Don't know what to expect...

  1. AllAroundTheLight
    On the outside, I have everything going for me...a college undergraduate student with a 3.88 gpa, two jobs on campus, and a paid research internship lined up for this summer. On a personal level, the "addict" part of me loves the thought that he has access to legitimate drugs - amphetamines, xanax, klonopin, and ambien, all prescribed a relatively high doses (2mg each xanax and k-pin, 12.5mg CR Ambien)...I shudder at calling myself what I really am, an addict. Because some part of me had known it was true long before I really was put into circumstances that required this self-awareness.

    I'm scared. Last week my psychiatrist sent me a letter in the mail saying that as of July, he would "no longer be seeing medication-only patients," which is what I was for him. No time or money for the extra therapy when the fact of the matter is I know full well that I at some level view this doctor as my drug dealer. The reason he sent me this letter likely has to do with liability issues I'm sure. He also sent a release form for a new psychiatrist that I would be seeing. Effectively writing me off, as if he was aware that he just wasn't making enough money for me to be worth the liability risk for him. I'd pay out of pocket to see him every 3 months of so (over the course of about a year) - just $100, very manageable. I know that doctors may be wising up to potential for addiction, especially for people my age.

    Things were perfect. I had the Xanax, the "best" benzo out there, the Klonopin as well for more medically relevant purposes; the Ambien, I don't know what I would do without. Yet I am smart enough to know this is all a lot, that the initial allure of these medications was ever so deceiving. A "high" from Klonopin is groggy tiredness, not too much different with xanax at this point. The Ambien still does what it's supposed to, for the most part. My sleep is still shit, as is my diet and a few other factors related to stress that I won't get into on my first post.

    **Please spare any "stay away from benzos" suggestions...I get where that is coming from. It's a bit too late for that now. Physiological changes have occurred. I don't know if I could die from suddenly quitting cold-turkey, which, needless to say, frightens the hell out of me...

    What I wanted to do by writing this is just to know that someone is listening. I don't even care that this person is someone I know nothing about, yet it beats what I have around me. I cannot (currently) find the strength to just man up and picture a life without dependency. I can't be sunk yet...I don't abuse the medications, but with such high doses prescribed, I might as well be.

    Like I said, I'm terrified of the coming months, the prospect of finding a new doctor that is a) more pricey b) more suspicious (although I am very good at "playing them" at this point) and c) requiring a lengthy period of having to build up trust...

    If anyone can offer any words of advice on how they might view my situation, or if they just have any general supportive comments, I could really use them now. I don't know where else to go (do not bring up re-hab, it's not quite THAT bad...and yes, I've been through it to know what it's like). Therapy would help. But unfortunately every therapist has been a waste of my time. I need someone smarter than me. I know how pretentious that sounds, but it is true. When I can predict exactly what is going to come out of their mouths the moment I bring up drugs...I know I've wasted my time.

    And perhaps I've wasted my time writing this on here. I hope not. I hope for someone to communicate to me that they know where I'm coming from, that they actually care (as much as one stranger can care about another stranger that they think they might share things in common with). I've read other blogs and have been amazed by the amount of support shown, so I thought I've give it a shot.

    Thanks for listening.

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  1. Beenthere2Hippie
    Yes, you do seem a bright guy with lots going for him. But, without meaningly being rude, "Big deal." Let's face it: the world is made up of billions of bright and capable people.

    What makes the successful people different from the rest is that they know themselves and what they want. You cannot expect people with degrees in psychiatry who treat you as a drug-prescription patients only to be invested enough to give you meaningful answers to life's trials and tribulations. Those answers must come from inside of YOU and take time, application and perseverance on your part.

    My suggestion is that you stop "playing" your doctors and drum up the courage to live your life in a grown-up way. Using drugs on a constant basis is never a good idea, and much of life's responsibilities require a clear head. Enjoy your highs occasionally and with caution and use your drugs from what they were intended--as medicine (take as prescribed). The rest will fall into place over time--the healer of all things.

    In wrapping, if you have developed a habit that scares you and you cannot detox from yourself (see self tapering in forum), then it's time to seek professional help. There are no painless, easy ways out of benzo dependence.

    Best of luck to you-
  2. AllAroundTheLight
    I don't really think I can argue too much with what you said because a big part of me knows this to be true. Of course there's an issue because I "want" not to have to "grow up" in this way. The drugs have been there during some of the most formative years of my life - not to say those are not over -and so they have very much become a part of me. Naturally, having the drugs present makes me feel safe, but in reality, I have come a long way from abusing them at all like I once did, which is something I keep trying to tell myself to be optimistic about. I find it difficult to encourage myself and I'm sure these drugs have gotten in the way of some emotional development over the years... Still, it's easier to be optimistic about something when you've got other people telling you that you've got it right.
    I'm going to look into self-tapering, thanks for the suggestion and taking the time to read this and reply!

  3. Neuropsychonaut
    Only you know the right thing to do, its that niggling feeling in the back of your mind, probably the voice that you try to ignore. If you are not happy with who you are at the moment (which is probable given that you have posted here) then you need to change. I can't tell you how to change because I don't know what it is like to be you. I too know what it is like to 'self-medicate' and keep yourself in a place where you feel comfortable. If this is a place where you want to be then that is entirely up to you. Yet it seems that what your really asking for in this post is a way to get out.

    I know where you coming from to some degree, I have also had to make the hard choice to leave a life that is chemically comforting. I certainly wouldn't recommend stopping and think the link to tapering is certainly useful for you. But you need to ask yourself some serious questions. Can you accept yourself as you are? If you can then carry on doing what your doing and I hope very much that nothing bad (health wise) happens to you. If however you feel that things need to change then do so. Take baby steps and make one little change a day. Keep doing this until you reach a point where you can look at your life and think "yea I've done it."

    Its cliche, but life is short. I hold the philosophy that when I'm old and grey I can look back at my life and think to myself " I have no regrets."

    I have a therapist as well and I know far more then she does. I hold a BSc in Psychology and I am going on to do a masters in cognitive neuropsychology. However, a therapist isn't there to tell you anything you don't already know, they are there to help you come to terms with things you are afraid to admit to yourself. If you are scared now its probably a good sign, a sign that things in your life are changing and that you have the choice to decide the way things go. It's a horrible experience when you feel the ambiguity of change but see it as an opportunity, a time when you can choose the way things will go.

    Don't give up on therapy, change the way you see it. It is there so that you don't have to have crazy discussions in your own head and so that someone who cares is there to listen. Don't be hard on yourself, thinking about leaving the comfort of a 'chemical blanket' is like the thought of getting out of a warm bed and into a cold day, no one likes it! Trust yourself and make your own decisions. If you are happy with the way things are then screw what anyone else says and carry on. But if you want change then go for it, a little bit at a time.

    I hope at least some of my rambling makes some sense and I'd like to hear how things pan out for you.
  4. AllAroundTheLight
    Thanks, I really appreciate what you had to say. It really is making itself clear to me every day, every night at least. I have this rigidity that I have to take the meds by a certain time or I know I'll be groggy in the morning and/or not be able to be fully present mentally in's very limiting when you actually are trying to live a life for yourself. With xanax, klonopin and ambien right now, taking even dosages smaller than prescribed feels like I am doing something wrong on some days. Although I have improved somewhat on not being too "hard" on myself. If nothing else, I'm confident that the benzos have slowed my emotional growth over the past couple of years. Not halted it, but made it such that it is clear to me that there is something not right when I know that I yearn to be around people who accept me, yet I make sure to avoid situations where I even come into contact with people.
    It could always be much worse, but the life I am living is my own. Either way, I'd like to start really feeling that this is the case, but I have a growing conviction that having xanax or k-pins there in case I get nervous (about almost anything) enough is really getting in the way of me feeling like I truly own myself. I see so many other people around me, many unmotivated, naive, ignorant or not disciplined who all seem to at least have a grasp on their lives. (That really doesn't sound like it makes sense) What I'm trying to say is that there are these people who are just so clearly comfortable with who they are, and they don't apologize for it. I admire it but it's a trait that I'm working on, part of the reason I thought I might start writing a blog in here.

    Neuropsychonaut, it sounds like we have some pretty similar opinions.As I've said, I think part of me is still at a point where I'm looking for some sort of validation...even if that's "you get to make all your own choices..." It is obvious but encouraging once one stops and thinks about it. I guess it's worth mentioning that coming out as gay at a bad time for our family probably wasn't the most helpful event 2 years ago. Not saying I shouldn't have done it then, but that it puts things in perspective for me when I look back and think about how closely related that desire for affirmation is to my sexual orientation. Never been in any kind of meaningful relationship - and I'm a firm believer that there's no point in even seeking one out until I get my shit together with the drug dependence

    Who am I kidding, it's a full blown addiction at this point. Whatever you call it I know I've got a physiological change of some sort in my brain chemistry. It will take years to really uncover who I am, why I am, why I even care, why anyone else would care. Naturally that's the hardest part. But I think acknowledging it and taking the first steps, frightening as they may be, are the right things to do at this point.

    By now, if you're reading this, be assured that your "rambling" probably makes a lot more sense than what I just wrote!
  5. AllAroundTheLight
    So I just came back from the 1st appointment with a new psych doctor. He said the medication regimen I am on now is "terrible." He wants me off of the ambien and benzos, and said that he has more or less an 8 month plan for me to get off of them, should I just to continue with him. He is smart. I know that I could have the successes I've had in life for the past 18 months for the next 18 months with the benzos and ambien, and he even conceded that. He also acknowledged that I have a difficult decision to make (with regard to proceeding with the meds). Man, my desire to pop a xanax as I'm writing this is up there. Could be worse, but definitely having some significant anxiety.

    My addict brain thought that paying $300 for a psychiatrist would mean that I would have no problem continuing with the adderall and aforementioned "downers." Interestingly, he suggested I start by replacing the remeron with a tricyclic antidepressant. The idea is that TCA's have anxiolytic effects and then I can gradually start chipping away at the kolonopin.

    I know this is the right thing for me health-wise. I'm also scared shitless about the fact that by this time next year, I won't have access to a quick relief of anxiety like I do now. no painless way of coming of benzos. but what scares me is having the cravings for the rest of my life. I am an addict
  6. bluenarrative
    Personally, I think tricyclics are very problematic, in lots of ways. But, I am not a doc. Maybe he knows what really is best for you. I have a few friends who are shrinks, and they generally reserve tricyclics for folks who do not do well (or cannot handle) handle more effective meds available today. If I were you, I would ask my doc what he-- quite specifically, hopes to accomplish with the new regimen, and what some of the alternatives to tricyclics might be, for your case.

    Ambien is a weird drug. If you have sleep issues (I do) then you might want to consider substituting, say, 75 mg or so of Trazadone for your Ambien. Trazadone is a lousy antidepressant, but it does a good job of addressing sleep issues. And it has considerable anxioletic qualities. You might be able to kill two birds with one stone by using Trazadone as a sleeping aid.

    Others, undoubtedly, know a LOT more about these things than I do. But, I offer you these suggestions based on my own offhand knowledge and experience with these meds.

    I am curious: what is your overall regimen of meds, beyond what you mentioned above? What, exactly, is the diagnosis (or diagnoses) that your old doc was trying to address?
  7. AllAroundTheLight
    Bluenarrative, first thanks for the comment. Trazadone will not work for me, nor will seroquel. Both give me terrible stuffy nose and make it impossible to sleep. The new doc suggested tricyclics because I had told I him I would not even consider taking SSRI's again. Terrible side effects and always made anxiety worse. I don't have any fucking idea why he thinks the older generation meds would have more tolerable side effects...

    My diagnosis is that of ADHD and an unofficial problem with anxiety and serious, serious insomnia. Adderall treats the ADHD well, but can sometimes contribute to anxiety. I'd probably be better off taking lower doses of the stuff. Enough to get me going, but not so much to where I feel like I need xanax every day to prevent the anxiety. As far as the sleep meds, I've been on just about every one that a psychiatrist might prescribe. Mostly anti-depressants, like remeron, trazodone, some anti-psychotics, like seroquel, zyprexa even. Also been on valium, klonopin, xanax, as mentioned, ambien and ambien CR. Also been on sonata...which seems too fucking easy to abuse. Those come in capsules where the powder is so easy to snort and it disinhibits you so fucking fast. I couldn't control myself. The stuff's only good for falling asleep, not staying asleep. As of now, I'm open to trying the tricyclics just so I can get on with it and convince my doctor that I just have to have the Ambien CR to sleep decently because I feel like I already know it's not worth doing these older meds for the side effects.
    -all the meds I listed weren't prescribed by the same doctor. Just my history...I feel like I've gone through all of them. Most that have abuse potential are a bad idea, I'll submit to that. But now, I don't really think there is much abuse potential to the ambien anymore. Probably due in large part to the insane tolerance I have for benzo's and Z-drugs by now. But I figure getting off the benzos is a start. I am an addict, and I have to be fully committed to whatever I decide because like it or not it will be part of my life going forward. Like I said before, I feel scared because it's as if I'm starting the same fucking routine of ineffective antidepressants for sleep/anxiety issues. Hell, I'll be open to other approaches (non-medicinal) to treat the anxiety, but the sleep problems are deep-rooted
  8. bluenarrative
    Getting off the benzos is a very good start. And it may be that doing so might, paradoxically, improve some of your issues-- particularly, the anxiety. I have known a few people with anxiety disorders who were rather irresponsibly given a script for benzos. Going off the benzos after taking them for a long time, for whatever reason, permanently resolved their anxieties. Go figure.

    For whatever it may be worth to you, my favorite people ALL have "mood disorders" of one sort or another. I'm not entirely sure that many mood disorders represent a "disorder" as much as they are simply part and parcel of who a person is. I think that this is a distinction that can only be made subjectively. All of the criteria for a differential diagnosis strike me as being, at best, annoyingly vague-- and, at worst, completely arbitrary. So, please, continue to consider what YOU want. Don't listen to any doc who tells you what he/she thinks that you should want. Any shrink not possessed of massive humility can do an awful lot of damage acting on 5he basis of arrogant or shallow assumptions.

    I sort of think that being upper-middle class in America today means, almost by definition, that a person can be easily diagnosed with some sort of clinical depression and/or ADHD. I do not know which is the cause and which is the effect. Are these conditions necessary for one to ascend into these ranks? Or does one develop these conditions because one is already located within these ranks? I have no idea. I am just passing on to you some observations that I have made... When I hire people to do cerebral work for me, I always look for people with these conditions-- they make GREAT workers, in my opinion! In particular, the ability to hyper-focus (something that comes naturally to people with ADHD) is an incredibly valuable asset in our complex contemporary world!

    My point is: all curses are blessings in disguise, if you know how to use them.
  9. AllAroundTheLight
    A little psych doc is great. He's understanding, knows not to give re-fills for controlled substances to someone who is trying to gradually come off them. It was relieving Friday, to know that I was being given this new med schedule and that I have the opportunity to do things different this time with this doctor. Simple, just do what I'm told to do and he's even pretty liberal with how much control I have over the Adderall (basically as long as I take no more than 35mg in one day, I'm okay right now)

    With the benzos, it will be a slow process. But his approach to the whole insomnia thing intrigues me. He isn't changes the benzos or even the Ambien yet. Just replacing remeron with a TCA called doxepin. Low dosages now of course, and it makes me noticeably more tired than remeron with tolerable side effects. I'm glad he's understanding about avoiding any withdrawal symptoms. I think this is all making it easier to be more honest with him than I have to my doctors in the past. 2 days in and I'm happy with the switch the doxepin. Med regimen will change about monthly, which is fine with me. It will be several months, assuming the doxepin can actually help stabilize things for more in terms of anxiety , before I'm "back." I have any idea what that even means. But hey, I'm excited to find out!
  10. eeevilgenius
    I doubt that the things that therapists have said to you concerning drugs are predictable because these individuals are less intelligent than you are. It seems more likely that they all say similar things because they are the truth, and the truth is sometimes the last thing that we want to hear, particularly where our substance abuse issues are concerned. After all, these are educated people, likely with specific experience in this area.

    Congrats on finding a sympathetic doc. That's invaluable. They are few and far between.
  11. AllAroundTheLight
    I had been trying to say earlier that my experiences with therapists and psychiatrists have been quite different. Unfortunately, therapists have certain patterns in thought they expect to see when I begin talking in detail about my substance use, whether I talk about "abusing" it or just wanting to get off them. Their reactions are the same: they'll casually throw out the addict label, which I'm not saying that I'm not, (here at least but usually not to the therapists) but again that label is something only you can put on yourself. I self-identify as an addict, so no I don't appreciate anyone talking to me as if I am one unless I explicitly told them.

    Unfortunately, you are right. Therapists go off of what they normally see, and they've told me what they normally see has manifested itself in people my age, younger and much older as well. I suppose that to a certain degree, it's me wanting to be unique, the exception to the rule. At the same time, I feel strongly that someone can best help me if they really understand me and my background. A few sessions of me talking about a particular area does not constitute "knowing me."

    This new psychiatrist was straightforward and honest with me. If I am the same way with him, everything should be alright on that front. Hoping to gain more control of my life, and being open and honest to my psych doc. is only a small part of that. Thanks for the reply.
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