It IS an Illness

Originally posted 3/27/13:

I still struggle at times with the notion that depression, anxiety, and chemical addiction are physical diseases, and not just character defects. Recently, I had been doubting the disease model yet again, and was beating myself up about it. I suppose, though, this is part of denial -  a normal step in the course of change {more on that in another blog}. 

Then, it hit me: I know that what I have is a physical illness and that medication does in fact work for me because of the difference in my cognition / thinking when I am taking medication. 

Here's the supporting evidence:

1. The incessant cycling of negative thoughts has stopped. It is not that I have no negative thoughts, sadness, or anger - that would not be normal - it's just that I don't dwell on these indefinitely.
2. I like things again. No really, I'm serious. For at least two decades, not much appealed to me. I would do the things I know I should like, but everything at the banquet of life tasted like cardboard - the world was flat. I knew, for example, that horses, tennis, and time with family and friends should generate feelings of joy in me, but it was all....meh...take it or leave it...bland...grey - and at times even irritating.
3. Color, color, C O L O R has returned to my life. Once again, I enjoy colors in objects, nature, and furnishings. My clothes, for example, have gone from neutrals to vibrant blues, purples, greens, and...P I N K. {I still adore black too!}
4. I look forward to things. Yes, believe it or not, if nothing is scheduled on the horizon, I have actually created dates and outings in the past two months! I have reached out to female friends. This is the first time in a long time...no...this is the first time that I have ever done this! 

The fact that taking a physical pill does affect change in my thoughts and subsequent behaviors, speaks of a physical, underlying disease capable of responding to medication. And lest anyone confuse psychoactive prescription medication for opiates, let me underscore: the medication does not make me feel fantastic all the time. These are not "happy pills". The meds just simply permit me to feel the normal range of feelings that the average person is capable of feeling. They free me to be Me; and for that, I am truly grateful!

The Rub

I may or may not have mentioned it; but about two weeks ago, the same day I injured my back, I came down with sinusitis and bronchitis. The doctor prescribed an antibiotic and it seemed to help, but it didn't fully clear up the sinus congestion and cough, and the symptoms never fully went away.

This morning I woke with a fever and a full blown cough, so it's off to the doctor for me again. Here's the rub: I cannot take antihistamines because they interact with my medications. (I think the combination drives blood pressure up?)

Don't get me wrong. Antidepressant and anxiety medications saved my life and continue to promote my mental health. However, it stinks that during allergy season or when I have a cold, I have to ride the symptoms out.

If anyone has any ideas for an alternative, I'd love to hear about it!

Stay well friends! :)

The Funk Continues...

I'm still in quite the funk! I've been on edge and irritable for several weeks now. My self-esteem has taken a dip and negative thoughts are again cycling through my head. Don't know if this is because the new meds are wrong and Effexor was right, or because of the chemistry change in my head while switching meds. Either way, I don't like feeling this way, and I'm going to bring it up to the doctor tomorrow. 

On a more pleasant note, summer school is going well. I LOVE my classes! I look forward to the day when I'll be able to put it all to use in my own practice.

Well, I wish I had more to share - something more substantive - but that's it for now. 

P.S. - If there is anything in particular that you'd like me to blog about, I'm very open to suggestions! Drop me a note here or via email at: pink.hi.tops@gmail.com.

Medication Stigma

This post is dedicated to Dr. Lorente - best.psychology.professor.EVER!

You know, it took me about five years after my therapist first recommended it before I finally agreed to take medication*.

Why did it take so long? Stigma. I had heard so many negative things about medication online and in the media that I assumed taking medication was dangerous and / or a cop out. 

After taking medication for a year and a half now, I have a better understanding of what it does and doesn't do. 

Medication, effectively and correctly administered to the appropriate patient, can turn a life around and in some cases, save a life.

Medication does not give you perma-grin nor does it make you happy-go-lucky all the time. Medication just levels the playing field. It enables you to experience the full range of emotions that a normal person feels. It breaks one out of the negative grip of mental illness - depression and fear - and opens you up to possibility. 

I still get angry, I still feel down and cry sometimes, and I still curse in traffic; but I am also able to move on from these feelings now. Negative feelings no longer cycle around in my head over and over like a broken record.

{I also find it interesting that some of the people I've met who are psycho-active medication opponents also happen to drink alcohol. Nothing psycho-active there...}

I do agree with some of the naysayers, however, in that I personally think that some cases are misdiagnosed. I am not a big fan of a patient walking into a primary care physician's office, telling them they are "depressed", and the PC doctor prescribing something on the spot. I think these cases can lead to over-diagnosis, misdiagnosis, and feed the misunderstanding about treatment. A PC doctor is not the right doctor to diagnose and prescribe. They have about 5 - 10 minutes with a patient and in no way is that enough time to accurately diagnose a mental illness! The PC should instead refer the patient to an expert - a therapist and / or psychiatrist.

That said, I do think there are also many cases of underdiagnosis because patients fear a stigma. I know I did. 

*Note: 'Medication' in this post refers to medication used in the treatment of depression and anxiety.

Soap Box du Jour

All day long I've been on the brink of crying. I don't know why. I'm also ridiculously irritable. I'm also astounded at the cost of my medication and the bureaucracy and ignorance of insurance companies. 

I just paid $798.18 as a co-pay on one month's supply of Abilify; and I paid $115.49 for one month of Lamictal which is 100% of its cost. Why they won't approve Lamictal for me at $115.49 a bottle, but will approve Ability at $978 a bottle, I'll never know. 

Why is it that the insurance company is the one that dictates which meds are appropriate? Medication choice should be determined by the doctor with some input from the patient - not by some guy in a cubicle farm, wielding the Manual of Insurance-Acceptable Treatments which is updated each year by a "committee" consisting of one doctor and 19 accountants....

THAT is what is wrong with U.S. health care. It's run by companies that are "for profit", not "for patient". Although in the case of my insurance company, I'm not sure what they're thinking. They're operating at a loss with me. It looks like I'll be reaching my deductible very shortly...and then they'll have to pay $978 a month. Good!

Changing Meds...Again

It was a bad week for me overall. With the exception of that brief feeling of hope while waiting for psych class to start on Tuesday, I was not mentally well. The grey veil of depression began to creep back AND for the first time in months, amorphous anxiety hung in the air around me. 

I skipped one class because of it. Two others were cancelled by the professor, otherwise I may have skipped more. I spent several days sleeping on the couch all day long; and I had vivid dreams all night every night - waking up after each one.

Fortunately, I already had an appointment scheduled with my psychiatrist, and I met with him yesterday. He has put me back on one of the meds that he took off my regimen the last time we met. He said it's possible it was doing more for me than he thought. So we'll see.

I do feel a little better today. It's probably premature to say it's because of the meds I took last night, rather I think it's because my stomach bug seems to have subsided. (I wasn't feeling well physically yesterday afternoon either.)

I wonder if this is how it is going to be for the rest of my life.

Tweakin' the Meds Again

So I had another appointment with my psychiatrist today. The current meds - and perhaps one in particular (Lamictal) - seem to be working. My only complaint has been this enormous weight gain that I have experienced in the past year. No, I am not working out and eating well. Yes, I am 47. BUT...the rate of gain is far greater than any I have ever experienced (40 lbs in one year!) and I shared this with my doctor. He thinks it could be the Abilify, so he is now going to taper me off of that and increase the Lamictal. 

As they say, psychiatry is as much an art as it is a science. It's not unlike cooking - add a little of this, a little of that - a dash of this, a dash of that. If it's no good, lower or eliminate something, add a little something else...always tweaking. 

Weight gain aside, I am feeling better than I ever have been. Not manic, crazy good, but...normal, functioning good...and that makes me happy.

Adjusting Course

I was still struggling last week to keep out of the gravity of the Vortex...thus the lack of blogging. It finally got to a point where I had to see my therapist and psychiatrist. I simply could not un-rut myself.

Even though I am definitely better than I was a little over a year ago, my therapist says my thinking is obsessive and I over-analyze myself and my environment.

I met with my psychiatrist too, and he tweaked my meds. He reminded me about the importance of taking medication at the same time everyday, which I had not been doing. He also reminded me about the importance of proper sleep hygiene - turning off the TV, computer, and any glowing monitors/screens about one hour before bed-time, and settling down into quiet time before getting a full-night's sleep (8 hours).

Since, I met with him on Friday, I have been doing this; and dare I say, I am feeling a little better already. I wasn't tired and wiped out when I woke up this morning. I felt...refreshed!

I may have been blogging about this topic for almost a year now, but I don't think I had fully bought into the notion that I have a disease. My depression and anxiety is a psychological and physical disease that requires treatment and lifestyle modifications - much in the same way as heart disease or diabetes. I have said it over and over, but I am only now believing it. And now I'm going to make real progress in my recovery!

Anti-depression Rule #1

Did I mention in my recent post that one of the key ingredients for wellness is medication?

It seems I have forgotten this yet again. Today, I completely spaced out on taking this morning's big dose. This after having missed three nightly doses in the last week. 

By the evening, I knew something was off. I was unusually dizzy and very bitchy, bitchy, bitchy at the littlest thing! My husband pointed it out and then, only then did I remember the dose I should have taken 11 hours earlier!

Okay, Karen, press the reset and start again tomorrow!

Anxiety Again

For the first time in a very long time, I feel anxiety gnawing at me - a prickly static of constant worry about absolutely nothing. I forgot what that felt like, because the medication had been working so well. 

I have been a bit off lately with what I need to do to stay mentally healthy. Once again, my sleep schedule is out of whack; and as usual, I haven't been exercising. In addition, I haven't been taking my medication properly - e.g., taking it at 8:00 am one day, and at 11:30 am the next; and missing doses altogether. 

I know you are probably tired of hearing this, but I really, really have to get back on track.

---------------------------------------------------------------------------------------------------------------------------------

An hour later...

Well, I did it. I exercised for the first time in two (or more?) months, but it wasn't my idea. My husband has been watching me sink backwards and rallied the troops this morning for a family bike ride to Starbucks. I'm glad now that we went, but getting me up and dressed was nothing short of an exorcism! 

The trick will be making sure I get to bed by 11:00 tonight, taking my pills on time, and exercising again tomorrow. I have to have faith that sticking to these basics will pay off in the very near future - if I can just hang in until then.

Depression is Not a Character Defect

I still struggle at times with the notion that depression, anxiety, and chemical addiction are physical diseases, and not just character defects. Recently, I had been doubting the disease model yet again, and was beating myself up about it. I suppose, though, this is part of denial -  a normal step in the course of change {more on that in another blog}. 

Then, it hit me: I know that what I have is a physical illness and that medication does in fact work for me because of the difference in my cognition / thinking when I am taking medication. 

Here's the supporting evidence:

1. The incessant cycling of negative thoughts has stopped. It is not that I have no negative thoughts, sadness, or anger - that would not be normal - it's just that I don't dwell on these indefinitely.
2. I like things again. No really, I'm serious. For at least two decades, not much appealed to me. I would do the things I know I should like, but everything at the banquet of life tasted like cardboard - the world was flat. I knew, for example, that horses, tennis, and time with family and friends should generate feelings of joy in me, but it was all....meh...take it or leave it...bland...grey - and at times even irritating.
3. Color, color, C O L O R has returned to my life. Once again, I enjoy colors in objects, nature, and furnishings. My clothes, for example, have gone from neutrals to vibrant blues, purples, greens, and...P I N K. {I still adore black too!}
4. I look forward to things. Yes, believe it or not, if nothing is scheduled on the horizon, I have actually created dates and outings in the past two months! I have reached out to female friends. This is the first time in a long time...no...this is the first time that I have ever done this! 

The fact that taking a physical pill does affect change in my thoughts and subsequent behaviors, speaks of a physical, underlying disease capable of responding to medication. And lest anyone confuse psychoactive prescription medication for opiates, let me underscore: the medication does not make me feel fantastic all the time. These are not "happy pills". The meds just simply permit me to feel the normal range of feelings that the average person is capable of feeling. They free me to be Me; and for that, I am truly grateful!