Psychiatric Drug Bingo

Depressed on Antidepressants

“You’re not crazy,” said the first psychiatrist of many I would speak to, as I blankly stared back at him from my bed at Cayuga Medical Center’s Behavioral Health Unit.. “You just have some issues to work through, is all.”

Cliché start to another tale of mental illness? Maybe.

Millions of young people are either being misdiagnosed or prescribed the wrong medications for depression or related illnesses. My struggle is similar, although not quite as severe as some of the young people today who taken dozens of medications to combat their mental illnesses.

I should go farther back to more accurately depict my journey through the mental health system. Pinpointing the beginning of my depression is hard, if not impossible. What I do remember vividly are my experiences with taking psychiatric drugs once I was more or less forced out of my ongoing denial of my depression. My reluctance stemmed from trying to avoid being labeled as weak or being boxed into the stereotypes of an attention-seeker, or even “emo.”

Medication for depression is common today, as is my experience of coercion to take psychiatric medication. The number of antidepressant medications available is vast, and includes but is not limited to Prozac, Zoloft and Lexapro.

Increased suicidal behavior linked to antidepressants is getting more and more attention in the media. Influxes of articles detailing this have appeared, along with studies finding that young people from ages 18 to 24 experience increased suicidal thoughts However, the problem arguably isn’t being taken as seriously as it can be, still.

Even though a label warning on antidepressant medication would inform patients of the inherent risks of their medication, mental health organizations reject this idea. Most people who suffer from depression do not seek treatment and carry a 15 percent greater risk of suicide than those who are treated, according to Mental Health America, a nonprofit patient advocacy group.

Psych ward

A year ago, I had yet to experience anything with psychiatric treatment, including medication.

When I woke up on the morning of January 28, 2006, I felt calm. I had no idea I would end up in the behavioral health unit, a thinly veiled euphemism for “psych ward,” at Cayuga Medical Center, before the day was over.

The night before, I had had a few drinks with friends before returning alone to my apartment. Normally I would have gone straight to sleep, but I wasn’t able to sleep because my thoughts were racing. I attempted to call several friends, but most were unavailable or said they would call me back.

Becoming more frustrated by the moment, I succumbed to tears. I started instant-messaging friends as my fingers stumbled across the keyboard, trying to explain my desperation. Uninhibited and hysterical, I repeated, “I don’t want to be around anymore.”

Leaving my room for the hallway, I took my cell phone, called a friend and sobbed as he tried to get me to calm from my apparent nervous breakdown.

My memory of the night is still hazy, but the image of three policemen finding me huddled on the floor in my apartment stands out.

“We understand you have a knife,” one said, repeating information I had given to a friend I had instant messaged an hour before, who called the police when I had stopped responding. My eyes darted back and forth, as I looked for a way to flee the scene, in vain.

“No. I’m fine, I just want to go to sleep,” I said, closing my cell phone and holding out my empty hands.

So, I faced the humiliation of being patted down for proof that I was indeed weapon-free and promptly taken to the hospital for several days of interrogation.

Ironic, isn’t it, that a suicidal, depressed individual would be sequestered in a stark white room? I wondered: How was this going to cure my depression and anxiety? I stared at the ceiling before eventually falling asleep. I was awoken early in the morning, angry, hung over and confused, and told I had to attend group therapy. Reluctantly, I went.

“What’s your goal for today, Heather?” asked a chipper nurse, leading our discussion.

“To leave,” I said, unwilling to discuss my mental health with people who screamed at any given moment or stared at me intently, for long periods of time, for unknown reasons.        

Once I returned to my empty room, I fell asleep again, only to be awoken by another psychiatrist who demanded an answer for my nervous breakdown the night before. I had little to say other than I felt less than thrilled about being in “the loony bin” for what I considered the result of drinking too much.

My diagnosis? Dysthmia. And the medication I was given to cure me? Zoloft. My choice in the matter, from being taken to the hospital, to being medicated, was not one I took actively, but I was ready to try it to put an end my distress.

Coercion and mind freedom 

 Psychiatrist Peter Breggins, M.D., of Ithaca, New York, is well acquainted with the mental health system’s tendency to coerce patients into taking medication. Breggins does not typically speak to journalists and would not speak to this one, but he has been published extensively on the subject.
“Unfortunately, too few people seem interested in stopping organized psychiatry's thirst for coercive power which is once again on the increase,” he wrote in his recent article “Psychiatry's Reliance on Coercion.”

Breggins is not alone. Psychiatrichuman rights is the main issue nonprofit organization Mindfreedom International focuses on. Director David Oaks says he attempts to provide psychiatric patients more choices in mental health care. The organization tries to combat "fear, force and fraud" enacted by the mental health system and reviews how the mental health system treats (or rather, mistreats) its patients.

Wrote Breggins in another article, ”There are innumerable kinds of crises and emergencies that psychotherapists and counselors deal with in community service agencies and private practices, including threats of suicide and homicide...Sometimes the cause of the emotional crisis seems rooted in longstanding psychological distress of interpersonal conflicts.”

In my situation, my friends and family became frustrated when my response to their inquiries about what caused my depression was, “I don’t know.” As far as I can see, I was given medication to save me from harming myself.
As the weeks rolled by, the Zoloft I was taking made me increasingly agitated and I had violent mood swings. Zoloft contains a stimulant that, for some people, increases impulsivity and can induce manic behavior.

Cutting

Selective Serotonin Reuptake Inhibitors, also known as antidepressants (such as Zoloft), are prescribed for depression and anxiety. The drugs cause the neurons in the brain to soak in the serotonin already produced by the brain, to regulate mood imbalances.

While antidepressant medication is supposed to be useful for sufferers of “unipolar” depression, it can cause havoc to the lives of those diagnosed with mood bipolar disorders. My problems with antidepressants are described accurately in an article, “Serotonin Reuptake Inhibitors: the good, bad, and the ugly,” on a Web site dedicated to “crazy medications,” crazymeds.org.

“Although any antidepressant can trigger a mania, the odds are just better with SSRIs,” the Web site says, “Not just fun, fun, FUN euphoric manias where you max out all your credit cards and start but never finish half a dozen creative projects, but nasty, dysphoric manias where you rage at everyone and everything in sight and cause physical harm to yourself and others. Even if you aren't bipolar you might bring about a quasi-manic state by taking your meds inconsistently and upping the dose by accident or design. There's just no telling if you'll get happy mania or nasty mania.”

The smallest disappointments gave me cause to throw breakable objects, burst into body-convulsing sobs and deliberately cut myself. Although I was humiliated to admit the problem to friends and family, self-injuring (or “cutting,” as it is referred to) became my coping mechanism of choice.

“Antidepressant stimulation can lead to violence as well as suicide and a wide variety of abnormal and even psychotic behaviors,” Breggins wrote in [better to cite journal. Or, at this point, would be ok to use “Breggins has written.”  “Furthermore, medical professionals, especially my colleagues in psychiatry, continue to resist and even to ignore the scientific evidence and the warnings from the FDA. The FDA itself has shown no willingness to take the next step—to ban these largely ineffective and highly dangerous agents.”

Cutting was an escape that allowed me to temporarily dissociate from my emotional distress, because the physical pain was a distraction. Though it is hard to find an exact statistic, it is estimated three to five percent of the population uses self-harm for similar reasons. While counterintuitive, self-harmers experience a sense of relief from their repetitive behaviors.

My secret bad habit caught up with me, though, as it became more addictive and the injuries became more severe. I could not hide my problem for long. My roommate walked into my room after I had severely lacerated my arm, which required nine stitches and an awkward lie (about tripping on the stairs) to doctors asking for an explanation.

Drug cocktails

When I returned to speak to a doctor at Ithaca College’s Hammond Health Center, her wide-eyed horror at my stories spoke for itself. She did say, however, that my mood instability was cause for concern, and prescribed me Zyprexa. I was told it was a sleep aid and would help me sleep at night, but I was skeptical, so I “googled” the name.

The banner on the Web site for Zyprexa reads, “There is hope!” and says that 20 million people in the United States take the atypical antipsychotic mood stabilizer for bipolar disorder or schizophrenia. Immediately I felt disappointment and anger at being misled by a doctor.

Nevertheless, I continued to take the medication I had been given for several weeks, until I decided the mood-stabilizing was sucking away what little motivation I had and went off it, against the recommendation of my doctor. I told my doctor I didn’t think Zyprexa was a mood-stabilizer at all. Rather, it seemed like a mood eliminator, because I could not be alert or function properly after I had taken it.
After hearing this, my doctor referred me to a psychologist to undergo “extensive talk therapy” and to another psychiatrist off-campus, because “mental illnesses treatment was not her forte,” and perhaps a new doctor could prescribe the correct medication I needed.
My new shrink had surprisingly little emotional response to my stories of woe and did not make eye contact with me once. He gave me a new diagnosis: acute mood instability, which could potentially become a full-blown bipolar disorder with time. New medication: I would continue to take Zoloft at the high dose, as well as Celexa (another SSRI, and Neurontin, an anti-convulsant medication prescribed off-label for mood-stabilizing.
“Drug cocktails,” as they are called, are common for people with psychiatric illnesses. Because people respond differently to medication, psychiatrists frequently play a game of guess and check with their patients until the correct dosage and medication is found.
I was taking three medications at once by March, two months after I had been admitted to the hospital. Although I had made progress with my psychologist and uncovered some of the reasons for my depression, I was still unhappy overall. I felt the medication had taken away my full palette of emotional responsiveness I once had, so by mid-April, I decided that I would no longer take medication.

Cold Turkey

My psychiatrist, less than thrilled with my decision, demanded an explanation and asked me if I would like to try a new medication instead of going cold turkey from my antidepressants and mood stabilizers. I assured him I was not interested in playing medication bingo again, since when I examined my behavior, I had become a completely different person. I wasn’t able to hold back from manic behavior, and I placed most of the blame on the medication I had been taking.

I had reached my limit, even though my doctor begged me to start taking a new drug, Effexor, which is “particularly effective for those suffering from treatment-resistant mood disorders.”

Once I stopped taking medication, I began to feel more like my old self. The temptation to cut myself waned, as did my impulsive decisions and uncontrollable anger. Not everything was rainbows and smiles, but I was more in control of myself, rather than being controlled by the medication I was taking.

When does the struggle to find appropriate medication become more of a battle than it is worth? It’s a personal choice for anyone who finds themselves caught playing medication bingo.