Part of living with a mental illness such as bipolar disorder is figuring out your “triggers” and how to:
A) avoid them
B) learn to deal with them when they can’t be avoided.
Sounds easy enough right? Wrong. That couldn’t be more wrong.
Triggers are a very serious thing, and very specific to each person. What triggers me may have little effect on you or someone else. One of my biggest triggers that brings on massive fear and anxiety is running out of my medication. Oh boy I can’t begin to describe the stress that comes a long with this one, it’s a big one. Let me invite you into my head for a little bit. Buckle up, it’s bumpy in here.
I take on average 6 tablets a day, sometimes 8 as needed. I won’t get into what it is that I take, let’s just call it your basic standard cocktail for bipolar disorder, except the antipsychotics. I have nothing that is considered a narcotic or benzo, and I have no restrictions on my file nor a history of abuse with my meds. I have this structure with my meds. Sometimes I use a pill organizer, sometimes I don’t. It’s organized chaos, and believe it or not I know exactly where every last pill is. I take them at the same time every single day. I have alarms set on my cell, my iPad, my husband’s cell, the next door neighbour’s (ok maybe not, but you get the idea). What I’m saying is, I am acutely aware of where my meds are and when I need to take them. Oh and did I mention, I do not like meds but have over the years accepted that I do need them.
I have been using the same pharmacy for well over a decade. It’s like an episode of Cheers when in walk in, everyone knows my name. Last month a new tech came to town. She didn’t know my name. She did fill my meds though and when she handed them to me she asked me if I had ever done a med review. I explained to her that I do a med review every time I sit down with my psychiatrist. She then said that the pharmacy offers these services free of charge and that I should consider having one done. I thanked her and didn’t give it another thought.
A few weeks later I’m sitting in my psych’s office and I’m filling out a form which is basically giving my psych permission to look up my pharmacy history. I thought this was strange, I figured she already had this information. Okay, that’s fine. So I have my appointment, go home, and that night before bed I go to take my meds and realize that one of my meds has only been filled for two weeks, not one month. The next day I phone the pharmacy and speak to the new tech to explain the mix up with my meds and she tells me that I must come in for a med review before my meds are filled.
My stomach tightens, my palms become sweaty and I start to feel dizzy. It’s fight or flight time.
“I don’t understand. Is there a problem?” I ask her, trying to breathe through gritted teeth, all the while thinking, ‘If I don’t have my meds, I’m going to go manic. Does she not understand what happens when I go manic. How can this tech hold my meds?’ I am a mess. Instantly everything is amplified.
Her breathing and her condescending tone on the phone is grating on me, “This really is beneficial to you, Nicole”. I confess I never heard the words that she said after that. I was so distraught with the thoughts racing through my mind that she could have been looking right at me and I wouldn’t have heard anything.
How dare this woman tell me when I’m going to get my meds. Does she not get it? Is she going to seriously make me sit through something I don’t need in order to get my meds that I do need? How can she do this?
Now my mind is racing. I’m calling my husband. I’m calling my doctor.
What if I run out of meds? Oh God, the last time I ran out I went up so fast that I required hospitalization. I can’t let my entire life fall apart over this woman and her control freak ways. Who is she and what job is she gunning for?
Ok Nicole, just breathe.
I called my psych and the pharmacy supervisor and straightened out the problem. It turns out there was no problem. She never said that they would hold my meds. She had offered me a free med review with the pharmacist as a courtesy that my pharmacy offers. You know, one of those situations where they advise you on the best time to take your meds, what meds you shouldn’t take at the same time. Are you having any side effects that we can help with? Wow. I don’t even know where to begin with my overreaction.
I went to the non-mandatory med review after I picked up my refills. It was great. Everyone was so helpful. All of my questions were answered and a glaring light was also switched on for me. Obviously the med issue is a far bigger trigger than I thought. This needs to be dealt with right away. I worked myself into a frenzy over nothing. I imagined something that wasn’t even a possibility and I ran with it. Absolutely, anxiety over meds is a real thing, but this was ridiculous. This was self-induced stress from an imaginary situation that played on a very real trigger. I think it’s time I go back to try some more CBT classes or something. Real life triggers are hard enough, I don’t need to be causing myself issues where there are none.
Oh, and the mix up with the shortage of my meds by two weeks, that was because I was previously prescribed half a tablet and had been increased to one full tablet without the script being re-written. It was a simple breakdown of communication.