Depression on My Mind News, insights and commentary into depression from Christine Stapleton. 2017-06-13T00:54:33Z https://blogs.psychcentral.com/depression/feed/atom/ Christine Stapleton http://www.christinestapleton.com/ <![CDATA[Addiction, recovery and sex]]> http://blogs.psychcentral.com/depression/?p=5666 2017-06-08T13:36:10Z 2016-04-13T14:16:42Z When I was new in recovery I memorized the 12-Steps.shutterstock_217407427

Then, at a meeting I heard someone mention the 13th Step. What!? There’s another step I have to do? I asked what the 13th Step was.

“It’s hitting on newcomers – hooking up with newbies,” I was told.

“Ah,” a much younger and better looking me said to myself. “That’s why all these guys are giving me hugs and buying me coffee.”

I stopped hugging guys that creeped me out – stuck out my hand instead. I learned the true understanding of “helping the newcomer.”

I listened to my sponsor and old-timers I trusted: “You don’t get into relationships or date when you are in early recovery.”

“Why?” I asked.

“Because nothing will take your mind off your recovery quicker than a guy,”  I was told. “And besides, you have demonstrated and extraordinary inability to have a healthy relationship. Your picker is broken.”

And so I waited a year. I still made a couple of bad choices after that but I had enough sobriety under my belt to get through a break-up without picking up a drink or drug. Waiting a year before letting my hormones and some cute cunning addict get the best of me was probably the best advice I have been given and taken in my sobriety.

Which is why I can’t understand what the hell is going on in the world of recovery here in South Florida – where many young addicts who were ostensibly sent here to get clean – not tan and laid – are putting their tans and sex drives ahead of their sobriety.

The 12-Steps is a program of suggestions – not rules. That’s why it works. Addicts and Alcoholics don’t take kindly to being told what to do. We take suggestions – not demands.

However, this “suggestion” my sponsor gave me was not negotiable. No dating, no relationships and sex for one year (unless, of course, you are married or already in healthy relationship – which isn’t likely).

“Your picker is broken!” I heard over and over. “You want to learn how to find a guy who will respect you, treat you right? Then no guys for a year. Go to women’s meetings!”

“I didn’t drink with women,” I told my sponsor. “Why should I go to meetings with women?”

“Exactly!” my sponsor said. “Go to women’s meetings.”

Most of the newly recovered, under 30-year-olds I have met recently have little regard for this suggestion. Many are addicted to some of the most highly addictive substances on the planet – opiates – and some have used their bodies to get it. Now, with a few weeks/months clean, they put far more effort into keeping their teeth white and nails polished than abstaining from dating and hooking up.

I won’t even go to some meetings where “druggy buggies” dump sober home residents because there is so much hooking up going on. It’s like going to a meeting in a middle-school cafeteria at lunchtime.

It’s not just the newcomers having sex among themselves. You’ve got sober home (halfway house)  owners, operators, marketers, “behavioral health techs” – who are often nothing more than kids with maybe a year clean and sober – having sex with residents or clients at the IOP or PHP.

This is 13th Stepping in its most heinous form. “But it was consensual!” I hear newly recovered addicts cry. Or “I DO have a year!” – except the girl you’re boffing has only 3 months.

Consensual? Really? And I suppose that needle you stuck in your arm was consensual, too? When I was newly clean and sober I was told I didn’t have the mental capacity or common sense to make healthy choices.

It may seem like a hot 21-year-old girl who wears Daisy Dukes and a cut-off tank top to a co-ed meeting – who was sexually abused as a kid and raped as a prostitute – is consenting to have sex with you, but in reality – she’s not capable.

That’s just my opinion. Sure, under the law it’s consensual. But under the program of rigorous honesty and integrity that we abide by when we commit to getting clean and sober – this is not how we treat others or – most importantly – ourselves.

This one-year of steering clear of men and women will likely be as difficult as quitting drugs and alcohol. If you do it, you will learn how to set healthy boundaries. You will learn how to gain self-esteem that isn’t based on bragging to the guys in the sober house how you hooked up with that new girl after last night’s meeting.

Take drugs and sex out of the equation and learn who you really are and who you want to be.

Girl holding hand image available from Shutterstock.

 

 

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Christine Stapleton http://www.christinestapleton.com/ <![CDATA[What we’re missing in treating addiction]]> http://blogs.psychcentral.com/depression/?p=5650 2016-04-10T19:34:15Z 2016-04-08T11:37:29Z Addiction is a disease of the brain. Over and over and over we heard this at the recent National RX Drug Abuse & Heroin Summit in Atlanta.shutterstock_266332601 (1)

The president said it. His drug czar Michael Botticelli, said it. Dr. Nora Volkow, head of the National Institute on Drug Abuse, said it, along with the heads of the Centers for Disease Control, the Substance Abuse and Mental Health Service Administration, and just about everyone else who spoke at the summit.

But while they were busy convincing me of something that I – and most people at the summit – already knew, I heard little  from the speakers about making sure that the industry itself understands and respects the seriousness of this life-threatening disease.

I am not talking about residential treatment centers, where trained, licensed and regulated mental health professionals provide treatment for addicts and alcoholics. Nor am I talking about the physicians who are approved to write prescriptions for medications such as methadone, buprenorphine and naloxone. They already know and respect addiction as a brain disease.

I am talking about the places where addicts will receive the bulk of their treatment after they leave the safety of cloistered rehabs. I am talking about intensive outpatient programs, IOPs,  and the sober homes where addicts live in early recovery.

I did not go to every session at the summit. However, I did not hear anyone speaking about professionalism in IOPs or sober homes – the front lines in the war against prescription drug and heroin addiction.

It is hard to explain the value and importance of IOPs and sober homes to policymakers and parents who are not themselves addicts. I will try.

You are very sick and spend 30 days in a hospital’s intensive care unit, where your are watched round the clock. You are fed, carefully observed, and your meds are prescribed and dispensed by professionals.

Then, you are discharged to a group home, where you share a bedroom with another person with the same illness who may or may not be willing to stick to the discharge orders he (or she) was given when he left the hospital.

The people running the house are 20-something-year olds with the same disease who were discharged from the ICU just a few months before you. They have no formal training in how to treat this disease.

Some are on probation for crimes they committed when they were sick. Some barely earned their GEDs and have demonstrated on their Facebook pages their inability to write sentences that are not littered with profanities and spelling, punctuation and grammatical errors.

Three times a week you must go to treatment, where you participate in group therapy led by someone whose only qualification is that he, too, has the same disease. Sometimes you also do yoga. Or arts and crafts or golf therapy. Always, regardless of your progress, you must provide a urine sample – which is sent to a lab for expensive tests that your insurance company is billed for.

Then, you go back to the house where you hang out with your housemates and suck on vapes or smoke cigarettes, watch Sons of Anarchy or The Kardashians, and wait for a van to pick you up and take you to a 12-Step meeting.

This is the kind of treatment we provide for people with the brain disease called addiction. We think this is okay. But would we consider this treatment acceptable if the life-threatening disease was heart disease? Diabetes? Schizophrenia? Bi-polar disorder?

Sober homes and IOPs are where we need to respect and treat addiction as a disease. The people who work in these places need better training – maybe even degrees or certifications. Merely having the disease does not make one capable of treating the disease. Imagine if that is how we treated cancer.

At the summit I heard a lot about medication-assisted treatment, better training for physicians, and using naloxone to reverse overdoses. But I heard nothing at about improving professionalism and training or exposing corruption and profiteering at sober homes and IOPs.

How can we possibly expect people with the brain disease called addiction to stay healthy while living this lifestyle in these environments?

Vintage drug rehab sign available from Shutterstock.

 

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Christine Stapleton http://www.christinestapleton.com/ <![CDATA[Buprenorphine: How many patients is too many?]]> http://blogs.psychcentral.com/depression/?p=5642 2016-04-05T16:17:16Z 2016-04-05T16:07:21Z Last week the Department of Health and Human Services published in the Federal Register a notice of rulemaking for medication assisted treatment – MAT – for opioid abuse that would increase the maximum number of patients a practitioner can treat from 100 to 200.shutterstock_393787498

The proposed rule would apply specifically to buprenorphine, also known as “bupe”among drug users. The drug is used to wean addicts off prescription and street opioids, such as oxycodone and heroin. Buprenorphine joins methadone and naltrexone as the only three drugs approved by the Food and Drug Administration to treat opioid addiction.

The irony of the government’s efforts to regulate patient limits for buprenorphine, is that there are no limits on the number of patients a practitioner can treat with the prescription opioids that feed addition. In fact, there is no other prescription medications with patient limits.

With the exception of naltrexone, which blocks the euphoric effect of opioids and prevents an addict from getting high, methadone and buprenorphine are highly regulated. Methadone can only be dispensed at approved locations and requires daily administration.

Currently, practitioners who are licensed to prescribe buprenorphine are limited to 30 patients. After a year, that cap can be increased to 100 patients. The HHS rules proposed last week would up the cap to 200 patients, impose additional rules for record-keeping, require physicians to certify that they will provide patients with behavioral health services.

There is no question that buprenorphine works, especially when combined with behavioral therapys.

There is also no question that bupe can be abused and will get you high (unless it is combined with naloxone.) Although the high is much less than heroin or methadone, there is a chance – sometimes a good chance – that a prescription of buprenorphine will end up being bought, sold and used on the street like heroin.

As someone in recovery, I know first hand that anything that can – or even might – get an addict high will be crushed, swallowed, injected, inhaled, inserted in an attempt to do so. And because addicts undergoing trreatment with buprenorphine will go into withdrawal without it – they will buy burprenorphine on the street if for some reason they run out or cannot fill their own prescription.

Then there are the doctors with buprenorphine licenses. Most will be well-intentioned, but we learned during the pill-mill crisis that there are plenty of unethical physicians who didn’t wince at getting patients hooked on prescription opioid painkillers. Now they have an opportunity to get those same patients hooked on the drugs that will break that addiction and possibly create a whole new pill mill crisis.

Sound far fetched? These are just a few of the concerns I heard quietly discussed at two recent conferences on prescription drug and heroin abuse and treatment, including the National RX Drug & Heroin Summit in Atlanta last week, where President Obama touted his commitment to increasing access to MAT.

MAT is emerging as the weapon of choice in combating the nation’s opioid abuse epidemic. Hundreds of millions of dollars are being committed to MAT programs and it is supported by professional groups, such as the American Society of Addiction Medicine.

The movement is also doing a great service in breaking the stigma against addiction – showing that addiction is a real disease and like other real diseases, such as diabetes, it can be controlled with medication.

But unmentioned in any of the discussions I have heard is how MAT will be accepted in the 12-Step community, which endorses complete abstinence. Even now, many 12-steppers scorn others who use anti-depressants like Lexapro and Wellbutrin, claiming they are mind altering drugs – even though they will not get you high.

Since MAT’s success largely depends on combining it with behavioral therapy – such as 12-step programs – addicts on buprenorphine or the ever-popular benzodiazapine gabapentin – will find themselves ridiculed in some 12-step meetings.

HHS us accepting comments on its proposed rules until May 31. The comments will surely be interesting, controversial and divisive. With a record-number of people dying of opioid overdoses, this rule could open the door to hope or more corruption.

Prescription pad image available from Shutterstock.

 

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Christine Stapleton http://www.christinestapleton.com/ <![CDATA[Is self-sufficiency making you depressed?]]> http://blogs.psychcentral.com/depression/?p=5632 2016-03-08T11:43:07Z 2016-03-08T13:31:50Z Sunday marked the 13th anniversary of my mother’s death. Sixteen months before she died, my father passed. Eight months after she died, my dog died.shutterstock_374067976

I loved my parents – and my dog – very much. But I probably should have known something was up when I cried much more when my dog died.

I didn’t know anything about grieving back then. I didn’t know it could fester inside in my soul and come out sideways as anger, denial and desperation. I didn’t know that my grief would morph into a bizarre, extreme strain of self-reliance that would end two years later with a swan dive into a deep, dark depression.

My mother, who grew up on a farm in northern Wisconsin during the depression, believed deeply in self-reliance. If something needs to be done, you do it. Don’t bother anyone with your problems but always, always always hold out your hand and help someone else when they need it.

If snow needs to be shoveled, pick up a shovel and do it – and shovel your neighbor’s sidewalk while you’re at it.  If clothes need to be washed, wash them. If food needs to be cooked, cook it. She did it all and taught me to do the same. The more self-reliant you were, the better person you are. Self-reliance, generosity and a strong work ethic were virtues of the highest order.

So, I dealt with my grief and didn’t ask for help. I threw myself into my work and believed the more I helped others, the more I would get over the deaths of my parents and my dog. I figured that sorrow was something that melted over time.  And while you are waiting for it to melt, work your ass off.

That’s how I ended up on disability, antidepressants and a therapist’s couch. The clouds finally parted and I realized that what my mother had taught me about self-reliance was wrong. You see, every time you deny someone the opportunity to help you, you deny them the opportunity to feel as good as you do when you help people.

I felt horrible. I loved helping others. I loved the way it made me feel. But I had denied so many people the opportunity to help me. I had denied them the opportunity to feel good.

I would have to change my way of thinking. I would have to let people help me. But how?

I discussed this with a friend and she agreed – and I let her – help me learn this unnatural act. We went for a drive in her car and she took me to a full-service gas station. Instead of me pumping her gas and washing her windshield for her, we let the attendant do it.

My friend stood outside the car and chatted with the guy as he pumped the gas, washed the windshield and even checked the air in her tires – all things I was perfectly capable of doing. He seemed very happy to be helping and she was grateful.

Awkward.

Then we went to the grocery store. In the checkout lane she allowed a kid to bag her groceries, push her cart to her car in the parking lot and load her groceries into her trunk. Painfully awkward. She chatted with the kid and asked where he went to school and his plans for college. He seemed really pleased she bothered to ask about him and turned down a tip when she offered.

It was excruciatingly uncomfortable for me but I got the message. Little by little I started letting people help me. Years later I am still working on this. Sometimes I am good but sometimes I still fall into my old self-reliant ways. I still try to do others’ work for them – which I’ve learned pisses some people off…bad.

I am much better about letting people help me and I genuinely feel grateful and good about myself when I do so. But I feel profound sadness that my mother did not understand this. She never went to movies or lunch or shopping with friends because she was always working on something. She worked alone in silence. She seemed sad and resigned to her lot in life.

I miss her terribly. I still have to work on letting people help me. It still feels like an unnatural act. But I am getting used to seeing the joy it bring to others – and to me – when I make that connection, humble myself, and ask for help.

Helping hand image available from Shutterstock.

 

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Christine Stapleton http://www.christinestapleton.com/ <![CDATA[How to take antidepressants in sobriety]]> http://blogs.psychcentral.com/depression/?p=5620 2017-06-13T00:54:33Z 2016-02-16T14:01:09Z I am a recovered alcoholic. I also have bipolar II, which can manifest in depression.shutterstock_342000554

I am what they call “dual-diagnosed” – or “twice blessed” as those of us in recovery often quip. I was about 7 years into my recovery when I slid into a deep depression and was diagnosed and put on medications.

The decision to take antidepressants and a mood stabilizer posed a huge ethical and medical conundrum for me. I had heard from many fellow recovering alcoholics that WE DON’T TAKE MIND ALTERING MEDICATIONS! Obviously, antidepressants and mood stabilizers are – thank God – mood altering.

Desperate – and with the encouragement of doctor friend who understands addiction – I took them. It took several months find the right dosages and for them to kick in but when they did, my life – and sobriety – completely changed. I’m not saying my life got better but my ability to deal with life got much, much better.

But I still had a nagging feeling that I had relapsed and was no longer sober because I was taking these meds. I wrestled with it and only spoke about it – privately – with other recovering addicts and alcoholics who had also decided to take antidepressants or mood stabilizers.

Then, while reading reading the Big Book of Alcoholics Anonymous, I read this on page 58:

“There are those, too, who suffer from grave emotional and mental disorders, but many of them do recover if they have the capacity to be honest.”

I was grateful that the authors of the Big Book acknowledged those of us with other mental illnesses. However, I had no idea how the “capacity to be honest” fit in to dealing with both my mental illnesses. Aren’t we supposed to be honest in all our affairs – regardless of whether we have one, two or a dozen’ mental illnesses?

What does “capacity to be honest” mean for those addicts and alcoholics – like me – who have other mental illnesses?

Here’s what I came up with.

Be honest with myself. Exercise humility and admit that I need outside help. This is particularly difficult for addicts and alcoholics because asking for help is not a natural act for us. We spent our entire drinking and drugging careers convinced that we didn’t need help controlling our drinking and drugging.

The whole concept of asking for help and my inability to do it became painfully clear when a friend asked me how helping others made me feel.

“Wonderful!” I said. “I love helping other people.”

“Well,” she said. “When you refuse to ask for help, you are denying someone the opportunity to feel as good as you do when you help someone.”

Ouch.

For me, honesty also means telling ALL those who treat me – doctors, therapists, nurses – that I am a recovered alcoholic and that I do not want to be prescribed any drugs that I could get high if I took enough. Don’t give me drugs that can be abused unless it is absolutely necessary. That means opiates and benzos.

My mother taught me that “honesty is the best policy” but it never worked for me while I was drinking and taking drugs. Looking back over my years of sobriety, I realize honesty saved my life. It is as vital to me as my medications.

Honesty-is-the-best-policy image available from Shutterstock.

 

 

 

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Christine Stapleton http://www.christinestapleton.com/ <![CDATA[How private are a drug addict’s treatment records?]]> http://blogs.psychcentral.com/depression/?p=5601 2016-02-15T17:49:49Z 2016-02-15T17:47:10Z The confidentiality of alcohol and drug abuse patient records is under the government’s microscope.shutterstock_267836501

The Substance Abuse and Mental Health Services Administration – SAMHSA – has filed notice of rule-making for such records. The proposed changes to 42 CFR Part 2- HIPPA – were published in Federal Register on Feb. 9.

It’s been 29 years since there have been any substantive updates to the Confidentiality of Alcohol and Drug Abuse Patient Records regulations. A lot has changed, especially the recent push for an integrated, continuum of care and the use of electronic medical records.

I say changes are needed because you have a bunch of 20-something-year-old newly recovered addicts owning and operating some of the HIPPA-protected treatment programs, such as intensive outpatient programs, called IOPs. They, in turn, share a patient’s health condition with their “clinical staff” – who are also newly recovered 20-something-year-old addicts who have little or no formal training and often no more than a high-school diploma.

IOPs are often the first stop for addicts who have completed inpatient treatment. These programs popped up like weeds after word got out that insurance companies would pay thousands of dollars for urinalysis tests. All you needed was a physician to say the tests were medically necessary.

And because there are no officials standards of care within the industry recommending how often recovering addicts should be drug tested, IOPs began testing addicts in their program 3-5 times a week for a smorgasbord of drugs.

In defense of the IOPs, they also offer therapy and life skills training. Some of those therapists do have degrees in behavioral health and social work. But then you have the “facilitators.” These are the folks who lead group sessions, where patients share intimate details of their recovery.

These facilitators often have no or little formal training. Many are 20-something-year old recovered addicts themselves with high school diplomas and less than two years clean.  These “facilitators” are allowed to sit in on “clinical meetings” where doctors and therapists discuss a patient’s medical condition.

But say an addict has another medical condition – schizophrenia or bipolar – or is pregnant or has Hepatitis C which was disclosed during a private session with a licensed therapist and then the therapist then shares that information with the “clinical team” whose members include the “facilitators”  who are not medical professionals and have not formal training.

Is that a violation of HIPPA? Perhaps no. The patient probably signed a HIPPA waiver upon admission, allowing those treating her to share information. But consider this: the patient may be a 21-year-old addict who has been using heroin, methamphetamine, crack, pot and alcohol since since age 14, dropped out of high school and has been clean for 30 days.

Is that patient competent to sign a HIPPA waiver which allows his therapist to share medical information with “facilitators?” Say that addict – still high – was put on a plane 31-days ago in New Jersey –  where it was 10-degrees – and flown to a treatment center in Florida, where it is 75-degrees and the beach is a mile away.

You think that kid really understands or gives a damn about HIPPA?

The staff at the IOP also share a patient’s medical information with the operators of the sober house where the kid lives. Sober homes have no medical staff.  Yet  these operators – landlords who provide structured, sober living environments – discuss medical information, such as prescription drug compliance, with staff at the IOP.

Addiction is among the most stigmatized illnesses in the DSM-V.  You are dealing with a patient population that has already proven their inability to make healthy, safe and rational decisions. If there was ever a patient population that needed its medical records protected, it’s addicts.

If you have any thoughts on how HIPPA should be applied to this very vulnerable patient population, you can share them with SAMHSA. The Department of Health and Human Services, which oversees SAMHSA, is accepting public on the proposed rule through April 11. Click here to offer your thoughts.

Medical records image available from Shutterstock.

 

 

 

 

 

 

 

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Christine Stapleton http://www.christinestapleton.com/ <![CDATA[4 reasons why addicts should not trust doctors]]> http://blogs.psychcentral.com/depression/?p=5588 2016-01-26T14:20:40Z 2016-01-26T14:20:40Z Oneshutterstock_256151683

Last month I went to the emergency room with tightness in my chest and shortness of breath. I answered a bunch of questions about my medical history, told them about my depression and bipolar, the meds I am on and made it clear that I am a recovered alcoholic/addict and that I do not want to be given any medications that might cause me to relapse.

The doctor came, looked at my chart, looked at me and asked if I was in pain. I said no, just uncomfortable tightness and shortness of breath. .

“Do you have any pain?” the doctor asked.

“I’m going to give you some Ativan. It will help you relax,” the doctor said.

“No you’re not,” I said. “I’m a recovered alcoholic/addict and I don’t take benzos.”

“Why?” the doctor asked.

At this point, my chest tightens even more. Really, doctor?

“Because I’m a recovered alcoholic/addict and I don’t take drugs that can make me high to help me relax,” I said.

“Okay, how about some morphine?” the doctor asked.

My chest tightens and my blood pressure rises. I want to say, “Are you effing kidding me?” but I don’t.

“No,” I said. “No morphine. I don’t take opiates, either.”

“Well, then I’m just going to give you baby aspirin,” he said  and walks out.

The nurse looks at me and says, “I get it. Don’t worry. I’m going to write NO BENZOS OR OPIATES in your chart and I’m going to put this red allergy bracelet on your arm just to make sure you don’t get any.”

Two

Last week the same thing happened to a friend of mine – a recovered heroin addict. He went to the ER with a bad infection in his big toe. His toe was red and swollen and it hurt badly when he stood. He told the doctor the pain wasn’t so bad when he sat down. The doctor asked him if he wanted any painkillers.

“No,” he told the doctor, “I’m in recovery.”

Then the nurses asked him if he wanted painkillers. Then the doctor asked again. Finally, they gave up and gave him some extra-strength Tylenol.

Three

On the flip side, I met a young woman last weekend – a newly recovered addict – who said she was just about out of her psych meds and couldn’t afford them. The staff said they would call her mother about her insurance and getting the girl enough money for the co-pay. The staff didn’t call, she said. She had just a day’s worth of medication remaining.

Four

I also heard about another young woman – also in recovery – who told the staff at her outpatient treatment program that she was pregnant but was going to have an abortion. They immediately took her off her medications without considering alternative medications or that sudden withdrawal from the medications might cause her to relapse.

Getting clean and sober is hard enough. We don’t need doctors ignoring our efforts to stay clean by offering us benzos and opiates. And we don’t need doctors and their staff to cut us off or allow us to go cold turkey. These aren’t M&Ms. These are extremely potent drugs. The withdrawal symptoms can be horrible.

If you are dual-diagnosed like me, medications are as essential as 12-Step meetings, therapy and not trusting doctors.

Doctor dispensing medications available from Shutterstock.

 

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Christine Stapleton http://www.christinestapleton.com/ <![CDATA[How to screw up taking antidepressants]]> http://blogs.psychcentral.com/depression/?p=5581 2016-01-21T14:26:17Z 2016-01-21T14:09:52Z Once a week I refill my pill box. I take two antidepressants and one mood-stabilizer, along with a handful of supplements – fish oil, glucosamine, daily vitamin etc.shutterstock_190984571

One-by-one I take each bottle out of a basket, open it, deposit the pills in their daily nook and put the bottle back into the basket. I take my medications without fail and I have done this little routine countless times over the years.

Last week I screwed up. Big time. I forgot to put one of my antidepressants in the mix. It took five days and a swan dive into my black hole before I realized this. I probably would have discovered this faux pas sooner if I had been paying attention but I have been under a lot of stress lately and it has been difficult to focus on anything for long.

Day one and day two were typical crappy days. Day three my lovely mania emerged. I spewed my anger and frustration all over the newsroom. I realized what I was doing but my mouth was on cruise control and wouldn’t stop.

Day four I awoke with my head in a vice grip. Bouts of sudden dizziness hit me. I could not focus on anything but the bad things going on in my life. My appetite vanished. Anxiety and sadness sat heavy on my chest. WTH? Maybe my meds had stopped working.

I turned to my Hail-Mary, last-ditch solution: exercise. Maybe if I exercised really hard for long enough I could generate enough endorphins to counteract the depression. So I strapped on my running shoes and hit the road – for three hours.

I didn’t run the whole time. I was crying too hard sometimes and my knees began to ache. The tightness in my chest wouldn’t lift so I ran some sprints. Still nothing. No endorphins. No relief.

I got home, took a bath and slept for three hours. Day five I sent an email to my bosses telling them I wouldn’t be able to work: Please don’t call me. If you need me, txt or email.

Boom. Down goes Frazier.

That night I pulled out my pill box and poured the evening’s pills into my hand. I stared. Where is the Lexapro? I wondered if maybe I accidentally took it in the morning. Then I looked at the next day’s pills: No Lexapro. Then the next day: No Lexapro.

S#*t. I forgot to include Lexapro in my weekly cache. I immediately took the Lexapro. But now what? My nurse practitioner had often told me that if you stop taking an antidepressant it might not work again when you start back up.

I woke the next morning in a somewhat better mood but still unable to concentrate. That night I made damn sure I took my Lexapro. I woke up the next morning and stared at the ceiling assessing my mood. I felt fine. I FELT FINE!!! I still had the same amount of stress but I was no longer in my black hole! Halle-frickin-lujah!

I’ve heard people say they stopped taking their antidepressants cold turkey. They’re sick of taking them, they can’t afford them, they’re gaining weight or worried about the side-effects of long-term use.

The idea used to intrigue me. No more. Never will I stop taking my antidepressants without the blessing of my nurse practitioner.

I have a new protocol for taking my meds. Take the bottle out of the basket. Open the bottle. Deposit the pills. Put the cap back on the bottle and LEAVE THE BOTTLE ON THE COUNTER. Do not put the bottle back in the basket until ALL PILLS HAVE BEEN DEPOSITED INTO THEIR DAILY RECEPTICALS!

These aren’t M&Ms, you know.

 

 

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Christine Stapleton http://www.christinestapleton.com/ <![CDATA[Why you don’t know how much mental illness and drug abuse is really in your community]]> http://blogs.psychcentral.com/depression/?p=5558 2016-01-04T22:57:12Z 2016-01-05T14:04:07Z It’s Sunday night. I am sitting at my desk in the newsroom. I am a reporter and every couple of months I pull a weekend shift. The newsroom is quiet and I can hear the police scanners clearly.NEWS

During the day, with all that’s going on in the newsroom, the scanners are just white noise. The cop reporters pay attention but to the rest of us, they are annoying.

If you want an idea of how much mental illness and substance abuse is out there, listen to the police scanners in a major metropolitan area, like South Florida, where I work. Some agencies use human dispatchers but many of the calls are announced by a computer with a Siri-esque voice.

Rescue 12. Responding to area 19. Overdose intoxication. 123 Main Street. Tac 2a.

Rescue 6. Responding to area 12. Suicide attempt. 456 Main Street. Tac 6.

Even on a slow Sunday night you might get 10-15 seconds when the airwaves are silent. But that is rare. Dispatcher Siri is on the job – describing in her robot voice the tragic realities of mental illness and substance use disorders.

Despite all the overdose and suicide calls I’ve heard today, I won’t write about any of them. The media don’t cover suicides unless it’s a celebrity or the suicide caused a traffic jam. And we certainly don’t cover attempted suicides. As for overdoses, there are just too many and HIPPA prevents us from getting any details anyway.

Once upon a time, some editor somewhere decided that suicides and overdoses are private matters and should not be covered by the media. Why bring more shame and hurt to these people, right? So, we don’t cover your run-of-the mill overdose or suicide.

HELP MEWas this a wise decision? Should we cover suicides like we cover homicides? I don’t know. I see both sides: Why bring more sorrow to grieving families? How can we accurately portray the magnitude of the crisis in mental health care and substance use disorder if we don’t?

What this means for you – the news consumer – is that you have no idea how many people overdose or try to kill themselves. You would be shocked if you knew.

For every fatal overdose and suicide, there are countless non-fatal overdoses and attempted suicides. Those data are nearly impossible to get. I know because we’ve been trying to get hospital admission data for months as part of an investigation I am working and it’s not an easy task.

We gasp when we hear numbers about the rise of heroin overdose deaths. Where I live we’re seeing at least one overdose death everyday. Tragic. But if you want to know the real scope of the problem, we need to see the numbers of non-fatal overdoses and suicide attempts.

The government collects these data but there are very tight restrictions on who can use the data and for what. If some researcher or policy wonk doesn’t slice and dice the data at the hospital level, how will we ever find the hot-spots – communities and neighborhoods that are experiencing higher than average drug overdoses and attempted suicides?

How will we ever come to appreciate the magnitude of people that are suffering?

Listening to the police scanners is not the answer.

DATA dice available from Shutterstock.

Depressed teenage girl available from Shutterstock.

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Christine Stapleton http://www.christinestapleton.com/ <![CDATA[Why are all the great Christmas classics about depression?]]> http://blogs.psychcentral.com/depression/?p=5549 2015-12-23T16:19:24Z 2015-12-23T16:10:35Z Ever notice that the great holiday classic are about depression?its-a-wonderful-life-3

There’s George Bailey, the financially strapped father of a posse of rowdy kids in It’s a Wonderful Life. Then there’s Scrooge and the Grinch. And how about that Santa-denying mother in Miracle on 34th Street? Charlie Brown and his pathetic little tree.

Let’s not forget The Littlest Angel, a story about a little boy who dies, goes to heaven, can’t keep his halo on straight, can’t sing on key with the seraphim and misses his dog? Then there is that country western song little boy who want to buy his dying mama a pair of shoes. We have Elvis’ Blue Christmas and Do They Know It’s Christmas about people starving in Africa.

If you have depression like me, you’re probably already dealing with your own Christmas drama. The last thing you need is to watch a drunk father jump off a bridge on Christmas Eve. But there are lessons to be learned from these poor souls and how they pulled through.

They found gratitude. George Bailey’s gratitude came from seeing what the would would have been like had he not been born. Scrooge’s gratitude came in a dream, when he saw how his selfishness infected those who crossed his path and how he still had a chance to change.

These are all stories of hope and gratitude – two of the most powerful antidotes to depression. For me, antidepressants are necessary and easy but they don’t give me hope and gratitude. That’s an inside job. The antidepressants give me the ability to feel hope and gratitude but I must do the footwork and find it.

This has been a particularly difficult holiday season for me. Hope and gratitude have not come easily for me. I have had to search for it. I finally found it last weekend when I got off my pity pot and volunteered at a local bike charity, that gave away of 900 bicycles to kids who probably aren’t going to have much else under their trees.

Those three short hours of watching kids pick out the bike of their dreams filled me with hope and gratitude – hope that there still is big beautiful world out there and gratitude that I had been relieved of the bondage of my sadness.

I wish I could tell you that there’s an angel who will lift you out of your black hole. I wish Santa could take away your pain with a present under the tree. But this is real life – not the movies. Depression is real. But if we take our medications and do some footwork, we just might find some hope and gratitude.

For me this holiday season, that’s all I really want.

George Bailey from It’s a Wonderful Life available from Shutterstock.

 

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