WARNING: This is a (potentially risky) decision I have made for myself. It does not take the place of medical advice by a qualified mental health professional.
Today I had a conversation with 2 friends that confirmed a few thoughts I’ve been having:
- I will not go back to Psychiatrist B under any circumstances.
- I need to stop taking my current medications.
- Listening to music daily will improve my mood and possibly also my brain’s functioning.
- I need to be honest and talk about my disorder more often.
Psychiatrist B didn’t take my thoughts about harming myself and even committing suicide seriously, despite the fact that the drug he was prescribing me can cause such thoughts. He also needed assurance from me that it was worth gaining weight to have the possibility of recovering from a disabling disorder; that my mental health is more important than my appearance! (He also made the typical assumption that fat = ugly, which I have no desire to perpetuate.) As one of my friends put it, there’s a significant risk that if I keep going to this doctor, his problems will have a negative impact on my well-being. It also certainly doesn’t bode well that the “clinic” hasn’t made any attempts to contact me about rescheduling the follow-up appointment I canceled nearly a month ago.
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Regarding my medications, the bottom line is: they’re not providing the relief I need. Regardless of whether they’re helping “somewhat,” the fact remains that they are not helping enough. And there’s the possibility that they are causing or contributing to some of my more disturbing symptoms. I haven’t been taking them for the past few days and to be honest it’s been a very rocky road. At this point I’m unsure whether I should hold my ground until they’re completely out of my system – or start taking them again in smaller and smaller doses until it’s safer to stop completely (or I run out). Everyone seems to think it’s better to wean myself off them slowly, but I’m concerned about what might happen if my levels spike again after being so low for the past couple days. It’s also a lot easier to just not take them than to try to figure out what doses would be appropriate and remember to take them regularly.
It’s recently come to my attention that I’ve been doing my readers and the companies that make certain brand-name drugs a disservice. I’ve been taking generic “equivalents” of Zoloft and BuSpar (sertraline HCl and buspirone HCl, respectively); prior to beginning this blog I was taking bupropion in place of Wellbutrin. Anyone reading my blog would think I was taking the brand-name drugs and that they were causing or contributing to the undesirable effects I’ve described. This is most certainly not the case. In Generic Versus Brand: What’s In That Pill? Part 1, Disorderly Chickadee sheds light on how generic formulations of brand-name drugs often are not as effective as the brand-name version; in some cases the difference in functioning one experiences can be “like a brain transplant.”
Most notably, there is a huge difference between Wellbutrin and generic bupropion, enough so that one generic formulation was recalled. It’s not the one I was taking, but it still raises some suspicion that I might have done a lot better if I’d taken actual Wellbutrin instead. I’m also wondering whether brand-name Zoloft and BuSpar would be more effective (and safer!) than the generic sertraline HCl and buspirone HCl I’ve been taking.
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I don’t usually listen to music, unless you count the background stuff in Oblivion – which either alerts me to the presence of enemies or puts me to sleep. Yesterday I had the very pleasant experience of listening to some of the more upbeat tracks on a CD of instrumental Celtic music. The bass and percussion were very grounding and calming, helping me to feel safe … while the foregound instruments were lively and played complex melodies in compound meter.
I had a lot of fun listening to the music, felt calmer and happier, and thought it was having a desirable effect on my brain. It required enough of my attention that there was little to no room left for disturbing thoughts, and it seemed to help organize my brain. My hypothesis is that the regular firing of neurons involved in listening to the music (which are located throughout the brain) may have provided the stimulation, serotonin, dopamine, and information pathways my brain needed to function more effectively. I might need to experiment a bit to figure out how many times per day and for how long I should listen to music, as well as what types of music will provide the best effects … but overall I’m optimistic that listening to music regularly will help – a lot!
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Finally, it felt really good to be honest about what I’ve been struggling with and have my friends accept my reality. They listened and shared their own related experiences, which helped me feel less alone in my struggles. They offered advice – some of which I found helpful – but more importantly demonstrated that they support me in my efforts to take care of myself. “You know you can call any of us any time you need to talk, right?” Yeah, I do; I just need a reminder that there are people who want me to reach out to them in my times of greatest need, when I feel like I’d be doing everyone a favor if I just ceased to exist.
a day with depression 
I hope you haven’t already stopped everything. Some medications you can’t stop cold turkey, You could have a seizure or a complete mental episode. You should check with your Dr.
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Thank you very much for your concern and for taking the time to comment. I really appreciate it.
To be honest, though, I’ve needed some time to consider whether to approve your comment because I don’t really find it helpful. Please understand, it’s nothing personal. I’ve approved it, unedited, and am going to respond to it in hopes that this can be a learning experience for both of us – as well as for other readers.
I interpret the “tone” of the comment as authoritarian (“you should check with your Dr.” – a medical authority), even if that’s not how you meant it to come across. I wonder if you doubt my ability to make my own decisions – do you see me as an incompetent child? If I’m feeling particularly sensitive, my response might include further doubting my own decisions, feeling incompetent, worthless, etc. That’s really the last thing I need. I’m also inclined to believe that’s the last thing you meant, so I invite you to clarify your own intentions behind this comment.
I’m also not entirely confident that you read and understood (on an emotional as well as intellectual level) the content of my post – specifically, the paragraphs about why I can’t go back to my Dr. and why I’ve chosen to stop taking my current medications. I thought I’d explained myself very clearly, but perhaps I did not. Sometimes I wonder if I’m just so different from everyone else that, no matter how clearly I try to explain myself, they might never understand.
To respond directly to your comment: If by “everything” you mean taking my medications, then yes, I have already stopped taking my medications. I know it’s not safe to do so “cold turkey” – that’s why I put the warning at the beginning of the post. I’ve been having a harder time coping, with more difficulty making decisions, more anxiety, and more times when I cry or feel like crying that wouldn’t make sense to an observer. I have not had a seizure or psychotic symptoms (hallucinations; paranoia; disorganized thoughts, speech, behavior; etc.) and any disturbing thoughts I’ve had haven’t been that much worse than what I’d already gotten used to while taking the medications. It’s not ideal, but it’s survivable until I find the help I really need. I’m fortunate to have people who love and support me and whom I trust to help me through this, even if I’m not always the best at reaching out to them.
I’m still writing this blog, seeing my music therapist (Wakana), trying to figure out what I can do to recover, talking to people I trust, and taking steps toward finding professionals who will meet my mental health needs. So, from my perspective, I haven’t stopped “everything.” I’ve only stopped taking my medications.
Regarding my Dr. – Psychiatrist B – I do not feel safe “checking with” him. I did not feel comfortable telling him information he needed to make the right decisions about what medications to prescribe, because of how he responded to other things I told him. When I did try to tell him that information, he did not seem to take it seriously. He wanted to put me back on a drug he knew (or should have known, because I’d told him on day 1) I’d already had serious problems with. Worse, he was very limited in the options he was willing to consider – definitely NOT what I need while trying to find the medication(s) that is/are right for me, which is nowhere near a precise science. And he was unwilling to work with my music therapist – the professional who knows me inside-out, backwards, and sideways, wants to collaborate in order to provide me the best care possible, and is genuinely concerned about my well-being. She has been encouraging me to find a new psychiatrist for nearly two months now. I trust her judgment – and my own – a million times more than I trust his.
So, yes, I need to consult with a doctor regarding medications. It would really be much better if I could have slowly reduced the dose of my medication under the guidance of a doctor instead of stopping “cold turkey.” But doctors are not omniscient omni-benevolent omnipotent gods of medicine, whose words we can or should trust to define our very being. They’re imperfect humans just like everyone else, with different traits that may or may not match what an individual patient needs. As I hope I’ve made clear, I do not – cannot – trust “my” doctor to provide the guidance I need. Given my current reality, I’ve made what I perceive to be the best decision for me and I need others to respect that, even if they disagree.
I refuse to enter into a doctor-patient relationship where I have to ask permission to make decisions about my own brain, body, and quality of life (as “checking in” would imply, from my perspective). I need to find a doctor who acknowledges their own limitations and views me as the authority on myself; who understands that their role is to know everything there is to know about the different drugs that might help me and to make suggestions about what might help. To listen to my feedback and use it to help make another suggestion, if necessary. And to prioritize my recovery / well-being over all other concerns when doing anything that has anything to do with me.
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http://theicarusproject.net/HarmReductionGuideComingOffPsychDrugs
I understand where you’re coming from. Psychiatric drugs can often cause more harm than good. I am having similar feelings about my own medications. If it is the case that the benefits do not outweigh the side-effects, then I support your decision. I think you know that withdrawal can be scary. I urge you to read what seem to be relevant sections of the above document and continue seeking support from your friends in this time. Please know that I’m saying this not because I don’t trust your ability to do this, or that I think this is the wrong decision for you, but because I know it’s hard on anyone and it’s important to have support in difficult times.
Psychiatrist B sounds like an asshole who you don’t need in your life, but there are (believe it or not) psychiatrists out there who can help you to come off psychiatric medications safely and support you in this process. Psychiatrists aren’t just there to prescribe medication, they’re there to support your overall well-being and mental health, whether this means being medicated or not. I think of my psychiatrist as a consultant; someone who happens to know far more than I do about neuroscience and psychiatric medications, but I know more than she does about myself and my history and what has worked and not for me in the past, so we collaborate to come up with solutions. Sometimes the solution is to change the dose of my meds, or add a new med. Sometimes, however, the solution is to come off of a med entirely (perhaps replacing it with a natural supplement, or perhaps not), and she helps me to do this, suggesting alternative coping skills that could potentially take the place of said medication.
The Icarus Project, which I linked to above, has forums, support groups, artistic events, and mental health activism. The forums at least list a lot of valuable resources for coming off medication and for finding professionals in the area who are friendly toward alternative treatments. There is a directory of professionals somewhere in there. I’m mentioning this because the whole philosophy of Icarus is that people with mental health issues have the ultimate knowledge about themselves, and so should be in charge of their own treatment.
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Thanks so much. I haven’t gotten to read the guide yet, but I did take a brief look at the Icarus Project website and it seems like an extremely valuable resource. I’ll definitely be checking out the community, directory of professionals, and other parts of the site. š
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The DSM fails to account for co-diagnosis or āmulti-disordersā
If a loved one has obsessive-compulsive disorder, they’re likely to struggle with other anxiety disorders as well. Depression co-occurs with anxiety 60 percent of the time. All this is unexplained by the DSM. The only way to account for high rates of comorbidity or āco-diagnosisā is that many disorders are driven by the same underlying or Bill BIG word ā¦.(trans-diagnostic) mechanisms. Rumination, or āstewingā for example, is a major driver for both depression and anxiety — that’s why they are so often seen together. Though rumination may focus on different things (e.g., personal failures in depression vs. future catastrophes in anxiety) it is a required target of treatment across both diagnoses.
In light of its failures, one might reasonably ask: why a new DSM? In truth, this fifth edition is just moving a few deck chairs on a sinking shipā¦..seriously! Dumping the multi-diagnosis system and Asperger’s disorder while adding binge eating, hoarding, and excoriation disorder (skin picking) has brought us no closer to a classification system that explains what’s wrong and guides evidence-based treatment decisions. Soon we’ll need to finish what the NIMH started — lower the lid, hammer it down, and bury the Diagnostic and Statistical Manual of Mental Disorders.
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Thank you for your comment. I’m also inclined to be skeptical of the DSM. I have yet to read and evaluate the DSM V myself, so I’ll have to get back to you with my thoughts on the changes they’ve made. I have heard that there are criticisms, though, so the ones you list here do not surprise me.
I found the video on your blog ( http://billsickert.org/2013/08/11/prozac-has-a-natural-enemy/ ) very interesting. I’ll admit it seemed a bit sensationalist, but as someone who has taken a few psychotropic drugs I could relate to most of what the people in the video were saying. It’s terrifying to think that psychiatrists just sit around making money and ignoring the serious harm the drugs they prescribe can (and do) cause. I’m glad I trusted my instincts (and received support from loved ones in doing so); I’m no longer seeing a psychiatrist who didn’t take my suicidal ideation seriously. It may have been brought on – and was definitely made worse – by the drug he was prescribing me.
I would be happy to read any additional information you have about this topic, as long as it is not advertising a particular product. Thanks again!
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