I wanted to write something about medication. It's a new piece of furniture in my life really, and I'm still finding out where it goes and how to use it. If you have several unrelated conditions - and as we get older, it's more likely we'll have something - it starts off being about managing the conditions. And gradually as the conditions come to heel, it becomes about managing the medication. From the logistics of making sure you don't run out of anything, to making sure all the drugs are compatible, to remembering when to take what; it keeps one busy. I could almost say it was a hobby. I've done a little chart.
What I wanted to talk about also was managing expectations. There is an expectation that, once the condition or conditions have been identified, it just needs some tinkering with the meds to hit the right combination, and we're all happy bunnies.
A couple of years ago I went indoor climbing for the first (and possibly last) time. I needed to see off the lumpen ten year old who couldn't climb up on a flat roof. Anyway, you get all harnessed up and you have a partner who remains on the ground keeping your rope taut. This harness and rope business lends an amazing sense of invulnerability. I scaled the wall like a rather cumbersome spider and abseiled down cockily. A bit later, half way up a wall, I slipped. Despite the harness and rope, you can fall. Because the rope was taut my toes didn't quite touch the ground and the underneath straps went painfully up my chuff.
Similarly, you can be on medication that seems to be working; that becomes a routine way of staying normal. But despite that safety harness, you can still fall. It's scary when it happens because it feels like the sick, mental you has escaped again.
I don't think increasing the medication is necessarily the answer. You don't just keep turning the music up louder and louder to hide the sound. On the whole, the Amitriptyline works. It gives good normal, and anxiety seems to have gone, and the side effects are minimal. What it doesn't do - and what no medication can do - is stop up deep feelings of loss and lack. These things have to be handled some other way, not just be blotted out with more or different tablets.
I firmly believe that there should be no chemical therapy without talk therapy. With time one can hope to let go of the crutch that the pills provide, but speaking the truth (your truth) is crucial.
ReplyDeleteSorry Joan, I never replied to this. I was going to and forgot.
ReplyDeleteI've had enormous amounts of talking therapy over the years starting from the age of 19. I'd say it amounts to about six years in total. Some therapists/counsellors are much better than others. Some should be locked up - for example the man in charge of Hammersmith and Fulham MIND in 1981 who slipped me his home number and made it clear he wanted a relationship with me. When I cried he observed that I found it hard to believe someone wanted to be my friend...hm.
I think there is actually a chemical imbalance in my head that needs either constant or periodical sorting out.