My Big Pharma Drama

The drugs I hate to love.

Today is one of those glorious rare days I get to see my drug pusher – I mean my psychiatrist. Since Psychologist J has cancelled today’s appointment I thought why not go see Dr M, I mean it’s not like I need some time to myself or anything *eyeroll* (Why do I do this to myself? Why didn’t I take advantage of the free time and do sweet eff a?)

Dr M’s main roll in the pandemonium that is my mental health story is mostly to provide me with an assortment of medications to take daily and PRN (as needed) as well as to give me bite size pieces of useful advice. He’s not my first psychiatrist but he will definitely be my last because of his skill at mixing medications in just the right combination to enable me appear human.

I’m actually writing this blog entry from his waiting room because as per usual he’s running 1 hour late.

I have mixed feelings about psychiatric medication: it’s expensive, it doesn’t always work, it’s a bastard to come off, and it can make you fat and not good fat like PHAT, just regular fat. But it’s kind of a necessary evil I suppose.

I was first prescribed antidepressants in 1999 and was too afraid to take them until my mother screamed at me that she wasn’t going to put up with my moods any longer and so I should just take the damn pills.

That night I dreamt I was kidnapped by three men in white coats with a van and taken to an psychiatric facility where I knew they were going to inject me with drugs that would take away my memory. I scribbled desperate messages all over the walls and furniture for myself to read saying things like Don’t stay here! There is a life out there that you left! Escape! They’ve taken your memory! The next morning I took one Zoloft and so began my 20+ years of medication. In that time I’ve been on 2 types of SSRI antidepressants (Zoloft and Effexor XR), two types of antipsychotics (Seroquel and Olanzapine), two types of mood stabilisers (Lithium and Lamotragine) and a host of benzodiazepines (Alprazolam aka Xanax, Temazepam, Lorazepam and Diazepam aka Valium). Dr M found the perfect combination of 4 of those medications enabling me to hold down jobs, make progress in therapy, keep (most of) my friendships and meet my husband and eventually I came off all medication. In 2014, Dr M declared my C-PTSD “in remission”. Yay!!! I was finally sane! For a hot minute life seemed good.

When I fell pregnant my husband and I did everything we could to prevent the loss of this new found stability. We upgraded our private health to cover psychiatric facilities, I got a doula, the midwife was briefed about my trauma history, there were strick rules put in place about who could be in the room and who could touch me. But it seems no matter how much you prepare for a baby, trauma has a way of fucking it up. As much as I wanted to go into labour naturally, in hindsight I can see my body was like uh uh no thanks, I’m not letting anyone or anything near me, in me, or out of me. So I was induced. Nothing happened. My body was like nice try suckers, you can’t make do this. So they ramped up the syntocinon beyond all recommended levels and my body slowly chugged into action. The end of labour was not pretty, not calm and not private. Emergency necessitated doctors flooding in with people poking, jabbing and cutting as needed.

I was thrilled to have my baby. I didn’t sleep a wink the first night and just lay there gazing at him. Unfortunately that was also the end of sleep as I knew it. The first night we had him home, my husband fell asleep around 11pm and then the anxiety hit me. Not regular anxiety but what I’ve now come to learn is flashback to things done to me as a child at night. The flashback is indescribable – horror, terror, humiliation, numb hands, stomach churning, the urge to vomit, my arms aching, my legs tensed up in pain, and this intense desire to be dead, to be anywhere but here in the middle of this frightening body invasion. I woke up my husband and said “I’m not ok. I need to go back to hospital immediately.”

The anxiety never left nor did the intense leg pains (part as a result of labour and partly a memory) for a whole week and no amount of Endone or Temazepam would give me more than 2 hours sleep a night. A week after my son was born I finally got access again to my favourite drug – Seroquel.

Here I will add a gripe about how poorly staffed regular hospitals are in regards to ANYONE with any knowledge of mental health or psychiatric medications. Despite having been on 200mg of Seroquel for years, it took me a week to get access to 50mg because technically Seroquel is for Schizophrenia (but in low doses it is a brilliant anti-anxiety medication). It was dolled out to me daily by the local mental health team. The first night I took it I got 5 hours of glorious sleep.

When my son was 6 weeks old I spent 4 weeks in a mother/baby PND ward at a psychiatric hospital right when Dr M happened to be on leave for a month. All our medications were taken from us and we had to line up at the nurses station to get them in little paper cups and take them in front of the nurses just like in the movies. My precious stash of benzodiazepines were kept under lock and key. I was given my antidepressants regularly but they wouldn’t give me a Lorazepam unless I could convince them I was REALLY ANXIOUS.

“Have you tried taking some deep breaths?”

“Yes.” Oh for fuck’s sake. Are you serious?

“Have you tried doing a relaxing activity like mindfully like having a cup of tea or colouring in?”

“Yes. I had chamomile tea.” Jesus Christ, you can’t cure trauma with tea or scribble your way out of a flashback.

“I’ve also tried doing some CBT to challenge my anxious thoughts.” Just give me the damn meds woman!

It was also in hospital in one of the classes they made us go to that I learnt that you shouldn’t be on Temazepam for long because it “changes the sleep architecture of your brain” which seemed to perfectly describe my experience with it. Although I’ve taken several kinds of benzodiazepines to help me sleep through the anxiety, Temazepam has been the worst giving me a maximum of 2 hours of bad sleep. I fall asleep very fast, everything goes maroon, my mind splits into triangles and with two twists of the kaleidoscope I’m awake again and not refreshed at all.

Eventually I left the hospital, had an appointment with Dr M and he did what he always does, gives me multiple scripts for multiple benzodiazepines and antipsychotics and trusted me to take whatever I need whenever I want. So for the years I fed my baby at night, I would take my Seroquel, get some sleep, my baby would cry in the night, I would wake and the flashbacks would start, I would feed him, then take my Seroquel and go back to sleep for a few more hours. All hail Dr M for keeping me sane.

Now my son is almost 5, and I suppose I should start the difficult job of coming off this stuff. Or maybe I won’t. Maybe good sleep is more important than proving something to myself.

Dr M just got me from the waiting room. It’s a psychiatric outpatient medical centre attached to the psychiatric hospital I’ve stayed at twice. The second stay was the one I mentioned above, the first stay was many years prior and exacerbated my symptoms so much that I was on ridiculously high doses of Valium and Xanax for well over a year. Sometimes as I wait for Dr M, I see my old psychiatrist Dr C who didn’t listen to my pleas when I was in hospital when I begged her to put me in a single room not a shared one. Sharing a room with someone gave me flashbacks to the “intruder in the night” stuff. I eventually checked myself out of the hospital against her recommendation and began the worst 3 years of my life.

There is a real danger to psychiatric medications and psychiatric hospitals. Medication rarely does much. Its main purpose is to get you out of crisis and into a place of moderate awfulness but not so awful that you can’t attend therapy sessions. But once you’re on the medicine crutch and have a diagnosis, it seems that almost anything you say is not taken so seriously, after all, you’re crazy, right?

The Rosenhan experiment attempted to prove this. In 1973, Psychologist David Rosenhan had 7 colleagues fake symptoms of hallucinations to see if they could be committed to 12 different psychiatric hospitals across America. All were admitted and all were diagnosed with schizophrenia and prescribed antipsychotics. Once admitted they stopped acting unwell and tried to tell the staff they were healthy and just part of an experiment, not one single staff member believed them and saw their protests as a symptom of their psychosis. All participants were forced to admit to having a mental illness and had to agree to take antipsychotic drugs as a condition of their release. Even stranger was that, according to Rosenhan’s report, in all the hospitals, other inpatients were able to correctly identify them as imposters and accused them of being undercover agents or journalists.

There isn’t much to write about my appointment with Dr M today. I never dissociate around him. I’m not sure if its because he is small and rotund and vivacious and thus nothing like my father, or if it’s because we never discuss trauma in depth or anything too personal. As per usual, he asks me how I’m doing and I give him my current life story to which he says, “You poor chicken! I don’t know how you cope!” and follows it with a handful of practical suggestions, a fresh wad of scripts and then sends me on my way.

Maybe I have portrayed him as irresponsible given that he will prescribe me almost anything. But it’s because he says he trusts me, he knows I’m not a suicide risk and because deep down I hate that I need medication.

I hate Big Pharma, I hate how they withhold drugs, I hate that they overcharge, I hate that they often sell bandaid solutions marketed as cures. I hate that they bully developing nations, I hate that they’re about profit and not about research and innovation and yet without them, would I even be alive right now?

I would love to give them up but if you asked me today to chose between my husband and my Seroquel…ok I’d chose my Husband but it would be a difficult choice. There’s nothing I love more in the world than knowing I have a way to guarantee a break from flashbacks than can last literally MONTHS. There is no one in the world who can pull me out of a flashback like this pill can. Maybe one day therapy will change that, but for tonight I will take my medication and sleep well.

References

Manconi, M., Ferri, R., Miano, S., Maestri, M., Bottasi, V., Zucconi, M. and Ferini-Strambi, L. (2017). Sleep architecture in insomniacs with severe benzodiazepine abuse. Clinical Neurophysiology: 128,6:875-881.

Rosenhan, D (1973). On being sane in insane places. Science. 179 (4070): 250–258.