Medication · Updates

Medication Overhaul

Today the doctor tells me I am most definitely not depressed and that we need to take me off my antidepressants immediately. I protest when he tells me I am high, that we need to ‘level things out’. He tells me ‘you are sitting crossed legged, with pink hair, playing with a tangle toy and talking a mile a minute. You’re high.’ He promises that he won’t make me miserable and sucicidal and all those other nasty things.

So he’s stopping my medication. The aripiprazole (which, to be fair, I haven’t taken in months) can cause agitation and won’t help my mood anyway, so he’s discontinuing it. Taking out the trazodone, he’s hoping, will level me out. I will be seen again in a month. Thoughtfully, he gives me a list of four mood stabilisers I am to consider, each with a lovely set of side effects. Quetiapine, which he scores out promptly when I tell him I’ve been on it before and it made me numb and dumb (and fat). Depakote, which he tells me can cause spina bifida in any children I might have. Tegretol, which can make my hair fall out. And the Lithium- which will require regular blood tests but, if I have the right dose of it, shouldn’t make me too thirsty or need to pee. If my mood begins to dip, I am to call the CMHT and they will see to it promptly (which I’ll believe when I see it).

So I guess I’m feeling a lil anxious, confused, surprised? Horrified, actually, at the idea of being told Lithium is a potential treatment option. Me? Lithium! It all seems very ridiculous, really. I’ve grown up hearing that Lithium is for the real crazies, not for someone like me, who, god knows how many times was told confidently by doctors with a dismissive wave of the hand that I wasn’t mentally ill, didn’t have a severe mental illness, just needed to ‘get on with it’.

But over the last 11 months there has been a real shift. The consultant who had been happy enough to pen me down as borderline and leave it at that decided last March that it was ‘important’ that I knew what was going on for me. My CPN vouched that she wasn’t aware I had a BPD diagnosis, and said they were all in agreement that it was my mood that was the main issue, which, came as news to me, as all the consultants juniors had been lecturing me on ‘psychcoeducation’, of ‘learning’ about my ‘condition’, had signed my hospital discharge papers as of suffering from ‘EUPD, impulsive type’.

The consultant arranged a CPA meeting between himself, one of his juniors (both of whom were my inpatient doctors/the doctors I’d been seeing most recently), and old psychiatrist who was being put back on my case, CPN and a psychologist from the Personality Disorders team. In the two years it had been since I’d last seen my old psychiatrist, the few stints I’d had in hospital seemed to have changed her view that ‘other people had it worse’ and that I was just a silly little spoilt borderline girl who needed to ‘think positively’ and ‘get on with things’. Following the CPA she accepted readily that I was in a depressive episode and said helpful, supportive, validating things. A few months later, the PD team began their formal assessment. At the same time, I had my first ‘real’ elated episode- lasting two months, much longer than the previous couple of days here and there, which prompted my old (now regular) psychiatrist to revisit the idea of a bipolar illness which had been briefly mentioned twice in the past (though how seriously, I’m not sure). On stabilising she requested I see another doctor to take a fresh look at my case. The assessment report from the PD service came back confirming I didn’t have a borderline personality. And over the past few months my mood has, apparently, heightened.

But it was strange. Bizzare, to be sitting in the doctors office today and watching him draw a chart to explain my moods to me, to be told so definitively, as I was over the summer, that I am ‘high’, to hear big words like cyclothymia and severe depressions and bipolar disorder and Lithium applied to me, that in 5/10 years time the doctor could be saying ‘obviously it’s bipolar, how did we miss it?’ The same way being diagnosed with depression and anxiety was all those years ago, or swallowing my prozac every morning or getting stitches in my arm for the first time, or walking through the doors of my local psychiatric ward were all bizarre. Driving past the psychiatric hospital as a child; 13, gawking at the girl in my class who self harmed; demanding of my anoretic friend at 14 that she ‘just eat’- the world of metal illness was so far out of my orbit, that being sucked into it myself has never felt anything other than ‘lol there is no way this is actually happening to me’.

But this, of everything, Lithium, just seems beyond fucking ridiculous.

But I think my anxiety lies beyond the whole mood disorder/mood stabiliser thing- for one, I’m not really taking it in, trivialising it all, laughing it off, making lite of it. It’s just, after 6 years of being on medication- the only times I HAVEN’T been on any mood altering drugs being the times I stopped taking it myself (each occasion ending in crisis)- I’m a little curious and more than apprehensive. It’ll be interesting to see how things pan out over the next month, interesting to see if my mood will level out without drugs, knock me into balance, or, if it will end in disaster.

Either way, I’ve told him if I do become sad and miserable and suicidal and all those other horrible things, I will be banging on his door shouting ‘bitch, sort it’.


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