It took me a lot of years to accept the fact that I needed to be on medication. I still have days where I don’t like that reality. They are especially hard when a medication change looms large on the horizon. I get anxious and stressed. Last night when Virgil suggested the consult, my initial reaction was to get stressed. I sat at a near silent dinner willing my lips to share this news with my partner. Somehow they just wouldn’t leave my mouth. It was like someone had suddenly made me mute. I’m not sure why it was so hard to say anything. It may well have been the crushing feeling of disappointment. Another drug combo, that worked very well, just didn’t last. It took me quite a while, but I did force myself to say something. My partner and I discussed the reality of another med change.

For those who know this life, and the possible upheaval a change brings, they know it is scary. Is it better to stay with the drugs that aren’t holding the line? or is it time to make a change? Is it worth the uncertainty? In doing so, things can get much worse before they get better. None of these drugs are a magic bullet. There are dosages to tweak, and side effects to contend with. It is always the same. In the process you never know if it will work. You’ll never know if staying on the original combo would have been a better option.

It has been a long road for me when it comes to meds. In all honesty I have been on most of the psych meds out there. Usually a cocktail of them. I would say it is one of the hardest aspects of dealing with this illness. It is trying to balance that fear of the unknown while containing the dreams of something finally working. This is what makes the search for the right meds so very hard. I try not to be hopeful. I try not to be scared. Instead I get numb and walk somewhere right between the two. The mind is such a powerful thing. Consider for a moment how a mind alone can create a placebo effect. It is hope alone that creates that. The dark side of that equation is side effects. I think equally as driven by our minds alone. I eventually stopped reading drug inserts, and the PDR, because I feel it only makes it worse. Going in blind to a new drug, seems a better choice. If there is a side effect, it isn’t a product of my imagination. I have no list of side effects to imagine. I know you are probably thinking, you should read the inserts. You should be an educated consumer. I think in any other case that is true. If I am taking a medication for a medical issue, I do educate myself. I also can argue that I have experienced many of the side effects psych meds have to offer. They tend to all run in the same vein. Most are sedating, especially initially while adjusting to them. Many cause some degree of digestive upset. Also during the first month or so. On the whole I have read so much on each of the classes of drugs, and their uses, I don’t need an insert.

I endlessly read about how medications are thought to work. What drugs are in development. which are being used off label for bipolar (that is a lot!). I know about gene theories of depression, and the two short alleles. All of this does little for me as I try to grapple with the day-to-day living. Maybe someday there will be a gene therapy, probably not in my lifetime. That leaves drugs. Not a tremendous number of them. It is easy to exhaust all combinations. That is what scares me most. The day someone looks at me and says “sorry, there isn’t anything else”. Each med change is one step closer to that reality. That drives my fear and lessens my courage to try another combo. It dampens that dream of finding the “right” one.