Tag: psychiatric medication

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General

Bipolar Disorder and the Complicated Nature of Management

Misconceptions about the treatment and management of mental illness stem from incorrectly associating it with traditional treatments. That causes mentally ill people and their supporters to draw poor conclusions on how treatment will progress and what benefits management can provide.

As an example, consider a headache. You can down a couple over-the-counter pain relievers and it’s normally gone within a half hour. It’s pretty consistent for most people. Psychiatric medication, on the other hand, can be very random in the benefits it provides because it is dealing with a much more complicated problem.

A majority of mentally ill people that take psychiatric medication will not have a “perfect” experience with it. It may include side effects that are difficult to manage. It may make the person too numb to function or unable to think, essentially mirroring the effects of severe depression. It may only control a limited number of symptoms or not have as powerful an affect as needed. There are so many factors that influence how well psychiatric medication works that it’s just not possible to know ahead of time what exactly it will do from person to person. Brain and body chemistry are incredibly complicated.

Just swallowing the pills doesn’t mean they are going to fix everything or even eliminate it completely. Effective mood disorder management usually includes several other facets, like reducing stress, changing diet, giving up other chemical substances, exercise, and a consistent sleep schedule. And even after all of that, the person can still have bad reactions to certain situations and triggers.

Balance is an important choice as well. Some of us choose to stay on medications that provide a great deal of benefit with minimal side effects rather than pushing for an ideal solution that may bring more severe side effects with it. Why? Because there is no guarantee that we will ever reach that ideal place with our medication.

It’s all trade offs. Are these side effects worth the benefits I’m receiving? Should I keep pushing for something better or settle for how I feel now?

Mental health wellness can be a very messy affair. Even when taking medication, the person may still experiences symptoms of their mental illness that can be disruptive to their life. It’s rarely as simple as just taking a pill.

It’s important to maintain reasonable expectations. We, as mentally ill people, cannot just assume that our mental state and the damage resulting from it is going to be fixed with medication cocktail. Supporters and loved ones of mentally ill people need to understand that wellness is a marathon, not a sprint. It’s a long-term endeavor in which there can be many obstacles and bumps in the road.

There are times when the only choice you have is to ride out mental unwellness, whether you’re on medication or not. And for a supporter, that may mean needing to have a bit more patience as the waters calm in the mind of their mentally ill loved one, even if they are taking medication.

Sometimes all you can do is have patience.

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General

Generic Medications Are Not “Knock Offs”

Image courtesy of www.freedigitalphotos.net by jscreationzs.

A couple of weeks ago, I posted this list of generic meds I compiled in a public place. One of the very first comments I received was to the tune of “You shouldn’t be recommending drugs, let alone knock off drugs to people. You’re not a doctor.”

1. They are correct. I am not a doctor. And you will note that I have never claimed to be, nor will ever claim to be. Because I am not. I am an eloquent mental patient. Nothing more.

2. Did I recommend any drugs? No. I compiled a list of $4 generic psych medications out of public information freely available from your local Big Box retailer. I said “if affordability is an issue, you can discuss these with your doctor to see if any is a good fit for you”. That is not recommending a treatment. That is recommending that YOU TALK TO YOUR DOCTOR ABOUT YOUR TREATMENT.

In my purely unprofessional opinion and what I’ve personally witnessed, it may cause MORE damage to have someone go on a psych med for a few months and then need to come off of it because they cannot afford it. Bipolar Disorder is for life. You need to plan for long-term management. Can you afford $100 a month for prescriptions? Most people I know cannot. Therefore, $4 generic equivalents are a better alternative.

3. Generic medications are NOT knock offs. People wrongly assume that the medication industry is driven by the standard supply and demand model, like much of retail. It is not. A company patents a formula, researches it, and is allowed to attempt to recoup costs of development and profit from it in the time remaining on the patent – which is 20 years from the establishment thereof. They essentially set their own price point.

Medications that fall OUTSIDE of that patent period can be produced by any other company. Many times, they are produced by the original company and put out as “generic equivalents”. They are the same chemically. The only difference is that they are now outside of this patent period, so the company does not have free reign to put whatever price point they want on the drug. This is why new medications cost so much.

4. Doctors are not pharmacists. Doctors are not the financial wing of whatever entity they work through. They do not price shop for you. Their job is to treat whatever problem you are bringing to the table. YOU need to tell your doctor if price matters or you do not have insurance that covers prescriptions.

I take two generic meds – lithium carbonate and citalopram. I pay $8 a month for both of my prescriptions. The lithium works great; but I’ve always had a hard time with antidepressants. Is that the fault of the citalopram? No. Chemically, it is Celexa.

So long as I’m not ordering my psych meds from a sketchy, internet pharmacy based out of El Salvador; there is not going to be a difference between putting name brand Celexa in my body instead of citalopram. The only difference is the bureaucracy surrounding it.

This is not new or “secret” information. It is all publicly available if you look into how medications are developed.

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General Other

Representing Depression And Bipolar Disorder With The Drama Masks

Anyone that has spent any amount of time poking around the internet has likely run into the Laughing and Crying Drama Masks as representations of the dual nature of Bipolar Disorder. Of course, the Crying Mask can easily represent Depression. Hell, I use it on my Facebook page myself. But I had an epiphany while having a conversation with one of my visitors who goes by “T” in the comments. So thank you, T, for jogging this particular thought process that I’m working on writing about.

The thought processes I’m referring to is one I hear constantly from folks dealing with the struggles that we face. “I’m afraid of medication because I don’t want to be a zombie.” “I don’t want to take it because it might make me someone I’m not.”

But here’s the thing- the reason those Drama Masks are such a perfect representation is because the Disorder (and Depression) are essentially masking who you actually are. The unmedicated, often unwell person you know now may not actually be the person you are. Instead, the person you are is obscured because the Mask is on.

I’ll use myself as an example, as I typically do. From what I can gather, I started Bipolar cycling when I was about 13. I spent about 75% of my time depressed, 20% of my time hypomanic, and maybe 5% as “other”; normal or recovering from an unwell cycle where I didn’t immediately shift into another cycle. The person wearing the mask had precious few opportunities to actually peek out from behind the Masks in that time frame.

The caseworker I saw for diagnosis asked me, “when was the last time you felt happy?” I couldn’t answer that. I didn’t know what hypomania was but I knew my “good times” were very damaging and strange for me- so I knew that wasn’t happiness because that’s not how it worked for other people. Happy people didn’t fuck up their lives and do insane shit when they weren’t depressed (which was my frame of reference that I didn’t quite understand since I thought everyone struggled with the same shit I did).

I’ve had glimpses of regular emotions unstained by mental illness. Only a few times but I remember the feeling crystal clear because it was like 3 times in the span of 20 years. I felt happy once, for absolutely no reason at all. I felt sad when I found out my ex-Fiancee had moved on and was engaged again; and then I felt happy when I realized I was feeling sad with no hint of depression on the horizon. Honestly, I had no idea what to do with myself with it because in 20 years I do not remember EVER feeling JUST sad. It was always depression. Numbness. Nothing. Null and void.

Those Drama Masks are an apt representation because the real you is behind the Mask while you’re unwell. The medication, self-management, doctor appointments, all the bullshit that we hate fucking doing- it’s to take that mask off and set it aside. The person behind the mask is the real you.

And let’s face it- that can be a frightening and daunting prospect. I’m not perfectly medicated at the moment but I’ve had tastes of wellness that keeps me driving forward, keeps me self-managing, keeps me hungry to succeed. I know the apathetic bastard is waiting to come out if I slip back behind one of the Masks. Frankly, that guy is a fucking dick. But that’s the person I was when the Disorder owned me.

Those of you that have been dealing with this shit for a long time who are afraid of what you might become if you pursued wellness- don’t be afraid. It’s quite likely that you probably don’t know the person you actually are. And speaking from experience- my outlook on a lot of things changed but my interests really haven’t. I still love heavy metal and rap, book/dice and video gaming, reading and learning; and essentially everything I usually have.

What has changed? Perspective largely. I don’t look at the world through shit-colored glasses anymore. If I drop a glass in the sink and it shatters, the Depression doesn’t automatically go “that figures, you always fuck things up.” Instead, with that Mask taken off; it’s just a shrug and me saying “mother fucker” to myself.

And to quote T’s comment- “I appreciate the points you added about the goal of meds and side effects being manageable. It really did help to stabilize me. Funny, I would write profoundly deep and dark pieces in my depressive states. The second day of my medicine I was feeling silly and giddy and wrote a couple of lighthearted, funny pieces. So the creativity is still there, but more balanced, as well as the moods. I’m glad that making the choice to take the correct medications gives even more choices.”

That’s a perfect example of getting a glimpse of the actual person behind the Mask.

And I want you to always remember (and I will beat this drum loudly for the rest of my existence)- psych medication should accomplish two goals. 1. It should make your mental illness manageable. 2. It should have bearable/manageable side effects.

If it does not accomplish those two goals then it is NOT RIGHT no matter how much your doctor may want to brush you aside and get moving (much love and/or mad props to the doctors and nurses that actually give a shit about their patients). YOU have to be the one to advocate for yourself and your wellness. What the fuck good is trading one debilitating problem for another? It’s not a fucking solution.

Sooner or later you’ll find a way to pack those Masks away in a trunk, chain it up, and dump it in the ocean where it belongs. You’ll get to know the real you. It will probably be a long, hard, shitty journey. But goddamn victory will be sweet.

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Coping Other Self-Help

A Few Misconceptions Of Psychiatric Medication #Bipolar #Depression

I spend a significant amount of time talking about psychiatric medication because I run into so many people that have drastic misconceptions about it, its applications, and how to best find success with it. It’s perfectly fine if you don’t want to use psych medication to try and get stable. What’s important is that you are making an informed choice about it. My personal opinion is that it is impossible to get control over Bipolar Disorder without it. Yes- a person can minimize the impact of unwell periods through natural means. I have never heard of anyone being able to eliminate the cycles altogether, with data to back it up, through non-medication means.

-There is a fuse on explosive situations.
Due to my living openly with Bipolar Disorder, I get pulled aside by quite a few people for a few quick words. A lot of those encounters have to do with a friend or loved one who was on a psych medication and ended up killing themselves. I’ve ran into Bipolars who did not want to take psych meds because they had a relative who killed themselves while on it or had a friend who preached the evils of it.

Every time I hear one of these stories my mind is flooded with questions. Was the person drinking/doing drugs while on it? Were they taking it as directed? Did they contact their doctor if they are having problems? Did they try and quit cold turkey? All of these things can possibly have devastating repercussions.

A person starting a new psychiatric medication knows they are going into a potentially dangerous situation. Therefore, you need to take precautions to ensure it doesn’t blow up in your face. Stop and analyze your moods a couple times a day as you start taking it. If it is making you worse- CALL YOUR DOCTOR. It really is that simple. A person that slits their wrists isn’t doing it because of the pills they took 5 minutes before. It can be fast but there is plenty of time to catch dangerous mental shifts if you are paying attention and monitoring your thoughts.

-A Bipolar person will likely be on psychiatric medication for the rest of their life.
“I started feeling better so I stopped taking it.” “I only take it when I don’t feel well.” “I won’t have to be on it that long, will I?”

Yes, yes you will. Bipolar Disorder is for life. When you get well from taking the medication, you MUST continue taking the medication if you want to retain your stability. The medication replaces chemicals or stimulates processes in your mind that it normally lacks- which is the physical reason behind the drastic mood shifts of the Disorder.

I’m pretty sure that most of us have a story of when we decided we didn’t need medication anymore and stopped taking it. It’s a great way to cause chaos in your mind on an unprecedented scale. If you’re well- do yourself and your loved ones a favor and keep taking the meds. Yes, it sucks to be shackled to it the rest of your life. But if it’s any consolation, look at your life up until that point and decide if you want to go back to that or take some pills every day? Bring on the pills!

-There are affordable medications out there to get Bipolar Disorder under control.
A significant portion of the people I talk to about Bipolar Disorder are either broke as shit or are on their way to broke as shit. When I provide people with information or advice, I want to ensure they are getting useful information they can implement and use for an extended period of time without too much of a burden on themselves. I know there are plenty of times in my life that I couldn’t afford 100+ bucks a month for medication and I don’t assume others can either.

So! Below you will find a list of generic medications available from the Wal-Mart pharmacy (or check your local pharmacies/big box retailers to see if any of them have generic programs) that are $4 for 30 days. Generics are simply meds that are no longer in their patent period which is what commands the high prices of name brand medications as the company tries to recoup their development investment and turn a profit. A lot of times it’s the same company that originally held the patent that produces them.

When you deal with your doctor- ask for a generic equivalent if possible. You have to be proactive about being informed. Doctors don’t regularly monitor pharmacy prices.

Citalopram – Celexa – Antidepressant
Fluoxetine – Prozac – Antidepressant
Amitriptyline – Sarotex – Antidepressant
Nortriptyline – Sensoval – Antidepressant
Paroxetine – Paxil – Antidepressant
Trazodone – Trazodone – Antidepressant

Lithium Carbonate – Lithium – Mood Stabilizer
Carbamazepine – Tegretol – Mood Stabilizer

Fluphenazine – Antipsychotic

I presently take Lithium Carbonate and Citalopram. I tried Fluoxetine but it didn’t do a damned thing for me. Lithium is the gold standard of mood stabilizers and has been in use as one since about 1950. It works really well for a lot of people and is the standard to which all new mood stabilizers are held.

I typically do not “recommend” anything. My usual advice is just keep trying things until something works because your brain chemistry is unique to you. Just because something works for me doesn’t mean a damned thing for you at all. However, Lithium is the exception as it has decades of data behind it. If you need an affordable mood stab, I recommend researching and inquiring with your doctor about lithium carbonate. It can potentially have some very severe side effects and isn’t a good choice for people with high blood pressure or heart problems. Do your research on any medication you put into your body. Pharmacies give you fact sheets, ask your doctor, ask your pharmacist, whatever.

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