After 38 years, I finally heard something other than “Shut up and take your Prozac”

From doctors and therapists with their own agendas, to ones who seemed downright ignorant, my life was dominated by loss, frustration, anxiety, exhaustion, and the grief caused by all the devastation of it. Everyone seemed to be of one mind: shut up and take your Prozac.

Finally, it seems, some savvy psychiatrists are beginning to better diagnose and give some really good advice to depressed and anxious women whose lives have been wracked, both by their illness and by not getting the right treatment.

There is still a lot of stigma attached to mental, or what used to be termed emotional, illness, and a lot of that is due to the medical community’s mishandling of it.

For the first 30 some-odd years, I was never offered anything other than Prozac, no matter what it did to me, or how little it helped. In fact, it made things much, much worse. The first time I accepted it after the crisis of my divorce, moving back home, getting a new job, and learning to be a single mom, I was put on a fairly high dose, and it immediately pushed me into full-blown bipolar disorder. I would feel euphoric for weeks (but remained unwise and unmotivated), and then I would crash for weeks at a time. But since I didn’t know what bipolar was, I never put two and two together. When I told my psychiatrist about it, she simply cut me back to a lower dose of Prozac.

I begged my primary care doctor to put me through some tests — even just blood work. I felt there was something really wrong, even metabolically — the exact word I used. He ignored my plea and said I just needed to keep my appointments with my psychiatrist.

I tried telling the same thing to my (now third) psychiatrist. He simply shrugged and said, “You just have to accept that you are a depressive personality, and that you will always have to stay on a maintenance dose of antidepressants.” I knew that was not true — I was normally an upbeat person with a positive outlook on life. I loved life, loved people, but there was.something.wrong.

Thus began the endless trials of therapists and doctors, with no end of lame solutions. Divorce your husband, go back to your husband, say 10 positive affirmations in the mirror every morning. I even had one psychiatrist say to me in 2010, “Do you just want me to write a diagnosis of bi-polar in your record? I’m not seeing it, but if that’s what you want me to do, I’ll do it and give you some lithium.” When I got home, I sat with the bottle in front of me for days. I knew bipolar people. I knew that on no meds at all, what I was experiencing wasn’t the same thing as what they experienced. I also knew that lithium could be devastating for someone who wasn’t truly bipolar. I didn’t touch it.

I remember in 1976 marching indignantly out of my first psychiatrist’s office tossing over my shoulder, “I don’t want meds — I need coping techniques.”

My mother was emotionally ill, and all her meds just seemed to make her act out even more. She was institutionalized and given electro-shock therapy among other treatments. Because no one wanted to talk to me about my mother’s illness, I always figured it was the way people treated her — not understanding her — and the meds she was on that kept her ill. To a degree, that was correct, but it wasn’t the whole picture.

Sixteen months ago, I went to yet another psychiatrist out of desperation. I couldn’t work; I was a breath away from homelessness. I had to do something.

I asked to see a psychiatrist on an urgent care basis. She scheduled me for psych tests (a first in all those years!), and then I was scheduled to see a another doctor. It took almost four months before I saw the doctor who is now my regular psychiatrist. But when we finally met, nearly every word out of his mouth was a balm to my soul. First, he said, “You have ADHD and are atypical bipolar. The Prozac you’ve been on all these years has been absolutely the wrong thing for your diagnosis. In fact, it likely had the opposite of the intended effect.” Validation!

Then he spoke words that were like magic in my ears. He said, “You know I’m a doctor, so I’m going to ask you to take these meds. But these meds alone can not do it.” Oh, here it comes, I thought. They’re going to send me to a therapist again.

“I’m going to ask you to sign up for meditation classes, mindfulness classes, and to develop a more active lifestyle. Exercising is imperative,” he said. My eyes must have bugged out of my head. He was finally giving me those “coping techniques” I had asked for 38 years before. “Meds can’t do it all,” he said. “If you really want to get better, you are going to have to apply yourself to these things.”

It took six months for all the cobwebs to blow out when the medication finally got to the right therapeutic level in my system and took effect. But before that, using the meditation and mindfulness techniques began to transform me.

It wasn’t like I didn’t know about meditation and mindfulness; as a spiritual person, I knew a lot about them, but I was too overwhelmed to practice them. I hated exercise, and that overwhelmed me, too. Trying in drips and drabs to diagnose and treat myself, there seemed to be far too many variables to experiment with to figure out what would work for me. I had come to the point of “nothing I try works.”

It took someone to put it all together for me, someone to offer me the whole picture — to test me, diagnose me, give me the right meds — and to say: “…if you really want to get better….”

Looking back over the 38 years, there are a lot of things caused by my illness that can’t be repaired. Meditation taught me to let go of that. I made a lot of excuses for my behavior which I don’t have to anymore. Mindfulness is teaching me how not to behave that way. My active lifestyle is therapeutic in itself and bringing a calm and sense of stability that I have never known before. And the meds are what hold it all together, enabling me to have the focus and presence of mind to practice all of these things.

picture courtesy of Wikimedia Commons: Sir A. Morison – Lectures, mental diseases, 1826; plate Wellcome L0022709

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