When you have no meds
This could be a really irresponsible post, so first of all I want to say what I am not advocating here:
- Do not use this as an excuse to avoid seeing a doctor at all! See a doctor!
- Do not use herbal remedies (particularly St. John’s Wort) in conjunction with prescription meds, unless you talk to a doctor first. See a doctor!
- Do not take the attitude of “one of these wimpy little pills didn’t work, I’ll try taking three”. Been there, friends. Don’t.
- Don’t mix things that shouldn’t be mixed. Ask a pharmacist.
- In case any lawyers out there missed it when I said it before, I am neither a pharmacist nor a doctor!
All that being said, sometimes circumstances will conspire to bone you. You run out of your prescription on a Thursday; no repeats left; your doctor refuses to renew over the phone when the pharmacist calls, even though it’s pretty unlikely that you’ve stopped being bipolar between last month and this month; there are no appointments available on Friday; you are without your drugs until Monday at least. A good, compassionate pharmacist who knows you well (in a small town especially) might dispense you a few emergency pills to tide you over if he understands that you’re right out and it’s not a drug on any of the special schedules–i.e. you can probably forget about getting extra Xanax that way but Zoloft, sure. But in the big mean city it’s less likely.
Or maybe you’re travelling for a week and you spaced on packing your meds, or any other number of other scenarios. I’m just going to talk about stuff from over the counter that might help.
Sleep: So you’re bipolar, you use an atypical antipsychotic to ensure that you hit the pillow every night and don’t start building momentum for a manic flight. Awesome, me too. Stopping mine for even a day can mess with my equilibrium a lot. In fact, it was this one pill that conditioned me to stop forgetting to take all my damn pills daily, because while an SSRI can be easy to forget, you don’t forget to take the Happy Goodnight Downy Feathers Pill. Maybe you’re a lucky bastard who gets Ambien or Lunesta or something else that is serious business. If so, you will all join me in laughing contemptuously at the OTC options for sleep aids.
You ever hear a healthy person talk about sleeping pills? They’re terrified of them! ”I don’t want to be groggy in the morning!” ”I don’t want to get addicted!” ”Sleeping pills, I dunno, isn’t that how a lot of celebrities died?” ”Ambien, but doesn’t that take a week to work?” Tell them that it’s the exact same ingredient as Benedryl in different packaging and blow their minds. The good news: if for some reason you don’t want to be seen buying boxes of sleeping pills, buying Benedryl will just get you mild sympathy. Allergies suck, huh, buddy?
But let’s be real, if OTC sleep aids were going to solve your problem, your doctor would have told you to just take those for a few days. Instead she prescribed you a controlled substance. Your sleep problems are more than the dyphenhydramine HCl can really help you with. Can they help a little? Yes. Go for a long walk if you can in the late afternoon (or exercise harder if that’s your thing), avoid caffeine entirely for the duration, long hot bath/shower, take a couple of OTC sleeping pills or Benedryl and you’ve got a decent chance.
Lots of people like Tylenol PM or Nyquil, but be careful with those. It’s very, very easy to take toxic amounts of Tylenol purely by accident, it’s rough on the liver, and Nyquil especially has a buttload of it hidden in there. Get your doxylamine succinate (Nyquil’s active ingredient) in the form of Unisom or something so that there aren’t other ingredients that you don’t need messing with your organs.
Another thing that can work is Gravol (Dramamine in the U.S.), the anti-nausea/motion sickness pill. Some people say it gives them freaky dreams or makes them more awake. You can find out in a fun scientific experiment!
Herbal/alternative remedies: your mileage is really going to vary here. Melatonin and valerian do nothing for me (by the way, WATCH OUT with valerian in capsules, because that stuff has a very distinctive poo-like odour that will come back up your throat for awhile afterwards). Other people find that those remedies do work for them. For a person with serious sleep issues, chamomile tea is probably going to work about as well as…well, any other warm bland beverage. Lavender-related aromatherapy stuff is nice enough because I like the smell of lavender, but I am not convinced that it does any more than that. Actual herbs are all well and good but you know that things labelled “homeopathic” are just trying to separate you from your money, right? Right. Try whatever you can afford and hope for the placebo effect.
Anxiety: Sorry, bro. You can try the Benedryl or Gravol in the hopes of slowing down your central nervous system enough to calm down. This will work best if you do it at the very first sign that you’re having an attack. Or even before, if you’re anticipating a stressful situation. Being slightly dopey and sleepy in public is a million times better than having a panic attack. Valerian is also used for anxiety so if that does anything for you, try it again when your brain starts trying to convince you that your heart is exploding. My therapist taught me something roughly like this for handing panicky moments, and again, if you start before you’re absolutely screaming meemies then I think simple concentrating and gentle self-touch can keep you grounded. Because I often feel overheated and nauseated, I like to hang out in the bathroom (nice cool floor) and read books I loved as a kid (Calvin & Hobbes collections are my favourite). It’s about the exact balance of focusing me without challenging my brain too hard, and the nostalgia helps.
I will give another piece of personal non-medical advice with a lot of caveats. LOT. If you are of legal age, if you are a person who has never had trouble with alcohol, no one in your FAMILY has even had trouble with alcohol, and any conflicting meds are out of your system, and this is a particularly stressful occasion, there may be some benefit in treating things Victorian-style and taking a small amount of alcohol medicinally. Take one shot of something hard and put the bottle away. Follow it up with a glass of water. Do not make a habit of it, do not do it before a job interview, lots of caveats. But as unpopular as it is to say nowadays, I think this method can do people some good if it stays under control.
(Pro tip for people who get menstrual cramps: this one-shot method also works for that with very surprisingly speedy efficacy. My mother gave me a tiny liqueur glass full of Grand Marnier the first time I had unbelievably awful cramps, and it cleared that up fast. Possibly the sugar or other ingredients in liqueurs has something to do with it, because that seems to work better than the same amount of hard liquor.)
As well as believing that Demon Alcohol has its uses, I also think if you live in a jurisdiction where marijuana use is legal and you know from past experience that it doesn’t make you paranoid…what are you waiting for?
Depression: You are even more screwed than the folks with anxiety. If you have no access to your anti-depressants for several days or more, you really should agitate with the pharmacist and ask if there isn’t something she can do. Get a friend/family member to advocate for you if you can’t handle doing that. SSRIs and SNRIs can have ugly discontinuation syndromes, and some of the above will work on the symptoms (not the alcohol, friend), but a lot will depend on the half-life of the drug in question and how susceptible you are to side effects.
If the drug is out of your system, St. John’s Wort does seem to work a bit for me. (SSRIs and St. John’s Wort don’t mix, so be careful about this.) I take it in the tea form, and the results are okay: I feel a little weird but kind of happy shortly after. Once again, the same rule applies as for anxiety: the deeper you’re mired in it, the less likely that an herbal or OTC treatment will do anything for you. An ounce of prevention is worth a pound of cure, and if you know that you’ll be without your pills for awhile, you really have to take care of yourself in order to prevent Bad Things from happening.
That’s about it. We will be together again, Seroquel. One day.
someday there’ll be a cure for pain
that’s the day
I’ll throw my drugs away
We’re an endless emergency
Sometimes when things are at their worst, it’s scary to leave the house and sit through class or work when you feel like you’re going to start bawling at any minute. You can either deal with this by staying home and letting the problem get worse, or you can deal with it by radical acceptance.
Option A: ”Only pathetic losers have breakdowns in public. I’m not like that and I don’t want anyone else to think I am. I feel awful today so I’ll skip it and I’ll feel better tomorrow. Then I should be able to get through the day without any problems at all, because I’m not a total headcase…”
Option B: ”I may have a breakdown while I’m there. That’s happened to me before, because I have a lot of issues to deal with, and it might happen again. I don’t like that idea and I don’t want it to happen, but that’s the way it is. I can’t stay home forever so if I’m out in public and I have a meltdown, I’ll have to just deal with it.”
Obviously B is the more realistic way to look at things, so the point of this entry is how to deal with public meltdowns. What works for me is to make a kit containing everything you’ll need in order to lose your shit when you’re out of the house. There are a couple of benefits to this… Continue Reading →
Back on that horse
Going back into the System, after running around loose for awhile, would be demoralising except that you wouldn’t do it if you had any morale left anyway. I haven’t been to a therapist or a psychiatrist since I left Harvard North (about which, it looks like they’ve got about twice as overworked as they were when I was there), and I’ve been trucking along with GPs. This was because in the fertile dairy country where I was living my choices were limited–I would have had to go two hours away to see anyone competent–and also I was burnt out on therapy. When friends told me I should go back (your friends always know before you do) I would say “I wouldn’t have anything to talk about” like the stoic cowboy that I am.
It’s true as far as it goes, though, that you do sort of forget how to excavate all the Problems for a therapist, and you forget how to feel okay about crying in front of a stranger. But that all comes back to you. And you feel like a total pro about the rest. I have not felt like a pro about anything in quite some time so I guess this was nice.
The Pros all believe that my exotic sleep ailments (I have a fun collection of nightmares, bruxism, night terrors, sleep paralysis, and disorientation on waking that sometimes looks like short bursts of sleepwalking) are all caused by anxiety, which is in turn caused by me avoiding my problems. Since avoiding your problems is the best, I have not quite stopped doing that even though I did all the scutwork of going around to different school offices asking for PLEASE PLEASE ANOTHER CHANCE I’M SO MESSED UP.
In fact, I may avoid finishing this entry and instead leave you with John Mulaney’s bit about the pleasures of avoidance.
Your own brand of unhappiness
Keep your ears open to the promptings of your destiny and don’t worry too much if you and your destiny do not agree about what you should have, and when you should have it. Happiness is always a by-product. It is probably a matter of temperament, and for anything I know it may be glandular. But it is not something that can be demanded from life, and if you are not happy you had better stop worrying about it and see what treasures you can pluck from your own brand of unhappiness.
- Robertson Davies
Underneath the Ice
Warning: This post frankly discusses a suicide attempt and self-harm. If you’re in a fragile state, it might not be a good idea to read it.
In January of 2009, I had been living at home with my parents for a few years. Dropped out of university, no job, full-time melancholic. We lived in a small town on the St. Lawrence River. Very small. I had been diagnosed as bipolar II after a manic episode, and I was having lots and lots of trouble sleeping. I didn’t sleep at night; I’m nocturnal by nature and happy to sleep through the morning after staying up all night, but now I wasn’t sleeping in the morning either. I wasn’t sleeping in the afternoon. My doctor (a GP) had been prescribing sleep aids, and now he stopped. I cried in his office, but he stopped. I was still on benzodiazepines for anxiety, and although I was on Wellbutrin for depression, I wasn’t taking it. I might have also been on Depakote, technically, on paper, but I certainly wasn’t putting any of those little bastards in my mouth anymore. (Me and Depakote don’t get along, but for some reason I was ashamed to tell the doctor.)
Benzos will definitely make you sleep if you take enough of them, but (a) this means you don’t have enough left in the bottle to treat panic attacks, and (b) a heavy dose can often make the inside of your brain grim and dismal for the next day or two. I was dosing myself with a cocktail that makes me cringe just typing it out: 5-10 mg clonazepam, 4 or 5 Gravol (diphenhydramine), the remains of an old prescription for Zyprexa, melatonin, valerian, and a multivitamin, because good health is important!
Friends, don’t do this.
I Feel Drunk All the Time
Jesus it’s beautiful!
Great mother of big apples it is a pretty
World!
You’re a bastard Mr. Death
And I wish you didn’t have no look-in here.
I don’t know how the rest of you feel
But I feel drunk all the time.
And I wish to hell we didn’t have to die.
O you’re a merry bastard Mr. Death
And I wish you didn’t have no hand in this game
Because it’s too damn beautiful for anybody to die.
- Kenneth Patchen
How to go to the hospital
If you’re suicidal, people will often tell you to go to the ER, which is kind of a weird and scary undertaking. How do you just walk in, with nothing apparently wrong with you, and get taken seriously? What do you say? What will happen? Will you be able to get out? How does it work?
I have been hospitalized this way for suicidal thoughts, so I can answer some of these questions. I live in Canada, specifically in Ontario, so my experience won’t match yours if you life in Alabama or Alberta or Australia. Some stuff might now be outdated, even for my region, and it will be different if you’re a minor. But some of this will still be useful.
