With an illness that is volatile and unpredictable by definition/diagnosis, it isn’t as simple as “just take your pills in the blister pack, like I take my little heart pills.”
Yes, I try to faithfully take my meds in the blister pack, and on schedule. But it’s not enough, and it’s not that simple.
I’m trying to be proactive about my health, especially for my own safety. So, for example, when I crumpled in a mess of ruminations this afternoon, I took 3 different pills that I knew would help. Sometimes we need more meds than the blister pack provides. Sometimes we need less. When I fall back into severe depression, my entire drug needs will shift dramatically.
Furthermore, these meds, particularly the neuroleptics/antipsychotics, always have inconvenient and sometimes crippling side effects.
Weight gain, heartburn, diarrhea, dry mouth/tooth rot, and sleepiness are only what I consider the *inconveniences* of these meds for me.
Anhedonia, on the other hand, creates disability in my work and social life. Stomach acidity creates calcium oxalate stones in my kidneys. Some psychotropic meds, because they are psychotropic(!), can cause unexpected/unwanted negative neural side effects at the wrong time, such as over-stimulation, under-stimulation, or anxiety.
Despite that I’m the only person who is daily navigating this necessary evil, this system-created dependance on drugs, and there isn’t a single psychiatrist at Peace Arch Hospital who knows one day about my life, they’ve nevertheless labeled me as “chronically non-compliant,” which is a derogatory stigmazing label… it’s language that indicates that I’m an irresponsible person when it comes to my meds, when I’m literally complying with multiple doctor visits per week, and continually struggling with meds and how each of them has some impact on everything that’s volatile about me: mood, anxiety, ruminations/psychosis, energy level, sleepiness level, motivation.
The stigma is not only in the culture/neighborhood/church (“why would you quit that med? what, you were feeling better?”), but it’s coming from the mental health system. It’s coming from psychiatrists, psychiatric nurses, mental health “case workers” (social workers), and, less so, from some mental health workers and OTs.
Another problem is arbitrary diagnoses from multiple psychiatrists, often conflicting, and also med changes made by different psychiatrists, depending on which ward you’ve landed on, or which psychiatrist the disability providers force us to visit for a re-diagnosis every 5 years or so. The prognosis for Bipolar Disorder is lifetime, so they can stop bloody paying doctors to re-confirm that I’m Type 1 and have a legitimate medical condition. I wonder whether they harrass their clients who are disabled with paralysis, cancer, or an auto-immune disorder?
Here are two inter-tangled examples of stupid adult arbitrariness in the system: I posted in a Facebook Bipolar Support group that my doctor was trying Gabapentin for me because the College of Doctors is counting how many Clonazepam pills he prescribes, and threatening him with removing his license, even though every time I land in the psyc ward, whatever psychiatrist (under the same stupid beurocratic College, which is supposed to be making sure that we, the PATIENTS, are getting the care we need), I am always immediately prescribes clonazepam, because they all know it works! This leaves my doctor with yet another patient addicted on this med, again, and he’s in trouble for that. Anyway, yeah, I posted there, and a woman replied and said, “isn’t that funny, because here in Texas, Gabapentin is on Schedule whatever / controlled substances, while the doctors freely prescribe the benzos.”
Here’s another example of arbitrary diagnoses in the system:
Two BC doctors (licenced under the same BC College of Doctors and Physicians) have given me recurring prescriptions for cannabis for the treatment of bipolar disorder since 2016.
Then the next time I landed in the psyc ward (Jan/Feb 2018), they saw THC in my chemistry, of course, so I was immediately diagnosed with “Cannabis Abuse Disorder” by some bitch who had never met me, nor did she carefully inspect the DSM criteria for that disorder. She also diagnosed me with Borderline Personality Disorder with whatever Clusters. Look, when you meet me in a manic panic at the psyc ward, you’re seeing me at my lowest. So of course I’m having social and personality issues, especially when one of the other patients is a violent female offender (she showed me her criminal record) and another is a volatile young man with schizoaffective disorder who threatened to kill me after he overheard staff talking about my diagnoses (breach of information), and lunged at me, though he was held back.
I was so afraid of the female offender that I called the non-emergency RCMP line to give me a ride back from my pass, and guess what’s written in my files?
“Pt. was brought in by RCMP. Strange behavior, crawling on floor. Code White called and pt. committed to rubber room.”
They committed me for 17 hours. I lost all my human rights. I wasn’t allowed a phone call, I wasn’t allowed apple juice, I wasn’t allowed to have my doll (my only physical comfort during times of manic panic), instead they set him on a chair where I could watch the psychopathic female offender patient snatch him away from me. ( She was psychopathically torturing every single patient by attacking their weakness.)
They also needled me with two drugs, without my consent, one of which I do not recognize and still haven’t looked up, and I suspect it was adminstered while I was asleep on the mat.
Oh, and unlike for Epstein, the highest profile prisoner in the USA, they had full video surveillance on me. I couldn’t even shit without being on their video. I was only wearing one of those hospital gowns, which isn’t much different than being naked, especially when you’re trying to make sign language to the video camera. (“You do realize we can’t hear you in there, don’t you?”)
As for the 500 pages I have here from FOI requests from the WR Mental Health Center and Peace Arch Emergency and IPU wards, despite that they’ve censored the sensitive parts of *my* information from me because of things like, “this information might be harmful to the patient” (how can I argue against that, even though I’ve never struggled with self-harm?), I see that they’ve twisted me into a demon– bitch doctors who haven’t spent one day getting to know me, and social workers who begin with assumptions and start attacking me, when they’re literally supposed to be MY support, *my* case worker!
I suspect the PAH and WR MHC are worried that I might file a human rights complaint against them for their breech of my sensitive information to a dangerous patient, and the 17 hours of torture in the rubber room.
I’m not going to file a human rights complaint. That wouldn’t be good for my health. But I wouldn’t mind exposing a bit of the unkind stigmatizing behaviors I’ve seen in various institutions. This most recent time, I was at a ward in New Westminster. It was much more peaceful, because the patients were peaceful, but it was just another place to have another doctor monkey with my prescriptions, and “nurses” and “mental health workers” behaving like they’re too busy caring for patients to actually care about the patients. I understand that… they’re overworked, and they’re usually just trying to hold the fort down. Our mental health system is bursting at the seams. Not enough beds in the wards, and remember that substance abusers, who are sometimes a completely different crowd than people who, in the first place, have mental illness, are treated in these same wards. I’ve watched drug dealers administer heroin in the psyc wards. They come in as visiting family/friends, and nurses don’t have time to deal with it. Besides, the patient usually needs the drug anyway!
On a positive note, I’m hopeful about plans for a psychiatric triage in Surrey, intended to relieve the psyc wards.
About the “Borderline Personality Disorder” diagnosis: my psychiatrist, who has known me for almost 15 years, said, “Paul, you don’t have BPD.” My psychologist, who isn’t allowed to nevertheless diagnose patients, was surprised by the diagnosis, and said that in his professional opinion, I absolutely do not have Borderline Personality Disorder. Also, a staff member at the Whale House clubhouse said to me, “hmm, I’ve noticed that every patient coming out of the Peace Arch psyc ward has been diagnosed with BPD.”
My psychiatrist’s office unfortunately shares the same waiting area as the Mental Health Center. The receptionists literally glare at me, and they don’t even know anything about me! Nothing accurate at all!
It’s not their fault. I see that they’re all very intense and uptight, probably because of the unhealthy climate created by powerful women in their clinic. Every visit was some nerve-wracking, sweat-inducing scenario where I was made to feel like one of the bad people. (Although, my tension was often relieved when I left the doctor and went to the nurses for my shot… they were non-judgmental and caring.)
It’s impossible for me, and other mental health patients, to get out from under this, because, remember, we’re the crazy ones, so they can just say we’re being paranoid or grandiose. Our voice is silenced.
Back to the drugs and meds thing.
Most people with bipolar disorder have used, or are using, alternative drugs such as cannabis and nicotine, which show us promise, and (unfortunately) we’ve mostly all struggled with the bad alternative drugs like alcohol, street drugs, and prescription abuse.
Is it any surprise?
We’ve been put on addictive meds by the system. We need them. It’s not some big deal for us to try some new drug.
But our condition isn’t the same as diabetes or high cholesterol.
Please don’t assume that we’re careless with psychotropic drugs. They’re complicated, yet we need them, and we are all trying to figure out what works best at any given point in our day or week.
I sit with my fellow patients who suffer with bipolar disorder and schizophrenia/schizoaffective disorders. We’ve all got shakey hands. We all have a strange relationship with nicotine. We all love benzos and zopiclone. We’re normal people who are trying to figure out the mess we’re in.