Medication Madness: A Recovery Story

Gianna first asked me to write this back in December for the Recovery Page at her blog, Beyond Meds. It was posted there about a month ago, but I thought I'd put it here, too, since this blog is kind of about reclaiming one's life after being misdiagnosed with bipolar disorder and buying into the bullshit for a while before finally seeing the light.

In retrospect, I find it interesting, tragic, and infuriating that a gp and a psychiatrist were able to take an otherwise healthy woman suffering from situation-induced anxiety with a history of two brief periods of depression probably caused by as-yet undiagnosed hypothyroidism, and parlay that into a bipolar diagnosis and a life-sentence of medication-or-else.

I'd always had ups and downs. As a child, I'd been very anxious and very creative. As a writer I'd experienced intense writing highs when I could write for hours at a time and get by with very little sleep, and I'd also experienced intense creative lows where my mind seemed to be mired in muck and I couldn't eke out a single sentence for weeks on end. It never occurred to me to medicalize of pathologize that behavior...it was just part of me and who I was and how I operated.

In the fall of 2003, I went to my gp to get something to help me sleep. I'd taken Ambien before, when I had my creative periods and just couldn't get the wheels to stop turning long enough to fall asleep, and figured that was probably what I needed. At the time, we had a very difficult, anxious family situation going on—my best friend, who was in the process of getting a divorce, had moved in with us, and had promptly met and began an affair with my then-married brother-in-law, putting me smack in the middle between her and his bewildered wife. When I lay down to sleep, I couldn't stop thinking about what was going on and how to fix it. When I went to see my gp for help, my regular doctor wasn't there, and I had to see one of his partners. I was running on maybe three hours of sleep a night for the past week, and felt like I had way too much energy for having had that little amount of sleep.

The doctor asked me if I'd ever been depressed. I recalled two six-week periods, on in 1999 and one in 2001 when I had felt really down, unmotivated, and exhausted. Each of these periods of "depression" resolved on their own without medication. Sure, I'd felt horrible, but I was a young mother stuck at home with two small children and no car (let alone no time to write), which hadn't exactly been part of my career-oriented game plan. The doctor decided that I might be bipolar and asked me how I felt about seeing a psychiatrist. I was a bit surprised, but figured she probably knew what she was talking about and said I would make an appointment. She told me it would probably be a number of weeks or possibly months before I could get in to see anyone and that she would prescribe something for me to take to "bring me down" until I could get an appointment.

She gave me Zyprexa.

She also drew blood for a thyroid test, saying it was possible that my thyroid levels were high.

I managed to get an appointment with a psychiatrist six weeks out. In the meantime, I thought it wouldn't hurt to do some research on bipolar disorder. What I learned did not make me very happy. I read the DSM laundry list of symptoms of bipolar disorder, and realized that I had had all of those symptoms at one time or another. I began going through my journals and noting times when I had been down and times when I had been unusually creative or energetic. No pattern emerged, but there were an awful lot of ups and downs.

A week after my initial appointment with the gp, the thyroid results came back, and I learned that my thyroid levels were low and that I would need to start taking Synthroid. This was no surprise, really, as my mother had been diagnosed with the same thing years ago. But I have to wonder now just how long that had been going on, and whether it might have played a part in those two periods of "depression" I'd experienced a few years earlier.

The Zyprexa took a week or so to kick in, but it did seem to help. By the time I went to see the psychiatrist, I was sleeping better and my anxiety levels had come down somewhat (former best friend had moved in with brother-in-law, so I wasn't having to deal with that situation on a daily basis), though they were still a lot higher than normal. When I finally went to see the psychiatrist, I believed I had educated myself about bipolar disorder, and was fully prepared for him to diagnose me and medicate me. After a 45 minute interview, this man whom I had never met before and knew nothing about me other than my answers to his standardized questions, diagnosed me with bipolar II and told me that I would need to start medication immediately and that I would need to take it forever.

He did not once ask about anything that might be going on in my life.

To his credit, he wasn't too thrilled that the gp had prescribed Zyprexa. "We don't like Zyprexa," he told me, "but I'm sure she was just trying to help." He prescribed Depakote for the mood swings and trazodone (an older antidepressant with the helpful side effect of making one extremely sleepy) to help me sleep.

In my research, I had read that many writers and artists who had been diagnosed with bipolar disorder refused to take medication because it stopped them from being able to create. I told him I was a writer, and I was concerned about my ability to write while on medications. He gave me a condescending look and said, "Depakote won't kill your creativity." I took my prescriptions and dutifully made an appointment to see him again in four weeks.

At my next appointment, I told him I was still feeling a lot of anxiety, although I was sleeping better. He prescribed Lexapro, an antidepressant, because he said it would help with the anxiety and that he was concerned that untreated anxiety might lead to depression.

I swallowed all the propaganda, hook, line, and sinker. I became a student of my moods. When I felt good, I was "hypomanic" and needed to call him and ask him to increase my Depakote. When I felt lousy, I was obviously becoming "depressed" and needed to have more Lexapro. There was no room for normal, human emotions in my illness, for any emotion I felt might be the herald of disaster. My doctor told me on every appointment that the medications were "saving my life" and that if I ever stopped them I would ruin my life.

My Depakote dose went up and up and so did my weight. Within six months I had put on sixty pounds, and within a year I was suffering from terrible pain in my feet from plantar fasciitis, which the foot doctor whose advice I sought told me had been brought on by gaining so much weight so quickly. He prescribed orthotics and stretching exercises, but also told me that it was likely that I would not find a whole lot of relief until I lost some of the weight. I tried the orthotics, I tried the stretching, I tried to lose weight, and finally I submitted to painful cortisone shots, which brought some relief, but alas, only for a few weeks, and then the pain would return.

Pain became my constant companion. It was so bad that many evenings I was in tears. I couldn't be on my feet for more than ten minutes without excruciating pain. Housework had to be done in fits and starts. Grocery shopping became a nightmare, and I had to strategically plan shopping trips that would keep me in just one area of the store for the minimum amount of time. I missed out on taking the children places like the zoo, the science museum, and the amusement park because I just couldn't be on my feet for that long.

Soon after starting the Lexapro, my moods began to cycle rapidly. During my first year on Lexapro, I experienced three depressive episodes and two hypomanic episodes. My doctor took this as validation that being on medications was the right course, because obviously my illness was worsening, and it was a good thing we'd caught it before things really went off the rails.

It never occurred to me that the medications might be the cause of the mood swings.

As the doses of medication increased, my mind started to shut down. Where once I had possessed a rapier wit, now it was all I could do to get the right word out without stuttering. My hands shook and I couldn't do the fine needlework I'd always taken pride in. And worst of all, my verbal abilities disappeared. I couldn't write. I couldn't remember things. I couldn't even find the right words half the time. I also lost all interest in sex, and I found myself unable to care about anything. Life just drifted by, and nothing ever seemed to touch me. In fact, the only time I really felt anything was when my moods cycled up or down.

But I had to keep taking the medications, right? Because if I stopped, I'd "ruin my life", and I was damned lucky that we had caught this problem before things got really out of hand. A doctor had told me so, and he was Educated and Informed, so he had to know what he was talking about, right? After all, he was a professional psychiatrist—an expert on mood disorders--and a professor at a respected university, to boot. I could trust him...right? And after all, my mood swings had become much more frequent and much more severe in recent months. All proof to me that I was doing the right thing.

As time went on I became more and more drugged and disillusioned. I couldn't write anymore so my dreams of writing and publishing novels for a living went down the toilet. By the fall of 2004, over-medicated and overweight, the future no longer seemed bright and full of colour and energy. It looked cold and numb, the colour of ash. And I had pretty much resigned myself to the idea that this is my life now. I have bipolar disorder and I'm lucky to have a life at all.

I tried complaining to my psychiatrist about some of this, but although he listened, I do not think he ever really heard me. And he had an answer for everything:

"I'm concerned about the amount of weight I'm putting on," I told him at one appointment. "When do the risks of carrying around this extra weight outweigh the benefits of taking the medications?"

"You are taking the best medications we have available," he told me, and his manner made me feel like an ungrateful child asking for a second helping of dessert.

"What about going off the medications for a while and seeing what happens?" I persisted, aware that weight loss wasn't going to happen on Depakote—I'd already been trying, and was having no luck.

He gave me a severe look and said, "You are an intelligent woman. Your episodes have been more frequent during the last year, and you know that if you stop taking your medications, you will ruin your life."

Eventually, in the winter of 2005, after months of me pestering him at every visit, he finally agreed to let me try Lamictal. I was very excited at the prospect, because I had read that Lamictal was not as sedating as Depakote—I might actually be able to think and write while on this drug—and it was weight neutral, so I might be able to lose weight as well. I was instructed to cut my Depakote down over a few weeks from 2500 mg to 1000 mg, and then start the Lamictal, then taper the rest of the Depakote after I was up to 100 mg of Lamictal a day. Within three months, if all went well, I would be off the Depakote entirely.

Unfortunately for me, I developed the dreaded Rash, and was told to stop the Lamictal immediately. Cold turkey. I was on 100 mg at the time, and stopped as instructed. A week later I came down with the worst "flu" I'd ever had and was in bed for six weeks with the worst fatigue I had ever felt. I was so exhausted I could barely get off the couch to stagger to the bathroom. I didn't have the energy to make dinner or do laundry, or anything I normally did. My husband had to take over pretty much all the household chores as all I was capable of doing was lying on the couch sleeping 18-20 hours a day. At that time I'd never heard of Lamictal withdrawal, and my doctor had not mentioned anything about the risks or symptoms associated with stopping it so abruptly, and so I assumed I'd had a rotten bout of flu. I know better now.

So the Lamictal experiment had failed, but I was down to only 1000 mg of Depakote, and was beginning to be able to think a bit more clearly. My memory was better and I didn't feel like I was groping for the right words all the time. The shakes had mostly gone away, although I still couldn't do really fine needlework. And I was starting to care about things again. I felt so much better on the lower dose that I told my doctor I wanted to stay there for a while. He agreed.

The turning point came that spring when my husband suffered a severe heart attack. In a cold, numb daze, I dealt with it. I called the ambulance, I called the neighbor to take care of the kids, I drove (with my terrible sense of direction and fear of getting lost) into the big city to a hospital I'd never been to before, and I held it together. I didn't cry. I didn't feel much of anything, actually.

Fortunately, my husband survived. He had a catheterization procedure done, which he came through with flying colours, and was out of the hospital within three days. But I still couldn't feel anything. I couldn't even cry, and I knew that wasn't normal.

At that point, I decided that I'd had enough of being drugged numb. I was completely unable to respond to normal human emotion, and I began to fear that I was not able to respond to my children appropriately. When I told my doctor that I was concerned about the fact that this traumatic, life-changing event had occurred and that I had been unable to react to it, his response was, "Well, the medication protected you."

Yeah. Thanks ever so, doc.

That was my last visit to him. Without having a clue what I was doing, I tapered my medications down over the next month, and by the summer I was off of Depakote and Lexapro. I was still taking trazodone to help me sleep, because I still believed I had bipolar disorder, and that I needed to do everything in my power to stay stable. I embarked upon a program of healthy living—excellent nutrition, supplements, regular bedtimes with trazodone to make sure I got my sleep. I even gave up caffeine. I'd been a regular Diet Coke drinker for years, but I knew that caffeine could mess up my sleep, and I'd had it hammered into my brain for the last year and a half that proper sleep could be the difference between stability and a manic episode. When I was on the medications, caffeine was often the only thing that allowed me to see through the drug fog long enough to get the kids off to school in the mornings, but with the dulling effects of medication gone, I found that I didn't need caffeine any more. For exercise, I started a simple yoga routine because that was about the only thing I could think of that didn't involve impact that would hurt my feet. I found that I enjoyed yoga a lot, and this naturally led me to an interest in meditation, which I added on to the end of my yoga program.

The first week completely off meds was rough. My emotions were all over the map. But I refused to pathologize them. I told myself that I'd had everything deadened for the last year and a half, and that I had to become accustomed to feeling things again. I told myself that I had a year and a half of chemically suppressed emotion that I needed to deal with, so I let myself cry, I let myself feel whatever it was I needed to feel, and embraced the fact that I could feel at all. After that week, things eased up and I began to feel more like my old self.

I began to lose weight slowly, and the yoga had an unexpected benefit—even before I had lost much weight, the pain in my feet began to ease up (although it did not disappear entirely until I had lost thirty of the sixty pounds I'd put on). Soon I was able to go back to my usual activities, and even take short walks.

I was still taking trazodone, and I still believed that I had become that most dangerous of creatures, an Unmedicated Bipolar. Months went by and I was still unable to write. I was afraid that something, either the bipolar disorder or the medications, had damaged my mind, destroyed my creativity. I tried everything to bring it back, but nothing seemed to work. The ability to write seemed to be intact, but it didn't move me that way it once had, there was none of the sparkle I recalled, and I lacked the drive to do the one thing that I had once believed to be my life's purpose.

A couple of years passed. I was still taking trazodone, and I lived in constant fear that I was going to have an "episode" and not be able to control myself. Eventually, the fear got to me and I decided that, knowing how long it takes to see a psychiatrist, it might not be a bad idea to have one on board, "just in case." I found one not too far from my house, and went to see him. Even though I had been stable off medications for nearly three years, he wanted to put me back on medication. I told him I would consider it, but I also told him point blank that I refused to take anything that would make me gain weight or make me stupid. He named three medications—Abilify, Lamictal, and Trileptal. I told him about my past Lamictal problems (the rash, at least, not the withdrawal symptoms, as I still believed it had just been a nasty bout of flu), and he suggested that if we increased the dose much more slowly and without Depakote present that things might go better. He told me to research the medications he had suggested and we would discuss them next time.

However. In my research I came across Phil Dawdy's Furious Seasons, and Gianna's Beyond Meds, and after doing much reading and thinking, I decided that this new psychiatrist had a hell of a lot of nerve suggesting that I ought to be on medication when I'd been completely stable on just trazodone for nearly three years. And in fact, I decided that I didn't want to be on trazodone anymore either, because from what I'd been reading, it just might be responsible for my lack of enthusiasm for writing.

My trazodone taper was a lot smarter than the others. It took me about four months to go from 200 mg a day to nothing. I had headaches for a few days every time I lowered the dose, and I had a couple of weeks somewhere in the middle where I'd have scary flashes of suicidal thoughts. But I persisted, because during this time, I was reading recovery stories and looking into alternative mental health solutions, and realizing that drugs might well have been part of the problem rather than the solution.

In my reading, I also came across some information about the artificial sweetener Aspartame being implicated in mood disorders. When I thought back over my own history, I realized that my mood swings had started in college, soon after I'd turned to diet soda as a study aid. I'd never liked coffee or tea, and didn't want the calories in regular soda, so Diet Coke became my drug of choice. More importantly, those mood swings had stopped when I'd stopped drinking Diet Coke.

As I write this, I've been off mood stabilizers for over three and a half years, and off of trazodone for about six months. My enthusiasm for writing seems to be returning, and I feel better and more stable than I have in years. The mood swings that followed me through college and beyond are gone, and I've felt neither depression nor hypomania since stopping mood stabilizers and aspartame. I am incredibly grateful to Gianna and others who have shared their recovery stories on her site, because if I hadn't found this resource, I might well have listened to that second psychiatrist last year, and allowed him to frighten me back onto the medication merry-go-round.

I no longer live in fear that I am going to lose control or that the Bipolar Monster is going to rear its ugly head and ruin my life. I no longer believe that I have untreated bipolar disorder. I accept the fact that I had symptoms of bipolar disorder, but as more and more time passes with no recurrence of these symptoms, I become more and more convinced that these symptoms were caused by a toxic reaction to Aspartame, and have nothing to do with bipolar disorder.

For a while, I was pretty angry. Angry that drugs like Aspartame could be put into the food supply because they were supposed to be "safe". Angry that I could be diagnosed with a major mental illness so quickly and easily by someone who had never met me. Angry that the diagnostic criteria for this life sentence left no room for life-circumstances and that the doctors I saw never asked about anything beyond those narrow criteria. Angry that my doctors saw medications as the only treatment options available and refused to consider alternatives. And mostly angry at myself, that I bought into the whole thing in the first place, that I listened to doctors without questioning. That I bought into mainstream media perceptions. That I was a sheep. Baa...

But you can't stay angry forever, and my yoga practice has helped me to accept what happened and to make peace with it. I had to go there to get here, and I like where I am now. That which does not kill us can make us stronger...and perhaps wiser, if we are open to learning from it.

Today, I've lost about forty-five of the sixty pounds Depakote packed onto me, and my feet no longer hurt—I can now do some of the higher impact activities I used to enjoy. I'm starting to write again, and rather than feeling angry, I'm starting to feel like I had a pretty lucky escape.

Hopefully reading my story might help someone else start to think and to question...and maybe give them the inspiration to stage their own lucky escape.

Knowing When to Slow Down

Part of being well and staying well is knowing how to pace yourself. Sometimes we load too much on our plates and then we get stressed out and don't do any of the things we're trying to do to our satisfaction.

My sleep is still disturbed after my trazodone withdrawal, and I'm trying not to take anything to help because I feel like then I'm just trading one chemical for another. As a result, I'm a little more tired than usual, and a little less alert.

I think I need to slow down and be kinder to my body and mind.

I am not doing well with coming up with anything to say today. In addition to it being summer and having the kids home all day and needing attention, I have a couple of other projects going--coming up with the curriculum notes for my journal class this fall, and working on a book about bipolar disorder and wellness strategies. I think I need to post a bit more sporadically...so I will try to get something up a few times a week, but I think I need to slow down a little...I'm running out of steam, I don't want to push myself so hard that I end up dropping the blog entirely. I'll still be visiting your blogs, but I don't think I can keep up the pace I've set so far!

Writing Prompt: How do you know when you are trying to do too much? What signals does you body give you? What signals does your mind give you? Do you listen?

Trazodone Taper, Part 10.5: Sleep

While tapering off of trazodone has been really good for my mental acuity and creativity, I am still struggling with sleep. I took my last 25 mg of trazodone last Saturday night, and since then I have had a difficult time falling asleep and staying asleep.

Sunday night I tried Sleepytime Tea (by Celestial Seasonings)--the one with valerian and chamomile...which did actually make me sleepy, but not sleepy enough to ignore the fact that I had to get up to go to the bathroom several times because I drank tea at bedtime!
The next few nights it took ages to fall asleep, and it felt like I was awake a good part of the night...although I didn't feel too bad in the morning, so I must have gotten more sleep than it seemed.

I wonder if maybe when I'm not on trazodone, I just don't need as much sleep. I got it beaten into my head by my psychiatrist that I needed to get 8-9 hours a night or I would get hypomanic...but before my diagnosis, I did fine on 7 or 7 1/2 hours. I'll have to play with my bedtime and see what happens.

Last night was actually much better...I think because I made an effort to avoid caffeine after lunch. I fell asleep fairly quickly, but was rudely awakened at 1:30 am by my weather radio telling me we had a severe thunderstorm watch (a watch, for Pete's sake! I think that after 10:00 they should really only have the thing go off if a tornado is bearing down upon my house...anything else, I'd rather sleep through, thank you!). I had no sooner gotten back to sleep when the storm hit, keeping me awake for over an hour.

Writing Prompt: Yesterday I wrote about journal writing rituals, and now I'm thinking about bedtime rituals. Do you have a bedtime ritual? If so, what do you do to get your mind ready for sleep? (If you've got any good ideas, go ahead and post them in comments--I'd be interested to hear what other people are doing to get to sleep!). My kids have a bedtime ritual, and it seems to help them settle down. Me, I don't really have anything other than grab a glass of water, go upstairs, brush teeth, hop into bed and read for fifteen or twenty minutes. Maybe I need to do some yoga or meditation before bed...I think it's a matter of, well, I know I should do this, but...you know.

Trazodone Taper, Part 10 (The End!)

Last night, for the first time in a few years, I didn't take any trazodone. I had a cup of chamomile and valerian tea before bed...which was a mistake, because then I had to keep getting up to use the bathroom. The tea did make me sleepy, but not sleepy enough to ignore my brain, which kept yammering on at me in a particularly shrill tone that I hadn't taken my trazodone and that I would never get to sleep.

I did not sleep well. It took hours to fall asleep, and then I kept waking up...and looking at the clock...you know the drill: if I get to sleep now, I'll get five hours...hmmm...I can probably get by on five hours... and an hour later: if I get to sleep now, I'll get four hours... I know I'm not supposed to be looking at the clock, I do know this...but I looked at the clock anyway.

Still, I shall persevere, as overall, I'm feeling much better than I did on 200 mg of trazodone. I imagine I will adjust and hopefully tonight will be a better night. No naps today. No caffeine this afternoon.

Writing Prompt: Sleep is an essential part of our lives. We spend approximately one third of our lives sleeping. What role does sleep play in your life? Is it a time to mine the subconscious for dreams and wake up clutching a fistful of gold? Or is it something that interferes with the things you really want to do? Do you welcome sleep, or do you dread it?

Identity Theft

One of the most insidious effects of my bipolar diagnosis was the way it robbed me of my identity...

I was not suicidal, nor was I psychotic, or even a whole lot out of control. I initially went to my GP because I couldn't sleep. I hadn't slept more than a few hours for nearly a week, and wasn't feeling tired, and I figured that wasn't normal, I ought to be exhausted...so maybe I better get this checked out. I was also under an enormous amount of stress, and my anxiety levels were sky-high due to some extremely stressful Family Bullsh*t that was going on at the time. Did anyone ask about that? No. Instead, I was asked if I'd ever been depressed. And since I said yes (although I'd never been diagnosed or medicated for it), I was sent home with Zyprexa and Ambien, and told I should call a psychiatrist.

This led to an ever-descending spiral of self-doubt. In my reading, I learned that my writing highs--those times when I could just let go and write for hours on end--were actually "hypomania". And those times when I felt like I just loved life and really enjoyed everything I was doing--that was "hypomania", too...so the last two or three years of my life, which had been wonderful, happy years in which I felt productive, and excited about my future, suddenly took on the sinister aspect of an "illness". Which must be "managed." I learned that if I ever felt that way again--exuberant and loving life--that I should talk to my psychiatrist immediately, because I urgently required a "medication adjustment." And that if I didn't have my medications adjusted, the hypomania could steamroll on into full blown "mania" in which I would be completely out of control and need to be hospitalized (even though I had never been close to being "out of control"). I also learned that if I felt just a little bit sad, I needed to consider that a "warning sign" and to talk to my doctor because I might be getting "depressed". Which would require that another medication or three be added to my "cocktail" in order to prevent me from becoming so ill that I might kill myself (even though I'd never really considered that seriously before). Overnight, my perception of myself went from creative, confident and happy to "very sick and in need of medication for the rest of my life."

For the next two years, I would be haunted by the question, "How much of my personality is me and how much is it?" The answer, according to my psychiatrist, was that a lot of my drive, my energy, my productivity, and my creative whirlwinds could be attributed to it. So I figured whatever was left over once the medications were working, that was probably the real me. And since I lost my ability to think, laugh, create, write and enjoy life once I was medicated, I began to think that the real me wasn't worth very much, was she? She was actually a hopeless, dull-witted, exhausted lump who couldn't even speak without stumbling over her words, and didn't want to do anything but sit on the couch.

Life was pretty dismal for those two years. I no longer had the capacity to enjoy life, and the medications I was taking actually made me more sick. My moods began to cycle, and within a year I'd had three "episodes" each requiring that my medications be adjusted (read "increased") and that new medications be added. My doctor pointed this out to me as proof of just how sick I was.

I am so glad that I retained enough clarity and sense of self to say Enough. Unfortunately, it took a near-tragedy to shake me back to my senses (my husband's heart attack and my inability to respond to it in any sort of normal way). But however it happened, I did finally see the light and realize that my misplaced trust in psychiatry was only making me sicker, and that there had probably been nothing wrong with me in the first place that a little therapy or education in stress management wouldn't have taken care of.

I stopped taking medications over a very short period, probably too short, but then I didn't have much in the way of medical support--my psychiatrist's view of stopping medications was that it would be "stupid" and that I would "ruin my life". He didn't say It would be a bad idea, but if you're hell bent on doing it, here's how to do it safely, no, he just said Don't.

When I came off of meds, I was a mess. I had no idea who I really was anymore. After being told that all the things I had loved about myself were due to my illness, my self-confidence had taken a serious hit. I was terribly overweight and out of shape and dreadfully ashamed of myself for having let myself get into that condition. It took a long time for the anger to fade, for me to accept what I'd allowed to be done to me. And in some ways, I think I am still working on that acceptance, because the anger is still smouldering away in there.

After I was off most of the drugs, my sense of self, my sense of humor, and my ability to enjoy life slowly returned over a period of a few months. It took a longer time for my creativity and my confidence in myself as an artist to return--after all, I'd been told that all of my artistic achievements were actually manifestations of my "illness". For a long time I wondered if my drive to create--to write and to "make stuff"--would ever come back, or if the medications had damaged my brain in some subtle way and I'd never be able to create again--or worse, even want to.

Thank goodness I took my life back into my own hands. I dread to think where I would be now if I hadn't. I certainly wouldn't be myself.

Writing Prompt: Has there ever been a time in your life when your identity, your sense of self, was threatened by a label, an event, or a person/group? How did you deal with it and in what ways did this experience change you? If you've never experienced a threat to your sense of self, what sort of event do you think it would take to do this? Where are your vulnerabilities?

Trazodone Taper, Part 9

Last weekend I dropped my trazodone down to 25 mg from 50 mg. I've had headaches on and off since Monday, so that's not good, but next weekend I'm stopping it entirely, so we'll see how that goes. It's funny how some cuts I've not noticed anything in the way of symptoms, and others I've had headaches for a week after.

The stuff isn't doing anything to help me sleep anymore, which isn't surprising, considering that 50 mg never did much for me, either. I forgot to take my Benadryl the other night, and didn't feel anything from the 25 mg of trazodone after I took it. So one more week on trazodone and then I'll be done with it.

I think I should get Bonus Points, don't you? And not just for the trazodone thing, but for policing that slumber party last night. Bonus Points...redeemable for all kinds of cool prizes. I keep telling The Chief I want a Rewards Program of some sort, but he just laughs and pats my head. Sigh.

Writing Prompt: You are stranded alone on a deserted island for an extended period of time. Food and water are plentiful. What five things would you absolutely have to have with you in order to remain sane?

Trazodone Taper, Part 8

I dropped my trazodone from 75 mg to 50 mg last weekend, and yesterday afternoon I felt particularly fatigued. I'm not experiencing any other symptoms, and I'm getting plenty of sleep, so it's possible that this is due to the reduction in trazodone.

The good news is that I'm sleeping well and I'm not having any mood issues at the moment. I plan to stay at 50 mg for two weeks, then do 25 mg for another two weeks, and then stop it entirely.

Trazodone Taper, Part 7

After two weeks at 100 mg, and no withdrawal symptoms after cutting from 125 mg to 100 mg, I decided to do another cut this past weekend, from 100 mg to 75 mg, with the option of going back up if necessary.

So far, so good. I've slept well at 75 mg the past week, and so far no headaches or depression. If all goes well, I could finish this thing before summer's end.

Trazodone Taper, Part 6

I wasn't actually planning to cut my trazodone again this past weekend. And I definitely wasn't planning to cut by a whole 25 mg, but there I was on Saturday night, already in bed, tired out due to the Benadryl I've been taking for my allergies, when I realized that all I had on the bedside table were 100 mg tablets. I didn't have any of the 50's I'd cut in half, and I hadn't yet cut any of them into quarters. And even if I had, they were downstairs, and I was just too damn tired to drag my butt out of bed, slither downstairs and muck about cutting pills into tiny bits.

So I just took 100, and told myself that if I felt lousy on Sunday, I'd take 125 again, and not try to taper until next weekend.

But I felt fine on Sunday. No headaches, no depression. And I felt good on Monday, too. And so far (except for the allergies), I'm feeling good today, as well. So we'll see. As I keep reminding myself, I always have the option to go back to 125 mg for a while if I need to.

Do I Really Have Bipolar...

...or am I just a horrible person looking for an excuse for my sometimes admittedly rotten behavior?

Self doubt occurs with alarming frequency, these days. If I do have bipolar disorder, then where are all these "episodes" I'm supposed to have, one after the other? Seems the only time I had episodes one after the other was when I was taking medications that were supposed to help. Go figure.

And the thing I call the Big Mania happened during a period of incredible stress and Family Bullshit. I don't know how anyone could survive it intact.

So maybe I don't have bipolar disorder.

But...there is a pattern of depressive episodes and hypomanic "writing on fire" episodes that must then be explained. And I can't explain them. All I can do is look at some of the things I got up to when I was supposedly manic and shake my head and mutter, "WTF was I thinking?"

So, okay, maybe the diagnosis does have some merit.

But...if that's the case, don't I need to be on medication for the rest of my life? Because if I really do have bipolar disorder, isn't it awfully irresponsible of me to be running around unmedicated? I mean, after all, it's not just me, here, I have a husband and kids...

But...I'm doing everything I can to stay stable...and it seems to be working...other than the nasty effects of the trazodone withdrawal, but that's the medication, not me...

But...my doctor shakes my confidence every time I see him, because he says I'm taking a huge risk, and wouldn't I like to try Abilify, because it's got a really benign side effects profile...

This is the crap that keeps me awake at night.

(See Furious Seasons post today about the overdiagnosis of bipolar disorder for the post that inspired this one and got me thinking, again, about whether I am bipolar or just horrible...)

The Path to Wellness, Part Three: Where's the Map?

Getting off the drugs wasn't hard. I just stopped taking them. Gave a bit of thought to the fact that since I'd been on them for nearly two years, I probably shouldn't stop them cold turkey, but I did stop them pretty damn fast. Within two weeks, I was done. The third week was pretty hellish in an emotions-all-over-the-map sort of way, but I was convinced that all the medications had done was make me sicker, and I was determined to get off them as quickly as possible.

I guess I was lucky.

I had no professional advice on stopping the meds, other than my psychiatrist telling I'd be stupid to stop taking them. I didn't have internet access at the time, so I wasn't aware of all the wonderful, supportive people who were out there trying to do the same thing I was. Of course, perhaps if I'd known then what I know now, I might have been too scared to try to stop the meds...who knows?

As my mind began to clear, I realized that I had a hell of a lot of work to do. My body was shot. My blood sugar was borderline high. I was overweight, in constant pain, and was completely out of touch with myself.

I started myself on a program of yoga, healthy eating, music, and writing. The yoga I started by default--it was the only sort of exercise I could do that was bearable for my sore feet--they hurt so much that even walking any distance was out of the question. The healthy eating was much easier to do once I didn't have Depakote giving me carb cravings. I picked up my guitar for the first time in about ten years and started playing again. I tried to write every day, just a little in the journal at first, and then more as my mind cleared. Slowly, things got better. I lost weight. My feet started to feel better. And I started to get a clearer picture of who I was through my writing.

I just wish there'd been a map of some sort. A book. Some information on how to reclaim my mind and my life...

Hmmm....maybe I should write one...

Trazodone Taper, Part 5: Holding Pattern

I was planning to cut my trazodone dose from 125 mg to 100 mg this weekend, but I have been having headaches all week--not bad ones, just annoying ones--and have been feeling depressed and anxious, all of which are possible side effects of trazodone withdrawal. So I'm going to stay right where I am for a while, and see if these symptoms abate. Ideally, I should not cut the dose until I'm feeling as good as I was before I started tapering. I'm also revising my idea of how quickly this taper should go, after reading Gianna's post on the dangers of withdrawing from psych meds too quickly. I should probably drop to 112.5 mg instead of 100 mg. After all, I've been on this med for five years...it's not unreasonable that it would take a while to get off of it. And the idea here is to try to make myself feel better--not worse. Patience, Grasshopper, patience.

It Speaks So Loudly...

I hate this feeling of detachment that floats down from above and smothers me like a warm, wet blanket. It makes me feel stupid and foggy.

I cannot think, focus, rest, imagine, dream, anticipate, work, care, love, touch, reach out...

I wander around here, restless, bored, and unable to settle to anything.

My thoughts are dark, a never-ending carousel of "what's the point?" and "is this all there is forever?" and "what did I used to fill my days with when I didn't feel like this?"

I know this is just the insidious voice of depression, and I should try to ignore it. But sometimes depression speaks so loudly, it makes me deaf to all but its grating voice...

Hopefully this is just another symptom of trazodone withdrawal.

Medication Withdrawal: A Warning

After reading one of Gianna's recent post about her own journey withdrawing from psych meds, I feel compelled to chime in on the subject of medication withdrawal. If you're reading here because you are looking for info on withdrawing from psych meds, I would urge you to do your homework before you begin. Talk to your doctor. Get medical support if you can. Learn all you can, check out Gianna's blog, Psychiatric Withdrawal and Recovery for links to a lot of other helpful sites. And above all, as Gianna cautions, listen to your body.

If you've read my previous posts about medication withdrawal, you know that I stopped taking most of my bipolar medications over a very short period of time and without medical support. I was stupid. And I was damn lucky (it happens--we are all different. What one person can do cold turkey with no problems could be six months of withdrawal hell for someone else). I was not aware that these drugs were something I had to withdraw from. My knowledge of drug withdrawal was limited to what I'd seen in the movies concerning street drugs and what I'd learned in health class in the 8th grade. It never occurred to me that the same might be true of prescription drugs (other than opiates). I mean, they're legal, aren't they? (Yes.) And safe? (Um...no.) Isn't that what the FDA is for? (In your dreams.) Wouldn't my doctor have told me if there were serious issues like that concerning the drugs he was recommending I take? (Apparently not, since he didn't.)

Well, they might be legal, but I certainly wouldn't call them safe. Now that I have more knowledge, I'm withdrawing from my last medication--trazodone--very slowly, and I'm letting my body adjust to each change in the dosage. And even going slowly, I'm still having withdrawal symptoms--headaches, suicidal thoughts, and insomnia.

So if you're thinking about coming off of your medication, don't just stop taking it. Do yourself a favor and do your research, talk to your doctor, and above all, listen to your body.

Okay, I'm done now. I'll slither down off my soapbox and go wash some dishes or something...

Creative Recovery?

So part of what I'm doing here is trying to put myself in a position where I have to write every day. The idea being that I've got to do something to loosen all the sediment that is clinging to the pipes in my brain. Once, the words flowed freely through those pipes and came pouring out onto the paper faster than I could catch them. The buckets overflowed, and my head was packed with ideas.

Now, it's a struggle to find the words. I have moments when I can just tool along without thinking about it. Brief moments. But I can't seem to call back the ease with which I used to do this. I can't seem to find the passion I once had for it.

My hope is that once I've managed to get the trazodone out of my system--which probably won't be until sometime late this summer--things will start to improve.

If they don't, I'm not sure what else I can do. I've worked through Julia Cameron's The Artist's Way and Walking in this World...and I started her book Vein of Gold, but I've reached the point where I'm sick and tired of all this introspection, and it isn't helping me get my passion back...it's just making me dwell on what I can't seem to do anymore.

When I think about working on the novel which I am trying to work on, my head fills up with glue, a wave of exhaustion washes over me, and I come up with twenty other things that need doing much more than me sitting down a the keyboard...or twenty other things I'd rather do.

I feel lazy and stupid.
Maybe I am.
Maybe I've forgotten the first rule that I used to live by:

Just do it.

Trazodone Taper, Part 4.5

Right, I'm ready to fling the rest of the trazodone down the loo and flush it away for good. Headaches I was prepared for. Had a couple of bad ones when I decreased the dose too fast.

Flashes of suicidal despair I was not prepared for. Especially after four years of stability.

How can 25 mg make such a difference?

What is the advantage of putting myself through several months of gradual tapering when I could quit cold turkey and be done with it in a week or two?

I know. Brain chemicals. Let my system adjust to the new dose. It wouldn't be good idea to just stop taking it.

I'm gritting my teeth and putting up with it. But I want this crap out of my system YESTERDAY.

Trazodone Taper, Part 4

I dropped my trazodone dose from 150 mg to 125 mg the other night, and it is going better than when I attempted going from 150 mg to 100 mg. No headaches, and I was able to get to sleep. Of course, the Benadryl I took for this lousy cold might have helped with that... My GP prescribed some 50 mg tablets so I can do the taper more gradually. I plan to stay at 125 mg for a couple of weeks, then drop to 112.5. Small steps.

Not that I'm feeling any more awake today. I'm actually feeling rather like something the cat dragged in...and I don't imagine I look a whole lot better. But that's okay, cuz you can't see me!

Trazodone Travesty

After doing a bit of research on trazodone withdrawal, I have learned that this "benign" (psych doc's description, not mine) medication that I have been using to help me sleep for the past five years does actually cause withdrawal symptoms if you stop taking it. Thanks to all four of the docs who've prescribed this drug for me at various times, for letting me know this important information.

I have found that I may have some or all of the following to look forward to: aggression, anxiety, balance issues, blurred vision , brain zaps, concentration impairment, constipation, crying spells, diarrhea, dizziness, fatigue, flatulence, flu-like symptoms, hallucinations, hostility, indigestion, irritability, impaired speech, insomnia, lack of coordination, lethargy, migraine headaches / increased headaches, nausea, nervousness, over-reacting to situations, paranoia, repetitive thoughts or songs, sleep disturbances, severe internal restlessness (akathisia), stomach cramps, tremors, tinnitus (ear ringing or buzzing), tingling sensations, troubling thoughts, visual hallucinations / illusions, vivid dreams, and (inhale) worsened depression.

I've certainly got the headache. I'm going to have to rethink this 50 mg/week thing I thought I was doing. I've put a call in to my GP, to see if he will give me a prescription for the 50 mg tablets (I currently have only the 100 mg ones) so that I can reduce the dose more gradually.

Still, I'm of two minds about this thing. I've always been a yank-the-Bandaid-off-and-get-it-over-with kind of gal, and the idea of having to slowly taper off of this stuff really sticks in my craw. On the other hand, I suppose I've been on it for five years, what's a few more months?

Well, I'll plan to do the taper because that's the responsible thing to do, and I know better now than I did when I went off my other meds. But don't be surprised if I get agitated, irritable, hostile and flatulent enough to fling the remaining pills down the toilet.

Trazodone Taper, Part 3

I dropped my trazodone by another 50 mg, so I'm down to 100 mg, and I had a terrible night. Couldn't get to sleep, couldn't stay asleep. Hopefully this was just A Bad Night and has nothing to do with the lower amount of trazodone. I suppose tonight I'll have to take some Benadryl as well.

Ah, well. I guess I'd rather take Benadryl every night for a while than trazodone.

Life After Meds: Creativity

The biggest casualty of my foray into modern psychiatric treatment was my creativity. The doctor who prescribed Depakote for me promised me it wouldn't kill my creativity. And I suppose technically, it didn't...but it changed it beyond recognition, and in some ways I'm still waiting for things to get back to the way they were before chemical intervention derailed my career.

The interesting thing about creativity and Depakote was that although the medication effectively silenced me in terms of the flow of language, it did not stop me from being visually creative. I could make dazzling scrapbook pages. I could draw and paint (as well as I could before meds, anyway, which isn't saying a whole lot!). And if I'd been able to hold a needle without my hand shaking, I could probably have done my beloved quilt art, as well, assuming the Depakote left me enough energy/motivation to do so...

Coming off medication did not improve matters overnight. Although I experienced only a week of very obvious emotions-all-over-the-map stuff when I stopped the Depakote and Lexapro completely, there were far more subtle effects that lingered for many months after my last dose of medication.

Emotional and motivational effects that are completely subjective, making them difficult to measure. How do you quantify damage to your creative drive?

It was over a year before I felt I was able to articulate as well as I could before meds. A year and a half before my creative spark made enough of a comeback that I actually wanted to do something artistic or musical. Two years before I felt the desire to pick up needle and thread again. And although I still have the ability to write (or at least, to string a few coherent sentences together), it doesn't hold the magic for me that it did before meds.

In some ways, I still feel very much like I am in a cage. Except this cage is not one that I can touch or see...it doesn't have an obvious way out. And the only reason I know it exists is because I remember what it was like to be free.