The Sane Guide to Living with Mental Illness: Medications

I was watching cigarette advertising from the 1950s onwards on Youtube today. It’s all very aspirational, grand cars billowing Camels smoke from the driver’s window, doctor extolling the virtues of Chesterfields and such like. So I made my own non-aspirational cigarette advert.


Here is another one of my more sensible guides to mental illness, this time, medication, from someone who’s been on most of them and suddenly packed in nearly all of them. (Although I am on 50mg Lamictal with Seroquel now to see if it dents my mixed episode). I guess a lot of you who are already on medications won’t find this helpful, but some other people might.


The Psychiatrist has decided that you’re mental. Well done! By now you’ve probably been told what flavour of mental you have. The flavour favoured by most is bipolar disorder but you may have been told you have schizophrenia, depression, anxiety, a personality disorder, obsessive compulsive disorder or an eating disorder. Or even more than one of those things! That’s good, it means you’re extra special.

What will happen now is that they’ll hold a little conference behind your back to determine whether you’re going to be prescribed medication, going to be referred for therapy or whether you’re going to be kicked out of their office.

Chances are, you’ll be prescribed medication. It’s likely that they’ll be an antidepressant, antipsychotic, anti anxiety drug or mood stabiliser. Or pick and mix from all of the above.

So, here is the guide to medication.

1. You’re taking them because…?

Psychiatrists sometimes have a habit of thinking that their patients won’t understand clinical terms like “psychosis” or, “you’re flipping the fuck out”. So they might use helpful little phrases to explain to you why you’re being prescribed a certain medication, and they try to avoid frightening you by implying that your behaviour is a little…let’s say, off?

“This will calm you down”- “You are vibrating like a badly drawn cartoon”.

“This will help….even you out”- “You have burst into tears six times and then burst out laughing another ten for the thirty minutes you’ve been said here”.

“These should help lift your mood”- “You tried to kill yourself with my stapler”.

“These will help alleviate your compulsive behaviour”- “I’ve noticed that you’ve been counting the vowels I use in my sentences” (That was twenty three).

“These will help with your strange beliefs”- “You’ve referred to yourself as The Queen for the duration of this discussion”.

2. Know your enemy

Occasionally, a doctor will withhold a diagnosis from you or whoever bought you to the psychiatrist in the first place. Generally, you can guess what’s up with you via your medication. Antipsychotics, like Risperidone, Quetiapine, Amisulpride, Haloperidol and Olanzapine are generally used for psychotic disorders like schizophrenia, schizoaffective disorder, delusional disorder, manic depression, some types of personality disorders, some sleep, anxiety and compulsive disorders and occasionally, depression. Antidepressants like Prozac, Citalopram and Effexor are used for depression, some personality disorders, panic and anxiety. Anti anxiety drugs (the ones that are benzos, not antidepressants like Paxil) like Valium are for anxiety and panic and mood stabilisers, usually anticonvulsants, like Lithium (which is an antimanic), Depakote, Carbamazepine and Lamictal are used for some types of depression, personality disorders and manic depression.

If you have the interweb, and you do, since you’re reading this, research your medication. But be prepared to find out some things you didn’t want to know about…

3. Side Effects

Psychiatric medications are notoriously awful to take for some people and chances are you’ll have side effects. In short:

Get used to drooling. Antipsychotics and anti anxiety drugs can be really sedating and make your body go a little bit floppy, though it probably feels as though your limbs are made of lead. They can also cause you to slur your words, so, a little bit of spit might make a dash for freedom.

You will feel weird for a few weeks. Lots of medications take a while to work on the illness they’ve been prescribed for. In the wilderness of waiting, you might feel weird. You might feel blunted, spaced out, anxious, irritable or you might be having some odd thoughts. Tell your doctor.

You will sleep forever. If you’re taking antipsychotics, anyway.

Avoid the scales. It’s a shitter but psychiatric medication can make you gain weight. Antipsychotics are worst, anticonvulsants like Lithium and Depakote are pretty much wank too, antidepressants can be tricky and anti anxiety drugs, well, the benzo type, aren’t meant to be used for more than a week or two, so you shouldn’t gain weight from them.

Shake, shake, shake. The anticonvulsants will give you the shakes, listed on the PI sheet as “tremors”. It can be a bit embarrassing as people might assume, like they did me, that you’re an alcoholic. Try not to take sugar in your tea as it just causes confetti.

You might not think as clearly as you used to. Most drugs affect how your mind works. Even caffeine does, so psychiatric medications will. Well, they’re designed to. For the first while taking them, your head might be a bit foggy and…

I had a point here, but I don’t remember what it was… because I’m taking antipsychotics.

4. Don’t expect miracles.

Some drugs work on some aspects of illness very quickly. Antipsychotics are good for getting people out of psychotic and manic episodes pretty fast. Antidepressants can lift your mood within a fortnight.

You have to take drugs in order for them to work. If you’re not taking the medication as prescribed, the medication isn’t “not working”. You’re just not taking them.

There is more to mental illness than direct symptoms and medication isn’t a cure for them. The chances of you being suddenly completely better are slim, and because of this, medications will be changed, doses will be adjusted and other treatments will be drafted in alongside them.

You don’t actually have to take medication if you don’t want to. There will be times when you will have to- i.e if you’re under section, but aside from that, you can choose. Of course, if you’re under the care of a psychiatrist or mental health team, you will be strongly advised to take what they’ve prescribed you.

But, you can weigh up the pros and cons of medications. If the side effects are too much, say so, because another medication can be tried. If you hate the way they make you feel, say so, same applies. The decision is ultimately yours, though.

In reality, it’s best if the decision is ultimately yours and someone elses’ because getting ill again- relapsing into mania or psychosis, for example- means that you won’t be in the place to decide if you should be taking them because you might feel that nothing is wrong. It’s always good to have someone else tell you that you’re mental when you don’t believe it yourself.

5. The medication Hissy Fit.

Yeah, chances are you hate your medication, even if it is helping. You’ll want to flush them down the toilet, chuck them into the Thames, strap them to a rocket, etc etc etc. Have your hissy publically with the doctor before you decide to do the above, as they will be only too happy to tell you what a pain in the arse you were when you weren’t taking medication.

6. If you’re going to continue medication, DON’T:

Drink. Alcohol and psychiatric medications are a ridiculous mix. They make you a lightweight and you’ll be drunk a lot quicker, but be less inhibited so you’ll drink more. That way lies making a total dick of yourself in front of your friends, passing out in the street and pissing yourself or ending up in hospital.

It can be dangerous to drink alcohol while on certain medications like Lithium and Depakote.

And alcohol is a CNS depressant and it will generally make any mood unstable. There’s no point in taking an antidepressant to make you feel better, only to get wasted and feel like shit.

Take drugs. Because you’re already pumping powerful chemicals into your body and you don’t need more.

Drive. Don’t even attempt to drive if you’ve just taken an antipsychotic as it will result in a DUI and probably the end of your car. Don’t cycle either, because, like me, you might find that you’ve forgotten how to steer and career into the pavement of the Seven Sisters Road.

and DO:

Get a pill organiser. One of those cheap plasticky things you can get from chemists for the princely sum of £4.99. They sort your pills out by day so you can’t forget or take too many.

Keep tabs on them. By recording how you feel every day. Or ask someone else to do it for you if you don’t trust your own insight.

Drink lots of water. Because they can piss about in your blood stream, liver and kidneys.

7. And if you’re not going to continue taking medication:

Do it slowly. Don’t come off medications suddenly. They are drugs, and like any drug, they might have withdrawal. Do it slowly.

Look into other treatments. Like therapy, for example. For some people therapy works as well as or better than medication.

Tell someone. If you’re in the right frame of mind to. Quitting medication can cause a relapse that you might not notice but other people will. Subtle things, like stripping to your knickers and running into traffic.

Anyway, that’s my Sane Guide to Medication. Anything you want to add?

21 Responses

  1. I had a point here, but I don’t remember what it was. Because I’m taking antipsychotics.

    I was laughing and making faces until then… but that made me choke. XD Then it went downhill. I actually choked.

    I probably shouldn’t read the sane guides (much less the insane guides) when I’m drinking juice.

  2. antipsychotics are very often also prescribed for anxiety and ocd/eating disorders. Scaryily…olanzipine is given to eating disordered patients because it can help with rituals, and help put on weight…

  3. “You are vibrating like a badly drawn cartoon” – started well and then got better and better!

    Re the shakes: that old joke: old man in a pub trying to get his mug of cider to his mouth, shaking like a leaf. Bystander: “Do you drink much?” Old man: “No, I spill most of it.”

  4. That made interesting reading, written in clear to understand English, a must for anyone I think using the mental health system!

  5. I’ve been lurking here for ages and too shy to say anything, but this post had me by turns pissing myself laughing and nodding in sombre recognition, so I decided it was maybe time to say hi.

    I love, love, love your blog. It makes me feel insecure about blogging myself because I know I’m not one tenth as good. Please take that as a compliment.

    I’m 30, diagnosed manic-depressive nearly ten years ago (blimey…). Back then I think maybe English psychiatrists weren’t so au fait with the bipolar 1/2 thing, because they never told me, but if pressed I would say bipolar 2, with mixed episodes/aggravated depression/the joy in a bag that is depression with psychotic features (but not for some years now).

    Your blog is wonderful. You are amazing. Keep it up. Please.

  6. Great post.

    I’m on an anti psychotic but I ain’t giving up drinking because I could care less if my liver gives up. It would save me the price of a bullet.

  7. Probably the most informative blog in the world while at the same time making me piss myself laughing at something that’s er…informative

  8. I take antipsychotics (amisulpride), and I don’t have trouble drinking a couple of glasses of wine or driving (though not both at the same time 😉

  9. Alcohol is a CNS depressant, not a mood depressant, although it does tend to increase mood lability. I haven’t found it’s seriously conflicted with any medications I’ve been on except for benzodiazepines. Combined with alcohol these a) make me do very stupid things and b) make it very difficult to remember what stupid things I’ve done.

    Whether it’s a good idea to drink when you’ve got a mental illness is a different issue to whether mixing alcohol and medications is a bad idea. Some meds do, some don’t, some will just for you. Mostly if you read the patient information leaflet you can find out.

    In general, it’s just fecking dangerous to take psychiatric medications and alcohol. A lot of them work your liver hard (like Depakote) so adding alcohol into the mix will make your liver work harder.

    The liver doesn’t actually work this way. It’s not a muscle you can tire out. Rather, it’s a storehouse of various enzymes (and other things). When you take a drug, your liver processes it using enzymes and other things. If none of these things is used in metabolising alcohol, then taking both together can”t affect your liver any more than taking them separately would.

    With Depakote, there’s some worries that it may cause liver damage (hence the liver function tests). This risk isn’t higher if you drink while taking it, but you should avoid alcohol because it may increase the side effects.

  10. Fair enough! I bow to your good science.

  11. It’s seriously conflicted with my meds but I might just be a lightweight. I went absolutely mental while drinking on Carbamazepine and Seroquel.

  12. Spot on, hilarious, informative, ’nuff said

  13. Fantastic post, makes me very glad I’m not on any…

  14. Laughed so much at your non-aspirational advert. Got to leave work now, will catch the rest of your post later.

  15. Hilarious! and right on the money, too. I like your guides.


  16. […] Pole to polar has another guide to living with mental illness: So! The Psychiatrist has decided that you’re mental. Well done! By now you’ve probably been told what flavour of mental you have. The flavour favoured by most is bipolar disorder but you may have been told you have schizophrenia, depression, anxiety, a personality disorder, obsessive compulsive disorder or an eating disorder. Or even more than one of those things! That’s good, it means you’re extra special. What will happen now is that they’ll hold a little conference behind your back to determine whether you’re going to be prescribed medication, going to be referred for therapy or whether you’re going to be kicked out of their office. […]

  17. i’ve been trying to find out why my psychiatrist always tells me not to drink alcohol while on anitdepressants. i’ve noticed that i can get drunk faster sometimes, especially when i drink a lot in a little amount of time. but my doc also says it will keep the drugs from working…but i can’t really find any information about how or why. anybody?

  18. justwondering they will not let me have them as now drinking so much they say it flushes any good they will do out of your system, so until go through the next phase, no medications….which is catch 22 seen as was on them 2 years….plus was told was throwing them down my throat…not good idea when they will not give you anymore due to high risk….so now is hell….but this made me laugh.

    • I agree that drinking is a horrible idea. Not only while taking medications, but also for you BP. It’s a major trigger. My worst episodes happened while I still drank.

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