May 19th, 2023... When I orignially wrote this post I was furious. I was furious about my dependance on insurance companies and pharmaceutical companies for the medication I needed. I felt disempowered and trapped...I wanted out.
When I wrote this post I had enormous hope in a natural path to healing. I wanted to feel my full self, the beautiful, messy, crazy me.
When I wrote this post I had hope that my journey included healing my mental illness with holistic methods; Yoga, cbd oil, food, exercise...
When I wrote this post it was early in my titration. My mental illness was still fairly dormant so pursuing Yoga, exercise and nature walks was easy. After beginning to reduce my medication, I felt more empowered, I felt like I was taking control of the illness and that I no longer needed to be dependent on huge corporations that couldn't give a shit about me.
Breaking free from medication was my mantra, and I wish it could've gone to plan...but it didn't.
Yet, like other entries, I didn't delete this post because it is a part of my journey, a part of me that I choose to honor and embrace. I learned a lot during that time, no matter how painful. And the Journey continues.
Disclaimers:
I am a licensed psychotherapist, light-worker and spiritual guide. This article comes from the experiences within my personal journey to healing and is not intended to be used as medical advice. The decisions about medication that I write about were made with extensive education and consideration.
In addition, I am in no way apposed to the appropriate and moderate use of psychotropic medications.
I've been on lamotragine, an anticonvulsant drug and mood stabilizer, for 12 years. I took it for bipolar and, I will be honest, it was a game changer.
Prior to taking the medication, I experienced intense depression that contrasted bouts of rage that I just barely kept under control. In fact, that's how I felt all of the time...just barely keeping my brain, my life, my body under control.
The lamotragine seemed to erase the agitation. I felt calmer as the depression melted away. I felt as though I could finally participate in my life rather than riding a constant roller-coaster or mood swings.
Then, in 2018 I began to take a second medication, fluvoxatine, for OCD.
After my daughter was born in 2016, the OCD had taken over my life, tormenting me constantly, intruding in every moment with horrific, violent images. My every day was an obsession about my daughter's possible death.
Again, the medication eradicated this mental torment within a matter of weeks. Soon I was free of the horror and I was able to be present, to share in the joy and love of parenthood. Shortly after the weight of OCD had been lifted, I experienced a spiritual awakening that allowed me to open the doors of WHC with confidence.
Side note...the awakening got messy...really messy. But that story I will save for my next article.
While these drugs seemed like miracles at the time, there is a big, big downfall that no psychiatrist wants to talk about...what happens when they stop working? Not IF... but WHEN.
In 2021 I got COVID. There are so many ways this affected my life, yet there was one very unexpected way that is the focus of this article. This mysterious virus caused the medications that changed my life to suddenly stop working.
As I noticed old, forgotten anxieties, thoughts, emotions and moods reemerging, I felt confused, frustrated and desperate for answers. I searched the internet for other people dealing with the same post-covid problem, but there was nothing amid the scores of "long-hauler" accounts.
Naturally, there were articles on how the pandemic was affecting mental health, but nothing about the virus actually changing once effective medications into capsules that seemed like nothing more than sugar pills.
Of course, I hoped another medication could help me as much as these previously did.
My medication provider recommended I continue taking lamotrigine since I'd been on it for over a decade while embarking on a search for new medication to treat the OCD. This made sense to me. Changing two medications at once seemed like it would overburden my brain and make the search far more painful and imprecise.
Even so, finding a new medication proved to be arduous and beyond frustrating. I tried one after another with no success. In fact, often, they made the anxiety worse. Finally, I asked to try venlafaxine, also known as Effexor. She was hesitant and I knew why.
Venlafaxine is known for its horrific withdrawal syndrome, even when forgetting to take only one dose. The withdrawal creates strange tingling sensations in the brain (aptly known as "brain zaps"), headaches, body aches, anxiety and more. Yet I was desperate. I had taken this medication for a short time in my twenties and recalled it had been helpful, so I persisted.
Shortly thereafter I started taking an extended release tablet form of the drug.
This is where the story changes.
Soon I would be propelled onto a new journey of deep healing.
Venlafaxine worked. I finally began to feel relief from the OCD and intense anxiety. I finally began to feel like my old self again. We slowly began to increase the dosage to a point that I felt balanced. I started to sense the return of hope.
And then my insurance company sent me a letter.
It read that the company would not cover the venlafaxine extended release tablet I was taking. It read that I could switch to the extended release capsule, which they would pay for. No problem here, right?
I called my medication provider and she gladly switched the prescription to capsules and sent it into the pharmacy. I picked up the new form of the drug and began taking it that evening.
The next day I noticed something bizarre.
Even though I had taken the medication the night before, I was having symptoms that felt like withdrawal. Initially, I doubted myself and dismissed it as "in my head" because of the change in my prescription. But it not only persisted, it intensified.
I knew I was experiencing withdrawal syndrome, so I called my pharmacist. He had no answers for me. I had taken the medication on time, the same time I had taken the tablets, so withdrawal syndrome made no sense.
Yet, I knew my body was telling me the truth. I knew there was something wrong. So, once again, I found myself scoring the internet for answers.
That is when I found...one single sentence in one single article stating the answer:
"Venlafaxine extended-release tablets (Osmotica Pharma) have been approved by the FDA as a “new drug,” though they are bioequivalent to Effexor XR capsules...however, they are not therapeutically interchangeable, due to the different dosage forms of these products (tablet versus capsule)," (Kaufman, PharmD, BSc, RPh)*.
There it was in black and white.
These two forms of the same drug are not interchangeable, they cannot be haphazardly switched without causing the consumer to experience a brutal withdrawal syndrome.
I was dumbfounded. I was incensed.
My insurance company had flippantly sent me a letter in the mail to switch a medication with absolutely no knowledge about the effect this could have on me, my health and my life. I was angry at my medication provider and pharmacist for having no education on the different forms of this medication and how switching them would affect their patients.
In that moment something within me changed. In that moment I realized it was time to heal.
Really heal.
For so long I have turned to psychiatry to cure my imbalanced brain. While I had also turned to Yoga, talk therapy, meditation and spiritual modalities, psychiatry was always a part of the equation. Medication had seemed like it was a pivotal piece to my quality of life.
While I am well aware that caution is needed when taking psychiatric medicine, I had put trust in my medication provider to keep me informed. I had put trust in psychopharmacology. Yet, as I read this one sentence in this one article I realized I had been misguided.
I realized my health was under the control of a health insurance company and not my own. I realized that my medication provider was not fully educated on these medications because the information was simply not being made readily available to her.
My insurance company saw that capsules were cheaper than extended release tablets. That was the only consideration. They saw me as a cost. Not as a human being.
Yet, even beyond this, I had to face a more difficult truth.
Psychiatric medication, which had once helped me, was now oppressing me. Now my thoughts had become fixed on ensuring I could get this medication to avoid withdrawal, rather than taking this medication to live a fulfilling life. My thoughts were now on affording a medication no longer covered by my insurance, a medication my body was physically dependent on. My thoughts were on surviving...not healing.
Isn't psychopharmacology about providing a bridge to healing? Isn't medication about providing a useful bolster so that one day we may be able to lift ourselves on our own? Isn't it about providing a sense of mental stability to those of us that may feel incredibly unstable?
The next day I made the decision to discontinue venlafaxine, but I had to wean off of it slowly.
To begin the process, I went to the pharmacy to pick up another prescription of a smaller dosage. The pharmacist then informed me that my insurance company had also declined to cover lamotrigine, the mood stabilizer I had been taking for 12 years.
I could feel the rage boiling under my skin. No, not bipolar rage. I was enraged at being hegemonized.
I thought with vital certainty, no more.
At that moment I decided to discontinue them both. I decided I had to find another way to manage my brain's imbalances. I would not be looking outwardly for another pharmaceutical.
I had to look within.
I had been taught to fear myself and my natural rises and falls. I had been taught to fix myself, rather than move with the waves. I had been taught to mute myself, rather than to lean in and listen closely.
I had been taught that anxiety, obsession, hypo-mania, dysphoria, and depression meant that there was something wrong with me. I had been taught that if I felt these things, I needed to silence them quickly and neatly by picking up another bottle at the pharmacy.
A bottle that made insurance companies a lot of money.
But what would happen to me if I felt them? What would happen to me if I opened myself to them? What would happen to me if I attributed no meaning to them? What would happen to me if I simply witnessed the experience as it waxed and waned?
What would happen if this 43 year old woman with bipolar and OCD chose to no longer use pharmaceuticals to neutralize the imbalances in my brain?
Well...that is the decision I've made. I am still weaning off of both medications slowly and am nearing the end.
To assist in my healing...
I began taking CBD oil daily along with fish oil, turmeric, black pepper and apple cider vinegar. I now go to the gym three times a week to exert energy and feel my body's strength, and today I began Yoga therapy to anchor myself into the Divine Feminine.
I am not at baseline yet. This period of discontinuation and withdrawal is not a picture of how I could feel once there is no trace of these medications in my blood.
Through this process there are times when anxiety feels like seething lava in my chest. There are moments when my brain feels chaotic and disorganized and mornings when I cannot seem to get out of my own way. There are evenings when I feel like numbing my brain in a bowl of Lucky Charms and a Netflix marathon. There are days when I can feel hypo-mania bursting within me, as if my mom-minivan engine is flooding with high octane.
Yet, through it all, I am glad to be here, I am grateful to be embarking on this journey to deep healing. I am interested in seeing myself fully and clearly and no longer believe I need to be fixed.
What I once begged to numb I now desire to feel, to observe with non-judgement, to witness with compassion and to integrate into my whole. This is a new leg of my awakening, which simply continues and continues, evolving and moving like the earth itself.
And like I observe Nature, its perfection and beauty, I also observe myself.
Sources:
*https://www.the-hospitalist.org/hospitalist/article/124034/close-and-personal#:~:text=Venlafaxine%20extended%2Drelease%20tablets%20(Osmotica,products%20(tablet%20versus%20capsule).
Hi, I'm Sarah Dionne, I am so glad you're here. I'm a mom, psychotherapist, light worker and intuitive guide.
If you're here, reading this, there is a reason. After all, as we seek we are guided to what we need. Take a moment to browse my other articles here, I hope that I can continue to provide you with insight and support along your way.
Also, visit my Etsy Shoppe where I sell uplifting artwork and gifts that provide inspiration and love to moms and children.
Thank you again & All Good Things,
Sarah
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