With World Mental Health Month drawing to a close, it's absolutely crazy (pun intended) that there is such a stigma around mental health. Where there isn't a stigma, there's a bunch of fruitloops on the internet who claim to be experts and most GPS are just not equipped to deal with anything more complicated than mild depression.
I've been battling the last few months with physical and psychological ailments and it's really felt like there's no end in sight. They seem to feed each other in an endless cycle and it's literally taken turning myself inside out and a near death experience to get me on the right path.
I the last few months I lost my father, uncle, cat, job, use of my left knee and almost all my self-worth. When I look back now, I realize that although that's a HELL of a lot of loss for one person, I have not been alone.
When the clouds lifted a little, I could see beside me and recognize that I have a PHENOMENAL support structure. In therapy yesterday, I was asked to define who is inside my safe circle (my favorite author, Brené Brown, uses a quote by Theodore Roosevelt to describe these people as the people who really matter. The people facedown in the dirt getting the shit kicked out of them with you while they are also daring greatly), and who is on the outside... Who I could perceive as harmful. I was quite pleasantly surprised/ shocked/ confused that the proverbial trash seems to have taken itself out. Not that there isn't anyone that irritates or intimidates me, but all the threats have been removed. My "safe circle" has grown exponentially in the last few months and the people outside have started heading for the exists or have already left (I suppose Brené Brown would refer to those people as being on the stands in the arena).
This has not happened by magic though, I'm afraid. It's taken impossible decisions, unfathomable bravery, trust, the ability to withstand betrayal and abandonment, and a whole lot of PTSD.
Needless to say, I have needed to adjust my depression and anxiety medication accordingly, and that really was just the horrible rotten cherry on the cake (I normally quite like cherries, so just roll with me here).
I visited my local GP, who I've been seeing for a few years now instead of my actual doctor who originally properly diagnosed me and got me on the meds that changed my life, 7 years ago when I got divorced. My local GP is a great family doctor, but he is just not equipped to deal with complex mental health issues.
I have major depression and chronic anxiety disorder. I am also prone to serotonin syndrome. It's like I have an allergic reaction to anything that triggers or alters my serotonin levels and this means I cannot... Ever... Under any circumstances take SSRIs or SNRIs.
So after all the loss and death and injury and depression, I became a hermit and was living under my purple fluffy duvet. I lived there for three months, emerging only to collect and drop children from/at school.
I did not come down for meals, I was in too much pain to cook and I was living in my pajamas. I watched all 12 seasons of "Friends" and would do basically anything to drown out the gaping hole in my life that loss and abandonment had left. I was in agony, physically and psychologically.
My knee condition led to several dislocations which unfortunately also caused me to pinch a nerve in my back and let me tell you, there isn't much that's worse. I've had gallstones and had my gallbladder removed when I was 16 and I've had a baby. That pinched nerve was hell. The physical aspect of my pain deeply impacted my psychological state.
After a three-month wait since being denied surgery, I finally got in with the physio and occupational therapists at my local day hospital who equipped me with a brand new brace and encouraged me to go swimming at the gym (which I am now doing twice a week and THOROUGHLY enjoying). The idea is to manage the chronic condition in the long term. It's been quite something to come to terms with.
After two rounds of Voltaren suppositories and no improvement in my back, I decided it was time to go visit my GP. My plan was to ask him to increase my depression medication and to request a Voltaren injection to ease my back pain.
This particular GP has never understood why I'm on the meds I am on. He's never had faith in Lantanon/Mianserin and when I asked for an increased dose (which has been historically extremely effective) and admitted I'd been taking a worrying combination of pain medication and fast-acting anxiety meds (benzodiazepines), his reaction, instead of supporting or listening to me, was to shame me about my weight and brand me as an addict and promptly removed me from all my regular medication and placed me on an SNRI (Venlor).
The results were devastating.
I have had serotonin syndrome before and I know what to look out for. I was in such a state though, that I was doubting both my own sanity and my ability to read my own body. I wanted to believe my GP. He's been good to me with treating my knee, but in this instance, he failed me terribly.
I have been taking Alzam (Xanax) and Lantanon (Mianserin) in differing doses for 12 years now. I have been successful in weaning up and down in my dosage in both medications with no side effects or withdrawals whatsoever. When I became concerned about my self-medication, I thought I was doing the right thing by telling my GP, hoping to increase the Lantanon and cut down on the Alzams as, in the long term, this would prevent the constant barrage of panic attacks that were just completely exhausting my system.
I protested the medication change and pleaded with the doctor to understand that I have historically suffered from serotonin syndrome, but just like other underequipped healthcare workers in the past, he brushed aside my concerns and sent me out the door with my new script, with the assurance that because Venlor is an SNRI and not an SSRI, I would not get serotonin syndrome.
God. He couldn't have been more wrong.
If you have never had serotonin syndrome, let me paint you a picture.
Symptoms include:
Delirium
Hallucinations
Fever
Diarroeah
Vomiting
Intense panic
Suicidal ideation
Seizures (which I managed to avoid - THANK GOD)
These symptoms persist until the medication causing them has stopped.
My poor husband had to watch me descend into the abyss, with no way of helping me except to hold me in his arms and let me cry. Thank god, because the last time I went through this, I went through it alone. I've had serotonin syndrome before, but not for 4 whole days. I thought the world was going to turn into a black hole and swallow me alive. I felt helpless and shamed. I wanted to reach or to my GP to let him know we'd made a mistake, but given his attitude at my last appointment, I did not expect much sympathy. I did reach out eventually as the symptoms were not subsiding. If anything, I was getting worse. He couldn't be bothered to return my calls or messages.
I decided to make an appointment with my original Doctor across Town, who unfortunately charges quite a lot more than my local GP, but this decision was life-saving. I felt cared for, heard, understood, and validated. He agreed that my recommendation for treatment was the best option. I stopped the Venlor altogether which stopped the serotonin syndrome within 24 hours. We doubled my Lantanon dose and halved my Alzam intake. As a test for myself, I took a break from Alzam and experienced absolutely no negative side effects or withdrawal symptoms. I am now taking them responsibly and far less frequently thanks to the sharp decline in the number and severity of my panic attacks.
I am now sleeping right through the night and I cannot explain what it feels like to wake up and be at home in my mind and body. Those few days were horrifically frightening. Looking back it made me think of people locked away in asylums in the early 1800s/1900s and how they were mistreated, misdiagnosed, and abused.
Although the system is not perfect and we still have a very long way to go in spreading awareness and educating the general public as well as the healthcare practitioners who are supposed to be looking after us, I do believe we are making headway.
I cannot stress this enough. The right medication can be life-saving, but please, whether you're starting for the 1st time or changing meds, please do so under the guidance of an experienced mental health practitioner and ensure you have at least one person in your life who you can call at any hour. If things don't feel right, listen to your body, report to your doctor, and love yourself enough to do what is right for you.