The Perfect (Medication) Cocktail

click to read DeeDee’s bio

It seems like almost everyone who has been under long-term psychiatric care has embarked on a quest for the Holy Grail: the perfect medication cocktail. And it also seems like a lot of people never find it.

But I’m pleased to discover–my therapist and psych nurse both concur–that I’ve finally found mine. It treats a biological failure to produce enough of a couple critical substances: dopamine and progesterone.

My perfect cocktail includes sinus treatments, a slew of vitamins and supplements, a couple of psychoactive drugs, low-dose naltrexone, and progesterone (not pictured).

I’ve known for years that dopamine was to blame for my mood and attention issues because only dopaminergic drugs ever helped. But there’s no “dopamine deficiency disorder” in the DSM, so they’ve labeled me with ADHD and Major Depressive Disorder. Although Wellbutrin XL and Adderall XR is a bad combo for most people–it makes them anxious, wired, and twitchy–it’s exactly what I need.

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Miss Diagnoses

Anyone who has ever looked up a “serious mental illness” like bipolar disorder has been smacked in the face with dire warnings and frightening statistics about misdiagnosis. If you google my lifelong companion ADD, you’ll see lots and lots of dire warnings and hand-wringing about overdiagnosis. But you won’t run into are dire warnings, frightening statistics, and hand-wringing about repeated, compounded misdiagnoses.

Fat and Crazy

I’ve got nothing against being fat, or being crazy. I’ve been both, and I know that there are a million, zillion causes for packing on the pounds or losing your marbles. It’s not always due to factors under our control, but more often than not, lifestyle choices are a significant factor.

I’ve come to suspect that being fat was a major part of what made me crazy–or at least made it much worse. Well, not the ADHD – that’s been a lifelong struggle and there’s a super-obvious genetic link.

You Can’t Win at the Insurance Game

I am extraordinarily lucky: I have complete coverage health insurance. That means all therapy, lab tests, prescriptions, and other services – even chiropractic – are covered 100%. It sounds too good to be true, right?

It is.

The catch is that it’s a high deductible plan, and while my husband’s employer pays the bulk of the $11K deductible, we pay about $2K.

Mental Illness By Way of Hormones

That I have a mood disorder goes unquestioned; the true nature and biological aspects of cause are up in the air. Besides the usual childhood traumas and genetic influences, it looks like hormones are in part to blame. Don’t start any hating about stigmatizing women’s normal, natural cycle, because I’m not talking about a normal experience.

I’m talking about a set of oversensitive physiological responses to and/or chronic imbalances of basic hormones like adrenaline, cortisol, estrogen, progesterone, and testosterone. The kind of sensitivity to adrenaline, for example, that means I can’t have medications containing epinephrine (aka adrenaline, often found in injectable local anesthetics, to reduce bleeding) because it immediately sends me into shock.

Goals Are For Losers

Time flies, fun or not. A week, a month, a year simply…vanishes. I graduated a year ago, and it has taken most of that year to recover enough to think about next steps. Another job search, and probably moving. Continuing efforts to improve my health. Things like that.

But then my therapist (a.k.a. Hippie Dude) started asking about long-term goals, after discussing the issue of career choices for ages and getting nowhere. So goals might help, right? I gave it a try despite my doubts and made lists of “goals” for various part of my life.

Writing a Safety Plan

When I started creating a Wellness Journal awhile back, I found I didn’t have some of the “required” ingredients on hand, including a Safety Plan and a Wellness Plan. Fortunately, plans can be developed as needed, right?

I started with a little research and quickly learned that there are a number of different contracts and plans meant to improve accountability and interventions in mental health crisis situations.

When Do I Make the Call?

Everyone tells me I hold out too long. I don’t ask for help often enough or soon enough. I tell them that I don’t know when to ask; they don’t seem to understand.

I’m learning to recognize when things are going awry and when what I’m feeling should be considered “unacceptable” because it’s suffering, not pain. I’ve accepted, at least at an intellectual level, that everyone needs help sometimes, including me. That’s been no easy task.