There were many times I felt like I had the right medication regimen, or at least a regimen that was working, but I later found there were better options. Making medication changes has been one of the hardest parts of continual self-care after having had episodes of psychosis.
When it’s felt like my medications have been effective I’ve had a much clearer and sharper mind, I can solve problems with greater ease, and I feel more relaxed mentally and emotionally and I’m able to joke and laugh more. I tend to get along much better with friends and family. For six years it felt like my medications were working well, however, the meds had been affecting my stomach which got to a point of being intolerable and we decided to try switching them up.
At first I was hopeful this would be a quick adjustment and I’d be feeling better soon. The hopefulness was that the med change would resolve my stomach issues but the fearfulness was that I wouldn’t feel the same as I previously had. On the medication regimen I had been on for the prior six years my cognition was moderately clear, I had enough energy to get through my day, and I had the intellectual capacity to have meaningful social connections and conversations. I was fearful that switching the medications might incapacitate me by reducing my energy, limiting my cognition, and taking away my social skills.
Making med changes always feels scary because I’m not sure if I’ll be the same person after having switched to different meds, or also how long it might take to get there. At this point in my recovery I have a good sense of how I want the medications to make me feel, so this has been a good barometer to base decisions with medications from. I also have awareness as to how I want my functionality to be in terms of my work, my social life, and just in terms of my overall cognition.
While making the med switches I have been fortunate to have a doctor who listens to me and realizes the medications are in my body and are affecting my cognition and life which I’ve found to be really important. He’s open to allowing me to make decisions and he gives me information and we make the decisions together. There’s a ‘withness’ within the decision making that I really appreciate. He knows that the medications are going into my body and I need to be on board with what’s happening rather than having a forcefulness that might otherwise disincline me to listen to him. I think it’s also respectful in realizing that I’m the expert on how I feel regardless of the number of years of medical training he has had and that I need to be included in the decision making process given I’m the one who will be living with the results.
We started by trying to subtract one of the medications which I was informed needed to be out of my system before I could try a new one. The first day or two I was okay but by the third and fourth days it became hard to focus and I was a shadow of myself. The quality of my work was diminishing and I was afraid of making mistakes at work. I also noticed my personality was very limited and I wasn’t talking and laughing as much as I had been. I had lost my level of functionality very quickly without this med and it felt terrifying. Having had the experience of having all my cognition slip away so quickly was alarming.
It made me realize how dependent I am upon the medications and the power they have to improve my life but also to take away the quality of my life if they became unavailable. After having had this experience I went back on the same medication I had been on previously. I did so because I was afraid I was going to lose my job or make mistakes at work that could be harmful to people and I was also just worried my personality and cognition weren’t where I wanted them to be. With these things being said, it’s taken a lot of courage to try switching medications.
I felt stuck because returning to the prior medication regimen helped me to be the person I wanted to but simultaneously my stomach wasn’t doing well with the med and the side-effects were bothering me every day. I had this mentality of feeling like I had to sacrifice the well-being of my stomach to have mental and emotional well-being and that I couldn’t have both. It seemed like a bad trade off which wasn’t working for me at the time. It also tapped into emotions of unfairness and just frustration with wanting to feel well overall and having to make sacrifices of my physical health just to be able to do things that the average person can do without medications or without having to make these sacrifices. Mental illness has forced me to make a number of sacrifices over the years just to stay well. Sacrificing my GI health for my mental health tapped into some of these past feelings of frustration and anger.
With the medication change we were trying to get rid of one class of anxiety medication to help my stomach feel better by switching to an anxiety medication within a different class. This wasn’t working so we decided to try a different medication within the same class to see if this might react differently with my stomach. After more trial and error we eventually added a new medication that helped with my focus and we also found an anxiety medication that worked differently than the prior ones had. This resulted in having better mental and emotional health than I had ever had from any med regimen including the regimen I had been on for six years.
There was definitely a lot of frustration and fearfulness in this process. One of the trade offs though was that my stomach still wasn’t quite as functional as I wanted it to be which has been challenging. The med change did lessen the severity of the side-effects for my stomach which made it at least bearable. We also consulted a GI doc to see if he had any recommendations or suggestions and I’m still currently working with him.
One of the realizations I had during this process was that I am not necessarily looking for perfection with the medications but finding balance between my stomach working well enough and my brain working really well has felt like a decent compromise. Ideally my stomach would work perfectly but I’m currently thinking this might be a side-effect I have to tolerate to have the cognition I’m wanting. We’re still in the process of seeing if there are other meds we can swap out to gain these same effects.
Another key takeaway has been being more open to trying different medications until I find something that works really well. For the six year spurt where I felt my medications were in a good place I was really stubborn in not wanting to switch anything. However, in retrospect those six years might have been much easier for me had I been willing to at least try making medication switches. In years prior to the six year spurt I definitely had doctors who mismanaged my medications so there was a fearfulness around allowing anyone to change anything in my medication regimen just due to having had so many bad experiences with medications before my current doctor.
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This post is republished on Medium.
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