I had to learn how to love myself enough to take care of myself.
February 12, 2015 11:04 AM Subscribe
I had to rearrange everything I knew to allow myself to look up the number for a psychiatrist, and rearrange even more to actually make the call. It takes courage and strength to look the stigma of being medicated in the face and push through it, to persist because you care about feeling whole and happy and calm more than you care about what other people think. Loving yourself enough to take care of yourself when it is easier not to is a revolutionary act.Tracy Clayton (a/k/a @BrokeyMcPoverty) for BuzzFeed: When Taking Anxiety Medication Is A Revolutionary Act.
And so I became a revolutionary.
yeah, I cannot tell you how many horrible little stories you hear about 'when drugs go wrong' featuring people who claimed SSRIs 'changed their personality' and made it so that people 'could never be happy again.' you know, we don't, as a society, lend a lot of credence to medical industry. a lot of that is probably due to the flaws in how it's run and such but as far as research and peer review goes, I don't think there's much else out there that has this kind of rigor and support.
when I went in for treatment for depression and anxiety, I didn't go into it thinking that it would be some confrontation. I just dialed down on the ego and trusted that these people who paid a lot more than me for their education and put in many more years than I did in treating people like me would know what they were doing. maybe part of that is figuring out how to separate the 'illness' from the 'self.'
maybe taking shrooms way back in the day helped, too, insofar as it allowed me to feel this entire other spectrum of happiness and gregariousness that I was too anxious or depressed to even conceptualize. shrooms provided an epiphany that led me into treatment. the medicine had the effect of letting me know that I could constantly be 'normal' ie happy, my own person, free from neurosis, and that it was something worth working towards, could be worked towards, and could be sustained, with work. I don't know about relying on medicine all the time, cheap as it is, but their illness is not my illness and I am not their doctor so I can't judge.
but yeah. getting it out of my head that depression and anxiety weren't fixed character traits but rather dynamic illnesses that could subside is a paradigm I think is worth considering if you're thinking about getting treatment.
posted by saucy_knave at 11:27 AM on February 12, 2015 [9 favorites]
when I went in for treatment for depression and anxiety, I didn't go into it thinking that it would be some confrontation. I just dialed down on the ego and trusted that these people who paid a lot more than me for their education and put in many more years than I did in treating people like me would know what they were doing. maybe part of that is figuring out how to separate the 'illness' from the 'self.'
maybe taking shrooms way back in the day helped, too, insofar as it allowed me to feel this entire other spectrum of happiness and gregariousness that I was too anxious or depressed to even conceptualize. shrooms provided an epiphany that led me into treatment. the medicine had the effect of letting me know that I could constantly be 'normal' ie happy, my own person, free from neurosis, and that it was something worth working towards, could be worked towards, and could be sustained, with work. I don't know about relying on medicine all the time, cheap as it is, but their illness is not my illness and I am not their doctor so I can't judge.
but yeah. getting it out of my head that depression and anxiety weren't fixed character traits but rather dynamic illnesses that could subside is a paradigm I think is worth considering if you're thinking about getting treatment.
posted by saucy_knave at 11:27 AM on February 12, 2015 [9 favorites]
Better living through chemistry. I went more than a decade knowing I needed help, but it took falling in love for me to actually act. I didn't want to be the unreliable jerk I was because I was having good and bad days.
posted by joelr at 11:28 AM on February 12, 2015 [3 favorites]
posted by joelr at 11:28 AM on February 12, 2015 [3 favorites]
SSRIs worked (and are working) for me too.
posted by infinitewindow at 11:29 AM on February 12, 2015 [2 favorites]
posted by infinitewindow at 11:29 AM on February 12, 2015 [2 favorites]
Me too.
posted by jeff-o-matic at 11:33 AM on February 12, 2015
posted by jeff-o-matic at 11:33 AM on February 12, 2015
I need to bookmark this article so I can bring it out every time there's an AskMefi that's along the lines of, "I'm suffering horribly from this thing that might be depression but I'm not going to a therapist or getting medicine for it for x reasons; what should I do?"
posted by tofu_crouton at 11:38 AM on February 12, 2015 [3 favorites]
posted by tofu_crouton at 11:38 AM on February 12, 2015 [3 favorites]
Also, there is still a bizarre taboo about these things. I know it's a personal choice, but I recommended them to a couple friends with issues... or at least suggested that they might want to look into these drugs. These were guys who regularly drink, smoke weed, and have done all kinds of psychedelics i the past. And their reaction was severe suspicion, that anti-anxiety/depression drugs would somehow be too big a leap for them to even try.
Weird. But the 90s was full of anti-depression drug hysteria.
posted by jeff-o-matic at 11:38 AM on February 12, 2015 [1 favorite]
Weird. But the 90s was full of anti-depression drug hysteria.
posted by jeff-o-matic at 11:38 AM on February 12, 2015 [1 favorite]
SSRIs do nothing for me (and in fact, the side effects are unbearable), but after going through dozens of drugs, my psychiatrist found an anxiety medication (an off-label usage, in fact) that has literally saved my life. Stops almost all the intrusive thoughts I get, and lets me live my life.
It used to be when something fucked up in my life, I would immediately think about killing myself, and that would completely overwhelm my ability to function, completely take over every mental process and leave me utterly unable to function. My anxiety meds shuts that off, and I am eternally grateful for them.
posted by and they trembled before her fury at 11:39 AM on February 12, 2015 [14 favorites]
It used to be when something fucked up in my life, I would immediately think about killing myself, and that would completely overwhelm my ability to function, completely take over every mental process and leave me utterly unable to function. My anxiety meds shuts that off, and I am eternally grateful for them.
posted by and they trembled before her fury at 11:39 AM on February 12, 2015 [14 favorites]
SSRIs worked (and are working) for me too.
+1 reporting in, 8 years. This is probably the best article I've read about the subject.
Now if I could just give up wine...
posted by colie at 11:44 AM on February 12, 2015
+1 reporting in, 8 years. This is probably the best article I've read about the subject.
Now if I could just give up wine...
posted by colie at 11:44 AM on February 12, 2015
I finally was able to get over my internal shame of my (very successful and needed) medications, and I seem to be able to surround myself with non-judgmental peers who don't think twice about what I take to get through the day. However, thanks to genetics, my son has started his own round of meds, and I'm getting the same tired shit from people I thought better of: you're going to warp his development, he'll never get a chance to think he's normal, he's just being a teenager, he's going to think you don't like him as he is.
Overall, I'm looking back fondly on the days where people just thought I was harming myself. The self-righteous handwriting about psychiatric medication and parenting is a Sharknado-like combination.
posted by bibliowench at 11:48 AM on February 12, 2015 [2 favorites]
Overall, I'm looking back fondly on the days where people just thought I was harming myself. The self-righteous handwriting about psychiatric medication and parenting is a Sharknado-like combination.
posted by bibliowench at 11:48 AM on February 12, 2015 [2 favorites]
And for me.
Anxiety and depression are symptoms, not punishments. Medication works. Talk to a doctor, they will not judge you, they can help you.
posted by fallingbadgers at 12:13 PM on February 12, 2015 [1 favorite]
Anxiety and depression are symptoms, not punishments. Medication works. Talk to a doctor, they will not judge you, they can help you.
posted by fallingbadgers at 12:13 PM on February 12, 2015 [1 favorite]
I wrote about this a little in response to this AskMe - I too was immensely reluctant to go on anxiety medication. I'm pretty sure that pushing past that reluctance saved my life, at least in the sense of allowing me to have any sort of life worth living. For me, one of the things lurking underneath it all was that my anxiety was somehow an essential part of my self. I told my psychiatrist in that first meeting, "I don't know who I am if I'm not worried." She had the best possible response: "well, now you get to find out."
posted by Ragged Richard at 12:14 PM on February 12, 2015
posted by Ragged Richard at 12:14 PM on February 12, 2015
I suffer from anxiety disorder and depression, as well as the ever reliable panic attack. I used to take medication for my anxiety and stopped when they ran out. Now I know I should take them or get back on them, but I refuse because I am being an idiot and thinking that I can deal with living my life without them. My husband would very much like me to reconsider because he sees how miserable I can be.
Long-winded way of saying thank you for posting and I need to not be stubborn.
posted by Kitteh at 12:29 PM on February 12, 2015 [4 favorites]
Long-winded way of saying thank you for posting and I need to not be stubborn.
posted by Kitteh at 12:29 PM on February 12, 2015 [4 favorites]
I'm very glad many people are being helped in whichever way works for them. But I don't appreciate people diminishing the very real negative experiences others have had. The "hysteria" of the late 90s was at least partly the result of prescribing doctors just totally invalidating the (very real) side effects experienced by not a small number of patients. YMMV. Some drugs work for some people; not all drugs will fix everything for everyone.
posted by cotton dress sock at 12:34 PM on February 12, 2015 [7 favorites]
posted by cotton dress sock at 12:34 PM on February 12, 2015 [7 favorites]
If anyone reading this has anything in the area around anxiety and depression that they can do, I implore you to look for ways to continue to reduce the hurdles necessary to get help for them.
There are so many obstacles that are put up without any thought, because the rest of society works that way. The best example I can find was looking at a website for social anxiety, only to find that when you looked up someone in the area to help, all they gave was a phone number to call. As if people with social anxiety aren't going to have any problems making the call. Someone has to get over their anxiety to be able to make the call to get help getting over their anxiety.
I think about this every time someone suffering from depression commits suicide. People post lists of suicide hotlines. That's great, except for all those people who aren't going to be willing to call because anxiety gets in the way, or they're so low on themselves that they don't want to bother someone else with their petty troubles.
You want an idea for a great way to reach out and help people in this situation? Online scheduling of someone to come out and do at least the first therapy session in their own home. No having to call anyone or talk on the phone. No having to drive somewhere unfamiliar and find parking. Lower the barriers to entry. Tailor the help that's offered to what people need.
posted by evilangela at 12:35 PM on February 12, 2015 [14 favorites]
There are so many obstacles that are put up without any thought, because the rest of society works that way. The best example I can find was looking at a website for social anxiety, only to find that when you looked up someone in the area to help, all they gave was a phone number to call. As if people with social anxiety aren't going to have any problems making the call. Someone has to get over their anxiety to be able to make the call to get help getting over their anxiety.
I think about this every time someone suffering from depression commits suicide. People post lists of suicide hotlines. That's great, except for all those people who aren't going to be willing to call because anxiety gets in the way, or they're so low on themselves that they don't want to bother someone else with their petty troubles.
You want an idea for a great way to reach out and help people in this situation? Online scheduling of someone to come out and do at least the first therapy session in their own home. No having to call anyone or talk on the phone. No having to drive somewhere unfamiliar and find parking. Lower the barriers to entry. Tailor the help that's offered to what people need.
posted by evilangela at 12:35 PM on February 12, 2015 [14 favorites]
It's hard not to come across as judgmental when discussing this and it's a topic that usually springs up without giving me adequate time to prepare for so I'm likely to sound worse than I intend, but psychiatry is a lot more messy and ugly than it's ever likely to be credited for here. Here's a good article on a lot of the history and dodgy science inherent in psychiatric medicine. It's largely junk science, or, where it's almost accurate, it's almost accurate by accident.
There are also issues of class here. Access to non-abusive psychiatric treatment is, at least in the US, kind of a huge marker of class privilege. It's not surprising that MetaFilter leans toward uncritical cheerleading, but this is actually a much more nuanced and complicated topic. Speaking as someone who can't access psychiatric treatment at all really (though I don't entirely want to; lots and lots of abuse and bad experiences down that hall, nevermind that huge swaths of it aren't even led by sound science).
posted by byanyothername at 12:39 PM on February 12, 2015 [3 favorites]
There are also issues of class here. Access to non-abusive psychiatric treatment is, at least in the US, kind of a huge marker of class privilege. It's not surprising that MetaFilter leans toward uncritical cheerleading, but this is actually a much more nuanced and complicated topic. Speaking as someone who can't access psychiatric treatment at all really (though I don't entirely want to; lots and lots of abuse and bad experiences down that hall, nevermind that huge swaths of it aren't even led by sound science).
posted by byanyothername at 12:39 PM on February 12, 2015 [3 favorites]
"look at all my people"
I started a small anti-depressant this winter, and I can't believe what a difference it makes. I've tried to be really open in talking with other people about it, doing my own little part in "this is an illness and it's ok to talk about," because I appreciated all of my medicated friends having that conversation with me. Normal is never going to happen, but not spending hours each morning finding the will to get out of bed is worth it in itself.
posted by BekahVee at 12:45 PM on February 12, 2015 [5 favorites]
I started a small anti-depressant this winter, and I can't believe what a difference it makes. I've tried to be really open in talking with other people about it, doing my own little part in "this is an illness and it's ok to talk about," because I appreciated all of my medicated friends having that conversation with me. Normal is never going to happen, but not spending hours each morning finding the will to get out of bed is worth it in itself.
posted by BekahVee at 12:45 PM on February 12, 2015 [5 favorites]
> Someone has to get over their anxiety to be able to make the call to get help getting over their anxiety.
Literally the words I've used to explain my difficulties to others. I was only able to get around it by asking someone else to make the appointment for me, and I'm just now starting on an SSRI to see if it will help.
posted by I-Write-Essays at 12:46 PM on February 12, 2015 [2 favorites]
Literally the words I've used to explain my difficulties to others. I was only able to get around it by asking someone else to make the appointment for me, and I'm just now starting on an SSRI to see if it will help.
posted by I-Write-Essays at 12:46 PM on February 12, 2015 [2 favorites]
Regarding barriers, SSRIs are generally very cheap. Not everyone can afford $10-20 per month, but most people can. And if it works the ROI is huge. Cost-wise, the biggest hurdle is getting a script.
posted by zennie at 12:56 PM on February 12, 2015
posted by zennie at 12:56 PM on February 12, 2015
I'm very glad many people are being helped in whichever way works for them. But I don't appreciate people diminishing the very real negative experiences others have had. The "hysteria" of the late 90s was at least partly the result of prescribing doctors just totally invalidating the (very real) side effects experienced by not a small number of patients. YMMV. Some drugs work for some people; not all drugs will fix everything for everyone.
Yeah, I have GAD and went through several tries with SSRIs and some other antianxiety drugs. I didn't feel numb - I had escalating depression, fluey symptoms, headaches, muscle pain, just horribleness. Finally decided those drugs are not for me. But that's not for me, and I definitely would never try to extend my experience to people at large. That's the weird thing about these drugs, individual experience can vary so greatly. For me what has worked is LOTS of exercise, eating really well, and sleep meds with the occasional benzo in case things get out of hand, which they thankfully haven't in a while.
posted by zutalors! at 1:00 PM on February 12, 2015 [2 favorites]
The prescription is cheap. Access to regular medical monitoring is not. Finding a doctor willing to entertain the validity of patients' subjective experiences, or to work through five or ten trials of different drugs, including off-license uses, is luck.
posted by cotton dress sock at 1:02 PM on February 12, 2015 [6 favorites]
posted by cotton dress sock at 1:02 PM on February 12, 2015 [6 favorites]
Finding a doctor willing to entertain the validity of patients' subjective experiences, or to work through five or ten trials of different drugs, including off-license uses, is luck.
Also extreme persistence, at least if you're in a large metro area.
posted by zutalors! at 1:05 PM on February 12, 2015 [1 favorite]
Also extreme persistence, at least if you're in a large metro area.
posted by zutalors! at 1:05 PM on February 12, 2015 [1 favorite]
Not only do I think anti-anxiety and anti-depressants are awesome (for the people for whom they work), I wish we had a bunch of nootropics and mood elevators we could buy over the counter. I don't understand the belief some people possess that there is something morally suspect about taking a pill to change your subjective experience of life. The fact that the folks holding this opinion will often expound upon it while guzzling coffee or beer is the cherry on the poop sundae.
posted by Justinian at 1:13 PM on February 12, 2015 [18 favorites]
posted by Justinian at 1:13 PM on February 12, 2015 [18 favorites]
I'm one of those people who should probably be on meds, but has always put it off because it's:
1) terrifying because of the small but real chance I could have a bad reaction (since I know someone who has in the past and guess what? I'm anxious about everything anyway!)
and
2) getting over the anxiety enough to actually call someone about it is still not something I've been able to do.
Anything to alleviate either or both of those anxieties would go a long way to help me and probably a lot of similar people.
posted by downtohisturtles at 1:32 PM on February 12, 2015
1) terrifying because of the small but real chance I could have a bad reaction (since I know someone who has in the past and guess what? I'm anxious about everything anyway!)
and
2) getting over the anxiety enough to actually call someone about it is still not something I've been able to do.
Anything to alleviate either or both of those anxieties would go a long way to help me and probably a lot of similar people.
posted by downtohisturtles at 1:32 PM on February 12, 2015
Peter Kramer wrote the book _Listening to Prozac_ where he worried about overuse of SSRIs.
He was alarmed to find how extreme the anti-medication sentiment became over the years and he wrote another book, _Against Depression_, which is about how extremely serious depression is, how serious its neurological consequences are, and how just because we may have questions about the way a particular medication is used in general, that's no damned reason to handwave the illness out of existence or to hesitate to treat it aggressively in whatever way is available.
He did a bunch of blog posts for Psychology Today, which analyzed a lot of popularized news stories about psychiatric illness and medications.
Really good reading.
Here's a piece of his in the NYT called "In Defense of Antidepressants," as an example of the sorts of things he writes these days.
posted by edheil at 1:35 PM on February 12, 2015 [5 favorites]
He was alarmed to find how extreme the anti-medication sentiment became over the years and he wrote another book, _Against Depression_, which is about how extremely serious depression is, how serious its neurological consequences are, and how just because we may have questions about the way a particular medication is used in general, that's no damned reason to handwave the illness out of existence or to hesitate to treat it aggressively in whatever way is available.
He did a bunch of blog posts for Psychology Today, which analyzed a lot of popularized news stories about psychiatric illness and medications.
Really good reading.
Here's a piece of his in the NYT called "In Defense of Antidepressants," as an example of the sorts of things he writes these days.
posted by edheil at 1:35 PM on February 12, 2015 [5 favorites]
I read this article and enjoyed it but it made me wish Celexa had worked for my anxiety. :( Both Celexa and Lexapro have helped my depression but neither seem to make me less anxious.
I feel like my doctor takes my depression seriously but she doesn't understand how miserable the anxiety is as well. She has me on 15 mg of buspirone a day, which doesn't do shit. I would really love to have a week where my stomach wasn't clenched and I wasn't holding my breath all the time, you know? I feel like I would be much less depressed if my body wasn't always in fear/flight mode.
posted by Squeak Attack at 1:45 PM on February 12, 2015
I feel like my doctor takes my depression seriously but she doesn't understand how miserable the anxiety is as well. She has me on 15 mg of buspirone a day, which doesn't do shit. I would really love to have a week where my stomach wasn't clenched and I wasn't holding my breath all the time, you know? I feel like I would be much less depressed if my body wasn't always in fear/flight mode.
posted by Squeak Attack at 1:45 PM on February 12, 2015
Open offer: if anyone here has identified a mental health professional with whom they would like to make an appointment but can't get over their own internal barriers to make the call, I will make the call for you. I find making phone calls to be quite easy and pleasant, even enjoyable, so you wouldn't be putting me out or burdening me at all. I have a lot of friends who hate the phone (and I am married to one of them) and so I do this a lot. Memail me to take me up on it; this offer does not expire.
posted by KathrynT at 2:02 PM on February 12, 2015 [47 favorites]
posted by KathrynT at 2:02 PM on February 12, 2015 [47 favorites]
downtohisturtles: 1) terrifying because of the small but real chance I could have a bad reaction (since I know someone who has in the past and guess what? I'm anxious about everything anyway!)
The first dose for any medication is usually a very small one to look for side effects like this. The expectation is to take a small amount for a set amount of time - with SSRIs a minimum of two weeks is a good idea because the medication has to build up to sustainable levels - specifically looking for unwanted changes, then stepping the dose up until you are getting the desired effect.
The major potential wrinkle with anxiety is that it is often twinned with depression (you could view this as an expression of bipolarity as well; I tend to not try to stuff everything into that single diagnosis, but Arguments Could Be Made). I have had clients where we have successfully treated one only to have the other show up.
Another important part of this is finding a psychiatrist who works with your vibe and who you feel comfortable asking questions of. Ask all of them. Make lists, if you want. If a psychiatrist gets stroppy then they aren't a good fit for you and ask for a referral. It would also be a good idea to get a therapist who can help with the more psycho-social end of things, because often treating anxiety is about both calming the fight-flight-freeze response, and identifying and addressing now-maladaptive habits that have developed in response to the fight-flight-freeze response.
2) getting over the anxiety enough to actually call someone about it is still not something I've been able to do.
If you have someone you trust, having them sit with you can really help. One thing I do with my clients is sit with them while they make scary phone calls, and smile reassuringly if they look at me. Sometimes we write out scripts (sometimes I write out scripts for myself!). Sometimes we breathe together, too. See if you have a friend who can do this for you; calling people is scary.
posted by Deoridhe at 2:09 PM on February 12, 2015 [1 favorite]
The first dose for any medication is usually a very small one to look for side effects like this. The expectation is to take a small amount for a set amount of time - with SSRIs a minimum of two weeks is a good idea because the medication has to build up to sustainable levels - specifically looking for unwanted changes, then stepping the dose up until you are getting the desired effect.
The major potential wrinkle with anxiety is that it is often twinned with depression (you could view this as an expression of bipolarity as well; I tend to not try to stuff everything into that single diagnosis, but Arguments Could Be Made). I have had clients where we have successfully treated one only to have the other show up.
Another important part of this is finding a psychiatrist who works with your vibe and who you feel comfortable asking questions of. Ask all of them. Make lists, if you want. If a psychiatrist gets stroppy then they aren't a good fit for you and ask for a referral. It would also be a good idea to get a therapist who can help with the more psycho-social end of things, because often treating anxiety is about both calming the fight-flight-freeze response, and identifying and addressing now-maladaptive habits that have developed in response to the fight-flight-freeze response.
2) getting over the anxiety enough to actually call someone about it is still not something I've been able to do.
If you have someone you trust, having them sit with you can really help. One thing I do with my clients is sit with them while they make scary phone calls, and smile reassuringly if they look at me. Sometimes we write out scripts (sometimes I write out scripts for myself!). Sometimes we breathe together, too. See if you have a friend who can do this for you; calling people is scary.
posted by Deoridhe at 2:09 PM on February 12, 2015 [1 favorite]
Not only do I think anti-anxiety and anti-depressants are awesome (for the people for whom they work), I wish we had a bunch of nootropics and mood elevators we could buy over the counter. I don't understand the belief some people possess that there is something morally suspect about taking a pill to change your subjective experience of life. The fact that the folks holding this opinion will often expound upon it while guzzling coffee or beer is the cherry on the poop sundae.
A point I keep having to make is that my untreated psychiatric symptoms include effects associated with some pretty hard drugs. Physiologically, anxiety disorder feels a lot like taking an amphetamine (which I tried for three days under a doctor's supervision).
posted by CBrachyrhynchos at 2:40 PM on February 12, 2015 [1 favorite]
A point I keep having to make is that my untreated psychiatric symptoms include effects associated with some pretty hard drugs. Physiologically, anxiety disorder feels a lot like taking an amphetamine (which I tried for three days under a doctor's supervision).
posted by CBrachyrhynchos at 2:40 PM on February 12, 2015 [1 favorite]
Finding a doctor willing to entertain the validity of patients' subjective experiences, or to work through five or ten trials of different drugs, including off-license uses, is luck.
I agree with you, cotton dress sock.
I am fortunate enough to have such a doctor. But, it can often be difficult to find other physicians who will respect or understand her course of treatment and then work in conjunction with it. Especially with off-license use.
posted by eviltiff at 3:25 PM on February 12, 2015 [1 favorite]
I agree with you, cotton dress sock.
I am fortunate enough to have such a doctor. But, it can often be difficult to find other physicians who will respect or understand her course of treatment and then work in conjunction with it. Especially with off-license use.
posted by eviltiff at 3:25 PM on February 12, 2015 [1 favorite]
It's really really hard to get to "I deserve not to feel like this."
(As distinct from "I don't deserve to feel like this." Duh, nobody deserves anything, so what etc etc.)
posted by PMdixon at 3:44 PM on February 12, 2015 [3 favorites]
(As distinct from "I don't deserve to feel like this." Duh, nobody deserves anything, so what etc etc.)
posted by PMdixon at 3:44 PM on February 12, 2015 [3 favorites]
Before I get in a long narrative, for those with phone anxiety let me recommend any of the online medical records - clinical communication systems such as Epic's myonlinechart. If one's carer is in such a system, you can just send your doc a HIPAA-compliant secure email while making an appointment or checking your appointment schedule. It's even easier to have a someone help type or read any test results one is too distressed to deal with. However, only the larger clinics or HMOs in the US are using these modalities. Care teams with any email or other text-message systems have really helped me communicate better.
posted by Dreidl at 5:29 PM on February 12, 2015 [1 favorite]
posted by Dreidl at 5:29 PM on February 12, 2015 [1 favorite]
OK, Why I Am Afraid of the Psych Profession
Like many queers of my age, I had forced psychiatric mistreatment (outpatient where the docs told my parents *everything* after promising me they wouldn't, several bouts of inpatient with over-medication and threats of electroconvulsant sessions, being sent to schools that continued the forced medication), when still under my parent's control. I can only be grateful organized "reparative therapy" torture for lesbians didn't exist yet, although it was getting started in the time period I was confined.
Unsurprisingly, it took until I was in my 30s before I voluntarily and truthfully interacted with psych providers. (I had to BS my way through psych and medical gatekeepers to access the sex-change care of the time) However, I did trust my primary care doc to prescribe sedating tricyclic antidepressants and eventually, anti-anxiety agents. At last I could step off the rage/numbness carousel enough to work effectively and have lasting relationships.
What made the difference for me was MY choosing what effects I wanted the interventions to have. And then finally experiencing physical calm. Until I was medicated, I had NO idea, even after years of Buddhist meditation, what my body felt like relaxed instead of constantly primed for receiving or giving aggression.
After a few years of *voluntarily* drugging myself down to passivity, I was then ready to consider talk therapy on my own terms. While modifying my medications, still via my primary care doc, for their mood-lifting effects rather than damping everything down so I could bear feelings at all. I had some horrible and sometimes humorous experiences with SSRIs, until we found the right combo where I was calm, motivated and had a sex-drive, too. Eventually, after about 4 years of very directed therapy (yay for CBT!) I was able to stop the medication except for very rare bouts of anxiety.
Even being diagnosed with multiple progressive and (eventually) fatal disorders haven't made my anxiety or depression come back more than episodically. I guess physiological good fortune, the right drugs, and the right therapists make a difference after all.
But in the US, accessing or keeping an effective mental-health team is really, really difficult, and even harder if one is poor and/or in a marginalized social group. Sometimes resisting (possibly) inappropriate mental health care is the only remaining empowered therapy/medication choice a person has.
posted by Dreidl at 5:41 PM on February 12, 2015 [8 favorites]
Like many queers of my age, I had forced psychiatric mistreatment (outpatient where the docs told my parents *everything* after promising me they wouldn't, several bouts of inpatient with over-medication and threats of electroconvulsant sessions, being sent to schools that continued the forced medication), when still under my parent's control. I can only be grateful organized "reparative therapy" torture for lesbians didn't exist yet, although it was getting started in the time period I was confined.
Unsurprisingly, it took until I was in my 30s before I voluntarily and truthfully interacted with psych providers. (I had to BS my way through psych and medical gatekeepers to access the sex-change care of the time) However, I did trust my primary care doc to prescribe sedating tricyclic antidepressants and eventually, anti-anxiety agents. At last I could step off the rage/numbness carousel enough to work effectively and have lasting relationships.
What made the difference for me was MY choosing what effects I wanted the interventions to have. And then finally experiencing physical calm. Until I was medicated, I had NO idea, even after years of Buddhist meditation, what my body felt like relaxed instead of constantly primed for receiving or giving aggression.
After a few years of *voluntarily* drugging myself down to passivity, I was then ready to consider talk therapy on my own terms. While modifying my medications, still via my primary care doc, for their mood-lifting effects rather than damping everything down so I could bear feelings at all. I had some horrible and sometimes humorous experiences with SSRIs, until we found the right combo where I was calm, motivated and had a sex-drive, too. Eventually, after about 4 years of very directed therapy (yay for CBT!) I was able to stop the medication except for very rare bouts of anxiety.
Even being diagnosed with multiple progressive and (eventually) fatal disorders haven't made my anxiety or depression come back more than episodically. I guess physiological good fortune, the right drugs, and the right therapists make a difference after all.
But in the US, accessing or keeping an effective mental-health team is really, really difficult, and even harder if one is poor and/or in a marginalized social group. Sometimes resisting (possibly) inappropriate mental health care is the only remaining empowered therapy/medication choice a person has.
posted by Dreidl at 5:41 PM on February 12, 2015 [8 favorites]
I'm glad the author found something that worked for her. I did not like the article a lot, especially the part where the author felt it necessary to contrast herself to the "babbling, unwashed, self-harming, occasionally murderous lunatics" that she saw on tv. She may think she's describing a stereotype, but I feel like she's perpetuating it. Those babbling unwashed self-harming people (people! not lunatics!), they do exist in real life too, they're usually not murderous, and they're just people with a mental health problem that was not as easily fixed by the first medication they tried.
posted by blub at 1:04 AM on February 13, 2015 [1 favorite]
posted by blub at 1:04 AM on February 13, 2015 [1 favorite]
Finding a doctor willing to entertain the validity of patients' subjective experiences, or to work through five or ten trials of different drugs, including off-license uses, is luck.I was lucky that I had an extremely cooperative psychiatrist, that I had been seeing for years on a monthly basis. We went through a lot of different medications, through all the different side effects that each would inevitably give me, and he was responsive to my complaints about each one, and ultimately found something (off-label, even) that did help. Yet at the same time, through all of that I was still very much constantly suicidal and depressed. Things were very much touch-and-go for a very long time.
Also extreme persistence, at least if you're in a large metro area.
But, in addition to my psychiatrist, I also had access to a therapist that I was seeing weekly, and an incredibly deep support-base outside of medical care. I recognize that I have had incredible amounts of privilege and luck just for all of that to be able to happen, and that if any of my circumstances were different, I might not have received the care I did and I might even not be alive right now.
posted by and they trembled before her fury at 4:40 AM on February 13, 2015 [3 favorites]
Never found a thing that works. I read others' descriptions of how they pop a couple of pills and they slowly become themselves again and it sounds like science fiction to me. Here's what I get from all the different elixirs I've ever had prescribed to me: sleeplessness. Everything I've taken feels like a placebo with the only additive feature being that I can't fucking sleep.
Maybe there was an instance or two when I could almost sort of say, after taking this pill or that pill for a while, "Maybe I feel better? Ever so slightly? But it's hard to say. I'm fucking exhausted and depressed because I lie in bed for hours and hours and only sleep for three."
Apparently, psych meds are some sort of miracle for everyone else. Me? Same as I ever was, wasting my life and stuck in a corner from which I can't escape.
Articles like this just make me feel more broken.
posted by samizdat at 9:04 PM on February 16, 2015 [1 favorite]
Maybe there was an instance or two when I could almost sort of say, after taking this pill or that pill for a while, "Maybe I feel better? Ever so slightly? But it's hard to say. I'm fucking exhausted and depressed because I lie in bed for hours and hours and only sleep for three."
Apparently, psych meds are some sort of miracle for everyone else. Me? Same as I ever was, wasting my life and stuck in a corner from which I can't escape.
Articles like this just make me feel more broken.
posted by samizdat at 9:04 PM on February 16, 2015 [1 favorite]
Apparently, psych meds are some sort of miracle for everyone else.
I think it's more that people who find them a miracle are most likely to be in a position to talk about it - both because their suffering is significantly lessened, and because they fit the expected narrative of "take meds, be better" that people in a pill-focused culture want. In my experience, I have had clients where the pills put their head above water and then the real work began, I have clients where it takes the edge off, I have clients where it does very little, and I had one client where it was actively impairing, and removing 80% of his medications led to improvement (we did it in a hospital in the context of medical treatment); an engaged and educated client can get a lot more out of medication, but medication doesn't fix the auxiliary stuff and there are some things medication doesn't seem to touch.
For example, every client I have who hears voices still hears them on medications. Delusions tend to remain mostly in place as well; the way I would describe it is that the medication "loosens the hold" so that a skilled clinician can step in and try to introduce new scripts, new practices, new stories etc... that might help over time. Likewise, anxiety and depression are often in a locked relationship with each other that requires treatment in addition to medication; the medication just helps set the ground upon which the work of identifying and processing issues and challenges can be done.
In a very real way, we don't understand what we are doing with psychiatric medication, even when it works. This means that every client is the subject of a very particular, individual study on their own and their psychiatrists part, which can feel horrifically dehumanizing and cold and ultimately undermine itself if the client feels negated by the process (some find the detachment helpful, others don't; people are complicated). I don't have any easy fixes for this, though; I wish I did. I hope there is some small comfort in knowing you are not alone in your experience of medication not helping.
posted by Deoridhe at 1:36 PM on February 17, 2015 [3 favorites]
I think it's more that people who find them a miracle are most likely to be in a position to talk about it - both because their suffering is significantly lessened, and because they fit the expected narrative of "take meds, be better" that people in a pill-focused culture want. In my experience, I have had clients where the pills put their head above water and then the real work began, I have clients where it takes the edge off, I have clients where it does very little, and I had one client where it was actively impairing, and removing 80% of his medications led to improvement (we did it in a hospital in the context of medical treatment); an engaged and educated client can get a lot more out of medication, but medication doesn't fix the auxiliary stuff and there are some things medication doesn't seem to touch.
For example, every client I have who hears voices still hears them on medications. Delusions tend to remain mostly in place as well; the way I would describe it is that the medication "loosens the hold" so that a skilled clinician can step in and try to introduce new scripts, new practices, new stories etc... that might help over time. Likewise, anxiety and depression are often in a locked relationship with each other that requires treatment in addition to medication; the medication just helps set the ground upon which the work of identifying and processing issues and challenges can be done.
In a very real way, we don't understand what we are doing with psychiatric medication, even when it works. This means that every client is the subject of a very particular, individual study on their own and their psychiatrists part, which can feel horrifically dehumanizing and cold and ultimately undermine itself if the client feels negated by the process (some find the detachment helpful, others don't; people are complicated). I don't have any easy fixes for this, though; I wish I did. I hope there is some small comfort in knowing you are not alone in your experience of medication not helping.
posted by Deoridhe at 1:36 PM on February 17, 2015 [3 favorites]
@Deoridhe said, "In a very real way, we don't understand what we are doing with psychiatric medication, even when it works. This means that every client is the subject of a very particular, individual study on their own and their psychiatrists part."
This is something I simply can't get past. When I was hospitalized, a psych nurse who was really pushing another go-round with meds* asked me if I would turn down insulin if I was a diabetic. I told her that when a mental health professional could take a pill out of a bottle, sit it down on a map of my brain and explain where and by what mechanism it would begin to work on my specific problems, I would be more likely to give them another try. Until then, keep talking about psych meds like they're some sort of panacea, and I'll keep pushing back as I call you on your claims and ask you not to look at me as a guinea pig for your clinical trials for the next two years as you "try to get the levels right and see what works for you."
This is not science. This is guesswork.
Being a subject of such a process makes me feel awful.
* of course, when I was in, I was being given something; I mean pushing them as a long-term experiment once I was released.
posted by samizdat at 10:09 PM on February 17, 2015
This is something I simply can't get past. When I was hospitalized, a psych nurse who was really pushing another go-round with meds* asked me if I would turn down insulin if I was a diabetic. I told her that when a mental health professional could take a pill out of a bottle, sit it down on a map of my brain and explain where and by what mechanism it would begin to work on my specific problems, I would be more likely to give them another try. Until then, keep talking about psych meds like they're some sort of panacea, and I'll keep pushing back as I call you on your claims and ask you not to look at me as a guinea pig for your clinical trials for the next two years as you "try to get the levels right and see what works for you."
This is not science. This is guesswork.
Being a subject of such a process makes me feel awful.
* of course, when I was in, I was being given something; I mean pushing them as a long-term experiment once I was released.
posted by samizdat at 10:09 PM on February 17, 2015
samizdat: Although I agree how psychiatry has a lot to do until they match other medical areas of research I'd be wary to call it "guesswork." For example, I was skeptical of Rx (as my family did not believe in *any* forms of mental illnesses) and I went through a series of doctors and other related people for my anxiety for a while. But I did find the right combination of CBT and Rx which helped me immensely and I'm grateful for all the research people have spent and invested as I probably wouldn't not be alive if not for them.
The same idea as I cringe inwardly when I read the word "miracle" because it's overgeneralizing too much of what is a tiring and often demoralizing experience of trying out different brands and dosages. Not to mention side-effects and basically how disruptive it can be if one is working full-time or a student too.
I do agree with author as it does not change my basic personality but instead lets me continue to do my work despite being unhappy, tired, or unmotivated too. In a perfect world I would find a place where I wouldn't be stressed out or forced to into certain moulds but so it goes. It's not perfect but good enough.
And that's fine.
posted by chrono_rabbit at 5:00 PM on February 19, 2015
The same idea as I cringe inwardly when I read the word "miracle" because it's overgeneralizing too much of what is a tiring and often demoralizing experience of trying out different brands and dosages. Not to mention side-effects and basically how disruptive it can be if one is working full-time or a student too.
I do agree with author as it does not change my basic personality but instead lets me continue to do my work despite being unhappy, tired, or unmotivated too. In a perfect world I would find a place where I wouldn't be stressed out or forced to into certain moulds but so it goes. It's not perfect but good enough.
And that's fine.
posted by chrono_rabbit at 5:00 PM on February 19, 2015
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posted by ambrosen at 11:25 AM on February 12, 2015 [4 favorites]