How can you tell that you psychiatric medication is working?

[netsavy006]

If you have to be your own judge and didn't have any one else to rely on for feedback for information on your condition other than your prescribing doctor, how can you tell your medication is working?

(and please don't just say reduction of symptoms, that's so generic. Examples, please).

Thanks,

Andy.

[confused]

Here is a link of signs your meds are working from about.com

http://bipolar.about.com/cs/faqs/f/faq_medswork.htm

[nibblerd]

That link from about.com pretty much says it all. I felt a very gradual decline in my manic symptoms over the first 2 weeks of lithium treatment. As it got better my thoughts were not racing uncontrollably, my obsessions became more controllable and my knee-jerk reactions of anger and hostility slowly went away. But then I spiralled into depression, so there are other things I have yet to fix.

[null0trooper]

(and please don't just say reduction of symptoms, that's so generic. Examples, please).

Less frequent or less severe seizures can literally be a matter of life or death to an epileptic, so don't sell "reduction of symptoms" short.

More sleep / Less sleep. - stimulants and some antidepressants are capable of either one, and that can be an intended effect or a side effect. (FYI, insomnia and hypersomnia are both symptoms of depression)

Antidepressants are hard to self-judge because the best indication that the med is working is that you don't see why you still have to keep taking it (at stable blood levels, there shouldn't be a lift/crash cycle tied to when you take the pills each day) But since complete remission of symptoms is more than some of us can hope for, I'll settle for not feeling like I'm stuck all the way in The Pit.

APs may not make the voices or ideations go completely away, but they may be less severe or less frequent. Perfect? No. Better than nothing? Oh, hell yes.

Stimulants for ADHD can be a tightrope walk between "not enough" and "too much". People *around me* probably appreciate less self-stimming and fidgeting far more than I could quantify it. I'm fairly sure I drive slower. I'm much more easy-going, but not quite as patient (if you count not wandering off or finding something else to engage my attention or falling asleep as "patience") All of that is "reduction of symptoms" and it varies between just about every ADDer, because few of us can stand being medicated enough for complete abatement (I've done it. Once. And to this day I have NO idea how you people can stand only having one or two trains of thought going on in your head at once.)

On the other hand, when I've forgotten my Adderall too many times in a row, my nose stuffs back up or starts running uncontrollably.

[netsavy006]

Less frequent or less severe seizures can literally be a matter of life or death to an epileptic, so don't sell "reduction of symptoms" short.

epilepsy is not a psychiatric condition, it's neuological. I asked about psychiatric.

[dancesintherain]

My psychiatrist leads the way with his questions, but it usually involves looking at the illness on a symptom by symptom sort of basis. For me, things like sleep and eating are quick to go, so we assess that (quality and quantity, through the night, falling asleep reasonably easily, etc.). How am I handling the day to day life? (People handled that above...things like staying on top of responsibilities, doing necessary cooking and cleaning, etc.)

What about mood and thinking? Is my thinking clear and logical, can I focus on things, is it at a nice measured pace (as opposed to speedy or dulled). Am I having crying spells or sadness attacks? Any anxiety attacks or anything that's caused me to use prn meds?

Anywho, that's just some of it...but that's the general stuff we go through. He doesn't ask me question by question....I give my own narrative first and then hell follow up with specifics on rhings he's concerned about or that I missed.

The other twist is the "what if anything has changed since last time"...which is what we start with. Very quick update on any big changes (e.g., called off wedding, moved into new apartment) and quick summary of how I subjectively feel like Im doing.

[mudpuppy]

Andy, maybe keeping a mood journal would garner you some insight.

This is also why therapy is a good idea- your therapist can help you analyze symptoms and the degree of symptom reduction.

[SashaSue]

Andy, why don't you have anyone to get feedback from, given that you live with your mother and your brother, and have a case manager and a compeer? Are none of these people able to comment on how you seem to them?

[notfred]

Less frequent or less severe seizures can literally be a matter of life or death to an epileptic, so don't sell "reduction of symptoms" short.

epilepsy is not a psychiatric condition, it's neuological. I asked about psychiatric.

Then don;t read the answer. Problem solved. You don't get to control what others answer. After all your history here you should be glad people even read, let alone respond, to your excessive questions.

nf

[rowen]

I would consider talking to your psychiatrist about this when you see him.

[Velvet Elvis]

Are you dead yet?

It must be working

[december_brigette]

@ confused - that is an excellent link. definitely helps me see where I need help.

db

[null0trooper]

Less frequent or less severe seizures can literally be a matter of life or death to an epileptic, so don't sell "reduction of symptoms" short.

epilepsy is not a psychiatric condition, it's neuological. I asked about psychiatric.

You asked about psychiatric medications, not psychiatric conditions, and the truth is that anticonvulsants are widely used as psychiatric medications. Your pedantry is misplaced given the imprecision in the original post, the fact that CrazyBoards specifically includes epilepsy in its service mandate, and the fact that neurology and psychiatry aren't as completely divorced from each other as you would have them be.

Furthermore, I have it on good authority that temporal lobe partial seizures and auras can be a particularly graphic form of psychological hell, and can easily find pointers to research into the comorbid occurrence of other psychiatric disorders with temporal lobe epilepsy (e.g. PubMed,) while personality disorders aren't entirely uncommon with medically refractive epilepsy in general (Neuropsychiatry Online.)

[helloheartbreak]

Are you dead yet?

It must be working

This seems flippant on its face but honestly years and years ago when I first started meds I asked my pdoc how would I know if they were working he said pretty much exactly this, with the addition of "Six weeks ago did you think you'd still be walking around in the world? Did you think you'd want to be?" I still had a ton of problems, but that's something. Some times you have to take what you can get and keep trying.

More concrete examples - I talk to people, I check my mail (huge problem for me), I answer my phone, I sleep, I eat, I get out of bed, I want to do things.

And reduction of symptoms can be huge - 5 days after I started Fanapt I didn't have voices or crushing paranoia 24/7. That goes a long way toward keeping me safe.

Try keeping a journal like others have said so you can really see what's going on with yourself. And listen to what the people around you say.

[girl_interrupted]

I have energy, focus, want to leave the house, find I have some balance in my mind and that I'm not counting as much or obsessing over how something looks. I have my confidence back. Keeping a journal is a great idea, because it helps measure pre med change and going though the med change and I find it one of the best tools to know if the meds are working.

[water]

My life feels doable and even rewarding. I have energy to talk to friends and go grocery shopping. I look forward to work. Getting out of bed in the morning does not feel hopeless.

Most of all, when that miasma of depressive gunk gags me I know instantly this will pass very soon. Depression on drugs - you know it will not last.