Tuesday, May 3, 2016

My mental health treatment experience.

I've shared a bit about my treatment on here, but I wanted to write a post focusing on exactly what has helped me get better since my treatment has been a bit unconventional and I'd like to share about the things that have helped me in case there is anyone else they might be of use to. Of course, treatment is different for everybody, and what works for one person might not work for another, so these are just a few possibilities among many. I hope that more research will be done to develop even more forms of treatment of ways to make them as accessible as possible to people in need.

I guess I should start by outlining my progression of treatment. Let me first say that for a very long time I resisted getting any treatment for my mental health issues. I was depressed starting at the end of sixth grade. Something just changed inside of me and I abandoned my friends, kept to myself, wrote a lot of disturbingly angsty poetry, and was regrettably curmudgeonly with my family. I also suffered from general and social anxiety starting in childhood. I can pinpoint it to first grade, when I had a particularly nasty teacher and unsettling school conditions that triggered my anxiety to emerge, but I would imagine that I also had elements of anxiety issues even before that. I also had my first panic attack in mid-elementary school.

So I grew up knowing I had anxiety disorders and I had some awareness that I might be depressed, though I assumed that it was part of being a teenager, but I never sought counseling or anything. I don't really know if I realized that that was an option. When I was probably ten though, my mom found out from a friend about a vitamin supplement called Inositol, which helps with anxiety. My mom had me take this off an on in my adolescence and beyond (I'll talk about it more later). But for a long time that was the only treatment I really had.

In college, my anxiety and depression still remained a struggle, but I was hesitant to go to the school counseling center, maybe because of my fear of new situations. I went once in the spring of my freshman year after a traumatic incident, but I didn't like that way the counselor I saw treated me so I cancelled my appointment to return. In my sophomore year, a friend of mine who also struggled with anxiety started going to one of the school counselors and shared with me that she really liked the woman. I began to consider trying counseling, but I went through an extremely stressful time where I stopped sleeping because of nighttime panic attacks, which really took a toll on my physical and mental well-being. I became overwhelmingly depressed and suicidal. It was this that made me realize that I needed to get treatment. My mom scheduled me to see the psychiatrist who had treated other people in my family who had panic disorder, but I had to wait until I went home for spring break to see him. That was one of the longest waits in my life.

Being forced into getting treatment for an emergency situation made me acquiesce to the idea of getting treatment for my longer-standing issues. I had been resistant to going on medication to help my anxiety even though it made my life miserable, and I still was very hesitant, especially reading those awful potential side effects listings. I was scared. I was worried about gaining weight, developing some condition or another, dying, or what have you, and I was resistant to the idea of needing help. I was open to seeing the counselor, but was too stressed to arrange to see her until after I came back from break, finally rested and medicated.

I saw the psychiatrist and received a prescription for a very low dose of Klonopin, which I still take (at an even lower dose than before). Oh, I don't think I'll ever forget the beauty of falling asleep that first night, laying my head down and conking out and sleeping through the night for the first time in a month. Such peace and sweet relief! Thank the Lord for modern medicine. I had tried a number of other sleep aids and exercised an hour every day in spite of my extreme fatigue but nothing had worked. It was definitely a chemical inbalance and my adrenaline hormones misfiring and producing too much adrenaline at the wrong times. I don't know what I would have done if I hadn't been able to get medical help...I was absolutely ragged and batty. It was worse than insomnia (which I've also had at other times in life) because I wasn't just not sleeping, I was filled with anxiety chemicals giving me be jolts of anxious adrenaline when I wanted to sleep. So I leave the medication skeptics with that,

I had decided that I should also go on medication to help me with my anxiety and depression problems, an SSRI (the most common form of antidepressant medication), but my psychiatrist was reluctant to start something at the same time as the Klonopin, and I was going to England a week after I finished classes. So I began on Paxil when I got back from the trip. I actually couldn't even swallow a pill at first, but quickly forced myself to learn due to the ridiculous price of the liquid Paxil (no small feat!) It took us a year to figure it out, but it turns out I am actually not able to process/tolerate SSRIs or most antidepressants. I thought I was getting better though, perhaps a placebo effect sort of thing and a situational thing because I had a good summer and was pushed out of my social anxiety boundaries by my job. But I began sleeping ten or twelve hours a day and I recognize now that it was probably because my body was having a bad reaction to the SSRI (this is a rare condition, so please don't let it deter you from taking an antidepressant as they have been a tremendous help to many people, just be sure to consult a medical professional, keep in touch with them, record your symptoms, and talk to your doctor and cease taking the drug if things become worse for you! Even better, have your psychiatrist administer a genetic test to see how your body processes different meds before you begin taking any...it will save you a lot of trouble and possible harm.)

I became depressed again starting over the winter break of my junior year. I continued to see the counselor at school, which was both helpful and unhelpful, even hurtful at times. I tried to go off of my Klonopin because my counselor advised me it was highly addictive and I should try to go off. My psychiatrist weaned me off over the course of a week - a terrible practice if one is well, even worse if they're better. Weaning off of any medication, I've learned, should be done over a month or so and my depression was made worse during this time by my psychiatrist putting me on and off of medications with very short adjustment periods. Don't let a doctor do this to you!

I had a horrid physical and emotional reaction to going off of the Klonopin (shaking visibly, emotional breakdown, etc.) so my psychiatrist had me go back on it. I cycled through a variety of medications during this time, remaining on the problematic Paxil all the while. Wellbutrin was one addition. Much later he tried Lithium in hopes that it would increase the potency of he Paxil. Nothing worked and some things made me worse. I went through the worst physical and emotional depression in my life and was absolutely debilitated, crawling through the semester, even going home for half a week and having my mom take off to come up at another point. It was really awful and I continued to feel bad even after returning home for the summer. My psychiatrist switched me from Paxil to Zoloft and I stayed on that for a couple months, along with the Lithium for a while. I slept at least ten hours a day still, waking up between 11am and 1pm and often still needing to take another nap. I began to gain weight, just like I had feared, probably fifteen pounds at first...in the whole of that year, I think it ended up being thirty (this for someone who had been about the same weight ever since I stopped growing). I also had another nervous breakdown in the fall after doing half a semester of school.

I also had a genetic test done that summer after my junior year from hell. A company was offering them for no fee to the patient for a month as a promotional, so my psychiatrist recommended I have the test done to find out which medications my body is and is not able to process. This was a real Godsend. All it required was a quick cheek swab that was sent off to a lab for testing. The results revealed that I have some particularly picky genes. SSRIs and most major antidepressants were deemed inadvisable for me to take. Haha. Too late for that. For some reason, my psychiatrist kept me on the Zoloft in spite of this, while he struggled to figure out a new plan of action. He did put me on a supplement called Deplin, which is a material your body makes (if I remember correctly) to process the chemicals that SSRIs are meant to replace that people with depression and anxiety don't create enough of. It was hoped that this would help me start processing the SSRI. It had little effect. I visited my GP to have testing done to make sure I wasn't dealing with a thyroid problem but the tests came out all clear.

I went to the psychiatrist for the second to last time and he flipped through my file with a furrowed brow, before announcing that he wanted to put me on a new antidepressant, one of those ones you see the commercials for, and while it wasn't an SSRI or one of the others that had been marked a definite no-no for me, I was fed up with the medication game and had some trepidation about starting a new one. The psychiatrist agreed that I should go off of the Zoloft (it was the only thing I was still on besides the Klonopin at this point), but continue taking the Deplin since it's something he body needs to produce and my body was found to not make. This time he had me wean off of it over the course of a month. It was not an easy time. The doctor had also told me about an off-the-shelf supplement called SAMe that was another substance the body makes naturally that people with depression are found to produce less of. He named this as a possibility that had helped other clients of his. He also pushed me to see a counselor, which I knew I needed to do but was putting off because of what a stressful, expensive process it was.

I decided to find a new psychiatrist, disillusioned with the realization that he had kept me on a substance that was causing my problems and that he had been taking me on and off medications at rapid rates in the spring. It was hard to realize that my issues in the spring had probably been mostly the fault of the medication I took to help my problems. Of course, I hate to tell people that my medication made my problems worse because there's already so much stigma against medication and I've had so many friends who were suffering under the weight of anxiety and/or depression but refused medication as an option. I'm glad that I was finally pushed to seek help. I'm glad I sought counseling and medication. I'm glad my mom encouraged me to do so. And even though it was a treacherous journey, I survived, came out stronger, and was forced to seek help that I wouldn't have otherwise. I see so many people struggling through life with unhealthy coping mechanisms and stressful lifestyles, tolerating their unhappy state or illness, insisting that they can bear it on their own because they are afraid or reluctant to or too busy to. I'm glad I was forced to learn how to live a healthier lifestyle and to find supplements to help my anxiety.

I decided, at the suggestion of my mom, to go off of the Zoloft and see how I felt, then try the Sam-E. We both felt my body had been through too much, going through all of these medication changes, and it needed a break before I tried a new treatment. I despaired of things ever improving, but they got better first with my being off of the Zoloft, then improved with going on the Sam-E and Inositol. I am now doing remarkably well. I don't think I've felt happy in years and years. I don't feel tired all the time either. It's nice to be able to do things and have hope for a successful future. I wish everyone could feel as I do.

Here's an overview of the things that helped, just as a reference:

  1. Art therapy / counseling: I began seeing an art therapist late last fall. Finding a counselor is really hard, but I encourage people not to give up, to remember your happiness is worth the price, you deserve the help, and to trust your instincts. I learned about art therapy in a psych class I took at college and was intrigued by the idea. I had found traditional counseling kind of stressful so it's nice to be able to have a project to work on while I talk with my counselor (or not talk, if I choose). It's also made me look at my issues from a different perspective as I delve into making an artwork to represent them. And I've learned to have more grace with myself; the art doesn't have to be perfect, I can be positive about myself, and I can give myself credit for my accomplishments. I recently started to meet every other week instead of every week b/c I'm doing better and have a busier schedule, but I wish I had allowed myself to go to more often than once a week when I really needed it. Counseling definitely has its limitations, but it is definitely beneficial as well, particularly in helping you reframe the way you perceive your life and self. My counselor helped me learn to say no to some things and limit stress in my life and allow myself to be in recovery.
  2. Inositol: This supplement has been proven to be as effective as medication for some people. The nice thing is that it's actually a B vitamin taken from rice, so for people uncomfortable with going on a medication, it's an easier first step to treatment, and can be equally effective. It mainly helps with anxiety and comes in a pill or powder form. I get it from iHerb.com (though, disclaimer, I wasn't paid to endorse it). You can mix the powder into liquids. The tricky thing is remembering to take it and going through the effort of putting it into the liquid or swallowing a buttload of pill capsules (they're on the larger side too, fyi). But it's cool stuff otherwise and has a lot of research supporting its effectiveness. I definitely notice an increase in my anxiety levels if I forget to take it for a few days. Also, I haven't noticed any side effects.
  3. SAMe: Also a supplement. It can be bought off the shelf in stores like Costco and possibly Target. The name is short for S-Adenosyl Methionine, which is a chemical that people's bodies naturally produce but that some people who suffer from depression may not produce enough of. SAMe, to quote the package, "is involved in numerous biochemical reactions in tissues including liver, joints, and brain. SAMe is also required for the biosynthesis of critical neurotransmitters and hormones." Basically, it's a natural supplement that can help some people who suffer from depression improve their mood and cognitive function. It has worked very well for me and on days when I forget to take it, I notice that my depression symptoms will come back significantly. I wish my doctor had recommended it before I tried psychiatric meds. I haven't had any side effects with this. It should be noted though that you must be completely off of antidepressants before taking this and it should be taken in the morning on an empty stomach. I take 600 mg a day and it has helped me a lot!
  4. Deplin: When I took the genetic test I mentioned earlier, I found out that my body also didn't produce enough of something called an L-methylfolate which helps the body to process the chemicals that antidepressant medications try to supplement. My psychiatrist prescribed a supplement called Deplin that provides your body with this natural chemical that my body does not produce enough of. You have to order it from a company but if you suffer from clinical depression and find that medications don't work well, ask your psychiatrist about this.
  5. Time: My recovery and treatment process just took a lot of patience and time! I'm still processing things that happened to me a year ago and I've learned to accept that and let myself continue to experience the emotions that reminders of the past can bring up. On a physical level, even when I finally went off of the medication that was making me so sick, it took over a month for it to get out of my system so I could stop experiencing the negative side effects. Have patience with your body and yourself and have hope! Even if something isn't working now, doesn't mean you won't find something that works in the future. Six months ago I thought I would never get better or be able to finish college, but now I'm back in the swing of things and looking at applying to graduate school!

These are the three major components of parts of my treatment that actually helped me recover. I would also say that rest, taking a break from school, writing on this blog, and giving myself room to be sick were also significant helps, and I wish I had done more of each. I should have relaxed more and not tried to go to school last fall while I was still recovering. I wish I had been easier on myself and accepted that I needed time to heal. I also wish I had stayed in better contact with my mental health caretakers and asked for more guidance about how I could contact them outside of regularly scheduled appointments.

People always advocate exercise but I was much, much too tired and I kind of hate exercising. Maybe it would have been beneficial but I wouldn't encourage pushing yourself too much especially since it's easy to develop anxiety, obsession, and guilt around exercising. Also common is pushing people to volunteer or be involved in the community. I tried this but just ended up being more upset and stressed because getting involved in volunteering has turned into a stressful process of applying, even interviewing, and training nowadays and organizations aren't always very courteous with volunteers. It was also awkward to explain my situation to people. What helped me more was crafting. I would recommend taking up a hobby if you're looking for something to do. Websites like Pinterest and Craftsy give online training so you don't have to go through the overwhelming process of going to a class. But overall I wish I had just given myself permission to take a break and read or watch TV or sleep. Sometimes you just need to recover and take your mind off of your difficult thoughts.

So my main message is this: Don't be afraid to seek help if you are feeling more and more burdened by daily living! It may be a long process, but there is hope! There are also alternative treatments that people may not discuss as much, so if mainstream treatments are working for you, ask your psychiatrist and counselor about other options or look into them yourself! Also, if possible, get outside support and let trustworthy friends and family know what's going on in case treatment gets more painful than helpful. It helps to have an outside perspective you can see how you've reacted to different treatments and who can give you courage to walk away from a treatment provider or method that isn't working for you. But know that there's nothing wrong with getting help and you deserve to live a happy, healthy life!!

Disclaimer: I did not receive any sort of compensation for any of the things I plugged in this post and I was not asked by anyone to write this post or mention any of these products. Also, this is solely MY OWN treatment experience. Everyone is different and has a different chemical make up so the treatments that worked for me may not be helpful for everyone and may even be harmful for some people, which is why you should always consult a trusted, qualified health care provider before starting any kind of mental health treatment. 

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