Managing Emotional Instability: Navigating Depression and Medication Challenges

Emotional instability

I suffer from depression, and my medication treatment has not been effective.
I started taking antidepressants and antipsychotic medications in March of this year, and I have been on them for over six months.
The suicidal impulses still persist.
A few weeks ago, I switched doctors, and my new doctor advised me to stop the medication, citing many side effects and lack of efficacy.
He also mentioned that there is a risk of impulsivity associated with these medications for individuals under 24 years old, and suggested switching to psychotherapy.
Recently, I tried to stop taking the medication, but one day I suddenly felt an impulse that I couldn't control, and I ended up swallowing ten tablets of tranquilizers, which led to palpitations and a visit to the emergency room.
Previously, when I visited a clinic, the doctor would only prescribe a week's worth of medication because they were aware of my history of overdose.
Now that I am at a larger hospital, I can obtain a month's supply of medication.
I would like to ask how I should communicate my situation to my primary doctor during my next appointment.
Whenever I feel impulsive, I tend to take a large amount of medication, simply to stabilize my emotions.

Tang Tang, 20~29 year old female. Ask Date: 2016/11/23

Dr. Wu Enliang reply Psychiatry

Hello Tang Tang,
I suggest that you bring this letter to your next appointment to show it to your attending physician.
You have described everything in great detail.
Wishing you a speedy recovery.

Reply Date: 2016/11/23

More Info

Managing emotional instability, particularly in the context of depression and medication challenges, can be an incredibly complex and nuanced journey. Your experience reflects a common struggle faced by many individuals dealing with mental health issues, especially when it comes to finding the right balance between medication and therapy.

Firstly, it’s important to acknowledge that the feelings of impulsivity and the urge to self-medicate with higher doses of medication, like the incident where you took ten pills, are serious and should be addressed with your healthcare provider immediately. This behavior can be a sign of underlying distress and may indicate that your current treatment plan is not adequately addressing your needs.
When you return to your psychiatrist, it’s crucial to communicate openly and honestly about your experiences. Here are some points you might consider discussing:
1. Current Symptoms: Clearly describe your current emotional state, including any persistent feelings of depression, anxiety, or impulsivity. Be specific about how these feelings manifest in your daily life and how they affect your ability to function.

2. Medication Side Effects: Share your experiences with the medications you’ve been prescribed, including any side effects you’ve encountered. This information is vital for your doctor to understand how the medications are impacting you and whether adjustments are necessary.

3. Suicidal Thoughts and Impulsivity: It’s essential to be candid about any suicidal thoughts or impulses you’ve experienced, especially the recent incident of taking an overdose. This is a critical aspect of your mental health that requires immediate attention and may necessitate a reevaluation of your treatment plan.

4. Previous Treatment Experiences: Discuss your past experiences with medication and therapy, including what has or hasn’t worked for you. This context can help your doctor tailor a treatment plan that aligns more closely with your needs.

5. Desire for Stability: Express your desire for emotional stability and your willingness to explore different treatment options, whether that involves medication adjustments, therapy, or a combination of both.
6. Concerns About Medication: If you have concerns about the risks associated with taking certain medications at your age, such as impulsivity or other side effects, bring these up. Your doctor can provide insights into the benefits versus risks of continuing or changing your medication regimen.

7. Support Systems: If you have a support system in place, such as family or friends, mention this to your doctor. They can help you develop a plan that includes support from those around you, which can be crucial in managing your condition.

In addition to these points, it may be beneficial to consider the following strategies as you navigate your treatment:
- Therapeutic Alternatives: Since your doctor has suggested focusing on therapy, be open to exploring different therapeutic modalities. Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), or mindfulness-based approaches may provide you with tools to manage your emotions more effectively.

- Crisis Plan: Work with your healthcare provider to develop a crisis plan that outlines steps to take when you feel overwhelmed or impulsive. This plan can include emergency contacts, coping strategies, and safe environments.

- Journaling: Keeping a journal of your thoughts and feelings can help you identify triggers for your impulsivity and provide a safe outlet for expressing your emotions.

- Mindfulness and Relaxation Techniques: Incorporating mindfulness practices, such as meditation or deep breathing exercises, can help you manage anxiety and emotional instability.

- Regular Follow-Ups: Ensure that you have regular follow-up appointments with your psychiatrist to monitor your progress and make necessary adjustments to your treatment plan.

Remember, managing depression and emotional instability is often a process of trial and error. It’s important to be patient with yourself and to seek help when needed. You are not alone in this journey, and with the right support and treatment, it is possible to find a path toward greater emotional stability and well-being.

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