On Being Crazy and the People Who Stand to Make Money from This Situation

CptHamilton

So this isn't a "hey, diagnose my problem for me, Internets!" thread or anything, but it's about mental health care. I'm pretty sure this is inside the rules.

Long and long ago I posted on here for help getting therapy. Various things were tried. Jobs and insurances were lost and gained. Finally therapy was achieved, followed my psychiatric recommendation, followed by drugs, followed by FREAKING THE FUCK OUT.

Now, it's possible that I was always just fucking off my nut. I went to the therapist for moderate to severe depression and mild to moderate anxiety. I got put on a drug (I'm not going to list what ones or what dosages because that isn't the question here). It helped a little. I got some more of that drug at my request to see if it could help more. It did fucking miracles for about a week, then I had a psychotic break. Full on catatonia (the thrashy kind, not the snoozy kind), delusions, hallucinations, loss of speech. You name a psychosis symptom, that's me.

Things were tried. Therapists therapized. Psychiatrists and GPs prescribed, un-prescribed, re-prescribed, and varied dosages.

I'm currently well off of drug #1, as well as being off drug #3 that precipitated the suicidal thoughts (not actions or urges; no worries, gents, I'm not topping myself and I've informed all of the appropriate personnel on this so don't feel compelled to urge me to the ER or anything, I'm just saying for sake of clarity here). Drug #4 helped with the new anxiety and nervous tics but seemed to be inducing a greater tendency toward delusion and hallucination. Drug #5 I was told by my walk-in psych consult "Oh it's fine, very mild, no worries, give it a shot." I was then told by a pharmacist, "No, this is strong shit with serious side effects" followed by another pharmacist saying, "No no no, don't take that under any circumstances your brain's ass will be fucked for life with relative certainty" and another mental health professional saying, "Mrrmmmehhh... probably not. Pass if you don't want to risk those side effects."

So right now I'm on nothing. The bad thoughts (suicidal, delusional, confused, etc.) are still there. They go up and down in intensity and I'm not drug-free long enough to say whether it's for sure all down to a series of drugs with psychosis as a potential side effect or not.

I go to New Psychiatrist #3 and set up New Therapist, 'cause I couldn't handle the old firm's attitude and Old Therapist is a nice lady who is out of her depth with my brain problems. NP#3 says, "Yeah, well, maybe, I dunno. I mean, not really but okay." to my protests against Drug #5. Do I need to be on anti-psychotics? Maybe so, maybe no. Could all be drug-induced, we really can't know without waiting it out, but we can't wait it out 'cause you're fucked in the head right now. She gives me options. Drug #6a or #6b. 6a is like 5-lite: more anti-psychotic, just a milder one with less chance of making my tongue stick out of my mouth forever or my feet fall off. 6b is the new juice; I'm not really sure what the fuck it does besides hopefully let me sleep through a night and maybe even out my moods. It's a mood stabilizer of some sort. I won't know exactly what sort until I get my hands on the drug info packet.

So cometh my actual question for Help and/or Adviceing on:

Who the fuck can I ask what to do here?

I say this because I've gone through 6 licensed medical professionals whom I am paying to help me at this point and every one of them has either not had an answer, given me some variant on the "no magic bullet, but here's six things we could try dosing you with" speech, or flat out lied to me (mild, pleasant side effects my ass). I have a network of friends and relatives who are in the medical and/or mental health fields whom I can ask for advice, but all of them have biases. Variously: They don't want me to be crazy-go-nuts. They have a bias against certain classes of drugs. They think that Big Pharma is conspiring with the providers of America to over-drug us all.

I can ask the dude at the drug store in the white coat, but I know some of those white coated drug store dudes. I mean no disparagement upon them or their profession, but I feel like I'm tossing dice on whether any particular one is qualified.

Who can I ask if I should just stop taking drugs and see if I go back to the depressed, anxious dude I've been for most of my life, or if I need to keep riding the psyochotropic merry-go-round in the hopes that something fixes my shit? The pharmacists are maybe not qualified. The providers are almost certainly biased in favor of giving me drugs. The therapists aren't qualified. The friends and relatives maybe can't be trusted in this case. I can't trust my gut because I literally have a guy in my head who is giving me advice. It's good advice of the "Dude, put down the fucking pills and get someone else to measure you a dose 'cause you're fucked in the head right now" variety, but he's still a hallucination. For all I know all of my concerns here vis-a-vis prescription-grade psychotropics advice could just be paranoia induced by my (drug induced psychosis | actual mood/mental disorder).

This isn't just a "try it and see" situation because both branches of the Pants of Destiny here may have carnivorous weevils in them. No Drugs could lead to my experiencing serious and worsening psychosis if I have a legit disorder and this isn't all participated by medicines. Yes Drugs could lead to permanent, adverse changes in my brain chemistry. We are outside of Paxil and an Ambien territory here.

So: I don't want you, Internets, to diagnose me. I don't want you to tell me which drugs I should or should not take. I want you to tell me how to find out what's right for me. Advise me: am I being paranoid? Help me: what real, qualified people that I haven't talked to--or have--can I talk to?

Librarian

How long have you been off the meds? How bad do you feel right now?
If your current condition is a possible side effect of previous meds, how long do you think you can ride it out to see if things get better? Do you think you can hang in there a bit longer?
If yes, you might want to see how things turn out first.
If not, you might not have much choice in the matter.

One thing about the whole psychiatry/psychology business is, that it is not an exact science like mathematics or physics. It is absurd how different practioners will swear on different techniques and medications, some not even scientific at all(stuff like NLP).
They just like to pretend it is.
So the only thing you CAN do is probably get as many opinions as possible and then decide on the matter.
IANADoctor, but I know that people in the US are heavily biased towards therapy and medication, people will suggest it in this forum for every little thing, but you can not blindly trust every psychiatrist, so I understand your reservations.
But your situation sounds very severe and you need help, is a prolonged stay in a mental health clinic an option for you?

EDIT: To clarify, I am absolutely not against medication for mental health issues, but I completely understand how you would be scared by a new med that might be potentially harmful and that several pharmacists warned you off.

CptHamilton

How long depends on the med. I've been on a number of things. Some of them long enough that they are no longer in my system, other stuff not. The only thing that's probably still floating around in me is Valium. I've been off it for about two days, which isn't long enough to tell anything with Valium since its elimination half life is like 100 hours or something ridiculous. But then my symptoms are incredibly rare as Valium side effects. Of course, I have a tendency to experience every negative side effect of every drug I take for anything, so.

Yeah, I know people like to over-therapize and over-medicate. I did genuinely need to do something about my depression and anxiety issues before I started this whole road. Just therapy maybe would've been enough but I was willing to give what was meant to be a fairly standard, safe (as psychotropic drugs go) medication a shot. My bad.

I also know that it's not exact. I mean, everyone I talk to tells me so. Which is really why I made this thread: there seem to be no hard answers and I'm a guy trying to make important decisions whilst in the grips of an anxiety disorder. Fuck me, right?

I'm not at the inpatient stay point right now. A couple of episodes I've had probably would have justified a hospital visit but the circumstances made that impractical and I pulled out of it okay. I know I sound batshit nutso in this thread because I'm here talking about all the things that are wrong with me, but I'm actually pretty functional right now. Back at work, driving myself, the whole deal. I'm not an imminent danger to myself or others, so hospitalization would be kind of an overreaction. If it were necessary then yeah, it's a thing I could do.

I don't know how long I could ride it out. I mean, it depends on how it turned out. I have days when I'm basically fine and nothing outside of what's going on inside my head and some uncharacteristic behaviorisms would give away that there's anything wrong. Other days I have attacks and I'm completely non-functional. Those seem to be basically going away as the more neuro-chemically active stuff leaves my system. My current psychiatrist recommended a sort of low-dose mood stabilization, wait and see plan. That's okay with me and I'm fairly comfortable with it. But I've become paranoid that this new 'low-dose mood-stabilizer' is anything but, hence my dilemma.

Librarian

Nah don't worry, you actually sound very precise in your assessment of the situation.
You should not worry about the new low dose med before it comes to it, just check if the medication you will be getting is really relatively harmless, like your psychiatrist tells you,
Valium is a benzodiazepine, as you surely know already and withdrawal can be pretty heavy, depending on how long you took it. That might also explain anxiety attacks and the like. So maybe it really is a side effect of that?
If you are currently able to function during the day you really should not worry too much, unless you notice things are getting worse.

CptHamilton

I don't really want to get into attempts to determine what is or is not a side-effect or withdrawl effect here. No offense or anything, but it's the internet. Plus I don't want to break H&A rules and I already have peeps with letters after their names to do that for me.

But thank you for the advice. It's good to hear that I'm being basically coherent and not making a mountain of a mole-hill. Just having a stranger agree that I'm not tangenting off into the wild blue is more helpful than you will, hopefully, ever discover

Librarian

No, I definitely do not want to diagnose anything. Just saying it could be because of that. But it sounds like you are already in touch with people who are better qualified to decide that.
My gut feeling right now is you probably should trust your psychiatrist with this low key medication and see how it goes. Just my 2 cents.

Frei

As an aside, inpatient therapy has nothing to do with how "functional" you feel you are. It's a way to get precise, monitored care in a very structured environment. It's not a place they just lock up crazies or whatever, that's a pretty big misconception. As far as what you're saying here, it's pretty impossible for anyone to give you real help because you already feel the myriad of professionals who have tried to help you have been wrong or unqualified, and no one here will be any more qualified to instruct you.

Librarian

I very much agree with this.

ceres

So. Yes, medications CAN do what you're describing, and some can take a very, very long time to get out of your system. If I were you I'd take a really long time on NOTHING if I thought I could take it and wait till I felt sure it was all out of my system before I made any decisions about anything, and certainly before I put anything else into it. Just from what you're saying about people's reactions to your one med I feel like I could hazard a few guesses as to what it is and feel like one of those would be correct.. and probably the ages of the pharmacists and psychs who gave each answer would be enough to tell me. If I AM right on any of them, I can understand being extremely hesitant to jump into that. But I am not you, and I have no idea how you feel.

Unfortunately, there's no real answer here to "how do I find what's right for me" other than "try a bunch of stuff until something works." When I first called my doctor needing medication, he wanted to try me on one that wouldn't make me gain weight, and it made me pretty angry like all the time. The next one I tried was a combination drug that was like magic... until I had a complete breakdown about a year later from my mood going back and forth so much, and I didn't even notice how bad it was until I was sobbing in a corner on my kitchen floor one day for no reason I could pinpoint. I went to see someone else and was prescribed something different, and that one is My Drug. It does almost nothing perceptible unless you know me really well, in which case you might notice that I am generally the same person but a LOT less obsessive and a LOT less likely to fall into a depressive episode that can last for days because the supermarket was out of fucking cheerios.

I had to go through like eight different medications and many therapists before I found the right ones, and you probably will too. If you are currently on the path of trying medication after medication to fix the side effects of the medications before them, that is going to be really, really difficult for you to do. The problem is that as you know I'm not a professional, and in the end you are going to have to pick one to trust. I know damn well that each time you have a bad experience with a medication it gets that much harder to trust the next, and it's the same with the prescribing doctor. One of the things that helped me get through when I was having trouble with therapy and the idea of going back on medication, despite the fact that I desperately needed both of those things to function, was to try to keep in mind that no one could make me do anything; what I took and who I trusted to give it to me and who I trusted to try to help me was ultimately my decision. It's a tough one to make, and it took me a long time to get there, but in the end you have to do what makes you feel safest.

I know you don't trust yourself, but ultimately that's what you need to do: trust yourself to pick the best provider/medication/advice/path for you, and take it. Also trust yourself to be able to see if that provider/medication/advice/path isn't working so you can try a new one.

CptHamilton

Thanks for the further advice, folks.

You'd probably guess wrong, Ceres. It's a very new drug. The lady I know on a medication review board for a psych institute had never even heard of it. That was actually one of the biggest factors in my decision not to take it. Not that it was new, but that the guy gave it to me a) as a couple of sample packs and b) with very inaccurate information regarding the effects and potential side-effects. It stank badly of "I just talked to a drug rep about this yesterday, here have some." But you're probably guessing in the right family and they all have basically the same potential side effects anyway.

I hear what you're all saying and by and large I already either know and/or agree with it. I know it's a process and all.

I picked up the new drugs yesterday (also: what the hell is up with drug prices? Valium is like $6 for a hundred tablets, SSRIs and anti-psychotics and anti-convulsives and shit are like $1-5 a pill; damn you, Big Pharma *shakes fist in impotent rage*) and stood there for a while last night trying to decide whether to take the first dose. I eventually decided that getting off the classes of drugs I was on previously and getting onto this new class was going to have to do for now.

I wanted to try just going flat back to nothing for long enough to get it all out of my system, but that can take months. If it were just me to worry about I'd be willing, but I have a wife who is both financially dependent on me and doesn't deserve to be put through me being a potentially giant, hot mess for months. So in the end I took the pill. I feel surprisingly good today, but I imagine that's largely psychosomatic as a result of having made a decision that I feel good about.

In the end I guess I really just wanted someone to listen to me whine and tell me what I already knew. Thanks everybody. Seriously. You can lock this up now, @Ceres, since decision-time is over.

Druhim

Hey, you're not whining. You're going through some heavy, serious shit and you have plenty of reason to be frustrated.