Sometimes Less is Not Better

I have been trying to write this post for days, but the words haven’t been coming easily.

As part of the master plan to slim down my med cocktail, and after successfully weaning off of the antidepressant, I jumped the gun with the planned elimination of the antipsychotic. The result was I had to ask my husband to call my psychiatrist.  Thankfully  DH and the Dr staged an intervention and a few days and a few doses of Abilify later, I am back up and running.

The experience was frightening.

Thoughts raced, ideas about who I am and what was going on around me became more bizarre.  My sense of time was utterly warped.  The only time I believed I could shut down the thoughts was during sleep, which I tried to get a lot of.  But, that endeavor ultimately failed because my dreams were vivid enough that sleep was neither useful nor restful.

In retrospect, I believe what I experienced was actually a mild psychosis.

Since I never even came close to this state in the past, I can’t help but wonder whether being on the Abilify in the first place has in a way been addicting.  Will I ever be able to live my life without being held hostage by a little, blue pill?  On the other hand, does it matter, since I am already tied to a hand full of other pills until death do us part?

I’m not sure there is a moral to this post, or even a point.  Oh, besides the fact that it’s better to be a compliant patient when it comes to discontinuing antisychotics. And, the fact that now I am terrified about having further psychosis – I’m not longer ‘untouchable’ as I thought I  might have been from the lack of psychotic features for the last 45 years.

In the end, I suppose, it’s putting my husband through a fire and choosing to hide out from my son while the whole drama was unfolding that’s been the worst of all.

 

What a horrible experience! I’m so thankful that the worst has eased and you can find yourself again. It really doesn’t matter what you name the experience, it was completely caused by the sudden withdrawal and change of medication. Switching meds *takes time*. It’s always a trauma, always unsettling. Pleasepleaseplease go slow and be gentle with yourself. Try very hard not to categorize or box yourself in during this process—it’s just the flux of chemistry, not the real you. Whether you need Abilify or not doesn’t matter. What matters is getting back to You. A you that can open her arms to her husband and child.

Oh, Sandy – thank you so much. You always say such inspirational things. It was unsettling, to be sure. But the last three days I’ve started to feel like the old me again and that’s a relief. I hope you are doing well. I need to catch up on your blog!

Hi,

This morning I was nominated for two awards with very similar names, which was slightly confusing. One was called ‘Versatile Blogger Award’ and the other ‘The Vesatile Blogger Award.’

Both had different pictures and yet both required me to share 7 things about myself and to nominate 15 other blogs which I follow.

You can find out about them and my response to them here: http://reson8freedom.wordpress.com/2012/03/25/versatile-blogger-award-the-versatile-blogger-award-a-double-blessing/ but even though I am sure you have already been nomimated for at least one of them I thought I would nominate you for the both of them.

I hope that is ok but I really do enjoy reading your blog and wanted to include you in my nominations.

Kind Regards

Kevin.

Hi 🙂

I got tagged this morning in the Tagging Game part ii and since I have to then tag 11 bloggers I of course had to include you.

Apologies if you have already done this or are fed up with the game already (it seems that I am behind the times a little with all this)

But should you wish to play along here are my answers. http://voicesofglass.com/2012/03/26/tagging-game-part-2/

Kind Regards

Kevin

Your point is an excellent one, tempting as it is to people to slim down the medicine regimen, which can quickly get out of hand. It does seem that the meds just pile up, accompanied by side effects you’d be happy to see the backside of. I hope you’re back on track, and achieving stability. There is some more recent research on how to treat treatment-resistant bipolar maintenance that I’ve been looking into, and that can potentially decrease the number of pills–if the research lives up to its promise. Anyway, I’m doing a set of 2 posts on alternatives to the standard piling on of mood stabilizers and the usual atypicals (do I hear Seroquel and Zyprexa?). Might be worth a look–the first one, “Beyond ‘Beyond Lithium’–Treament-Resistant Bipolar Maintenance, Or Not Staying Put, Part I’s” at http://wp.me/p22afJ-Qs and Part II should be out tomorrow. Hope you and/or your readers can find something helpful in them. Meanwhile, maybe no new innovations on your part for a while is best? Wishing you health and stability, Candida

Hi, Candida. So sorry, I just noticed your comment was stuck in the Spam folder. Yes, you’re right…no more innovations for a while is absolutely best. I did read your Beyond Beyond Lithium post and found it very interesting. Although my new Drs tried their best to get me to say, “Yes!” to Lithium, I’ve found great success with Trileptal. So, there are alternatives out there. Thank you for bringing that forward – it’s a very important topic. I hope all is well in your world, Vivien

This sounds like an awful experience. I have had similar experiences with vivid dreams and I could find no respite. I really hope that you are able to continue to stay med compliant. It is hard to do when we are feeling good.

As for Abilify, I could not stay on it for long due to akathesia, but I know I will be tied down to antipsychotics as well as an antidepressant and a mood stabilizer for the long haul. It is something that is very hard for me to accept, but I have come to the conclusion that the benefits far outweigh the risks.

Accepting that we’re a slave to a little pill forever is a really difficult thing, I agree. But I never thought I would ever get as bad as I did, so the pill wins 🙂 I’ve heard others complain about the Abilify side effects. How long did it take until the akathesia set in?

Oh, wow. I had no idea it all happened that fast. Glad your Dr got you off ASAP. As long as you’ve found something that’s giving you relief, that’s the main thing.

I am satisfied. I’m on a classic antipsychotic called trilafon. I have had no manic episodes since going on it. I also just started Wellbutrin to go along with my lamictal. They seem to be working well now.

Vivien, I am so sorry you experienced this. Psychosis is the ultimate Boogey Man, because at least with mania and depression you still feel as if you retain control. With psychosis, all bets are off.

Just try to remember that you were able to get through this state. You had a support system in place to help you, but ultimately you were the one who got yourself through it. My support system does a wonderful job of taking care of me in psychosis, but ultimately, I am the one that has to live through what goes on in my head.

And know that one episode does not condemn you to a lifetime of future episodes. You have a treatment plan that worked for this, and now you have even more knowledge about what your mind needs.

*hugs*

Hi Vivien,

I was very pleased to find your site today. I just finished watching the Homeland series and was googling around for commentary on it. I’ll have to go back now and comment on your post on that, but your post here about medication really caught my eye. I completely relate about being on cocktails of medication and trying to get back control of your treatment; and I also understand about Abilify in particular.

I was prescribed Abilify (along with Lamictal) following my first manic episode when I was first diagnosed with Bipolar Disorder. It’s something that I tried coming off of a couple of times, and was very difficult, but I did eventually get off it and I am very glad for that. It is a strong medication and I experienced side effects from skin discoloration to emotional ‘numbness’. I never truly felt like myself whilst taking Abilify. I didn’t act or feel in my personal or professional capacities as I would have done without it, and when I look back on that period of my life I almost don’t recognise myself. It was difficult to come off it, but with my doctor I came down 25mg every couple of weeks until I was off it. Psychotic symptoms are likely if you come off it ‘cold turkey’ (I tried that too and it is not advisable!), but if you do it slowly it is fine. If you and your healthcare professional feel like it is the right time for you to do that, then you can get off it too.

I guess that the major point I’m trying to make is that Abilify is a drug for when you are experiencing major episodes, and that it is extremely helpful for that time scale. But it is also possible – and arguably preferable – to take it out of your cocktail when you are ready for it.

I feel for everything you’re experiencing and wish you all the best.

Sarah

Hi, Sarah: Thanks so much for the thoughtful reply. It gives me hope to hear that people do successfully come off of Abilify and feel much better afterward. I appreciate you sharing it took a few attempts to make it work. I have a feeling I have a few more in my future as well. My Dr did say she wants to eliminate it from my cocktail but we are waiting for a more stable time to do so (moving on the horizon, and we all know how stressful that can be). Glad you found the blog, too! Feel free to poke around & I hope you’ll come back. Hope you had a nice holiday – Vivien

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