“I was not taking [my prescription] quite as often as I was technically supposed to. Partly, I kept forgetting, but also there was something else I couldn’t quite identify, some way-down fear that taking a pill to become myself was wrong.” ― John Green, Turtles All the Way Down

“Listen to the people who love you. Believe that they are worth living for even when you don’t believe it. Seek out the memories depression takes away and project them into the future. Be brave; be strong; take your pills. Exercise because it’s good for you even if every step weighs a thousand pounds. Eat when food itself disgusts you. Reason with yourself when you have lost your reason.” ― Andrew Solomon, The Noonday Demon: An Atlas of Depression

 

I have been taking psychotropics in one form or another for nearly thirty years. As someone diagnosed with rapidly cycling bipolar disorder with psychotic features and mixed states, one pill doesn’t do the trick. I need a minimum of a mood stabilizer, an antidepressant, and an antipsychotic. I also need prn meds in case I can’t sleep or if I have an anxiety attack. My current “cocktail” mostly worked to provide relative balance for over a decade, but it needs to be “tweaked” often for optimal effectiveness.

Then along came 2020. My year of intense grief. Not only did I face losses associated with the pandemic, but both my parents died. Dad in July of cancer. Mom in December of Covid. The cumulatively effects of grief compounded my mental illness such that it set off an extensive manic episode. I could not safely manage it as an outpatient, so I admitted myself to the psych hospital where I stayed a seek. They introduced a high dose of a potent antipsychotic which induced sleep but also left me in a fog.

Sometimes with psychotropics you have to make a deal with the devil. The only safe option for me at that time was to be sedated. The hope was with time and other treatment, I can be weaned off or at least substantially down from that particular drug. That plan has largely worked. I am on just 33% of the dosage I was on inpatient. But it’s still enough to knock me out. In the past week I have slept 65 hours, an average of over 9 hours a night and I still feel fatigued much of the day.

So why not continue weaning, you might ask? Good question. I asked it of my psychiatric nurse practitioner. She was willing to try. In response, my body and mind went wild. I had a major manic episode, followed three hours later by a panic attack. It seems the level I now take is the best therapeutic dosage. At least for now. Now I need to establish relative balance for awhile before making any adjustments.

Psychiatry is not an exact science. Some argue vehemently that psychotropics are actually the cause of mental illness. This dangerous thinking leads many sick people to go off medication which contributes to major destabilization and can even lead to early onset dementia or death. As someone with a critical brain illness, I know I need to take medication as prescribed by my psychiatric nurse practitioner. I will make the most of the waking hours I have and, do what it takes to promote health in other ways.