Learned something new yesterday

Well, I was titrating off my Celexa and went hypomanic. I attend a partial hospitalization program, and when they asked about whether any of my meds had changed I was honest and told them. I thought, what's the worse they can do? Put it down as a goal of med compliance? No biggie.

Until yesterday. What they can do is up my days from 2 to 3! I know they are doing what they think is best for me, but really didn't expect it. To me, going back to 3 is like saying, "you're failing".

As much as I understand their intentions, I did ask why and my Case Manager wrote something down and said nothing else. She didn't ask what extra day I was coming, so I assume it's on hold.

Just venting I guess. Thanks for listening.

You aren't failing. You tested the waters, because of whatever reason compelled you to come off your meds. It's human, your decision. There's so much lit out there, about med free, there's so much stigma out there, about being on meds. You are human, you made a choice, albeit not with pdoc approval, and it led to hypomania. Now, you know this, about your body. Yes, you are back up to three days, from two. It's a slip, not a fall. And it's certainly, not a fail.

Take this experience, learn from it. Learning your human limitations.

They also refused last week to allow me to come in for Saturday group. Changed my goals. Nothing about med compliance though. But was one about talking to my case manager more. Ugh! Talking in 4 groups a day and to an outside therp is already enough for me.

For every action there is a consequence.......we have to learn what we are willing to accept & act accordingly. Yes, sometimes we have to test things because when things are going well, we think we don't need the meds any longer....but when we realize it's NOT working & that being on the meds really is helping that in itself should be enough for us to determine what the best action REALLY is.

It stinks having to be on meds......I am on pain medication for migraines that won't go away (24/7)....but the medication works so well that I don't feel the pain even though I do get the symptoms. But several times I tried coming off the pain medication which is similar to coming of psych meds because there is withdrawal big time if not done appropriately. I lowered the amount by 1/4.......& the migraine pain was creeping through.....I hate pain....so obviously, we never lowered the amount any more Yes, I was doing it through my pain specialist but even if I was doing it myself....as soon as I noticed that it wasn't working to come off, we went right back up to the normal dose (which is high).

So when you noticed the hypomania....is there some reason you didn't realize that coming off your meds wasn't working....or did you like that hypomania feeling & were trying to get away with feeling it again & didn't WANT to take your meds as prescribed?

Sometimes when our mind is clouded, we don't always do what is best for ourselves.....this is why the program you are in & the people monitoring how you are doing.

Were you angry that they refused to allow you to come in for the Saturday group? Were you hoping for just med compliance & not the other consequenses. Sounds like they want you to talk to your case manager more so they can understand where your thoughts are coming from & really what you are thinking in doing this?

Life is always just really about the choices we make.....wise or not wise & the effects that they cause in our life are what we have to live with. If we don't like how things turn out then we have to wisely think about what we need to change to make our life more acceptable to ourselves.

This is going to sound dumb, but please excuse my ignorance. But ... where does everyone find these group therapy things and case managers making goals and mental hospitalization things? My therapist wants to downplay my depression ("Have you tried to kill yourself?" "No." "Then it's probably mild depression.")

I mean, here where I live the only way you're going to end up hospitalized for mental health is when you try to commit suicide and then that's only for the actual injury, you'll have to be out as soon as the injury is treated. When I talk to my doctors about my meds it's:

"Did you try to kill yourself?"
"No but ..."
"Okay, I'll extend your script for another 3 months ..."
"But ..."

Maybe it's a midwest / Kansas thing? (Y'all just weak-minded ...)

Actually, I have never had too much trouble titrating off any meds I had, with or without my pdoc's approval. This time, I became hypomanic for the first time, and as I understood it, this was just a side-effect of titrating off. I am not officially labelled Bipolar to I assumed that the hypomania would last a little while, then I would stabilize. At worse, I might crash but only a little and would not titrate down further until I became stable again. I had been doing so well for quite some time and frankly, believe (and still do) that I will not always need an AD. When I crashed and realized I was getting pretty bad, I went back up. As long as my pdoc agrees to help me titrate off when he and I think I'm ready, then I agreed to go back up.

I do know they are doing what they think is best for me, but it is difficult for me to relinquish control and 'allow' myself to be directed by others when I don't want to do something. That is a long established issue that I've been working on now that I've been in this program.

To me, therapy is the answer, meds are temporary. I actually thought I would be able to get off them with no problem, they would see how well I was doing still and then I would 'spring' the news on them.

I was not angry about not coming to the program on Saturday. I know that it is less monitored. I just had made so many commitments during the weekdays and so little to do on the weekend that I felt it would be a better fit. If they didn't like it, I was a little disappointed, but accepted it. And they are trying to work around my schedule until I can actually schedule my appointments around the PHP.

Thanks for your input.

Well, to tell you the truth, I lived in Indiana for years and was hospitalized several times either for suicide attempts or ideation. The only times I've been referred to an IOP was when I was suicidal and usually only having been released from the hospital. After moving to California and ending up in the hospital, I assumed that I would be released and left to my shrink and therp. They are the ones who scheduled me for the PHP. The only reason I complied was because I had promised my therp that I would try, one more time to get better. It has worked out better than I thought it would.

Also, unfortunately, sometimes it also depends on your insurance. I've seen some pretty ill people 'released' because their insurance wouldn't cover the PHP...it is a long-term program. Usually with the wrong insurance or none, you are usually 'treated and streeted' at a hospital without benefit of other programs here. It is very sad.

I'm sorry you don't feel like you're getting the help you need. Is your therp also your pdoc? Have you discussed wanting a program like this with your pdoc?

Good luck!

Actually, I haven't. It never crossed my mind until you mentioned it. I guess I'm used to taking what I can get. I go to my pdoc tomorrow so I'll bring it up.

Thank you!

A lot of professionals and patients I have dealings with believe meds are lifetime. I think they should be viewed of as a tool for healing instead. If it is time and your pdoc is willing to work with you on withdrawal you are really fortunate. My pa a few years ago insisted that it should only take two weeks to come off an ssri. Everyone is different and for me it was more like 2.5 months. It was very tiny amounts and a cleanse that worked.

I think it is when they were trained. I'm in co and there are lots of doctors like that (one would ask "were you able to go to work?") but there are new ones that are much better with patients. My therapist has even started compiling a list for her clients. Unfortunately they don't take insurance so if you can't pay up front it is a problem. I cannot afford those drs right now but I called one and he referred me to a pa that shares the same philosophy.

Are you really looking for hospitalization or are you looking for something more structured or intensive?