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August 31, 2012
Pebbles, Potholes, and Perspective
Medication Management
by Sarah Hancock

The magic question for the day is, "Which meds are you on?" I swear I hear the question whenever I disclose I have an illness to a person. You know what? I can't really blame you.

When I was first diagnosed, I wanted to find out which medications were working for people who had my illness. Why? I wanted to get on the one that worked! I especially wanted to do that when meeting people whom I perceived as successfully living with the same diagnosis. However, after 14 years of experiencing symptoms of some sort, let me share with you some things I've learned along the way.

Recommending someone go on a particular medication that worked miracles for your aunt is much like trying to fit a cast from someone else's broken leg onto your own. I'm serious!

Recently my eight-year-old niece broke her leg. She now has a cast from her hip to her toes. If I broke my leg tomorrow, would her cast help me? Even if we broke the same leg, in the same place, I still couldn't use her cast. It's not tailored for me. If I tried to use it, it could actually do me harm. Although this is a painfully obvious comparison, many people still believe that if a certain medication works for their neighbor, it will work for their son as well. It may work, or it may not. Since there is a lot of chemistry involved, medication that was completely ineffective for me might be the wonder drug for you.

Psychiatric medication is interesting. The majority of psychiatric meds do not work instantaneously like an aspirin. Nor do they work like an antibiotic where you can just take the drug diligently until the bottle is empty. Psychiatric medication is in a completely separate category from many other medications people are familiar with.

Unlike many medications, most antipsychotics, mood stabilizers and some antidepressants take six to eight weeks to become therapeutically effective because your body has to metabolize the medication. That's like eating a chocolate cake and not even tasting it for more than a month — while still craving chocolate!

The problem is, many people start taking medications but don't feel any immediate difference so they give up medication. The psychiatric meds take a long time to metabolize, so the effects are only gradual. One day you're upset or experiencing symptoms and three weeks later you realize, "Gee I'm feeling better." The change was so gradual that it took some time to register.

Because the medication takes longer to metabolize, it takes longer to adjust to the side effects. Consequently if a medication knocks your socks off and you end up sleeping 18 hours a day, not many people have the patience to endure the 6-8 weeks of feeling like a slug when there aren’t any perceived benefits. Not many people are willing to watch their loved one metabolize a medication when they seem over-drugged. Not many people have the patience to deal with a formerly productive loved one who becomes a zombie while adjusting to the medication.

The truth of the matter is, you have to give the medication a chance. If it's not working in 6-8 weeks, talk to your doctor and let him know. He can adjust the medication up or down. If it still doesn’t work, tell your doctor you want to try something else.

The key? Don't give up! Some people are put on the right medication the first time. Other people go through years of adjustments till something works. The good news is that medications are being invented on a regular basis. Take care of yourself. Keep the dialogue with your doctors open. They can't adjust something if they don't know how the medication affects you or your loved one.

If you have a loved one who takes or needs to take medication, please be as supportive as you can. You're loved one's willingness to take medication is often dependent on the support he receives from you. If you are upset with him for not getting out of bed and being lazy even though sedation is a major side-effect of his medication, he might stop taking his medication so that you won't be upset with him for being lazy.

I guess my point is that medication can work if you give it time, if it's the right medication, if you have an open conversation with your doctor and if you have positive support. With those variables taken care of, recovery is possible!

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