I’m a bit late with this, but here’s the follow-up post to Going Meds Free, my last one.
At first, Sadie’s medication break went well. Which is not to say she didn’t have any problems. She still had periods of being extra hyped up and impulsive, anxiety attacks and bursts of rage. But these episodes happened when she was taking Abilify, too.
So I held my ground whenever she tried to blame being off medication for her anger or inability to control her behavior. As calmly as possible, I’d remind her that she had these struggles when she was on Abilify. And that it would take a while for her brain chemistry to adjust to being without it. I told my husband—who wasn’t thrilled with the idea of Sadie going off her meds— the same thing when he made similar remarks. He claimed he noticed her getting wound up and agitated more often, and easily, as soon as she stopped taking Abilify. Maybe he did. Maybe I just saw what I wanted to see because I really hoped this experiment would be successful. The truth is probably somewhere in between.
I knew the real test of how well Sadie could function without meds would come when the stress-free days of summer ended and she returned to school. Last year, we switched her from a large public school to a small private school for kids with learning differences. Her new school’s safe, nurturing environment is a much better fit for her. But it’s still school. The strain of having to hold it together for almost eight hours a day, focus, navigate social situations and do homework can be too much for her.
Houston, We Have a Problem
The first few weeks of school went okay. But it wasn’t long before Sadie was spending much of her time in the school psychologist’s office. The psychologist noted that she seemed “more revved up” than she was last year.
Things started going downhill at home, too. Almost every night, Sadie experienced a combination of anxiety and restlessness that made sleep next to impossible. She’d scream that her brain was attacking her and that she was “ruined” and ‘broken.” One night, she howled like an animal while I held her. She shrieked that she couldn’t go on like this and wanted to die. Her private therapist also observed that Sadie was the most manic she’d seen her in a long time. During their sessions, she talked very fast, acted overly silly and said things that didn’t make sense.
It was clear that she was unravelling. The same day we met with Sadie’s psychiatrist to discuss trying a new medication, I got an e-mail from the school psychologist that erased any lingering delusions I had about postponing this step. Below are a few excerpts from it:
- I am growing increasingly concerned about Sadie’s mental and emotional well-being and her education. In every class, every day, she is completely unable to focus. She is either in my office, the school head’s office, or somewhere in the hallway because she simply cannot sit still or participate in classroom activities.
- Sometimes she seems to want to jump out of her skin. She almost looks like she’s in pain, but when I ask her about it, she can’t ground herself enough to even know if that’s what she’s feeling.
- One day she told me she was biting her lip to try to make it bleed. I asked her why she was doing this and she said because she is very stressed about school and not getting her work done. I’m worried she’s not only missing a great deal of learning, but her self-esteem is also suffering.
- We are seeing her cycle through highs and lows very rapidly.
- At the end of one of our talks, Sadie began laughing uncontrollably about nothing. She was literally on the floor and couldn’t control herself.
- I happened to walk by her science class one day and saw her lying on the floor, not participating and unable to redirect. All of her teachers have told me about similar instances.
Where We Are Today
For almost a month now, Sadie has been taking Latuda, an antipsychotic with fewer of the more common side effects—like weight gain—this family of drugs is notorious for. The good news is, we noticed positive changes almost immediately. The anxiety and sleep problems disappeared. Her school’s staff reported that she was calmer, happier and better able to focus and participate in class. On the negative side, for the first couple of weeks, she was nauseous. More frightening were the spells of severe depression that struck her every evening. Her doctor assured me such “break through” episodes of depression are common for people recovering from an acute manic or mixed state of bipolar disorder and that they’d start decreasing. Thankfully, they did. For now, at least, Latuda is proving to be a much better medication for Sadie than Abilify.
You may be wondering if I regret taking her off medication in the first place. I don’t. If I hadn’t taken this four-month detour, it would have nagged at me. This experience also reinforced the fact that my daughter has an illness that will probably require life-long treatment. Like cancer, asthma, diabetes or other serious diseases, that treatment usually includes medication.
I’m also pursuing alternative therapies like mindfulness—Sadie started taking yoga with me and loves it— and homeopathic medicine. I hope that even if she does need psychiatric drugs for the long-haul, these healthier options will let her use fewer of them and help her manage her illness more effectively as she grows up.