Tag Archives: Psychiatric Medication

#Depression: What It Feels Like to Me

I have had experience with low moods since I was a child. Nonetheless, until a few months ago, I was never diagnosed with depression. During the last round of diagnostic revisions, my psychologst decided to diagnose me with depressive disorder NOS along with dependent personality disorder and borderline personality disorder traits. I am not sure I agree and my psychologist admitted at first that it was more her needing to give me a diagnosis on axis I to warrant me staying in the institution than my actually needing treatment for this.

Today, Aspiecat described what depression is like for her. I could relate to some of these experiences, but nto others. I am going to describe what it’s like to be depressed for me.

Let me first say that low moods are my default. I am pretty sure that dysthymia, ie. chronic but mild depression, is a more useful diagnosis for me than depressive disorder NOS. Apparently though my psychologist doesn’t feel I meet the criteria for that. Really not remembering a prolonged time when I did not feel low makes me wonder whether I’m truly depressed or just pessimistic. I know that depression and optimism do not mutually exclude one another, but I tend to gravitate more towards the negative than the positive.

Then there is the state, as opposed to the trait, of being depressed. Like Aspiecat, I experience two forms of depression: the first in which I feel numb and inert and the second in which I mostly feel despair, sadness and often anger. The former tends to last longer and be harder to overcome. During this state, I sleep more than usual, eat irregularly but usually more than normal, am slower than usual and generally unmotivated. I don’t usually experience the extremest of dark thoughts in this state. Rather, I worry and feel a bit anxious. I may experience suicidal ideation during this state, though it’s rarer than when I’m in my state of despair. I am also less likely to act destructively, unless you count binge eating. When I do experience suicidal ideation in this state, it’s more of a logical, thought-based kind focused on self-hate rather than an active wish to die. I just can’t be arsed to care about life.

In the state of what Aspiecat refers to as meltdown, I, like her, experience all kinds of negative emotions. I think I may be somewhat alexithymic (unable to read my own emotions) too. I often express my emotions as anger when I’m in this state anyway, even though I think I experience many other emotions. I am more likely to experience suicidal thoughts and to engage in destructive behaviors in this state. I am usually agitated rather than slow.

Unlike Aspiecat, I prefer the state of despair to the state of numbness and inertia. There are several reasons for this, one of which may just be the fact that I’m currently numb and not liking it. Any emotion seems better than this state of inertia now. I however also feel that my despair is more actionable, because it tends to be more situational.

Other people also tend to understand my state of meltdown more than my state of inertia. They see me lying in bed all day as a choice, whereas when I’m in meltdown, they see my despair. They may not accept my agitation in this state, but at least they notice that I’m not doing well. My medication also tends to help with this state more than with numbness. I do take an antidepressant in addition to an antipsychotic, but I’m not so sure it helps with my low moods. The antipsychotic and maybe the antidepressant too do take the edge off of my agitation.

Unfortunately though, people see my state of despair as more needing treatment than my state of numbness. This may be because I don’t tend to respond well to psychotherapy and medication-wise, there is simply more to be done against agitation. I take a high dose of an antipsychotic on a daily basis. I also have a low-potency neuroleptic, an anti-anxiety benzodiazepine and a sleeping pill (also a benzo) as PRN medications. All of these can be seen as depressants. Like I said, I do take an antidepressant too, though in a low dose. I am not so sure it works, but then again it isn’t a great medication for the kind of atypical depression I experience. By this I mean that it isn’t shown to be too effective with depression that is characterized by inertia, eating and sleeping too much and general anhedonia (numbness). This kind of depression is particularly hard to treat.

Because other people are more bothered by my meltdowns than by my state of anhedonia, I also feel they tend to want me to be numb rather than agitated. I mean, of course they don’t actively want me to be numb, but they see it as less of a problem, because it causes little disruption to others. I go along with this and have never asked for more help, medication-wise or otherwise, with my inertia-based depression. I am not so sure that I should.

Milestones in My Mental Health Recovery

This week #theprompt celebrates its 100th edition. I was guessing at the prompt for this week, as I often do, and this time, I was right: milestone. There are many milestones in one’s life. Birthdays, particularly important ones like eighteen or thirty. Graduations, be it from preschool, high school or college. Getting married, the birth of a child or grandchild, and the list goes on. When I thought of the word “milestone”, however, I thought of the milestones in my recovery from mental health problems. I am going to share them here. I include steps I’ve taken in my journey with autism here too.

1. Realizing I have a problem. In a way, I was always aware of my being different, but I didn’t realize there might be somethng really, clinically “wrong” with me till I was fifteen. Then I realized I may be autstic. Or something else. I quickly developed quite the obession with about half of the DSM-IV. Then, when I was seventeen, my parents talked me out of thinking I was autistic or otherwise anything other than blind and extremely intelligent and oh maybe a hypochondraic. Never mind that hypochondriasis is a real mental illness.

2. Admitting I need help. I first admitted this the day after I decided I might be autistic, so when I was still fifteen. Then again, I was too shy to tell my parents or my teacher or basically anyone that I really needed more than a teacher with a social skills checklist telling me all that I was lacking in terms of social skills. I remained too shy to directly ask for help for years. They were other people asking for help for me. First, it was the teachr with the social skills checklist calling the blindness rehabilitation center for me. Then it was my staff at independence training calling mental health services. Then it was the police calling the crisis service after I’d made a suicidal threat in public. I still have a problem asking for help directly.

3. Starting counseling. My first experience with counseling was at the blindness rehabilitation center I went to after high school. That wasn’t all that successful. Then, at the mental health agency where I was diagnosed with autism in 2007, I started sessions with a community psychiatric nurse. This was quite helpful. It was probably my most successful counseling experience so far.

4. Starting medication. I first started medication in the summer of 2007. That wasn’t a success. I hadn’t expected the psychiatrist I saw to suggest I go on an antipsychotic, because the nurse I mentioned above was suggesting a benzodiazepine on an as-needed basis. I did end up taking said antipsychotic, but stopped taking it again several months later. The second time I went on medication, another antipsychotic this time, I was extensively educated and got plenty of time to think it through and make a decision. I consciously decided I wanted this medication and it’s been a great help (with an antidepressant and several PRN meds added later on).

5. Checking myself into a mental hospital. Of course, it wasn’t literally that I checked myself in. I didn’t take the initiative to call the crisis service or my treatment provider, which I didn’t even have at the time. After all, I’d moved a few months prior and the new mental health agency was doing the diagnostic testing all over again. Nonetheless, I consider it a major milestone that I agreed to be admitted into the psychiatric hospital.

6. Moving to a resocialization unit. I spent sixteen months on a locked unit, largely because my meltdowns and emotional outbursts were too severe for any less restrictive unit to want me. Finally, however, the resocialization unit did want me after I half lied myself into being accepted. I think this was a major step, as I got much better care on the resocalization unit than on the locked unit. After spending over four years there, I moved to my current unit, which is also rehabilitaiton-oriented but doesn’t have as strict guidelines on how long you can be here. Not that they were followed by the other unit either. I really went here to be closer to my husband, whicch I currently am not anymore since the move, but oh well.

7. Discharge. This milestone is to come this summer. I’m going to move out of the psychiatric instituttion and live with my husband. I’ll continue to get some form of psychiatric treatment, but of course this is a step towards recovery of a “normal” life.

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Six Discoveries Made on a Psychiatric Unit

On The Mighty today, there’s an interesting article on little discoveries made at a psych ward. I seriously thought I had invented playing card games as a life saver, but apparently I haven’t. Having spent eight years on one psychiatric unit or another, I can add a few more discoveries to this list.

1. The smoking area is the coziest spot on the ward. I don’t sit in the smoking area nowadays anymore, because I don’t want to associate with my fellow patients that much. On the acute unit though, I spent hours in there as a non-smoker just because it was the best place to have good conversation with patients.

2. Not just picky eaters like me despise the food. We had relatively good food when I was first admitted in 2007, but as budget cuts took over, the quality of the food declined sharply. Now we’re lucky if we have noodles, because they are pretty much the only food that isn’t too bland to be real. If someone with a specil diet or who is a vegetarian is admitted to our unit in the middle of the week, too bad. Food is delivered in bulk quantities, so no-one gets to choose what they want to eat anymore. If you’re a vegetarian or have a special diet, you can only hope that the staff will remember to order your food specifically. By the way, the vegetarian food is the worst of all kinds.

3. “Therapy” means you’re stuck with an adult coloring book. “Work” means going to the industrial arts department. I still don’t understand how people can call day activities their “job”.

4. On most wards, you can’t access the kitchen cupboards with food in them or even get a drink outside of meal times. I am fortunate to always have spent time on wards where you could get food or drink freely, except for coffee, but an increasing number of units are locking patients out of the kitchen or its cupboards. The reason is patients often make a mess. I remember a long time ago this locking of kitchen cupboards being discussed at the intensive care acute unit (not a unit I ever resided at). One nurse rightfully said that the patients on this unit have hardly anything they can control, so why should the times they eat be controlled too? Unfortunately, he didn’t get his way and the cupboards were locked.

5. People manage to argue over the remote even though everyone has a TV in their room and there are three TVs in the day rooms. Seriously, a fund founded by one patient’s parents provides TVs for everyone in their rooms, and still oftentimes the same soap opera is on on each of the three shared TVs.

6. Every doctor has their favorite prescription medication. I am still surprised the psychiatrist at the resocialization unit didn’t prescribe Ritalin to me, because he prescribed it to practically everyone. Benzodiazepines, of course, ar handed out like candy, except to me, because I told the psychiatrist I have a family history of benzodiazepine addiction and personal experience of its withdrawal. I am 100% confident that most of the other patients on benzos are effectively addicted, but apparently they’re too unwell to ever get off their pills anyway. Did you know that “severe psychiatric illness which requires high doses of benzodiazepines” (ie. chemical restraint) is one of only a few grounds to get the drugs covered by insurance. The other three are epilepsy, anxiety disorders when a person has tried at least two antidepressants unsuccessfully, and last but not least, palliative sedation in end-of-life care.

Tips for Coping with Suicidal Thoughts

Screw you, #BEDN. I screwed up the day after I planned to continue writing everyday this month. Yesterday was a bit stressful. I baked an apple pie to remember the eighth anniversary of my psychiatric institutionalization, but I also felt overwhelemd with memories from the day of my crisis. In addition, yesterday was designed to be plan your epitaph day by the inventors of weird holidays. I only found out through this week’s #TuesdayTen. I was originally planning on writing a post on tips for coping with suicidal thoughts for #TuesdayTen, but the pressure of having to think up ten coping strategies and the doubts as to whether it’d fit in, made me skip the occasion. The idea stuck around though, so I’m going to write down some coping tips today.

The first important key is realizing when depression or despair sets in before you reach rock bottom. When you are acutely suicidal, most of the tips I’ll mention below will sound completely useless. However, if you’ve realized you are depressed or otherwise severely distressed, you may be able to enlist the help of others in staying safe. Here are some tips that can help you through some suicidal ideation. When you are actively planning suicide, these tips may no longer work and you’ll need to go to the emergency room or psychiatric crisis service.

1. Enlist the support of family or friends. Like I already said, supporters, such as family may be able to help you remember why you want to live. If not, they may be able to intervene to keep you safe whilst getting a mental health professional involved. When I was in my crisis in 2007, I had no support in the city I was in at the time. That is, I had my parents, but they weren’t particularly helpful (and I honestly can’t fully blame them) at the time.

2. If you don’t have family or friends to support you, there are support sites and telephone hotlines for people in crisis around the world. While again, if you are in acute danger, you need to go to the emergency department or psychiatric crisis service, when you are still able to talk it through, do so.

3. Think of what your goals are, what you want to get or avoid with suicide. Obviously, religious beliefs about an afterlife aside, you won’t gain anything from suicide. That doesn’t mean it doesn’t seem like it. Some people believe: “At least I’ll be able to rest then.” In this sense, what you want to avoid through suicide is important too. Discuss with your family or a mental health professional how you can reach this goal while remaining alive. For example, I knew as I was talking to the crisis service psychiatrist in 2007 that I didn’t really want to die – I mean, who wants to? -, but that I couldn’t cope with my life as it was anymore.

4. Think of the people you’ll leave behind. No, I don’t mean thinking of them having to make funeral arrangements and how selfish you are for leaving your family with the financial burden. That is not going to be helpful. Just for your information, as a family member, don’t ever burden a suicidal relative with this kind of crap, no matter how confident you are that they are “just doing it for attention”. However, if you do have people you still care about when you’re in despair, thinking about them can help lift your mood. Despair is an incredibly lonely feeling, but there are people who care about you.

5. Be careful about chanigng medications or other treatments for depression while you are actively suicidal. Though electroconvulsive therapy (ECT) is relatively safe for severely depressed people, antidepressants carry the risk of increasing suicidality. Always be sure to discuss suicidal ideation with your mental health professional and don’t change your medication regimen without close supervision, preferably from a psychiatrist.

Deciding to Go on Psychiatric Medication #Write31Days

31 Days of Mental Health

Welcome to day 5 of the #Write31Days challenge. Today I’m focusing on a difficult decision people with mental illness might face: the decision to ask their doctors to prescribe them psychiatric medication.

Of course, patients do not make the decision to get on medication alone. Neither do doctors. Unless the patient’s mental illness causes them to be a threat to themselves or others, they cannot be forced to take medication. The patient decides whether they’ll swallow the pills prescribed to them, but the doctor ultimately decides what to prescribe. In other words, the decision about psychiatric medication is a cooperative process between doctor and patient.

Each time that I went on psychiatric medication, it was my doctor or another mental health professional who’d taken the initiative. Then again, being an informally-treated patient, I each time had the right to informed consent and chose to take my pills.

The first time I went on medication, in the summer of 2007, I was very seriously distressed. Looking back, the timing of my going on medication was about as wrong as can be. If I have to advise other patients on starting medication, I’ll advise them to change as little about the rest of their treatment or their lives as possible whilst trying the medication. I was pretty stupid in this respect, going on medication a week before I moved into independent living. Consequently, I didn’t have the opportunity to assess whether the medication worked. Maybe it did, but it is quite likely that, if it worked at all, it kept me just millimeters from falling off the edge of sanity.

I was also quite ill-informed about the medication’s side effects. The medication I was prescribed was Risperdal, an antipsychotic known for its metabolic side effects (ie. weight gain, risk of diabetes, etc.). Though I didn’t get any of these side effects as far as I knew, I did develop palpitations. The prescribing psychiatrist brushed this off, saying it was probably stress. Could be, but I’d never had this symptom before and never had it again. Since I know where to find reliable medication information, I quickly found out that heart palpitations are a relatively rare but very possible side effect from this medication.

Like the decision to go on medication, the decision to change a dose or to go off a medication again, requires cooperation between doctor and patient. Because I had moved a week after going on Risperdal and I didn’t have a psychiatrist in my new city, my GP was prescribing my medication. Understandably, she wasn’t sure how I’d do if she allowed me to quit the medication, so she was hesitant about this. I eventually just told her I was going to quit one way or another, and she recommended a taper schedule. In general, doctors have patients taper in relatively large steps, halving the dose one to several times and then stopping. It is however wise to taper more slowly.

I landed in a mental crisis four weeks after going off Risperdal. It is not known whether my going off of Risperdal caused me to fall off the edge, but I didn’t go back on medication right away. In fact, I didn’t go back for another more than two years.

I currently take Abilify, another antipsychotic, and Celexa, an antidepressant. People on antipsychotics are monitored for metabolic syndrome every six months to a year in my institution. When the monitoring project started, we were also given a long list of potential side effects and asked whether we had them or not. I had some, but not enough to warrant lowering my medication dose. The most common side effects of antipsychotics, other than metabolic syndrome, are movement disorders, like parkinsonism (stiffness and tremors similar to those in Parkinson’s Disease) and akathisia (severe restlessness and urge to move). There are medications that can counter thse side effects, particuarly parkinsonism. I don’t take any of these medications. However, it is very important to carefully consider the dosage of the antipsychotic and medications against its side effects. After all, most people want as few medications as possible, so it may not always be wise to counter each side effect with another medication.

Choosing Happiness In Spite Of Mental Health Issues

I have been reading a book about a woman with Asperger’s Syndrome and bipolar disorder. I have Asperger’s too, plus bordelrine personality disorder, which has some similarities to bipolar disorder. When I was sad because I recognized some symptoms this woman experienced, my husband said that the experiences I described are entirely normal.

This was a bit of a shock to me. Of course, I’m more than my mental illness. I am a woman, a wife, a blogger, a crafter, etc. too. What shocked me was that, in fact, struggling to an extent is normal. It isn’t like, as a mentally ill person, I am always struggling, and it isn’t like, as a currently mentally healthy person, you’re always blissfully happy.

I also read a post on happiness yesterday. In it, the author writes that, in spite of depression or other mental health struggles, you can choose to be happy. I commented (I think the comment is sitll in the mod queue) about a mental health support group on Facebook that is called something like “Mentally Ill People and Supporters Who Love life”. This, plus the realization about certain “symptoms” not being symptoms of a mental illness per se at all, made me realize that maybe happiness has little to do with mental illness.

Of course, depression clouds our minds and people in (hypo)manic states, like the woman in the book, often feel ecstatically happy. But still, you can choose to be optimistic, to be positive in spite of depression. I have in fact met and heard of and read about many people with major depression who call themselves optimists.

Like with any other outside circumstance, we can change our perception of a mental illness. This requires looking at our mental illness as something outside of ourselves, and that takes mindfulness.

It feels a little counterinuitive to see myself as separate from my mental illness, but maybe that is what it takes to choose happiness in spite of my mental health issues. I may have mood swings and feel depressed, suicidal even one moment, angry the next and then joyful, only to go back to depressed. This doesn’t define me, however. It is in fact possible to look beyond the immediate darkness of depression.

My classical culture teacher in high school once said that there is only one moment when you can be happy in your entire life, and that’s now. Having practised some mindfulness has indeed helped me embrace this statement and choose happiness now. If I choose happiness for a minute every sixty seconds, I’ll be happy no matter what happens.

It of course isn’t that simple. Some people more easily find the peace of mind to choose happeness for a minute every sixty seconds than others. This could be related to mental illness, such as major depression often taking over your entire mind. In this sense, the comment in the linked post that you cannot look to medication to make you happy, is only partly true. While antidepressants don’t make you happy indeed – they don’t do that, and it’s nothing to do with how badly yu want them to make you happy -, they do take away the darkest shadows of depression, so that depression doesn’t completely take over your mind anymore. That way, people with major depression will have the ability to actually practise mindfulness again, because, in fact, severe depression does make this next to impossible.

Medications are not for mild depression or anxiety. They firstly do not work that well and may have side effects. In addition, however, when mental illness doesn’t take over your mind, you still have the ability to look beyond it and enjoy your life in spite of it. Cognitive-behavioral psychotherapy works far better for mild depression or anxiety than meds, because it teaches you to choose your thoughts and actions and therby choose happiness.

I have to make a confession here. I have thought of asking my doctor to increase my antidepressant, even though I have only mild anxiety now. I look at those times when I am joyful and wish these occurred more oftne. Now I realize that I in fact have a choice. Anxiety at this point doesn’t take over my mind. If it did, I’d definitely look to medication. This is why I won’t go off my medication, which helped me climb out of the valleys of an unquiet, anxious mind. Medication is there to treat mental illness, and it is quite effective in my case. I won’t say I’m free from mental illness, but with regard to anxiety, for the most part it is mild, more like everyday worry than severe, debilitating madness. I can still manage it if I put enough effort into it. I shouldn’t want a blissful life thanks to my happy pills when I can choose that sense of bliss myself.

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Mami 2 Five

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.

Benzodiazepine Use: Benefits and Risks

A few days ago, I was sent an E-mail requesting I post an infographic on my blog about the dangers of benzodiazepines. The infographic was created by a dual diagnosis recovery center for people with a mental illness and co-occurring addiction. Because it is very much focused on the U.S. situation, I cannot repost the infographic here without further comment. I don’t do that anyway. Instead, I’m also sharing my knowledge of and experience with benzodiazepines, their benefits and risks.

The Hidden Dangers of Benzos
All rights reserved. Attribution: first posted on DualDiagnosis.Org

Benzodiazepines are a class of tranquilizing medications, among which are diazepam (Valium) and lorazepam (Ativan). While they can legally be prescribed for a range of conditions – insomnia, anxiety, panic attacks, seizures, etc. -, the Dutch insurance system limits coverage for benzodiazepines to four conditions:


  • Maintenance treatment of epilepsy or as-needed treatment of an epileptic seizure.

  • Treatment of anxiety disorders, when treatment with at least two antidepressants has failed.

  • Treatment of multiple psychiatric conditions that require use of high doses of benzodiazepines.

  • Palliative sedation during end-of-life care.


Physicians who prescribe benzodiazepines for these conditions, need to add the code B2 to the prescription.

I have used benzodiazepines on several occasions. First, in 2006, I was prescribed a benzodiazepine sleeping pill. It was at the time still covered, but no longer would under the current insurance regulations. However, from 2007 on, I’ve used several benzodiazepines for PRN use for irritability. Whether this falls under the multiple psychiatric conditions rule, I do not know, since I am in an institution so medications are covered anyway.

In 2010, I was on Ativan daily for three months. I was on a moderate dose of 3mg/day. After these three months, I told my psychiatrist I felt I no longer needed the Ativan. He changed the prescription to as-needed and I quit taking the benzodiazepine cold turkey. That truly wasn’t a wise choice. A few days from quitting, I was trembling and shaking. At first, I thought it was the antidepressant I’d started taking three weeks prior, but I eventually realized I was probably experiencing Ativan withdrawal. I spoke to my psychiatrist, who put me on a taper schedule that took several months. Ultimately, I spent almost as long trying to taper the Ativan as I’d been on it.

I honestly never found relief from benzodiazepines. Usually, I slept for a few hours then was irritable again. Then again, it seems that with irritability, the goal is to knock you out, not to really make you feel better. I also learned recently that benzodiazepines should really not be prescribed to people with borderline personality disorder, as the anti-anxiety effect causes borderline patients to be disinhibited and potentially become aggressive. I don’t think I ever experienced this myself.

I tend to develop tolerance to benzodiazepines really quickly. With the sleeping pill I took in 2006, I was given ten tablets that I used up over a six-week period. No daily use at all. Still, the last few pills didn’t really work at all. Please realize that, if you got used to one benzodiazepine, you’ll likely develop tolerance to the next pretty soon too. In November and December of 2007, I was on three different benzodiazepines, with about ten benzo-free days in early December. The first, I got used to within five days but kept taking for a month anyway. Then I had the ten days when I was off benzos – but on a stronger tranquilizer that is really an antipsychotic. Then I started taking nitrazepam (Mogadon), one of the more expensive benzos out there. It worked for about two weeks, but I did use the neuroleptic as adjuvant treatment. By the time I’d gotten used to the Mogadon, my doctor thought it would be time for something other than a benzo, but the psychiatrist disagreed and put me on diazepam. That didn’t work and I quit all tranquilizers at the end of December.

I have not been on any benzodiazepines for about a year now. I took Ativan as-needed until the summer of 2013, but it hardly worked so I now take promethazine (Phenergan), a low-potency neuroleptic. I do not want to be on benzos anytime soon again. Then again, I don’t suffer from epilepsy or a significant anxiety disorder and my irritability is kept relatively under control by a daily antipsychotic and PRN Phenergan.

When I ran the above infographic by some fellow bloggers to determine whether it was genuine, some people told me they did great on benzos. If you’ve suffered from severe anxiety for a time and antidepressants have not worked, I can totally see why you’d try benzodiazepines. If you have epilepsy, something has got to drag you out of a seizure. Therefore, even though I have personally not had luck with benzos, I don’t want to say that benzodiazepines are necessarily bad. I like the Dutch insurance policy, making sure that people won’t reach for benzos too soon but those who need them, can get them.

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.

Was My Hospitalization Inevitable?

I was reminded yesterday about the situation surrounding my psychiatric hospitalization in 2007. I had been put on antipsychotic medication three months prior and had quit taking it again three weeks before I ended in crisis and was hospitalized. Yesterday, when talking to my therapist about this situation, she suggested more or less that being hospitalized could’ve been avoided if I just continued taking my meds.

Really, I consider my crisis inevitable. When I was still taking my medication, I was very irritable; just not irritable enough for the crisis team to intervene and hospitalize me. “But other people don’t like to be hospitalized,” my therapist said, as if by quitting my medication I’d somehow manipulated the crisis team into an unnecessary admission. The thing is, I’d been on the edge of a crisis ever since I moved into independent living. Maybe quitting my medication was the final straw, but is it all that strange that you want help when you’re struggling with meltdown after meltdown after meltdown?

I saw this reasoning all along when I still lived independently. I remember my care coordinator once saying that it was better for me to bang my head against the walls of my apartment, than to go outside and scream. Well, what the bleep? Isn’t a person’s safety more important than the person being a pain in the butt? Besides, it isn’t like I made a conscious choice either way.

For clarity’s sake: hospitalizations aren’t fun. The psychiatrist who admitted me, didn’t do so to please me. In fact, I didn’t ask to be hospitalized, as I didn’t know what I needed really. Hospitalizations happen as a last resort. Long-term institutionalizations are certainly not a choice either. And just so you know, the fact that I’m an informal patient doesn’t change that.

Why did I have a full-blown meltdown yesterday after my therapist asked me to name the pros and cons of asking for help less? Why did I feel offended when she suggested that, with medication, I could’ve been kept at home? Why do I struggle with all this “least restrictive environment” bullcrap that I hear everywhere? I’d like to consider my hospitalization avoidable, and maybe it was if I’d just continued taking those pills. But as I said, I was completely on the edge for all those three months. Apparently, however, intervention is only inevitable if you’re literally (nearly) dead, and if you aren’t, quality of life doesn’t matter. Especially not if you’re also a pain in the neck.

mumturnedmom