“What meds are you on?”

“What meds are you on?”

I am pretty sure that every person with a mental illness has had THIS CONVERSATION at least once when they sit down with another person with a mental illness.

By the time that conversation comes about we’ve all learned that there is no one magic pill to cure mental illness.

That is a painful lesson we don’t usually start out knowing, though.

My introduction to psych meds – not pretty

My first experience with psych meds was in September 2000.

After yet another bout of serious depression I was convinced by friends to go to a doctor. Without an in-depth conversation and just a cursory discussion of my history I was diagnosed with depression and PTSD and was put on ZOLOFT, a very common anti-depressant. Handed the meds and sent merrily on my way.

I spent the next three months flying higher than I knew could have ever been possible. Pure. Full-blown. Manic. Episode.

Over the course of those three months I went through moments of “this is amazing. I’m not depressed anymore so this is AWESOME!” I’d felt this sort of high before (what I know now were minor hypomanic episodes). I loved them.

I went through periods of intense creativity and productivity.

Was going to uproot my life and transfer to a school in Florida for reasons I absolutely cannot remember.

I got the idea that I could do anything and decided I was going to learn two new languages (Spanish and Arabic) and become a translator for the UN.

Then I became completely unable to focus. I couldn’t untangle my mind. I wasn’t sleeping for days at a time. Jittery beyond belief. Irritable.

My relationships with my roommates detonated.

Into the third month I finally felt entirely out of my mind. Paranoia ruled me. I thought I was crazy. And ultimately, I became suicidal.

Pills and a bottle of vodka. It became my first experience being hospitalized.

I’d gone to the doctor to be fixed. Instead, I felt like she broke me.

And even then the proper diagnosis did not come about.

THAT is what a misdiagnosis and going on the wrong medication might do to someone.

Is it any wonder that people can be mistrustful of doctors and of going on psych meds? It certainly made me.

I blamed the doctor. I quit going to therapy. And I threw away the drugs that caused this mess in the first place.

Then I spent the next several months going through what I thought was me being a complete nutcase. I began to fail all my university classes as I found myself unable to leave my dorm room for weeks on end unless forced to do so.

Before spring semester came to an end I finally couldn’t handle it anymore and I went back to the doctor in tears. I begged her to FIX ME.

Shortly before my 21st birthday I was finally diagnosed with Bipolar.

Then came the struggle of trying to find the right medications that would actually help me.

What medications are we talking about?

One of the most important things to know about mental illness is that while the symptoms can be treated, the conditions themselves are not curable. Most people don’t understand that. Medications are used for maintenance and management.

Another thing to understand is there are a LOT of different types of medications used to treat mental health conditions. And it’s important to remember that medications that may work for one person may not work for another. There are a lot of options out there, though. So don’t give up.

I found the following list of the major categories of psychotropic medications on GoodTherapy.org, but the National Alliance on Mental Illness is the best resource online that I’ve found if you want to really dig deep researching specific medications.

However, for today’s purposes, I’m going with this list. And for amusement, curiosity, or maybe just a future conversation starter, I have highlighted the specific medications I’ve been on at one point or another over the years.

• Antipsychotics: These medications are most often prescribed for the treatment of psychotic issues such as schizophrenia. These drugs fall into two categories, typical and atypical antipsychotics.
  • Typical antipsychotics include:
    • Thorazine (chlorpromazine)
    • Trilafon (perphenazine)
    • Stelazine (trifluoperazine)
    • Serentil (mesoridazine)
    • Prolixin (fluphenazine)
    • Navane (thiothixene)
    • Moban (molindone)
    • Mellaril (thioridazine)
    • Loxitane (loxapine)
    • Haldol (haloperidol)
  • Atypical antipsychotics include:
    • Abilify (aripiprazole)
    • Clozaril (clozapine)
    • Geodon (ziprasidone)
    • Risperdal (risperidone)
    • Seroquel (quetiapine)
    • Zyprexa (olanzapine)
• Antidepressants are a broad category of psychotropic drugs used for treating depression. There are several different classifications of antidepressants:
  • Selective serotonin reuptake inhibitors (SSRIs): These medications gradually increase the amount of serotonin, a neurotransmitter, in the brain. Common SSRIs include:
    • Celexa (citalopram)
    • Lexapro (escitalopram)
    • Luvox (fluvoxamine)
    • Paxil (paroxetine)
    • Prozac (fluoxetine)
    • Zoloft (sertraline)
  • Monoamine oxidase inhibitors (MAOIs): A less common variety of antidepressant drugs, MAOIs are often a last option with complex, treatment-resistant depression. Common MAOIs include:
    • Emsam (selegiline)
    • Marplan (isocarboxazid)
    • Nardil (phenelzine)
    • Parnate (tranylcypromine)
  • Tricyclics (TCAs): These older antidepressant medications have been pushed to the sidelines by newer, generally safer medications. Still, some people do not respond to the new antidepressants, so TCAs may be prescribed. Tricyclic medications include:
    • Anafranil (clomipramine)
    • Asendin (amoxapine)
    • Elavil (amitriptyline)
    • Norpramin (desipramine)
    • Pamelor (nortriptyline)
    • Sinequan (doxepin)
    • Surmontil (trimipramine)
    • Tofranil (imipramine)
    • Vivactil (protiptyline)
  • Seretonin norepinephrine reuptake inhibitors (SNRIs): These medications work by slowly increasing the amount of norepinephrine in the brain. Common SNRIs include:
    • Pristiq (desvenlafaxine)
    • Effexor (venlafaxine)
    • Cymbalta (duloxetine)
• Antianxiety/antipanic medications: These medications are used to treat a variety of chronic and acute anxiety issues, from generalized anxiety to panic attacks. Antianxiety and antipanic medications on the market include:
  • Ativan (lorazepam)
  • BuSpar (buspirone)
  • Inderal (propranolol)
  • Klonopin (clonazepam)
  • Librium (chlordiazepoxide)
  • Serax (oxazepam)
  • Tenormin (atenolol)
  • Tranxene (clorazepate)
  • Valium (diazepam)
  • Xanax (alprazolam)
• Stimulants: Typically, stimulants are prescribed to people with attention-deficit hyperactivity (ADHD). They help regulate disorganized thought processes. Psychomotor stimulants include:
  • Adderall (amphetamine and dextroamphetamine)
  • Dexedrine (dextroamphetamine)
  • Ritalin (methylphenidate)
• Mood stabilizers: This category of psychotropic medication is typically used to treat intense, repeated shifts in a person’s mood, which may be common for those experiencing bipolar, schizophrenia, or borderline personality. Many mood stabilizer drugs are also commonly categorized as anticonvulsant medications.
  • Lamictal (lamotrigine)
  • Lithium

Most Frequently Prescribed Psychotropic Drugs

1. Xanax (alprazolam)
2. Zoloft (sertraline)
3. Celexa (citalopram)
4. Prozac (fluoxetine)
5. Ativan (lorazepam)
6. Desyrel (trazodone HCL)
7. Lexapro (escitalopram)
8. Cymbalta (duloxetine)
9. Wellbutrin XL (bupropion HCL XL)
10. Effexor XR (venlafaxine HCL ER)

Psych meds and me

I can see that in the 20+ years I’ve been on (and off) psych meds, I have taken, at various points or another, fourteen of those medications.

There is a tendency, I am afraid, of some doctors just throwing medication at a person and sending them on their merry way. My first psychiatrist did that, as did many doctors I’ve been to over the years.

Some of the medications thrown my way turned me into a zombie. Others made me overly jittery. One unfortunately common side effect of many caused me to gain huge amounts of weight – a depression trigger for a lot of people (me included). Some made me feel suicidal.

These negative side effects would cause me to distrust my psychiatrists and sometimes give up on meds entirely.

Other times I’d go on meds and I’d start feeling like myself again. I’d thank my doctor and go on my merry way, thinking I was fixed. Then I would (of course) go into another episode and have to go back and try things all over again – feeling, yet again, completely broken and without control.

I used to go on and off meds as frequently as I started and stopped going to therapy. This would lead to frequently disastrous results.

Let me tell you – college and the years following were a nightmare for me. I barely graduated. I was hospitalized two more times. I went into enormous debt. I was forced to live by the whims of circumstance rather than choice.

Nobody had told me that medication alone wasn’t the answer. It would take finding the right doctor as well as finding the right therapist to finally gain some control over my illness.

It wasn’t until my late 20s when I finally realized that talking to my doctor (and having one that invited input) rather than quitting medication cold turkey or allowing them to just throw something new at me was the key to keeping me on an even keel.

Based on the reasons I felt the meds weren’t working, we would discuss a change in medication entirely, adjusting the dose, or adding something new to the cocktail.

Becoming an active participant in the discussions with my doctor on what I was being prescribed gave me that sense of control I’d never felt before.

It hasn’t always been pretty. But I kept trying. And when we’d find medications that worked for me, I’d stay on them until we needed to make an adjustment.

Wellbutrin for my depression.
Lamictal as my mood stabilizer
Ativan for my anxiety

This is the particular cocktail of medications I have been on for the past four years. Doses have been adjusted from time to time, but I’m doing better than ever before in my life.

Therapy and medication work hand in hand to manage my various disorders.

Therapy provides the tools necessary to steady myself on the emotional teeter totter that is my brain. Allowing me to stay balanced as I work my way back to standing again in the middle when things tilt in one direction or the other.

But it’s the medications I take that provide the strong structural support that helps keep the beam centered in the first place.