Since I have started this blog, I have gotten a chance through text, email and physical conversations to interact with a lot of people, some I have never even met before. Of all of the people I have talked with, I guess the most common question would best be summarized this way: “What is working for you?”
Obviously, there is no guarantee that what works for me would work for anyone else. Yes, it has been successful for me, but mental health care is not a “one size fits all” science. That is the most frustrating part. Meds work, but we don’t always understand how they do work, but we know they do.
But what I wanted to do was to lay out my course of treatment and what has been tried.
One of the things we learned in group therapy is not to talk about specific medications. If you ask me, I can only tell you what meds I am on and how they have worked for me, but will do that privately.
I am on a Selective Serotonin Reuptake Inhibitor (SSRI) for my OCD. Except for about a 3 month period when my insurance company was being difficult, I have been on this medication since originally diagnosed with OCD in 1998. Just before I went into my partial hospitalization program, I had a dosage increase in response to some of the symptoms I was having as this depressive episode wore on. While some have suffered some bad side effects with an SSRI, I have been lucky in that I have never experienced a side effect from this medicine. That 3 month period when I had to switch medicines, I had a side effect of weight gain of about 25lbs in the 3 months I took it.
I am also on a mood stabilizer. I had actually started on this medication within a month of the PHP I was in. This med helps to keep the swings of bipolar on a more even keel. This is the med that has required the most adjustment. It was increased in the PHP, then increased again last week due to some lingering racing thoughts. I only had a two slight side effects with this med as the dosage was increased over time. When I stated the increased dosage, I felt like I had things crawling on my head, but that went away after about 3 days. The other side effect for me was it impacted my insomnia and I can’t do that. Sleep is hard enough as it is. So we just moved it from at night to in the morning and that problem was solved.
The final med I am on is a med to keep my anxiety lower. It is a medication that was prescribed “off book.” Off book only means that the meds work for things that it wasn’t necessarily developed to do. I will not do benzos for anxiety and my doctor agrees with that. This new med was added this month after getting out of the program and it has lowered my anxiety level tremendously.
Now, I hear you already and promise me, I have said the same thing multiple times throughout the last 20 years. I don’t want to be on meds. I don’t need them. I will get better in a few days. I am just not a happy person. All I can tell you is that I finally just accepted that I will be on these medications for the rest of my life if I want to truly be happy and live my best life. I have tried 3 times to come off my meds over the years. Everything went well for awhile, right up until it didn’t.
“So, if meds work so well, how did you wind up in the loony bin?” This time, because I screwed up. While deep in the throws of a depressive episode, I cancelled a few doctors appointments in a 2 week period and wound up running out of my meds. During that 2 weeks, as the chemistry went back to the deficient levels in my brain, I crashed. It was the last straw and I couldn’t deal with it any more.
I don’t have a stigma any more about taking my meds. I have said it in this blog before, but you wouldn’t tell someone with high blood pressure to quit taking their meds, or someone who is diabetic to not take insulin. These meds are no different. With these types of disorders, the chemicals in the brain aren’t “normal” and they need help to stay regulated. In fact, there are some studies that are seeing brain shape abnormalities in some bipolar patients. It is a medical issue and sometimes, a medical issue requires medicine.
Let’s start here with a lesson that I learned the hard way, meds alone will not work. Let’s go back to the medical theme I just used. Say a guy has to take cholesterol medicine to lower it. Should he take the medicine without also changing his diet and habits? No. Meds are just a part of my overall treatment plan. If I don’t work on me, the meds will make me stable, but won’t make me better. That is where therapy fits in for me.
Obviously, I did a ton of group and individual therapy during my 6 weeks in the PHP. That is all we did for 7 hours a day, 3 to 5 days per week. Upon graduating the program, I have found a new therapist and have begun seeing her. For now, I will see her once per week. Eventually I hope to bring the frequency to once a month after we get through all of this stuff.
Once again, I can hear the snickers of your thoughts of me on the shrink’s couch. We aren’t sitting in there talking about my “inner child” or “mommy/daddy issues.” It is nothing like what you have seen on TV or in the movies. I go for one hour once a week and we have a conversation. It is nothing more than a conversation with someone about a subject where they know a hell of a lot more than we do. Is it hard? Yes, but “soul” work is painful. Is it exhausting? Yes. Every day when I got home from the program, I would take a nap. When I got home from therapy last week, same thing. It is emotionally exhausting sometimes. Do we talk about some tough subjects? Yes, but keeping them bottled inside of me hasn’t worked out really well for me.
I used to think it as all psycho-babble. Quit going to therapy years ago because “I don’t need this.” Therapy is the second part of my treatment.
This is the big change for me. Quite simply, I have never done this before. Any of it. This is a concept that I am having to really dedicate myself to. There are a couple of things that I do every day to reflect individually on my therapy.
I meditate 3 times a day. I do a 20 minute session soon after I wake up to get me focused for the day. I will do a short (5 minutes) at lunch time or whenever I get a chance during the middle part of the day. I can do this one anywhere and have done it in the front seat of my truck many times. Then finally, I do another 20 minute session at about 7 or 8 to start quieting down for the night. I used an app called Headspace for my meditation (Melissa uses a different one but I’m not sure which one.)
Meditation is one of the most misunderstood practices. I’m not in there lighting incense, chanting to the moon or flipping tarot cards. Meditation teaches you to quiet your mind. It helps you to process feelings and emotions, to learn to feel your mind wandering and bringing the focus back, which is the area where I struggle the most. I am so much more effective when I can slow the thoughts down. I sleep better, I am more focused and mentally sharper.
I also do workbooks. Currently I am working on one that is concentrating on the OCD side, since the last one I did was more emotion based than cognitive. They are all over the internet or in your local bookstore. Because Mindfulness is what my meditation is based on, I find the workbooks tailored to that approach work best for me. I actually enjoy doing them.
I journal and do a lot of writing there. Starting with a new therapist, finishing up the program have meant me journaling a lot more than blogging here lately. The journal is and will remain private.
Taking the time to get some stomach issues (again) and a couple of other things and making time for physical care Way more important to my mental health than I ever thought it was.
And finally, knowing where my limitations are and drawing clear boundaries. If I think going somewhere is going to be too difficult, I don’t go. That doesn’t mean I stay in the house all day, not at all. I just avoid the situations that I know are going to cause me great stress.
Drop a line in the comments section and let me know what has or is working for you. All we can do is to learn from one another. If you have any questions that I didn’t answer here, just let me know and I will answer it to the best of my ability.
Rmember to love yourself first & always