A writer I follow on social media recently asked her audience to share their experiences with Wellbutrin, if any, as she was considering taking it for depression. My Wellbutrin story was too boring to share, as the only negative effect I experienced was its failure to ease my depression. It didn’t elevate my heart rate to dangerous levels the way desipramine had, nor did it make me so groggy that I couldn’t drive, the way carbamazipine had. As medications that failed me unremarkably go, Wellbutrin’s failure was remarkable nonetheless; it was the only antidepressant that didn’t pile its own debilitating side effects on top of my depression’s insistence that I had to die. It simply stood aside and watched me stumble under a weight that grew heavier every day, exerting the same influence on my well-being as nothing at all.
If “nothing at all” sums up my best experience with antidepressants, it also represents the averaged efforts of the psychiatrists who prescribed them. To be fair, my psychiatrists were good, hard-working people who wanted to help. The following anecdotes show how their efforts were hampered by the imperfection of psychiatric medicine and our imperfections as people, including mine.
My first psychiatrist could not have known that desipramine would elevate my heart rate to dangerous levels. The effect of a medication isn’t known until it is tried. I fault him, however, for not warning me that such an effect was possible. I was in the military at the time, doing mandatory mile and a half runs several days a week. If he had to prescribe a medication that could provoke a heart attack when combined with the exertions that accompany military life, the least he could have done was tell me what to watch for. I was “fortunate” that the events leading to my first suicide attempt occurred shortly after I started desipramine. My vitals were checked frequently in the psych ward and the problem was soon discovered. But this experience left a hairline crack in my ability to trust psychiatrists. I was still willing to give antidepressants a try, but every successive medication failure and every bad interaction with a psychiatrist eroded that trust a bit more.
My second psychiatrist possessed an unfortunate flaw that undermined his compassion and decency: the moment he decided which pigeonhole to stuff me into, he stopped listening to me. He got a number of things wrong, and when I tried to explain how his opinion differed from the facts, he wasn’t interested. Ironically, one of the first things he told me when we first met was that he knew it would take time for me to feel comfortable sharing the things that were hurting me. Apparently, he did not want to hear it when those things centered around his dismissal of the facts pertaining to my situation. I blew off an appointment with him one day and never returned. My trust was broken further; effective treatment depends on a solid understanding of the problem, and we could not achieve that if he wasn’t willing to listen.
My third psychiatrist was simply unfortunate. The first thing he did when we met was reach for his phone and tell me that he had to return a call, then withdraw his hand slowly and say, no, I had waited long enough so let’s get started, shall we? His monologue couldn’t have been more staged if David Mamet had been standing in the corner, yelling “cut” as the scene ended. I was in the VA’s voc rehab program at the time, and my participation was contingent on receiving treatment for my issues. So I continued to see that disingenuous jackass because I didn’t believe I had a choice. That changed when I told him that a recent urge to cut had dissipated quickly. He said, “Do you read? That is a pretty advanced word! Since you seem to have a vocabulary, I don’t need to talk down to you.” No kidding, jackass. I’ve only been reading since I was four, “dissipated” is not a particularly advanced word, and other providers in this facility manage to treat their patients with respect whatever their opinions of their intellects may be. Of course, I didn’t believe that I could voice any of this, as I feared I would be punished for doing so. But the cracks in my ability to trust had deepened irrevocably. I never saw him again.
My fourth and final psychiatrist finally drove home how hopeless treatment was. I was far from an ideal patient. My deteriorating trust and growing resentment over having been forced back into treatment made me spiteful and unwilling to share things that might have helped. My final psychiatrist seemed willing to listen, but much of the time, I said nothing. I needed to feel that I had control over my fate, and I asserted this with the only power I believed I had. My silence. My past experiences stewed in that void where a productive conversation should have taken place. Memories of previous interactions that had conditioned me to expect little from the new guy coupled with recollections of previous medications that had done nothing for my depression while impeding me with side effects that ranged from irritating to dangerous. Despite this baggage, I could have made an effort if we were going to sit in his office and take up each other’s time. Much of the time, I didn’t.
Of course, it didn’t help that when I took a chance on telling the new guy what I needed from my medication, he blew me off. I was trying to become a cabinetmaker and Zoloft had made me sluggish, making it difficult to work. Could I please have an antidepressant that didn’t obstruct my goals? I knew he’d blown off my concerns when he described carbamazepine, the medication he had chosen. “You won’t be able to drive or operate machinery while you are on this.” “Great,” I said. “Commuting to my job at the cabinet shop is out.” “Oh, you work in a cabinet shop? What do you do there?” “Operate machinery.” Maybe there wasn’t a medication that would have worked. But his unwillingness to discuss my concerns did little to reverse the trust issues I already had.
Around this time, I became suicidal while experiencing my worst psychotic episode ever. Returning to the psych ward was sobering. My problems were serious, spurring my decision to give carbamazepine a shot. The frustrations began quickly. The levels of the medication in the blood must be monitored, so I reported to the lab before I saw the psychiatrist. He would check his computer, discover that my results weren’t in the system yet, and call the lab. The lab would tell him that carbamazepine panels were done by the night shift and the result would be available the next morning. I would come back the following day and he would say it wasn’t at therapeutic levels so we needed to up the dose, “but not too much because your liver function is worrying me.” Like lithium, carbamazepine is hard on the liver. This was worrisome for me because I learned that this psychiatrist had memory problems. Every time I saw him, he would call the lab when he saw that my results weren’t in, and they told him every time that the night shift does those, call back tomorrow. Was I going to end up needing a liver transplant because he couldn’t keep track of my blood panels?
On top of that, the medication made me so groggy that I often missed work. Many days I couldn’t drive. When I was at work I couldn’t focus. The day I nearly cut my thumb off on a power saw because I couldn’t concentrate on what I was doing was my final day under psychiatric care. I disposed of my remaining pills and never saw that psychiatrist—or any psychiatrist—again. My needs differ so radically from the care that psychiatrists and antidepressants provide that the three lines describing us on a pharmaceutical company’s graph will never meet at a solution.
Despite my assessment that my Wellbutrin story was too boring to share, I shared it with the writer anyway as a prelude to telling the story more fully here. Many times, I have had to justify my decision to go off meds and I hope that this narrative will do that. While I have opted out of taking medication to treat my depression, I do not claim that everyone should abandon their meds or that we should exile psychiatrists from healthcare. I would simply like psychiatrists to do a better job of recognizing the individual character of their patients and to help them find solutions that suit their aspirations as well as their illnesses. As I said in my final message to the writer, “I hope you find a solution that works for you, whether it involves antidepressants or not. Good luck.”
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.
Calvin, it sounds like you were looking for a way to establish more control over your life, and psychiatry gave you the opposite. I found it sad hearing you decided that staying silent was your only remaining way to accomplish that. I’d say your story is far more compelling than you may think it is. I found myself thinking, “Man, if they told me what they told him, and gave me as little hope, I’d have wanted to kill myself, too.”
You were VERY badly served by psychiatry. They did less than nothing – they undermined your belief that anything COULD be done, and I find that unforgivable!
I agree with Steve, psychiatrists “undermined your belief that anything COULD be done, and I find that unforgivable!”
But, of course that is their goal with their claimed “life long, incurable, genetic illnesses” – which are not “life long,” not “incurable,” and not “genetic” illnesses … just lies.
As to my Wellbutrin story, the common symptoms of Wellbutrin withdrawal were the etiology of my bipolar misdiagnosis. And since the current psychiatric treatment protocols for bipolar are staggeringly unwise – they recommend treating the common adverse effects of one anticholinergic drug, with more anticholinergic drugs – which can cause anticholinergic toxidrome poisonings.
Suffice it to say, getting off all the psychiatric drugs was what helped me, too. And your “psychosis” may very well have been a result of anticholinergic toxidrome as well.
At least I hope this little slice of info gives you more arsenal, when you feel the need to justify your “decision to go off meds.”
God bless in your healing journey, Calvin. And thank you for sharing your story.
I was experiencing psychotic episodes prior to being on any kind of medication. At the time of the episode I describe in the essay, I was on half a dose of carbamazepine, and taking no other medications. It is possible that anticholinergic toxidrome was responsible, but I think that my extreme emotional turmoil at the time contributed more to its development. My issues in general are more related to trauma than biology, I suspect, psychosis included. Thank you for sharing the information on toxidromes. It was interesting reading.
Your description of your experience with Wellbutrin reminded me of Joseph Heller’s novel Catch-22. As if I weren’t suspicious enough of a profession that now appears to have embraced the novel’s portrayal of the Army Air Corps as a blueprint for how it should conduct itself.
I was in therapy much of the time that I was also seeing a psychiatrist, and that moderated the influence the psychiatrists had on my own opinions of what was wrong with me or what was effective. The therapists were doing the work, every week, for an hour or two. The psychiatrist saw me less often, every three months at one point. I became inclined to judge the efficacy of the psychiatrist’s work solely on whether the medications were helping. Their opinions on other matters pertaining to my depression carried little weight with me. Something that struck me was how little agreement there is between psychology and psychiatry in the causes of depression and other conditions. A psychiatrist once told me that psychologists were confused about some aspect of mental illness or other. I don’t remember exactly what it was now. I do recall my trust in both psychiatry and therapy slipping at that moment. Sadly, I do not believe that I benefited from therapy much, either. The therapist I spent the most time with was trained in the Rogerian tradition, which essentially is, “Life sucks.” I say, “And?” He replies, “And nothing. Life sucks. End of story.”
Those psychiatric neurotoxins should not exist. There is no medical justification for them.
Those who make and distribute them should be prosecuted for Crimes Against Humanity.
Like Peter Breggin says, “People are depressed because they are leading depressing lives.”
I psychiatrist said that medications can appear to be ineffective during periods when things are going worse for me. At the time, I was in the military, working in a job for which I had no aptitude, which resulted in my being screamed at and called stupid regularly. Those were not happy times.
Calvin May, Your story is very interesting. First, when I read your post and you mentioned carbeminezine; that was the first drug I had real trouble with because it lowered my white blood count so much it affected my immunity and they took me off it. This second post about being in a job, albeit in the military, of which you had no aptitude for and endured constant “screaming” is similar to somethings I went through, although not in the military. I am looking forward to your article on the VA Voc Rehab to see how it might parallel the State Voc Rehab that I was involved in. What I see continually in your story that bears some similarity to my story is how both of us seemed to almost “forced” into jobs into which we did not belong because we had no aptitude for… It seems far worse than putting the “peg” in the wrong hole…Since, I freed myself from psychiatry, etc. I have been thinking about this and how it has affected my life. I am not giving up. I have just been seeking answers and seeking ways to “structure” my life now, despite it all. I am not one to cry sour grapes. I just want to understand, so I can make my life happier and better from now on… Thank you.
I highly recommend this book by Johann Hari, Lost Connections.
The GRIEF EXCEPTION
Almost everybody who is grieving, it turns out, matches the clinical criteria for depression. If you simply use the checklist, virtually anyone who has lost someone should be diagnosed as having a clear mental illness.
This made many doctors and psychiatrists feel uncomfortable. So the authors of the DSM invented a loophole, which became known as “the grief exception.”
They said that you are allowed to show the symptoms of depression and not be considered mentally ill in one circumstance and one circumstance only—if you have recently suffered the loss of somebody close to you. After you lose (say) a baby, or a sister, or a mother, you can show these symptoms for a year before you are classed as mentally ill. But if you continued to be profoundly distressed after this deadline, you will still be classified as having a mental disorder. As the years passed and different versions of the DSM were published, the time limit changed: it was slashed to three months, one month, and eventually just two weeks.
— Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions
~ by Johann Hari
Next, I highly recommend you look into IFS… Internal Family Systems… developed by Dr Richard Schwartz.
Here is an overview… even though it speaks to Borderline specifically, the same principles apply for “depression”… which I personally always “translate” now to GRIEF…
Depathologizing The Borderline Client
By Dr. Richard Schwartz, Internal Family Systems (IFS)
I read an article by that author which had some good insights. I can’t remember the name of it now. However, Mr. Hari has a history of fabrication in his journalism, so I am inclined to take anything he says with a grain of salt.
Reading the article by Schwartz reminded me of a therapist who struggled more visibly with her own internal protective mechanisms than most therapists I had met. Her inability to master her more negative impulses often impeded her ability to help, even though it seemed she wanted to. This paralleled one of her observations about me, though. She said I was like a person in a sinking rowboat who wants to get ashore, but bats the people away who are trying to help. In my case, it was because I had gone ashore in the past and it was no better than drowning. In her case, she may have needed more affirmation from her clients than was appropriate.
“Once in a generation emerges a person with a phenomenal capacity to explain the human condition. Calvin May is not that person.”
You did pretty good.
Thank you. 🙂
Psychiatric drugs don’t “chemically treat” anything. They’re industrial strength emotional insecticides that CHEMICALLY TRAUMATIZE the brain and body. They create iatrogenic illness that become versions of PTSD. It could be referred to as I-PTSD: iatrogenic post traumatic stress disorder. But some people are lucky enough to only be numbed out – but calling either one “medicine” is pretty disgusting.
Psychiatry is highly successful in DESTABILIZING patients and with their endless complex polypharmacy patients become patients for LIFE! That is the business model and it is very lucrative for the industry.
Many of us at times look up out high school classmates to see what has become of them after a few decades. Psychiatrists would never want to check and see where their former patients are after decades in the endless psychiatric “treatment” because they all know that it nearly always means POOR OUTCOMES.
The writer states ” To be fair, my psychiatrists were good, hard-working people who wanted to help.”
If the writer wanted to really know the truth about how sincere and well meaning his psychiatrists were then he should get his patient files and see for himself. Any psychiatrist practicing for more than 20 years knows that these powerful drugs are just suppressing symptoms and not targeting anything. Psychiatry is a long con and after the patient gets on the endless rollercoaster, merry-go-round and finally musical chair the patient is left destabilized and worse off than before.
I did look at my files. They reflected the psychiatrist’s frustrations that the medications they had chosen weren’t working. They never blamed me or themselves. I believe most of them were sincere in their desire to help. Psychiatrists face two problems. One is that the substantial gaps in scientific knowledge constrain their ability to help. They may have known for decades that antidepressants are bogus, but I don’t believe they continue prescribing them out of malice, but because a better solution hasn’t been found. (At least from my experience with therapy, which was a train wreck also.) The second is that they turned themselves into one trick ponies by limiting their services to prescribing medication. They have no choice but to push pills, even as evidence against antidepressants grows, because that is the only club in their bag. I am oversimplifying a bit here; psychiatrists may still be able to contribute to the treatment of conditions like schizophrenia. It is also worth noting that because patients have the right to examine their own medical records, providers typically don’t write things down that they wouldn’t want the patient to see. That tends to limit the usefulness of medical records for the purpose you describe. They are unlikely to record evidence of actual malfeasance in any case.
I’d like to read more of your work. You write well and your life is very interesting.
Thank you. I submitted another essay. I don’t know if the editors will accept it or not.
Probably the only real antidepressant is people. We get what we need from involvement with people.
CERTAIN people. Other people are pretty depressing!
Good point. We need more of those CERTAIN people.
As I experienced the roller coaster of feeling bad and then better, I realized that the common thread when I was most depressed was people. The more I was able to escape from people, the better I felt.
! appreciate your story. I can tell that despite it all, you still have a wry sense of humor. That is commendable, because actually, it is humor, joking, cartoons, comics, etc. that wake people up to the truth. Dire warnings and foreful activism only seek to either bore people or act as a boomerang. When a sense of humor is maintained, no matter what happens, good reigns. I talk a lot and say nothing, but I am familiar with the drugs you mention. Carbemezapine was the first psychiatric drug that gave me trouble because it lowered my white blood count to dangerously low levels making me less resistant to infection. Still, I kept trying the drugs. Perhaps, for some they work. I, also see, that you were involved in the VA VR program. I was not involved in the VA version of VR, because I am not a veteran, but I was involved in the regular version associated with state government. In my experience, I wish it could be better and really help people. But then there is so much more I know about myself now that could be useful. But they have all these wierd rules and close their eyes to information, etc. that could truly help their clients. Anyway, who says I or anyone need to be rehabilitated. We just need a little assistance to help us in adaptions to our lives in our areas of “weakness” and also, assistance in how to parlay our “strengths” however unusual they might be. May the Force Be with you. Thank you.
I psychiatrist once objected to my sense of humor, labeling it “sarcasm.” It is often lost on people in positions of authority, like psychiatrists, that things do not occur in a vacuum. My “sarcasm” was enabling me to cope with his failure to listen to me. If he had been listening, the sarcasm would have been unnecessary.
I will probably write about my experiences with VA Voc Rehab in more detail at some point.