Tag Archives: Celexa

Then and Now: A Timeline of My Mental Health

It is often hard to see how far we’ve come on our journeys in life until we look back at where we came from. I am no exception to this. I tend to feel that I’m not improving in my coping with my mental health issues. There’s still this hurricane in my mind, after all. It is also hard because, whenever I seem to improve in my behavior, people’s expectations rise even higher. To shed light on the positive changes I’ve made on my journey through life with mental illness, today I will write a timeline of events related to my mental health.

2007: I was hospitalized on the acute ward on November 3 of this year. I was not allowed to leave the ward without someone accompanying me. For the first few days, I even had to have a nurse accompany me. After those first few days, any adult could accompany me, but they had to sometimes assure the nurses I was safe with them.

2008: I started out the year with a setback: I was given a seclusion plan, which meant I could be secluded if I was a burden to other patients or staff. By early February, however, my privileges were finally extended so that I could go off the ward unaccompanied for fifteen minutes. By early March, my privileges were quite suddenly extended to four hours of unaccompanied time off the ward, which is the maximum you could get at that unit. If you had this privilege, you could ask for extended leave if you had a reason for it. My seclusion plan was also lifted, only to be reintroduced again by June. Fortunately, I never had to actually be secluded, but the nurses frequently used it as a threat. The plan was lifted again in September, but only so that I could be moved to the resocialization unit.

2009: I transferred to the resocialization unit in March of 2009. I did mostly okay until September, when I had a major meltdown which elicited another patient’s aggression. The possibility of moving me to the locked ward for a few hours if I acted out was introduced into my treatment plan.

2010: I was sent to the locked unit for the first time. This did lead the staff to consider medication, and I agreed. I started on a low dose of Abilify, an antipsychotic, in late February. It had to be increased to a moderate dose by the summer and by September, Celexa, an antidepressant, was added. Both helped calm my anxiety and irritability. In November of this year, I was diagnosed with dissociative identity disorder and PTSD.

2011: I was on the waiting list for an autism-specialized group home and went there to stay over for a week-end in October of 2011. Unfortunately, the group home had changed its target population and there was too little support by the time I stayed over there. I didn’t end up going.

2012: I started planning to live with my husband by this time, originally pretty much solely because I didn’t have any suitable alterantive. I don’t mean this to insult my husband, but I didn’t feel I should be burdening him with care duties if at all possible. We moved into our aparetmetn by December. Meanwhile, I was trying to get treatment for my DID/PTSD.

2013: I had an intake interview with a psychiatrist who thought she could treat my DID/PTSD. She ultimately ended up turning me down. It had nothing to do with me, but she was too busy with her physician duties. I moved to my current institution, where i was soon diagnosed with borderline personality disorder. I started schema-focused therapy, but this had little effect. My Abilify also got increased some more.

2014: I continued to struggle, but for the most part was quite stable. My Abilify had to be increased one last time in late 2014 (I am now at the highest dose). I did improve in my behavior and got a more cooperative relationship with my staff. I spent a few times in seclusion, but always voluntarily.

2015: I decided I wanted to live with my husband for real this time. We have been making arrangements, though it’s been slow-going. We will be moving to the tiny village sometime in December, so concrete arrangements cannot be made till then. I have been trying to get a med review for a few months now. Though my mind is still very unquiet, particulalry as my discharge out of the institution draws closer, I don’t tend to act out as much as I used to. I was in seclusion for a while last Monday, but before then it’d been over six months.

As I look back, I see that sometimes I take steps back and sometimes I take leaps forward, but in general, I’m moving up. I’ve never had to be moved back to a more restrictive unit, though I’ve sometimes wanted it. My medication did have to be increased a lot, but I don’t see that as entirely negative.

I am linking up with the 1-word blog challenge hosted by Lisa and Janine. The word choices for today are THEN and BREAK.

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Psychiatric Medications for Autism #AtoZChallenge

Welcome to another day in the A to Z Challenge, in which I focus on autism. Today, I will discuss psychiatric medication as a treatment for autistic symptoms.

Many autistic children and adults take one or more psychiatric medications. Most of these are prescribed off-label, which means they have not been approved by the U.S. Food and Drug Administraiton (FDA) or similar agencies in other countries for the specific purpose of trating autistic symptoms, but the doctor feels they may benefit an autistic person anyway. In 2006, risperidone (Risperdal) got approved for the treatment of irritability in autistic children ages five to sixteen. In 2009, aripiprazole (Abilify) got approved for this purpose too. Both of these medications were originally developed for treating psychotic symptoms in people with schizophrenia, but they are commonly used for treating irritability in people with conditions like bipolar disorder too.

Antidepressants are also commonly prescribed to autistic children and adults because of their potental effectiveness in treating anxiety, depression and obsessive-compulsive symptoms, all of which are common in autistic people. Fluoxetine (Prozac) has been FDA-approved for treating both obsessive-compulsive disorder and depression in childern age seven and up. Citalopram (Celexa) was specifically studied for its effectiveness in treating repetitive behaviors in autistic children, but was not found to be very effective.

Since many autistic people have comorbid attntion deficit (hyperactivity) disorder, many also take stimulants like methylphenidate (Ritalin or Concerta). Some autistic people take anticonvulsants, usually for epilepsy, but these medications can also be used as mood stabilizers.

Many autistic people have strong opinions on medication. For example, many people feel that medications are too often used in a situation where there is limited support in order to drug someone into compliance. A few years ago, I read of a study on intellectually disabled people in institutions, which compared the classic antipsychotic Haldol to Ripserdal and placebo. Each, including placebo, was equally effective, presumably because the people in the study got quite a bit of attention from researchers and this decreased their aggression. I have mixed feelings about this. I may’ve written earlier that I was prescribed Risperdal a week before moving into independent living in 2007. In this situation, clearly the medication was used as a substitute for proper care. However, since going on Abilify (and Celexa) in 2010, I have also been feeling significantly better and more able to cope. When you get your child on medication, it is important to change the medication only and allow other circumstances to remain as much the same as possible. Otherwise, you won’t be able to test whether the medication works.

Medicating Away for Autism: Dilemmas and Disillusions

A few weeks ago, I saw an old post on autism and medicating and what’s the dilemma being tweeted again. It got me thinking about my own journey on the path of the medication controversy.

I first learned about autism and medication from the likes of APANA (Autistic People Against Neuroleptic Abuse) and Autistics.org. It was communicated clearly on these sites that autistics should only take medications if the right supports are in place, they’re themselves suffering (as opposed to the parents suffering from the autistic’s behavior) and if the medication is not an antipsychotic. I took this information at face value. When I was myself diagnosed with autism, I became an enthusiastic autistic advocate. I was soon disillusioned.

When the option of medication was first mentioned to me, I was miserable. I had the right supports, although I was soon going to lose them due to moving into independent living. An antipsychotic wasn’t the first medication mentioned. But it was what I ultimatley ended up on. I wrote a blog post the next day about really well-informed consent. I wasn’t really aware of the fact that I had truly been mildly coerced into consenting and that 95% of the “really well-informed” bit came from my own Internet searching rather than the psychiatrist.

I quit my antipsychotic eventually when I realized it was being used as a substitute for proper care. I used the side effects as an excuse, but really I was still miserable, only just not miserable enough for increasing my supports. I was really fortunate that the psychiatrist who ended up admitting me to the hospital three weeks later, didn’t consider prescribing me the same antipsychotic, or any antipsychotic, again.

For years, I was without daily medication. I noticed how the use of PRN oxazepam was coerced, and I wasn’t going to go along with it – unless I was truly miserable. Or unless seclusion was touted as the only alternative.

In late 2009 and early 2010, I had the worst irritability I’d had in years. I knew that I might benefit from more support, but I also knew this wasn’t feasible, and my support was okay at least. So when my psychologist proposed I talk to the psychiatrist about medication, I consented. The psychiatrist gave me plenty of inforation, including many of his reasons for and against particular drugs (mood stabilizer vs. antipsychotic and if an antipsychotic, which one). He also gave me a week to think, and I consider the consent I gave this time for taking the antopsychotic Abilify to be really well-infomred.

My dose, however, had to be increased several times. I remember once telling the substitute psychiatrist, a much less considerate doctor than my regular psychiatrist, that I felt I needed more support, but I was bluntly told off and prescribed a higher dose of Abilify. Of course, legally I could’ve refused, but the irony of informal hospitalization is that you’re mde to believe you have a choice, only you don’t. I had, after all, been threatened with forced discharge if I didn’t consent to seclusion a few years prior, and this time, I didn’t even have a home to go back to, so what choice did I have?

For three years, I did fine on a moderate dose of Abilify. I did get a low dose of the antidepressant Celexa added, which forutnately never had to be increased. Then, in the summer of 2013, I moved to my current institution and soon found I had more meltdowns. I was threatened with the locked ward, in the kind of way where nurses don’t really mean it but just want to scare the crap out of you, so what choice did I have but get my Abilify increased again. And again?

I’m now at almost the highest dose of Abilify that can be prescribed, a five-fold increase from my original dose. I’m feeling really drugged up lately and in a kind of agitated state where I’m too drowsy to get out of bed yet feel irritable nonetheless. I’ve raised this issue with the staff and my psychologist several times, but nothing has come out of it.

Currently, I’m taking an antipsychotic to manage behavior that other people suffer more from than myself while I don’t have proper support. After all, proper support isn’t needed when you aren’t a pain in the neck of the staff, and when you are a pain in the neck, it’s all “attention-seeking” and “overreactivity” and they’ll treat you like crap until you’re begging for a PRN pill. Is this what Autism Daddy means? I’m assuming he wants the right support for his son, but he doesn’t care that other people are drugged up for a dentist’s appointment. Now I know that his son is more severely aggressive than I was when I gave my really well-informed consent to the original dose of Abilify, but I’m still worried.,/P>

As I wrote in my previous post, my psychologist considers medication to be a substitute for proper support. I disagree, but I’m afraid that I just got to go along with it, and the fact that I’m an informally admitted patient only makes this a little harder.