Tuesday, 22 January 2013

III) To Pill, or not to Pill?

I have been on some form of medication since I was 14 years old,
I am not sure what that first prescription was for or what it was, I suppose I could ask my doctor to check the records next time I go, but I believe it was probably for anxiety, as I was seeing a counsellor at the time (my second counselling experience by then).
Luckily for me and my shady memory, I have kept a journal from the age of 13, and kept track of all these things.. although I was prone to write more about boys and celebrity crushes for most of those years, and little details about medications and doctor visits. However it's in there, as minutely detailed as it is.

So that first medication I cannot comment on, I don't know the name, nor the purpose, but my SECOND prescription was definitely an experience I would not like to repeat!
Aropax/Paroxetine: or as I knew it, "the robot pills".
I had never felt so numb in my life. I was 16 years of age when I got myself diagnosed with depression... and  Aropax is what I was prescribed.
I felt so fricken numb all the time, I couldn't reach a happy high, and when I hit the lows, it was with a numb, scarily calm mindframe that I operated.
It was this mindframe that led me to attempt to cut my wrist with a craft knife... I remember rocking back and fourth and talking to this little craft knife that I had put a clown sticker on, I called it my happy clown, and sawed with the blunt little blade into my flesh for well over an hour. It hurt, a lot, and didn't do a lot of damage.. I still have the scar today, but It was a pretty butchered job.
so I took the panadol and nurofen from the first aid cabinet in the kitchen, and slowly but calmly forced myself to down the lot. It was only 40 pills or so, but if you have ever ingested too much panadol in your life, you will know it is the worst pill to overdose on. It makes you feel HORRIBLY sick, and sore, and does the worst liver damage, I spent much of the night puking up little white pills.
When I finally told my mom why I was so sick it was the next day, and my hospital stay was probably pretty redundant. I am very blessed though, because I escaped without any liver damage, and was right as rain within a few days.
 Shortly after this episode the drug was withdrawn from use in people under the age of 18, this is a statement relating to that action;
Food and Drug Administration requires this drug to carry a black box warning, its "most serious type of warning in prescription drug labeling",[48] due to increased risk of suicidal ideation and behavior. The warning also applies to other SSRIs, but the concern began with reports of suicidal behavior in paroxetine trials, as well as recommendations from the United Kingdom Medicines and Healthcare products Regulatory Agency urging that paroxetine not be used in individuals younger than 18 years
Er, nice timing. Thanks guys!

Ah well, luckily for me, life went on, and I was switched to Cipramil/Citalopram.
I don't think I ever gave this drug a really FAIR trial, as at this time I ran away from home and lived in a shoe box flat with my friend, and spent my days drinking and underage clubbing, and working a few shifts a week hungover and pretty useless really.
I forgot pills, or refused to take them, or swigged them down with a bottle of beer. Either way, I don't think they had a chance, so I cannot comment on the effectiveness really can I?

I think I gave it a better shot the following year when I shifted back home to my parents.
But after finding it relatively ineffective I was transferred to Fluoxetine/Prozac.
Fluox has a rep for giving you more energy. I don't recall this magical effect, in fact I remember falling asleep in class (at Polytechnic) at the end of every day, just could NOT stay awake. Wether this was because I was  a teenager and didn't know what an early bedtime was, or if it was because I have suffered from Restless Leg Syndrome: or as my boyfriend at the time (later to become my husband) called it: Wriggle Feet for as far back as I can remember, and had a hard time falling asleep because of this... I don't know. But I definately did not have energy to spare!

Off we went to University, moving down to Auckland, and was hunky dory til' I had a panic attack in the middle of the day at University, I remember sitting in the library working on a group project and I just couldn't breathe. I leant my head up against the grill on the window and gulped in air, everyone was chattering noisily around me but it was all a blur.. noone noticed when I picked up my books and my bag and just walked out of class.
I walked to the bus stop... caught a bus home. And refused to go back.
I went home to my home town to see my regular doctor, who put me on to a counsellor who recommended I move home to my parents for at least 8 weeks so I could see her regularly. Those 8 weeks turned into 7 years, but that is another story.
Probably didn't help that I had turned to alcohol and drugs in this time, to cope with the anxiety and depression. I don't need to tell you that anti-depressents and drugs and alcohol don't mix. I remember at a young age sharing my anti-depressents with some of my friends to drink with on one occasion, as they got you drunk much faster.. dangerous in hindsight, but you do what you do at that age.

After my first child, I hit a dangerous low, my doctor lowered my prescription from 20mg to just 5mg, and as she was rather religious she projected her view onto me that taking anything at all was selfish etc.
So I stopped. I spent much of my pregnancy withdrawn and incapable of functioning. I remember lying in a cold bath for 6 hours waiting for my partner to get home and help me out. My midwife intervened toward the end of my pregnancy and said that my child would be at higher risk if I was depressed and unable to cope, then he would be if I took 20mg of Fluoxetine (It had no known effects as of yet on pregnancy, but trials had not been going long enough to ensure no side effects), she also recommended I change doctor, so I did.
Luckily by some miracle my son was born healthy and happy, 9 pound 1.. and there seemed to be no adverse effect from my medication I took at the end of my pregnancy. I was able to breastfeed with the medication, but I was still quite depressed, and he weaned himself off around 9-10 months as I think my milk was just too low by the end of the day due to the depression and tiredness, and he was a hungry lil monster.

My new doctor prescribed me Venlafaxine/Effexor.
All my previous drugs had been SSRI's (selective serotonin reuptake inhibitors) - in a nutshell, these types of drugs control how much of, and where your brain recieves the seratonin it makes.
The new medication, Effexor, was a new class of drug, a SNRI (Serotonin-norepinephrine reuptake inhibitor) ... it basically increases the concentration of serotonin and norepinephrine in your brain.
It has a very short half life, so half a day without it and I would be experiencing symptoms such as numb extremities, nausea, dizziness and lack of periphial awareness. Basically I couldn't drive to save myself.. or it was very dangerous to do so. An entire day without it and I would have to remain lying down in the dark.. more than a day? I would end up in the foetal position in the backyard wishing for death.
A friend who came off this drug likened it to a heroin addiction withdrawal. It took them two weeks of solitude to remove this drug from their system.

But it seemed to have a completely different effect. I worked my way up to the higher end of the scale dose wise, and seemed to be doing a whole lot better.
I became pregnant with my second child, and was advised to stay on the medication but that I wouldn't be able to breastfeed. I was severely sick during my pregnancy and the hormones seemed to cancel out my medication, so that I once again became withdrawn. I made it to two midwife appointments my entire pregnancy and not much else in between.
After my daughter was born (a healthy 8.1) things improved, my hormones balanced out again and my husband was able to help with feeding her during the night etc, as she was bottle fed.

After a while it was decided the effexor was pushing the manic moods up, and I needed a mood stabilizer.
I had been prescribed various things such as Clonazepam for panic attacks, but the mood stabilizer was to be taking regularly. I started off with 20mg of Lamotrigine.
Unfortunately I had a severe allergic reaction and was sent into quarintine for what was thought to be a severe case of measles. An all over body rash, vomiting and just general UGH ness.
But my doctor touched the rash, pulled off her mask and declared it to be burning hot, not typical of measles at all. She reviewed my medications list, informed me to desist with the Lamotrogine ASAP and within a few days I was right as rain.
However I still needed a mood stabilizing medication and Sodium valproate/ Epilim was prescribed.
I still take this drug today in conjunction with Venlafaxine/ Effexor. However I am now on maximum doses.
I take 60mg of Epilim and 275mg of Effexor in the morning, and a furthur 60mg of Epilim at night.
The Epilim helps quieten my brain, I have less social faux pas, and I can think clearly. I can also get to sleep a little better at night.

Unfortunately a side effect of the Venlafaxine is disturbed dreams and sleep. I have been battling Insomnia for years now, and have disturbing nightmares every night without fail.
After another suicide attempt I was prescribed Quetiapine to help me sleep... and while it does help me get to sleep faster (past the RLS and restless brain period I enter upon drowsiness) - I still have the crazy dreams and wake during the night.
It was determined I have sleep Apnoea as well, and I am on a waiting list for a sleep trial....
I have been prescribed Nortriptyline at night in the mean time, to try and get me into a deep sleep beyond the realm of nightmare land.. it is supposed to help with RLS too, and the sleep apnoea,
I am still on a really low dose and don't notice much of a change, apart from feeling very tired the next day... but it is early days yet.

Currently I take 11-13 pills a day. This includes my birth control and anti-hystamines. Both I cannot live without, as my birth control cancels out 'that time of the month' - which besides being annoying as the average female can contest to, it throws my hormones into serious whack, pretty much cancelling out the effect of all medications. A danger I cannot afford for a week every 28 days.
My anti-histamines are a must, as over the years I have just developed an extreme sensitivity. I cannot go a day without them without feeling irritable and itchy all over, and by the second day my chest gets tight and my eyes are hurting, I feel nauseas and headachy, and 3 days without them I can barely breathe.

So that is the history of my medications, I have requested a medical history from my doctors as I am sure there are some I have missed out... if anyone has any questions for me about my experiences with meds etc, feel free to ask away. Or inform away.
I must add I have also tried herbal varieties such as St John's Wort, but as you cannot use it with anti-depressants, or more importantly for me, birth control, I had to give it up. I didn't notice a change personally when I did use it, but then again I have two 'Major Depressive Disorders' and depression, anxiety, OCD and  a few other various syndromes and disorders such as insomnia, apnoea and Restless leg syndrome.
I fear I may need a cocktail of drugs for the rest of my life, only time will tell... but I know that life is much better with them than without.

Without these drugs to help me feel stable, I felt like I was living my life on knife point, everything was skewed.... I was living in constant fear of everyone elses opinions, I was slighted so very easily (I still am, but not to the same degree) and could not for the life of me, see the forest for the trees.

So while there are very many differing opinions on pro-drugs, or anti-drugs.. those that think all you need is god, or a good kick up the behind... some who just want to treat themselves naturally, and some who swear by the prescription pad.. I myself believe...what ever works!
No one thing in my mind will 'cure' or 'solve' whatever seems to be the problem... so you cannot pop some pills and expect life to fall at your feet, perfectly in place.
But I think if medication gets you to a place where you are then able to address the issues and help yourself, then so be it. If you are worried about people thinking less of you, then try and remember that a) It is none of their business, and b) until they have walked in your shoes, they have no right to judge.
We are all different, physically, emotionally and chemically..
and is often said in the world of mental health;

You wouldn't begrudge a diabetic their insulin, or a cancer patient their chemo.. depression is no different, just because you cannot see what ails someone, doesn't mean it doesn't need treatment.

x Sarah

1 comment:

  1. You'll have to forgive me for being so shocked, but I had no idea that you and I were pretty much going through the same deal when we became friends at school. Aside from the Lamotrigine, I have been on all of the same meds you've mentioned here at some point.

    You didn't really talk too much about what kind of therapy you've had in this blog, so I'm not going to speculate on that. But I know that for me, while the meds did a lot of the work, it was therapy that really made the difference. I was lucky enough to be able to see a psychologist who specialised in CBT through CAHMS for almost two years. I don't consider myself to be completely cured of depression, because I'm experiencing it right now... but I find it a lot easier to manage without meds.

    Anyway, thanks for sharing this, Sarah. I already felt pretty well connected to you, even though we live 5 hours away from each other and I barely see you any more... but this sealed the bond on my end just a little bit more.

    I really hope you don't have to spend the rest of your life on meds. You deserve to be happy and healthy. Don't give up the fight. I love you! All of your friends love you! :)