Saturday, November 10, 2012

The role of antidepressant medications in my life

When I forget to take my medications for a few days in a row, I don't have the energy to do anything.  I don't want to leave my house, I don't want to talk to people, I can't manage enough energy to clean.  I barely have enough energy to make or buy food to eat.  When I remember to take my meds every day, I can manage to be a functional human being.

There are a decent amount of people out there who have tried to convince me I don't need to take my medications.  They bring up how often antidepressants are over prescribed.  I agree that there are many medications which are over prescribed, antidepressants among them.  However, antibiotics are also over prescribed, and you don't often see people telling people with bacterial infections that they don't actually need the antibiotic.

I'm a big believer in psychotherapy.  I believe in it because I know that it has permanent effects on brain structure.  For many mental disorders (but admittedly, not all), psychotherapy has the strong potential to be a cure (with a therapist that works for you (note I didn't say "with a good therapist", some therapists will be good for some people, and bad for others, which is why it's important to "shop around" until you find a good fit)).  However, for some people, it won't always work by itself.  I worked with a psychiatrist once who said that for some people, they needed to be able to look at their life in a different light *while* they participated in psychotherapy.  This is the role of antidepressants, to allow a different perspective.

My depression is pretty severe.  Even when I am not in a terrible mood, suicidal ideation is a near-daily experience for me.  It is extremely difficult for me to not be overwhelmed by both personal and farther-reaching events which may affect me.  In addition, I find it extremely hard to empathize with people in difficult situations without becoming overwhelmed with sorrow for their positions.  All of this takes a strong toll on my energy level.  I am constantly struggling against this, all day, every day, unless I participate in escapism.  But, of course, I can't go through life reading fiction and watching TV shows.

So, I do what I need to do, which is to take my medications.  These allow me to do simple things, like clean the cats' litter box, or bathe, or even something as low impact as going to a fast food place to get some food.  Back in September of this year, I stopped being able to do these things.  I wasn't eating, wasn't sleeping.  I was having trouble moving enough to even go to the bathroom.  Things hadn't been this bad for me since childhood.  This was the result of several different bad experiences which all happened within a month of each other.  What actually happened isn't as important as the effect of these experiences, so I'm not going to go into the specific events.  My point is, there are people who say that I can get by without the medications, and I'm pointing out that without them, I start slowly dying.

To be completely candid, I'm offended when people tell me I don't need my medications.  They don't know the details of my life.  They aren't familiar with my brain chemistry.  They don't know why I take these medications.  They assume, because they've read an article about how antidepressants are over prescribed, that I must be one of the dupes who is taking drugs because pharmaceutical companies have convinced me, or my doctor that I need them.  I started taking bupropion after a very sincere suicide attempt, which landed me in the emergency room, intensive care, and a psychiatric hospital.  (The hospital prescribed an SSRI, the bupropion came afterwards, when discussing with a psychiatrist what effects SSRIs have on me, and how my depression affects me.)  This wasn't the result of me going to my primary care physician and telling them I feel a little blue.  The latter is what is assumed, though, by anyone who has suggested to me that I don't need to be on my medications.

Do I want to be on these medications?  No.  I'd rather not have to make an effort to remember to take these pills every day.  I don't want to take these for the rest of my life.  By being in psychotherapy, I'm taking steps to resolve my illness, so that I can hopefully, in the future, be able to get off of these drugs.  But that really does not mean I should be off them now, or that I don't know what I'm doing by taking them.  So, to those who feel like they can tell me how I'm being fooled by "Big Pharma", please keep track of your own life, rather than telling me how to live mine.

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