I had yet another psychiatrist appointment this past Friday since my body seems to hate every anti-anxiety medication I try. The most recent one I tried, BuSpar, ended up giving me a rash over my entire body so bad that the nurse who pre-screened me told me she’d never seen one like it before. It also made me lactose intolerant, which apparently is rare, as is the skin rash. ‘Yay for me and my medication/side effect sensitive body’. I thought with some of my characteristic sarcasm.
I’d never had a problem with lactose before, only since I’d started taking the BuSpar. There was even one night where I was eating a cup of ice cream and watching said rash spread to the side of my arm it didn’t currently cover. Both of these things were unacceptable and enough for me to drag myself back to my psychiatrist’s office.
The doctor had recently increased the dosage as, even after taking it for about a month or so, I was still having panic attacks when I hit stress overload. Being that it’s not a realistic strategy to avoid stress entirely, I was hoping this increase would help me better manage the anxiety part of my generalized anxiety disorder. At first, it was fine, other than the nausea and aforementioned lactose intolerance. I’d experienced this when I first started taking it but it went away after a week. I didn’t think anything of it at the time.
But then I got to nearly the third week of taking the BuSpar and both the nausea and lactose intolerance got worse. It wasn’t too much longer later that the skin rash started developing. When I got in to see the nurse, the one who commented on the rash, I found out what the problem was.
My lovely provider had done something you’re never supposed to do, if the nurse’s reaction was any indication. She turned to me and told me “that’s why! She increased you from 20 mg a day to 60 mg.” That’s triple what I was taking before. You’re not supposed to jump the dosage like that, as I found out. I was horrified and angry at the same time. I couldn’t believe this person who was supposed to have my best interests at heart had made such a colossal mistake.
There’s an implicit trust patients put in their doctors: that, since they’ve spent all this time studying and doing residencies, as long as you’re completely honest with them it’ll work out for the best. I’m not supposed to have to be worried about checking my doctors’ work. I shouldn’t have to overemphasize that none of the doctors I’ve seen recently have been any help and I’m frustrated as hell.
The last doctor who did help me left after the last time I saw him, which was in July. He actually took the time to talk to me and actually figure out what would be best for me. He prescribed me the first antidepressant that’s worked for my depression, which is often a co-occurring disorder with anxiety. It’s been a literal lifesaver as my depression occurs with suicidal thoughts and only seems to get worse with age.
So the nurse, seeing such a colossal dosing mistake, assigned me a new doctor and gave me a sooner appointment. The day of the appointment I get a call from the old provider who asked if I’d be comfortable going down to half a tab of the BuSpar. This is where I got even more irritated: 1) ‘cause no one was apparently listening to me about the possible allergic reaction I was having to it, and 2) why would half a tab work when the lower end of the full dose didn’t? Are you using your supposed big brain to think about this?
I had to remind the person on the phone that I was scheduled for an appointment with a new doctor later that day. I ended up being told to go to the new appointment anyway to ensure that it was the BuSpar causing the rash and lactose intolerance and to see what else I could do.
The new doctor turned out to be even worse than the old one. I had the last appointment of the day and from the moment I entered his office, he seemed irritated. He didn’t even wait until I sat down to start accosting me with questions. When I finally did sit and begin explaining my situation, he constantly interrupted me and then accused me of “blocking” his help (or “help”, which is what it felt like).
Psychiatrists are supposed to have your file, read over your initial intake and make a decision based on that. If not, they’re supposed to listen to you and not make you feel like you’re making it up because you have one working medication and you look and act fine while you’re talking to them. Medical professionals are also supposed to know that a lot of times, people with depression and anxiety aren’t always depressed or anxious. In fact, those with these illnesses often become masters at hiding how not okay they are because of the stigma still associated with both. They keep that part of them well hidden until they figure out if they can trust you to accept all of you. This applies to everyone, especially doctors.
It was only after I burst into tears at the fact that it didn’t seem like he was going to help me either that his ears magically perked up. I told him that literally no one lately had been helpful. He asked what the non-helpful people’s names were and it seemed like we were getting somewhere.
Wishful thinking. He asked if I wanted to try Seroquel, a drug he told me isn’t one of the addictive ones (benzodiazepines) and is usually prescribed for mania. In low doses, he said, it can be used for anxiety. He also said he wanted me to read up about it. I was so worried that I was going to be stuck again with one part of my disorder treated but not the other that I agreed. I was also desperate to get out of an uncomfortable situation.
Both of those reactions are a lovely part of the anxiety part of generalized anxiety disorder as well, by the way. Who wouldn’t love his or her brain automatically jumping to the worst conclusions first and making him or her more prone to bursts of crying or anger? And those are the more tolerable parts of the disorder. Why on earth would anyone want to treat that, right?
Being the cautious and curious person I am, the instant I left the office, I Googled “Seroquel”. A whole host of worrisome side effects appeared. Some of the scarier ones included: neuroleptic malignant syndrome, which can kill you, increased risk of high blood sugar, low white blood cell counts and cataracts.
Granted, anti-depressants can have scary side effects too, but they’re preventable for the most part as long as you don’t drink too much coffee, alcohol or any grapefruit juice. The side effects of Seroquel were the opposite of preventable. In fact, it seemed like it would cause more problems than it would solve.
According to the FDA’s drug information on Seroquel, you’re not supposed to use it with other antidepressants as it can make anyone up to the age of 24 more suicidal than they originally were. It also said that doesn’t usually happen to those over the age of 24. Given my propensity for rare side effects, though, I wasn’t sure I wanted to take the chance. The hits kept on coming: not only was Seroquel not approved, even in low doses, to treat generalized anxiety disorder, it wasn’t even all that effective against it. When you add in that it was usually discontinued because of the side effects, I wondered if I’d seen yet another irresponsible doctor.
I kept weighing the visit in my mind as I drove to Walgreens to fill the prescription. This new doctor did seem in an awful hurry to get me out of his office since it was close to their 3:30 p.m. closing time. The side effects kept running through my mind and as I parked, I could feel my instincts screaming at me not to fill this prescription. I was still battling myself, not sure if I should just try it, that it might be okay.
The sense of dread continued the whole walk back to the pharmacy, but I still gave the pharmacist the prescription. I Facebook messaged two of my best friends, hoping they could give me perspective about this. The pharmacist at my psychiatrist’s office had told me what to watch out for in terms of bad side effects, but I was still uneasy.
Once my friends found out about the side effects, they were scared for me. Taking that and considering that usually my instincts are right on the money, whether I listen to them or not, I thought * maybe * I should get a second opinion. This thought gained more steam the more I considered the place’s incompetence lately. I decided not to take the medication until I was sure it was safe for me to do so. I don’t think that will ever be the case, but I’ll ask a doctor who actually knows what he or she is doing what he or she thinks.
The longer I thought about the appointment, the more pissed off I got. Wasn’t it the psychiatrist’s job to weigh the safety of the drug against its effectiveness against my disorder? His job to warn me of the risks associated with it and the likelihood of side effects in my case?
How is it ethical to be combative to a new patient and then prescribe a drug that has the side effects of death, serious heart problems and increased risk for diabetes without taking a detailed history? He only asked if there was anything else I wanted to tell him and to read about the drug first, as if he just gave it to me so I’d get out of his face. I just wish I hadn’t been too freaked out to see it at the time.
This disorder has interfered with my life in a lot of different ways and at inopportune times. It’s stolen my motivation, my ambition, my energy, my “chill”, my patience, and my focus. All I’ve gotten in return is physical pain, a tendency to be scatterbrained, a habit of self-sabotage and racing thoughts. So you can see why I’d be just a tad freaked out that this might go back to being untreated long term.
This experience and an abundance of others that have been related to me have made it clear that information on anxiety disorders is almost nonexistent. For one thing, the difference between normal anxiety, like in the case of a test or a job interview, and an anxiety disorder is huge. Anxiety is a normal part of life, as is depression, but it’s only when either of them start disrupting your life that they become a problem.
Take the nerves you feel before that test or interview and imagine feeling like that all the time. About everything, especially anything new or uncertain. That’s one part of generalized anxiety disorder. Another is the physical symptoms: rapid heartbeat, elevated blood pressure, migraines, nausea, stammering and pain that shoots through your entire body, tightens your muscles and doesn’t leave.
Then there’s the panic attacks, the inability to focus on one thing at a time, feeling like everything is a catastrophe and perfectionism among other things.
Letting this disorder build up is like the old analogy of a frog put into a pot of water where the temperature is slowly increased. Before the frog realizes what’s happening, he’s in a pot of boiling water. He tries to jump out at the point, but it’s too late.
This fundamental fact is often the most misunderstood thing, even by some medical professionals. This is frustrating because said professionals know just enough to diagnose anxiety disorders and which medications are available for treatment. They don’t seem to know much else, sometimes not even which medications will work best and safely for the patient’s specific case. It’s more go-go-go so you can get everyone out on time.
It’s already hard enough for those who think they might be struggling with mental illness to ask for help. Psychiatrists like mine only make it harder.
That can also discourage many people from ever trying to get help again. In fact, I’ve heard more horror stories about therapy, psychiatrists, psych wards and medication than I have positive ones. The more difficult your case, the less time the doctor wants to spend with you.
Psychiatrists have to take the Hippocratic Oath, where one of the tenets is “I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism”. Knowing this makes it even more anger inducing that some doctors, who supposedly want to help people, willingly ignore this.
Do better in 2017, mental health professionals.