Inspired by a post over at Disorderly Chickadee.
Sometimes, I feel like I’ve been on every psych med in the PDR. I’m not that far off.
It started with imipramine. I was diagnosed with ADHD when I was 5, though in reality, I think I was just smart, bored, and more than a little obnoxious. I don’t think I ever had true ADHD; I’ve never had trouble concentrating on things that interest me. I’m not sure why they put me on an antidepressant rather than a stimulant, which is generally the protocol for treating ADHD. My mother used to ground up the pills and mix them with applesauce, which just made the applesauce bitter. To this day, I can’t stand applesauce.
I think the next med was Zoloft, when I was 12 or 13. By this time, the diagnosis was Major Depressive Disorder. I went through most of the SSRI’s by the time I was 15, and none of them helped. By that time, I was cutting several times a week, drastically restricting my food intake, and purging semi-regularly. I was also having panic attacks and consequently spending a lot of time hiding in bathroom stalls.
My first hospitalization came when I was 15, for self-injury. That’s when we started in on cocktails. Antidepressants, mood stabilizers, antipsychotics, benzodiazepines. I couldn’t focus, couldn’t write, couldn’t make myself care about my life. I gained weight rapidly, mostly on the antipsychotics. My psychiatrist put me on Abilify a few weeks after it came out–“just to see what will happen,” he said. For ten days, I wandered around telling people, “Something’s wrong with me. You have to fix it.” When they asked what was wrong, all I could say was, “I don’t know, but you have to fix it.” My muscles started twitching uncontrollably. I took myself off the Abilify, against my psychiatrist’s orders, and I could think and move again.
Through all of that, though, I was very high functioning. I went to the Alabama School of Fine Arts, ranked as the #4 high school in the country, and did the Alabama Advanced Academic Diploma as well as an MFA-level program in creative writing. I wrote, published, won awards. I was Emperor (aka president) of the Latin Club. I worked at a restaurant on the weekends. I volunteered with Jefferson County Teen Court, Special Olympics of Alabama, and McWane Science Center. I was a National Merit Scholar and got a full academic scholarship to college.
There were several times I took myself off meds. Despite the dire warnings of every doctor I talked to, it worked pretty well. The meds had never helped with the depression, PTSD, or dissociation, just blunted my abilities to think, feel, and function. But eventually I’d get hospitalized and medicated again. My family got tired of dealing with me and had me involuntarily committed to a state psychiatric hospital. (That place is a whole other post, if I ever work up the nerve to write about it.)
Around 2009, I had a sleep study done. I’ve had sleep problems all my life, but typical sleep meds like Ambien and Lunesta never helped. Turns out I have several sleep disorders: PTSD-related nightmares, circadian rhythm disorder NOS, central sleep apnea, and alpha-delta disorder. The central sleep apnea is untreatable, but I was finally able to get on meds that helped with the rest of the sleep problems: prazosin for nightmares, gabapentin for circadian dysrhythmicity, and amitriptyline for alpha-delta. It made a huge difference to finally be able to sleep like a normal person.
Around that same time, I began to realize that my depression got significantly worse during the 7-10 days before my period. (Three of my four suicide attempts have been in that window of time; the one that wasn’t happened before I started menstruating.) I started tracking the symptoms and brought the information to my psychopharmacologist, who diagnosed me with PMDD and put me on Mircette (hormonal birth control).
Then in the winter of 2010, I decided to have ECT. I’d exhausted all the med options my psychiatrist could offer me, and I was suicidally depressed. I had 39 ECT’s over several months, mostly bilateral brief pulse. It helped for a little while but then just quit helping.
The treatment program I’m in now focuses a lot on integrative health. Meds are used, but they aren’t the main focus. In fact, my psychiatrist here is the first one I’ve ever seen who’s been knowledgeable about tapering off meds and willing to try it out. He’s also very thorough at investigating possible physical causes for psychiatric symptoms and is comfortable working with alternative treatment methods. After a ton of bloodwork, he diagnosed me with MTHFR polymorphism and put me on Deplin (L-methylfolate, the active form of folic acid). It really has been my magic bullet: for the first time in my life, I’m not depressed! It’s pretty great. This doctor also took me off birth control and switched me to Prometrium (bio-identical progesterone) for just the week before my period.
So my current cocktail: Deplin 15 mg, prazosin 3 mg, amitriptyline 75 mg, gabapentin 900 mg, and Prometrium 100 mg three times a day during the week before my period.
In conjunction with my psychiatrist and nurse, I’ve also started using supplements. A multivitamin,flaxseed oil (omega fatty acids, the vegetarian alternative to fish oil) for depression, calcium/magnesium/zinc, B-vitamin complex, vitamin D3, and 5-HTP.
For the first time in my life, my med combo is working. I mostly credit the Deplin, but I think getting off birth control also helped, and finally being able to work out is also helping significantly. And kitties. Everyone should get a prescription for kitties. There’s not a lot in this world more comforting and grounding than having a warm, purring cat on your lap. Therapy is also very helpful for me, but right now I’m STILL without a therapist. *sigh* But I’m working on that, and things are good otherwise.