Stopping Your Medication Doesn’t Make You “Free” or “Clean”

Here is an excerpt from a new series in The New York Times Opinionator section titled “Going Off:”

Two years ago, meds delivered me from depression. Now I’d like to find a cleaner escape, one as effective as meds, as compelling to me as self-deprivation. Or I’d like to learn to live without trying to escape. Or maybe I’d like to refocus my lens, to stop seeing my brain, my body, as a prison.

I hesitate to link to these articles, written by Diana Spechler, because they’re so egregious in suggesting that going off psychotropic medications is a journey we should all consider if we want to be “free” or “clean.”

We’re all on our own journeys—of that I am certain. I don’t judge Spechler’s decision to stop taking medication. What I do judge is the conceit of the column: that to go off of medication is a form of strength. For many of us, going off medication means jeopardizing our lives.

That The New York Times has published these essays in 2015 boggles the mind.

Please, if you are taking medication, do not let the stigma attached to psychotropic medications as illustrated by this column make you consider stopping treatment, especially if you have bipolar disorder.

To stay on medication, to continue with treatment, to accept that you can’t necessarily will yourself out of a depression or calm yourself down from mania: that is strength. That is freedom. That is, I promise you, no less clean or authentic a life as anyone else’s.

Depakote and Weight Gain: Trying to Lessen Side Effects

Psychotropic medications can lead to weight gain.  This is a fact.

However, I have had some doctors who have been entirely unsympathetic to my desire to not gain weight from my medications. One doctor actually said to me, “I would like to see you ten pounds heavier,” as if his opinion about my body were relevant to the conversation.

Other doctors–my current doctor included–have realized that weight gain does is not inevitable for everyone.  I have managed to adjust my medication, taking 100 mg of Topomax, to counteract the Depakote weight gain (something that works for me… not for everyone!)

My point here is: it’s important for doctors to help us mitigate side effects as much as possible.  It’s bad enough to know that we will need to take medication, most likely, for life.  We need to therefore know that our doctors are working with us to find meds that have the fewest side effects possible.

Some antispychotics, like Zyprexa, have actually led to diabetes, and thankfully, law suits that have brought the issue to light. Medication should not cause illness.

Organizing your medication: half the battle

Sometimes my pills get totally out of control.  They’re  scattered between the bedside table and the bureau. I don’t have a sense of when I’m going to need refills.  I just take my nightly dose out of the bottle and stop using pill containers.

This is just a short post to say that, if you’re bipolar and on lots of medication, organizing your pills once a month or so is half that battle.
Organizing tips:

• If possible to get mail prescriptions (like medco) with your insurance (here’s hoping you have insurance), do it.
  Having a larger supply of meds just makes everything easier.  Less of a chance you will run out.
• Buy at least four weekly pill boxes (get them at any drugstore), and fill up for the month.
  This way, you will use that one chunk of time once a month to get all the drudge work of plunking pills into plastic boxes out of the way. Each night, all you have to worry about is having a glass of water, opening up the little compartment and swallowing.
• Put all the extra bottles in one designated place.
  A nice shoebox works. Or a smaller bureau drawer.  Lots of people still keep pills in medicine cabinets, but experts say that pills should not be kept there.

These are perhaps obvious tips, but when I first went on my medication, I would just keep bottle in my nightstand drawer–scattered–and when I get disorganized I sometimes find myself with drawers filled with pills as opposed to what I should have: neatly organized pillboxes, refilled every month.

Pills

I just spent an hour organizing my pills. It’s quite a production. I’d had everything in a shoe box, and somehow all the bottles spilled into a total mess.  Now everything is in its place, and I have six weeks where I don’t have to do anything but open a little plastic box and pop away. Every time I do this, I think–where will I be four, five, six weeks from now?

Here’s a rundown of the recently reduced cocktail: Depakote (500mg), Seroquel (25mg-75mg); Topomax(100mg); Wellbutrin (150mg); Lunesta (1mg–sometimes); Xanax (can’t remember the mg … sometimes).

This is what mania looks like…

In the mirror, I see my face differently. All of my flaws vanish and tonight, I am beautiful. I walk around my apartment, colors and patterns popping out more vividly than ever. At work, I speed through every task, but when I receive an e-mail that’s inappropriate, instead of letting it go, I crave confrontation, a reckoning, drama.

I have sex with people I barely know, and I like it.

I talk to myself in the mirror, say the things I want to say to the jerk who wrote me that e-mail.

My head feels swollen, tired. But something is buzzing. Something that keeps me awake. Keeps me thinking about everything.  I have big plans. I am going to finish this novel. I am going to apply for a new job. I am going to get a boyfriend. A great boyfriend. All of these things seem, suddenly, possible.

My medication. As I get undressed, I convince myself to skip the Seroquel like I did last night, since that skipping plus caffeine I drank today led me to this place, I know. I look down, pick up the pills to swallow them, and at the last minute, gulp the Seroquel down with everything else.

Now the Seroquel is shutting my brain off. I can feel it working. My eyes are crossing even though I’m wired. I’m not going to be able to resist sleep, though I want to stay up.

Do I really need to drug myself to stay alive? I can’t help but feel this way, resent the fact that I couldn’t just stay up and keep buzzing like any other normal person with good ideas after midnight.

Living in Color

More of us bipolar folks need to speak out because when you hear about a bipolar person in the news, they’re doing something insane.

So many people think we’re just raving lunatics. In my writer’s group the other night, I was workshopping my novel, which is based on my own life. One of the guys in the group said: “It’s such a bummer that she has to be bipolar.” Well, yeah, I guess it is a bummer. So often I think I just want this all to go away. I want to stop thinking about the medication. I want to stop thinking that I’ve just said or done something crazy.

But then, there are other days, like today, when I think: this is part of who I am. And maybe I was put on this planet to speak out. To give other people who are just experiencing these frightening symptoms hope that they can live a “normal” existence. No matter how crazy you get, you can always turn back from that black hole of madness and find peace.  Medication has saved me, but I don’t take so many meds that I feel drugged. At this point I have realized that the dance of controlling my mood swings–the hypomania, the depressions, the pills, the therapy–that’s who I am.

I mean, if I could magically make it all disappear and still feel filled with life and energy, I’d do it. But if making the symptoms totally disappear means sucking some of the color out of my life, well, then, I’d rather have the ups and downs and live in a more colorful world.

Skipping Seroquel

Tonight I’m not taking my Seroquel. My doctor knows that some nights I don’t take it. I take a very low dosage that ranges from 25 mg from 100 mg if I really need to knock myself out of a hypomanic episode. I really need to be able to get out of bed tomorrow morning by 7:45 a.m., and the 25 mg makes me groggy.

Earlier, I had my writing group. I workshopped a scene where I talked about Seroquel and hypersexuality. People were shocked because they knew nothing of mania. One woman in my group started talking about the work as if she really knew where I was coming from because she has gone through depressions. While this is true to a certain extent, depression and bipolar disorder are not the same thing.

She also added that she got through her depression “without medication.”  This kind of comment drives me crazy. What people don’t understand about Bipolar (Bipolar I especially) is that you can’t just get through it without meds. At least 99 percent of people cant.  Yes, I can skip my Seroquel tonight, but I’ve taken Depakote along with a cocktail of other drugs for 10 years, and that’s how I’ve kept myself out of the  hospital.

Medication is not a choice for me.

No one would tell a diabetic: “stop taking insulin.”

People don’t get it.

When do you tell someone you’re bipolar?

I haven’t posted lately, probably because I’ve been consumed by a new relationship. Well, I don’t want to ‘jinx’ it by calling it a relationship, but let’s just say I’m dating someone that I really like. Usually I keep all my medication in my night table drawer. Usually, I keep at least a dozen pill bottles around and when I need to, I sit on my bed with some television program in the background to entertain me while I put 5-6 pills in each daily compartment of the plastic cases I use to keep things organized. So my drawer is a mess of orange pill bottles and three plastic old-lady pill cases.

Since the new guy started coming over to my place, I’ve put the pill boxes and the pill bottles in a shoe box. The shoe box is in the bottom drawer of my bureau.  Put simply, I’m hiding the pills just like I’m hiding the bipolar disorder. (Or am I just not revealing information that I shouldn’t reveal at this point anyhow?)  It’s been about a month since we started dating. In the past, I’ve blurted out “I’m bipolar” at the beginning of knowing someone. Once, in a moment of complete and utter madness on my part a few years ago after a terrible break up, I decided to tell a guy I was bipolar on THE FIRST DATE. I’ve now realized that bipolar disorder is something that I deal with and not something that the person I’m dating should have to deal with explicitly, especially at the beginning of a relationship. Yes, it is who I am as a person, but I have things under control.

Still, at a certain point, I feel obligated to tell him. I feel like he has a right to know, but I fear judgment and I fear what I know has happened in the past. Which is that once you tell someone you’re bipolar, suddenly you’re the one who’s really troubled. The one who is judged when she’s in a bad mood. The one who, the other person feels, might be worth leaving because she’s not “stable,” even though, I would argue I’m so obsessively tuned in to maintaining my stability that I’m in fact more stable than most.

This is my brain off Seroquel

OK I admit it.  Or maybe I’ve already admitted it on this blog: I’ve skipped the Seroquel these past few nights. It seemed like a fine idea until now, as I sit here with this buzzing in the back of my brain, with a tired body, with heavy lids that want to close over dry eyes if not for these thoughts darting every which way, keeping me up, keeping me open.

At work today that my behavior was a little strung out. I was obsessively creating outlines and feeling competitive with coworkers. I was feeling overconfident. I was over-sharing about my family and speaking when other people were not really interested in hearing from me. The beginnings of hypomania at its finest.

But instead of staying home tonight like I should, I’m going out to a friend’s birthday party.  I’m going to put on a skirt that’s too short because even though I’m exhausted, I’m also elated. I’m charged up, and short skirts were made for nights like this. (Here’s the clinical definition of how I’m feeling.)

p.s. gotta love the irony that this morning I’m offering bipolar tips and this evening i’m admitting to hypomania.  but i’ll have it under control soon.  i will. i will.

Dancing With Seroquel

no one drugged their way out of this kind of mania...

When I start to get manic, there are some things I always notice about my changing behavior before it becomes wide-eyed craziness. (I didn’t think I was anywhere close to manic until this morning, but here I am, feeling way way way “up.”) Actually, I haven’t had a full-blown manic episode that’s landed me in the hospital in 10 years; since that 28-day hospitalization in college, I’ve flirted with mania and often become what the professionals term “hypomanic.”

Now that I’ve clarified that. When I’m hypomanic (still able to go to work/school/not completely delusional), it feels like great fun for a little while. What I feel is utterly grateful to be walking around on this beautiful planet. Literally, I will think to myself, “I’m beautiful. I’m great. I’m so lucky to be alive.”  I’ll buy clothes. I’ll flirt with everyone in my path.  I’ll come up with some big project that, in my mind, is the most ingenious idea anyone has ever had.

But then  I do something really stupid. Then the bubble bursts. I send a really inappropriate e-mail to an ex-boyfriend or co-worker. I am at a party, and I find it necessary to monopolize everyone’s attention, but then I can’t remember what the hell I’m saying. Finishing sentences becomes impossible because my thoughts are slippery inside my head. Things start to crumble.

It’s once I get embarrassed and/or scared by the hypomania (and sometimes this is just because the reality of being in a state mental hospital 10 years ago is still so vivid in my mind) that I douse the manic fire with 14 hours of Seroquel-induced sleep followed by a Seroquel hangover that has me in a state where I’ve all but forgotten the unabated bliss I felt before drugging myself the night before.

I only take a very low dose of Seroquel on a nightly basis, but last night I skipped it entirely.

I just felt like I wanted to get up early this morning.

I felt like I was sick of the Seroquel.

That little pink pill was annoying me.

And sadly, maybe I am searching for a little mania, even if I know it’s bad for me.