Forgive yourself for everything.
July 27, 2015 2:39 PM Subscribe
"What you want to avoid is panic. What you want to teach yourself is that you deserve better than lying alone in a dark room, imagining yourself buried." || Diana Spechler for NYT's Opinionator: 10 Things I'd Tell My Former (Medicated) Self, the final installment in Going Off, a series of essays recounting the challenges Spechler has faced in gradually discontinuing her regimen of psychiatric medications.
It should go without saying that this is not medical advice.
Can you imagine asking your doctor about prescription-strength Cool Ranch Doritos?
[I]f there are days when Cool Ranch Doritos are the best thing you’ve got going, then by all means enjoy. Buy the family-size bag. Pop it open, crack a beer, watch an entire season of “Dexter.”
Anyway, it's good to see healthcare advice in the NYTimes has graduated to the op-ed dept. from its former home in the Style section, providing an alternate reality where Apple Watches cause cancer.
posted by a lungful of dragon at 3:25 PM on July 27, 2015 [3 favorites]
Can you imagine asking your doctor about prescription-strength Cool Ranch Doritos?
[I]f there are days when Cool Ranch Doritos are the best thing you’ve got going, then by all means enjoy. Buy the family-size bag. Pop it open, crack a beer, watch an entire season of “Dexter.”
Anyway, it's good to see healthcare advice in the NYTimes has graduated to the op-ed dept. from its former home in the Style section, providing an alternate reality where Apple Watches cause cancer.
posted by a lungful of dragon at 3:25 PM on July 27, 2015 [3 favorites]
One day we will treat the romanticized notion of going off ones psychiatric meds with the same level of romanticism that is warranted for choosing to avoid vaccines.
Today is not that day.
posted by ArgyleMarionette at 4:15 PM on July 27, 2015 [27 favorites]
Today is not that day.
posted by ArgyleMarionette at 4:15 PM on July 27, 2015 [27 favorites]
One day we will treat the romanticized notion of going off ones psychiatric meds with the same level of romanticism that is warranted for choosing to avoid vaccines.
I have one qualification to offer to this comment. Psychiatric medications are used to treat both acute and chronic mental health issues. Some people struggle with temporary, situational bouts of mental illness. Things like drug addiction, short term identity crisis, personal hardship, and traumatic loss can cause people to have mental health problems that, with proper care, do eventually get better. But once the medications start throwing a person's normal chemical balances out of whack, it might be hard to tell if they're really well again or not. I definitely think choices like that should be made under the close supervision of appropriate mental health professionals and not on the advice of personal life coaches, gurus, and the like. But once you get on medication for an acute problem, there really is supposed to be a day in the future when you can get off them again. How do you tell you're well again or not if you never do?
posted by saulgoodman at 4:33 PM on July 27, 2015 [23 favorites]
I have one qualification to offer to this comment. Psychiatric medications are used to treat both acute and chronic mental health issues. Some people struggle with temporary, situational bouts of mental illness. Things like drug addiction, short term identity crisis, personal hardship, and traumatic loss can cause people to have mental health problems that, with proper care, do eventually get better. But once the medications start throwing a person's normal chemical balances out of whack, it might be hard to tell if they're really well again or not. I definitely think choices like that should be made under the close supervision of appropriate mental health professionals and not on the advice of personal life coaches, gurus, and the like. But once you get on medication for an acute problem, there really is supposed to be a day in the future when you can get off them again. How do you tell you're well again or not if you never do?
posted by saulgoodman at 4:33 PM on July 27, 2015 [23 favorites]
One day we will treat the romanticized notion of going off ones psychiatric meds with the same level of romanticism that is warranted for choosing to avoid vaccines.
"Everyone has an opinion about depression. Everyone has an opinion about psychiatric medication."
What day was it when adverts like these started to be treated with deserved horror?
Clearly, there's a class privilege argument here, because it's the New York Times, but Spechler's rationale for gradually going unmedicated is not especially romantic, unless you're going to argue that a professional writer ought to stop writing because doctor knows best:
"Everyone has an opinion about depression. Everyone has an opinion about psychiatric medication."
What day was it when adverts like these started to be treated with deserved horror?
Clearly, there's a class privilege argument here, because it's the New York Times, but Spechler's rationale for gradually going unmedicated is not especially romantic, unless you're going to argue that a professional writer ought to stop writing because doctor knows best:
Bupropion and lorazepam saved my life, and I am not only grateful, but reverent: modern medicine is miraculous. But now that I’ve graduated from survival mode, now that I can’t even access the hopelessness I once felt, my writer’s block feels pressing. On meds, I’m sealed off: nothing can come out of me — graceful sentences, anger, tears — and not much can enter, either; nothing can hurt too badly. I don’t want to live like that.posted by holgate at 4:40 PM on July 27, 2015 [7 favorites]
"The time will come when you wake each morning not woozy with dread."
See now that never came for me until I started taking the drugs. I just developed a bunch of ineffective and self-destructive coping techniques up until they became clinical problems on top of my primary issues.
Also the whole ebullient proclamation she fixed her relationship obsessing — been there! Seen my friends do it! Experience says "first time since you were 12" is a solid breakthrough but not by any means the end of the pattern.
Anyhow, if you need to take drugs to feel OK you should. Or vice-versa. Shouldn't be any shame in either option or the middleground whether you're a raver or author or whatever.
Also she reiterates that nonsense about SSRIs quelling ones iinner muse. A destructive and silly myth. A myth akin to "heroin will make me write better" (RIP Bradley Nowell) and "I can't be productive without LSD" (Syd Barrett).
posted by Matt Oneiros at 4:41 PM on July 27, 2015 [10 favorites]
See now that never came for me until I started taking the drugs. I just developed a bunch of ineffective and self-destructive coping techniques up until they became clinical problems on top of my primary issues.
Also the whole ebullient proclamation she fixed her relationship obsessing — been there! Seen my friends do it! Experience says "first time since you were 12" is a solid breakthrough but not by any means the end of the pattern.
Anyhow, if you need to take drugs to feel OK you should. Or vice-versa. Shouldn't be any shame in either option or the middleground whether you're a raver or author or whatever.
Also she reiterates that nonsense about SSRIs quelling ones iinner muse. A destructive and silly myth. A myth akin to "heroin will make me write better" (RIP Bradley Nowell) and "I can't be productive without LSD" (Syd Barrett).
posted by Matt Oneiros at 4:41 PM on July 27, 2015 [10 favorites]
Also she reiterates that nonsense about SSRIs quelling ones inner muse. A destructive and silly myth.
Neither destructive, nor silly, nor a myth. Side effects vary. It's okay for her to say that her drugs made her less creative. It's not okay for someone to say her description of her side effects was nonsense.
posted by mittens at 4:56 PM on July 27, 2015 [18 favorites]
Neither destructive, nor silly, nor a myth. Side effects vary. It's okay for her to say that her drugs made her less creative. It's not okay for someone to say her description of her side effects was nonsense.
posted by mittens at 4:56 PM on July 27, 2015 [18 favorites]
You're right, it's presented as opinion in this instance.
posted by Matt Oneiros at 5:04 PM on July 27, 2015 [1 favorite]
posted by Matt Oneiros at 5:04 PM on July 27, 2015 [1 favorite]
The brain disease as explanation for trauma, emotional symptoms, or difficult behaviors is really not actually founded in evidence based science in the same way vaccines are.
We may in fact look back on this time in horror that we were using chemical restraints to mask the effects of harmful environments and trauma our humans are currently enduring in their families/social/school and physical environments. We are too often giving clinical labels to normal reactions to abnormal situations or developmental environments. "the fact that all feelings, thoughts and behavior require brain activity to happen does not mean that the only or best way to change — or understand — them is with medicine."
Shaming people for rejecting medications they found harmful is not actually as empowering to people who have coped with their mental wellness as you might think. And I would challenge you to provide actual evidence your claims are based in science rather than simply referring to the battle to get vaccine research accepted to mock people's personal experience with healing from mental health symptoms or finding they are in fact healthier without meds which is actually something plenty of psychiatrists even support patients with achieving.
posted by xarnop at 6:00 PM on July 27, 2015 [19 favorites]
We may in fact look back on this time in horror that we were using chemical restraints to mask the effects of harmful environments and trauma our humans are currently enduring in their families/social/school and physical environments. We are too often giving clinical labels to normal reactions to abnormal situations or developmental environments. "the fact that all feelings, thoughts and behavior require brain activity to happen does not mean that the only or best way to change — or understand — them is with medicine."
Shaming people for rejecting medications they found harmful is not actually as empowering to people who have coped with their mental wellness as you might think. And I would challenge you to provide actual evidence your claims are based in science rather than simply referring to the battle to get vaccine research accepted to mock people's personal experience with healing from mental health symptoms or finding they are in fact healthier without meds which is actually something plenty of psychiatrists even support patients with achieving.
posted by xarnop at 6:00 PM on July 27, 2015 [19 favorites]
I have mixed feelings about this because I want to support someone sharing a deeply personal story about this, but I also don't like the way it seems to be predicated on what she says is a recognition that the body is a "self-sustaining ecosystem."
And you know, frankly, part of me just hates her because her story is about teaching writing classes and going on artist trips and befriending Mexican healers in the italicized temescal. Weaning off medication is hard, and I know she went through a lot. But honestly, I'm more than a little jealous that that's what her process looked like. I "weaned off" medication because I couldn't afford to stay with a psychiatrist. I cut pills into small bits and tried to stretch things out (fun fact: if you go to a doctor about this, they will assume you're an addict and not write you a prescription). I had daily migraines for two months, severe nausea, and then chronic migraines for nearly three years afterward. Maybe she's just talking about wonderful moments she had in among the hardship, but I can't relate to standing in the sunshine, yoga mat in hand, expressing gratitude, because that's not how any of it worked for me.
I feel like a jerk to admit that I'm caught up in such petty bitterness, but it's how I feel. I have no way to relate to that story, and it feels like reading about how someone's life got so much better when they started eating imported Wagyu, because the American stuff just doesn't cut it, you know. And here I am.
posted by teponaztli at 6:13 PM on July 27, 2015 [36 favorites]
And you know, frankly, part of me just hates her because her story is about teaching writing classes and going on artist trips and befriending Mexican healers in the italicized temescal. Weaning off medication is hard, and I know she went through a lot. But honestly, I'm more than a little jealous that that's what her process looked like. I "weaned off" medication because I couldn't afford to stay with a psychiatrist. I cut pills into small bits and tried to stretch things out (fun fact: if you go to a doctor about this, they will assume you're an addict and not write you a prescription). I had daily migraines for two months, severe nausea, and then chronic migraines for nearly three years afterward. Maybe she's just talking about wonderful moments she had in among the hardship, but I can't relate to standing in the sunshine, yoga mat in hand, expressing gratitude, because that's not how any of it worked for me.
I feel like a jerk to admit that I'm caught up in such petty bitterness, but it's how I feel. I have no way to relate to that story, and it feels like reading about how someone's life got so much better when they started eating imported Wagyu, because the American stuff just doesn't cut it, you know. And here I am.
posted by teponaztli at 6:13 PM on July 27, 2015 [36 favorites]
I was incredibly, incredibly lucky with weaning off. At the time I decided to discontinue medication to see how it would go, I was on 450mg/day Wellbutrin and about 4mg/day of clonazepam. Sailed off both with zero side effects (apart from a severe depressive episode through the depths of winter).
As saulgoodman said.. sometimes psychiatric medication is like an antibiotic, sometimes it's like insulin. And really the only way to know is to try living without. What we need to encourage is the understanding that both states exist; for some people it makes sense to take X for a while to make it through and then move on, and for some people it makes sense to never ever stop.
posted by feckless fecal fear mongering at 6:57 PM on July 27, 2015 [11 favorites]
As saulgoodman said.. sometimes psychiatric medication is like an antibiotic, sometimes it's like insulin. And really the only way to know is to try living without. What we need to encourage is the understanding that both states exist; for some people it makes sense to take X for a while to make it through and then move on, and for some people it makes sense to never ever stop.
posted by feckless fecal fear mongering at 6:57 PM on July 27, 2015 [11 favorites]
One day we will treat the romanticized notion of going off ones psychiatric meds with the same level of romanticism that is warranted for choosing to avoid vaccines.
I benefited very much from a psychiatric drug at one point in my life. Maybe more than once depending on what counts as a psychiatric drug. But this is not remotely a fair comparison given how awful the well-established side effects of many of these drugs can be. Now if you are looking forward to a day when psychiatric drugs will be as effective and safe as vaccines, well, I certainly hope so.
posted by atoxyl at 8:03 PM on July 27, 2015 [4 favorites]
I benefited very much from a psychiatric drug at one point in my life. Maybe more than once depending on what counts as a psychiatric drug. But this is not remotely a fair comparison given how awful the well-established side effects of many of these drugs can be. Now if you are looking forward to a day when psychiatric drugs will be as effective and safe as vaccines, well, I certainly hope so.
posted by atoxyl at 8:03 PM on July 27, 2015 [4 favorites]
What day was it when adverts like these started to be treated with deserved horror?
Horror? I wish it were still that easy to get amphetamines though.
posted by atoxyl at 8:05 PM on July 27, 2015 [2 favorites]
Horror? I wish it were still that easy to get amphetamines though.
posted by atoxyl at 8:05 PM on July 27, 2015 [2 favorites]
To me, vaccines aren't a great example, but maybe it's more along the lines of Metformin. Metformin can do some really brilliant things. It can also have side effects which are really, really uncomfortable. It's still useful enough for it to be worth it being an early line of treatment for several different issues. But if you don't respond well to it, it's not impossible to make lifestyle changes that can get your blood sugar under control... it's just also not guaranteed that any one person will actually be able to do so. "I stopped taking Metformin and I'm glad I did because the runs never let up and it was horrible, and I'm doing okay right now on a low-carb diet" is like 10,000% legit. But caution should be taken not to cross over into "Metformin is a bad drug and taking maintenance medication for blood glucose control is bad", which can actually get people dead.
Some of this is just weird--um, trans fats cause mood swings, really? But mostly my problem is with all the starry-eyed "everything will work out for the best" stuff. That sort of thing creeps into a bad zone, for me. Mostly, I'd be fine if this were just her talking about her, but I don't think you get into the NYT that way. If the way you earn your living as a professional writer is by heavily suggesting other people would be fine off their meds, I'm all for creative work but maybe that's not actually a kind of creativity the world needs.
posted by Sequence at 8:31 PM on July 27, 2015 [6 favorites]
Some of this is just weird--um, trans fats cause mood swings, really? But mostly my problem is with all the starry-eyed "everything will work out for the best" stuff. That sort of thing creeps into a bad zone, for me. Mostly, I'd be fine if this were just her talking about her, but I don't think you get into the NYT that way. If the way you earn your living as a professional writer is by heavily suggesting other people would be fine off their meds, I'm all for creative work but maybe that's not actually a kind of creativity the world needs.
posted by Sequence at 8:31 PM on July 27, 2015 [6 favorites]
How the fuck do people get daily benzos? I've had severe panic issues, both chronic and acute and even during the worst panic attacks only been given a tiny handful and told to ration them carefully.
One bastard even gave me depakote because of social anxiety. Depakote is brutal and amazingly serious overkill for someone wanting to be able to have a conversation with co-workers without panicking.
It must be amazing to have doctors that will listen to you and give you scheduled meds without being treated like you're an addict.
Something about the article, how glib and "shucks one day you're gonna wake up and life will work and you'll have a great diet and everything will fall into place" The vision of a functional life she paints, full of yoga and farm stand vegetables, is so absurdly privileged it makes me hurt.
posted by Ferreous at 8:42 PM on July 27, 2015 [16 favorites]
One bastard even gave me depakote because of social anxiety. Depakote is brutal and amazingly serious overkill for someone wanting to be able to have a conversation with co-workers without panicking.
It must be amazing to have doctors that will listen to you and give you scheduled meds without being treated like you're an addict.
Something about the article, how glib and "shucks one day you're gonna wake up and life will work and you'll have a great diet and everything will fall into place" The vision of a functional life she paints, full of yoga and farm stand vegetables, is so absurdly privileged it makes me hurt.
posted by Ferreous at 8:42 PM on July 27, 2015 [16 favorites]
feckless fecal fear mongering: "sometimes psychiatric medication is like an antibiotic, sometimes it's like insulin."
Ah, no. This is not backed by science. It's basically pharma marketing. Unlike bacterial infections or diabetes, we don't have the foggiest idea what the etiology for most forms of psychological distress or undesired behavior categorized as "mental illness" actually is, or even if these issues are appropriately understood as biological problems. The theory that a "chemical imbalance" causes mental illness is (despite decades of research) still an unproven hypothesis, and as far as we can tell the drugs don't correct any proven chemical imbalance or deficiency. We don't really know why they work, and in many cases we don't even have a lot of solid evidence that the drugs don't do more harm than good over the long term.
Here's critical psychiatrist Joanna Moncrieff explaining a few misconceptions.
posted by Wemmick at 8:49 PM on July 27, 2015 [13 favorites]
Ah, no. This is not backed by science. It's basically pharma marketing. Unlike bacterial infections or diabetes, we don't have the foggiest idea what the etiology for most forms of psychological distress or undesired behavior categorized as "mental illness" actually is, or even if these issues are appropriately understood as biological problems. The theory that a "chemical imbalance" causes mental illness is (despite decades of research) still an unproven hypothesis, and as far as we can tell the drugs don't correct any proven chemical imbalance or deficiency. We don't really know why they work, and in many cases we don't even have a lot of solid evidence that the drugs don't do more harm than good over the long term.
Here's critical psychiatrist Joanna Moncrieff explaining a few misconceptions.
posted by Wemmick at 8:49 PM on July 27, 2015 [13 favorites]
The vision of a functional life she paints, full of yoga and farm stand vegetables, is so absurdly privileged it makes me hurt.
To me, it sounds like all she's doing is painting a picture of beginning to respond in an embodied, emotionally coherent way to simple life pleasures (or just stimuli).
posted by cotton dress sock at 9:17 PM on July 27, 2015
To me, it sounds like all she's doing is painting a picture of beginning to respond in an embodied, emotionally coherent way to simple life pleasures (or just stimuli).
posted by cotton dress sock at 9:17 PM on July 27, 2015
That's a bit loaded, sorry. I should say that the piece captures my experience after weaning off of Paxil.
posted by cotton dress sock at 9:24 PM on July 27, 2015
posted by cotton dress sock at 9:24 PM on July 27, 2015
I probably came off angry because my experiences with meds have often been either really messed up in terms of doses and access, so often my tapers were like "oh I'm out of prozac, guess I like brain-zaps now" It's kind of the way the article framing it as there's this great world out there if you just learned to love it without meds, and have access to medical staff who will listen to you, and you can afford to do so, and you're going off them to help your creativity and get back into these very upper middle class pursuits. It's not a realistic picture for most of us. I can't take time off my job to have a week where I'm a mess because of withdrawls, for me fear is that my next doctor won't be so understanding and decide that they want to choose my new meds without my input.
In the article it makes it sound like you just need to cry it out treat yourself to a cheat night for a while and everything will work out, but there's so many underpinnings that allow those methods to work that I don't even know if the author is aware of what luck she has to be able to use these methods to get off medicine.
posted by Ferreous at 9:45 PM on July 27, 2015 [10 favorites]
In the article it makes it sound like you just need to cry it out treat yourself to a cheat night for a while and everything will work out, but there's so many underpinnings that allow those methods to work that I don't even know if the author is aware of what luck she has to be able to use these methods to get off medicine.
posted by Ferreous at 9:45 PM on July 27, 2015 [10 favorites]
Oh god, yeah no, it took me the better part of a year, going super slowly, and it was horrible, and I was useless for most of it. After the fact, though - by the tail end of it probably, this is some years ago now - I felt a similar relief to be freed of the anhedonia, weird detachment, apathy, and just, indifference to people I cared about that characterized my time on that med (contrasted with the painful sadness in a dark hole that was the depression that preceded it).
The noticing broccoli and sun on the feet and being able to cry again (at all) bits were what I was mostly thinking of. I really was grateful for experiences like that coming back to me. (I definitely didn't make it to any retreat.)
posted by cotton dress sock at 10:06 PM on July 27, 2015
The noticing broccoli and sun on the feet and being able to cry again (at all) bits were what I was mostly thinking of. I really was grateful for experiences like that coming back to me. (I definitely didn't make it to any retreat.)
posted by cotton dress sock at 10:06 PM on July 27, 2015
Ferreous, you're not alone. I'd have memailed that but I wanted to make sure you saw it.
posted by JLovebomb at 11:27 PM on July 27, 2015 [1 favorite]
posted by JLovebomb at 11:27 PM on July 27, 2015 [1 favorite]
Sorry, I'm going to have to respectfully disagree about the widespread acceptance and love for psychiatric meds. I don't think anyone is pushing SSRIs as the One True Solution, at least not in the parts of the world where people are routinely told to pull themselves up by their bootstraps and have some more faith.
I'm glad going off meds worked for the author, I really am, but I can't help hearing the proclamation with a hefty side of, "See, you weren't REALLY sick."
posted by chainsofreedom at 4:06 AM on July 28, 2015 [4 favorites]
I'm glad going off meds worked for the author, I really am, but I can't help hearing the proclamation with a hefty side of, "See, you weren't REALLY sick."
posted by chainsofreedom at 4:06 AM on July 28, 2015 [4 favorites]
How the fuck do people get daily benzos? I've had severe panic issues, both chronic and acute and even during the worst panic attacks only been given a tiny handful and told to ration them carefully. One bastard even gave me depakote because of social anxiety. Depakote is brutal and amazingly serious overkill for someone wanting to be able to have a conversation with co-workers without panicking.
At least Depakote smells like M&Ms, so you get this tiny burst of optimism when you open the bottle. Then you take it and immediately gain 20 pounds and fall asleep, if you're me.
The daily benzo thing is an exercise in injustice. Two times in my life, I have had relatively unfettered access. Once, was after coming out of the hospital, when I had this extremely sweet but possibly early-senile psychiatrist who couldn't hear a word I said but was extremely free with the Depakote. Three a day, every day, like the world's most relaxing multivitamin. And now, I have a GP who, while not that liberal, still offers to give me monthly refills of my Ativan. I certainly don't need it daily, and take it maybe once a week, if that, but it is very comforting to have around, because nearly every other time in my life when I've run for help for panic, I got the same response you describe, that skeptical look, that "let's try something to lower your background anxiety and depression to see if that will help with the panic that is leaving you twisting around in your bed terrified to stand up or speak or do anything." Being treated like an addict. Oh, hey, doc, you know who has no trouble getting drugs? Actual addicts.
I have a pretty big damned grudge against psychiatry because of that.
But my grudges don't stop there. The first few times I went off meds, nobody knew to taper down. The docs looked at me like crazy when I tried to describe the brain freeze, the little lightnings at the corner of my vision, the way the world wasn't moving quite in sync with my head. It wasn't until I found a community of knowledgeable depressed people, putting together their stories about withdrawal and half-lives, that I really understood what I was doing wrong, and then could taper more sensibly...and only then did docs seem to get the message, and of course now they act like they knew it all along. (And I didn't get the deluxe NYT-author treatment while tapering either, usually just freaking out in the dark in whatever shitty apartment I was about to get kicked out of.)
Bleh. The whole experience left a bad taste in my mouth. I don't begrudge anyone their psych meds--mental disorders suck, they ruin lives, you find your relief where you can--but after decades of the meds, I am just so burned on them.
posted by mittens at 4:30 AM on July 28, 2015 [4 favorites]
At least Depakote smells like M&Ms, so you get this tiny burst of optimism when you open the bottle. Then you take it and immediately gain 20 pounds and fall asleep, if you're me.
The daily benzo thing is an exercise in injustice. Two times in my life, I have had relatively unfettered access. Once, was after coming out of the hospital, when I had this extremely sweet but possibly early-senile psychiatrist who couldn't hear a word I said but was extremely free with the Depakote. Three a day, every day, like the world's most relaxing multivitamin. And now, I have a GP who, while not that liberal, still offers to give me monthly refills of my Ativan. I certainly don't need it daily, and take it maybe once a week, if that, but it is very comforting to have around, because nearly every other time in my life when I've run for help for panic, I got the same response you describe, that skeptical look, that "let's try something to lower your background anxiety and depression to see if that will help with the panic that is leaving you twisting around in your bed terrified to stand up or speak or do anything." Being treated like an addict. Oh, hey, doc, you know who has no trouble getting drugs? Actual addicts.
I have a pretty big damned grudge against psychiatry because of that.
But my grudges don't stop there. The first few times I went off meds, nobody knew to taper down. The docs looked at me like crazy when I tried to describe the brain freeze, the little lightnings at the corner of my vision, the way the world wasn't moving quite in sync with my head. It wasn't until I found a community of knowledgeable depressed people, putting together their stories about withdrawal and half-lives, that I really understood what I was doing wrong, and then could taper more sensibly...and only then did docs seem to get the message, and of course now they act like they knew it all along. (And I didn't get the deluxe NYT-author treatment while tapering either, usually just freaking out in the dark in whatever shitty apartment I was about to get kicked out of.)
Bleh. The whole experience left a bad taste in my mouth. I don't begrudge anyone their psych meds--mental disorders suck, they ruin lives, you find your relief where you can--but after decades of the meds, I am just so burned on them.
posted by mittens at 4:30 AM on July 28, 2015 [4 favorites]
One day we will treat the romanticized notion of going off ones psychiatric meds with the same level of romanticism that is warranted for choosing to avoid vaccines.
Hey, I know you didn't mean for it to be, but that's a pretty hurtful statement for those of us who have experienced the difficult choice of coming off meds. My doctor and therapist support me in that choice 100%, but, to my surprise, many of my friends and fellow anxiety sufferers do not. It's very strange to be weaning off meds, in a community (of people with mental illness) where long-term or lifelong medication is accepted as the best treatment.
I am currently tapering off after a decade (woah) on various pills. I had my first real orgasm in years this weekend. I also teared up looking at a sunset. This is strange, but I'm so grateful I can experience this and not need to curl up in a ball under my bed. This works for me, and I wouldn't have known if I had bought into the idea that psych meds are always for life.
posted by third word on a random page at 5:15 AM on July 28, 2015 [3 favorites]
Hey, I know you didn't mean for it to be, but that's a pretty hurtful statement for those of us who have experienced the difficult choice of coming off meds. My doctor and therapist support me in that choice 100%, but, to my surprise, many of my friends and fellow anxiety sufferers do not. It's very strange to be weaning off meds, in a community (of people with mental illness) where long-term or lifelong medication is accepted as the best treatment.
I am currently tapering off after a decade (woah) on various pills. I had my first real orgasm in years this weekend. I also teared up looking at a sunset. This is strange, but I'm so grateful I can experience this and not need to curl up in a ball under my bed. This works for me, and I wouldn't have known if I had bought into the idea that psych meds are always for life.
posted by third word on a random page at 5:15 AM on July 28, 2015 [3 favorites]
"The vision of a functional life she paints, full of yoga and farm stand vegetables, is so absurdly privileged it makes me hurt."
This is part of why I see healing as an issue of poverty and access to healthy lifestyle as a bigger barrier to healing than the way we invest our money and research into miracle pharma cures.
We KNOW social support, reduced job stress (changing jobs or reducing work hours), financial stability, taking the actual amount of time off needed to process emotions or process emotional instability, healthy diet (and access to prepared food if coping with illness and too sick to cook), exercise (and coaching, and a host of other things can help but when someone is very ill they need a team of people helping them be able to do these things. This takes time, effort, resources and that all adds up to MONEY.
Sick people need help and we already know a lot of things that are needed we just don't want to spend the money. I don't have any beef at all with psychiatric meds being available to people who want to try them, but I do have a huge problem when we are skipping over a lot of evidence based research that the environment plays a major role in mental health and there is a lot we know could be helping people but we refuse to invest in the infrastructure or systemic changes that would both protect mental health in the general population and provide meaningful support to those coping with mental illness issues whether or not they are on meds.
I do think the general public and people who have been required or encouraged to take psychiatric meds have a deeper level of faith based belief in the science behind the meds than actual psychiatrists I have talked to or read writings from. Most (with exceptions) are pretty up front that they really don't know what or if the science behind them is and that they pretty much use them because it seems to help people and that's the model they are working with not because Evidence Based Medicine!! Many write openly they wish they could focus more on different models of therapy or multifaceted approaches to healing but the financial issues and pressures of the job literally are pushing them and patients in the direction of less meaningful interaction and more reliance on pills as a first and sometimes only course of action.
I'm just waiting and hoping for the general public to wake up and start pushing for meaningful change along with a lot of therapist and psychiatrist concerned about this kind of thing such that voting for "more mental health care" stops being about investing in pharma research and more controlling tactics to force people to take meds-- and means REAL change and investment in multifaceted modes of treatment that generate meaningful and lasting healing.
People DO deserve to be able to take yoga classes, meditation classes, eat farm fresh veggies, have a buffer from work stress.... and these kinds of things really might help a lot with healing. If so, the fact that people don't have access to them should not be seen as a sign of "privilege" but as a failure of our community to make healthy lifestyle accessible to all people and especially those who are sick and hurting and really need it.
I think this is a great example of how the word "privilege" can be used as a tool to mock those with healthy lives or being treated well and to suppress positive change, instead of to point out what everyone deserves and how wrong it is that too many are going without.
posted by xarnop at 5:37 AM on July 28, 2015 [8 favorites]
This is part of why I see healing as an issue of poverty and access to healthy lifestyle as a bigger barrier to healing than the way we invest our money and research into miracle pharma cures.
We KNOW social support, reduced job stress (changing jobs or reducing work hours), financial stability, taking the actual amount of time off needed to process emotions or process emotional instability, healthy diet (and access to prepared food if coping with illness and too sick to cook), exercise (and coaching, and a host of other things can help but when someone is very ill they need a team of people helping them be able to do these things. This takes time, effort, resources and that all adds up to MONEY.
Sick people need help and we already know a lot of things that are needed we just don't want to spend the money. I don't have any beef at all with psychiatric meds being available to people who want to try them, but I do have a huge problem when we are skipping over a lot of evidence based research that the environment plays a major role in mental health and there is a lot we know could be helping people but we refuse to invest in the infrastructure or systemic changes that would both protect mental health in the general population and provide meaningful support to those coping with mental illness issues whether or not they are on meds.
I do think the general public and people who have been required or encouraged to take psychiatric meds have a deeper level of faith based belief in the science behind the meds than actual psychiatrists I have talked to or read writings from. Most (with exceptions) are pretty up front that they really don't know what or if the science behind them is and that they pretty much use them because it seems to help people and that's the model they are working with not because Evidence Based Medicine!! Many write openly they wish they could focus more on different models of therapy or multifaceted approaches to healing but the financial issues and pressures of the job literally are pushing them and patients in the direction of less meaningful interaction and more reliance on pills as a first and sometimes only course of action.
I'm just waiting and hoping for the general public to wake up and start pushing for meaningful change along with a lot of therapist and psychiatrist concerned about this kind of thing such that voting for "more mental health care" stops being about investing in pharma research and more controlling tactics to force people to take meds-- and means REAL change and investment in multifaceted modes of treatment that generate meaningful and lasting healing.
People DO deserve to be able to take yoga classes, meditation classes, eat farm fresh veggies, have a buffer from work stress.... and these kinds of things really might help a lot with healing. If so, the fact that people don't have access to them should not be seen as a sign of "privilege" but as a failure of our community to make healthy lifestyle accessible to all people and especially those who are sick and hurting and really need it.
I think this is a great example of how the word "privilege" can be used as a tool to mock those with healthy lives or being treated well and to suppress positive change, instead of to point out what everyone deserves and how wrong it is that too many are going without.
posted by xarnop at 5:37 AM on July 28, 2015 [8 favorites]
"I feel like a jerk to admit that I'm caught up in such petty bitterness, but it's how I feel." I will add being pissed off that some people are ignorant of how much difficulty is in others lives is perfectly fair way to feel.
I think what the author did to heal is not available to far too many people, and this is an injustice as far as I'm concerned, worth being angry and bitter about.
posted by xarnop at 5:44 AM on July 28, 2015
I think what the author did to heal is not available to far too many people, and this is an injustice as far as I'm concerned, worth being angry and bitter about.
posted by xarnop at 5:44 AM on July 28, 2015
How the fuck do people get daily benzos?
In my case it was a 1-2 punch of major anxiety problems and needing to combat the bad-coke-like side effect of the Wellbutrin.
And to be fair, it's pretty reasonable for doctors to be leery of long-term benzo prescription, given how hard it is to get off them. They're kinda nasty drugs tbh.
posted by feckless fecal fear mongering at 7:02 AM on July 28, 2015 [1 favorite]
In my case it was a 1-2 punch of major anxiety problems and needing to combat the bad-coke-like side effect of the Wellbutrin.
And to be fair, it's pretty reasonable for doctors to be leery of long-term benzo prescription, given how hard it is to get off them. They're kinda nasty drugs tbh.
posted by feckless fecal fear mongering at 7:02 AM on July 28, 2015 [1 favorite]
I was prescribed a two-month stash of benzos to get me through the onboarding process of the medication I started taking earlier this year for anxiety and PTSD. At this point I'm pretty well settled into a stable dosage of my regular daily med, and have the remaining benzos just sitting around to be used in event of airplane travel or major anxiety attack.
What's dumb is that I am so afraid of using them up, because what if my doctor won't ever prescribe me any again, that when I DO once in a while have a major anxiety attack I don't take them. Because what if later there's a WORSE anxiety attack? And I am out? I have like forty-five pills left that I am afraid to take when I legitimately need them, because someday I might need them even more. The system is ridiculous and my brain is ridiculous and the two have collided in a spectacularly ridiculous way.
posted by Stacey at 7:53 AM on July 28, 2015 [6 favorites]
What's dumb is that I am so afraid of using them up, because what if my doctor won't ever prescribe me any again, that when I DO once in a while have a major anxiety attack I don't take them. Because what if later there's a WORSE anxiety attack? And I am out? I have like forty-five pills left that I am afraid to take when I legitimately need them, because someday I might need them even more. The system is ridiculous and my brain is ridiculous and the two have collided in a spectacularly ridiculous way.
posted by Stacey at 7:53 AM on July 28, 2015 [6 favorites]
I am in the process of adjusting my antidepressant meds right now and I'm at the point where if I thought I could go unmedicated without bad long-term consequences I would do so in a heartbeat.
But I just went for a week without any meds (to get a drug that was making me a manic ragefiend out of my system, whee) and man I remember why I started taking this stuff in the first place. Bleah.
posted by murphy slaw at 8:06 AM on July 28, 2015
But I just went for a week without any meds (to get a drug that was making me a manic ragefiend out of my system, whee) and man I remember why I started taking this stuff in the first place. Bleah.
posted by murphy slaw at 8:06 AM on July 28, 2015
Feeling defensive, now, enough to want to explain that I went off before tapering down was a thing doctors supported people with, before brain zaps were really taken seriously by medical people. My relation with my psychiatrist ended badly, after he called me at work to rage at me for giving 23 vs. 24 hours' notice for a missed appointment. (My boss could hear him yelling from her desk, he'd called her line to get me.) For support, I leaned heavily on an internet forum, where people speculated hopefully and anxiously, based on others' anecdotal experience, about when and whether this or that would come back, whether Benadryl or fish oil or B complex vitamins might help with the zaps or make it possible to respond to music again, or to other people, in appropriate ways. I remember feeling so frustrated with the vertigo and zaps, I begged a walk-in doc to give me anything to rid me of them, and the doc kind of eyed me, saying, "yeah sorry, I think I've heard about this, but you're on your own". I worked, but mostly wasn't great at it. Tapering down was all I did that year.
I was furious with my doctor, Glaxo Smith Kline and that whole industry, and myself, for ages, for the loss of that year and the few before. Like everyone else, I'd been fed up and just wanted to feel better, would do anything to make it stop; everyone agreed this was the way to do it. It's possible Paxil helped with some things, it probably did help stop the bleeding, as it were. But some things about me just haven't been the same since, and I still miss those things. A certain sensitivity that was essential to who I was, a whole way of processing experience and relating to the world, isn't there anymore. Yes, hard to pick out what's that and what's time and me just changing or aging, sure, but... I don't know.
I am now in the position of possibly being faced with taking another med, for something else, and I am kind of terrified of rolling the dice again.
posted by cotton dress sock at 8:32 AM on July 28, 2015 [5 favorites]
I was furious with my doctor, Glaxo Smith Kline and that whole industry, and myself, for ages, for the loss of that year and the few before. Like everyone else, I'd been fed up and just wanted to feel better, would do anything to make it stop; everyone agreed this was the way to do it. It's possible Paxil helped with some things, it probably did help stop the bleeding, as it were. But some things about me just haven't been the same since, and I still miss those things. A certain sensitivity that was essential to who I was, a whole way of processing experience and relating to the world, isn't there anymore. Yes, hard to pick out what's that and what's time and me just changing or aging, sure, but... I don't know.
I am now in the position of possibly being faced with taking another med, for something else, and I am kind of terrified of rolling the dice again.
posted by cotton dress sock at 8:32 AM on July 28, 2015 [5 favorites]
In addition to the money issue that xarnop raises, it is damn hard to find a therapist anyway, but especially one trained in a modality that helps you. It would be great if David Burns was everyone's psychologist, but what I usually get when I mention CBT to my healthcare providers is, "Oh yeah, I remember learning about that in school." Out here in the sticks I don't know what I'd do if I needed EDMR or something else specialized.
But yeah. I dislike the idea that mental illness should be seen as people just having a normal response to a shitty situation, because it means that most of everyday life is a shitty situation, and that's just not a tenable position with so few psychiatric resources in the vast majority of rural America.
posted by chainsofreedom at 12:32 PM on July 28, 2015 [1 favorite]
But yeah. I dislike the idea that mental illness should be seen as people just having a normal response to a shitty situation, because it means that most of everyday life is a shitty situation, and that's just not a tenable position with so few psychiatric resources in the vast majority of rural America.
posted by chainsofreedom at 12:32 PM on July 28, 2015 [1 favorite]
Stacey, I hear you on that fear of running out. I can get very nauseous when I'm anxious. I went to the hospital with severe dehydration at one point not too long ago, and they gave me a bottle of anti-nausea pills to help keep liquids down. But they gave me a bunch, and I ended up rationing them out and using them when I was in a situation that would make me anxious. And it would be that constant decision: "is this situation important enough to warrant using one of the pills?" And then there would be one less in the bottle, until I was down to my last couple and I was thinking "well, will I need one for this event, or can I get through this and use it for the next one?" It really reminded me of other things I've been prescribed.
The thing is, I'm able to get through life events without being horribly sick, but I think it's very hard for people to imagine just how rough it is when it feels like a constant fight just to have a normal day. I'm really against the idea that mental health just comes down to brain chemistry, and I'm especially angry about the way people can use that to give negative and demeaning labels to each other. But I think some people really have no idea just how hard daily life can be. The idea that "well, you don't need the medication to do this" can often outweigh how miserable it is to have to bend over backwards, every day, just to feel like you're hanging on by a thread.
In theory, I'd be as against medication as anyone else, but Jesus, it's like people expect you to suffer on principle because otherwise you're "just masking symptoms."
posted by teponaztli at 1:50 PM on July 28, 2015 [5 favorites]
The thing is, I'm able to get through life events without being horribly sick, but I think it's very hard for people to imagine just how rough it is when it feels like a constant fight just to have a normal day. I'm really against the idea that mental health just comes down to brain chemistry, and I'm especially angry about the way people can use that to give negative and demeaning labels to each other. But I think some people really have no idea just how hard daily life can be. The idea that "well, you don't need the medication to do this" can often outweigh how miserable it is to have to bend over backwards, every day, just to feel like you're hanging on by a thread.
In theory, I'd be as against medication as anyone else, but Jesus, it's like people expect you to suffer on principle because otherwise you're "just masking symptoms."
posted by teponaztli at 1:50 PM on July 28, 2015 [5 favorites]
It's really weird reading this stuff about the impossibility of getting necessary prescriptions. Literally the only time I had to be concerned about using up any of my PRN meds was when my doctor cut me down to weekly refills instead of monthly/90 day (couple different scrips) because I'd swallowed everything in my medicine cabinet. (And yes, white male here, there's probably some privilege attached to that experience).
There's something in the American collective psyche, it seems, that's really attached to suffering and punishment. It destroys so many people. I am so very sorry that you have had trouble getting medications necessary to function.
posted by feckless fecal fear mongering at 1:58 PM on July 28, 2015 [2 favorites]
There's something in the American collective psyche, it seems, that's really attached to suffering and punishment. It destroys so many people. I am so very sorry that you have had trouble getting medications necessary to function.
posted by feckless fecal fear mongering at 1:58 PM on July 28, 2015 [2 favorites]
One day we will treat the romanticized notion of going off ones psychiatric meds with the same level of romanticism that is warranted for choosing to avoid vaccines.
+
Also she reiterates that nonsense about SSRIs quelling ones inner muse. A destructive and silly myth.
Hey so like, i almost didn't reply to this but this is actually a weird sort of ableist garbage on its own. Vaccines, when working properly, are an objective thing. They either work or they don't. Most, i'm not going to say all, but a large portion of psychiatric meds are a subjective thing. Whether they work or not is up to the owner-operator of the brain and body they're being applied to.
Similarly, this is not a static system where it's like "apply drugs problem fixed forever". Drugs stop working, or start working differently, or as was mentioned above underlying stuff or stressors change and suddenly you're getting a bunch of side effects with no benefit.
You don't just vaccinate yourself against mental health issues, they aren't flu shots.
It's yet another way that mental health issues are in the double bind of not being real problems since it's like all in your head, and simultaneously being something that's just sooooo easy to fix if you'd just take your meds. People see it as either being nebulous, overly complex, and possibly made up or just so simply and that the people dealing with them are just too stupid to take their pills and be less annoying to everyone around them.
I've experienced both of these, and i've also had life changing improvements from quitting antidepressants that were just fucking with me after years. It took me, again, years to be normal but i now feel better than i ever did then. I know many people with similar experiences, or who are currently starting that journey.
And yea, you literally get shit from people when you're on them, shit from different people for quitting, and shit from people if you have issues you're dealing with but you're not on medication because you're not doing the totally obvious thing.
Also, yes, many people really do have issues with flat affect and "quelling ones inner muse" with SSRIs and many antipsychotics. And the way that's talked about almost seems like the kind of shaming drug addicts get when they describe being high.
Is it so hard to just believe what people say instead of preloading your own crap on to the situation and discussion?
posted by emptythought at 2:21 PM on July 28, 2015 [6 favorites]
+
Also she reiterates that nonsense about SSRIs quelling ones inner muse. A destructive and silly myth.
Hey so like, i almost didn't reply to this but this is actually a weird sort of ableist garbage on its own. Vaccines, when working properly, are an objective thing. They either work or they don't. Most, i'm not going to say all, but a large portion of psychiatric meds are a subjective thing. Whether they work or not is up to the owner-operator of the brain and body they're being applied to.
Similarly, this is not a static system where it's like "apply drugs problem fixed forever". Drugs stop working, or start working differently, or as was mentioned above underlying stuff or stressors change and suddenly you're getting a bunch of side effects with no benefit.
You don't just vaccinate yourself against mental health issues, they aren't flu shots.
It's yet another way that mental health issues are in the double bind of not being real problems since it's like all in your head, and simultaneously being something that's just sooooo easy to fix if you'd just take your meds. People see it as either being nebulous, overly complex, and possibly made up or just so simply and that the people dealing with them are just too stupid to take their pills and be less annoying to everyone around them.
I've experienced both of these, and i've also had life changing improvements from quitting antidepressants that were just fucking with me after years. It took me, again, years to be normal but i now feel better than i ever did then. I know many people with similar experiences, or who are currently starting that journey.
And yea, you literally get shit from people when you're on them, shit from different people for quitting, and shit from people if you have issues you're dealing with but you're not on medication because you're not doing the totally obvious thing.
Also, yes, many people really do have issues with flat affect and "quelling ones inner muse" with SSRIs and many antipsychotics. And the way that's talked about almost seems like the kind of shaming drug addicts get when they describe being high.
Is it so hard to just believe what people say instead of preloading your own crap on to the situation and discussion?
posted by emptythought at 2:21 PM on July 28, 2015 [6 favorites]
But yeah. I dislike the idea that mental illness should be seen as people just having a normal response to a shitty situation, because it means that most of everyday life is a shitty situation, and that's just not a tenable position with so few psychiatric resources in the vast majority of rural America.
It's also kind of offensive if you know or if you are a person who has experienced intractable mental illness - especially of the "most people's brains just don't do that" variety - despite extremely supportive circumstances. But by all means there are a lot of factors that contribute to making a situation better or worse and we certainly don't have a precise handle of what exactly is going on in the brain.
posted by atoxyl at 2:48 PM on July 28, 2015 [1 favorite]
It's also kind of offensive if you know or if you are a person who has experienced intractable mental illness - especially of the "most people's brains just don't do that" variety - despite extremely supportive circumstances. But by all means there are a lot of factors that contribute to making a situation better or worse and we certainly don't have a precise handle of what exactly is going on in the brain.
posted by atoxyl at 2:48 PM on July 28, 2015 [1 favorite]
"Normal response to a shitty situation" might be a bit of a strawman take on what was actually said here though.
posted by atoxyl at 2:49 PM on July 28, 2015
posted by atoxyl at 2:49 PM on July 28, 2015
I'm glad this series is over and I want to pitch one called "Staying On," in which I moralize about the superiority of being on drugs and the lack of sensitivity and creativity that people who are off drugs clearly have.
Seriously, though, it would be really great if people who wrote and talked about their experiences on or off drugs would not assume that their experience is that of everyone else and that what's right for you is what's right for everyone. Sure, sometimes, she qualified what she said, but the implication in a piece like this is that this advice is applicable to people other than her and it really isn't.
Also, I am left wondering how much her change in meds contributed to the break-up she mentions. One reason that I do not want to come off meds so long as they are working (aside from the very pressing fact that depression sucks and I don't want to re-experience it if I don't have to do) is that when I am off antidepressants, I tend to be really needy and my constant demands for reassurance aren't conducive to relationships. Being *less* sensitive to myself allows me to be *more* sensitive to others, not less.
Of course, her experience could be different and she could be totally her best self off meds.. but the way that she just sort of dropped the break-up in there does leave me curious.
Regarding trauma, if the drugs work, why *should* you have to do all the hard work of talk therapy on top of having had the experience of being traumatized? We'd never romanticize physical therapy for stroke victims if a pill could instantly restore normal function— why do we think that there's some arduous journey that's better than drugs if you've had trauma?
It's one thing, of course, if the drugs don't work. But when they *do* work, it really irks me that people think it's morally superior to struggle.
posted by Maias at 3:26 PM on July 28, 2015 [7 favorites]
Seriously, though, it would be really great if people who wrote and talked about their experiences on or off drugs would not assume that their experience is that of everyone else and that what's right for you is what's right for everyone. Sure, sometimes, she qualified what she said, but the implication in a piece like this is that this advice is applicable to people other than her and it really isn't.
Also, I am left wondering how much her change in meds contributed to the break-up she mentions. One reason that I do not want to come off meds so long as they are working (aside from the very pressing fact that depression sucks and I don't want to re-experience it if I don't have to do) is that when I am off antidepressants, I tend to be really needy and my constant demands for reassurance aren't conducive to relationships. Being *less* sensitive to myself allows me to be *more* sensitive to others, not less.
Of course, her experience could be different and she could be totally her best self off meds.. but the way that she just sort of dropped the break-up in there does leave me curious.
Regarding trauma, if the drugs work, why *should* you have to do all the hard work of talk therapy on top of having had the experience of being traumatized? We'd never romanticize physical therapy for stroke victims if a pill could instantly restore normal function— why do we think that there's some arduous journey that's better than drugs if you've had trauma?
It's one thing, of course, if the drugs don't work. But when they *do* work, it really irks me that people think it's morally superior to struggle.
posted by Maias at 3:26 PM on July 28, 2015 [7 favorites]
Hey. Sorry to anyone I offended or if my comment minimized your struggle to get off meds. That was not my intent. It was an angry reaction.
From my personal experience, the stigma of being on meds is really really intense, and articles like this often get mailed to those of us on meds who "seem to be doing pretty good so hey maybe you should just try going to one of these sweat lodges in Mexico!"
I get these comments all the time. They are all some variant of: "Just get up and stop feeling so sad and DO THINGS!" So my comment was an angry reaction to that.
I realize vaccines are not a good/accurate comparison.
I have "failed" in "getting off meds" myself each time I've tried. I am presently struggling with the decision of trying again to go off meds given I've been roughly ok for several years. Not sure how I should factor leaving reactive comments on the internet late at night into that decision.
Anyway, sorry to those who took the comment as a personal criticism of going off meds. Not the intent at all; more power to you and I wish you well.
posted by ArgyleMarionette at 3:56 PM on July 28, 2015 [2 favorites]
From my personal experience, the stigma of being on meds is really really intense, and articles like this often get mailed to those of us on meds who "seem to be doing pretty good so hey maybe you should just try going to one of these sweat lodges in Mexico!"
I get these comments all the time. They are all some variant of: "Just get up and stop feeling so sad and DO THINGS!" So my comment was an angry reaction to that.
I realize vaccines are not a good/accurate comparison.
I have "failed" in "getting off meds" myself each time I've tried. I am presently struggling with the decision of trying again to go off meds given I've been roughly ok for several years. Not sure how I should factor leaving reactive comments on the internet late at night into that decision.
Anyway, sorry to those who took the comment as a personal criticism of going off meds. Not the intent at all; more power to you and I wish you well.
posted by ArgyleMarionette at 3:56 PM on July 28, 2015 [2 favorites]
There was this, from xojane: It's Fine if Other People Want to Come Off Their Psychiatric Drugs, But I Am Never, Ever Quitting My Meds
posted by teponaztli at 3:58 PM on July 28, 2015 [1 favorite]
posted by teponaztli at 3:58 PM on July 28, 2015 [1 favorite]
From my personal experience, the stigma of being on meds is really really intense, and articles like this often get mailed to those of us on meds who "seem to be doing pretty good so hey maybe you should just try going to one of these sweat lodges in Mexico!"
Fair enough. People are so generally inclined toward unsolicited, obnoxious commentary on mental health treatment that one might choose to stay on one medication, discontinue another, and be criticized for both decisions. How people who have had to make decisions about these things react to articles like this probably depends on which sort of criticism they find most currently exasperating.
posted by atoxyl at 4:10 PM on July 28, 2015 [2 favorites]
Fair enough. People are so generally inclined toward unsolicited, obnoxious commentary on mental health treatment that one might choose to stay on one medication, discontinue another, and be criticized for both decisions. How people who have had to make decisions about these things react to articles like this probably depends on which sort of criticism they find most currently exasperating.
posted by atoxyl at 4:10 PM on July 28, 2015 [2 favorites]
In my experience, going off meds (unless you're on serious anti-psychotics or mood stabilizers, and you're talking to someone who knows you without them) is almost always treated as this kind of valiant thing, like going to the gym or something by others.
I don't think I've ever heard the same for staying on or starting on meds.
posted by Ferreous at 5:04 PM on July 28, 2015 [5 favorites]
I don't think I've ever heard the same for staying on or starting on meds.
posted by Ferreous at 5:04 PM on July 28, 2015 [5 favorites]
I wish a few critics of medication had been around when a quack psychiatrist put me on meds starting around age ten. I had no one on my side to say, "no, you don't have to take them if you don't want to," and she basically took the emotional half of my adolescence.
posted by Wemmick at 5:30 PM on July 28, 2015 [4 favorites]
posted by Wemmick at 5:30 PM on July 28, 2015 [4 favorites]
There's something in the American collective psyche, it seems, that's really attached to suffering and punishment.
When it comes to ourselves?! We are the greediest, self-absorbed fuckers in the world. We have a medication- and medical access problem because of a select few who think a punished and suffering majority is a fine price to pay for consolidating wealth and power. Don't forget — the ones who are voting against their best interest believe they are doing the opposite. Suffering and punishment is for other people.
posted by Room 641-A at 5:51 PM on July 28, 2015
When it comes to ourselves?! We are the greediest, self-absorbed fuckers in the world. We have a medication- and medical access problem because of a select few who think a punished and suffering majority is a fine price to pay for consolidating wealth and power. Don't forget — the ones who are voting against their best interest believe they are doing the opposite. Suffering and punishment is for other people.
posted by Room 641-A at 5:51 PM on July 28, 2015
I have "failed" in "getting off meds" myself each time I've tried. I am presently struggling with the decision of trying again to go off meds given I've been roughly ok for several years.
I don't know you and you don't know me. At the same time, historically not coping when not on meds + ok when on meds = stay on meds, for me.
posted by feckless fecal fear mongering at 5:52 PM on July 28, 2015
I don't know you and you don't know me. At the same time, historically not coping when not on meds + ok when on meds = stay on meds, for me.
posted by feckless fecal fear mongering at 5:52 PM on July 28, 2015
her experience could be different and she could be totally her best self off meds.. but the way that she just sort of dropped the break-up in there does leave me curious.
it would be really great if people who wrote and talked about their experiences on or off drugs would not assume that their experience is that of everyone else and that what's right for you is what's right for everyone
Yeah, it would be really great if people weren't inclined to cast doubt on other people's experiences based upon their own experiences.
posted by holgate at 7:03 PM on July 28, 2015 [1 favorite]
it would be really great if people who wrote and talked about their experiences on or off drugs would not assume that their experience is that of everyone else and that what's right for you is what's right for everyone
Yeah, it would be really great if people weren't inclined to cast doubt on other people's experiences based upon their own experiences.
posted by holgate at 7:03 PM on July 28, 2015 [1 favorite]
I've encountered a myth in the world that all psych drugs will inevitably turn you into a zombie, kill your sex drive and make you no fun at all. I made the mistake of characterizing Spechlers reportage of experience as a generalization spun and ready to be woven into the fabric of this common mythology.
Similarly, there's a myth that some recreational drugs inevitably make you more creative, feel more deeply and de-zombifie. I think each myth has an element of truth but in either case the expected outcomes are not given (though certainly possible). Neither drug mythology is a solid basis for a course of action.
I've been asked so many variations on "well doesn't the drug make you feel numb/empty/hollow/uncreative" -- well no, it doesn't, not for me. Not for a lot of people. Definitely for some people, often variably across similar drugs. I wouldn't take it if it did zombify me. I take it to cut down on the dread and fixating, otherwise I have the whole range of feelings and thoughts!
I really didn't say what I meant well and in parts mistook Spechler's writing as exhortation (possibly because parts of it sound like vacations I'd like to take) and generalization despite coming to it with "op-ed" in mind. I never meant to deny Spechler's qualitative experience which I don't doubt she had. Sincere apologies for any rankling.
posted by Matt Oneiros at 7:14 PM on July 28, 2015 [2 favorites]
Similarly, there's a myth that some recreational drugs inevitably make you more creative, feel more deeply and de-zombifie. I think each myth has an element of truth but in either case the expected outcomes are not given (though certainly possible). Neither drug mythology is a solid basis for a course of action.
I've been asked so many variations on "well doesn't the drug make you feel numb/empty/hollow/uncreative" -- well no, it doesn't, not for me. Not for a lot of people. Definitely for some people, often variably across similar drugs. I wouldn't take it if it did zombify me. I take it to cut down on the dread and fixating, otherwise I have the whole range of feelings and thoughts!
I really didn't say what I meant well and in parts mistook Spechler's writing as exhortation (possibly because parts of it sound like vacations I'd like to take) and generalization despite coming to it with "op-ed" in mind. I never meant to deny Spechler's qualitative experience which I don't doubt she had. Sincere apologies for any rankling.
posted by Matt Oneiros at 7:14 PM on July 28, 2015 [2 favorites]
well, the fact that it's written in second person (even though ostensibly to herself) *does* make it sound like exhortation, inevitably. If she believed it applied only to herself, she wouldn't publish it in the NYT, but just put it in a diary.
and since she *did* publish it in the NYT in this way, I can cast doubts on it as much as I like because an oped is the opening for a debate. If I was simply generalizing from my own experiences and assuming they were the same as hers, I wouldn't have qualified them by saying that maybe I'm wrong.
The problem isn't sharing one's experience or even trying to generalize from it— it's overgeneralizing and assuming that what's true for me about a drug experience is true for you about the drug. I very explicitly didn't do that— but by writing the piece in second person, she made generalizing from her to "you" part of the way her story is read.
As a writer, these kinds of choices matter and they affect the way readers respond.
posted by Maias at 7:27 PM on July 28, 2015 [3 favorites]
and since she *did* publish it in the NYT in this way, I can cast doubts on it as much as I like because an oped is the opening for a debate. If I was simply generalizing from my own experiences and assuming they were the same as hers, I wouldn't have qualified them by saying that maybe I'm wrong.
The problem isn't sharing one's experience or even trying to generalize from it— it's overgeneralizing and assuming that what's true for me about a drug experience is true for you about the drug. I very explicitly didn't do that— but by writing the piece in second person, she made generalizing from her to "you" part of the way her story is read.
As a writer, these kinds of choices matter and they affect the way readers respond.
posted by Maias at 7:27 PM on July 28, 2015 [3 favorites]
This is a hard thing for some of us to talk about, because it’s literally a matter of life or death for us, and we don’t share the same answer. As a young adult, avoiding meds as a point of pride came damn close to killing me. I’ve been on and off various medication in the decades since then—sometimes intentionally, sometimes because I switched jobs and realized with 2 days’ dose notice that I had to choose between rent and treatment—with various degrees of success. I’ve done poorly while taking certain meds and better with others (and done poorly not taking certain meds and better not taking others), and my current situation is working mostly okay for me for now. (Though I still need to self-monitor because I know that can change.)
The thing is, it’s really hard to hear somebody strongly recommend a different course than the one that happens to work for you without getting defensive. There’s no way around it: people in this thread have had terrible experiences with the same treatments that (I am reasonably certain) have kept me alive. And vice versa. I need to keep reminding myself that people with opinions and experiences that resemble those I used to hold are not a younger, more foolish version of me; and the advice I would scream at a younger version of myself is probably not remotely applicable for anyone else (and that my current, mostly-okay situation has the same dosages/lack-thereof as the worst time in somebody else’s life).
…you know, after rereading the article—less defensively, this time around—I may just be rephrasing her point #9.
posted by nicepersonality at 7:33 PM on July 28, 2015 [5 favorites]
The thing is, it’s really hard to hear somebody strongly recommend a different course than the one that happens to work for you without getting defensive. There’s no way around it: people in this thread have had terrible experiences with the same treatments that (I am reasonably certain) have kept me alive. And vice versa. I need to keep reminding myself that people with opinions and experiences that resemble those I used to hold are not a younger, more foolish version of me; and the advice I would scream at a younger version of myself is probably not remotely applicable for anyone else (and that my current, mostly-okay situation has the same dosages/lack-thereof as the worst time in somebody else’s life).
…you know, after rereading the article—less defensively, this time around—I may just be rephrasing her point #9.
posted by nicepersonality at 7:33 PM on July 28, 2015 [5 favorites]
I got so angry at this article that I had to come back to this thread and go back to reading it a dozen times before I was able to type this response. I don't think I am really angry at the writer, who is only voicing her own experience, and I wouldn't want to shame her into being silent. But, dammit, I wish I had the choice. I'm jealous. I've had a hard time staying on my antidepressants lately because they make me sleep all the time, but I've tried going off them and it doesn't seem like a safe option, so this piece hit me at a bad moment. (Not to mention the business of finding an okay psychiatrist on my insurance and not letting my prescription run out.) One of my big fears is that the reason I haven't been able to write creatively for the past couple of years is that my medicine is getting in the way, and this series brought that all up again for me. I get afraid that the medications are making me miss out on life, but without treatment, I might not have a life. I don't know, man. I'm projecting all over here. If there's one thing I wish I could change, it's the idea that people who are more sick than others are somehow failing. I'm sure the author wishes she could change that too.
posted by thetortoise at 8:30 PM on July 28, 2015 [4 favorites]
posted by thetortoise at 8:30 PM on July 28, 2015 [4 favorites]
I am envious of people who understand the connection between their creativity and drugs. Mental illness and medicated convalescence burned away my formative years, before I was able to put down any sort of creative foundation or produce anything worthwhile.
One of my biggest fears is someday deciding to put away the chemical crutches and walking with my own feet, only to find there is nowhere left for me to go.
posted by Freelance Demiurge at 8:32 PM on July 28, 2015
One of my biggest fears is someday deciding to put away the chemical crutches and walking with my own feet, only to find there is nowhere left for me to go.
posted by Freelance Demiurge at 8:32 PM on July 28, 2015
I apologise for earlier slight snark, because nicepersonality's comment covers things much much better. This is really hard. Looking again at those adverts from the 'tranquilized fifties', lithium and tricyclics and nasty rough benzos helped people and hurt people, often in capricious and arbitrary ways; SSRIs and modern anti-psychotics do likewise.
Both the treatment and broader social context of mental illness reflect more continuity over a very long period than we'd perhaps like to admit. There is still a strong whiff of two primitive models (or myths) fighting it out for pre-eminence, one in which you're possessed by evil spirits, the other in which something is broken deep inside you. I'm not sure that's going to be resolved any time soon.
posted by holgate at 9:33 PM on July 28, 2015 [1 favorite]
Both the treatment and broader social context of mental illness reflect more continuity over a very long period than we'd perhaps like to admit. There is still a strong whiff of two primitive models (or myths) fighting it out for pre-eminence, one in which you're possessed by evil spirits, the other in which something is broken deep inside you. I'm not sure that's going to be resolved any time soon.
posted by holgate at 9:33 PM on July 28, 2015 [1 favorite]
We KNOW social support, reduced job stress (changing jobs or reducing work hours), financial stability, taking the actual amount of time off needed to process emotions or process emotional instability, healthy diet (and access to prepared food if coping with illness and too sick to cook), exercise (and coaching, and a host of other things can help but when someone is very ill they need a team of people helping them be able to do these things. This takes time, effort, resources and that all adds up to MONEY.
I know that when I am on holiday, I do a better job looking after myself than when I have to spend most of the day at work, doing things other than looking after myself. I know that I feel better when I have social support. Once, years ago, I was actually able to come off meds altogether because I had enough social support. I miss those days, but they ain't coming back anytime soon. And these are the twin poles around which my depression oscillates: I cannot look after myself properly and there is no one to help.
Those are exaggerated statements, of course, because depression exaggerates. It's probably more realistic and accurate to say that I am not good at looking after myself properly in the time I have available, and although my friends help with social connection, I need more than they can give me. So I have my meds, and mostly they help me get by. I might spend the majority of my time off in bed, unable to do things like exercise or prepare actual meals for myself, but hey, you do what you have to, right? Except it's not enough to get by and my physical health is suffering along with my mental health, and you know where that particular feedback loop leads.
Earlier this year I tried coming off my meds so I could go on a different sort. It was untenable. I was unable to function normally. I think if I ever have to try it again, I will have to take time off and impose on friends for a schedule of babysitting me. And you know, if I knew that my environment had changed enough that it might work in the long run, I'd give it a shot.
But I have to work, and it seems that looking after myself properly is a lot closer to a full-time job than I can afford. And I cannot force my friends to forsake their own lives to become more a part of mine. I cannot force some unknown person to love me, to become the caretaker of my emotional support - even if I wanted such a thing, which I don't.
I wish there was an obvious answer. There doesn't seem to be one. In the absence of being able to implement the changes that would mean most to my environment, I'll keep clinging to the meds as the one of the only things keeping me afloat, and wonder how long I can keep it up.
posted by Athanassiel at 1:46 AM on July 29, 2015
I know that when I am on holiday, I do a better job looking after myself than when I have to spend most of the day at work, doing things other than looking after myself. I know that I feel better when I have social support. Once, years ago, I was actually able to come off meds altogether because I had enough social support. I miss those days, but they ain't coming back anytime soon. And these are the twin poles around which my depression oscillates: I cannot look after myself properly and there is no one to help.
Those are exaggerated statements, of course, because depression exaggerates. It's probably more realistic and accurate to say that I am not good at looking after myself properly in the time I have available, and although my friends help with social connection, I need more than they can give me. So I have my meds, and mostly they help me get by. I might spend the majority of my time off in bed, unable to do things like exercise or prepare actual meals for myself, but hey, you do what you have to, right? Except it's not enough to get by and my physical health is suffering along with my mental health, and you know where that particular feedback loop leads.
Earlier this year I tried coming off my meds so I could go on a different sort. It was untenable. I was unable to function normally. I think if I ever have to try it again, I will have to take time off and impose on friends for a schedule of babysitting me. And you know, if I knew that my environment had changed enough that it might work in the long run, I'd give it a shot.
But I have to work, and it seems that looking after myself properly is a lot closer to a full-time job than I can afford. And I cannot force my friends to forsake their own lives to become more a part of mine. I cannot force some unknown person to love me, to become the caretaker of my emotional support - even if I wanted such a thing, which I don't.
I wish there was an obvious answer. There doesn't seem to be one. In the absence of being able to implement the changes that would mean most to my environment, I'll keep clinging to the meds as the one of the only things keeping me afloat, and wonder how long I can keep it up.
posted by Athanassiel at 1:46 AM on July 29, 2015
" I think if I ever have to try it again, I will have to take time off and impose on friends for a schedule of babysitting me."
I don't actually think needing or receiving high levels of emotional support and caretaking is actually bad. It's only bad if a community or group of people decide it's bad because caring for each other is gross and yucky and hard! And unlike other forms of hard work it's associated with women so it can't possibly be valuable or noble or effect real meaningful change in the world or human welfare.
ONLY "REAL" medicine can impact health! Not like that fake woo nurturing stuff women do. Unless you're looking at the effects of kangaroo care on human health and... WOW there's actual real effects! Apparently a lot of research is finding that we are missing a critical component of health and healing by being obsessed with pharmaceutical options as the only way to impact healing of the body.
Trust me I respect what people do to survive in the meantime of us creating actual supports for those with emotional needs and mental health symptoms which are real and require assistance-- to take or not take meds is something I respect individuals deciding. What I don't respect is people fighting tooth and nail to REMOVE non-med options from the table while spouting "science" and derogatory comments about people who find they are healthier and happier off meds.
Programs like this one in Boulder are designed to provide a therapeutic but independent living environment, there are a lot of programs like this that improve quality of life a great deal, however there is a problem of paying for them when providing high levels of support is considered innately shameful and not worth funding. Therefore they tend to be private, available only to people whose family can and will pay for them.
We know a lot about the kinds of resources that really help build long term health but like so many things we will find any loophole to avoid paying for it and doing it and the "medications are the best and only REAL treatment" mantra gets in the way of seeing these options as viable or providing sanctuary and care for people who do want to make the transition to life without meds but need supervision and care for a long period of time to do so.
What's more the idea that independent living is more important than the actual experienced quality of life of the person in question is very much a cultural thing where needing social support is considered the plague and such people should essentially either die off or at least waste away outside the presence of others. I hope there is a time when we see this as emotional neglect and abuse of our people rather than the proud way of life too many see it now. It IS hard to support people coping with trauma, difficult emotions, behavioral problems, the effects of developmental trauma. I think it's great for people in pain or struggling to have access to meds, but that doesn't mean it's ok for us to require they take them so we can avoid doing the hard work of supporting those in need even when it's not pretty.
This is the kind of heroic work women used to do FOR FREE, now that women have lightened their load and know to demand pay, we are now faced with- do we turn it into a medical enterprise to justify paying people to support those in need since that's the only way we can see emotional needs are "real" the way physical needs are? Or do we just admit emotional needs are real to begin with and admit we should be paying people to do this work to begin with without medicalizing the process of grief, trauma, painful childhood experiences or other issues that deserve the level of humanity and respect of being called real and the debilitation horrifying effects of them REAL even without smacking a clinical label on those reactions... on that pain.
posted by xarnop at 6:14 AM on July 29, 2015 [1 favorite]
I don't actually think needing or receiving high levels of emotional support and caretaking is actually bad. It's only bad if a community or group of people decide it's bad because caring for each other is gross and yucky and hard! And unlike other forms of hard work it's associated with women so it can't possibly be valuable or noble or effect real meaningful change in the world or human welfare.
ONLY "REAL" medicine can impact health! Not like that fake woo nurturing stuff women do. Unless you're looking at the effects of kangaroo care on human health and... WOW there's actual real effects! Apparently a lot of research is finding that we are missing a critical component of health and healing by being obsessed with pharmaceutical options as the only way to impact healing of the body.
Trust me I respect what people do to survive in the meantime of us creating actual supports for those with emotional needs and mental health symptoms which are real and require assistance-- to take or not take meds is something I respect individuals deciding. What I don't respect is people fighting tooth and nail to REMOVE non-med options from the table while spouting "science" and derogatory comments about people who find they are healthier and happier off meds.
Programs like this one in Boulder are designed to provide a therapeutic but independent living environment, there are a lot of programs like this that improve quality of life a great deal, however there is a problem of paying for them when providing high levels of support is considered innately shameful and not worth funding. Therefore they tend to be private, available only to people whose family can and will pay for them.
We know a lot about the kinds of resources that really help build long term health but like so many things we will find any loophole to avoid paying for it and doing it and the "medications are the best and only REAL treatment" mantra gets in the way of seeing these options as viable or providing sanctuary and care for people who do want to make the transition to life without meds but need supervision and care for a long period of time to do so.
What's more the idea that independent living is more important than the actual experienced quality of life of the person in question is very much a cultural thing where needing social support is considered the plague and such people should essentially either die off or at least waste away outside the presence of others. I hope there is a time when we see this as emotional neglect and abuse of our people rather than the proud way of life too many see it now. It IS hard to support people coping with trauma, difficult emotions, behavioral problems, the effects of developmental trauma. I think it's great for people in pain or struggling to have access to meds, but that doesn't mean it's ok for us to require they take them so we can avoid doing the hard work of supporting those in need even when it's not pretty.
This is the kind of heroic work women used to do FOR FREE, now that women have lightened their load and know to demand pay, we are now faced with- do we turn it into a medical enterprise to justify paying people to support those in need since that's the only way we can see emotional needs are "real" the way physical needs are? Or do we just admit emotional needs are real to begin with and admit we should be paying people to do this work to begin with without medicalizing the process of grief, trauma, painful childhood experiences or other issues that deserve the level of humanity and respect of being called real and the debilitation horrifying effects of them REAL even without smacking a clinical label on those reactions... on that pain.
posted by xarnop at 6:14 AM on July 29, 2015 [1 favorite]
This thread is really hitting me hard, because not only have I dealt with a huge internal struggle to take antidepressants in the first place, and it was exactly what I needed (well, after the first 3-4 options which didn't work), and got me to a place where I had enough life-supports in place that I was able to go off them...
I am thinking of a good friend of mine, who went on the same antidepressants as me, as a broke stressed young university student, going through a period of mild to moderate depression. And how, in the decade that followed, no Doctor, not even once, suggested that as an adult with his life mostly together, he might try tapering off them. I realised no one ever suggested that to me either, that I was the one to advocate and push for it myself, at which point I got assistance with that.
The only experience he was having, was forgetting his meds, and thinking that the withdrawal that hit, was his depression, just lurking beneath the surface, waiting to get him.
It wasn't.
He has finally been off his meds for around 6 months now, and he is going through this intense period of growth. He was basically celibate for his 20s, and he has a sex drive again, he is actually crushing on people and starting to date. He is overwhelmed by how happy things make him, because he was always numbed before (which is absolutely what you need if the alternative is constant emotional pain! But it is not the same as being off meds for him or for me).
I am so angry, because I can't help but feel like he has had a decade stolen from him.
I am angry because he is smart and intelligent, and we had discussed our meds before, but I had no idea that he didn't know that the symptoms he had when he missed meds were most likely withdrawal, not underlying depression or anxiety, I didn't know that HE didn't know that for less than severe depression, meds are not necessarily the best option, or that they aren't necessarily long term. He thought he just had to take them for the rest of his life, a life that *he* was only half living.
Unfortunately, until Doctors and therapists are more inclined to suggest tapering for patients who are stable and secure, withdrawing with meds is always going to be patient driven. Yes, I think that is stupid. Yes, I would prefer it if a more systematic approach was taken to evaluating life stressors when someone goes on any kind of psychiatric meds, and evaluating whether they still need to be on the meds when they are in a less stressful situation, with better life supports. But until that is common, it is going to be patient driven.
And that is doing a disservice to so many people. I am thinking of the guy I spent a couple hours with at a party a couple of weeks ago, trying to encourage him to get evaluated for depression. He didn't want to go on pills for the rest of his life, he didn't want to become 'not him' etc etc. I really tried to point out that that would always be his own choice, and he would only have to stay on meds if it was making his life better than it is now. That it was comparable to insulin, because untreated diabetes absolutely screws with your head, had he not seen anyone on a sugar low? That going on meds if that was the right choice, would not stop him from making changes to his life which might make him not need antidepressants, just like how a type 2 diabetic might be able to change lifestyle factors and get off medication, but that if he couldn't, or he was the equivalent of a type one diabetic, that he still had the choice of having a better quality of life than he had now. I hope he gets help.
I feel like the narrative that you will be stuck on meds, is not helping anyone, and contributes to people not wanting to go on them, or trying to get off them in circumstances that don't make medical sense, out of a feeling of being trapped.
posted by Elysum at 8:44 AM on July 29, 2015 [5 favorites]
I am thinking of a good friend of mine, who went on the same antidepressants as me, as a broke stressed young university student, going through a period of mild to moderate depression. And how, in the decade that followed, no Doctor, not even once, suggested that as an adult with his life mostly together, he might try tapering off them. I realised no one ever suggested that to me either, that I was the one to advocate and push for it myself, at which point I got assistance with that.
The only experience he was having, was forgetting his meds, and thinking that the withdrawal that hit, was his depression, just lurking beneath the surface, waiting to get him.
It wasn't.
He has finally been off his meds for around 6 months now, and he is going through this intense period of growth. He was basically celibate for his 20s, and he has a sex drive again, he is actually crushing on people and starting to date. He is overwhelmed by how happy things make him, because he was always numbed before (which is absolutely what you need if the alternative is constant emotional pain! But it is not the same as being off meds for him or for me).
I am so angry, because I can't help but feel like he has had a decade stolen from him.
I am angry because he is smart and intelligent, and we had discussed our meds before, but I had no idea that he didn't know that the symptoms he had when he missed meds were most likely withdrawal, not underlying depression or anxiety, I didn't know that HE didn't know that for less than severe depression, meds are not necessarily the best option, or that they aren't necessarily long term. He thought he just had to take them for the rest of his life, a life that *he* was only half living.
Unfortunately, until Doctors and therapists are more inclined to suggest tapering for patients who are stable and secure, withdrawing with meds is always going to be patient driven. Yes, I think that is stupid. Yes, I would prefer it if a more systematic approach was taken to evaluating life stressors when someone goes on any kind of psychiatric meds, and evaluating whether they still need to be on the meds when they are in a less stressful situation, with better life supports. But until that is common, it is going to be patient driven.
And that is doing a disservice to so many people. I am thinking of the guy I spent a couple hours with at a party a couple of weeks ago, trying to encourage him to get evaluated for depression. He didn't want to go on pills for the rest of his life, he didn't want to become 'not him' etc etc. I really tried to point out that that would always be his own choice, and he would only have to stay on meds if it was making his life better than it is now. That it was comparable to insulin, because untreated diabetes absolutely screws with your head, had he not seen anyone on a sugar low? That going on meds if that was the right choice, would not stop him from making changes to his life which might make him not need antidepressants, just like how a type 2 diabetic might be able to change lifestyle factors and get off medication, but that if he couldn't, or he was the equivalent of a type one diabetic, that he still had the choice of having a better quality of life than he had now. I hope he gets help.
I feel like the narrative that you will be stuck on meds, is not helping anyone, and contributes to people not wanting to go on them, or trying to get off them in circumstances that don't make medical sense, out of a feeling of being trapped.
posted by Elysum at 8:44 AM on July 29, 2015 [5 favorites]
That it was comparable to insulin, because untreated diabetes absolutely screws with your head, had he not seen anyone on a sugar low?
This is so true. When I was pre-diabetic at a certain point a few years ago (due to weight gain/poor diet), it did some real damage to my relationships with people before I got the diagnosis and figured out why I was having such intense spells of irritability, confusion, and impatience. Getting my sugar levels under control resolved the issues immediately. There are underlying medical problems that can look like mental illness, which makes me wonder how often people medicate the wrong problems. There's no doubt, the right meds at the right time can save a person's life though, so these are complex issues.
posted by saulgoodman at 9:22 AM on July 29, 2015 [2 favorites]
This is so true. When I was pre-diabetic at a certain point a few years ago (due to weight gain/poor diet), it did some real damage to my relationships with people before I got the diagnosis and figured out why I was having such intense spells of irritability, confusion, and impatience. Getting my sugar levels under control resolved the issues immediately. There are underlying medical problems that can look like mental illness, which makes me wonder how often people medicate the wrong problems. There's no doubt, the right meds at the right time can save a person's life though, so these are complex issues.
posted by saulgoodman at 9:22 AM on July 29, 2015 [2 favorites]
Getting my sugar levels under control resolved the issues immediately. There are underlying medical problems that can look like mental illness
The very fact that things like this are possible is, to me, evidence that of course mental illness has identifiable (partially) physiological causes. That doesn't mean we really understand those causes or that medication is the only effective treatment naturally. I did first come in here on a "don't chastise strangers for not taking their meds" tip because I've known people who had a really shitty time even though my personal experiences with psych meds have ranged from positive to neutral "well I wanna start having sex again now so imma quit these easy peasy."
posted by atoxyl at 2:15 PM on July 29, 2015 [1 favorite]
The very fact that things like this are possible is, to me, evidence that of course mental illness has identifiable (partially) physiological causes. That doesn't mean we really understand those causes or that medication is the only effective treatment naturally. I did first come in here on a "don't chastise strangers for not taking their meds" tip because I've known people who had a really shitty time even though my personal experiences with psych meds have ranged from positive to neutral "well I wanna start having sex again now so imma quit these easy peasy."
posted by atoxyl at 2:15 PM on July 29, 2015 [1 favorite]
Social support is absolutely critical and for some, it's all that is needed. And I think that people should always work to find ways to improve the number and quality and relationships in their lives (the number needed/wanted will vary widely with temperament) because it not only makes you happier but also healthier.
But some people— like me— often can't benefit from social support without meds because I start thinking that my loved ones don't "really" love me and that I'm fundamentally unlovable and if they really knew me, they'd drop me or hate me. I know cognitively that it's absurd, but without meds, I have constant doubts and a sense that all is not well. I spent years self medicating this in my teens and early 20s and it nearly killed me.
It wasn't until I got into recovery from heroin and cocaine addiction and seven years later (which I wish I hadn't waited through) started antidepressants that I truly was able to feel good in my relationships without constantly needing reassurance, which is very annoying for people around you to provide and can make *them* feel bad because you seem not to believe them. If you are severely anhedonic, it can also suck for people around you because nothing will satisfy you and again, they may think something's wrong with them, rather than you being inconsolable because you chemically cannot feel pleasure.
Anyway, I've been extremely lucky that I seem to have found a combination that works for me and if meds aren't working for someone, they absolutely should come off. But I will argue fiercely against coming off because you think it's more "authentic" or "natural" or you feel guilty because you aren't "really working on yourself" or because any reduction in sensitivity (even if you are by nature so seriously oversensitive that it makes you dysfunctional) is "numbing" because I think the morality that suggests that all meds are "cheating" is hypocritical and fails to understand and respect the wide variety of human wiring.
posted by Maias at 5:29 PM on July 29, 2015 [3 favorites]
But some people— like me— often can't benefit from social support without meds because I start thinking that my loved ones don't "really" love me and that I'm fundamentally unlovable and if they really knew me, they'd drop me or hate me. I know cognitively that it's absurd, but without meds, I have constant doubts and a sense that all is not well. I spent years self medicating this in my teens and early 20s and it nearly killed me.
It wasn't until I got into recovery from heroin and cocaine addiction and seven years later (which I wish I hadn't waited through) started antidepressants that I truly was able to feel good in my relationships without constantly needing reassurance, which is very annoying for people around you to provide and can make *them* feel bad because you seem not to believe them. If you are severely anhedonic, it can also suck for people around you because nothing will satisfy you and again, they may think something's wrong with them, rather than you being inconsolable because you chemically cannot feel pleasure.
Anyway, I've been extremely lucky that I seem to have found a combination that works for me and if meds aren't working for someone, they absolutely should come off. But I will argue fiercely against coming off because you think it's more "authentic" or "natural" or you feel guilty because you aren't "really working on yourself" or because any reduction in sensitivity (even if you are by nature so seriously oversensitive that it makes you dysfunctional) is "numbing" because I think the morality that suggests that all meds are "cheating" is hypocritical and fails to understand and respect the wide variety of human wiring.
posted by Maias at 5:29 PM on July 29, 2015 [3 favorites]
because any reduction in sensitivity (even if you are by nature so seriously oversensitive that it makes you dysfunctional) is "numbing"
It is actually numbing for some people, though, Maias. Blunted affect and apathy are documented side effects of some (particular) drugs in some (particular) people. (And depersonalization, with withdrawal, in some cases.) They also, it's worth noting, are core features of some mental illnesses, so obviously worth worrying about to some people.
I haven't seen a single person here suggest that "all meds are "cheating" ". Not one. I've seen people talk about their own experiences (and about possible political solutions to some of the hypothesized contributors to many mental illnesses, but I don't think that position was put forward in lieu of medication, that's been clarified a few times).
As far as I'm concerned, drugs are morality-neutral. It's a question of looking at the costs and benefits of a (particular) drug in a (particular) person. Some of us have just been talking about our own calculations and costs. That's it.
As far as I'm concerned, morality only comes into it when we look at issues around access to care - economics, best practices (like regular and thorough medication monitoring - happens for how many?).
posted by cotton dress sock at 6:45 PM on July 29, 2015 [2 favorites]
It is actually numbing for some people, though, Maias. Blunted affect and apathy are documented side effects of some (particular) drugs in some (particular) people. (And depersonalization, with withdrawal, in some cases.) They also, it's worth noting, are core features of some mental illnesses, so obviously worth worrying about to some people.
I haven't seen a single person here suggest that "all meds are "cheating" ". Not one. I've seen people talk about their own experiences (and about possible political solutions to some of the hypothesized contributors to many mental illnesses, but I don't think that position was put forward in lieu of medication, that's been clarified a few times).
As far as I'm concerned, drugs are morality-neutral. It's a question of looking at the costs and benefits of a (particular) drug in a (particular) person. Some of us have just been talking about our own calculations and costs. That's it.
As far as I'm concerned, morality only comes into it when we look at issues around access to care - economics, best practices (like regular and thorough medication monitoring - happens for how many?).
posted by cotton dress sock at 6:45 PM on July 29, 2015 [2 favorites]
BTW: I really liked her analogy to:
"Before peeling back bandages, you have no way of knowing if the wounds are still open."
It acknowledges that if there are still open wounds, bandages are exactly the right choice.
---
I noticed the use of numbing, above, in Maias post, and thought it might be a reflection of the words in my post.
"he was always numbed before (which is absolutely what you need if the alternative is constant emotional pain!" - not sure if I made it clear that he wasn't though.
My friend thought the meds were working for him, because he couldn't see any side-effects...
because he had nothing to compare to...
because he'd been on them for nearly a decade...
after a short period of moderate depression.
Now he's off, he keeps talking about all the side effects that he didn't realise were his meds.
He is happier now. He had almost no sex drive on citalopram, and then went to escitalopram, which was a slight improvement. Nobody said, should you even be on these medications?
He didn't realise. He didn't know.
He's dated more in the last 6 months than the last 8 years. No relationships in all that time. EIGHT YEARS. He feels like he's back in his early 20s, but all this time has passed while he has been on autopilot. He sleeps better. He's losing weight. He had gastrointestinal symptoms that have largely gone away. He's happy, and sad very sometimes, and he hadn't really been happy in the last decade. He's blown away by sunsets, and buildings, and art. I feel guilty because I've known him all that time. I'd been on citalopram too, actually, I think it was better for me than it was for him, and for far shorter periods.
I raised it with my Doctor each time I thought I wanted to try going off/changing antidepressants (2... 3 times? Turns out part of it is seasonal allergy symptoms), and tapered off. I haven't been on any meds for 3 years at this point.
If I suffer from depression again in the future, I will find a Doctor, I will tell them what works for me (Not prozac - gave me a rash, not Amitryptyline - hysterical crying everyday, not sertraline - not sure why we tried that?).
He isn't a one off.
Thing is, I know people are prescribed antidepressants when they shouldn't be. Or for longer than they should be.
I resisted antidepressants for a long while because I was 'offered' them as a teenager, when I didn't need them. I turned them down, with my mothers support, which was the right choice then, because I wasn't depressed. I've HAD major depression in my adult years, and I absolutely wasn't then. What I was, was ADHD.
I was failing to do my homework in school and running late all the time, and when sent to a therapist, she asked me to talk about any sad things that might have ever happened in my life. I really thought that's what I was supposed to be doing? Dredging up every bad or sad thing that had ever happened in my life in a weekly session, argh! And then I left it behind the rest of the week, because I was fine. Such a crap therapist.
She finally got frustrated with me as I was failing to complete my therapy homework (ADHD!), and then offered antidepressants.
I don't know anyone who had their Doctor suggest going off antidepressants first. Plenty of, yeah sure's though.
Meds, antidepressants, anxiolytics. They are necessary, they are needed - when they are needed.
And in her case, in mine, in his:
"You are so lucky: Your healing was done, as you suspected it was."
---
Relationships:
I've broken up from relationships when going onto, or going off meds. It wasn't their fault in either case, but it was enough of a stressor, or gave me enough clarity that I realised the relationship wasn't working, hadn't been working, and I shouldn't have been in that relationship. I've also broken up before or after going on long trips. Same reason, essentially.
Absolutely no regrets in any case.
---
I'm thinking of people reading this thread...
If anyone is reading this and thinking about going on medications? OR going off medications?
* Do read Crazymeds.com. If something your Dr says contradicts crazymed's advice? Go back to your Dr, because crazymeds is usually right. That goes for tapering onto medications, as well as tapering off (as I discovered for Strattera).
* If you're on meds, and your life isn't working so well, and you're desperately looking for something to change... going off your meds is not the thing to change. Go back to your Dr and let them know in case there is something they can do to help.
* When to go off your meds: When everything is running smoothly, much more smoothly than before you started. If you think of your work, your home environment, your friendships and your romantic relationships, the general impression is good. You can make a coherent case for why things are different now, and why you are a functional being. You have a therapist/counsellor who supports you in this. You discussed it with your Dr who supports you in this (I do know people who've suggested their Dr never would - well, get a new Dr, your old one is unable to pattern match and problem solve). You reduced commitments for the next few weeks and upped the routines (movie nights at a friends). You followed the tapering schedule from crazymeds.
* You made your decisions about what you will do if going off is NOT working, before going off meds - what symptoms will make you call a Dr. Which people to call if you are not sure. How 'wanting to die' at any time is ABSOLUTELY 'call a Dr' worthy (this goes for going ONTO medications - Amitriptyline, I hate you). If you ever get benzos for emergencies from your Dr, this is a good time.
posted by Elysum at 7:25 PM on July 29, 2015 [2 favorites]
"Before peeling back bandages, you have no way of knowing if the wounds are still open."
It acknowledges that if there are still open wounds, bandages are exactly the right choice.
---
I noticed the use of numbing, above, in Maias post, and thought it might be a reflection of the words in my post.
"he was always numbed before (which is absolutely what you need if the alternative is constant emotional pain!" - not sure if I made it clear that he wasn't though.
My friend thought the meds were working for him, because he couldn't see any side-effects...
because he had nothing to compare to...
because he'd been on them for nearly a decade...
after a short period of moderate depression.
Now he's off, he keeps talking about all the side effects that he didn't realise were his meds.
He is happier now. He had almost no sex drive on citalopram, and then went to escitalopram, which was a slight improvement. Nobody said, should you even be on these medications?
He didn't realise. He didn't know.
He's dated more in the last 6 months than the last 8 years. No relationships in all that time. EIGHT YEARS. He feels like he's back in his early 20s, but all this time has passed while he has been on autopilot. He sleeps better. He's losing weight. He had gastrointestinal symptoms that have largely gone away. He's happy, and sad very sometimes, and he hadn't really been happy in the last decade. He's blown away by sunsets, and buildings, and art. I feel guilty because I've known him all that time. I'd been on citalopram too, actually, I think it was better for me than it was for him, and for far shorter periods.
I raised it with my Doctor each time I thought I wanted to try going off/changing antidepressants (2... 3 times? Turns out part of it is seasonal allergy symptoms), and tapered off. I haven't been on any meds for 3 years at this point.
If I suffer from depression again in the future, I will find a Doctor, I will tell them what works for me (Not prozac - gave me a rash, not Amitryptyline - hysterical crying everyday, not sertraline - not sure why we tried that?).
He isn't a one off.
Thing is, I know people are prescribed antidepressants when they shouldn't be. Or for longer than they should be.
I resisted antidepressants for a long while because I was 'offered' them as a teenager, when I didn't need them. I turned them down, with my mothers support, which was the right choice then, because I wasn't depressed. I've HAD major depression in my adult years, and I absolutely wasn't then. What I was, was ADHD.
I was failing to do my homework in school and running late all the time, and when sent to a therapist, she asked me to talk about any sad things that might have ever happened in my life. I really thought that's what I was supposed to be doing? Dredging up every bad or sad thing that had ever happened in my life in a weekly session, argh! And then I left it behind the rest of the week, because I was fine. Such a crap therapist.
She finally got frustrated with me as I was failing to complete my therapy homework (ADHD!), and then offered antidepressants.
I don't know anyone who had their Doctor suggest going off antidepressants first. Plenty of, yeah sure's though.
Meds, antidepressants, anxiolytics. They are necessary, they are needed - when they are needed.
And in her case, in mine, in his:
"You are so lucky: Your healing was done, as you suspected it was."
---
Relationships:
I've broken up from relationships when going onto, or going off meds. It wasn't their fault in either case, but it was enough of a stressor, or gave me enough clarity that I realised the relationship wasn't working, hadn't been working, and I shouldn't have been in that relationship. I've also broken up before or after going on long trips. Same reason, essentially.
Absolutely no regrets in any case.
---
I'm thinking of people reading this thread...
If anyone is reading this and thinking about going on medications? OR going off medications?
* Do read Crazymeds.com. If something your Dr says contradicts crazymed's advice? Go back to your Dr, because crazymeds is usually right. That goes for tapering onto medications, as well as tapering off (as I discovered for Strattera).
* If you're on meds, and your life isn't working so well, and you're desperately looking for something to change... going off your meds is not the thing to change. Go back to your Dr and let them know in case there is something they can do to help.
* When to go off your meds: When everything is running smoothly, much more smoothly than before you started. If you think of your work, your home environment, your friendships and your romantic relationships, the general impression is good. You can make a coherent case for why things are different now, and why you are a functional being. You have a therapist/counsellor who supports you in this. You discussed it with your Dr who supports you in this (I do know people who've suggested their Dr never would - well, get a new Dr, your old one is unable to pattern match and problem solve). You reduced commitments for the next few weeks and upped the routines (movie nights at a friends). You followed the tapering schedule from crazymeds.
* You made your decisions about what you will do if going off is NOT working, before going off meds - what symptoms will make you call a Dr. Which people to call if you are not sure. How 'wanting to die' at any time is ABSOLUTELY 'call a Dr' worthy (this goes for going ONTO medications - Amitriptyline, I hate you). If you ever get benzos for emergencies from your Dr, this is a good time.
posted by Elysum at 7:25 PM on July 29, 2015 [2 favorites]
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