Tuesday, April 08, 2008


I was driving into work this morningish listening to NPR and this woman talk about a book she has written called 'Madness: A Bi-Polar Story' or something like that. She was talking about the medication she was on and it made me decide to write this post.

While I don't have bi-polar I do have an anxiety condition and ADHD with a splash of depression (although depression is a pretty nebulous term). My severity of these conditions isn't too bad untreated but it is enough to warrent medication.

I've talked to some people about this and many share my same reservations I had with taking medication at first. I went through various techniques (psychotherapy and acupuncture, etc) for years before I finally decided to try the medication route. While the acupuncture was very effective on my anxiety and depression, it didn't help so much on the ADHD side of things.

I don't know that I talked much about my anxiety before and I don't know that I will in this post. I will say that at one point in my life it got to the point where even standing in line at the G-Store was too much for me. That didn't turn me on to medication and, in fact, I had the anxiety somewhat under control by the time I started taking it. Not all together sure why I decided to throw that in this.

Eventually, after talking this over at length with my therapist I asked for a reference to a shrink. The guy I went to originally was exactly what you probably expect a shrink to be. Quick, 15 minute in and out with a prescription. Granted, he had my case file from my therapist but still, I hate being treated that way.

He started me on prozac and Wellbutrin. The prozac was for the ADHD and the Wellbutrin was for the anxiety/depression. He started me on the lowest doses. Both of these were effective for treating those issues but I would crash HARD around 4 pm everyday.

During this time I started to work with a life coach to try to get my life in order (read: organization). The shrink I had been seeing moved on so I need a new one. I mentioned this to my coach who referred me to a different shrink that treated the person and not the condition. My appointments with this one are close to an hour and we go over everything that is going on before adjusting medication, etc. Much more to my liking. Over time I moved from prozac to Lexapro and from the ordinary Wellbutrin to a new XL version that is slow release and lasts 24 hours. The result was no more crashing at 4 pm, yay!

Eventually Cymbalta came out that treats both serotonin and norepinephrine which previously required two medication to treat. Additionally, its a pretty small dose (25 mg or something). I just take one of those a day now and it works quite well. There is a post on my blog about the brain shocks you get if you stop taking it cold turkey, wicked stuff those.

I tell you all of that to tell you this: Sometimes I wonder if the medication makes me not me but some weird pseudo-me. I think that is a fear for a lot of people considering this and it is a valid fear. The radio progam I was listening to this morning brought this up as well and the woman put the conclusion I guess I came to a while ago for succiently. What she realized was that when you are not taking the medication the person you are is sick, the medication allows the real you to come out and I agree with that. The only reason someone might even be going through doubts about taking meds is because they know something is keeping them from being who they really are. Medication is a way to realize that person.

Let me describe something else that might help. When I was off my medication I would have some pretty large swings in mood. Not bi-polar levels because I wouldn't be manic but I would experience large levels of anxiety and dread, lots of catastrophising and what-if'ing everything. What the medication has done is it takes that edge off. My personality hasn't changed but has instead leveled out. My reactions to situations are more paced and in proportion to the situation where before they would sometimes be very out of proportion (both over and under reacting). The way I picture it is if I were to draw a picture of a line that waves up and down, kinda like a sine curve, those highs and lows would represent those peeks where I over/under react to situations. The medication sorta caps those highs and lows so my reactions happen within a smaller range.

Addtionally, the ADHD side of me still functions but in a more good way now. I still can juggle multiple topics and think out-of-the-box, etc but I am able to focus better when it matters. It isn't so much of a grey fog like it used to be. That isn't to say that doesn't happen, but it is more manageable now.

Wow, this was a lot longer than I had intended. In any case, if anyone is dealing with whether or not to try medication then by all means ask questions!


James said...

Do you ever read dooce.com? I think it's probably one of the most popular personal blogs out there. Anyway, she has written a lot on her history with depression and medication. One of the most profound quotes from her is:

"I still take 40mg Prozac every day, and here's where I cannot be emphatic enough, I will continue to take it or something like it for the rest of my life. I will not ever be off medication."

That's from this entry:


She maintains a whole category of depression-related posts:


Also of note is a post her husband wrote on his blog about living with someone with depression:


All good reads if you have the time.

Clyde said...

Wow! Excellent post. I have debated the medication question with myself for several years. Recently, I find that I am more open to it and reading your thoughts helps to reaffirm that openness. At this point, my therapist doesn't think I need meds, but if that day comes, I am hoping to be prepared to do what's best for me.

SuperMel said...

I've taken meds during several periods in my life and I was damn glad they existed. It allowed me to get through things that my depressed brain just could not handle, much less work through with a therapist.

If you feel comfortable answering, what caused you to go off your meds during a particular period? Side effects, or wanted to experience things unmedicated?

Kirsten said...

Great post and very well explained! I completely agree that the meds help the real you come out w/out all the "commotion". I'm all for it when its needed, but am also cautious about overprescription by doctors these days just b/c they want to throw a pill at any problem. Sometimes depression is just depression and it passes....sometimes not. A professional really needs to take the time to determine which is which.

Ryan said...

I never purposedly stopped taking my meds, only when I forgot I was out of refills or something like that. Once it was almost two weeks and that was rough. I do forget to take it for a day sometimes but I feel it the next day.

I want to talk about something Clyde and Kir touched on and that is when you really need meds. I believe that medication is prescribed too often in situations where it isn't warrented, particulary by general practicioners, etc. You should never get psychiatric medications from anymore but a shrink, in my opinion. And not even then until after you have seen a counselor and tried more traditional therapy and then recommended to a shrink. It should be the last resort for dealing with an issue.

Additionally, I believe taking medication shouldn't be the end of counseling, but instead needs to be done in conjunction with it. The medication helps deal with the symptoms so you can get to the heart of an issue and deal with it, thus eventually being able to cease the medication.

With that said, there are some cases where someone's brain chemistry is just screwed and you can't function without medication. No amount of traditional therapy is going to address those sorts of issues. But I feel that those sorts of issues are more in the minority.