Mental health blogger Fiona Kennedy talks about the pros and cons of adjusting your dose
‘Should the time come in the future when I simply cannot cope despite every effort I make, then I would be willing to consider medication again, with the caveat being that therapy has to happen first.’
This was the conclusion to an article I wrote for this series back in September. Since then, I have continued to reduce one of my medications, and have noticed some interesting consequences. Some are welcome, others are less so, but both make me seriously question the validity of taking these drugs in the first instance.
I should probably preface this by saying things are not going well for me right now. I’m struggling to keep myself going, and am extremely confused about many aspects of the whole concept of mental illness – what’s in my power, what isn’t, how I can help, when to push myself, when to give myself a break – even thinking about it is exhausting. It’s also entirely possible that this whole thought process is directly linked with reducing drugs, which adds another delightful complication to the situation.
Before I started tapering, I was taking 125mg per night of an anti-psychotic known as Quetiapine (in higher doses it’s used to treat schizophrenia and psychosis). Honestly, I wasn’t entirely sure what it was doing for me, other than ensuring a solid night’s sleep as it completely knocked me out. Sleep has always been a problem for me, so I was more than happy with this particular side effect. Otherwise, the changes that come about as the result of taking these drugs are so gradual that it’s hard to recognise what’s medication related, and what’s me. The intention was that it would stabilise severe and frequent mood swings.
I’m now down to 50mg, and it’s only since starting to reduce that I can see very clearly some of what was entirely medication related. The first was in actual functioning. It had me unbelievably slowed down, particularly in the mornings. This certainly stabilised my mood, but it made day to day life more challenging in other ways.
I noticed that change within a week or so. Rather than walking in circles around the kitchen forgetting what I was meant to be doing, I was actually able to just get up, get everyone fed, get the lunches sorted, and get the kids to school, without feeling like I was dragging myself through mud.
Another huge difference has been in my appetite and weight. I had gained quite a lot of weight in recent months, particularly after moving to the highest dose. I was constantly craving carbs and sugar – possibly in an effort to give myself more energy – and was eating far more than I needed to. A couple of weeks after the first reduction I noticed I had lost weight, and my eating pattern has changed completely. The cravings for sugar and carbs are gone and I’m not over-eating.
All of this brings me back to my original question about the validity of taking these drugs at all.
When trying to manage any kind of mental health difficulty, there are a list of things that we’re all told will help – a healthy diet and regular exercise are top of that list. But then we’re given a drug that works incredibly hard to make these already challenging strategies all but unattainable.
How am I supposed to get up and exercise first thing in the morning when I can barely think clearly enough to find the cereal? How am I supposed to maintain a healthy diet when my system is craving the last thing I actually need? And how on earth am I supposed to sustain the motivation for either when despite my best efforts at both, my weight continues to increase?
Of course, now that I’m tapering, I’m faced with a whole other can of worms. I can’t deny that my mood has been affected, and I’m starting to move back towards older, less helpful behaviours and coping strategies. While my thinking is less cloudy, it’s more confused, and I’m so tired.
Some of this is because I’m not sleeping as well as I was on the higher dose, and some may I suspect be a part of the process of my body adjusting to a different level of chemicals. Some may argue that it’s the start of a relapse, but I’m not prepared to accept that. Not yet.
The more I think about this, the more I believe that as a society we’re approaching mental health from all the wrong directions. I want to get off these drugs, but it’s going to take a monumental level of effort to keep myself going through the tapering process. If I can’t, there’s every chance I’ll be told I need to increase them again, which brings me right back to square one.
I’m not saying medication is bad, or wrong, or unnecessary. I would just love to be at a point where every other possible avenue is explored first, and that those avenues are available to everyone, not just the privileged few who can afford them. I know there was a time in my life when the only option I had was medication, but I wonder if taking that route is after creating as many problems as it tried to resolve?
If you are affected by any of the issues raised in this article you can contact Samaritans free any time from any phone on 116 123 or visit www.samaritans.ie to find details of your nearest branch. You can also find online information at www.yourmentalhealth.ie