lot of poor choices about what I ate and how much, and I wasn’t physically active. Finally, in 2014, my mom sat across the table from me, watching me eat dessert, and said: “If you’re not careful, you’ll be over three hundred pounds soon.” That struck terror into my heart. I’d gone too far, and I had to find a way to reel myself back in. Continue reading

Helped, but not cured

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With episodes, no matter how many tools I use, I still hurt deeply. I cannot be cured. The goal of medicine and coping strategies in my case is to ameliorate my symptoms, not eliminate them. I do have good days. Sometimes I can string them together for a while, but this is how my brain works, and I don’t get to trade it in. Sometimes the idea of living sick for the rest of my life makes me very, very depressed. It can even lead to a thought spiral, which in its own right can trigger an episode.

I can lessen my pain; I cannot eliminate it. Having to live in this consciousness has the unfortunate consequence of being aware that I’m in pain. It’s deep and broad, and sometimes I get swallowed up and go very far away. So far I’ve always come back.

I’ve tried to kill myself twice. The first was hanging; my neck didn’t break and I got caught and was cut down. The second was an overdose of lithium. I planned that one much more thoroughly, and it was not at all an impulse decision. I had to wait two weeks after I finalized my plan so that I could get my refill and have enough to take ten grams or 10,000 milligrams. Eight grams is the lethal dose. I don’t know why I survived, but I’m sure my liver is shot. The good news for me is that it’s only been two times that I’ve tried to commit suicide in the course of eleven years, and my last attempt was only two years into my diagnosis.

Almost everything is much easier now. I’m able to handle my episodes with more strength and sometimes even grace. There is a steep learning curve in bipolar and mental illness, and you have to master things like pharmacies, insurance, doctors, prescriptions, refills and of course your own survival skills that you build as you grow. I know now that I have to be my own advocate as a patient because getting health care of any kind is not a “customer is always right” situation. You either work the system the way it is, or you go without.

Not being cured of bipolar, ever, is discouraging in the extreme. I have to be vigilant with my meds, my exercise, my diet, my sleep schedule, and my mindfulness in order to stay alive. Then, depending on the day, I throw in some other coping tools to help whatever needs helping. I’ve made it to thirty-one years old and twelve years bipolar. I’m pretty damn proud of that.

By Emily Harrington