On Medication Dependency, or You Get What You Get and You Don’t Throw a Fit

Recently a woman I know told a group of people about her decision to taper down her depression and anxiety medications. She explained that she’d needed them when she was working because her job was so stressful, but now that she’s retired, she doesn’t feel like she needs them anymore.

“I’ve come to the realization that medications are great while you need them,” she said, “but then you come to a time when you don’t need them anymore.”

She wasn’t speaking to me directly, and she doesn’t know about my bipolar diagnosis. She was just telling her story, and her story is that she had mental illness that was situational, and now that her situation has changed, her mental health has changed and she no longer needs medication.

My story is not going to be like that. I’m tapering up my medications and there won’t be a time when I will be able to taper them down again, unless it’s to replace them with other medications.

I’m forty years old and I’m tied to the timer on my phone, taking medications three times a day, trying to keep my levels stable so I can keep my moods stable and avoid undesirable side effects. This is my life until we add more medications and I have to work those into my schedule, too.

This is the reality I’m reluctantly learning to accept, and even though I know that the woman tapering down her meds wasn’t talking to me, I still felt it as a kind of indictment. The thing that’s wrong with me is lifelong. I can do things to make it better, but I can’t control it all by myself. I’ve tried for years and haven’t been able to keep things in check, and that’s why I went to the psychiatrist in the first place, and while I’m grateful to have medications that can help, I still have this feeling that I only need them because I’ve failed. If I tried harder or found the right combination of diet, sleep, exercise, meditation, stress relief, anti-inflammatory herbs, aromatherapy, biofeedback, light therapy, omega-3 fatty acids, self-help books, TED talks, social media memes, and acupuncture, I would be able to manage this without medication.

My logical mind knows this isn’t the case, but I’m finding that my logical mind isn’t as loud or as persistent as the part that feels like a failure. I don’t believe that taking medications is a failure. Not really. But there’s still that little voice of doubt and blame. The nonjudgmental conviction that I need the medication to help me do all of the things that help me stay healthy is there, but it’s still unsteady. This woman’s words caused it to wobble just a little more.

The other difficult part is knowing that I’m not independent. If society breaks down, even just a little bit, and I can’t get my medications, what happens to me? Well, if I can’t taper down and I have to quit cold turkey, potentially bad withdrawal effects might happen, but beyond those, what will I do once I no longer have the help I’ve learned to rely upon? Although now that I think of it, maybe I’ll be just fine; hypomania is often helpful in a crisis situation, and when the crushing depression hits, at least I won’t be the only one (unless I’m the only one left on Earth, but that’s an unlikely scenario).

Even short of the collapse of human culture, I’m not footloose and fancy-free anymore. If I fly somewhere and cross time zones, what calculations will I need to do to figure out when to take my medications? Will they confiscate my pills when I go through customs? What if they take my bags and I have to wait for hours and can’t take my medications?What if I want to thru-hike the Pacific Crest Trail or hike the El Camino de Santiago or walk the length of Chile or bike across Canada or join the Peace Corps? Can I pack enough medication for an extended stay in out-of-the-way places?

Really, though, I know that my concern isn’t all about medication. It’s about what this diagnosis means for the rest of my life. What avenues are closed to me now that I know I have bipolar disorder? What choices are off the table?

I am grateful that I’ve already had my children and was able to bear them and breastfeed them without the decision of whether to go off my meds or expose them to the medications in utero or through my breast milk. Of course, they’ve grown up with a mother struggling with mood swings, but they’ve also grown up watching their mother do everything in her power to be healthy and strong and better for them and for herself. There’s got to be a benefit in that. And now they can see me working through the issues that come with taking psychiatric medications.

In one of the bipolar books I read, a patient describes her new bipolar diagnosis as a “death sentence.” I don’t think of it as a death sentence, anymore than living with it without having a name for it was a death sentence, but I do see how it is a kind of life sentence. But there are plenty of life sentences we all have to deal with. Some of us have Type I diabetes. Some of us have premature baldness. Or multiple sclerosis. Or chronic fatigue syndrome. Or arthritis. Some of us are too tall for most cars or too short to reach the high shelves in the grocery store. Some of us have bipolar disorder.

My friend used to tell her preschool-aged daughter when she’d whine that she wanted the pink cup, not the green cup, “You get what you get, and you don’t throw a fit.”

So, this is what I’ve got. And if I take my medications as prescribed, hopefully I won’t throw a fit. Or if I do, it will be a medically dampened fit.