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heilmania

Choosing between mental and physical health

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If you had to choose between mental health and physical health, how would you decide? Which would you choose?

I'm currently facing the prospect of developing diabetes, cardiovascular problems, high(er) blood pressure, and other fun things that come with being on maxed-out doses of the only medications that keep my shit together, that allow me to live my life in a very high-functioning way. I know for a fact, after having been taken off said medications, that I literally cannot keep my job, run errands, keep the house tidy, go a day without an anxiety attack, hold suicidal thoughts at bay, or be fully present without the help of some pretty strong shit that will likely and ultimately put my physical health at risk. 

So, would you, do you, choose quality of life mentally or physically? 

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What meds are we talking about, heil?

I guess I'm making that choice right now. I have to choose mental health even if it is at the expense of physical health later on. There is no way I can live without meds. I will die by my own hand without meds far sooner than any health problems that I might develop later on.

The only meds that are hard on the body that I am taking are Abilify and Tegretol. But these form the backbone of my cocktail. Antidepressants really won't affect your health too much unless they put weight on you. There was a scare about benzodiazepines and dementia a couple of years ago, but I think that has been explained as a non-causal correlation and not as benzos actually causing dementia. Atypical antipsychotics do have the potential to cause diabetes and higher cholesterol. But, as I said, I really can't live without the Abilify.

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16 minutes ago, jt07 said:

What meds are we talking about, heil?

I guess I'm making that choice right now. I have to choose mental health even if it is at the expense of physical health later on. There is no way I can live without meds. I will die by my own hand without meds far sooner than any health problems that I might develop later on.

The only meds that are hard on the body that I am taking are Abilify and Tegretol. But these form the backbone of my cocktail. Antidepressants really won't affect your health too much unless they put weight on you. There was a scare about benzodiazepines and dementia a couple of years ago, but I think that has been explained as a non-causal correlation and not as benzos actually causing dementia. Atypical antipsychotics do have the potential to cause diabetes and higher cholesterol. But, as I said, I really can't live without the Abilify.

Adderall, cardiovascular problems; Abilify, diabetes, high cholesterol; Klonopin, diabetes; Remeron, weight gain; Effexor, high blood pressure. I was maxed on everything but Remeron a couple months ago, and now that I've been tapering down, I'm a mess.

I guess I'm asking more as a big-picture question, not really about particular meds and what they (could) do.

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Better a good but short life than a long but bad life. Besides this there is still a lot of stigma about health issues from my point of view: 'easier' to have physical than mental problems.

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I'll take sanity. Without sanity, day-to-day sanity, I'll kill myself, so worrying about the possibility of heart disease or diabetes down the road is something that's just going to have to wait. 

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Don't confuse potential side effects that you might not get with absolute certainty that you will get them. Remember that drug companies have to list every adverse condition that is possibly related to their medication. That Adderall causes cardiovascular problems and Klonopin causes diabetes are new ones to me. These meds are generally safe when taken in their therapeutic ranges.

Things like blood pressure, cholesterol, etc. can be monitored easily. If you have a physical every six months you really have nothing to worry about.

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Posted (edited)
9 hours ago, heilmania said:

So, would you, do you, choose quality of life mentally or physically? 

That's something I've never thought about, really........

I really have lost just about everything to my MI, but at least I'm still alive......But honestly, I feel as though I'm just existing, not really living.

 I'm basically housebound, can't work, can't even cook except for microwaved stuff, and someone else gets my groceries, and does basic household chores for me...

So, I'm not sure how to answer............My psych meds possibly do at least keep me from opting out completely, but not much else., ...and according to my last health exam, the meds aren't causing any physical problems for me yet.

Edited by CrazyRedhead

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I don't think it's a simple as "this" or "that". Mental health is intertwined with physical health and vice versa, that it can be hard to separate what is what.

At my batshit craziest and while on a ton of different meds, I found out I developed Metabolic Syndrome from Geodon and Chemical dependency from Klonopin after 7 years on both. So my doctors and I decided to taper me off my meds for my physical health.

In reality though, my physical issues from the meds were causing mental symptoms and mental health causing some physical issues. The tapering sucked, and some side-effects of it lasted for a while after, but it helped me and my doctors re-evaluate my physical AND mental health and started treatment for the symptoms of my Mental Illness and not the mental symptoms of my bad health. If that makes sense? 

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I would choose my mental health.  If it was an choice of either/or. (Although a recent respite from depression has allowed me to improve my physical health and that, in turn,  helps my mental health.  Also,  I was able to start an exercise program and that has become really important to my mental health. But I couldn't start exercising on my own. I tried and tried.  I went to a clinic for 2 1/2 months and was able to start some healthy habits. I was lucky to have that experience). 

 

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2 hours ago, jt07 said:

Don't confuse potential side effects that you might not get with absolute certainty that you will get them. Remember that drug companies have to list every adverse condition that is possibly related to their medication.

This is a very important point. It's ridiculous to base your treatment regimen now on things that could happen but haven't happened yet.

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I also choose relative sanity over potential physical illness. 

I do monitor my weight and my BP. I have risk factors for diabetes, high BP and heart problems. Not all meds with a side effect of weight gain will cause you to gain weight, so make your decisions based on how you're responding.

Frankly, I'm hoping that if I can find the right meds to help me feel better then I will be able to do other things to more proactively protect my physical health (e.g. lose weight, exercise, eat less prepared/processed food).

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Heil, remember that the big CB question has always been: Which Sucks Less? The MI, or the side effects from the meds? Unfortunately, science just doesn't know enough about the brain yet to give us side-effect-free meds. Until it does, we're always going to have that question to answer, and that choice to make. The fact that we even ask the question means that the MI sucks mightily, so much so that we begin to question whether our quality of life is acceptable, or whether a different - but also reduced - quality of life would be preferable. For me, my mind is the thing that is going to determine whether I feel well or not. If my mind feels well but my body isn't well, my mind can still take a positive view on life, and can work to heal my body. But if my mind is sick and my body is well, I am going to feel unwell regardless of how well my body is doing. I'll take a well mind every time.

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Tough Question.

For me personally, I think I'd probably sacrifice my health to feel better emotionally.

But I think physical health is more important, if that breaks down, much more breaks down.  And vice versa I suppose...

I'm struggling with HBP atm too, and effexor isn't helping that.

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I have heard this from big-time health nuts time and time again, "oh! You don't need all those meds! All you need to do is just get out and exercise and you'll be fine!" and I'm like "...no... seriously... you don't even understand..." I will give this to them, it is important to attempt to maintain physical health no matter what, because that will almost always make you feel better, even if it's as little as supplementing a vitamin deficiency (when I had a vitamin D deficiency, I felt like an 80-year-old trying to get out of chairs and my car and felt down and sluggish, but upon starting Drisdol, I felt like a completely different man—same with Deplin, which my insurance yanked coverage of out from under me, thanks assholes...).

But one has to have the will to want to take care of oneself—if one is depressed, psychotic, manic, or in some other altered state of mind due to their MI, one will probably not have their physical well being on the top list of their priorities. For me, I'm bipolar type 2, and I primarily struggle with deep, bottomless chasms of major depressive episodes, accompanied with suicidality and occasionally psychosis. When I'm in the bottom of that pit, I don't even have the will to get out of the bed much less even go for so much as even a 30-minute walk in the park... How would I be expected to go to the gym regularly and maintain a regular exercise regimen in a state like that? Back in November last year, I was doing C25K and got half-way through it, then X-mas happened, then I got depressed again, and fell out of it and haven't been back to the gym since. I went on Parnate, which caused 50 lb weight gain, and a few other meds here and there which have caused weight gain too, currently Rexulti, which has caused weight gain before, but I decided to try it again, and sure enough I've gained 20 lb in about a week and a half which is apparently uncommon for most people. But enough about that.

Personally, I think it's a matter of balancing both rather than a dichotomous choice of one or the other. I think mental health does play into feeling able to keep up with physical health quite a lot, so addressing mental health first would be where I personally would start and when/if I start to feel good enough and have the motivation, I would start exercising, eating better, etc., all that good stuff.

I'm close to the heaviest I've ever been in my life, but I constantly measure blood pressure, blood glucose (went through a pre-diabetic state there for a little bit and had to start Victoza, which I'm still taking), count calories and carbs with MyFitnessPal (if I can remember to... also depends on if I'm "on my diet right..." lol(. All of these are the very least I can do during times when I'm at my worst. Every once in a while, I can push through my depression because I'm like "OMG I'VE NEVER WEIGHT THIS MUCH IN MY LIFE!" or "WTF MY FASTING BLOOD SUGAR IS 140 MG/DL!!!", and that kind of shocks my mind out of depression and puts me into desperation mode... lol. That's just me though.

I've been through all the "weight-friendly" meds and taken a few "non-weight-friendly" meds, and my general impression is that if it doesn't cause weight gain, it doesn't work, and vice versa. At least for me, meds that cause weight gain are likely going to be the ones that will work. Except for Remeron... that just made me binge eat—no sedation or antidepressant effects... or Seroquel or Zyprexa, which made me a zombie and made me binge eat too. But the best I believe one can do is take whatever medication(s) work for oneself and do what they can to manage any metabolic/weight gain/cardiac symptoms as best they can through regular preventative doctor visits and, well, yes, other meds to counter the side effects of one's psych meds (not cool but sometimes you have to do what you have to do).

I hope this has made sense... I feel a little mentally discombobulated at the moment and unable to convert my thoughts into words... lol.

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interesting question... i've been rather fortunate of late with medications, despite having suffered various side effects over the years. i would like to say i'd choose my mental health, but i've discontinued at times past because of the side effects, which has always resulted in my becoming symptomatic, doing stuff, eventual hospitalization.....etc. i wouldn't quit my depot injections if i could've and they probably were what stabilized me for the first time in several years and back and forth, just on principle alone.

the combination i'm on now could cause me to have blood cell problems, metabolic issues, weight gain, diabetes, cardiovascular issues, movement disorders, seizures....etc. the only thing i actually have is constipation. i do a lot of blood draws in a year, but so far they've turned up ok. one day they might not. or i could suddenly gain a bunch of weight.

it's hard for me to say that i would choose physical comfort/health over mental comfort/health, but i will say i'm fortunate not to have serious side effects (yet, touch wood), because i cannot say without reservation that i would choose my mental health, in light of past experience. and i get that that's a bit fucked up...

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My philosophy: put in all of the lifestyle interventions that I can to be stable, build up techniques from therapy and then take the minimum amount of non-PRN medication I can. As a disclaimer, I'm not at the level that I would like to eventually reach, but I know that the only way for me to reach that level is to taper extremely slowly. I'm one of the most sensitive patients to meds that my pdoc has seen. 

I know there are ways to mitigate some of the effects from meds. I stopped all refined carbs for a year, and exercised each day - I was on 20mg olanzapine (Zyprexa) and I lost a notable amount of weight. I've been slack since I've been on Seroquel and I've put on a lot. I think it's possible to maintain a healthier weight than what I have now (I'm in the middle of normal BMI but I have a very light frame so should be a little lighter), and I put it down to me not having the superhuman discipline that I used to have. 

I don't know whether I'm just getting older or whether the meds are making me sick, but my physical health is much worse than it used to be. Aside from the weight, I have frequent migraines and headaches, severe IBS and consequences (hernias, reflux, multiple colonoscopies this year), I had some precancer stuff removed, I developed severe acne and was advised to go on Accutane. I'm in my 20s.  

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I like to think that I see both sides of prioritzing the mental vs. physical equation. It's a see-saw that tends to be extremely difficult to balance. Throw in all the relationship/environmental variables that tug at our moods and emotions and it can be as frustrating as trying to teach a boulder to swim. 

I think balance becomes the goal. When it is difficult to distinguish the cause of the changes in mental/physical health, yeah.. It is frustrating. There is a lot at stake by making the inappropriate choice for what to focus on trying to improve. There is always a consequence.

Mental illness is a master of encouraging us to chase our own tails and question the motivations of everyone and everything. 

When faced with the ultimatum of having to prioritize one over the other, by sacrificing social and environmental stressors, both my mental and physical health improved dramatically. Unquestionably, for some, that is not an option. 

It's a riddle. And, as individuals, we have our own unique considerations. But, I do know there are more than 2 pieces to this pie. If only it was as simple as a coin toss, right?!

 

Edited by Lms-Kaz
Word nerd.
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Id rather be at a healthy weight and not in poor health than sane. But somewhere deep down I can't allow myself to unravel my sanity.

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