“happy pills”

Whenever I hear medication referred to as “happy pills,” I cringe.  I take Prozac, Effexor, and Risperdal every single day, and let me tell you, they are not happy pills.  They don’t incite any kind of happiness or euphoria in me– in fact, the kinds of drugs that do that are generally illegal stimulants (heroin, cocaine, MDMA).  When people refer to mental health meds as “happy pills,” they are inferring that I get my happiness from a drug, which is point-blank untrue.

My medication essentially brings me to a “zero level” so that I can interact with the daily life in the same way as everyone else.  I still have good days and bad days, and I am influenced by events, experiences, and emotions.  These meds are in no way a blanket stimulant.

Now, I know that most people who use the term “happy pills” are generally not trying to cause a riot, but I believe that society needs to be more careful with its words.  Terms like this cast a negative stigma on taking meds and sometimes prevent people from pursuing psychiatric help, people who could really benefit from it.

I know there are a lot of opinions on medication.  It was a five-year tumultuous experience for me to get on the right cocktail of meds (including horrible side effects [Luvox, Clomipramine], mind vomit [Paxil], and a near-death allergic reaction [Propranolol]), but I believe it was worthwhile.  So while I appreciate the vibrant debate over the value of medication, I wish that we could all agree to not degrade meds by calling them “happy pills.”

meds are not happy pills

end of an era

Last week, I ventured to the Fairview Medical Center at the University of Minnesota to see my beloved psychiatrist Dr. Suck Won Kim for the last time before his retirement.  Dr. Kim is a skinny Korean man with salt-and-pepper eyebrows and sharply combed hair.  I met him first in 2008 when, after years of failed prescriptions, my old psychiatrist essentially threw in the towel and referred me to Dr. Kim, a national expert on OCD who has seen over 3,000 OCD patients.

The first time I met with Dr. Kim, he asked me about what meds I had tried.  And when I had told him, he resolutely said, “No more of that.  You are done with that.”  And he started me on Effexor XR, which I am on to this very day.  Dr. Kim spoke with such confidence that I had felt confident.  I remember thinking, I think this might actually work this time.

But Dr. Kim wasn’t done after he wrote out the prescription.  He turned to me and said, “Cognitive-behavioral therapy.  Tell me, have you heard of it?”

I had.  Horror stories.

“It’s the best treatment there is for OCD.  I’d like you to call Chris Donahue and get an appointment.”

“Okay.”

“It will be hell,” said Dr. Kim, telling me what to expect.

And it was– but it set me free from the reign of OCD.  And that is why I was feeling sentimental as I sat in the office of this OCD genius for the last time, feeling cheesy but needing to tell him that he was one of my heroes.

A Night to Believe 2012, Part One

I am so excited to announce that I will be reading an excerpt from my novel, Lights All Around, at “A Night to Believe” next month, culminating OCD Awareness Week!  I emailed today with Michael from the International OCD Foundation, and they are purchasing my flight to Boston and two nights in the Sheraton.  I am beyond thrilled to attend and SO excited to share part of my story with the OCD community.

Thank you to everyone who voted for my submission!  I will update again after the event … which I am nervous about (a little) … reading the excerpt will be an exposure in and of itself.  Nothing like ERPT right in front of a crowd, eh?  🙂  I think I am up to it.

Is anyone else from the blogosphere going to be at this event?  I’d love to meet you, if so!

Myers-Briggs Type Indicator

Are you familiar?

Wikipedia says, “The Myers-Briggs Type Indicator (MBTI) assessment is a psychometric questionnaire designed to measure psychological preferences in how people perceive the world and make decisions.”

Essentially, it’s this test you can take that will tell you what type of person you are/personality you have.

 

Years ago, I took the official test and tested as an ENFJ, which seemed quite accurate and which made me join the ranks of other famous ENFJs such as David (king of Israel), Ronald Reagan, Dick Van Dyke, and Oprah Winfrey.

Over the years, I have grown increasingly more introverted, so I’d really like to take the test again and see where I fall on the scale.  Although the official test costs money, there are free versions of it online.

Just retook it.

STILL ENFJ.

I have a hard time believing that.  I am far more energized by being alone than by being with others.

And yet …

The new test said I was 1% extravert.  The old one said 100%.  That’s a pretty big jump.

In the interest of discovering, trends …

If you have OCD, what is your Myers-Briggs type?  Do you find yourself more introverted or extraverted?

medication is scary, part two

It took me approximately five years to get on the right medication.

Over the course of the five years, I experienced the following:

* rapid weight gain (30 pounds in one month)

* deep lethargy, during which air felt stale and I had to nap for 2+ hours every day after work

* mind vomit (a phrase I coined, meaning that taking the medication exacerbated my OCD, sending me into frenetic, panicked obsessions)

* a visible tremor

* drymouth, as stanch as if I were eating Saltines and peanut butter

* dizziness and vision loss, usually paired together (One time I had a whole conversation with someone without telling him I couldn’t actually see him … I hope I appeared to be looking him in the eyes.  The dizziness/vision loss combo happened so often that I actually got used to it, could continue walking across my apartment without even slowing my step.)

* Jello-legs, so terrible that I had to lean against the stairwell wall as I descended from my second-floor apartment

* excessive sweating

* lactation (you think I’m kidding, but I’m not)

* a spasm of pain in my back that once DROPPED me to the floor like I’d been tackled from behind

* an allergic reaction that nearly killed me (please, PLEASE do not take new meds unless you have Benadryl in your home!)

And then along came Dr. Suck-Won Kim, my sweet, wonderful expert psychiatrist, who got me onto my perfect dosage of Prozac, Effexor XR, and Risperdal.

And want to know what?

It was all worth it.

“reasonable doubt”

I read an interesting article today called “Casey Anthony, Reasonable Doubt, and OCD” by Stacy Kuhl-Wochner at the OCD Center of Los Angeles — you can read the entire article here.

Just wanted to quote a little bit of it for all you blog readers to consider, especially after having an interesting phone conversation along these same lines with my college roomie Megs.

Being a therapist who specializes in treating those with OCD, I can only imagine what an especially difficult task quantifying reasonable doubt would be for many of my clients.  People with OCD and related OC Spectrum Disorders such as Body Dysmorphic Disorder (BDD), Hypochondria (Health Anxiety), and Social Anxietyare on a constant quest for answers to unanswerable questions.  They seek to quantify that which cannot be quantified, to gain certainty when it is only possible to be “pretty sure.”  These are questions that most people who do not have OCD can accept despite their inevitable doubts.  But for many people who experience OCD or a related spectrum condition, “reasonable” doubt often feels unbearable.

Doubt is such an intrinsic part of OCD that the condition has often been referred to as “the doubting disease. Some common doubts seen in OCD and related OC Spectrum Disorders include:

  • Are my hands clean enough to ensure that I won’t accidentally make someone sick through casual contact?
  • Am I straight enough to to be certain that I am not actually gay?
  • How do I know if I really love my spouse?
  • What level of pain is a enough that I should visit a doctor to see if I have a serious medical condition?
  • What is the right amount of eye contact to avoid being seen as socially inappropriate?
  • How do I know whether I am a good person or a bad person?
  • If I become angry at my child, does this mean that I do not love them enough, and that I am close to mentally snapping and harming them?

The only realistic answer to these and similar questions is to accept that nobody has 100% certainty on these issues*, and to stop the mental checking.  The goal is to make decisions based on what is “most likely”, given all the evidence.  For people with OCD, it may feel terrifying** to make that leap and take that chance because their brain is telling them that absolute certainty is required.

*JLS adds: That is why the point of cognitive-behavioral therapy is not to remove uncertainty but to make one okay with uncertainty.

**”Terrifying” doesn’t even touch it.

Thoughts?  What’s the most basic thing you know that you have doubted before?  (I have sometimes wondered if all of life that I’ve “experienced” so far is only a dream.)

I’m a Christian and I take MEDS!!!

After I wrote an article for the college newspaper, one of my former professors asked me if next year I would speak to his biblical counseling class.  Apparently, the day after the paper came out, the class had had a whole discussion on whether believers should use medications.  This professor said that in general the class seemed to think that therapy should be “enough.”

And it may be.  For some people.

I’m not going to preach, but I will do a little copy-and-paste job here and share an old story:

A man who couldn’t swim very well was stranded in the middle of the lake. He prayed to God, asking Him to save him from drowning. Shortly after, a man on a boat came by.

“Do you need some help?” He asked, slowing his boat to a stop next to the man.

“No thank you,” The man replied. “God will save me.” The man with the boat shrugged his shoulders and kept going.

Next, a man with a canoe paddled next to him, slowing to a stop and asking, “Do you need some help?”

“No thank you. God will save me.” The man replied, smiling. The man on the canoe shrugged, and paddled on.

Next, a man in a tiny paddle boat came by, stopping next to the man and asking, “Do you need some help?”

The drowning man replied, “No thank you, God will save me.” The man in the paddle boat shrugged, and paddled away.

The drowning man did indeed drown, and when he reached heaven, he asked God “Why didn’t you save me?”

God replied “I gave you three boats. What more did you want?”

bullying my bully

This post from Pure O Canuck inspired me to post this excerpt from my novel.

There were new magazines on the table beside me but the same display of brochures.  I skipped the
pamphlet about CBT, feeling I knew more about it than I wanted, and chose one labeled “Narrative Therapy.”  I had intended just to skim it, to amuse myself as I waited, but the heading on the inside flap caught my attention.  “The person is not the problem,” it boldly claimed.  “The problem is the problem.”

The brochure shared how narrative therapy assumes that stories shape a person’s identity and has an emphasis on externalizing the problem.  “Name the problem—allow it to have its own identity—so that you can assess and evaluate its presence and ultimately choose your relationship to it.”  I thought briefly about Ellen’s story and the scene she’d written the other night about tricking the wizard into revealing his name.  Name something and steal its power.

On the back of the pamphlet was a photo of a young lady with thin white-blonde hair, and beneath her photograph, there was a quotation: “When I started thinking of my anorexia as separate from myself, the real healing began.  I named my problem Ed (for ‘eating disorder’), and I continually reminded myself that Ed was a liar and started to take back control.”

It all resonated with me.  In fact, it was exactly what I had been doing this last week—employing
Dr. Foster’s strategy, making observations: I am the messenger.  OCD has the message.  We are
not the same. 
“The person is not the
problem; the problem is the problem.”

“Neely,” said that familiar accent, and I looked up to see Dr. Lee, nodding at me before tearing down the hall like a shot.  I tucked the pamphlet in my purse and made my way, alone, down the hallway to his office.  I knew the next words before he spoke them, and I mouthed them along with him: “Come in.  Close door please.”

            This time he decided to reduce the Prozac, dropping me from thirty milligrams to twenty. 
He typed it into his computer and murmured, “Looking good … looking good …” as he did so.  Dr. Lee swiveled his chair to look at me.  “As we lower your dosages, you’ll have to double your behavioral therapy efforts.  You will do okay though.  This is good.  We reduce medicine side of things.  We are almost there with meds, agreed?”

“Agreed.”

“Almost there,” he said again, looking at me as if my potential were dancing atop my head like a little flame.

 

I noticed the brochure when I searched through my purse for my keys.  I sat in the driver’s seat of
my car, looking at it, re-reading it, thinking about it.  “Name the problem—allow it to have its own
identity—so that you can assess and evaluate its presence and ultimately choose your relationship to it.”  I didn’t know if Dr. Foster would approve, but as I turned the key in the ignition, I imagined my OCD as a little black dot sitting on the passenger’s seat beside me. 

It was the size of a large fist, perfectly round, and it had attitude.  Even sitting in the passenger’s seat, I could feel the way it tried to masquerade as my smarter, oppressive friend.  Its condescending
grin showed it didn’t think much of me, especially in this moment as I left the hospital, the gathering place of the weak.

As I drove, I felt the dot exuding confidence.  It actually annoyed me to the point where I said aloud, “You know what?  You think you’re sooo cool, but you’re a dot.”  Then I realized that I was talking outloud in my car and laughed a little bit.  This couldn’t possibly be what the brochure was talking about, could it? I thought.  Then with only the slightest glance at the passenger’s seat out of the
corner of my eye, I visualized a change in the black dot as I dressed it in baby clothes—a tight little blue onesie and a binky in its mouth.  It was enraged by this turning of the tables.  “Now who looks dumb?” I muttered with a smile on my lips.

PANDAS

The PANDAS that I’m talking about has nothing to do with these guys …

 

 

 

 

 

… and everything to do with childhood strep throat.

PANDAS = Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections

Say what???

PANDAS describes a set of children in whom an ordinary bacterial strep infection can turn into a neuropsychiatric disorder.  The strep seems to cause the body’s immune system to build up antibodies that – who knows why – turn traitor and attack the basal ganglia in the brain.

In other words, a simple case of strep throat gone to hell.

Sometimes a child gets strep throat, and the body gets confused– instead of fighting off the bacteria, it attacks the basal ganglia … which leads to obsessive-compulsive disorder.

The first time I had an intake with a psychiatrist, she asked about my past medical issues.  “Ummm … I broke my elbow twice,” I said, thinking how a broken bone had nothing to do with my head issues.  I reached: “And I’ve had strep throat like a million times.”  I felt a little stupid and way too thorough.  Keep it to related issues, I thought to myself.  Duh.

But my psychiatrist perked up.  “Did you know there’s a strong connection between strep throat and OCD?” the doctor asked me.

Apparently, this is a little controversial, and some doctors aren’t convinced.  But come on– how many cases of strep-followed-by-rapid-onset-of-OCD do you have to see before you raise an eyebrow at the connection?

My doctor– Dr. Suck-Won Kim, the absolutely brilliant OCD expert at the University of Minnesota– believes there is a strong correlation, and I’m in his court.

A scene cut from my book:

“You have heard of PANDAS?” he asked.

            “I have,” I said, although I couldn’t remember at the moment what it stood for.  “It’s when kids get strep throat and then OCD.  Or something like that.”  I realized that I probably sounded stupid, explaining PANDAS to an OCD expert.

            “So many PANDAS studies … it has to be solved because far more OCD cases are strep-linked than people know.”

            “Yes, I had strep a lot as a kid.”

“YOU DID? YOU SEE?!”  Dr. Lee became animated as if a moment ago I’d said no such link between strep and OCD existed but now he was proving me wrong.

“The first time I met with a psychiatrist, she asked about my medical history.  I didn’t have a lot to share, but I happened to throw it out there that I’d had strep throat a lot, and she said it was probably connected.”

“She knew that?” asked Dr. Lee, impressed.  “That is uncommon.  Most doctors have no clue.” 

For more information on PANDAS, feel free to check out

I think I had strep throat nine times as a child.  Can anyone beat that?  Leave a comment!