As I lay hooked up to my IV for my last infusion, my mind drifted to the inconvenience of taking both psychiatric medications and medications to counteract the weight gain, high blood pressure, and high cholesterol. I am now facing a bigger challenge, which is to balance out my thyroid hormone that my body no longer produces after the removal of my gland with cancer. In order to feel anywhere close to normal, my endocrinologist has to find the right dose of Synthroid. I have to take this drug every morning, half an hour before eating or drinking anything besides water. It is easy to be afraid and ask why me? Is it normal? Am I crazy? I know when I was a child taking Risperdal and Paxil, I asked myself these questions. I recall being nine years old, the first time I tried to swallow Risperdal, I felt a horrendous taste towards the back of my throat. The taste was so bad that my mother came up with the idea of taking the whipped chocolate nougat filling from inside a three musketeers bar and wrapping it around the tablet so that I didn’t experience that taste. At the time, when I thought of mental illness, I thought of characters created by William Shakespeare, Charlotte Bronte, and Emily Bronte, who get driven to insanity. After more than twenty-five years of learning about myself, I realize that these characters were created prior to the twentieth century and are based on a limited body of knowledge about mental health and the science that’s out there keeps people in my situation on their feet.
A number of my childhood friends were diagnosed with autism as children and were pressured to take Risperdal as a first step towards helping them be less irritable. Like me, they became tired from the side effects and eventually ended up taking Abilify to lessen the side effects. Contrary to what people may think, this is not a trend that was as simple as psychiatrists not understanding that there was a spectrum. My generation just happened to be in elementary school when Risperdal was approved for treating irritability caused by autism. Abilify didn’t become popular until I was in high school by which point my mood was stable enough to keep calm while other students were causing trouble, but staying energized all day was much harder. My childhood psychiatrist was reluctant to switch me from Risperdal to Abilify due to the mood swings I’d had, but my mother, who was getting her doctorate in Clinical Psychology at the time, persuaded my psychiatrist to give it a try.
With Abilify, it was much easier to work hard and study. Eventually, I got my Bachelor’s degree in Cinema and Photography from Ithaca College in upstate New York and shortly after I came home, I got my Master’s degree in Integrated Digital Media from New York University. These felt like the most productive years of my life. When I was just out of graduate school, however, at the age of twenty-five, I was struggling with bipolar disorder, but it went undiagnosed. I learned the hard way that maintaining the metabolism that I had as a teenager and being able to continue eating loads of junk food without gaining weight was unrealistic as was being able to avoid taking medication that didn’t cause some degree of weight gain.
Things spiraled out of control to the point where I found myself in a psychiatric hospital for the second time and was instantly put on an extremely high dose of Zyprexa. Not only did I suffer more fatigue and weight gain than with any other medicine, but I came out of the hospital with a terrible case of depression, which made it difficult to try to form good eating and exercise habits. While there were some improvements when I found my current psychiatrist and he was willing to try me on Abilify again, I fell back into a deeper depression five years ago while switching other medicines to prevent kidney failure. As a result of these twists in my health, I switched from Abilify to Seroquel, an antipsychotic known for its effect on bipolar depression. According to my psychiatrist, Seroquel is the best medication out there for bipolar depression. The drawback that he acknowledges to be true is that there is currently no antipsychotic that is highly effective at treating, mania, anxiety, and bipolar or unipolar depression.
Judging from my own experience with the mildest of mood stabilizers, I have to trust that is the case. Although I felt better and was able to make healthier choices after I started Ketamine less than a year later, I became more irritable, more sleep deprived at times, and more vulnerable to feeling manic on a much milder level. My psychiatrist would say that taking any combination of two antipsychotics would increase fatigue. Last week, however, I explained to my psychiatrist that I felt like Seroquel and Ketamine were doing amazing things together for depression, but that if I didn’t try a small dose of Abilify or something like it, my anxiety and irritability would get out of control. He then agreed to the unconventional decision to reduce my Serouqel by a small amount and add the lowest dose of Abilify to see if it’s effective. So far, I feel like it is. Each radiation appointment feels tolerable as much as I eagerly await this to be over. Whether you’re a psychology student or a patient with a dual diagnosis, self-advocacy and suggesting unconventional approaches can be scary. I recommend a humble approach because some doctors are too trusting and others are too stubborn. I’ve got one that is cautious but aware of both of my conditions.
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