Talkin' Psychiatric Medication Blues

"I wouldn't trade 1 stupid decision for another 5 years of life."

-James Murphy

Let's talk about drugs.

Or if you're like me, let's take some drugs.

But not too much. This is a super long read.

5 YEARS AGO

We're gonna go back to 5 years ago. February 2018. That was the last time I ran a half marathon. That's really striking a chord with me this February. See, this is the coldest winter Logan has had in years. So cold, I started a gym membership to run on treadmills instead of trying to keep running outside. Hard to believe that 5 years ago, I was running 4 days a week outside throughout January. And I was running farther and faster too. I ended up doing that February half marathon in Boise in 100 minutes. I was not cold. I also was not on any psychiatric medication at all. At least not yet. And maybe I should have been? Let's talk about it.

In October 2017, god congratulated my existence with my first-ever kidney stone. I remember a day after trying out some acupuncture, I wondered if I had passed it unknowingly. Because instead of constantly, my kidney pain simply was reduced to being felt on-and-off. Surely enough, an x-ray didn't find anything, and a lab test showed I was no longer peeing blood. I did it! Let me tell you man, I've heard horror stories, and I'm aware that me passing my kidney stone without excruciating pain is hitting the ultimate jackpot. But I was so confused. Why were my kidneys still in pain?

My doctor talked with me for like an hour about how the kidneys are sensitive to stress, and that I was probably experiencing continuous pain because I am a very anxious person. He actually prescribed me some SSRI's. But I can't remember what they were called. Because I never picked them up.

I compensated a bit. I at least started seeing a therapist in November. Honestly, I had been diagnosed with anxiety years ago. Yet I was in denial of how bad it was at this time in my life. Looking back? Of course I think I should have listened to my doctor and started out on SSRI's. But for different reasons than one might think.

THE MIGRAINE HORRORS

At this time, I started running a lot, eventually leading to my half marathon. It was around March 2018 when I started experiencing some trippy shit. Numbness in the face and wrists. Feeling like life around me isn't going on. Prolonged bouts of eerie clarity, borderline euphoria. Randomly losing balance while I walk. Waking up in the middle of the night feeling fuzzy. Pains in different assorted areas all over my head. Frequently dizzy. A tingling crown around my scalp. Slowed speech, where I often forgot how I was going to end a sentence as I was speaking. And scariest of all, feeling an entire side of my body go numb, with slurred speech included. I thought I was suffering from some neurological disease, and even had a brain MRI scheduled within the month. But one day in March, I had a surprise attack while I was at work. Everyone around me watched me freeze up and try to speak slowly through one corner of my mouth. Ended up taking an ambulance to the local hospital and getting a brain MRI right there and then. Despite experiencing most of the common symptoms for a stroke, they found absolutely nothing.

I was diagnosed with "worsening migraines." They gave me a packet of migraine info and told me to go home. I was so freaking confused. I thought I knew what a migraine was. Lightheaded. Cluster headaches. Auras occurring in one eye. Eventual nausea. Apparently there are lots of different types of migraines. I had been experiencing hemiplegic and vestibular migraines. I still get migraines all the time these days, but usually in the form of feeling lightheaded, dizzy, or feeling those assorted pains around my head. Luckily no more stroke symptoms.

So how did doctors help me out? They gave me a couple meds. One that stood out to me was effexor. Effexor is a common drug used to help with severe migraines, and I could tell it was working for me. 

EFFEXOR 

It wasn't until a couple months into taking it that I found out they also worked as SSRI's. My doctor did not bring this up. Found out via internet. But I was ok with it. 

I figured I was supposed to be on that stuff anyways. So I chose to prolong my prescription. For as long as I saw fit. It was hard for me to notice at the time, but this led to me having a very weird summer.

I started having these new breakdowns. Something clearly physiological about them. My body just going comatose out of nowhere, and breathing gets bizarre. They last anywhere from 10 to 90 minutes. I did not see the connection between all this and the pills that had helped me lose my migraines. I've had multiple diagnoses as to what these breakdowns actually are, but most doctors agree that they're panic attacks. And it's apparently common for them to attack you like that, out of the blue. I've had them scattered over the last 5 years, but that 2018 summer, they were pretty darn prevalent.

It was also that summer that my suicidal thoughts felt very real. It was the first time I ever called the suicide hotline. I was luckily still seeing my therapist at the time, who had officially diagnosed me with depression. That was a first. Not surprising, but a first. And in a September visit with this therapist, I had surprise panic attack right in front of her. She claimed that she basically watched me "pass out" right in front of her. Her clinic shared a building with a doctor, so they were able to help me walk over to his office right away.

This doctor knew I had anxiety and depression, but he did not know what was going on. So he told me to come back right away if I had another episode. I did so, in October. And this time, he was just really bugging me. I particularly remember telling him that when he was talking to me, it felt like he was talking down at me. Without much explanation, he decided to prescribe a little sumthin-sumthin called quetiapine. And it blew my mind. I felt instantly sedated. I was sleeping like 10 hours a day, and I was ok with it. Because the way I felt while I was awake was super refreshing. 

QUETIAPINE

It wasn't until a couple months into taking it that I found out these meds were antipsychotics. My doctor did not bring this up. Found out via internet. But I was ok with it. 

Because I had moments where I felt more like myself than I had since freaking 2009. That is no lie. Particularly when it came to music. Since my anxiety rocked me around late-2009, I had missed the way music used to make me feel. It's crazy, to this day, much of my favorite music memories come from 2019. And that was a big deal to me. While I often think fondly of this time, there were some clear outlying issues in my life. I was still also on the effexor, which apparently kept me depressed. I was sleeping much more than working, by a lot. But I was just this warm ball of sedation. I guess it was "good." But it was 0% "normal." 

I decided to switch up my life and get a job as a TV news producer at a station in Twin Falls. I could live with my parents while also feeling like I had a cool job. I didn't actually want to do it, and I kinda just agreed to it to appease my parents. People make choices like this all the time. What made this particularly life-altering was my newfound difficulty with living a more stressful lifestyle on my hefty medication. It was not pretty.

2020 SUCKED

What's crazy to me is that people couldn't recognize that I was dying inside. I had a slew of underwhelming new therapists, including a psychologist. I did take a GeneSight test that revealed which medications worked better with my gene patterns than others. While this changed what specific pills I would stop and start taking, I insisted that I stay on antipsychotics. I insisted that the stuff I was on in 2019 changed my life, and I should go forward with those types of drugs. It's crazy that all the meds I took in 2020 were positive matches on my GeneSight test, because they all made me feel like different types of terrible. Those suicidal thoughts I experienced in 2018 were in full force during this time. But I didn't tell anybody about it.

I eventually moved back to Logan and got my old Logan job back. By 2021, I started taking a new trio of antipsychotics, anti-anxiety, and SSRI meds. I thought it was a vast improvement from any of my 2020 drugs. Which is weird, because little did I think to research at the time: None of these pills were positive on my GeneSight test. Not sure how my doctor came up with these meds, but I didn't even think twice about it. I should probably blame him for all this, but I really should have said something. Or tried getting an opinion from someone else. And this "new" SSRI? It was the return of effexor. The one that started it all.

I actually already had a weird history with SSRI's in years past. Effexor was not my first. I was on something from 2010-2012 (my mission era) that wasn't really much to write home about. Also a couple different times in college where I was taking 3-month prescriptions, after talking with a doctor about my struggles with common migraines. But when it comes to my 5-year mess with medication, effexor is what started it all.

2021-2022 WAS A MESS

Anyways. This trio of meds would be my monthly refill for over 18 months. I eventually decided I was tired of how unnatural my nightly antipsychotics made me feel. I finally found a new doctor I could talk with about this, and he agreed that I should try going off them. This was July 2022. It made me feel free on multiple levels. Free, but not necessarily "healthy." 

My struggles with suicidal thoughts had continued throughout 2021 and 2022. I would call the hotline on randomly assorted nights. But more often than suicide, the act of self-sabotage I often envisioned was running away. I made a makeshift attempt at this sometime this last August. And I'm gonna blame this on my increased dose of effexor.

After not being considered for a leadership position at work, I decided I'd try running away somewhere without telling anyone. I left my phone at my work desk, alongside my literal Bachelor's Degree with the words "WHO DO I HAVE TO BE?' written in pen on the back. I drove to the middle of nowhere. Ended up spending the night in Soda Springs. Returned back to Logan the next day because I had a CBT/ACT therapist appointment, and realized I probably needed to talk to her more than anyone else. This wasn't without stopping by the workplace and giving an R-rated, self-deprecating speech to 2 of my bosses. I believe I said "fuck this and fuck that and fuck me" multiple times. After randomly snapping out at my podiatrist the next week, my doctor decided to tone down the effexor and give me an atypical antipsychotic. While this helped with my freewhein' sense of angst, I eventually took a leave of absence from work in October. Because I caught myself noticing how used I had become to having suicidal thoughts. 

Luckily, this doctor encouraged me multiple times to try to find my 2020 GeneSight test results. I finally found them stashed on an old document on my laptop. Not shockingly, effexor was in my affective red zone. I immediately got switched to a pill with a more positive response. This helped out A LOT. And my story is getting better from here.

THINGS HAVE GOTTEN BETTER

Ever since I started quetiapine in October 2018, I've had nightmares every night. It doesn't seem to matter which pills I'm on anymore, the nightmares have just stuck around for some reason. In January, my doctor suggested I stop taking the SSRI's I had just started a couple months ago. While the nightmares are still here, I would dare say the results of this change were better than expected. Without a morning SSRI for the first time in 5 years, I FEEL EVEN BETTER now. Like, as I'm awake. I tried explaining this to him the other day, and he responded with something a doctor has never told me before: "I can tell." 

For the record, I still take that atypical antipsychotic at night. But that's it for now. I am kinda curious what it would be like if I went from 1 psychiatric medication to 0. But I'll definitely talk with my doctor about this in a couple weeks. This stuff, latuda, it works with both serotonin and dopamine. And it's also approved by my GeneSight results. It's hard for me to tell if I should just do away with medication entirely these days, but latuda has a lot going for it in this argument. I'm ok either way.

So I'm off SSRI's for the first time in 5 years. Aside from the weather getting much colder around here, this is the real reason this February has me thinking of February 2018. And honestly, this is the most "normal" I've felt in forever. I wonder if going completely off meds would help me feel more normal, but it's a tough call. Like, straight up, I was extremely anxious 5 years ago. That doctor who prescribed me SSRI's in 2017? He knew what he was talking about. My anxiety got much worse after I graduated college in December 2016. And life has kinda sucked since then. Especially with my failed games of musical chairs with psychiatric meds. I wish I took those original prescriptions so that I could understand the immediate effects of the pills I take, a skill I only picked up a few months ago. The fact that my first 2 sets of drugs in 2018 were given to me without explanation is pure insanity. And no matter how pressed for time a doctor tends to be, they really gotta explain this shit to their patients. 

But going back to my life sucking since I graduated college... That's not really what this post is about, so I'll try to tie this in briefly. I've struggled with my identity, and trying to separate that from my occupations. I refuse to settle with a stable career, and have preferred to just stay at this job clicking through utility bills with my headphones on. 5 years ago, I was doing this same job, and I'm still doing it today. And it was driving me nuts back then. I really don't reminisce about that time, other than how fast I was running. I honestly must admit, I'm actually less anxious than 5 years ago. More depressed, yeah, probably. But since I stopped taking those morning SSRI's, I've felt much more "normal." And I intend to go forward with that trend.

UNNECESSARY POSITIVE OUTRO

I know it sounds like I just talked a lot of shit about the world of psychiatric medication, but hear me out on this. Try to get a GeneSight test and don't lose it. You could go backwards on mistake. Do whatever it takes to find doctors who will actually talk to you and listen to you. And you should talk to them and listen to them. My current guy just so happens to specialize in this specific medical field, so I lucked out there. Find out what therapy works for you. I take cognitive behavioral therapy mixed with acceptance and commitment therapy. I personally prefer it to talk therapy. 

Holy crap. I just wrote a whole paragraph giving other people mental health advice. God forgive me. I think the overarching message behind my advice and my stories is that we can only find what's specifically right for us, and not for other people. It's honestly the path we have to take. Like honestly, screw all the drugs I've been talking about if they've been bad to you. There's literal science behind why certain drugs work better (or worse) with certain people. You can be on 10 meds or 0. Whatever makes things better. I'm just so glad I feel noticeably more normal these days. 

I absolutely resent all the folks out there who say people are becoming mentally unhealthy out there with their endless search for endless happiness. Maybe some people do that, but I myself have been hunting for some basic psycho-emotional stability. Being able to function with proactive behaviors and being able to feel your full range of emotions sounds like a beautiful combo to me. 

And that's the end of this blog.