This from the blog Bipolarblast

Drug addicts can be made..they need not seek…they only have to find YOU who tell them the drugs are safe.

This is in response to an article in The Washington Post:

Critics say benzodiazepines are broadly over-prescribed and can have serious side effects. Some patients find themselves on high dosages after a few years because their bodies need more of the drug to get the same effect, according to health experts.

Unfortunately, there’s not a single mention of actual dosage amounts in the article. What are “high dosages?” 2 milligrams per day? 10 milligrams? Or does the dose intensity depend on the patient, in which case only a patient’s retelling of the experience of taking the drug can help determine whether the dose is high or not.

John Steinberg, a physician and former medical director of the chemical dependency program at the Greater Baltimore Medical Center, estimates that 10 to 20 percent of those taking the drugs for extended periods will have problems with dose escalation and physical dependence. “For a serious side effect, that’s a fairly large, significant number,” he said. “It is, after all, a devastating and debilitating adverse effect for those who experience it.”

Increasing the dose is clearly the doctor’s purview, but the patient bears some responsibility in the matter. Facts on benzos are just a Google search away. Increasing the dose to get the same effect is a massive warning sign that something’s going wrong, and the treatment should take a turn for the better. The problem, in addition to doctors who don’t seem to care how much of a particular benzo their patient is taking, seems to lie with the patients’ ignorance of the drugs they are taking. Today, it is beholden on all people to do research on their own for every drug they are prescribed.

Again, from the Washington Post:

Robert DuPont, former director of the National Institute on Drug Abuse, who has written several books on addiction and anxiety and maintains a psychiatric practice in Rockville, said the drugs are widely successful in treating panic and anxiety. He said that 90 percent of his patients have no difficulty taking the medicine, and those with problems are most likely to be people who’ve had issues with addiction in the past.

“The typical patient that I see with anxiety is taking [benzodiazepines] well within the green-light zone,” he said. Addiction is an entirely different issue, having to do with a person “essentially falling in love with a chemical high,” he said. “For those people, they’re booze in the form of a pill.”

Again, it comes down to the patient being honest with themselves and with their doctors. Correct dosage of benzos relies almost entirely on a patient’s ability to understand what the drug is doing for them. Is it knocking them out hard, blurring out the world and making all their anxieties go away? Then the dose may be too high. Is it helping in some small way while the patient keeps in mind the addictive qualities of the drug? Then things will be all right.

Research the drugs you take. I wish every patient taking meds for psychiatric illnesses had the opportunity or the knowledge to do their own research. These are still the dark ages, and P-docs are shooting their arrows in that dark. They don’t know what dose will work until the patient tells them so, and of course doctors who are not the best will leave you on the pills so long as they seem to be working and YOU continue to say they’re working. Addiction to medication is a two-way street, to use a tired old cliche, and it’s time patients took greater control of their mood-altering drugs.

In many cases (depressive bipolar being the signal case), those with the disorder tend to be dilettantes, tend not to stick to one thing or another. This probably has something to do with the staying power of confidence – or lack of. Although I’ve been feeling better lately, I don’t take it for granted and I’m only waiting for the next low to hit, in approximately two or three days. Something like that. Dilettantism. What was I saying? What was I trying to do? Oh, yes, that’s right, I was going to try to become a computer programmer even though I’m a writer and TV editor and producer and I have a million other things to occupy my time. But today I’ve got the heebies, the bipolar expansiveness not helped by copious amounts of coffee, Starbuck’s French Roast Bold, and I’m standing here with lines spinning out from me in every direction.

I came across this in Coming Out Crazy:

“Last night, I read the short chapter on “Morality and Self-Respect” and, to quote Marcus Aurelius – “I do my duty. Other things, trouble me not.”

Dr. Pies often illustrates the Stoics ideas with practical contemporary examples, in this case a woman who couldn’t do enough to satisfy her mother – a problem I’ve had.

Do I want to lose my soul in trying? No way. So, after reading Dr. Pies and the ancients, I fell asleep peacefully with the words of Epictetus ringing in my ears: “If you fulfill your duties, you have what belongs to you.” Or as Dr. Pies suggests, “the only real possession to which we may lay claim is our own moral integrity. Everything else in life either belongs to someone else or is beyond our control.”

This can kill a writer’s – or this writer’s – ability to come up with anything new to say. I want to write about my mental illness, but sometimes the illness itself keeps me from finding the right words. I write obsessively in my journal, recording sometimes every thought that passes through my head, like talking to myself. But I don’t want to do that here. How much of the rambling can a blog take? Blog posts are supposed to be short and to the point. They’re not supposed to show evidence of mental illness, of indecision, of self-doubt. But I’m here to say, I have self-doubt like a hammer hitting my back. I’m not put together, I’m not smug about writing in a blog. I’m keenly aware that I have no readers (yet?) and I’m struggling to keep this thing going. I want to reach out and meet people through this effort. And I want to be lyrical again. This is why I’ve reduced the amount of Lamictal I’ve been taking by 100 mg down to 300 mg. It’s not always better living through chemistry, I think. I think some medications can keep one down, can suppress the minor highs of bipolar that can get one through the week.

If anyone is out there reading this, I’d sure appreciate some advice on switching psychiatrists. I’m in the process of doing that right now thanks to my current doctor leaving my insurance provider. He’s not making it easy, saying “So you’re going to kill me,” when I said that I needed to switch to a doctor who’s in my network. Feelings of guilt over leaving mixed with a real liking for this doctor, with whom I’ve been for a little over a year now. He pulled me out of a crisis of manic depression and I don’t want to leave him, but my checking account demands it.

So, other than just severing the ties, how do you go about switching doctors with as little pain as possible?