This post is to do with ‘the meds dilemma’, by which I mean all the dilemmas that come with being on psychiatric medicine, especially anti-psychotics. There a lot of things that we as patients struggle with, which I’m sure directly affects others like friends and family, but especially the patient.
Probably one of the biggest things is knowingly taking medication that causes side effects. This is such a difficult issue. For example, I myself have experienced all sorts including: weight gain, tiredness, muscle stiffness, hand shaking, bad hand co-ordination, drooling, akithisia, lethargy, concentration issues, memory issues, constipation and increased hunger. Who would want that? Who would knowingly continue medication with such awful effects? Why should you have to put up with that? Well, to keep well mentally.
The horrible dilemma is that even though you may have many side effects, you may actually have been improved mentally. So the dilemma is: do you stay on something that is frustrating you physically, or risk going back to a state where you could end up frightened and confused, or even go back to hospital?
Every time you start a new medication, there is always that frightened sense of: what will this do to me? What side effects will I get? If you are already mentally unstable, the immediate side effects will put you off medication even more. If it is felt that you really need the medication mentally by a medical professional, you may not know this anyway due to lack of insight. Therefore there is double the dilemma. How do you persuade a patient to take something when they may be tired, hungry and irritable from what you just gave them?
For everyone who has carried on with treatment despite this, and become well mentally, there is still the issue over whether you wish to continue. The guidelines say that anti-psychotics should be used for at least 2 years with one episode, and 5 years for more than one episode (or so this is what I have been told by psychiatrists). At the moment I am 2 and a half years into these 5 years, with 3 years before that on other anti-psychotics. I’m not sure how much more I can take of the weight gain, for example. I’m worried I’m storing up major health problems, I’ve heard I could die earlier and I’ve heard it’s shrinking my brain. I asked my psychiatrist about these and she dispelled them. However, I’m not sure I trust her. Do we really know enough about these medications to be sure? How do I know I won’t die earlier.
The thing is, if I reduce my medication I risk a relapse; but if I stay on it I risk becoming morbidly obese. Can you see the dilemma?
So next time you are frustrated with someone who is dithering over their medication, know this: the side effects suck and we just don’t know what that is doing long term.
I am not saying I am anti-medication, by the way. I myself am on clozapine and am not planning on going cold turkey, ever. Nor am I going to reduce myself (I’ve been sectioned for this before a few years ago). But the side effects are getting more and more problematic and my dilemma grows by the day.
Take care, Skye.