To Med or Not To Med, That Is the Question.

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The decision whether to use or not to use medication to treat psychiatric illnesses is something many people struggle with; I know as I was one of those people. In this post I want to share my experience with medication. This is definitely not intended to be medical advice, but rather a reflection of my experiences as a reference point to others who may be exploring the medication decision at the moment.

I’ve experienced the medication debate through both myself and with the parents of the special education students I work with. Many of these children suffer from anxiety, ADHD or emotional deregulation and their parents are often struggling with the decision of whether to use medication or not. I know this feeling well. When I first began seeking treatment for my mental health I was extremely opposed to medication; I didn’t want it and I felt like I didn’t need it. I remember the moment my psychologist suggested I make an appointment with a psychiatrist and the absolute opposition I felt towards this. I also remember my first psychiatrist appointment where I was handed a script for antidepressants and the sense of being completed defeated that came along with it. Taking that first pill may have looked like a simple process to an outsider, but inside my head a battle was going on – I didn’t need medication, I could do this on my own.

Reflecting back my opposition to medication seem to come from a number of different avenues – I was afraid of the dreaded side-effects the leaflet that came with the medication detailed plus all the horrible experiences I’d read about online, taking medication suddenly made my depression seem much more real and serious, and in a way I saw it as weak, as though I should have been able to overcome this without taking pills.

Fast forward 18 months later and I have a real sense of appreciation for the way my medication has helped me. To give insight into what I take, my current medications include antidepressants (Venlafaxine), antipsychotics (Quetiapine) and benzodiazepines (Diazepam and Lorazepam).

I’m not going to lie, these medications have some seriously shitty side effects. I’ve experience the dreaded weight gain, fatigue and drowsiness, a clamping jaw (this was the worst!), vivid dreams, sensitivity to bright lights and lowered libido. Despite taking these medications for over a year I still have this side effects decide to crop up now and again, and some are constant. The withdrawal is also awful. If I don’t take my quetiapine sleep is impossible, without my benzos I become an overemotional, crying mess (yes, even more so than usual which is saying something when you have BPD) and forgetting to take a dose of my venlafaxine before I go to work in the morning results in the absolute worst withdrawals of all – nausea, vomiting, dizziness and these awful electric shock like feelings in my brain. There is definitely a crappy, horrible size to medication that I’m not going to sugar-coat.

Despite this, the benefits I’ve experienced make it worth it. Medication is not an easy fix to mental illness. I still struggle immensely and undertake therapy weekly with both my psychologist and Psychiatrist, have a community mental health worker who I talk to on a weekly basis, and I’m gearing up to start my second round of group Dialectical Behaviour Therapy (DBT). I don’t see medication as a sole treatment and rely on my therapy and DBT skills every single day; rather, medication is an accompaniment to this. Medication has lowered my day-to-day level of anxiety to one that is manageable for functioning, it has stabilised my moods during periods of non-distress (somewhat of course, my BPD makes mood stabilisation difficult) and it has helped the depression lift from never-ending and constant to periods of weeks at a time where it is relatively manageable. Without the mood stabilising effects I’d be too heightened to apply my therapy skills, and this is wherein lies the benefits of medication. It allows me to get to a point where I’m able to function enough to try and apply positive and effective skills and changes to help long-term. I see this a lot with the children I work with too – often I teach them emotional regulation and social skills that they can role-play beautifully, however put them in an actual situation and the heightened state they are in makes transference impossible. While it’s not my role to give advice on whether or not medication is a good option, I have seen it help immensely in many situations.

One struggle I have with medication other than the side-effects is the potential to overdose. I have had over 10 OD’s in the past year, and a majority of them have been with my prescribed medication. When you access to an arsenal of medication that can put you sleep or completely zone you out in under ten minutes it’s unbelievably hard not to take them when things become overwhelming. My partner currently manages my medication for this reason, but I often find ways around this and it doesn’t eliminate the danger completely. The management of medication is something that seriously needs to be considered if you decide to go down this route.

Reflecting back of my initial reasons for not wanting to make medication demonstrate how strong the stigma associated with medication is, even for those who are currently in therapy for mental illness. I consider myself to be quite an open and accepting person, and even I was so tuned in to the negative connotations people held about medication that it presented barriers for me in seeking it. I think this is something society really needs to overcome. We don’t judge people who take medication for physiological illnesses such as high blood pressure or diabetes, so why do we judge medication for mental illness where there are proven physiological elements to it?

The decision whether to use or not use medication for psychiatric illness is something everyone needs to address on their own. Each person is different and what works for some will not work for others. However I want to stress there is no shame in taking medication for mental illness. At the end of the day you need to do what is best for your recovery and sometimes medication is part of that answer.

 

 

 

BPD Awareness Week.

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Yesterday marked the first day of BPD Awareness Week in Australia, and what would be a blog about Borderline Personality Disorder without a post focused on this?

This years focus is on raising awareness about BPD while decreasing the stigma associated with the disorder, and as someone who suffers from Borderline Personality Disorder I can’t stress how important I think this is.

I’ve been diagnosed with BPD for about a year and a half now and I’m no stranger to the stigma that comes along with it. I’ve had my parents tell me to “just stop ruining your life” after an overdose, my GP tell me to consider others worse off such as starving children and the homeless (because curing mental illness is that easy), my partner’s family members tell him how I’m not good for him, my partner’s grandmother asking him if I’m physically violent towards him after she read up on BPD in a quick Google search (despite never giving an indication of being abusive towards him in the six years we’ve been together, three of which we lived with her) and my work place enforcing unnecessary and unfair restrictions on me due to having to take time off for mental health hospitalisations.

In a nutshell, the stigma and discrimination associated with BPD sucks. I find most people either consider you to be acting dramatic or just seeking attention, have no idea what BPD is or assume you are an embodiment of all the negative associations with BPD you read on Google (such as manipulative, abusive, uncontrollable, etc.). People with Borderline Personality Disorder are already hypersensitive and aware to other’s attitudes and opinions of them, and dealing with this kind of stigma is unbelievably detrimental. For example, my GP once told me my behaviour was taking too much of a toll of those around me and that if I ever had children the government would take them away. This brief comment sent me into a month-long suicidal spiral. While these comments are not always meant in a malicious way it doesn’t mean they hurt any less.

It’s because of this that the awareness around BPD needs to be raised; both in the community and among health professionals. Yes I have BPD, and yes I’ve had six psychiatric hospitalisations in the last 18 months, and yes sometimes I go into awful depressive slumps that take me weeks to crawl out of, and yes I struggle socialising with family and friends, and yes I self-harm, and yes I’ve had way too many dangerous overdoses. But that’s not all that I am. I have a job working with special needs children and I have two uni degrees while studying for a third and I always go out of my way to be kind and friendly to others and I own a house and have a partner and a small zoo of pets that I love. Unfortunately, however, people tend to focus on the former, something I’m sure other suffers of BPD and mental illnesses are far too famililar with.

This is not okay. This needs to change. People with BPD are not lost causes or not worth it. They are people just like everyone else who have amazing things to offer. 

Even if BPD Awareness Week can help even a few people gain a better understanding of BPD then I consider that a win; each person who becomes informed is another person who will no longer contribute to the stigma so many people with BPD face.

I also think it’s important to appreciate the amazing people in my life who have supported me through this illness. I have an incredible psychologist, an amazing psychiatrist, an excellent community mental health team and most of all an absolutely wonderful partner who has been with me every step of the way even though he sometimes struggles to understand and despite the fact alot of my ineffective behaviours impact greatly on him, too. I know how lucky I am to have these supports and I’m so thankful for them.

For more information on BPD Awareness Week check out BPD Awareness – there are some awesome programs and events running all over Australia throughout this week and they have excellent resources available if you want to educate yourself or others. We all need to work together to make this change happen and BPD Awareness Week is an incredible step in the right direction.

 

 

R U OK?

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Today is R U OK? Day and what would a mental health blog be without a post about it?

As someone who suffers from mental illness I know what a difference a few simple words can make, or how much it can mean to have someone check in just to ask if you’re okay.

I know R U OK? Day is sometimes criticised for being too superficial and not practical and I get that, but I also think it’s a great opportunity to raise awareness about the prevalence of suicide and mental illness, and while it won’t help everyone, sometimes that initial contact can mean everything to someone struggling.

Try to check in with all the special people in your lives today; a few words can go a long way.

Untangling My Brain.

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Tonight marks the last night of my inpatient treatment; tomorrow I get to go home. I’d love to proclaim that I feel completely healed and I’ll never step back into a psychiatric hospital again, but realistically I know, while not impossible, it’s also not likely. This was my sixth or seventh inpatient stay in a year and a half, and deep down I know that they’re probably not over yet; that I probably still have some things that only inpatient treatment is going to help.

And while that isn’t a bad thing, I’m trying not to focus on it too much tonight. Instead, I’m trying to zen myself out for tomorrow – mindfulness, DBT emotion regulation skills, the works. Oh, and medication (I can’t forget my two good friends diazepam and lorazepam). I’m still struggling though. Leaving inpatient treatment is such a confusing mesh of emotions – excitement, relief, fear, anxiety, etc. And worry – there are lots of things I’m worried about. Some things are trivial, others are not. To list just a few:

  • I’m worried my puppy will have formed a better relationship with my partner than me over the three weeks I have been gone.
  • I’m worried my partner and I will end up in an argument a few hours (or even minutes) within leaving here and all the anxiety will come flooding back times ten.
  • I’m worried about the logistics of maneuvering my suitcase to the car without crushing the bunch of roses I received and the bonsai tree I’ve been trying to grow while here.
  • I’m worried about returning to work next week and how they will have handled the time I’ve had off.
  • I’m worried about what time to set my alarm for tomorrow morning.
  • I’m worried that I won’t be able to manage the suicidal/self-harm thoughts I’ve worked on managing while here, and as soon as something goes wrong I’ll act on them.
  • I’m worried about the million appointments I have to go to over the few days after my discharge (okay, a million is exaggerating, but I still have to fit in appointments with my Psychologist, Psychiatrist, Community Mental Health and GP).
  • I’m worried things will be back to where they were before, or worse, within a few days of going home.

See what I mean? Some warrant worry, some not so much. So right now, instead of sleeping, I’m trying to categorise these worries in my mind based on importance and rate to which they need to be attended to. I use a Catostrophe Scale with the kids that I work with, and damn I need one right now. Ah, the life of an anxiety sufferer.

I love the picture above, and I’m trying to keep it in mind tonight as I struggle. It’s a good reminder that life is messy and hectic and crazy and confusing, and that moving forward never looks simple. But eventually you untangle things and get somewhere, even if it’s just the tiniest step.

Wish me luck on untangling my brain tonight so I can get some sleep!

Finding A Pro.

The nurses always marvel at the way I’m able to swallow pills without water. Sometimes I’ll be passing the meds window and not have my drink bottle, and I’ll stop to grab them instead of having to come back later. Considering how tiny most of them are it doesn’t seem like a big deal to me, but I get a lot of comments about it.

I always reply with a shrug and a smile but sometimes that voice in my head almost wants to shoot back, “Considering you’ve seen my file and know how many times I’ve overdosed, you should know I’m pretty much a pro at this pill swallowing business.”

Hey, ease with swallowing pills can count as a pro to BPD, right? I mean, you gotta take what you can get with this mental illness thing sometimes!

Oh and the picture goes out to my partner, I know he’ll sympathise when he sees it.

More Than Anything.

Tonight is just one of those nights; a mixture of struggling to get to sleep, endless nightmares and ruminating thoughts that, no matter how much I challenge them, won’t get out of my head.

What I want more than anything at the moment is one day in which I don’t think about how I want to be dead.

Maybe that is too blunt to write, but it’s a reality of mental illness and I’m done with the sugarcoating.

A Message To Demi Lovato.

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While my own mental health struggles have been going on, things with Demi Lovato have been going down as well. As someone who also suffers from mental illness,  I know how hard and exhausting the fight can be, and I felt compelled to address some of the negativity I have been seeing surrounding this.

First off, I want to say that Demi Lovato is kick ass. She has battled with mental health since she was a young child. While it may be easy for people to stand there and make comments about how “disappointing” she is, or how she needs to be a “better role model” – unless you’ve been through it, you have no idea. And even then, everyone’s battle is unique, and we can neve really understand anyone else’s. What I do know is that battling mental illness is exhausting. It doesn’t matter how long it’s been since your last relapse, or how long you’ve been struggling, it never gets easier. You get better at handling it and you learn new tools to manage it, but eventually it wears you down. We all have slip ups. Look at me. In a year and a half I’ve been in hospital six times. I’ve overdosed more than I can count. I’ve given up self-harming so many time I can’t even remember, and then fallen straight back into bad habits.

One thing that gets me about this world is how negative we are to others. That negativity gets us no where. All it does is spawn hate and sadness. Why not, instead of throwing hate out into the universe, we show love and compassion and understanding? People who are sick do not need condemnation. They need support.

And so I want to write this little message to Demi. Even though I know it will probably never get to her, I hope that whoever reads it will stop and think just for a moment about how too they can show love and compassion to someone in their life who really needs it. Believe it, it really does make all the difference.

Demi, I’m so sorry to hear what you have gone through. I know what struggling feels like. I’ve been there myself. But you have overcome stumbles like this before, and I know you will overcome it again this time. You are beautiful and compassionate and radiate love, and your friends and family and fans see this. Not for one second have you disappointed anyone. Your courage and your openness with fighting mental illness is what makes you a role model – you show young people all over the world what it looks like to fall and get back up again. I hope you take as much time as you need to recover. We’ll all be thinking of you on while you do, and we’ll all still be here when you’re ready.

Life Update.

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Trigger warning for this post.

The last few months I have let my blog slide. I could contribute it to a number of things – returning to work after my last hospital stint, starting a new postgrad course at Uni, just general life business. But the truth is, the lack of blogging is mostly because of the downward spiral my mental health has taken. I have wanted to blog about it, to get it out and try to process it, but each time I try my fingers seize up and a million more pressing things to do fill my head. But for some reason, after taking double my normal dosage of Seroquel, I’m buzzing and my fingers are itching to type. I don’t know where to start; choosing a place to start is always the hardest. So I’m just going to let me fingers flow freely and see where they decide to take me; to take us.

You may remember I had my second psych hospital stay in May/June this year. It was my fifth overall in the last year, and my longest at a month. When I left, I felt amazing. I didn’t feel like I was held together by sticky tape, but rather, properly stitched together just like people are meant to be. My head wasn’t foggy, but completely clear. My anxiety was in check, simmering beneath the surface where I could manage it. It was the best I could remember feeling in a long time. I was excited to go back to work. I’d gotten back into painting. We welcomed a new puppy to the family. I was determined to put in effort with my friends. And I had an awesome breakthrough with my Psychologist looking at structural dissociation. There were some tough things – issues returning to work and some arguing with my partner – but that was to be expected and I worked through it and I was doing it – I was ACTUALLY managing life.

I can’t pinpoint the moment it changed no matter how much I try to. But suddenly the urge to overdose was back in my head. At first it was a hum I could easily tune out. It became louder and louder, though. A hum. A steady beat. And then it was full blast. All the time. Overdose. Overdose. Overdosing will fix this. You’re stressed. You can’t handle this. Overdose. Why are you even trying. You know what you need to do. Overdose. Overdose. Overdose. Stop kidding yourself. Overdose. I fought it. I talked to my Psychologist, my Psychiatrist, my Community Mental Health Worker, Lifeline’s online chat, Mental Triage Crisis Hotline. But soon my mindset changed – I went from fighting it to waiting for the right moment to do it.

A fight with my partner gave me that opportunity I’d been waiting for. We got into a huge argument one night. At first it was the same as usual – crying, screaming, him becoming frustrated. And then he said words he says all the time when I push and push. “I’m done. I’m done with us.” Normally this would make me cry and scream more, however this time a wave of relief washed over me. It was my moment. I spewed out horrible words over and over again – “Good. I’m done, too. I hate you. Get out of my room. Get out of my house.” until he left to sleep in our guest room. And then, without a second thought, I proceeded to take a whole bottle of Ativan, along with Seroquel and Diazepam. I don’t know what my next plans would have been, but Mental Health Triage had sent an ambulance to our house after an earlier conversation in which I failed to call them back. They arrived as I took the last diazepam. I remember leaving with them on that Tuesday night, and then nothing.

I woke up on Thursday morning in hospital. I was completely out of it and repeatedly asked if I could go home. In my mind a nurse told me yes, although I don’t know reliable this is. This is the part that gets really scary for me. I completely disassociated from myself for what followed; I was there but I was only watching. I had no control. I got dressed, proceeded to walk to the shops across from the hospital, and downed around 80 Panadol in one quick motion. My partner turned up (I had called him and told him I was catching a bus home, and he immediately knew I wasn’t okay) and dragged me back to the emergency room. I remember only faintly talking to a doctor before I was out. Apparently it was scary. I was given a breathing tube and put in an induced coma. Doctors told my partner they didn’t know how I was going to wake up and if I would be okay. I don’t remember any of this, of course, I just remember waking up the next day. I guess I should fine this scary; my worst overdose and a definite life and death moment, my paracetamol levels thousands what they should have been. But I don’t. Not at all. Part of me feels detached from it; like it wasn’t me. But deep down I can feel part of me was there. When I overdose it’s usually to “escape”, not to kill myself. But with this overdose it feels different. That deep, down part of me thinks that maybe this was the first time I actually wanted to die.

Following all of this I’m, of course, back in the Psychiatric Hospital I’m becoming a regular at for what I’m estimating must be my sixth stay. My Psychiatrist and I made a treatment plan for a two week stay which I committed to. Except I don’t think I really have. That’s because the suicidal thoughts are stronger than ever. They never leave my mind. I make lists of why I should kill myself. I research and write down the lethal doses of different medications. I make different suicide plans and plan them out to a t. It’s bad. I manage to keep this from her until Friday, where I spent the night with my nurse alternating between hysterical tears about how I can’t do it anymore, calm announcements of how I was telling my psychiatrist at my appointment the next morning that I was leaving and going to kill myself, and then giddy smiles about how relieved I felt about dying and how excited I was. Play. Rewind. Repeat. The next day my Psychiatrist removed my accompanied leave rights and upped my medications, and when I told her I wanted to go home she shut the conversation down immediately by telling me if I took one step from the hospital the police would be bringing me back.

I have spent the remainder of the weekend sleeping. I get up, take my morning medication along with PRN that knocks me out, wake up, skip lunch, take another dose of PRN that knocks me out again, get woken by a nurse for dinner, then take more PRN to knock myself out before bed where my night meds knock me out for the fourth time. I just don’t want to think or feel at the moment; it’s all too confusing. One moment I’m thinking about the upcoming Uni assignment I have due and making plans for when I get home, and the next I’m reminding myself that I need to kill myself and I’m back to noting out my clear and precise suicide plans.

Frost’s poem The Road Not Taken keeps coming into my head as I sit here tonight typing this. I feel as though I’m standing in front of two paths myself – one where I drag myself up and try and again, and one where I admit that I’m just too tired to keep doing this anymore, and end it. Because it’s true – I am so, so tired of this fight. But it also feels like I’m not the one who gets to make this choice; at the moment I feel as though I’m at the mercy of my brain and what it wants to do. It might be my brain, but I feel so disconnected from it. I have no control over it. It does and will do what it wants.

And I think that’s what scariest of all.