Mental Health, Medication and Me: The Journey to an Answer

My decade long battle to find a treatment that worked.

Written by Mirna Ismail Grlj

01 Mirna has lived with OCD and anxiety since childhood. Her obsessions have spanned a wide range of themes — sexuality, violence, relationships, self-image, etc.

02 For a decade, she lived with side effects from medication that made her experience manic episodes. No doctor could give her an answer.

03 Eventually, it was discovered that she is a slow metabolizer of drugs, and that she needed to be on a compounded, lower dose. She wants others to know that if they think something is wrong, they should push for an answer and not stop until they get one.

My obsessions ranged from reoccurring images of horror movies, to sexual images, violent images, relationship obsessions and self image obsessions.

Eventually I couldn't deal with it anymore. I needed answers. I switched from one general practitioner to another, psychologist to psychologist, trying to find out what on earth was happening to me. But no one, I mean no one, had an answer.

I didn't understand how this was possible. Yes, the medication helped with my anxiety, but where had these highs and lows come from? How did no one know?

I suffered for ten years without an answer. But I was stubborn and keen enough to not give up. I continued questioning doctors, until one day, my general practitioner referred me to a second psychiatrist. I thought "great, another doc." I'll keep going around in circles. But I was wrong.

At my first appointment with this new doctor I got an answer. Finally. After years and years of these episodes, he said he thought I was a slow metabolizer. Changing from medication to medication wasn't the answer. Instead, I need to stay on my current and get it compounded. The lowest dose this particular medication comes in is 30mg, and for someone who might be a slow metabolizer of drugs, even that can be too high, leading to intense side effects.

So we agreed to compounded 5mg capsules. At first, I needed to slowly wean myself off of the higher dose until those nasty side effects disappeared. I went from 30mg to 25mg and stayed on that for a month. I immediately noticed a decrease in my episodes. Then I dropped to 20mg. The side effects were basically gone!

My episodes were spaced out to every couple of months, rather than a few times a week. I was elated. Every time I saw my new doctor, I wanted to cry and hug him. What a miracle! Ten years of suffering with no answers, seeing every psychiatrist I could find. And then this. I went back to my general practitioner, filled him in on the situation and asked why nobody else had been able to figure this out. Apparently it's rare, so it hadn't crossed their minds. It was crazy to me that an extremely small dose that would normally be given to children, was a full dose for me. Eventually we added another compounded medication to the mix, and once again, at .3mg its impact was huge. Enough to put me to sleep at night and get some rest from my after hours thoughts. All in all, a rare and confusing situation, but one that I'm so happy was eventually solved.

What I want other people out there, especially those suffering from OCD, to know is that they should never give up. Keep looking for answers. Push if you have to. I was overlooked and unconsidered for years until I finally found a medication made specifically for me and my metabolic rate.

I hope my story sheds some light for those in similar situations. While rare, there are likely others out there in the same boat. I know how lonely it can get when it feels like no one understands. Finding a treatment that works for you is so important. There is no shame in taking medication for mental health, just like there is no shame in medication for physical health.

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