A Mental Health Post – Trouble on the Horizon

An Uncertain Future

rodrigo-mtorres-473883-unsplashThere is an uncertain future for The Bipolar Writer.

I wanted to preface this post with some background before we get to what I learned at my recent visit with my psychiatrist on Monday. Since my diagnosis, I have been a part of the California Adult Behavioral Health System of Care. If you have followed my blog for any length of time, you know that being in the system can be tough because you are at the whims of the local government and things are always changing– and in my experience, it is never for the good of the patients.

Since 2012, when I had a stable psychiatrist in my life, it has been a revolving door of the psychiatrists. I have changed psych doctors at least twice a year since 2012. What is worse is their primary purpose is to maintain my medications. That was fine, I understood the process, and while it is not ideal, over the years, I have learned to go with it because I have great consistency in my therapist. What is worse is over the last two years the system is moving to see psychiatrists over the computer on a webcam. That is where I find myself in an uncertain future.

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I went to my appointment on Monday with some level of comfort. Then my world changed. My “over the webcam’ psychiatrist told me that the county is not allowing him to prescribe my most crucial medication right now– Ativan. It is because I am not seeing him face-to-face (at least that was his answer. The whole thing was very sketchy.)

My first reaction was “what the f*ck!”

Sorry about the cussing but this is all bad. For those that don’t take Ativan, I will tell you why this is bad. Ativan is very addictive medication, and any psychiatrist worth their salt will tell you the only way to get off Ativan is a prolonged and steady process. If not, withdraw is a possibility (it is a controlled narcotic.) So there I was sitting there, lost again staring down at the possibility of going without the one medication that can have disastrous effects.

Now, there is hope. I will have to get an emergency appointment (hopefully) with a psychiatrist in the building (which what my psychiatrist said was necessary.) The first thing I did when hearing this news is finding my therapist, who is also my caseworker, and I put her on getting me that appointment. At this time she is working on it, and in the meantime, there is a real possibility of running out of Ativan by next week.

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There is hope that I will get my prescription filled before I run out, but that is not the worst part of this situation. Every year it seems the government is cracking down and decreasing the amount of Ativan that people can have and take. This would be fine if there were a real alternative.

I have been on Ativan for almost eleven years now and not once has the answer been to lower my dosage then wholly getting rid of it. Instead, the response to my ever growing issues with social anxiety is to increase the dosage. What happens when the government decides that I can’t take my current dosage of 2mg twice a day, or completely take me off with no warning? It is a real possibility from what my doctors are telling me. Yet, there is nothing in place for that eventuality. I could realistically end up hospitalized in the psych ward again, which I fought since 2010 to stay out of that place entirely.

This is the problem with our mental health system in this country. It never works towards fixing the issues. When I was in the psych ward in 2007, when I was started on Ativan, I was not given a choice or told the realities of longterm usage.

I have been thinking a lot recently if my reliance on Ativan is making my social anxeity worse. I don’t leave my house without it, and I rely on it every second of my day. I can feel when the Ativan is out of my system. The anxiety rises to the point where I must take another pill. The way it makes me feel the worst way. I didn’t ask for this, and I have honestly asked over the many psychiatrists what can we do differently and never once got a solution. It is a double-edged sword.

I am curious to hear from the community. Is anyone else dealing with these issues? In your opinion, does the Ativan make my anxiety worse? Have you found a useful solution or alternatives? Have you gone off Ativan? Please leave your comments below.

I will keep you all updated during the week.

Always Keep Fighting

James

Photo Credit:

RODRIGO MTORRES

Anika Huizinga

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Benjamin Davies

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47 Replies to “A Mental Health Post – Trouble on the Horizon”

  1. I’m thinking of you. Yes Ativan falls into a class of medications that are considered “short-term” usage. 11 years is a long time and your dosage is high enough that I can understand some of their concerns. However, in saying that, I went off Ativan after 5 years because it wasn’t controlling my anxiety anymore and I was at the highest dose allowed by my care team. They did switch me to another medication in the same family, but I can tell you that as your body withdraws from the Ativan you MUST be carefully watched (even if you need a small hospital stay). It will be hard on your body and mind. It is extremely addictive and your body will respond in negative ways to being removed (even in stepping down). Yes, I have experienced this. In my case, they have taken me off of a medication with a “cold stop” and tried another medication in a different class of drugs. It caused me to have negative reactions including severe rage that made me want to hurt myself and anyone and anything around me. I sought help and they have changed me to yet another class of medications. But it doesn’t fully work. Meditation, projects, working on myself with coping skills are a must for me and still struggling every day. That is why I haven’t been on my blog and stopped contributing here for a while. I need to focus on me and my mental health at this moment. I see posts, articles, and hope for ending the stigma but we (the ones who can help others understand) are being faced with road blocks everywhere that puts us in a position that makes it harder for us to function and speak up and out!

    Liked by 5 people

    1. Wow. I am a bit scared because of my long term usage. Thank you for sharing this and it is something that I will talk about with my doctors. I don’t know if I could handle a setback like a hospital even if it small. It sucks all around. Again thank you for this, it gives me a lot to think about

      Liked by 3 people

  2. Wow, I’m so sorry this is happening….i hate the fact that the meds they give us are necessary and we become reliant on them, both meds and docs. It’s hard enough to deal with that with changes to the system it’s even harder.

    Liked by 3 people

    1. Exactly. The system is broken in my opinion because there is no accountability. The constant changes hurt patients and it as the expense of their mental health. If this was 7 or 8 years ago I would have fallen apart already. I got better mostly on my own not because of the system.

      Liked by 2 people

  3. I don’t have a personal experience of this, but what a scary time for you. I hope they at least get to do this slowly, because it would be ridiculous to stop it just like that when you have been in them that long.
    With someone else saying here that this medication is just for short term, were you told that originally when you were first put on them, do you remember? Or is the deciding of this being short term come in later?

    Liked by 2 people

    1. It was almost six or seven years of taking it that a psychiatrist finally said “this was supposed to be a short-term solution.” But that doctor offered no solution. I actually had to research the medication to realize just how dangerous it really is in the long-term.

      Liked by 3 people

      1. Oh dear. Sounds like a doctor at fault, which you could claim for. I don’t know what medication it was over here, as I was young and not knowing much, but I remember there was a bit of a storm with medication where people were on meds longer than they should have had and sue claims were rolling in. I think some could not even come off it, because they been on it that long.

        My mum has been on mental health medication along time. Not much as she once did in tablets, but still is and always will be.
        I remember my mum asking the doctor if she could come off them, but they said she had been on them that long, it would be best not to. Mum is, as you know having a change in her medication though this year, with her mental health not being too good. Although mum seems to be better and she says she is, I do wonder if she feels the roughness with the change still. I think it’s still early days too and she is still be observed. Nothing has been changed recently, so whether they are happy with that, or not, or still seeing how mum goes, I’m not sure. I shall have to ask my mum Saturday about it.

        Liked by 4 people

      2. Mum has had mental health issues since before I was born. Started at 16. Mum seen I think she said Moses from the Bible . It was from that, that mum was classed Schizophrenia.
        I know mum was under a clinic one time when I was a toddler. My memory very vague, other than I remember walking up a particular hospital corridor to make our way to this. This clinic was knocked down and some point I think was when a day centre came about newly built elsewhere on hospital grounds.

        When I was 11, mum had a breakdown and spent time in a ward. As I have blogged, my dad would not have helped playing a part in mum’s health, as well as mental health can be unpredictable at times. Mum’s nerves I remember as being on edge. I remember the things visually mum was like, like rocking her leg, agitated sometimes.

        Later, when dad died and it was just me and mum, (I was 13 abouts,) and I was kind of doing things dad would have done, like painting, drilling a hole to put a screw in, fix things. But also I remember the mornings where it was like walking on eggshells in a morning. She’d ask for advice. (I’m a teenagerbeing asked an adult advice type question.) I would give it and she be fine, another time and there were many, I was snapped at in the first five minutes. It took three months of this, before I just snapped and said what is going on? Why you biting my head off? Which I squared when asking that question. She had stopped her night medication, because she couldn’t afford it. This was her most important medication, which she was soon put back on, when I went with her to an outpatient and said what she done. They also helped her to get free ptescription for her medication that she was entitled to, that someone else said she wasn’t. If it wasn’t for me pushing my mum to allow me to go to her appointment, I don’t know what would have happened

        Many years between then to present, she has been stable. I don’t know names of all tablets she has been on, but some years ago, they were reduced a little and all was good.
        My only concern for her mental health started in last year or two, on and off. But this is still being monitored.

        Liked by 1 person

      3. I totally understand your post and this comment. I was put on tramadol/ultram as a long term solution. When it’s not supposed to be used that long. For two and a half yrs i had a monthly script for 240 per month. And as a recovered addict i wasn’t even supposed to be given them at all. So that’s how i ended up in a methadone clinic.
        Ive got almost 10yrs clean of street drugs in November. And niw I’m hoping to hurry up and finish detoxing from that. My drs are very adamant that i can’t get psych meds. For ptsd and anxiety plus depression while on it.
        Now i wonder what’s in store for me when i CAN get them.
        I’ve got one idea for you tho. Maybe if you go to a emergency room and explain the appointment issue they could prescribe enough to get you through for a week or so?. I did that for asthma meds once. Sorry for this long post.

        Liked by 1 person

      4. That is actually my fallback. My psychiatrist told me that was an option (interestingly I didn’t know that was an option.) while that idea is good and I will use it if needed, I have spent every moment since 2010 to stay out of the hospital for mental health related issues. But I understand the need thank you for sharing this.

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  4. I have gone off of ativan a couple of times. The most recent, I was prescribed by my PCP and then my psych took me off of it (the clinic I go to also serves as a treatment center for addicts, so it is their policy they do not prescribe anything that can lead to dependancy or abuse). I was only on 1mg of Ativan prior to being taken off and given hydroxyzine in place of the Ativan. Later on, I was changed from tablets to capsules to use in emergency situations and given buspar as my daily anxiety med. I just recently got my buspar increased to 30mg 2x a day. I am lucky in that I did not have withdrawl symptoms getting off of the ativan, and I was taken off of it cold turkey. But someone like you who has been on it for a long time should certainly be weaned off of it.

    Liked by 2 people

    1. That is what scares me. I have become overwhelming reliant. I am not sure if I can get off of the Ativan. It is a scary thing to be at this point where I am trying to figure out my social anxiety and the only thing keeping me together is the Ativan at a high dose.

      Liked by 3 people

      1. I hope things work out for you. Sometimes I think being a patient alone is worse than the mental illness.

        Liked by 2 people

  5. It is bad that the govt. does not look at individual cases but changes things for everyone. My dr. has been very helpful and I hope that things don’t change with that. I am on a slightly different med. It is xanax xr which last for 24 hours.

    The govt is getting so crazy about all of this that they are discussing changing the status of a simple thing like Benadryl which is over the counter and in most otc sleeping pills, cold meds and many other things. Someone needs to start figuring this out. I hope you get your meds.

    Liked by 2 people

  6. I share you frustration. I am very disappointed in the entire system of health care in this country. People are capitalizing on people’s suffering. A profit driven health care system leads to these types of problems and I don’t see much hope. There has been so many times when I know I should have checked myself into the hospital because of my depression, but I know it never does any good. Even if they fix the problem, you run in to trouble with the prescriptions down the road at some point. Insurance can just say what they will pay for an what they will not. This is really bad for the patient. I don’t take medication anymore. I’m sure I need it. At times I really need it because it is all I can do to keep myself from blowing my brains out. My suicidal thoughts are overwhelming at times, but I have no confidence whatsoever in our health care system.

    Liked by 2 people

    1. It is a sad reality. You really outline the issues and yet there is no real end in sight. I have been a victim of the system and it hasn’t gotten better in my option. We keep fighting my friend. That is what we can control.

      Liked by 1 person

  7. So sorry to hear about your situation, James. It certainly seems like the mental health system worldwide is trying to go the same way as every other industry, and bend a knee to technology over face to face human contact. Whether it’s aimed at saving money (which, let’s face it, is almost always the case) or time, surely limiting or restricting a patient’s access to their therapist is not going to be of benefit to anyone but the number-crunchers and administrators. I hope you can get the situation sorted and stay on your meds. Crossing my fingers for you xo

    Liked by 3 people

    1. I am hoping as well. The update today is that there is no update. My therapist and case worker is still trying to get me to see a therapist live and in person. What it means is another psychiatrist change which is always hard to deal with.

      Liked by 1 person

  8. I empathize with your situation and understand your anxiety. The “system” is not the best, and change–particularly frequent or sudden–is so hard on all of us who have mental health issues. You are in my prayers–I believe strongly that there will be a GOOD solution that works for you 🙂

    Liked by 2 people

  9. I gradually tapered down and got off all my meds… It took a couple of years, and lots of fine tuning. Stopping Ativan cold turkey sounds insane. That’s just messed up. I hope everything goes well with your next consultation.

    Liked by 2 people

  10. I would think a good doctor would want to taper you off the medication. To quit cold turkey can be dangerous. Given the risks, the agency should be motivated to get you an appointment with a doc. If God forbid, you were to have a seizure going cold turkey, I imagine the prescribing doctor would be liable. Advocate for a taper. If you have to go to the ER to detox, there’s no shame in that choice. Goodness and peace.

    Liked by 1 person

  11. That is scary. I face similar fears over the Tramadol I take for my chronic pain. I have tried a host of other, non-narcotic drugs and was either allergic to them or they didn’t help. Now with the big opioid scare and crackdown, I am always afraid they will take away my only source of real pain relief during the worst flareups. I honestly wouldn’t want to live if I had to be in extreme pain all the time with no hope of relief. They won’t even allow you to take marijuana for the pain either!

    Liked by 1 person

    1. It really sucks my friend. All around the health care system is really a joke. I wouldn’t want to live with extreme pain as well. I will keep you in my own prayers my friend.

      Liked by 1 person

  12. I am so sorry to hear this. You will be in my thoughts and prayers! So many times since I found your blog I will think of your tag line: ‘keep fighting’. You have been such an inspiration. I wish I could give you more than that but I do not have experience taking Ativan. I do know some people who have slowly tapered off various medications. To echo what others have already said: going cold turkey sounds dangerous. I am going to pray that you find someone within this broken system who is willing to advocate for you!! Hang in there!!

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  13. Wow! I wish I could offer some helpful advice, but I’ve never been on Ativan so I have no experience. My issues are more depression than anxiety. I would think though that they would wean you off rather than cut you off cold turkey. How scary…if I must be honest. I don’t blame you either for not wanting to end up in the hospital again. Been there, done that.

    Liked by 1 person

  14. I know some people will not like my response. So I will apologize for my honesty with my lived experience response and feedback to this. I know everyone is different so please know I am sharing my experience and what I know from living and surviving this. I hope this helps and does not negatively affect anyone negatively. I am only trying to help so people will not go through what I have. As hard as it seems and as scary as it is, it is the best thing to do. Honestly, Doctors are finally getting smart. Like everyone that is currently taking a Benzodiazpepine, I felt exactly the same way. I loved my Klonopin. That was probably why I was on it for so long. The problem is that we did not realize the damage it was causing inside my brain and body at that time in my life. I wish I never went on the medication, but I did and am beyond happy I finally can live without that medication in my system. Most people I have talked to who have been on Ativan, Klonopin or any Benzos feel better and are very happy they are finally off. I went off Klonopin after over twenty years of use and went off cold turkey because doctors would not give it to me after my overdose. This was a beyond huge blessing in disguise because it saved my life. I know it does not seem possible that it can be that much better but it can and will. Honestly, going off Klonopin is the best thing I ever did in my life next to giving birth to my children. The two month withdrawal period was beyond horrific and is a different kind of hell I never experienced before. I experienced severe neurological impairments beyond description at this time. I have posts I wrote about it from March of 2018. I survived. Going off cold turkey is very dangerous so you should taper off the meds, but if you have to it is possible. It really is. I am living proof. You are never supposed to go off cold turkey though. There are things you can take to take away the edge of the withdrawal syndrome like Hydroxyzine. That works well. I survived and feel better than I ever have in over twenty five years since my bipolar diagnosis. I know it is scary. Remember the fear of the unknown is always worse than the actual situation you are facing. Truthfully I pray for the day that Benzodiazepines will never be used again and that everyone will be off of them. There is a huge crisis with Benzodiazepine use and the number of lives it is stealing and the damage it is causing. Do you know that most overdoses by Opioids usually are combined with Benzos as well. Which medication is the the most lethal. They cannot determine that answer for sure sometimes. It is the silent killer. The drug that is not being talked about enough yet.. but I guarantee it will when the truth of it comes to be known and accepted. The immediate feeling of taking the medication is euphoric and it helps take away the feeling of anxiety but it is just a band-aide that causes more harm than good. The answer to your question, “Do you think Ativan is making your anxiety worse?” The answer is YES. Klonopin made my anxiety worse because after the effects wear off your body craves more not because you are anxious but because you are experiencing withdrawals now. The withdrawal symptoms mimic anxiety but are worse than anxiety. Yes
    the withdrawals are horrific, but two horrible months are worth the rest of your life to feel better and mentally well. I hope this helps in some way. I have been very honest with my answers. I hope they make sense. Thank you for reading my very long ramble.

    Liked by 1 person

    1. Thank you. This was honest and you have real experience on both sides. Thank you. I have a lot to think about especially since things are not great with my Ativan. I have become attached and it’s not a good thing. I wish I could take two months. I just don’t have it. Between trying to finish my Masters, working and my blog I just don’t know. I will consult with my doctors in the coming weeks. Thank you again for being honest.

      Liked by 1 person

      1. You are welcome James and I am so sorry you are going through this. It is so difficult and it is so much easier on my side right now only because I have survived the difficult part. It is easy for me to say this now as I am not living it now. I understand. I just try to throw out words in hopes that they can help. I can’t lie of course… it is sooo difficult. I will pray for you my dear friend. I want this to work out for you and I pray it can happen. You deserve the best in life. I understand not wanting to stop life for two months. My life did stop for those two months. I could not do anything, but my situation of course was different. I was force stopped cold turkey and was on Klonopin as well so it may be a different experience than Ativan withdrawals. You have to be able to find a P-doc that can taper you off or at the very least prescribe Hydroxyzine or Buspar. My P-doc I have now can’t believe I was forced off cold turkey. He said I could have died or had seizures. It is very dangerous. I am blessed to be alive and survived it. I am not sure the answer. I guess going to the ER may be the answer and it may work because you have been on them so long. It is dangerous. Hopefully they can slowly taper you off so you never have to go off cold turkey and if you are tapered off you can still live your life. It will be more difficult but very possible. You can do this James. I will be praying for you. Keep fighting and be well.

        Liked by 1 person

      2. Always. I have had an experience with seizures. After my last suicide attempt in 2010 when I almost lost my life. It was the worse experience ever. I will figure this out and I will always keep fighting my friend.

        Liked by 1 person

      3. I am sorry you have experienced seizures and I am so happy you survived your attempt. If you have experienced seizures already they also need to take that into consideration with your situation. Best wishes and may your cup of life overflow with blessings.

        Liked by 1 person

  15. Wow, what a broken system. Ativan needs to be used with care, but that needs to happen in the context of the specific doctor-patient rather than decisions being made by regulators.

    Liked by 1 person

  16. 11 years is a long time. In Australia, they generally only give you a prescription for 2 weeks. I don’t think it’s a long term solution for anxiety disorders. Hope your doctor and the system can provide you with the help and support needed.

    Liked by 1 person

  17. well as you know ativan is so addictive! My psychiatrist refuses to prescribe it unless your an inpatient! I’ve taken it as an inpatient! but I always found it knocked me out! Even at 1 MG it would knock me out! I highly recommend coming off of it! It is prob making your anxiety worse! xox

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