Medication Management

“Do you really want to be on this stuff for the rest of your life?” - direct quote from my psychiatrist circa 2007.  I was finishing up law school, getting ready to sit for the bar and although my mood wasn’t stellar, I could probably swing it, right?  Let’s back up a bit.

In college, after years of undiagnosed mental issues, I had one weekend where I just laid in bed and cried.  My boyfriend was at an all weekend coding, and my roommate went home. My parents, who probably mean well, had spent my life in denial that there was anything wrong with me, despite, in hindsight, obvious warning signs that I was having problems.  I was all alone and couldn’t even muster up the energy to eat. I finally sought out something to keep the circle of darkness at bay.

From college until almost end of law school I was always on some combination of drugs, usually just rubber stamped by whichever psychiatrist I had at the time.  No doctor really cared enough to question why I had been prescribed Lexapro or Wellbutrin by the previous doctor nor did they care enough to figure out what was wrong with me and make sure the meds were actually effective.  Nor did anyone ever suggest going to real therapy. Still being alive was good enough, I guess. So the last psychiatrist I had in law school suggesting I just taper off of meds all together seemed reasonable. I mean, I guess - I was becoming a lawyer, not a doctor.

Fast forward three months and I just started a new job that drove me back into the abyss.  I was suicidal and in really bad shape and I had to get back on something fast. My husband is now in business school and I’m the breadwinner - not having a job wasn’t an option.  I found Dr. Walking Pharmacy who would literally give me anything I wanted. At some point, I had both a prescription for Ambien and Provigil. She also put me on other random drug cocktails to varying degrees of effectiveness.  (I had a visceral reaction to Cymbalta to the point that I considered suing the company). We’d shoot the shit once a week and she’d write out a new script. She was the one who diagnosed me with Bipolar Disorder II which is the only value add (besides the Ambien) in seeing her. Never was there a suggestion that I try skills based therapy to deal with the symptoms of the Bipolar.

I sadly had to say goodbye to Dr. Pharmacy to move to Japan where I was able to stay on the drug cocktail (now at Lamictal, Valium, and Wellbutrin) through some creative connections between an American licensed psychiatrist and his Japanese doctor hookup who could write prescriptions.  When I moved back to the States. I tried psychotherapy with this very very elderly woman who did the “explore your childhood” method of therapy which worked not at all, and I ended up dropping her in place of just going back to working with people who would just give me meds. I figured I’m still alive so that should be plenty of “therapy.”  

So here I am almost 20 years later thinking I could ride the medication train - until I crashed into the station.  I was trying to only treat the underlying disease without dealing with the most of the symptoms. Now I am in therapy (and it is tangible, results and skills-oriented treatment) working on handling the symptoms and it is actually pretty great.  I’m also now on four different meds (up from two this time last year and includes the old throwback, Lithium). I now see the meds akin to insulin. A diabetic needs insulin to live and my cocktail is no different. But the diabetic also gets a toolkit of how to manage the symptoms of diabetes.  I’m finally getting my version of that toolkit through good individual and group therapy.