Ask Anything Monday!

Hi. The problem for all of us is that we are seeing a person in an office. For "blue collar" workers that's a bit like being in the bosses' office; for "white collar" workers it's a one on one with a senior colleague-- either way it's intimidating.

As mental health issues are still viewed by many (both the ill & the "not" ill) as a form of weakness of character-- or something to be feared-- we are "twice disadvantaged".

I struggled with visits even though i see a well qualified & easy-going psychiatrist; we both have a fondness for cars so eventually, the visit would begin with a few words about cars.

I guess it's all about "space" & your place in that "space"-- your need to be there. Worrying about opening up won't break the dam walls; it may feel like it but if you begin to open up & things go too fast, your specialist will likely "grab" a point & draw you back to the reason you mentioned it.

Do the thing you fear because you can't live with it (fear); it's better to get that demon out of your head. Like a speed-bump, it is slowing you down & spoiling your "ride" through life.

Best wishes, Schultz.

Hi everyone! Happy Monday! 🙂

Firstly, a big thank you to @schultz , @Former-Member , @Rosie , @kato , @ClinPsych , @kenny66 , @Ellie & @Flame7au who responded to last week's Ask Anything Monday!

This week's AAM comes from a member who has tried a few different medication options -

I have been working with my psychiatrist for some time now to try and get a good combination of medication and dosages. My problem is that I don't know how I'm supposed to know when the medication starts working? What does it feel like?

And is it possible that I won't really notice it, like if it was gradual?

I'm just worried that I won't be able to see that one is working and that I'll just keep trying new meds forever...

There's no two answers alike for this question as different medications effect everyone differently.

I'm actually a MH nurse with a good working knowledge of psychiatric medications, but I'm a little bit ham-strung about how to answer your question because firstly, I don't know what you're being treated for and secondly, we're not allow to talk about specific medications on this site.

The most commonly prescribed drugs are for depression or psychosis, maybe both at once. Anti-depressants can take up to 8 weeks to bring relief, yet may not work well enough to get you back on top so a different one may then be tried. It seems like wasted weeks, but you really need that amount of time to see if the anti-depressant is going to do some good.

Anti-psychotics work almost immediately but can leave the person feeling very drowsy for days, however that will eventually wear off. Reaction times during this phase can be severely limited and so it's best not to operate machinery or drive a car until the body gets used to it being onboard.

Of course all of the above also depend on the dosage. For example, I'm on a low dose of a particular anti-psychotic for a particular symptom of my BPD. It's worked very well for me in that area, but those suffering a psychosis may be on a dose of the same drug several times higher than what I'm on.

I'm also on an anti-epileptic, used in my case as a mood stabiliser. It's a reasonable dose, but an epileptic would be on an even higher dose.

It's really a matter of "horses for courses" and I suggest you speak to your psychiatrist and discuss your concerns with him/her and don't be afraid to ask the same question you've asked here. If you have trouble remembering it, write it down before you go see your psych.

I don't think I've helped much, but all the very best to you anyway,

Ellie.

Its difficult to say without knowing the diagnosis.

However getting medication right can often take a very long time. I tried many combinations, a lot of which did not work to control my schizoaffective.

For me I tried to avoid medication that sedated me too much. So that was one of the things that I had as a must have.

On the question of insight as to whether it is working or not that is a tough. I can only talk about it from a schizophrenic point of view.

With schizophrenia a lot of the time you are living is an unreal word, which you are not sure about. delusion's and hallucinations are on feature of it. So its pretty easy to measure the change in behaviour brought about by the medication.

Likewise my speech and thinking is clearer. It starts to follow a logical fashion instead of being disjointed.

Yes, medication can take a long while to work and it can be very gradual. But for me it was very quick especially when one particular one was added to the mix.

Its not so much that you feel better but rather that you are better. I have longer times between episodes and more control over unusual behaviour.

If you are on the mood control drugs in conjunction with antipsychotics, the the change can be really noticeable with a withdrawal of manic depression bouts and much less severity.

I have a feeling of wellness about me when the medication is right. Some of the antipsychotics target manic behaviour but unfortunately its the one thing that I have a very hard time to get under control no matter what drugs I use.

Right medication is the key in my view to taking back control of your life.

It also important to remember that they all have side effects so that part has to be weighed up as well.

Your psychiatrist will be on top of this and be able to determine the effectiveness of your medication.

Kenny

Hi there,

Good question! Sometimes kind of hard to know if meds are "working".

I guess one suggestion would be to keep a journal about how you feel: whether you think you are experiencing any side effects, what is going on in your life on a day to day basis. I'm not sure what you are taking meds for but over time I think this might give you a clear indication whether your mood or stability has improved - you could try rating this (or both) each day out of 10 as part of the journal. I know that seems like a lot of work but if it isn't clear that it is helping it's quite understandable that you want to know - some of them do work gradually. Some of them don't work at all for some people, some of them make some people sicker.

I hope this helps somewhat. I think it can be quite a discernment process.

Kindest regards,

Kristin

Hi.

you ask a very sensible & real question. I'm not sure where to begin; between my Gp & various psychiatrists, i feel that the pharmaceutical industry would have collapsed had i not existed.

To get to the point you are at now, i'll describe some of the process i've experienced with my current psyc. When i was first referred to him it was by a Gp i respected & who had served me well through my psychical illness so i trusted him. We went through my medications & he knew where to begin (some psychiatric meds have bad interactions with other meds).

I was 42yrs. old at the time & not too timid to express myself so if a medication was causing problems, i explained them & "we" took it from there.

When i got a part-time job that required intense concentration for periods of time, he adjusted dosages of some meds & replaced others (it was a "wild ride" working & evaluating my reactions to the new meds-- but i look back with pride [that i hung in] & gratitude toward my Gp & my psyc for their faith & support).

I'm currently un-employed--- again --- & the medication wasn't enough so another "adjustment" has been made. I can only explain my side of the story--- i communicated my feelings both physical & emotional & was fortunate enough to have a psyc who offerred options, as well as decribing the "ups & downs" relating to each option.

Beware the opinions of well-meaning "non-specialists"! The last change to my psyc meds was disputed by my local chemist (i'm lucky, i have used the same chemist for 20+ yrs.).

At my next visit to my psyc i mentioned the "concern" & he referred to a medical book & assured me that the increased dosage was well within tolerances---- and the bonus! It has lifted my spirits & given me back some of the energy i was missing.

Have faith, communicate your feelings body & mind & know that even the "right medication" needs you to do some of the heavy lifting,

Schultz.

Hi,

after a period of time on disability, i found a part-time job that was exciting----- for about 5 mins. I hung in there & eventually earned a certain respect for being suitably dressed, on time & reliable. It was a fairly agressive work-place so i can't say i was happy---- but the money helped!

When friends asked how it was going i'd say "Not for very much longer" & they'd trot out the same plattitudes you seem to be hearing. Part of my mind would say "Don't let this place destroy your soul" & another part would say "You're better than these idiots-- show them who you really are!" So gradually i hardened up & accepted the challenge on my terms-- stay 'till the bills are payed & see how it goes. I lasted 9yrs & 7mths.

I rang in sick that last day & never went back; i'm not sorry i stayed; i improved my finances, got to meet a lot of good people, outlasted an "army" of newcomers & "resigned" in a way they deserved.

That's my story & it probably isn't what you wanted to hear but each of us is different & respond differently--- be yourself, do what your inner voice says & don't blame anyone-- not even yourself for what comes after; sometimes we try to "punch above our weight"-- sometimes we can-- sometimes we can't.

Schultz.

Hi Ellie,

"glad" to hear the mention of an anti-epileptic med in your comment. I suspect i'm on the same one; it was prescribed as a mood stabilizer & as i have a L4/L5 disc problem in my lumbar region (back) i've been told that it also helps (in conjunction with other pain meds) with pain signals

Rgds, Schultz

My only suggestion, based on personal experience, would be to keep a diary - note anything you feel is important from medication dosage, moods, appointments & sessions, pain issues, etc.

It can be very difficult to notice daily changes so even if you keep a diary and don't see something changing - you could take it to your psychiatrist and they may be able to see things. Sometimes we need to go outside the box and people around us can see things we don't notice.

I keep a daily diary and it's invaluable. Also, I write regular journals and over the years with the help of others (therapist, Dr, psychiatrist, friends, family) these have been very helpful in seeing changes I didn't notice.

Transferring the diary, or having it in a Word document on your computer, can make searching for information easier. Print it weekly or monthly, even colour code medication or 'code it'. Print journals for your psychiatrist and maybe ask him/her to regularly discuss how you think your medication is working. If you have multiple care providers then asking them to work together can also be beneficial.

I wish you well ... 🙂

JJ.