Real quick, as I’m sure you’ve heard my story before: “Medication-induced mania.” Primary care writes prescription for antidepressant to alleviate simple stress. Pill causes major manic episode. Episode creates chaos is patient’s life: five months of uncontrollable behavior/mood swings that result in financial ruin and general chaos. Patient becomes depressed, suicidal. Patient is committed to a hospital and is diagnosed bipolar.
This was my world. Two years of trial and error (mostly error) with psychiatrists trying to find the correct combination of medications to stabilize my newly diagnosed condition. Five psychiatrists all agreed that I would need medication for the rest of my life. They all stated that bipolar existed in me all along. Family and friends were told that I needed to stay on my medication. My children’s school officials were informed of my condition. My family was fed the myth that, much like when a person is diabetic, bipolar disorder is a chemical imbalance in the brain. “It’s nobody’s fault,” they said. “It’s a pre-existing condition.” They even linked it to a history of mental illness in my family.
For the first forty-three years of my life, I was normal. (“Normal” being someone that did not need medication to control his moods.) I was happy, energetic and successful. I was an honor student in high school, and an athlete. I spent much of my young adulthood searching for the meaning of life. I read many books on positive thinking and developed an inner need to be charitable. I went to college and graduated with a business degree in marketing and finance. I worked two jobs for a year to pay off some excess college debt. I then joined the Peace Corps, and spent almost three years in Cameroon. I was twenty-eight when I got back from Africa. I immediately settled down, got married, had three kids and started a very nice small business. Over the next fifteen years, I grew that company from zero to near $3 million in sales, with twelve employees. I golfed, coached, and participated in many of my kids’ after school activities. I owned a nice house and felt very satisfied with myself.
In February 2010, I decided to get divorced from my now ex-wife. We both agreed the marriage wasn’t working and we hoped to make it as amicable as possible. It was a very stressful period in my life, but I was dealing with it. At the time, I kept getting diagnosed with nonbacterial prostate infections. None of the infections could be verified with tests (much like mental illness) but they treated me anyway on three separate occasions— unsuccessfully— with antibiotics. My primary care doctor told me that, likely, stress was causing this reoccurring condition. It was not responding to traditional methods of treatment, so he recommended Citalopram, a generic version of the antidepressant Celexa, to alleviate the stress. I resisted at first, not wanting to take pills at all, but he convinced me that it was harmless and would take the edge off. He said I was going to need it with the impending stress of the upcoming divorce. Reluctantly I agreed.
Side note. There is a so-called “history” of mental illness in my immediate family. This should have been something that sent up red flags to my doctor. My mother was diagnosed with major depression more than fifty years ago. My sister was recently diagnosed bipolar, and my brother killed himself. Clear warning signs to any qualified professional. After reading so much for the past two years about how psychotropic medications may possibly cause or exacerbate psychiatric symptoms, I am now convinced that this “history” was, in part, probably created by the medication my family has been prescribed.
At first, Citalopram did not seem to help, so after ten days I went back to the doctor and told him I did not feel any relief. He assured me this was normal, that my brain had to adjust, and that in another two weeks I would feel better. I agreed to give it more time and in two weeks he was right. I felt great. I was happy… very happy. At the next appointment, I reported to him that I was sleeping better and my mood was vastly improved. He set up a third appointment in two months’ time. Day by day, my happiness increased. My mood was elevating, and soon my ex was calling me Mr. Happy. She could not understand why I was suddenly whistling and singing in the house.
Over the next two months, I became manic. I was uncontrollably euphoric, and not really understanding what was happening. I thought work was good. My personality, while elevated, was infectious, and people actually liked me more. I was very positive and full of energy. By May, I started to lose it. I could not sleep. I stayed awake all night writing. I started multiple companies and stopped focusing on my core business. I also started a few charities. I was spending money that I did not have. Seventeen years of good credit afforded me lots of flexibility at the bank. If you can believe it, I maxed my credit card out at about $150,000. I moved from a small 2000 sq. foot office, to a 10,000 sq. foot one. This cost about $50,000 in build out expenses.
Major issues soon followed along with incredible mood swings, spending sprees and intermittent fights with a soon to be ex-wife. She actually told me I was bipolar and in the middle of a manic episode. I told her she was nuts (little did I know she was half-right). It’s very difficult for someone who was in control for so many years, in charge of his own business, with access to large amounts of money, to experience mania. Who can help when the one in charge loses it?
Eventually, I agreed that my behavior and overall health was off so I went to the doctor. I had been falling asleep at the wheel and I was concerned for the safety of my kids. The doctor that prescribed the antidepressant was busy, so I met his nurse practitioner. I told her that I couldn’t control my thoughts, and was crying a lot (I actually started crying in the office.) I was also sweating and slurring my speech. She basically told me I was having an adverse reaction to the antidepressant. She wanted me to stop taking it immediately and start taking Gabapentin. I complied. A day after taking Gabapentin I was seeing double. I then swore off taking any and all medication. I also refused to see any more doctors.
Of course, abruptly stopping a psych med causes even more problems. I spent the majority of the next two months confused and barely able to work. Five months after taking the antidepressant the episode was finally ending. I had run my company into major financial trouble, caused lots of confusion, personal problems and my divorce was a total mess. The mania ended in late July, and for a few days, I was coherent.
When one “wakes up” from mania, there is a brief period in which things seem clear. This is when you have to face the consequences of the episode. It was then that I realized I was going bankrupt. The company I’d built so consistently for fifteen years was falling apart. I had also compromised many friendships and business relationships. I soon panicked and became instantly depressed. This is a typical consequence to mania. Major depression followed.
In early August 2010, I was suicidal and hit bottom. I voluntarily committed myself to a psych ward and was started on Lithium. I also took my first dose of Xanax (funny, I distinctly remember the nurse saying, “Xanax is harmless, but it is a bit addictive. Use it while you need it, then we will wean you off it.”) Two staff psychiatrists then convinced me that I was absolutely bipolar. I tried to tell them that I was never manic or depressed, and that the pill had caused the mania. They explained that medication-induced mania simply validates the fact that bipolar existed all along. They said I had been bipolar my whole life. I was told that I would need to take medication indefinitely. This is the rub: I had to admit, after reading the medical definitions of bipolar disorder and consulting with “professionals”, that I felt I was bipolar by definition.
As much as my common sense told me they were wrong, I was hoping that accepting the diagnosis and agreeing to take the new medication would help alleviate the suicidal thoughts. The idea of a magic pill or happy pill is very tempting. They initially gave me Lithium, and within a month it was toxic in my system. I was falling over and had no balance. In the months to come, my depression worsened, so they added Wellbutrin and Abilify. Many different mood stabilizers were also tried. Four more months passed and I was still depressed, so they kept increasing the doses of antidepressants. Eventually I came out of it. When I look back, it was exercise that helped the most. I started feeling better in early January, but not for long. I immediately elevated, then had incredible mood swings. Life was very unstable at this point, as was my medication list. Depakote, Trileptal, and Lamictal were all tried, but my doctor did not think I was stable on any of them. I was then given Seroquel, and was also tapered off Wellbutrin and Abilify. My psychiatrist decided I should add Risperdal, as my speech was rapid. Whew… instantly, I got depressed again. For seven months I was lethargic and mostly bedridden. I complained to my psychiatrist that the Seroquel was keeping me depressed. She told me this was my new baseline and that I had to get used to it. Honestly, there were many days in which I just wanted to die, and felt so hopeless and unemotional. It’s a wonder how one survives.
In November 2011, after a year on meds, in my second cycle of depression, I decided to find a new psychiatrist. She had recently put me on Zoloft and Abilify again, and though I was very depressed, she refused to take me off Seroquel. I was still taking 1-2 mgs of Xanax a night to sleep, and had forgotten about the promise to wean me off. Looking back, it’s no wonder people get screwed up for life being put on so many conflicting drugs. My medication list in itself was a prescription for bipolar.
I thought my new psychiatrist from the acclaimed McLean Hospital would be better. I told him my story and he told me he would help me to get me off meds. He initially tapered me off Seroquel and the other meds, but in the end, he decided to just shift me to Lamictal. He also felt the Xanax was necessary and not dangerous, and he added Adderall for my ADD. When I look at the side effects of these meds, it boggles my mind. He was better than my original psychiatrist, but still part of the system. He was a big proponent of all patients needing medication. In March and April 2012, my depression finally lifted, and a brief period of stability seemed to ensue, for maybe a month or two. I began escalating again in June, and my psychiatrist’s advice was to once again up my meds. Oddly enough, my prostate infection seemed to be back, and eventually I came to believe that meds were not only causing the mood cycles, but also my stomach problems.
I decided in early July 2012 to stop taking my medication. My stomach had shut down for a few days and my guess was medication was a big part of that. So I stopped taking everything. I know abruptly stopping psychotropic meds is wrong. Having done lots of reading and research on the web, I knew that psychosis may be headed my way. I did not stop seeing my psychiatrist or therapist during this time. They agreed to monitor me. Euphoria and psychosis soon developed. I had so many ideas, and lots of energy. I wanted to save the world: cure cancer, solve the energy crisis, fight the drug companies. I lost it completely for two weeks. I was actually having conversations with God. Eventually I came down and for a brief period I understood what happened to me and I was ok again.
Unfortunately, as in the past, depression soon followed. August 2012 was a very confusing month. I could not focus or understand my work. I ended up making about $50,000 in ordering mistakes. This exacerbated my depression and lead to even more mistakes. I was basically in bed for another two months. Once again, I was losing hope. My family wanted me back on meds, but I told them no. I had to break the cycle. I was depressed, but I had my common sense back. I’d been through two depressions in two years; both were treated with a barrage of antidepressants that did not help. Towards the end of the previous depressions, I started to work out. I now understand patience and exercise to be the key. This time I decided to do it on my own… no meds.
In November and December, I felt better. The deep depression lifted and the confusion subsided. I recovered financially as well, and even put in some controls in case of future episodes. I’m not convinced they are over so I’m trying to prepare for another possible swing or lingering side effect.
Over seven months without meds after two and a half years on them, I feel so much clearer in my head. I know my situation is not as complicated as some, but I think it’s important to note that I met with at least five psychiatrists in the past two years, and all of them diagnosed me as bipolar, as someone who will need medication for the rest of his life. They were all wrong. The DSM IV-TR has a clause that states “medication-induced mania” is not to be considered bipolar. This revision was made back in 2000. I was treated for two years with bipolar, and if I were not adamant about stopping on my own, I would have stayed on medication and likely ended up on SSDI.
Having read a few books and many great websites, on top of meeting others with similar stories, I now know so much more. Medication has its place, but there is no magic pill that fixes “mental illness.” I’m not even sure that mental illness exists in the way it is defined and portrayed in society. Psychotropic meds are causing these potentially temporary conditions to grow into lifelong illnesses. I have no doubt that medication caused my problems. It then further complicated them due to the numerous side effects that “professionals” treated with more medication. I’m lucky to finally be med-free. My goal now is to tell my story and spread the word about the dangers I experienced with psychotropic meds. We need to change the system, and I’m very motivated to figure out how. It seems there are many movements out there that are all closely related. I wonder if there is a way to connect them all to expose the truth… and save the world.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.