Making the decision about psychiatric medications and treatments

There are times I wish there was one drug to work for everyone.  I went through years trying to find a combination that worked for me, to be stable (if that is possible), keep the psychosis and mania to a minimum and depression at bay.  Part of the issue I faced in the early years of my diagnosis was being in the military, I moved around a lot.  So, just when I found find a good doctor and felt comfortable with them, it would once again be time to move.  I got to the point where I didn't care much anymore, especially when it came to one of the last doctors I had.  He rarely listened to what I had to say, I was on two medications and I was having awful side effects, I begged him to change them.  He would sit behind his desk and fill out his insurance forms for the visit.  After a few visits and no help I did the only thing that sounded logical to me, I weaned myself off all medications.  I'd had enough.  

Fast forward to a year and I crashed, hard!  It was then I realized that I was not going to be able to do this alone, I had to be on medication in order at least keep some level to stability.  The journey would become harder than I thought, but after three psychiatrists and psychologists, I found not only a medical team I could trust, but also a medication combination that was helpful.  It was not an easy road however; it took several attempts to find out that my system rejected just about every new drug that had come on the market.  In addition, the Anti-Depressants I was taking were actually causing some of my mania.  With that off the list it came down to relying solely on mood-stabilizers, anti-psychotics and anxiety medication, but as we slowly ticked off the list of medications I could not take I became more discouraged.  The main hurdle we faced, in my eyes, was the extent of my diagnosis, Schizo-affective was simply the tip of the iceberg, it also included General Anxiety disorder, PTSD, and Dissociative Disorder.   Thankfully I had a doctor that would not give up.    

In the end we came up with a combination of Lamictal, Neurontin and Klonopin.  The first two keep me stable, for the most part (not drug is going to make this go away completely) and the later helps me not only sleep (my brain refuses to shut down, especially at night), but I can take it during the day if I am having an anxiety attack.  It is important to add that medication alone was not the answer, at least for me, and while we discussed medications he decided to approach the subject of ECT, (Electro-Convulsion therapy).  The idea more than scared me, but I was desperate and I trusted my doctor.  I checked into the hospital, was admitted to the psych ward and for the next 10 days had five treatments, and then I had three treatments as an outpatient.  The experience as not what I expected, my only side effect was bad dry mouth afterwards, and a headache.  

Now being the challenging patient that I am, and while the ECT worked to ease my depression, it brought on mania.  We didn't see it at first, it was subtle, but there was something going on.  12 months later I was back and had a second round after I hit bottom again after losing my cousin to suicide, his death destroyed me and sent me into a severe mixed episode.   Since the last sequence of treatments had help with the depression, this time my doctor knew we had to take a different approach.  It is most common to administer the treatment to one side of the brain; however, for me he decided he had to administer to both sides in order to balance out the depression and mania.  It was like my mind was fighting itself for control and he was making every effort to call a truce.  There was some success with the treatments and balance was restored, but there was a part of me that had hoped that it would make it all go away, I was growing more and more tired of it all. 

I began tracking my symptoms a few years ago; I watch how my mania, depression, anxiety, psychosis and sleep fluctuate from day to day. With the graph I can see what may have been going on that day to cause more a depressive state and what may have caused anxiety.  It’s not fool proof, but it can give a general overview of what may trigger some of the mood swings and then I can make any changes I may need to. 

In the end, yes the ECT did help and the medications continue to keep things in check - for the most part.  Over time I realized that we must live with these illnesses as they are, work with a good medical team, and have a strong support system.  Without all these pieces in place we run the risk of continuing to hide behind our mask and tell the world we are “OK,” when what we really need is help.