Harm Reduction Guide to Coming Off Psychiatric Drugs: Part 4

Harm Reduction Guide to Coming Off Psychiatric Drugs: Part 4

Written by Will Hall

Published by The Icarus Project and Freedom Center

How Withdrawal Affects Your Brain and Body

In addition to placebo, all psychiatric drugs work by causing organic brain changes. This is why going off leads to withdrawal: your brain gets used to having the drug, and has a hard time adjusting when the drug is removed. It takes time to bring the activity of receptors and chemicals back to the original state before the drug was introduced. While doctors sometimes use confusing terms like “dependence,” “rebound,” and “discontinuation syndrome” (and there may not be dosage tolerance), the psychiatric drug action that causes withdrawal symptoms is basically the same as addiction. Tapering off slowly is usually best: it allows your brain and mind time to get accustomed to being without the drugs. Going off fast does not usually allow enough time to adjust, and you may experience worse withdrawal symptoms.

Important: the signs of psychiatric drug withdrawal can sometimes look exactly like the “mental illness” symptoms that medications were prescribed for in the first place.

When someone goes off a psychiatric drug they might have anxiety, mania, panic, depression and other painful effects. They can become “psychotic” or have other symptoms from the psychiatric drug withdrawal itself, not because of a “disorder” or condition. This may be the same, or even worse, than what got called psychosis or mental disorder before the drug was taken. Typically people are then told this shows their illness has come back, and that they therefore need the drug. However, it may be the withdrawal effect from the drug that is causing these symptoms.

This is why weaning off slowly is very important. And pay attention to how you feel each day over an extended period. Eventually withdrawal symptoms subside.

These withdrawal symptoms do not necessarily prove you need a psychiatric drug any more than headaches after you stop drinking coffee prove you need caffeine, or delirium after stopping alcohol shows you need to drink alcohol. It just means your brain has become dependent on the drug, and has difficulty adjusting to a lower dosage off it. Psychiatric drugs are not like insulin for a diabetic: they are a tool or coping mechanism.

However, when you have been on psych drugs for years, it can sometimes take years to reduce or go off them, or you may have long term physical or psychological dependency. Sometimes people on these drugs develop ongoing withdrawal symptoms, chemical brain injury, and damage. This may not be permanent, but sometimes people live the rest of their lives with these brain changes. Scientists used to believe that the brain couldn’t grow new cells or heal itself, but today this is known to be untrue. Everyone can heal: new research into “neurogenesis” and “neuroplasticity” means the brain is always growing and changing. Friendships and love, along with good lifestyle, nutrition, and positive outlook, will help nurture your brain and body to recover.

You may find that the goal of going off completely is not right for you at this time. You may feel better staying on your medication, and decide instead to just reduce or continue at the same dosage, and focus on new ways to improve your life. Follow your own needs without judgment or blame: get support for your decisions in the face of any feelings of shame or powerlessness.

            Remember, any decision you make is okay.

Why Do People Want to Stop Using Psychiatric Drugs?

People are often told that no matter what the side effects, psychiatric drugs are always better than suffering from “untreated” mental disorders. Some doctors claim mental disorders have a “kindling” effect, that early medication is best, or that madness is toxic and medications are “neuroprotective.” These theories remain unproven -- though ongoing crisis and a life out of control can certainly be cumulative stresses. Doctors spread fears unfairly: while medications are key in helping many people, many others have found ways to recover without psychiatric drugs. Many report their lives are better without them. Everyone is different, but sometimes people do deal with “psychotic” states successfully without medication. Diverse, non-western cultures often respond to and understand these experiences differently, even seeing them as positive and spiritual. It remains a personal decision how to relate to madness.

This is definitely a very individual choice. I would say pay close attention to how you felt before and after the medication and make a decision based on that. A lot of people feel ashamed by the fact that they are taking medication at all, even though it does help, and just don’t want to have to say they are taking any. Personally I would work on confronting the feelings of shame and recognizing that these are valid feelings, but not constructive. If something helps than it is okay for you. However if it isn’t actually doing you any good, than it is certainly time to look at an alternative route.

It’s not an either-or choice between taking psychiatric drugs or doing nothing. There are many alternatives you can try. In fact, some problems that are called symptoms of “mental disorders” might turn out to be caused by the drugs people are taking.

Harm Reduction Guide to Coming Off Psychiatric Drugs: Part 3

Harm Reduction Guide to Coming Off Psychiatric Drugs: Part 3

Written by Will Hall

Published by The Icarus Project and Freedom Center

Do Psychiatric Drugs Correct Your Chemistry Or Treat Illness?

People are told that mental disorders mean brain chemistry is “abnormal,” that illness is caused by genetic “predispositions,” and that psychiatric drugs are needed to interrupt a disease process and correct imbalances. However, this is not how medications work, and brain disease theories have not been proven by studies to be true. Believing these claims can reinforce a sense of being a helpless victim of biology, and leave people feeling there are no options other than medications.

Despite decades of costly research, no chemical imbalances, genetic predispositions, or brain abnormalities have ever been found to consistently cause a bipolar, depression, or schizophrenia diagnosis. The media report “promising” research that “needs further study,” but nothing conclusive has resulted. Even the fine print of drug company ads now typically says that conditions are “believed to be caused by” chemical imbalances, rather than making definitive statements.

Physical tests, such as brain scan or blood draw, aren’t used for diagnosis like bipolar, schizophrenia, or depression, and can’t reveal that your brain is abnormal. (Altered states with clear physical causes, such as, for example, concussion, dementia or alcohol delirium, are instead called “organic psychosis”). A baseline has never even been established for what constitutes a “psychologically normal” brain for all people. Three people with the same diagnosis might have very different brain chemistry, and someone with similar brain chemistry might have no diagnosis at all. While many people face physical problems like vitamin deficiency that a doctor or holistic practitioner can address, this might help emotional problems – or it might not --. Medicine has not discovered the biology of mental illness the same way as tuberculosis, Down Syndrome, or diabetes. Emotional distress and madness remain open to interpretation.

“Normal”. What is normal? I don’t think anyone is contesting that we’re trying to be normal. Normal is not a thing. We’re simply trying to find a better quality of life than what we’ve been living. That is why we resort to medication. 

What about genetics? Mental diagnoses can seem to “run in families,” but so do child abuse and poverty. Because of shared environment, expectations, and intergenerational trauma, family history can mean many things other than inescapable heredity. Studies claim 15that twins tend have a slightly higher chance of the same diagnosis, but this research is often flawed and results exaggerated. Parents know that children have different temperaments even at birth, but prenatal experience has an influence. Individual traits like sensitivity and creativity only become madness after very complicated social factors, such as trauma and oppression, have played a role. Even sequencing the human genome has not revealed any keys to mental illness, and the idea of genetic “predisposition” remains speculative and unproven.

My grandmother and my sister were/are both bipolar. The environments in which they grew up could not have been any more different. To say that it may strictly be an environmental cause, is too much of a stretch for me. I’m much more inclined to say that there may be a genetic link somewhere in there. 

In fact, the more neuroscience discovers about genes, behavior, and the brain, the more complicated the picture becomes. “Epigenetics” shows that instead of a “genetic blueprint,” the environment interacts to turn genes on and off. Using genetic science to oversimplify the diversity of human behavior is a throwback to the discredited concepts of social Darwinism and eugenics. It portrays some people as destined to be inferior, defective, and less than fully human.

This should be clear. That everything about us is a combination of not only our biology but also our environment. How we were raised, the things in our environment have a massive effect on our brains right down to the neuron level. This is probably why no two brain scans will ever look the same for two people with the same mental health issues; they’ve come about their problems through different environmental triggers and different parts of their brains have been effected.

Every feeling and thought exists somehow in the brain as an expression of biology, but society, mind, and learning intervene to make any causal relationship impossible to establish. Stress, for example, is associated with brain chemistry, but one person can thrive under stressful circumstances that are debilitating to another. The new science of “Neuroplasticity” shows the brain is constantly growing and that learning can itself change the brain: for example, psychotherapy can reorganize brain structure, and researchers found the brain regions associated with memorizing maps were enlarged in NYC cab drivers. If learning can affect the brain in such a profound way, then we are not as limited by biology as was once believed.

This is certainly true. Even being off my medication for only 6 weeks, with a lot of learned therapeutic techniques I am much more self-aware now. Even when I could feel my mood slipping, it was nowhere near as extreme, but when it wasn’t great, I had the tools I needed to keep it under control and express myself constructively and handle it appropriately. That’s not to say I would like to be off my medication forever, but I did notice that it was possible and there was a noticeable difference between this time and before I started taking my meds.

Without clear answers from science, psychiatric diagnosis is ultimately not a statement of fact but a doctor’s subjective opinion of a patient. The doctor inevitably relies on their own bias, assumptions, fears, and preconceptions. Doctors often disagree with each other, people sometimes have many different diagnoses over time, and discrimination based on class, race, and gender is common.

Hmm. Okay, for me this sounds like it’s only the doctors telling a person that there is something wrong with them and we, as individuals, never go to doctors seeking help in the first place. I sought out my doctor because I had been in extreme distress for over a decade and nothing I was doing on my own was working. I didn’t need a doctor to tell me that there was something wrong with me. I already felt that. I went to the doctor because I needed help feeling better. I didn’t only see a doctor though, I also saw my therapist. Doctors aren’t out to get you, they’re there to help you if you go to them for help.

Who’s to Blame? Yourself? Your Biology? Neither?

If biology and brain chemistry aren’t to “blame” for anxiety, voices, suicidal feelings, mania, or other distress, does that mean the blame is on you? Is it either your brain’s fault or your fault?

A psychiatric diagnosis can be a huge relief if the only other option is blaming yourself as lazy, weak, or faking it. When you feel powerless and people haven’t been taking your pain seriously, a doctor saying you have a mental disorder can be validating. Choosing to reduce or come off medication might seem like the wrong message, as if your suffering is not that bad and you don’t really need help. And not being able to come off can also feel shameful, like you should just try harder and it’s all up to you.

A psychiatric diagnosis is often just a starting point to help with treatment that may change over time as your doctor becomes more familiar with you. You can’t treat someone who is bipolar as if they are schizophrenic. It’s the wrong treatment. However, I do agree that it can often be validating.

This is unfair, either-or thinking that leaves people helpless and trapped in the mental health system. Pharmaceutical advertising preys on this dilemma: if pain is really serious, it needs medication, if not, you’re on your own. Empowerment means thinking beyond a narrow view, and embracing broader ways of looking at things.

Everyone needs support sometime: each of us has parts of our lives where we feel powerless. We all need to learn how to balance personal responsibility with asking for help. You don’t have to blame your brain to give yourself some compassion.

And if people ask, it’s your decision what to say or not say, such as “I’m a trauma survivor,” “I go though extreme states,” or “I’m different than most people, and I’m still figuring it out” -- or saying nothing at all. Connecting with others who share your experiences, such as peer support groups or the internet, can be crucial as you explore who you are.

Your suffering is real, whether you decide to take medications or not. Feeling powerless and needing help doesn’t mean you are a broken person or that you’re a passive victim of biology. Explanations like trauma, sensitivity, or spirituality are as valid as any. You still deserve help even if you don’t believe your brain is abnormal and even if you think outside the language of “psychiatric illness” and “mental disorders.”

How Do Psychiatric Drugs Affect The Brain?

Like any mind altering substance, psychiatric drugs are psychoactive and alter mind and behavior by affecting brain chemistry. Their usefulness, and risks, come from changing the brain/body and altering consciousness, including expectation and placebo.

Current medical theory is that most psychiatric drugs change the levels of chemicals called neurotransmitters (anti-convulsants, anti-epileptics, and “mood stabilizers” such as lithium appear to work by changing blood flow and electrical activity in the brain in general). Neurotransmitters are linked with mood and mental functioning, and all the cells of the nervous system, including brain cells, use neurotransmitters to communicate with each other. When neurotransmitter levels change, “receptor” cells, which receive and regulate neurotransmitters, become more sensitive, and can grow or shrink to adjust.

SSRI anti-depressants (“selective serotonin re-uptake inhibitors”) for example are said to raise the level of the neurotransmitter serotonin in the brain and reduce the number of brain serotonin receptors. Anti-psychotic medications like Haldol lower the level of dopamine and increase the number of dopamine receptors in the brain. This action on neurotransmitters and receptors is the same as for any psychoactive drug. Alcohol affects neurotransmitters including dopamine and serotonin, and cocaine changes the levels of both dopamine and serotonin, as well as noradrenaline, and alters receptors.

While these chemical changes in your body take place, your consciousness works to interpret and respond n your own way, Alcohol might relax you or make you nervous; anti-depressants energize some people or make others less sensitive. Because of the placebo effect and expectations, everyone is different. Your experience of medication may not be the same as other people, and will ultimately be uniquely your own. Trust yourself.

True. This is why that list of potential side effects is so ridiculously long; every person’s body and brain are different and may react differently. This is why you should have regular and frequent follow ups with your doctor. Doctors don’t prescribe drugs all willy nilly. Even for mental health issues. Yes, there is a certain amount of guess work when it comes to finding the right ones that work for you best without unacceptable side effects; because everyone’s body does react differently, but it’s not quite the crapshoot it sounds like.

And not for nothing, it can be the same way with physical medical drugs too. I have drug allergies. I’m allergic to penicillin and macrolide drugs which makes giving me antibiotics a real bitch. However it took me having a few really bad reactions to those medications before we figured that out. If I get sick I also get the most ridiculously expensive antibiotics which I prefer to simply avoid. With the exception of my love of wine, I eat very clean, I exercise constantly, and I live a preventative and healthy life style. I’m very rarely sick. Of course you can’t always avoid getting sick, but you can certainly take steps to keep your immune system strong and those things help.

My point is, it’s not just mental health drugs that are hit and miss. People react poorly to all drugs. Or they can react fantastically. Penicillin is lifesaving to billions of people and it damn near kills me. Some people hate the idea of antidepressants. I’ll happily stay on my SNRI because it improves my quality of life.

It’s important to have all of the facts, which is what this guide is helping us do, so that we can make informed decisions about what is best for us individually. It’s also good to know that there can be alternatives though b/c one size does not always fit all.

Stay Tuned.

Harm Reduction Guide to Coming Off Psychiatric Drugs: Part 2

Harm Reduction Guide to Coming Off Psychiatric Drugs: Part 2

Written by Will Hall

Published by The Icarus Project and Freedom Center

Looking Critically at “Mental Disorders” and Psychiatry

Doctors put people on psychiatric medications for experiences labeled “mental disorders:” extreme emotional distress, overwhelming suffering, wild mood swings, unusual beliefs, disruptive behaviors, and mysterious states of madness. Currently millions of people world-wide, including infants and elders, take psychiatric drugs when they are diagnosed with bipolar disorder, schizophrenia, psychosis, depression, anxiety, attention deficit, obsessive-compulsive, or post-traumatic stress. The numbers are climbing every day.

For many people, psychiatric drugs are very useful. Putting the brakes on a life out of control, being able to function at work, school, and in relationships, getting to sleep, and keeping a lid on emotional extremes can all feel lifesaving. The sense of relief is sometimes dramatic and the medications can stir very powerful emotions, and even feelings of salvation. At the same time, the help psychiatric drugs offer many people can leave little room to see more to the picture: others can experience these drugs as negative, harmful, and even life-threatening. As a result, it is rare in society to find a clear understanding of how and why these drugs work, or an honest discuss of risks, alternatives, and how to come off them if people want to.

For me, I have this feeling of relief. I also now the feeling of feeling trapped and and of drugs being harmful and life-threatening when they’re the wrong drugs. Sometimes you don’t have many alternatives though so you can’t find better ones and then you’re stuck living a partial existence; not fully yourself, but not quite as tragic.

Many doctors and TV ads tell people that psychiatric medication is necessary for a biological illness, just like insulin for diabetes. They promote the idea that the drugs correct chemical imbalances and treat brain abnormalities. The truth is different however. “Biology” and “chemical imbalances” have become simplistic sound-bites to persuade people to put their faith in doctors and quick fixes. These words arein fact much more complicated and unclear. Biological factors (such as nutrition, rest, and food allergies) affect everything we experience: biological “cause” or “basis” plants the belief that medication is the key to solving our problems. To say something has a biological cause, basis, or underpinning can give a message that the solution must always be a medical one and that “treatment” has to include psychiatric drugs. Once people have a diagnosis and start taking medication, it is easy to think of medication as physically necessary for survival.

Okay, here’s a problem. While I do feel like drugs can often be helpful because I do actually believe there may be a chemical imbalance or a synapsis misfire in some cases (like mine where I am Major Depressive). I do NOT however, believe it should ever be a “quck fix” or a stand alone fix. Medication should always be combined with therapy. For people with BPD, it’s often an issue of Nature and Nurture. There may be a biological component, but it’s often majorly an environmental one as well. To overcome those issues and the maladaptive coping mechanisms we’ve learned to adapt to those things we need therapy and support to deal and heal from them.

Not only is there is no solid science behind viewing mental disorders as simple malfunctions of biology “corrected” by drugs, but many people with even the most severe diagnosis of schizophrenia or bipolar go on to recover completely without medication. The experiences that get labeled mental disorders are not “incurable” or always “lifelong:” they are more mysterious and unpredictable. For some people psychiatric drugs are helpful tools that change consciousness in useful ways, but they are not medically necessary treatments for illness. Once you acknowledge this, more options become thinkable. And the potential risks of psychiatric drugs come under greater scrutiny, because they are very serious -- including chronic illness, mental impairment, dependency, worse psychiatric symptoms, and even risk of early death.

Now this I will agree with. It is perfectly reasonable to expect that drugs are not the solution and that you can heal without them. Mental Disorders are often a product of maladaptive coping mechanisms that can be unlearned, or at least, recognized, and a better option of coping can be chosen.

In discussing “risks” and “dangers,” it is important to understand that all life involves risk: each of us makes decisions every day to take acceptable risks, such as driving a car, working in a stressful job, or drinking alcohol. It may not be possible to predict exactly how the risks will affect us, or to avoid the risks entirely, but it is important to know as much as we can about what the risks are. Looking at the risks of drug treatment also means looking at the risks of emotional distress/ “psychosis” itself, and making the best decision for you. Maybe psychiatric drugs are the best option given your circumstances and situation, or maybe you want to try to reduce or come off. This guide is not intended to persuade you one way or the other, but to help educate you about your options if you decide to explore going off psychiatric drugs.

How Difficult Is Coming Off Psychiatric Drugs?

In working with hundreds of people over many years, we have found there is no way to predict how the coming off process will go. There is really no way to know in advance who can and who cannot do well without psychiatric drugs, who can do well with fewer drugs or lower doses, or how hard it will be. We’ve seen people withdraw successfully after more than 20 years, people who decide to continue to take them after being on for just a year or less, and people who struggle with long term withdrawal.

Because coming off is potentially possible for anyone, the only way to really know is to try slowly and carefully, and see how it goes, remaining open to staying on. Everyone should have the opportunity to explore this. The study by MIND, the leading mental health charity in the UK, confirms our experience. MIND found that “Length of time on the drug emerged as the factor that most clearly influenced success in coming off. Four out of five people (81%) who were on their drug for less than six months succeeded in coming off. In contrast, less than half (44%) of people who were on their drug for more than five years succeeded. (Just over half of people who were on their drug for between six months and five years succeeded.)” Facing these unknowns means remaining flexible and learning as you go: coming off completely may, or may not, be right for you, but everyone can become more empowered.

I’ll be honest. I was very opposed to the idea of psych meds my entire life. I finally “gave in” about 3 years ago. After being forced off of them a month and a half ago, even after weaning down, and knowing a lot of coping techniques, I know my life and mental state is much more pleasant on them. I don’t necessarily need them for my BPD (through therapy I’ve learned how to cope effectively and communicate through those issues) but I do for my anxiety and depression. You know what? I am perfectly fine with that.  

I hadn’t even figured out the right medication to go on after 6 months, let alone the right combination. If I had tried to come off before then? I would have gotten nowhere. Being on antidepressants for less than 6 months when I’ve been depressed since I was 12… would also do next to nothing for me. It’s really all about knowing what is best for you individually.  Don’t let these statistics sway you from trying or staying on medication.

How Do Psychiatric Drugs Work?

Most people begin taking psychiatric medications because they are “distressed and distressing.” They are either experiencing overwhelming states of emotional distress, or someone else is distressed with their behavior and sends them to a doctor – or some combination of both. There are many labels for these states, like anxiety, depression, compulsiveness, mania, psychosis, voices, and paranoia, and labels change over time. Doctors tell people that their emotional distress is due to a mental disorder which has a biochemical basis, that their distress is dangerous and must be stopped (such as fears of suicide or claims of deteriorating illness), and that medication with psychiatric drugs is a necessary treatment.

I feel like this is slightly outdated and a little inflammatory. Often that distress can be dangerous… to that particular person themselves and their quality of life and in order to live a

happy and healthy life they would like those things to stop… And sometimes drugs are PART of the solution, but drugs should never be the ONLY solution. Drugs can’t change the things in your environment that are going wrong. Drugs can’t help you rethink situations and learn to cope better. Drugs can’t kick out the negative influences in your life.

Psychiatric medications act on the brain to alter mood and consciousness like any other psychoactive substance. Because many medications can blunt or control the symptoms of emotional distress – by either tranquilizing a person, speeding them up, numbing sensitivity, or getting them to sleep – they can take the edge off extreme states. They help some people feel more capable of living their lives. It is important to realize, however, that psychiatric drugs do not change the underlying causes of emotional distress. They are best understood as tools or coping mechanisms that sometimes alleviate symptoms and pave the way for change – but with significant risks for anyone who takes them.

True. Which is why they should always be combined with a self-awareness improving form of exploration. 

Harm Reduction Guide to Coming Off Psychiatric Drugs

I thought I would talk about coming off Psych meds. (I’m back on mine now! But man that was not fun and I wish I had this information before.) I found a really handy guide. This guide is mostly written from a voluntary point of view, for people that want to come off drugs or want alternative options, but the information is helpful to know if you don’t really have much of a choice either so that you can prepare yourself. Sometimes psychiatric drugs are necessary and it will be a lifelong process. Sometimes they’re a temporary measure. Either way is perfectly fine. All that means is there is an imbalance of chemicals or a misfiring synapses happening. It happens. I’ll probably be on my antidepressants for the rest of my life. They make me feel happier and healthier than I’ve ever felt in my life. If that means taking a tiny pill or two a day, I’ll do that gladly. However for other people this might not be the case or wanted, but they don’t know it. The information I’ll be sharing here is very interesting. However there’s simply a ton of information here so I’ll do this in a long series. If you’d like to read it at your own speed you can find it here: The Icarus Project. I won’t post all of it but I will post a lot of it. So here we go: 

Harm Reduction Guide to Coming Off Psychiatric Drugs

Written by Will Hall

Published by The Icarus Project and Freedom Center

Author’s Note

This is a guide I wish I had when I was taking psychiatric drugs. Prozac helped me for a while, then made me manic and suicidal. I was sick for days after coming off Zoloft, with counselors telling me I was faking it. Nurses who drew blood samples for my lithium levels never explained it was to check for drug toxicity, and I was told the Navane and other anti-psychotics I took to calm my wild mental states were necessary because of faulty brain chemistry.

I used many different psychiatric drugs over several years, but the medical professionals who prescribed them never made me feel empowered or informed. They didn’t explain how the drugs work, honestly discuss the risks involved, offer alternatives, or help me withdraw when I wanted to stop taking them. Information I needed was missing, incomplete, or inaccurate. When I finally began to learn ways to get better without medication, it wasn’t because of the mental health system, it was despite it.

Part of me didn’t really want to be on psychiatric drugs, but another part of me desperately needed help. My suffering was very serious – multiple suicide attempts, hearing persecutory voices, extreme mistrust, mizarre experiences, hiding alone in my apartment, unable to take care of myself, Therapy hadn’t worked, and no one offered me other options. I was under pressure to see my problems as “biologically based” and “needing” medication, instead of looking at medication as one option among many. For a time medication seemed like my only way out. It took years tolearn that the answers, and my hope for getting better, were really within myself.

When I finally left the hospitals, residential facilities, and homeless shelters I lived in for nearly a year, I began to do my own investigating. I started judging my options more carefully, based not on misinformed authorities telling me what to do, but on my own research and learning. That process led me to co-found Freedom Center, a support community in Western Massachusetts that brings together people asking similar questions.

Through the Freedom Center I discovered that I was denied a basic medical right: informed consent, having accurate information about my diagnosis and medication. I learned that mistreatment like I went through is often business as usual in the mental health profession. I came across research ignored by  {professionals}, which confirmed my experience: most professionals are uninformed about coming off drugs, and even frequently stand in patients’ way, sometimes ending up harming them.

This guide brings together the best information we’ve come across and the most important lessons we’ve learned at the Freedom Center and the Icarus Project. It’s not perfect, and I invite you to contribute your experiences and research for future editions, but it’s a guide that I hope can be helpful.

Introduction: We live a world that, when it comes to drugs, is quite crazy.

One the one hand there is the War on Drugs, which keeps some drugs illegal, overflows our prisons, and hasn’t ended drug use. Then there are the acceptable drugs like alcohol and tobacco, advertised everywhere with promises of happiness and success while causing widespread addiction, disease, and death. Legal prescription drugs such as stimulants, pain killers, and anti-anxiety pills are just as addictive and risky as street highs, with a doctor’s seal of approval. And then there are neuroleptics, lithium, and anti convulsant drugs, which have very risky adverse effects but help manage and dampen consciousness when people feel out of control, so we call them “anti-psychotics” and “mood-stabilizers”.

With drugs in the picture, lives are often at stake, whether from addiction, adverse drug effects, or the risks that go along with emotional crisis and madness. Combined with the confusing messages from society about drugs, the result is a lot of fear. Drugs become angels or demons. We need to stay on them at all costs, or get off them at all costs. We look only at the risks, or we’re too frightened to look at the risks at all. There is no compromise: it’s black and white, all or nothing.

That, right there, should be a red flag. As Borderlines, we know this kind of thinking is dysfunctional.

It’s easy to fall into absolutist thinking when it comes to psychiatric drugs. Pro-drug advocates focus on the hrisks of psychosis and extreme emotional states, while anti-drug advocates focus on the risks of taking drugs. But it is the belief of this guide, and the philosophy of our pro-treatment choice work at the Freedome Center and the Icarus Project, that either-or thinking around drugs is a big part of the problem.

Harm Reduction For Mental Health

Absolutist approaches to drug and sex education teach abstinence, “just say no,” and one way for everyone. They work for some people, but not most, and if you don’t follow the model you can end up being judged, not helped.

“Harm reduction” is different: pragmatic, not dogmatic. Harm reduction is an international movement in community health education that recognizes there is no single solution for each person, no universal standard of “success” or “failure.” Getting rid of the problem is not necessarily the only way. Instead, harm reduction accepts where people are at and educates them to make informed choices and calculated trade-offs that reduce risk and increase wellness. People need information, options, resources and support so they can move towards healthier living – at their own pace and on their own terms.

Applying harm reduction philosophy to mental health is a new but growing approach. It means not always trying to eliminate “symptoms” or discontinue all medications. It recognizes that people are already taking psychiatric drugs, already trying to come off them, and already living with symptoms -- and that in this complicated reality people need true help, not judgment. It encourages balancing the different risks involved: the harm from extreme states, as well as the harm from treatments such as adverse drug effects, disempowering labels, and traumatic hospitalization.

Making harm reduction decisions means looking honestly at all sides of the equation: how drugs might help a life that feels out of control, how risky those same drugs might be, and the role of options and alternatives. Any decisions become a process of experimentation and learning, including learning from your own mistakes and changing your goals along the way. Harm reduction accepts all this, believing that the essence of any healthy life is the capacity to be empowered.

Everyone’s Experience Is Difference

There is no formula for coming off psychiatric drugs. What there is, and what this guide presents, is some common experience, basic research and important information that can potentially make the process less difficult. Many people successfully com off psychiatric drugs, with or without guidance, while others find it very hard. Many continue on psychiatric drugs because the benefits are greater than the drawbacks. But many people end up staying on psychiatric drugs without ever exploring options, just because they don’t know any other way.

When we’ve relied only on doctors, television, and mainstream sources, it might seem impossible to imagine dealing with our emotional extremes without psychiatric drugs. Maybe we’ve never heard of anyone going through what we go through without medications. Maybe a prescription was the beginning of people taking our need for help seriously, and medications feel like the only way to recognize that our problems are severe and out of {our} control. And when everyone around us has come to view medication as essential to our survival, considering a new path can feel too risky to even try.

Many of us get help from psychiatric drugs, but might not understand how they really work or what the other options are. Some of us never found medications useful, or medications even made our problems worse, and we are ready to try living without them. Sometimes people are torn between the risks of staying on and the risks of going off, or we take multiple drugs and suspect we don’t need all of them. Others may want to off but it’s not the right time, or may have tried in the past, experienced a return of frightening symptoms, and decided to go back on for now.

            All of this will be discussed in upcoming posts!

Our paths to healing are unique. Some of us don’t need to make any life changes, letting time and patience make changes for us. Others may need to make big shifts in nutrition, work, family life, or relationships; we may need to focus more on self-care, expression, art, and creativity; adopt other approaches like peer support, therapy, herbalism, acupuncture, or homeopathy; or find new life interests like going to school or connecting with nature. We may discover that the first step is getting restful sleep; we may need structure to help get us motivated; or to stop taking any recreational drugs or alcohol. Our priorities might be to find a home or a new job; we may need to establish stronger support networks of trusted friends; or it may be important to speak up with greater honesty and vulnerability about what we are going through.

Okay, well I don’t know that I support herbalism, acupuncture, and homeopathy, but if you believe in it and it works for you, more power to you. Everything else is sounds advice and things I’ve touched on before. Taking control of our lives, living clean, kicking out negative influences that spiral us down, and eliminating harmful substances; all very good advice.

The process might feel mysterious and arbitrary, and an attitude of acceptance and patience is vital. Learning means trial and error.

Don’t be afraid to make mistakes. As long as you learn from something, it’s not a mistake.  The only way to learn if something works for you is to try it. If it doesn’t work, you can always stop and go back to something you’re familiar with.  Life is not an absolute. You get to continue trying things until you figure out what works best for you.

Because each of us is unique, it is as if we are navigating through a labyrinth, getting lost and finding out way again, making our own map as we go. 

Just a bit of a Ramble

Hello Everyone,

I know I’ve been gone for quite some time. You’ve been in my thoughts. Nearly every day in fact.  I’ve wanted to write and be here. Honestly I didn’t feel like I had anything to say or contribute. I’ve been in something of a rut. Not a real depression, at least not the way I’m used to feeling depression, but just a serious funk.

There hasn’t really been anything wrong, but there hasn’t been anything right either.

I haven’t felt like there was anything for me going on that I could really contribute to the world b/c I didn’t feel like I was really much a part of it. Just sort of going through the motions and floating through day to day. That would make for very tedious writing.

Things have been getting better and worse.  Which for the most part, I guess is good. I don’t like feeling nothing. I would rather feel something than nothing.

So much and nothing at all has been happening. I’ve felt like I’ve been in one endless holding pattern. Small things that I’d hoped for I’ve been disillusioned of. This is actually fine for me. At least in that I found closure and was able to solidly move on from it. I would rather know one way or the other about something than to have to endlessly wonder. Even if it was not the ideal outcome. It’s the uncertainty that I find most maddening.

Up front. It’s an attribute I find incredibly appealing in people. When someone is not straight forward with me I find I get easily frustrated. Looking back, these are often the people that have caused the most turmoil in me. The people that have made me the most anxious, the most stressed out, the most emotionally turbulent are the people that have tried to play games, keep me guessing, made me wonder about their motives…. Don’t get me wrong, a little mystery and flirtation is one thing, but it’s the rest of the bullshit and keeping you guessing that is the problem.

When things get good, there are inevitably lows that come with the highs. I don’t even mean wild ups and downs either. Just yanno, being happy about something new, high… and then an accidental someone steps on a sore point and you have to explain a bad subject b/c they don’t know any better, low. I don’t mind that so much. I’m more ashamed of it than anything. I still struggle with that.  I feel like that’s basic human nature though. To not like something about ourselves that we aren’t proud of.   Maybe I’m more touchy than is normal, but that’s par for the course.  I’ve learned that one small “flaw” doesn’t define my whole. I have much more to contribute as whole person. And in general I am very happy with who I am. Even when my mood is kind of funky I have a lot to offer in the world. Even alone and being a solitary creature I create.  Not everyone will like me, or get me, and that’s okay. The people that are close to me certainly do. The people that I care for seem to care back and that means I great deal.

I must be doing something right after all this time =) If I can do it certainly it means that everyone else can to.

I’m rambling. I’ll not be such a stranger now, shall I?

~Haven~

Bye Bye Back Up

I’m off my medication right now. 

It does not feel good to feel this way when I know there is a better way to feel. Not by choice I assure you. My insurance changed and it doesn’t cover my Pristiq. Pristiq is insanely expensive out of pocket and right now I simply can’t afford it. I’m petitioning my insurance company but it’s taking a very long time. I just found out that part of the reason it’s taking so long is because even though I talked to my Psychiatrists office the day I submitted the request, they have done ABSOLUTELY NOTHING to get ahold of my insurance company in order to simply confirm that my medication is necessary. That is all the office has to do, say Yes this medication is necessary, and it will be covered. Call a number, which I found for them, gave to them, tell them Yes, and then the Insurance company will cover it. It’s been weeks. It’s extremely frustrating.

What’s extra aggravating is my pharmacy gives me texts messages to tell me with my prescriptions are filled. Since my prescriptions have been in review my pharmacy told me they would let me know when they were out of review and were ready to be picked up. I’ve gotten four false alarms.  It’s not any persons fault. It’s an automated system I believe so there is no person to be angry at. The people at my pharmacy are all very lovely and helpful, but it’s very stressful to get your hopes up that something finally worked out only to find out that, yet again, nothing actually happened. Disheartening really. 

My emotions and my moods have been back on edge for some time now. It’s amazing to realize how much my medication evens out my depression and stabilizes the turmoil. I feel like there’s a thin glass panel barely concealing what is roiling there sometimes. Fortunately I’ve had enough years in therapy that my self-awareness of what I’m experiencing is now controllable and I’ve learned to express what I’m feeling in a workable manner. It doesn’t feel good though. Not at all.

I’m sad so much more now. And much more anxious. Especially with a new relationship I also feel my old insecurities popping back up and I second guess myself all the time once more. He’s been good for me though. Where I think I would have been simply depressed I’ve found a lot of happiness lately and that’s been amazing. Though I do find that I get exhausted a bit more quickly, and stressed out more easily if something triggers me. Fortunately my communication is very good now and it’s fairly easy to talk through that. It’s good to have all those therapeutic techniques to back me up when I don’t have my medication to stabilize my brain chemicals. He seems to understand that too, and is okay with it. 

I really don’t know how much longer I can stand not having my SNRI though. This is not a fun feeling. 

Good Natured Teasing, Really?

I’m dating someone new. I have been for almost a month now. I’ve dated a lot of men and women. I generally get on better with women emotionally, though physically with men is a different. Sometimes I wonder if it’s just easier than talking to them or, honestly, letting them get closer to me emotionally. Regardless, that’s not what this is about.

This guy, we’ll call him B, is probably one of the sweetest, most considerate men I’ve ever dated. I’ve never dated a guy that wanted to spend so much time with me right away, or ever really. **Don’t get me wrong, a lot of the men I’ve dated wanted to spend time with me, but we went on our 2^nd date, and it’s been a month and I can’t actually say that it’s technically ended. We’ve spent every bit of our spare time together for the last month.**.  He routinely buys things for me that have to do with my extremely geeky interests, that he has no interest in at all, b/c he loves how much I love them.  I cook. I bake. I don’t think I’ve ever had anyone cook for me. He does. I had a bad sinus infection for a few days… so I didn’t expect to see him at all b/c no guy I’ve ever dated ever bothered to try to “take care of me” while I was sick before. I planned to sniffle and game on-line. He came over, made me dinner, bought ice cream and did all my dishes. (I made him cupcakes).  I keep waiting for some other shoe to drop and for him to just be an asshole, but he’s not. He’s adorable, and sweet, and grumpy in that “get off my lawn you damn kids” kinds of way that is exactly how I usually feel. He’s really great.

However… and I’m saying this in a way as to express it so as to show that I honestly feel it is more my hang up, than it is anything that he’s doing…

He teases me. He pokes fun at me for things. Random things and because I can be very serious about stuff. It hurts my feelings. I’m honestly not sure why. I believe I am the one overreacting about this, because he never does anything in a hurtful, condescending, or mean way. I make sure not to show that this stuff bothers me unless it gets to be too much. And then thankfully I can utilize the years of therapy I’ve had, collect my thoughts, and explain why things bother me. But even knowing that he has absolutely zero intention of making me uncomfortable or unhappy, the teasing still hurts me to an irrational level. It makes me angry, honestly. From the start, when I started this blog, I said Anger was my deadly sin. However, I’ve noticed that with the anger, I’ve also identified it’s source. It’s coming from a place of shame and insecurity.

My entire life, from one person or another, be it my father or an abusive ex-boyfriend, I’ve been told I wasn’t good enough. The teasing to me, feels like a jab at my character.  Jabbing at my character, who I am as a person, feels like you’re picking at my flaws… Picking at my flaws means there’s things that are wrong with me, and if I’m that flawed of a person, what could possibly be there for you to stick around for? I’m not perfect enough. I’m not enough of what you want. So clearly, leaving, abandonment, must be the next step yes? Probably not, unless I decide to make it happen that way, but that’s the way my brain seems to function.

Honestly I think he should have just as many abandonment issues, if not more, than I do, but he seems okay now, except he keeps pretty much everyone at a distance. That he let me in at all, is pretty big.

I don’t want to overreact. I’ve been very careful to let him know when he pushes me too far. It’s very early in this relationship. There is no way for him to know everything about me, or me about him. We’re still learning a lot about each other. I’m very upfront with my past and my level of brokenness. When he pushes me too much I really do try very hard to hold in my emotions, clear my head, collect my thoughts, and explain logically (and non-judgmentally!) why something he did bothers me. 

It should never be about blame. What is good natured ribbing to him, and I absolutely recognize it as such… still is triggering to me. I feel incredibly dysfunctional that I’ve had so many people in my life that have broken my ability to just see the humor in simple things without feeling hurt by them. **I’m actually in tears writing this**.

I want to be someone that isn’t hung up on that kind of pain. The combination of being off my meds (Another post- I really can’t afford them) but also having actually had a past with abusive people and a ridiculous life, it’s something I have to deal with as my reality. It’s okay for me to have problems because of my past. As long as I deal with them logically, and explain them rationally, and don’t simply react impulsively… which is often the problem with BPD… everything should be okay. That’s how normal people function, yes?

I’ve been so broken by the exes that told me I was worthless though. By a father that told me I wouldn’t be lovable. Every time I feel myself saying something “wrong” or simply “that makes me uncomfortable, I’m sorry, but here’s why….. “, I feel like it’ll probably be the end.

I’ve gotten much better about speaking my mind. Not settling for the bullshit, abusive treatment that I had in the past. But I’m still hyper vigilant that I’m going to do or say something wrong and it sets my anxiety into overdrive.

Thankfully through therapy I’ve learned to rationally discuss my issues or whatever problem comes up. Very quickly! He hit a big one or two pretty quick and he was incredibly receptive to what I had to say, which shouldn’t be shocking to me, but it was. Even now, I expect all men to treat me like my Evil-Ex or The One or any of the multitudes that were just in it for what they wanted out of it. Even in the face of someone very different, that kind of abuse stays with you. It actually is something of a Post Traumatic Response when people do certain things. It’s not the new persons fault, they don’t know! However, it’s triggering, and we need to know our triggers and be able to convey those problems accordingly!

I’m pretty sure that’s all that this teasing issue has been for me. It compounds on my personal insecurities. Never feeling good enough, being told I’ve not worthwhile, all of the things that go with being in abusive relationships and the shitty things that people before have done to you…. It always feels like an attack. One you’re not allowed to defend against, otherwise the person with have a ridiculous temper tantrum (Go GO Evil-Ex!) and punish you in some way. I also grew up with a highly critical father so “teasing” to me mostly sounds like criticism. It sounds like something that’s wrong with me. Something that makes me less worthy of being with that person. Which… as far as I can tell, is pretty much the exact opposite of what good natured teasing is all about.

Which is why it’s important to be able to take a step back and look at the persons real intentions. My Evil Ex would have actually be trying to hurt me with the things he said to me. B is just trying to be sweet and familiar. Everything with him is good natured and isn’t out to make himself look good, it’s just an attempt to be close to me. I can appreciate an attempt to be close to me, even if he doesn’t quite understand  yet, that I’m not as good about teasing.