Wednesday, March 28, 2007
The Danger Zone
"'Cause it’s another overcast day, Like it’s been for weeks, And I would blame feeling down on the weather If I had no other reason to be." (In Perfect Time ~ Jill Barber)

Ever wondered why so many patients stop their own meds? I used to wonder. Actually it used to p*$$ me off...
"What was the point of that? You came to us for help, we provided you with a medication which should only be adjusted with physician input, and you just stopped it?? You know better than a doc how to taper a med and when it truly isn't needed anymore??? Geez!!"
Of course I wouldn't say that to my patient, but that was what I was thinking. Instead I would try to delve more into the reasons behind their decision, to help me when formulating my teaching plan about how this should be handled better in the future.

So that was me, perfect nurse. Then along came February. (Actually, it was January on, but why quibble with details...) I'm faithfully taking my meds, and then I catch myself, every once in a while taking an extra one...
"maybe I just need a little more serotonin, maybe I just have gotten used to this level of med - I know the dosing range and I'm on the low end..."
I smarten up and go back to taking the prescribed dose. I work on other things to try to kick the funk - walking, exercising, eating better, going to bed before 1 am, avoiding alcohol even more than I usually do. Then I realize that I've missed a couple doses. Four, to be exact. In a row. And I'm feeling OK. Better than OK - actually kind of good. For the first time in months. So I start to think...
"Maybe I'm over this - I know the research says that a minimum of 9-10 months of treatment is required for remission and minimizing chance of recurrence - that's how long I've been taking this! maybe I'm ok. Maybe I can stop the meds..."
One would think that with my background I would recognize the red flags waving, but I don't. I do, however, know enough about antidepressants to recognize that they shouldn't be stopped cold turkey, but weaned off over a period of time so I take one, wait two days and take another. Then....


I get hit by a 2x4 (or maybe it was an 8x16), and it knocks me off my feet. There are indeed social factors contributing (a close family member is diagnosed with invasive cancer, a trusted child is caught being very untrustworthy, some really awful events at work), but amid the fog, the fatigue and the despair, the truth hits me.

I've just done what so many of my patients before me have done. I'm just like them. No better, no worse. Just a patient.

So every day I learn something new. And some new things are more humbling than others.



Blogger shrimplate said...

I hope you're feeling better.

One of my music teachers, e real hard-ass, used to dismiss our workload complaints sarcastically by telling us "Life is full of hills and valleys."

I loved that guy and he was a pretty good teacher.

Anyways, it might not be the meds and it might not be life circumstances and it might not be both.

Anonymous Anonymous said...

Good post.

I have a very similar issue as yours, but on the flip side. My life partner is taking antidepression medication, but does not like to discuss it openly. I sometimes worry that dosages are being missed or adjusted. The problem is, this is my partner, not my child. I'm not sure how to keep the balance between privacy and concern. When does 'giving someone space' become 'not seeming to care'? Or, when does 'keeping an eye on a situation' become 'not respecting someone's privacy'?? I need to figure this out. This is the most important person in my world. Help.

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