a label saying "Good" and a label saying "Bad", with fingers picking up the label that says "Good"
Medication / Mental Illness

Managing Medication Side Effects

I’ve mentioned before that the side effects from medications can be extreme and life altering. Yet when people look at me, they are often amazed at how normal I seem. I don’t seem overcome with side effects, yet I take medications. How do I manage this?

A rough start

When I began working with medications, I was very young and very much in denial of my illness. My doctor tried to prescribe meds that would help my mood swings and depression, but I was fighting against him, meaning that the meds had to work completely on their own. It didn’t work because that’s not how taking medications works. Medications can be life changing in both a good way and a bad way, but the good only comes with help from yourself.

During this period of my life, the side effects were severe, and I didn’t always know they were side effects. One drug made me very very tired. I wondered if I would always be so tired. I couldn’t even imagine having enough energy in school. I thought it was just part of getting old. (I know, a teenager thinking he’s old. Kids are silly, are they not?). I tried not taking them, but that just got me in trouble, and I wound up back on the drugs.

I also started twitching in different ways and becoming a slave to different tics (compulsive repetitive movements). I actually started to get pain in some places where I had tic movements affecting me.

Add to all this, the fact that the medications didn’t really help. They didn’t help because I was in rebellion against them. Some of my friends thought that the only thing the medications did was hurt me, and because of my resistance there was a small bit of truth in that.

A better approach to medications

Later, when I was in recovery, I cam to view medications as a tool, but not a solution. When I take medications, they might take the edge off of my struggles, but perhaps they don’t make them go away. Technically, I could always choose to take more medication with the approval of my doctor and my life will get easier in terms of symptoms even if the side effects get worse. But for me, I hate side effects. I know I need meds to give me the strength to take on the mental illness, but I want as little as possible. I want the help I need, but I want to be part of the battle.

A list of pros and cons

A pro/con list is useful in just about any decision making process and medication dosing is one of them. Now first of all, I recommend always obeying doctor’s orders. But if you have a good doctor, they’ll want to work with you and problem solve together how to get you on the right medications and the right dosing.

The typical balance style is a sort of mathematical inequality (at least that’s how my geeky brain looks at it.) Are side effects more or less bad than the therapeutic effect is good? Sometimes that’s easy to know. Once, I took a medication for depression that didn’t do anything for me for depression. Well, zero benefit is never going to be greater than any level of side effect so that’s a “No”.

But sometimes it’s more complicated. I took another medication that really controlled my symptoms and made me easy to get along with. But it caused weight gain to the point that I feared I might develop Type II Diabetes. So pros and cons: is the potential for diabetes worth it for that temporary peace of mind? That’s hard to say, but I ultimately decided on “No”. I told my doctor I wanted to try something else. Not only did I fear I would develop diabetes, but I was ashamed of my weight. It’s bad enough to look in the mirror and feel like you’re fat, but it’s way worse when there’s nothing you can do about it.

My doctor tried a different medication and it helped with the weight gain. I’ve actually lost a bit of weight because my efforts to not gain all the time became habits and now they work. I look way better than I did. But there’s another side effect. Now, shortly after I take the medication, I get an anxiety attack for a few hours. Normally, it wears me out and I just have to go to sleep to even cope with it. I decided to build that into my schedule. I take the medication at bedtime. By the time I wake up, I don’t struggle with that side effect, and it doesn’t seem to give me nightmares either.

I look at the inequality again: Is a daily anxiety attack more or less bad that peace of mind in general is good. Well, normally I’d say it’s more bad, but because I can use the taking it at bedtime workaround, it’s way less bad than the general peace of mind it good. Now, I like the inequality. This will work for me.

It’s your decision

This is how I’ve approached managing medications. The pros and cons list is essential for getting the most out of your treatment. If you need medications, that doesn’t mean you have to suffer horribly from them. I encourage anyone to have in depth conversations with their doctor and also to research and talk with other mental health workers. I am always willing to offer input on a medication situation, but know, above all, that this is your decision. You truly can take control of your mental health treatment.

Image by Fathromi Ramdlon from Pixabay

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He's One of Us

April 15, 2019