When Meds Get in The Way

Life is full of little things we take for granted to such a degree that we don’t even ever think of them – until they’re gone. When you begin taking psychiatric drugs, an unexpected plethora of such details opens up before you. What you once considered pleasant, but petty aspects of everyday life suddenly are luxuries you will have to do without, or cut down on, from now onward. You will need to revise and likely modify several of your habits in order to stay safe, and you may feel restricted in your personal freedom. To put it in plain English: you will be forced to redefine the terms “fun” and “freedom” for yourself, at least partially. I know how off-putting this sounds, but the good news is that it is possible as long as you keep an open mind. The following is a list of everyday luxuries I have had to reevaluate since getting on psychiatric medication.

Luxury #1: Booze

Officially, you are not supposed to consume any alcohol while you are taking psychoactive medications. Booze may alter the way your organism assimilates the active ingredients, and it also acts as a depressant. So, if you are already suffering from depression, regular pub-crawling is a no-no. Now, alcohol is an almost ubiquitous substance. What is more, we humans use it as a vehicle for social bonding. Drinking with others is not just about tickling our taste buds and our nervous system, but it is a social ritual. No matter if we are with friends, family or business partners: sharing a drink equals declaring you are on the same page with them, and on friendly terms. As alcohol is known to lower inhibitions, it also serves to break down barriers between people. As a consequence, being offered one or the other alcoholic beverage on all sorts of occasions is virtually unavoidable. Depending on your psychological equilibrium, you may have to reject those offers altogether. Personally, I have found I can have a few glasses of wine or juice with a shot of rum without experiencing any negative effects. As I have never been a heavy drinker, needing to set limits to my alcohol consumption has not been a big issue for me. Essentially, I am having the same amounts as always, only that when I first started taking psychiatric medication I had none at all for a few months and then carefully started experimenting with half a glass here or one shot there, until I felt certain it was doing no harm to me. However, if you are a customary drinker, you will need to become more self-disciplined.

Luxury #2: Caffeine

If you have ever been hospitalized in a psychiatric clinic, you may have noticed they offer decaffeinated coffee or decaf teas to their patients. Needless to say, caffeine is a stimulant. Depending on your diagnosis and your medication regime, you may have to say goodbye to your cuppa or at least reduce your intake. For someone with anxiety or mania, stimulants are not an option. In my particular case, I have found that coffee and tea do not affect me negatively, so I continue having them just as always during the first half of the day. I avoid caffeine after 5 pm, though, and given that I dislike most sodas, I never have coca cola or the likes. I also stay away from energy drinks or any other stimulants stronger than my habitual cup of coffee. Evaluate carefully, if possible together with your therapist or prescribing doctor, if sticking to your caffeinated drinks is alright for you. Try one cup of mild coffee in the morning and observe how you react both during the day and at bedtime, then make a decision based on what you experienced.

Luxury #3: Sugar and carbohydrates

In another article on this blog, I had written about weight gain as a negative effect of psychiatric drugs. Unfortunately, to limit the damage, you should reduce your intake of processed carbs and sugars significantly. Truth be told, if you are interested in healthy nutrition you ought to do so anyways. If you are on medication, avoiding processed foods becomes imperative. Eliminate them from your daily diet. Maybe allow yourself one eat-what-you-want day per week in order to keep cravings at bay. As I have a very sweet tooth, abstinence in this area is tough for me. However, I have found it extremely helpful that my partner and I have both decided to go low carb. In our fridge and around the kitchen, you will find no chocolate, no cookies, no cakes, not even white bread. If I ever felt like being “naughty” I would have to go all the way to the next grocery store, pick something out and stand in line for it, which makes breaking the rules a lot less tempting. Also, once you get the knack of maintaining a low carb and low sugar diet and explore some new recipes, your cravings for processed foods will diminish over time. As of today, I hardly experience any unruly longings and enjoy otherwise forbidden treats all the more when I come across them at parties or other special occasions.

Luxury #4: Foods you had never thought of as dangerous

If point #3 has motivated you to switch from drinking sodas to enjoying natural fruit juices, and you are sipping from a glass of refreshing grapefruit juice as you are reading this paragraph – stop! Grapefruit juice interacts with numerous medications because it alters the way your liver processes them. Interestingly, this fact does not appear on the label of juice packages, so you need to find out through research on the internet or consultation with a pharmacist. There are other natural foods under suspicion of interacting with certain medications: pomegranate is one of them, though studies haven’t yet confirmed how much it really interacts with medication. Some herbal medicines, such as Saint John’s worth and Valerian, potentially exacerbate or weaken the effect of psychiatric drugs. The same goes for some supplements. The following are links to pages with further information about drug-food interactions.

Free PDF on drug and food interactions for downloading by the FDA: http://www.fda.gov/downloads/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/ensuringsafeuseofmedicine/generaluseofmedicine/ucm229033.pdf

Article by the Academy of Nutrition And Dietetics: http://www.eatright.org/Public/content.aspx?id=6442477646

Again, none of this means you necessarily have to avoid these foods and beverages completely, but you need to be moderate in the amounts you consume and extremely attentive about possible negative effects.

Luxury #5: Spontaneous sleepovers or travelling

Before I say anything else: ALWAYS carry one or two extra doses of medication with you! It is rare to be unexpectedly confronted with the option of spending a night away from home or prolonging a trip for an extra day. Yet, in good theory, it can happen. Your flight may have been delayed or cancelled, you are too tired to drive home after a get-together or weather conditions are too bad to get on the road, or you simply wish to stay somewhere nice for a bit longer. All those situations can turn into a problem if you don’t have enough medication with you. Therefore, make sure to take an emergency backup wherever you go – near or far. The longer your trip, the larger your extra supply should be. On a normal work day I will carry a tiny pillbox with one spare dose in my purse. When I go on longer trips, I habitually put enough medications for an extra week in my luggage, and I also keep them in different bags in case one of them gets lost or stolen. Once we’re at it: also record your medication plan – names of substances, doses and schedule – in your agenda or on a piece of paper to keep in your wallet. Accidents happen, and the medical team scraping you up from the street must know about your using psychiatric drugs. Don’t forget to add other basic information, such as your blood type or any chronic conditions and allergies you have.

Luxury #6: Over the counter meds

Have a headache? Before you head to the pharmacy for some Aspirin, make sure you can actually take it. Many over-the-counter drugs interact with psychiatric medications, which can turn a vulgar flu into an adventurous slalom around dozens of red flags. For more information, go to my article on drug interactions.

Luxury #7: Sunbathing

This is an issue I luckily escaped. Some medications, including the ones I am taking, potentially render you more sensitive towards UV radiation. Depending on your individual case, you may need to apply sunscreen to your skin before leaving the house or quit sunbathing and tanning sessions. As I said, my tolerance – and love – towards sunlight is unaltered, but I advise you to monitor your response to it for as long as you are on medications.

Luxury #8: Overall independence

By overall independence I mean the ability to adapt to your surrounding circumstances without having to worry about where you get your medications from. It is only a few exceptional situations that would really challenge your flexibility in this regard: wars, cataclysmic natural events such as floods, hurricanes or earthquakes, social upheaval or economic collapse. Even though these events are not the most likely to occur, they are an inconvenient possibility. When your well-being hinges on the availability of any type of medical treatment, you realize how dependent you are on civilization, the integrity of your society and a functioning infrastructure. You cannot simply revert to an ancestral lifestyle or an existence of scarcity the way most others could – if grudgingly. Unfortunately, I have not yet come up with a way of getting around this problem. Probably, precaution is the best protection from shortages in supplies. Just as it is wise to keep a few gallons of drinking water and some emergency lanterns or candles in your house, also have a backup of your medications. In addition, stock up on your drugs in time. Do not leave picking up your prescription for last minute, but create  a safety margin of maybe a few weeks.

Luxury #9: Hardcore partying

For some, parties aren’t over before daylight. However, if your medication plan includes taking a sedative or tranquilizing drug in the evening, you may have to retire from power-partying and clubbing. Even if you can force yourself to stay awake, you may not be in condition to leave the house or, let alone, drive anywhere. And much less will you be able to enjoy the party. My longest night is usually New Year’s Eve, and even then I hardly make it beyond 2 or 3 am. I take my anti-psychotic at that time and then sleep in the next morning. On all other occasions, I am in bed before or roughly around midnight. Before you give in to feelings of rebellion, take into account that altering your sleep cycle also implies tampering with the regularity of your medication plan, which in turn can affect your psychological stability and performance at everyday activities. Ask yourself if it is worth it.

Luxury #10: Recreational drugs

I have never used any recreational drugs, but now that I am on psychoactive medications I also should not consider trying them. They interfere with your mental functions just as psychiatric medication does, which means all sorts of unforeseeable interactions are possible. Some recreational drugs are actually believed to trigger psychosis. Stay away from them if you can. I have met people who continued using recreational drugs, mostly marijuana, despite taking psychiatric medications, and who were claiming it was not harming them. Yet, in my opinion it is preferable to play it safe. Mental health is one of our most valuable goods! Should you be addicted to street drugs, please consult with your prescribing doctor and/or therapist before making any decisions. Special considerations need to be taken to handle your case.

These were the luxuries I could come up with based on my personal experience with psychiatric medication. If you can think of more aspects of everyday life that turn into luxuries when you are in treatment, please leave a comment.