By: Carissa Martos
For the first time in a decade, I’m on a new mental-health medication.
This is a huge event for me, as I have navigated most of my life as someone with anxiety, bipolar, PTSD, and chronic pain with…close to nothing, chemically. I’ve been on daily clonazepam, at the same .5 to 1mg dose, for 8 years, and aside from a brief stint on Cymbalta for nerve pain, I’ve been able to function for most of my adulthood. However, due to my ankylosing spondylitis and migraines, I’ve had a good deal more fatigue/brain fog/frustration, and my anxiety has spiked. So, when I found a therapist who was able to see all 6 members of my family (four of us are on private insurance and two are on Medicaid), I decided I would be willing to talk to her about my medications as well. I have a list of meds that haven't worked for me, stretching back to my 18th birthday, because I either fell asleep or got confused or became violently ill. My recalcitrance is deep.
Talking to a psychiatrist is also a wildly big step for me, as I avoid individual therapy (although I’ll enthusiastically participate in couples’ or family therapy, as I feel more comfortable with the role of therapist-as-mediator). I read, and I talk to people who I hope might be helpful, but I’m uncomfortable in one-on-ones with folks who are just trying to suss out “me” problems. In part, this is due to a long history of therapists that didn’t fit, and in part it is personal preference.
I met with Rebecca to, mostly, fill her in on each of the kids’ medications and let her know that I was aware of my challenges, and she noticed some interactions with my non-psych meds that were possibly contributing to the brain fog I was dealing with. In the first month, the Cymbalta was stopped, and my Topomax was reduced, which gave me a little more brain clarity (and the trade off is simply more sumatriptan for emergency migraines, but not enough more that I feel I’m on the losing end of the stick). Last month, though, I started on a low dose of Latuda. It's an antipsychotic (on label) but we agreed that long-term benzo use is probably not for the best, and that this might be worth a shot.
I’m not sure, yet, completely how I feel about it. Pysch meds aren’t like antibiotics, where you just take the course until you are done, or like a medication for arthritis where you can palpate the joint and see if it is improving flexibility/reducing soreness. There’s a lack of objectivity when it comes to self-assessing medication that impact your mood and the way your brain processes thoughts and feelings, so I’ve done the same thing I do with my daughter, and foster son.
I keep a journal.
Every day I write down when I take the med, my general mood for the day, and any noticeable spikes or variances in my mood or outlook. According to the data, I’ve been dealing with a little bit of nervous energy (the need to move or fidget more), but my mood has been relatively positive, and I have had fewer depressive episodes. I’m still exhausted, but that’s just more about what I do with my hours in the day, I think.
So, I have a functional relationship with a psychological NP, and a new medication. Here’s to the next decade.