I never considered the possibility that I had a mental disorder growing up. From the 6th grade on I had behavior issues. Most of the time, I was an obedient student. I did well in my studies. I was bit of a bookworm. I acted out occasionally. My actions were disregarded as raging hormones during puberty, but there were instances where my behavior was out of social norm. I disrupted class, yelled at teachers, walked out of class, and threatened other students. When I was upset I harmed myself, by slamming my head into the wall, desk, or locker. Those are some of the things I’m willing to share (there are other things that are too cringeworthy to share online).
I didn’t realize it at the time, but I had a lot of stressors in my life at the time. I moved to a lot of different homes, and changed schools several times. Both my aunt and my mother had cancer. My aunt passed away that year. My family was going through financial hardship. Although, we downsized, went to the food bank, pulled out of private school, we weren’t destitute. In fact, we were pretty blessed. My mother went into partial remission and all seemed well. Unfortunately my mother’s cancer came back more aggressive by the time I was in the 8th grade. My parents flew to a different state to seek treatment. We moved a couple times after that. My mother passed away when I was in the 9th grade. I worked everyday after school. Sometimes I’d sleep in class. My behavior problems continued, but again most of the time, I was an obedient student. It was just split moments under stress, when something triggered me. I sometimes saw the school counselor, or spent time with friends and teachers. While others overcome similar challenges. I did not know how to process my emotions. Often ignoring them and distracting myself with hobbies, work or schoolwork. I didn’t think there was a problem until I had a nervous breakdown after I graduated from high school.
Stress caught up with me. I wasn’t able to think. My thoughts raced. I wasn’t able to sleep. My outburst became more frequent and I wasn’t able to socialize very well. Again I harmed myself sometimes. I put myself in dangerous situations. I found myself just wandering around. Sometimes I wasn’t coherent. Other times I was lost in thought. I barely ate and I lost a lot a weight.
My primary care physician recommended that I see a therapist.
My psychiatrist tried talk therapy. After a few sessions of seeing little progress, he then prescribed me medications Zoloft, an SSRI for depression and Ambien, a sleep medication. We continued talk therapy. Unfortunately, I responded poorly to Zoloft and I behaved differently before and became more incoherent. My psychiatrist than prescribed me Lamictal (lamotrigine) based on my family history. Lamictal is used to treat epilepsy and bipolar disorder. It worked well. I felt better. I was able to think straight. Lamictal wasn’t prescribed when my mother was going through her ordeal, and I only could help but wonder what it would have done for her. Ambien helped me start up my sleep patterns. My doctor warned me of the dangers of Ambien. He did not want me to become overdependent on it. He recommended I take it to help start up my sleep routine, but I should adjust my daily activities so I can fall asleep without it. The most important part was to change my lifestyle. Without the change in my lifestyle, the medication’s effectiveness may diminish and it would be more difficult to treat my insomnia. With more sleep, lifestyle changes, and medication, I was able to communicate with my psychiatrist better. Therapy helped me find ways to express my emotions better. It gave me different perspective on things. It also helped me recognize triggers or some of my misguided or distorted views. My psychiatrist also talked to my family which helped. It was great to have a person in the middle to moderate some communication to help me heal. Prior to that, I felt that my cries for help were ignored or disregarded as minor or temporary. It built up until I reached my breaking point. My psychiatrist help address the issues.
I looked for a church home. Like my mother, I found comfort and healing whenever I prayed, socialized with others, or read the Bible. There’s comfort in knowing there’s a God that loves us and a community that loves each other. While I believe in the physical healing like the (the effects of medication on biochemical pathways), I believe in spiritual and supernatural healing as well. I believe God answers prayer. Sometimes the answer could be a doctor, sometimes it can be a miracle that can’t be explained. I felt like I was getting better. I didn’t have any outbursts for months. I slept well every day. My social life was improving.
I thought I was finally “normal” again and that I fully recovered.
A person stops taking medication after they recover from the flu. A person stops chemotherapy when the doctor declares them cancer free.
Because I felt better, I decided to stop taking my medication.
It was a mistake.
At times I felt great like I was on the top of the world. Then, my moods spiraled. I wasn’t back at square one, I was worse off then I’ve ever been. My mind raced more than ever. My outburst were more frequent. I’d do things that I normally wouldn’t do with lack of self control and poor judgement. I taken 1 step forward and 2 steps back. On my next doctor’s appointment, my doctor noticed the change and determined that I discontinued my treatment on my own. Because I discontinued treatment, I would need additional mood stabilizers. In addition to Lamictal, I was prescribed Lithium. He told me that I’d have to take these medications for the rest of my life. I wanted to get better so I followed his prescriptions. I got back on track, but I can’t help but feel powerless like I gave up my choice. I once asked my doctor about herbal remedies. He was open to the idea but he shared that based on the research he looked at, he hasn’t found anything that would be affective for me. So I continued with therapy. There were times where I still had episodes, despite being diligent with my medication. While I wasn’t completely satisfied with the results, it seemed like the best solution at the time. I figured I was better with it rather than without it.
Later on, I moved away to college. My doctor advised that I should visit the disabilities office for extensions on my test. That came in handy as I couldn’t focus or think as quick as I did in high school. It was both humbling and frustrating. Problems that would be easy to solve took me longer than normal. I experienced a couple episodes of anxiety and paranoia, but for the most part, I enjoyed my college experience. I got the rest I needed. I had less stress. I made friends. I ate regularly. It was like a vacation, where my only concern was my studies. Unfortunately, there was a point where I didn’t have a lot of energy. I was tired all the time and it interfered with my studies. I was away from home, so I visited the school psychiatrist.
The school psychiatrist asked me a few questions. He looked at my patient record and disagreed with the diagnosis and the treatment. He wanted to change my treatment from Lamictal and Lithium to anti-depressants. I explained my negative experience with Zoloft. He shared that if a treatment doesn’t work, then we could go on to the next one until we found one that worked. I didn’t really feel comfortable making a major change, especially after a quick assessment on my first visit. I expressed my concerns. He then shared that mood disorders are commonly misdiagnosed. Although I agreed with him to an extent, it made me realize there was no way of knowing who was right and who was wrong.
All psychiatrist make assessments to the Diagnostic and Statistical Manual of Mental Disorders or the DSM. It is subjective. An example of that is how medical views on homosexuality and transgenderism change over the years. Views on depression and bipolar disorder changed over the years. Some disorders have been reclassified. In 2013, they released the 5th edition of the DSM. Psychiatrist diagnose patients based on observations and prescribed treatments based on biological psychiatry, or medicate to change brain chemistry and neurotransmitters.
While there are research on how neurotransmitters affect brain chemistry and mood, they don’t quantitatively test your neurotransmitters. You can measure your blood pressure to test if you have hypertension. You can test your blood for blood sugar to test if you have diabetes. While it is possible to measure serotonin levels in your blood, saliva, or urine. There is no correlation has ever been established between neurotransmitter levels in the brain and the rest of the body. Labs can’t test for neurotransmitter levels in the brain, even if they could it constantly changes and doesn’t tell the whole story like whether or not it binds to the neurotransmitter receptors which causes a lot of debate over biological psychiatry and current treatments for mental disorders.
The theory for depression is that a person with depression have low levels of serotonin, and that anti-depressants such as SSRIs (Selective serotonin reuptake inhibitors) treat depression by increasing serotonin levels by blocking the reabsorption (reuptake) of serotonin into neurons. Unfortunately, SSRIs are prescribed whether or not a person actually has low serotonin since doctors can’t test for serotonin in the brain, they make their best judgement based on observations. They can’t be really sure what you have or don’t have, so it’s trial an error. Furthermore, research is showing brain chemistry is a lot more complicated than previously thought and that low levels of serotonin may not be the cause of depression, despite being the prevailing theory promoted for decades.
The first pharmaceutical anti-depressants were developed in the 1950s. Researchers hypothesized that antidepressants balanced brain chemistry to treat mood disorders. This created a new branch of psychiatry called biological psychiatry which overlaps with neurology. SSRIs were introduced in the 1980s and the idea of balancing brain chemistry was heavily promoted and marketed. Today, academics debate the efficacy and risks of anti-depressants and weigh the risks and benefits. With side effects like suicidal thoughts, serotonin syndrome, and more, the efficacy of SSRIs are disputed.
I didn’t know this back when I was in college, but I had to decide how I was going to move forward in my life. I was thousands of miles from home and I didn’t want to try different treatments without my family as a safety net in case there were negative effects. If I didn’t make any changes, I’d constantly have low energy and it would disrupt my studies and personal life. I didn’t want to discontinue treatment because I may relapse into my mood disorders. Feeling stuck, all I could think of was to pray.
I felt peace. I discontinued my treatment and told no one. I continued college without negative effects. Eventually, I got my energy back. I felt free. I was happy. Every so often, I’d fear that I’d have a nervous breakdown again or downward spiral. While it seemed like I was better than ever, I was still growing and learning, constantly finding healthy ways to express my emotions, communicate better, improve my physical and mental health.
I withdrew from my studies to be at home with my family that year. While I felt better than ever, there are days where I still had outbursts. There are days where I experienced symptoms of depression. I still had to deal with unresolved trauma and continue my journey to find some healing.
Disclaimer: I am not a doctor, nutritionist, or registered dietician. I do not claim to help cure any condition or disease. I do not provide medical aid or nutrition advise for the purpose of health or disease.
The information I provide is based on my personal experience and is for educational purposes only and is not intended to be a substitute for medical treatment by a health care professional. Information provided here does not take the place of professional medical advice.
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-Holan