The Strattera, the Cheetos and the Punishers.

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One of the problems with an overburdened health care system: once you have a diagnosis, they give you pills and send you on your way. There is no followup therapy unless you can source and pay for it yourself. You'll have to teach yourself what to do, in all likelihood, using the pills to help you. And you may need to put up a constant struggle for the medication you can get, depending on the nature of your disorder, if the paperwork isn't sufficiently straightforward.

So it is here.

We talked about this in November, not long after a psychiatrist looked me in the eye and named the problem. She said attention deficit/hyperactivity disorder can go completely unnoticed in girls for a long, long time. Among other reasons, we don't actually get hyperactive so much. This is where labels of plain old "attention deficit disorder" or "AD/HD inattentive type" come in. To anyone else, it just looks like staring out the window.

She didn't say much else. There wasn't time, and it wasn't her job. As with everything else, this one was going to have to be entirely self-taught. I banked on the meds being able to help with this.

It took another six weeks to even reach that point. Most of my attention was taken up with jumping through paperwork hoops.

I got Strattera instead of stimulants. Stimulants aren't approved for use in adult ADHD here; Strattera is. Also, stimulants didn't look like they'd play well with me given medical history, and Strattera's antidepressant effects looked as though they might be useful here. The whole idea with non-stimulant ADHD medication is that it should be easier to obtain, since the abuse potential is so low. Doctors can dispense sample packs. Refills can cover more than a month at a time.

Ha.

Prescription medication is a lot like soda or snack food. Just because one region gets it doesn't mean the rest will. What I've described above is the state of play in the US. They also have wonderful things like Diet Black Cherry Vanilla Coke and Baked Cheetos.

This is England. We get Pepsi Max Cino. We get Wotsits. And we don't get reliable access to Strattera.

A very small number of people -- fewer then ten worldwide -- developed severe liver problems on the drug. Some UK regional health authorities decided that Strattera should therefore be an absolute last line of therapy, and general practitioners shouldn't touch it even with a specialist's blessing. Even if that's the most sensible way to get the meds to them, and even if the psychiatrist remains involved in supervising the patient. Mine was one of the affected counties, although this was incredibly poorly documented.

This meant that I needed two liver tests to get on with treatment at all. I have to play a week or so of phone tag whenever I need a refill. My psychiatrist can't issue more than twenty-eight days' worth at a time, because she's based out of a hospital. If she's away for whatever reason, I can only get a week's cover from other people on her team. There is generally a risk that I won't be able to continue the meds because something will go wrong. It is actually harder for me to get this than it would be to obtain Ritalin, which isn't even an approved drug for adults. For that, there's an established handover procedure. For that, I could fill out a form and have the prescription delivered to my pharmacy once a month, right alongside the Allegra.

This makes me very nervous. I keep seeing shades of pemoline here. Taking medication on an ongoing basis is always a calculated risk. You have to gamble whether or not you're going to be worse off with the usual side effects than the disorder, and you sometimes have to decide if it's worth being one of the small number of people who get hurt worse than when they started. I've made that gamble a few times, and lost it more than once. It'd be one thing if this was just another thing which didn't help, or which makes a situation I can manage on my own a little bit easier.

The meds help. They really do. Strattera isn't what most people expect from an ADHD treatment, though, so far as I can tell. It doesn't go top-down. It doesn't bring focus so much as it lays the foundation to create focus. This isn't instantaneous. The advice leaflet suggests a rapid titration, but there's a fair bit of anecdotal evidence to suggest that building up slowly from a tiny dose is the way to go for many people. This is what I did.

I've been on Strattera since the end of December. The meds made it to my hands the day before I flew to America. I got the voicemail from my specialist telling me my initial blood test was clear I could start on the meds ten minutes before I boarded the plane. I took my first capsule sitting next to Eric, in his car.

The Strattera started working in April.


Let me wander off to the side for a moment. Let's be parenthetical.

One of the most frustrating things about having a known issue is getting advice about it. I feel horrible every time I offer it to someone else, because it's aggravating. I know that people mean well, and that whatever approach has worked for them or their friend or their great-aunt Martha. I know the article in question got a good response from others, and yes, that new approach with the zinc and the bananas looks awfully interesting. So I have to be polite, time and time again: "Thank you, but I've tried that and it doesn't work for me. Thank you, but the way things are for me, I can't incorporate that yet. Thank you, and I'm doing that, but the effect's not sufficient to deal with the problem without more help."

It's about as useful as just stop dwelling on it, put it that way.

Then, once in a while, I hit the Habbalah.

Yeah, I know. It's an In Nomine thing. Habbalah are demons. Before they fell, they were counselor angels called Elohim. Mind, the Habbalah still think they're angels. They're just doing God's work from the other side of the fence.

An Elohite would help you through your dilemma in a calm and reasonable way. If their advice wasn't something you decided to take, you'd at least know it came from a well-considered position. You'd know that your best interests were in mind at the time.

A Habbalite, on the other hand, wants you to feel bad for not doing the Right Thing. She has an agenda, and you should be strong and smart enough to realize what the right path is. He will tweak you and poke at you and screw with your emotions. Ultimately, the advice never came from a position of wanting to help you to begin with. The Habbalite wants to feel better about the Habbalite's worldview. If you tear yourself to shreds trying to fit with that, so much the better.

I run across a fair few Habbalah who aren't keen on the idea of taking psychiatric meds. This is distinct from the folks who are genuinely wary of them for whatever reason, or who feel a little hair-triggery around their overadministration, but accept that some people do need them.

I mean the ones who see the meds as evidence that you just weren't good enough to make it on your own. You weren't strong enough to break your own fugue, you weren't committed enough to stick with counseling, you weren't dedicated enough to stick to a routine or a diet or whatever it is that isn't taking pills for the rest of your life. Meds are what you do when you're desperate; hell, embracing a diagnosis is probably something you should only do if you're completely broken down. Extend this as appropriate; sometimes this becomes you weren't a good enough parent if you had to medicate your child.

There are variations on this. Here's one: if you do take the meds, it's only to get yourself to a point where you don't have to take any meds. If you're a fundamentally decent person, you should just be able to take what you learned from the meds and bull through it. (This one's especially hard if you struggle with a disorder that will kick you in the head if you don't keep up with the medication.)

I have trouble telling Habbalah apart from regular people at first. They all seem to smile the same way. They all seem to mean well. At the outset, they often say the same things. For example: "Well, have you tried X? You don't want to do anything so drastic without considering the alternatives. Are you sure you've got what you say you do?" (I've never been keen on what this assumes about the person, motive or no motive, but, well, we are forgiving.)

Or: "Do you really want to take pills your whole life?"

Tone is everything.

It's hard to remember the subtexts, too. "I'm strong because I don't have to medicate." "I was brave enough to come down off the drugs after three months." "My kid's special; I can't possibly blunt how special he is." And if the only way I can keep the passive-aggressive judgement hooks off of me is to fill in the blanks and repeat them under my breath, it feels like I'm manipulating myself. Which is just as bad.

Mind, we all have agendas. The best I can do is to remind myself is that none of us are angels here.

I thought the Strattera wasn't doing so well for a while, 'cause the advances seemed so tiny.

I can hold my head on one thing for longer and longer stretches. I can read the same book across three or four rooms of the house. I only need to be doing three things at once now to keep from feeling trapped.

(This has its drawbacks. I have just as many parallel strands of thought going on as I always had, but sometimes they don't seem to go fast enough. The worst symptom is a different sort of reduced creative output: not only am I shredding every word as soon as it comes out, there often aren't enough to add up to a complete essay when I'm done. I have to work more slowly, and it makes the loathing worse. Combine this with a tendency to scurry away for a week every time something stupid flares up, or any time someone says something I don't want to take focus from, and I cease to exist. I don't like this sort of slowdown; I prefer compressed thinking. Now I'm spending all my damned time writing the excessive context I was going too fast for a few months ago, and hating every moment of it because I know I'm bogging down the piece.)

And I still only have a certain amount of time I can spend per day on any given thing before the whole system craps out. Instead of being all smashed up against the wall when it happens, though, I'm frustrated because I'm not at the wall yet.

But there are also wins. Listing many of them sounds like I'm bragging about my ability to dress myself. The next one will as well, but it's important to me.

Like quite recently, while working on a website redesign. (Not this one, although that's next.) I had a bunch of almost organized files which all needed to be renamed by the date that they were posted. It wasn't straightforward enough to be automated sensibly; one would spend enough time sorting through the variations to accomodate them that one might as well rename them by hand. So that's what I was doing.

I'd been putting it off for ages. Working with numbers is a humiliating and embarrassing exercise for me. I am not good with numbers. I say this again and again, and folks giggle and dismiss it, because I must not mean what I say I mean. I am not good with numbers. I never have been. I have to concentrate on them incredibly hard for them to make any sense. I think in terms of containers and boxes and things in boxes, not lines and points along them. When I sort my pills, I have to sort them into calendar-shaped boxes to count them. The same goes for anything I need to count. It can take a while.

Looking at a list of posts with datestamps on them, then renaming their associated image files to match:

$ mv p122.gif 2004-04-29.gif
$ mv Unusual_Wallpaper_By_George.gif 2004-05-01.gif
$ mv p123.gif 2004-05-04.gif

registers to me as linear, not box.

I expected this task to take several weeks, or to have to ask someone else on the project to do it for me. I worried that I'd have to constantly count up to five and then to four again, or that four and five would change places on me, or worse. This is how it would have been a year ago. This is how it's always been.

It took two nights, batched off in four-hour rounds. I made one significant error which threw the count off by five, caught it after twenty renames, and was able to backtrack and mend within half an hour. I only spaced out noticeably when I was physically exhausted.

I couldn't do that before.

It's not that I'm desperately proud of the action -- that's not something I do; I think it's a negative trait to have -- but it was something I made note of. It's one sign of a foundation going in. Other people will still need to calculate the tip, of course.

For years, I'd have to explain to other people that there were things I couldn't do the same way, which required workarounds of me, because I didn't have that foundation. Trying didn't help. Being strong didn't help and being good didn't help because there wasn't any place for the skill sets to take root. I couldn't work top-down, so it's a good job that the meds don't either.

When taking 50mg/day of Strattera finally makes some of those skills kick in, I have to figure it's not just bashing my skull on the organizer tools that's helping. Yay, I can dress myself.


So, once a month, I worry. I get the Habbalah-voices in my head: "If you were just strong enough, you wouldn't need the Strattera." "Now you know what it's like, and how to start to do things. You could come off of this if you wanted to. You've learned now. If you just meditate to calm down, take your vitamins and keep your lists, you'll be fine."

No. No, I really can't. I really haven't learned yet. Not enough.

I've just started unraveling how twenty-something years of workarounds and compensations work, and I've just started getting my brain to a place where I can do that. And I don't know yet whether, if I come off the drug, things would stay in place. I suspect that they wouldn't, at least not for some time.

I get down to the wire and I keep worrying. One person or another won't or can't dispense. It takes at least 24 hours, sometimes longer, for the drugstore to get supplies. It's a week of planning for twenty-eight more days of chances. I don't have the new coping mechanisms down well enough yet to go it alone. I'm not strong enough yet not to get caught up in someone else's agenda.

Sooner or later, the fragile system might break down. If that happens, I don't know what I'll do. If nothing else, I'm going to find myself in Canada sooner or later, starting a whole new set of relationships with a whole new set of doctors and a whole new set of regulations.

Presumably, I'll at least have this to go on. I'm working as fast as I can.

41 Comments

Do what works for you, whatever that is.

My wife is on so many prescriptions, some of them for bipolar, that she has trouble listing them and I couldn't. But things are so much better for her (and, incidentally, me) now than they were ten years ago. If anyone, medical professional or well-meaning observer, has ever suggested to her an assumption that she's supposed to eventually wean herself off any of them, I haven't heard about it. When it happens to you, I might suggest, don't be afraid to tell the punishers, politely, "No, I'm sorry, that's wrong." If necessary, "You don't get to decide this. I do."

At first I thought Strattera was a car.

Well, that's me all over.

Late-diagnosis ADHD, one day forgetting my meds and staring at a squirrel all morning, and people going "You're so smart, you don't REALLY have a disability, do you?" and "But shouldn't you be totally normal if you're taking pills? Why do you still have trouble?" and of course "Well, you don't need pills, you need X".
Thanks, but I spent a decade of "not-pills" with behavioral psychologists and they just didn't work, because my brain is not shaped like yours. I can't magically concentrate that away with just enough willpower and dedication. It's like saying I don't need strong prescription glasses, I just need some COMMITMENT to FOCUSING FARTHER.

I myself am on a stimulant, which is fine for me, as long as I never, ever have another coffee again. For me, it was 2 weeks of medium level side effects, stabilization, and then a much better normal level than before. I sometimes forget they help because I have bad days like normal people do, getting flustered or forgetting things, but like I said, staring out the window at a squirrel did it for me, I know I need at least some medication to manage this. I just wish I had been treated sooner, it was a very frustraiting time beforehand.

And I know about the bragging about dressing yourself. I'm stupidly proud of getting to school on time each morning with all the items I need for my class. Actually getting the grades the amount of work I put into a day should garner. Occasionally being able to remind people of something they forgot because I did, in fact, remember. It's little tiny everyday miracles :)

Here's one: if you do take the meds, it's only to get yourself to a point where you don't have to take any meds.

I used to have that Habbalah voice. I took Trazadone for years for depression. Since I wasn't depressed anymore, I figured I could wean myself off of it. Then I started to have withdrawal symptoms, short temper, bouts of rage, chills, things like that. Turns out it wasn't withdrawal, that was me without medication, and the meds are actually a thermostat for my emotions. (I'm a berserker, ;-D.) It's not a matter of wanting to be on meds "for the rest of my life", I don't have a choice. It'd be nice if others could get that.

"Do you really want to take pills your whole life?"

I always wonder if they ask that of diabetic and heart medication.

I'm one of the twitchy ones, and I'm sure I have some Habbalite in me. But I ain't in other people's skin, and if it's something that they say is working... It's not my skin. It's not me. Now...

"Do you really want to take pills your whole life?"

Hello, Unithroid. Taking pills every day of my life is much better than depression, uncontrollable weight gain, fatigue, dementia, and death, thank you very much.

If I could get off 'em, I'd love to, but when one gets dizzy spells from low blood sugar, while breastfeeding, and still gains weight? Helllloooooo, there's a message here, and it's saying, "Your biochemistry is screwed up six ways from Sunday. Take the little green pill." I think I lost about 20 pounds. Maybe 30. Because my metabolism is back within norms. And it helps me not be so darn tired all the time.

Biochemistry sometimes sucks.

I don't think that I've ever been against medication. There are certainly times that medication is the best, and only, option to treat something. Psychological meds are no different. For a number of years my brother was on something for his ADD. The difference was significant. He went from being unable to sit still and do ANYTHING for longer than 5 minutes, to being able to function.

I know that it is a serious problem, and in this age especially, goes unnoticed too often. With the patently schizophrenic society we live in, we are half expected to be able to jump from task to task suddenly. Information bombards us at such a high rate, expecting us to been attention deficit already. Sometimes it almost seems like a defence mechanism against a world gone crazy.

Not that it doesn't make life hard, and not that it isn't a serious problem. I’d like to suggest that, if you are worried about the supply of your medication, you look for alternatives to augment your treatment. Go check out the PAL at http://www.mindalive.com/. Read the studies on ADHD in the research section (if you are inclined towards that technical stuff). Seriously consider trying it, or having your psychologist look into it for you. Yes, I work at the company. But I also know that the hardware works. It may be something else to help you combat the ADD, and every tool you have helps.

Wow. What a great post. I've missed Wednesday on here. Thanks for opening up like this.

My wife takes Zyrtec, Synthroid, and Zolfoft every day. If she forgets to take her meds I find out. Horrific headaches, exhaustion, or moody self-hatred and emotional instability are what I find when I get home from work.

My wife wants to get off of the Zoloft. Her desire isn't from some Habbalah voice, its from her desire for children. The thing that stops her is that she dosen't know how she will be able to function if she can't have Zoloft for 9 months.

From my experience the drugs are necessary for her to be able to interact with the world, and me. It sounds like this is helping you do that too Wednesday. I hope you continue to make progress.

I need to stop reading your posts.

I keep thinking, "This sounds just like me. I don't seem to have the mental strength I need, either. My mind wanders off and does weird things and I can't control it. Maybe I should look into getting medicine?"

And then I think, "But this could just be Med Student's Syndrome. I read about someone with an ailment and I immediately imagine myself having the same thing. I don't need medication, I need to get off my ass and get to work."

And I think about the psychologist that I was seeing for a few months, and that in the end amounted to nothing but money lost. And I think about mum's best friend from high school who is now a wreck with depression and borderline alcoholism, and who believes in absolutely nothing but medicine. And I wonder how many various ailments I could discover in myself if I set off to it.

...and in the end I just wish I'd never surfed across this site while avoiding my shoolwork in the first place.

It's like saying I don't need strong prescription glasses, I just need some COMMITMENT to FOCUSING FARTHER.

Actually, a new-age friend of my mum's once gave us a book with that exact message :) (I gave it a go with no success)

I would just like to say I found this essay very interesting, I hadn't realised that there was this problem with medication being cancelled which is very bad for some people but very important for others.

My roommate's on some kind of anti-depressants. Not because of any traumatic experience or anything, but just because her brain chemistry is naturally a little off-kilter, and if she doesn't have that corrected, she can't get anything done.

Counseling or something won't help because there's no psychological cause.

When the rood problem is chemistry, the solution probably is, too.

Myself, I don't know if the problem is Chemistry or psychology. Either way, I need to get around to doing someting about it.

... I just remembered i have ADHD.


let me just note: there is something truly infernal in forcing someone who has an AD disorder to plan ahead to get the meds they need to help alleviate the attention deficit thing. I mean, if you could plan that far ahead, dot dot dot etc etc

There's kind of a double bias in force when it comes to psychological meds. First of all, medicine in general is commonly seen as something that you do for a brief amount of time to get you from sick to well. The prospect of having to take medicine for the rest of one's life just strikes people as wrong, sick so to speak. It means that something is really, truly, horribly wrong. Which, well, it is, or else you wouldn't have to be taking lifelong medicine. Secondly, while it's getting better, mental diseases still freak people out. Something physical we can externalize as not being part of the person, but a mental disorder means something's fundamentally wrong about that person and that wrongness is part of their core nature. *wry grin* And then there's that fear, as with all diseases, that it might be contagious.

I will admit that I once was one of those people who felt that medication was only for until people could shoulder their burden themselves. Then, I met people who were good and normal people and could only stay good and normal so long as they stayed on their meds. I started seeing the medications as not a crutch, but as an artifical leg, something they needed to get around in life and they weren't going to grow out of.

Lastly, since I'm kind of shotgunning here, I suspect the whole issue of normality freaks people out too. It's easy to prescribe anti-psychotic medicine because it's pretty much a given that seeing things crawl out of the walls is not right. The idea gets more fuzzy to people when it comes to things like depression, OCD, or ADHD because people immediately think of mild versions of those and how they're more or less part of the human condition, and they start worrying over overstandardizing the human psyche.

And... I probably ought to hold on writing more, at least until I get my morning coffee and aspirin. I'm just not myself straight off in the morning.

The Habbalite wants to feel better about the Habbalite's worldview.
You've nailed it. That's how my own Habbalite tendencies work. (And those entities make great mythological sense too. Self-deluded do-gooder demons sound more plausible than the standard "I'm gonna tempt this guy to damnation and steal his car-keys because I'm BAAAAAAD" type. You may just have persuaded me to take up gaming. ;) )

Anyway, good luck dealing with the red-tape crap.

mckenzee asked:


"Do you really want to take pills your whole life?"
I always wonder if they ask that of diabetic and heart medication

Yes. Yes they do.

Sometimes they substitute "want to" for "have to" but yes.

My husband's got cystic fibrosis - genetic disease, screws with every major organ I can think of except the heart (directly) - will eventually kill him. As a "side effect" he now has diabetes as well. I think he's up to 17 prescriptions now.

People are fascinated. "Do you really have to take insulin every time you eat? And the enzymes? You have to take both?" "Do you really have to do respiratory therapy every day? Twice a day? For an hour each time?" My favorite part is when they're asking me about it because he's not around, and they add "Wow, that sucks."

The Habbalite feels great about their worldview - whatever was wrong with them before is now fiiiiiine in comparison, unless they're part-hypochondriac and now want to tell you about their bunion, because, you know, that's as bad as CF.

I've met two people so far who told me they could "cure" cystic fibrosis. Now that's a strong belief in your own world-view right there.

As for AD diseases, depression, and a good number of other issues, I'm strongly under the belief that self-medicating is a Bad Plan. My father's convinced there's nothing wrong with him (for years it was "nothing wrong with him that another beer won't fix") and he just needs to "be strong" while he drives the rest of us nuts with his obvious anxiety/depression issues. Strength has nothing to do with a miswired brain. I wish he'd let the internal Habbalite go and go get a *real* diagnosis with *real* medication. Those who are strong enough and brave enough to go to a doctor and find out what's wrong with them and how to patch it are, to me anyway, much stronger than those hiding behind their fear to find out.

Wednesday, I'm glad things are getting better. I hope it continues to go that way and they don't cut off the med altogether on you.

When your brain works so much differently than another person then the most they can do is accept it - they'll never be able to understand how the other person thinks. Being bipolar I'll be taking medicine for the rest of my life. And after being on meds for ten years I've stopped caring what anyone else thinks or says about it. I nod and smile and keep doing what works for me. Everyone's milage WILL vary.

Hang in there and good luck!

Say, I only read the Nielsens' blog irregularly, when bloggers I read link to them: what ever happened with Theresa's medication? Has she found a substitute, or an alternate source; or has she had to decide between something she's tried that didn't work as well or going off meds entirely?

A: Knock, knock!
B: Who's there?
A: Let's go ride bikes!

You are SO spot on about the Habbalah.

I've been taking anti-depressants since '99 (and reading In Nomine longer than that!), and I'd never made the connection. It is, however, right on the money.

It always strikes me how handy I find In Nomine references for classifying people. "Yeah, she's a total Balseraph" or "There's a Gamester for you."

I think I've given away too much; add a point of dissonance for me.

I myself never played In Nomine, but that does sound like a very interesting description. I myself fall firmly in the category of being wary of such medications, out of a belief that some doctors are a little quick to make snap judgements about a diagnosis. Case in point: my friend who was told by a doctor that she could never, and would never have children because the pain in her side she had been complaining about was clearly caused by the possibly cancerous masses on her ovaries and fallopian tubes he had gotten pictures of with an ultrasound. She had just been in a car wreck, which was the reason the ultrasound was taken in the first place (to check for other possible damage from the wreck) but she had been complaining of the pain for some time before that. He was all set to give her a complete hysterectomy.(Not sure if I spelled that quite right)

Now, her greatest wish in the world is to have a child, so just to make sure she sought out a second opinion with a new doctor, one who took one look at the ultrasound pictures and pronounced them utter crap. The 'masses' the first docter had seen were the presence of heavy bruising from the steering wheel of the car she had been driving, and by the time the new ultrasounds were done they were almost completely gone. Now, I know this doesn't have anything to do with psychological diagnoses, but I am getting there. My friend did go on to have more appointments, for her depression, panic attacks, the pains in her side that were getting steadily worse, and migraines. And she got a diagnosis that both shocked her and made complete sense, due to traumatic events in her childhood: post-traumatic stress disorder. She's on paxil and xanax now and her life has literally changed dramaticly. Due to adult-onset diabetes, she is currently in the program for the same surgery Eric had, but she is responding so well to changed diet and excercise that the surgery may not even be necessary by the time she is qualified for it, and she already controls her blood sugar without the use of medication. Her doctor has told her that she might well be able to go off her meds at some point, but not for a few years, at least.

On the other hand, I have talked to a woman who told me that her seven year old daughter was slapped with an ADHD diagnosis simply because she would get bored and restless when having to sit quietly for long periods of time, a diagnosis that was eventually proved to be wildly inaccurate, as medication did nothing for her, but enrollment in a gifted program helped immensely. I am reminded of the South Park episode about ritalin. I should wrap this up, I think, I have lost ALL track of my point.

I should mention that I DO know that plenty of people ARE correctly diagnosed, and do need the meds, and absolutely must take them. I just think that pharmaceutical companies have a little too much influence, and sometimes doctors are a little too comfortable making a diagnosis even if it doesn't quite fit.

I know I need my anti-depressants. My quality of life is radically different with and without my meds. I'm pretty sure that had I not been diagnosed when I was, I would have done something pretty stupid and dangerous by now.

Another point of dissonance for me; Alaemon will not be pleased.

I have to admit. I've done that Habbalah stuff.

I was talking about ritalin and how it seemed to be the new parent comfort drug. Kid's a little wild? Give them ritalin. Have a bad day and don't wanna deal with it? Give them ritalin.

Of course there are people who really need ritalin, but there's also a lot of people who don't and take it anyway.

I happened to be talking to a girl whose brother is on ritalin. Having put my foot in my mouth, I hurriedly tried to weaken my Habbalah ranting into "medication isn't the answer".

Man. I'm a jerk.

My self-righteousness goes further than that. I probably do have some problem that requires medication, but I refuse to be diagnosed. I don't want to know what's wrong with me (though I bet the list is quite extensive).

Any way... I guess what I'm saying is... I'm sorry for being a self-righteous Habbalah.

Thanks for the Habbalah description Weds, I'd never quite thought of them as so desperately needing to re-inforce their own worldview, just wanting to impose it on everyone else. It's a nice twist (that maybe everyone has thought of before now except for me).

As for medication, I think it is a tool like everything else and that a lot of problems can be caused by misusing it. I think the main reason medication gets misused (not counting deliberate abuse) is that doctors generally only get to spend about 10 minutes with a patient and 90% of the cases they deal with are maybe the same 10 conditions requiring standard treatment. Unfortunately that last 10% can be something totally off the wall that they miss and the patient gets screwed over big time.

Every drug will have a side effect (except angiotensin inhibitors I believe but that's another story) simply because our techniques are not well refined yet. It is therefore necessary to approach any medication, especially long term medication, with full understanding and careful consideration of potential problems. That said just because a tool can be misused does not mean we should refuse to use it when it is the best solution available.
People's lives are not a game and we do not score points or get a prize for 'least medicated man of the match'. I've hit my thumb with a hammer before but when I need to put a nail into a wall to hang a picture and you hand me a screwdriver because I 'should be able to handle my problems without it' we have a problem and it sure as hell isn't the hammer's fault.

"You can't be me, I'm medicated!"
---Sir Psycho from the Pinball game Medieval Madness The best pinball game. Ever.

My ailments are more physical than chemical, althrough I do have that alergy/asmtha thing to work on. At some point, I will have to face the face that I am going to lose the ability to hear all together and be unable to move because my inner balance ability (the cochlea) is also going bye-bye too. (I can only hear out of my left ear, and my right ear is the only ear where the cochlea is working. Obviously, both ears are so overcompensating so much I have to rest more often less I find myself having spinning rooms, increased tinitis, and just a general inability to hear as well.)

I could fix it with surgery. I don't know if I want to through. The costs are expensive (which I'm surprised that even with a social government that tries to cover all of your expenses as best as they can, it is not an issue. Obviously cost is the biggest factor here in the USA.), and I cringe when I hear about the latest in plastic surgery and other Doctor 90201 unnessary crap.

(Latest thing: designer outer labias based off of famous porn stars. I kid you not.)

There's also getting laser surgery to fix my eyes so I'd never have to wear glasses ever again. Missouri is voting on legalizing stem-cell research and one of the things that opponents will ultimately say that if it gets approved, there's no stoping research on cloning, genetic modification and other such very high tech but yet questionably moral futures.

Ultimately, it comes down to how far will you let yourself be altered from your original state, whether it be from nature, nurture, chemical, or physical manipulations. I try to stress to myself that ultimately I have to make the call and only I should choose such things. Sure, I want to know everything there is about a particular procedure or medication. I'll even let them give their moral opinions about this. But I don't ever want them to force me to make a decision. There's enough pressure as it is from my body.

This may sound terrible . . . but every time you make a post like this, it's a great encouragement to me. I don't know if it's that your experiences hit on universal feelings, or if the way you write them just makes them resonate, but judging from the comments, I'm not the only person who comes out of it saying, "Thank God, it's not just me."

So, thank you.

Every drug will have a side effect (except angiotensin inhibitors I believe but that's another story) simply because our techniques are not well refined yet. It is therefore necessary to approach any medication, especially long term medication, with full understanding and careful consideration of potential problems. That said just because a tool can be misused does not mean we should refuse to use it when it is the best solution available.

Eh, all drugs are controlled poisoning. Nonetheless useful and necessary as you state, but one must never forget that medicinal drugs are essentially trying to find a poison that will kill the disease before it kills the host.

For years I had a similar Habalah, called gym teachers. They insisted that I just had to work through the burning pain in my throat and chest whenever I ran, that I was being lazy when I couldn't do as many laps as the other kids in class.

Turns out it was a little thing called "asthma." Even now that it's been diagnosed, I have trouble remembering to take my inhalers, because I can't convince myself it's not my clogged lungs that are the problem. The problem is I'm weak.

See, I'm just surprised that cost isn't as big of an objection with these Habalahs. My parent's biggest problem to anything is the cost of doing it. Why bother going for a yearly check-up to pay a lot of money for a doctor to tell you you're fine? They'd reason. Aren't you suppose to go and pay a doctor only if you think you're not well? It's how my parents never went to get a regular check-up until my Dad couldn't stop losing weight and my mother fell and broke her hip. Now they learned the hard way that Dad had to deal with cancer and Mom had to deal with Ostreoporsos, or whatever they call that bone thinning disease.

They're much better, but still, I sometimes wonder if they wouldn't have to go through such drama and financial struggle if they had bite the bullet and paid for the check-ups much earlier. And then I realize, I'm doing the same thing now.

I'm going to have to get a copy of In Nomine's books, if only so I can read up on these lovely demonic types you mention.


I'm so glad you're seeing some changes, that you're feeling the beginnings of a more stable foundation in progress. Only someone who has been there can truly understand what it is like to have difficulty like this, but I can empathize. Certainly enough to know that there is no weakness inherent in having these troubles! If anything, your sheer tenacity in finding a proper diagnosis, sticking with the laborious process of obtaining the medication, and developing a new foundation for functionality is a trait to be admired, and one that belies weakness of character, or willpower.

In my own internal struggle for peace within myself, particularly in comparison with those around me, I've discovered one truth: There is no normal. There is only what works for you, and what doesn't. Keeping the Habbalah and their ilk from convincing you otherwise, this seems to me the truest path to happiness. Luck to you, lady.

One of the most frustrating things about having a known issue is getting advice about it. ... I know that people mean well, and that whatever approach has worked for them or their friend or their great-aunt Martha.

We call that "assvice".

( Because I have to -- it's the Lilim in me -- the In Nomine website is www.sjgames.com/in-nomine . Further, the core rules are now in PDF form. And it really is handy to be able to talk about the Choirs and Bands and Words; my sire is a Balseraph, and when I say that, it's just such fabulous shorthand...)

Further, the core rules are now in PDF form.

I love love love love love love love having happy searchable shorthand on the iBook. Love. The print books have an unfortunate side effect: "oh, I'll just reread this part. Oh, but now I want to know more so I'll reread this supplement, and..."

Heeheehee.

Having the core rules searchable helps a lot with the prior . . . um . . . Let's just say that I frequently wonder what the editors were smoking regarding the organization.

Making a sane organization is one of my goals whenever I get a go-ahead on doing a second edition.

But the PDF version is a lot easier to deal with.

I think core rules were supposed to be scattershot back then. There probably wasn't any smoking; anything which hits norepinephrine would probably make it easier to sort things sensibly.

Paul: I read Making Light daily, and that I recall she has not mentioned finding a replacement, but she hasn't mentioned having trouble with it either, so I presume she's muddling through. Everyone knows what happens when you presume though.

And now I feel the need to reinforce my own worldview. I don't personally have a prescription for or a need (I think) for habitual psychoactive drugs, but if I thought they would improve me, I would take them in a hot second. For years I kind of thought poorly of them, and the crucial insight (to change my mind) was thus: It doesn't matter whether or not there is something "wrong" with you. I mean, in many cases there is, and that's cool too. But if I (as noted, not currently medicated) were offered a drug to habitually take that would make me a more effective and happy person, with acceptable side effects, even in my current state of mostly-functional, I would take that too, and feel no guilt whatsoever.

The question for me changed from "Is this drug a crutch" to "will this drug make the taker a more effective/happier/smarter person". That question feels perfectly valid to me, independent of their/my/your current state, and seems to me to be the only valid metric for whether taking a drug is morally justified.

And I have to confess, I do regularly take one psychoactive drug, intended to make me more effective in my job. Unfortunately, it doesn't work very well and has irritating side-effects, but I take it anyway, because it's the best thing available. It is called caffeine.

I read where 1 out of every 6 british workers are drunk on the job. 1 out of every 6. And considering that beer (and wine and spirits) is a chemical drug you just drink...

And I have to confess, I do regularly take one psychoactive drug, intended to make me more effective in my job. Unfortunately, it doesn't work very well and has irritating side-effects, but I take it anyway, because it's the best thing available. It is called caffeine.


Ah yes, I too partake of a particular powdered Columbian drug that acts as a stimulant and is highly addictive.
Oh... coffee! Yeah, that stuff is pretty much the only way I keep myself aware and active at work.

This only reminds me that I wish I could afford Strattera again. I went on it a few years ago and it really was a wonder drug for me. I could focus. I had the potential to focus more. I could DRIVE!

Now that I no longer have perscription coverage, I'm off of it (its a couple hundred a month, more than half my wages) and trying to learn from it. But the moment I get coverage again, I'm going right back on.

It worked. With minimal side effects (dizziness, mostly, and a whacked out period) and maximum benefit, it was wonderful. I still had my days when I couldn't find control-but hey, my diabetic fiancee has days when he can't raise his blood sugar.

MelSkunk:
I'm stupidly proud of getting to school on time each morning with all the items I need for my class.

.
.
.

I bow before you. Seriously.

Is it bad that I burst out laughing at the "let's go ride bikes" thing before I realized that could be read as a perfectly logical continuation of the narrative in the joke and that therefore I can't really tell what it was trying to do? I still wanna steal it and make a T-shirt or something. Let's go ride bikes!
(hi weds! We're both still alive!)

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