Internet Doctor, With Honors

I read it on Google…. WebMD said…. My friend thinks I…. There’s a girl in at school/work/the gym…

This is how we diagnose ourselves. It’s slightly terrifying. It’s even more terrifying as many folks stroll into their diploma-ed doctor’ offices, armed with information pulled from non-diploma-ed sources and present their symptoms on a here’s-some-bias silver platter. Already stretched healthcare workers are left to quickly decide whether to go with the patient’s own diagnosis or to dig past the muddied presentation. I don’t think that’s how it’s supposed to work. This trend has been on my mind lately as I’ve heard from numerous diploma-ed sources that 2020 was the year of Write the Script. Maybe not numerous. But definitely a handful. Six months ago, I was like Heck, yeah, give those people all the drugs! Whatever it takes to get through this shit show of a year (dear WordPress, stop trying to autocorrect shit show when I reference 2020). But as the mud doesn’t seem to be clearing, the more uneasy I feel about that approach. For selfish reasons? Yes. There was a major shortage last year on an anxiety drug I’ve been taking for years. I was really pissed. Shouldn’t those of us who had anxiety before it was hip get priority seating in the pharmacy line? It’s like all those folks cleaning out the paint aisle at Michaels. Hello, I was an arts and crafter before we all had to stay home…can we not make a special section for new people to fight out the supply and demand issues?

Right. Back to the drugs.

This is a topic I thrive on due to experience. I’ve always been fairly up front with the mental health challenges I’ve had over the past gazillion years – times pegged as far back as grade school where I had spouts of anxiety (I was 100% sure the Russians were going to nuke us when I was in fifth grade). Now, nearing fifty, I am sure I’ve come to the other side of the mountain – the side where I’ve got it mostly all figured out – I know all the feels, what they mean, and I have developed a great management skill set. It wasn’t always like that. I spent a lot of time ignoring the suggestions of those around me to gain those management skills – ignoring them because I’d been conditioned to just head on into the doctor’s office and grab another prescription. It took the responsibility off of my plate, after all, if I could point to a pill not working or follow up a lashing with yeah, but I have (insert diagnosis).

I spent the first half of 2020 coming off several drugs – right when so many others were hopping onto them. Speaking of crazy, right? Rolling into a pandemic with a to-don’t list that would likely only make mental life even more difficult? But the process of doing that (and it was a long one) made me realize how far into the trap of happy-script-pads I’d fallen. A very common case of Oh, you feel nervous? Take this for that. What? Now you feel dizzy? Okay, take this for that. It gave you a rash? Take this for that. Now you’re not sleeping well? Take this for that. And so on. This isn’t special to mental health. Part of working through my mom’s extended summer vacation (see How I Got Here) was understanding the long list of medications she was on – and how many of them were band aids for symptoms caused by another.

One night at the end of 2019, as I was about to down a handful of pills before bedtime, I looked at Rich and said this cannot be right. In my hand at that moment was 100mg of Trazodone, 3mg of Lunesta, 2mg of Clonazepam, and 15mg of Melatonin – all aimed at getting me to sleep. In summary, that’s a shitload of drugs – enough to put a horse into a long slumber. I knew I had to do something or I would continue on this path of adding and adding and adding to the handful – and I had finally reached a point in my life where I felt like I could suffer through the withdrawal that I’d always heard so much about. And suffer I did. Or we did. It was a team effort that took nearly a year. There were many nights where I laid awake reading until dawn. There were several nights where I’d wake Rich up as the panic set in – and I’d let him hug me while I told myself over and over that this was just the drugs leaving my system – putting up a world class fight on their way out.

As a reminder – these were all prescribed to me. And those were just the nighttime drugs. By one doctor. With a degree in psychiatry.

It used to be that SSRIs (now I feel like I need to provide definitions) were meant to get folks over an emotional hump. I’m not sure when that changed – when it became a thing that once you started taking them, you could just consider it part of your life. Or has it changed only for females? I’ve noticed that when Rich needs a booster, he only gets a month’s supply – as if his doctor has zero intention of it being a long term solution. And, yes, I know – for some people that does work. I am not one of those – and I know this because of the super thorough testing I finally had done a few years ago. Still, I often think back to the doctor who first prescribed Zoloft to me and wonder why he never suggested it as a way to get over the emotional hump I’d run into. I began taking it after a string of panic attacks sparked by both my parents’ move and a weird phobia of driving brought on by a full blown meltdown somewhere on 95 South. I was heading to a family camping trip, turned around, went home, rang up my primary care doctor (this was back in the landline days), and told whomever answered the phone what had happened. One phone call and I had a prescription waiting for me at CVS. I had no way to research it. I didn’t know I should. It was 1995 – I was 24. I’d just figured out how to boil noodles – researching a whole drug category would have never crossed my mind. That wasn’t my job, right?

What followed was decades of different prescriptions to hold back the same ongoing issue, though it was given a different name from just about every doctor I saw. Depression. Panic Disorder. Personality Disorder. Obsessive Compulsive Disorder. Bipolar II. And, finally, Anxiety. The last one came after someone finally suggested some actual testing to nail down what was going on. I remember sitting in that doctor’s office thinking oh my god, there are actual tests for this? Because I’ve just spent 25 years feeling like a guinea pig to big pharma. The catalyst for that testing was my husband. I came to him with a pill sorter full of Bipolar meds. And, Rich being Rich, he did a bunch of research on Bipolar which he stuck in the back of his brain until he finally felt comfortable saying so….here’s the thing…I’m like 150% sure that is not what you have. I did not take that well, this attempted removal of my effed-up-brain badge. But the more he explained (in a very kind and caring way), the more I realized he might be right. And while it was a bit rough to admit to him that I was diagnosed by a one-sheet, I finally agreed to see a doctor who could do a bit of a deep dive. In other words – one who would not hand me a page from a Power Point they’d gotten at a seminar and ask any of this feel like you? Which is how I got my Bipolar diagnosis.

Here’s the thing – for those of you who have never had to seek mental health help – when you sit in an office at your emotional wits’ end, ALL THINGS ON ALL PAPERS feel like you.

About a month later, I sat in the tester’s office again, with Rich, and read a very long report that essentially said you are not bipolar or depressed or OCD or, or, or,…where you fit is within the anxiety spectrum…and also…all those meds that have been in and out of your live for two decades?…they didn’t work because they were not treating the correct pieces of you that needed a tweak. It was actually devastating. What? Shouldn’t I have been relieved and elated? I was actually sad. I felt like I’d lost all this time to feel normal-er in lieu of a string of try this, try that, try this, try that. I’d run around with this label for so long that I felt like I needed to make an announcement of apology to everyone I knew. And what about all those accolades for working through it? Holy faker! I mean, at that very moment, sitting in that office, I was loaded with Latuda – so much so that I had uncontrollable twitches. And I didn’t need to be? And no one thought that was odd? No, because, obviously, you can take a different pill to help with the twitches.

As I started the long process of coming off the wrong drugs…I began logging all the others I’d been on. I was just curious to see what a list of mis-diagnoses looked like on my Caremark card. Abilify, Ambien, Busparione, Celexa, Citalopram, Clonzepam, Depakote, Diazepam, Lamictal, Latuda, Lexapro, Lithium, Lorazapam, Lunesta, Paxil, Pristiq, Seroquel, Topamax, Topiramate, Trileptal, Trintellix, Wellbutrin, Xanax, Zoloft. Those are just the ones that I can remember. I am aware of the strides in mental health care and that the knowledge and treatment of it is night and day in 2021 compared to 1995. I appreciate the uptick in studies and new options and the okay-ness of being able to say give me a minute, I’ve got the anxiety sweats and I just need a quick pause. But I also know that there is a current trend of allowing patients to self-diagnose, through no fault of healthcare providers, because the American Psychiatric Association has taken a tone of just go with it…when patients enter doctors’ offices. Have I mentioned how terrifying that is? When you combine that new umbrella treatment plan with, well, everyone’s ability to find symptom supporters via the internet? We have started walking a very dangerous line.

This stuff is hard to come off of. The little pill that you’ve been prescribed to get over that emotional hump? Stopping that little pill kicks off an even bigger hump. The mild anxiety you felt before you began a quick test of a mood stabilizer? It’s nothing compared to the I am just going to lay on the floor and weep feeling of getting it out of your system. We are doing ourselves a huge disservice by allowing the internet to be our doctor – directing our treatment plans and then getting locked into these internal drug wars. We are killing our ability to work through difficult times organically – to experience our emotions, recognizing them and finding the joy on the other side of prevailing. This is especially true for our children – so many now armed with a prescription to start the day, chased by a Flintstone vitamin. How will they learn to recognize their anxiety? How will they learn to manage depression? How will they learn to control their mood swings if any ups and downs are removed via a milligram here or a milligram there. The kicker is – many who do try to come off the drugs end up on a higher dose when they slingshot backwards via the withdrawal. And we allow it.

I do get it – 2020 has been a shit show. In our household, we are experiencing our thirty-second round of pandemic fatigue. The uncertainty of our country’s political situation is not helping. None of this is to say that if you feel you need help, go get it. Let me put that in bold real quick so nobody yells at me. If you feel you need help, go get it. But, go. Keyword there. GO. Stay off the internet, avoid a social circle summary of your condition and go. Go with symptoms, not with your own treatment plan. Go with questions – what are all of my options, what is the plan for coming off these little pills, am I alone in these feelings, who can I see for guidance on management techniques…choose your own road, but don’t show up your own asphalt.

For me? I’ve been on a consistent cocktail for nearly three years now – the longest ever in 25 years. That tells me that we’ve finally gotten it right – imagine that? And by cocktail, I don’t mean handfuls – just a bit of a booster to keep the bugs at bay. I’m extremely proud of how that test and tweak silenced nearly all of the extreme ups and downs of previous years (likely accentuated by incorrect meds) putting me in a place where I believe I could, possibly, maybe, think about dropping down even further assuming the right approach is put in place.

Which I will save for when the shit show is over (you’re welcome, Rich).

On a side note… yes, find yourself a Rich. Someone who is willing to put in the work with you – holding your hand, offering hugs, digging through the research and believing in you during those times when you sure as hell do not.

And if you can’t fine one – sign me up.

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