It's a Secret

I know that not all of you will be supportive of me (in fact, I'm sure many of you will not), but I have a secret and it's killing me.

I stopped taking most of my medications 2 weeks ago, but I can't tell anyone in real life. My mother, who I generally tell EVERYTHING, would flip out and read me the riot act. I can't tell my friends because it would get back to my mother. I can't tell my coworkers because they don't know my diagnosis, and also because if I did spill the beans, it would get back to my bosses (who DO know) that I'm not being compliant with my treatment... and I would be in danger of losing my career over it.

I'm going through mood changes (mostly for the better) and withdrawals and such, and I can't confide in ANYONE.

Well, that's not entirely true. My psychologist knows, and he's on board, but I only see him once a week, which isn't much help day-to-day.

I just don't know where to turn to get this off of my chest. I'm not used to keeping ANY secrets from people, so this secrecy is killing me. I don't have anyone to talk to, and that's really hard for me.

Perhaps I can find some virtual friends here to help me through... please?

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Medicated I personally am not in favor of stopping meds, that is to say that I wouldn't do it myself. I would be climbing walls and driving people insane. BUT, I am NOT judging you, mmkay. So, ya know, if you feel fine or better now that you've stopped taking them, kudos! Good for you. I actually wish that I could do the same. I would love to go med-free and be okay. And, I think if your psychologist knows and is okay with it, then it's even better. I don't want anything to happen so that you lose your career and get constantly lectured by your mom--that would suck--so I hope this works out for the better for you. Good luck!!!

Medicated, you are an adult and you can decide whether or not to take your meds. Keeping secrets is extremely stressful, so I'm glad your t-doc knows. Perhaps one of your friends could be trusted? I'm just concerned that someone that sees you more often should know as well.

Most of my friends moved out-of-state this summer, so there isn't really anyone to "keep an eye on me," so to speak. My life consists of work and sleep and little else. I live alone with my cat, so there isn't anyone I see on a daily basis at home either. I don't know who I would tell.

I fear that my best friend (who is in another state until Sept) would tell others out of genuine concern for me and fear for my well-being. As much as I want to, I can't tell her. What it boils down to is that I don't think the people close to me would understand.

I'm not entirely uneducated in regards to medication. I am a healthcare provider, and have completed some training in psychiatry. I am familiar with how the various medications work and so forth. Even so, going against the recommendations of my psychiatrist was not a decision that I took lightly or made impulsively. For MONTHS, I practically begged him to reconsider my regimen, but he wouldn't budge. Finally, I carefully considered my medication list and picked and chose which ones I would eliminate, which ones I would keep, and which ones I would adjust the dosing. I have not abandoned medications entirely... just greatly reduced the number and dosage.

I will be meeting a new psychiatrist in the beginning of September, and hopefully he will be more understanding and respectful of my desire to stick to a minimalist approach. Although I would LOVE to not take any medications, I realize that that may not be realistic, considering my history of severe depressive episodes. (I'm BPII, so I've never been fully manic or psychotic... the depressions are the real problem for me.)

*sigh*

As I said, so far things are going fine. I'm having nasty withdrawals from the Lexapro, but on the whole, I have more energy than before, my thinking is clearer than before, and my appetite is much less (I gained 30 lbs since the new year). I didn't realize how drugged I was. At this point, my only regret is that I didn't make these changes sooner...

I just wish I could tell someone.

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I remember from your previous posts that you were having issues with your p-doc, so I can understand your position. I hear you on the speaking up sooner, I finally came to the same conclusion 3 months ago and finally voiced my concerns. I had gained 40 lbs. in 2 months after I was first diagnosed (2007) and yes my mental well being is more important than how I look, BUT being overweight has made me feel like crap. I am finally starting to drop the weight, but it's going slowly (so far 13 lbs).

Keep us posted and we can all look out for each other here as well.

I was so worried when you said you went off your meds, but I totally agree with choosing & lessening your meds to only the ones that are really doing the job. Being over medicated is the worst thing in the world. It's tough going through the withdrawal, but I am sure that in the long run, you will be better off. As long as you are on the meds that control your depression & keep you consistant I think you will definitely feel better. Guess my feeling is that you know you wouldn't get support in doing what you are doing, so doing it the way you are, & then showing everyone how much better you really are without those meds is sort of a show them sort of thing that will be proved when you are there.

I have so much trouble with meds, I ended up not being able to take anything except for the natural Omega 3 (EPA) for depression/anxiety as everything else knocked me out completely or have me horrible side effects. I'm not bipolar & realize that is a whole different situation than my own, but I do understand the horrible feeling of being overmedicated when they were trying every possible med to see if they could find something that worked. I don't make a very good guinea pig & ended up refusing to continue.....

I truly hope that once you are over the withdrawal that you will find this is the right answer for your situation & that you feel 100% better.

Yes, everyone is different - if I went off my meds I would suicide, for me it is that straight out. But I have also taken YEARS to get what I believe is the right meds mix and the psychiatrist I have had for the last 2 years is the best they come. I know what you mean about not having that trust relationship with your psychiatrist - I had several psychiatrists in a rown who literally nearly medicated me to death - I was on meds that were contraindicated for me for years and as a result I nearly died. I'm a 100% compliant patient but if I had known what was going on then I would have gone non-compliant. They DON'T always know what they are doing and moreover -THEY DON'T ALWAYS CARE. Some are in it just for a prestigious job and some, like the one I have now, have a vocation - just keep advocating for yourself until you get one who has a vocation.

Hi there,
I'm glad you feel comfortable to share this with us.
As you mentioned, you are by no means uneducated in this field.
Please just be honest with yourself (You have now put this responsibility on your own shoulders) and the moment you feel you are losing control, ask for help.
Online, with your pdoc, or T.

We are here for you whenever you need support

I'm with some of the others on here. I wish I could quit taking my meds but, I would spiral out of control! Just be careful and pay close attention to your moods! We're here if you need us!

I did practically the same thing in May. I weaned myself off of the meds I didn't think were helping and lowered the dosages on some others that I thought were too strong. I told my p-doc about it in retrospect, and she was not pleased. But, she said she would continue to work with me because my mood had improved with the adjustments that I made. In June my depression spiked and I had to go back on an anti-dep, but it wasn't until late July that I got on one that actually worked for me: Cymbalta. My depression has been minimal to non-existent since the day I started it. I'm on some new meds, but I still have a reduced set compared to as say April. And this was my design. If I hadn't taken myself off of so many of my meds and reduced their dosage, it's possible the Cymbalta wouldn't have worked and become the missing link. All this to say, I support you in your decision so long as you're doing it carefully and gradually and adjusting back onto things if you feel your mood slipping. That's what I did. It feels good to have some control over your own body...especially if the p-doc won't listen to you. About a year ago the psych nurse I was seeing wouldn't let me come off of Seroquel which was diminishing my will to live. I came off of it, while still on Lamictal and Wellbutrin and went into a 9 week manic episode. It was more hypomanic than manic, but it was awesome. The crash was not so awesome though. So I've had mixed results with adjusting my meds. I wish you all the best in your journey to become well.

I sent my psychologist an email yesterday basically saying that I was having a hard time with the secrecy and wishing I could talk to someone about it. (I NEVER email him, so this kind of contact is very unusual of me...) He sent me a reply AND called me this morning and advising me to get my psychiatrist's help as I wean from my medications... Saying that my psychiatrist is ethically bound to help me, even if he does not approve of what I'm doing. Is that true? It seems to me like the shrink could just tell me that I should still be taking ALL of my medications, and refuse to help me off of them. I also don't want any confrontation. I was planning on canceling this Friday's appointment and just disappearing...

I really don't want to tell my psychiatrist about this, but the fact that I'm experiencing withdrawals is making my psychologist very nervous. Not only is this out of his (the psychologist's) scope of practice, but he knows that he is on ethically very shaky ground for encouraging me in this decision-making process. I would never EVER hold it against him. I'm a grown-up and the decision was ultimately mine, but I think he's backpedaling a bit and feeling a need to protect himself. I don't blame him one bit, but I do feel like I'm losing my only real-life ally. He helped me come to this conclusion, and now he seems to be changing his mind on me. I completely understand why, but it's still hard.

So now what do I do? Do I go back on the Lexapro indefinitely until I meet with the new psychiatrist in September? Do I go back on a low dose of it to ease the symptoms, then face my current psychiatrist and ask him how to get off of it? Do I try to keep toughing it out and hope that my withdrawal symptoms will go away soon? I'm inclined to go with the latter.

Despite the fact that I discontinued two different mood stabilizers (Trileptal and Abilify), stopped one antidepressant (Lexapro), and decreased my dose of both Wellbutrin and BuSpar, I have noticed no significant changes in my mood... which reaffirms to me that I was being grossly overmedicated. Based on what I know about the nature of my illness, the odds of me rapidly going off the deep end (in either direction) are very slim (but not impossible), and that is a risk I am willing to take. I think it's inevitable that at some point I will become terribly depressed again, but no medication regimen has ever prevented that from occurring in the past... so what's the point? I don't want to wander around being overly drugged if it's not actually doing me any good, you know?

I'm not encouraging others to follow in my footsteps. I'd say that in the vast majority of cases, the psychiatrist's recommendations are probably the best course of action. Medication noncompliance is a HUGE problem in psychiatric practice, and I most certainly don't want to tell people to jump ship and dump all of their meds, because people generally stop taking their medications for the wrong (or ill-informed) reasons.

Do what's right for you, but be wise.

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As far as what your T-doc said about your p-doc being ethically bound to assist you I think he is correct. Your P-doc may tell you to go back on the meds he prescribed, but you just need to hold your ground and stand up for your rights as a patient. Bottom line you are moving anyways, so who cares if he gets pissed off?

In my opinion your Psychologist over stepped his boundaries and it would have been of better benefit to help you gain the confidence to switch P-docs. JMO.

On the phone this morning, my psychologist said the same thing about the psychiatrist getting pissed off: "So what?"

I don't know... maybe I just hate confrontation. I'd rather avoid the situation than face his displeasure. I have the scenario in my mind - I show up, he asks me how things are going... I say "fine," and then he asks me if I'm taking all of my medications... and I say "no." He then proceeds to tell me that I'm being very foolish and that what I am doing is extremely risky, and that he doesn't want me to end up in the hospital again, and that I should have just stayed on the medications he told me to take until I finished school... and so forth. At that point, how am I supposed to ask him to help me get off of the Lexapro?? I think the odds are high that he will "fire" me as a patient because of noncompliance... unless I agree to resume the medications I was taking. Placed in that situation, I might sheepishly agree but likely continue to not comply unless he managed to say something that could undo months of brewing resentment and distrust.

And yes, I am aware that my psychologist overstepped his bounds, but there were reasons that I was stuck with the psychiatrist I've been seeing... Namely that it's extremely difficult to get appointments with psychiatrists where I live - the wait is usually 6-8 weeks - and I was rejected by a couple of other clinics for reasons unknown to me.

I'm beginning to wonder if I'm not in my right mind. This entire situation is quite frustrating for me. I think I feel okay... but underneath the surface, I think I am very, very confused, and wishing desperately for an expert/authority figure that I can really whole-heartedly trust. I'm not so sure of myself any more, and that's not a happy feeling because I feel like I have no one to run to for help.

I jumped out of the plane and now I'm realizing that my home-made parachute is not as big or as tough as I thought...

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You deserve to have a P-doc that you can trust and feel that you are working as a team rather than someone who just tells you what to do. I got this list of questions to ask a perspective p-doc from a book I read. It may help when you go see your new P-doc in September:

1. Are you state licensed. (The only acceptable answer is yes!)
2. About how long would you expect the evaluation and treatment to take? Most wouldn't be able to answer precisely before talking with the perspective patient, but it's wise to try to get an idea.
3. How much clinical experience do you have treating patients with bipolar disorder? Generally speaking the more experience, the greater likelihood of success.

I also use a website that rates mds in my province to check out a perspective doctor.

Psychdocs can be intimidating but you have a right to decent and respectful treatment. Don't let the psychdoc run the whole show, but at the same time try to have an open mind to their suggested treatment plans.

So if you go off your meds too much, does the pdoc dismiss you as a pt. or what? I don't know that is why I am asking how this works.

Since this is the first time that I've been noncompliant, I don't really know. However, I would assume that the doc may feel that there's no point in him treating you if you aren't going to listen to anything he says. Wait lists are usually long, and his time could be better spent on someone willing to cooperate, you know?

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Status update:

The Lexapro withdrawals were so bad this morning that I finally took 5 mg to ease the symptoms. It worked wonders, but I hate that I had to take it again. I wanted to tough it out, and this will just prolong the process. Boo.

I'm meeting with my psychologist tonight. At our last contact he seemed really worried about me... and fairly worried about himself too, since he kind of overstepped his bounds by helping me decide to take my medications into my own hands. We definitely need to talk about this... he helped me get into this situation, so he'd better be willing to help me through it.

I was feeling pretty anxious about it last night, but I'm doing a bit better now... feeling like things are okay again.

I still haven't told my mom or friends or anyone... and that's hard, especially when you're not feeling well and going through withdrawals.

I'll update you on what the psychologist says tonight.

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Not sure what I can say which could help you as I've only been taking meds (Seroquel/Wellbutran) for bipolar for about a week. But I'd say that if you believe in a higher power, whatever you want to call it, that would be who/what you may want to ask for help. In other words, you might want to try prayer.

Just got home from my therapy appointment.

I'm not sure what to say.

As it turns out, he actually told me that he was resisting lecturing me himself. He was very concerned that I am jeopardizing my career unnecessarily, and encouraged me to think about whether being off medications was more of a priority than keeping my career. He says he understands my motivation, but states that the timing was not right.

I thought he was on board, but it was pretty clear at my visit tonight that I misunderstood. Completely.

Of course, he has to protect himself, and he was very clear that I HAD to tell the psychiatrist... because if something went wrong and he was the only one who knew that I had altered my medications, he would be ethically and legally liable. Understandably, the situation was making him very nervous, but I still can't help but feel a little like he helped lead me to this point, then bailed on me and left me hanging.

What does he want me to do? He wants me to go see the psychiatrist on Friday and tell him what I did... and emphasize to him that I feel better. Show up, deal with the lecture, and make the relationship more of a "just in case something goes wrong" sort of deal. He [the psychologist] really doesn't like the idea of me messing with my medications without having anyone to call upon in case trouble arises. That is a fair concern.

Will I go to the appointment on Friday? That's a definite maybe. I might go if only to ease the ethical/legal concerns of my psychologist who actually appeared legitimately anxious today... because I'm nice like that.

*sigh* What a mess.

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