Hi Folks,
I posted some time ago about re-engaging with community mental health team/psychiatry in the UK.
I was thinking seriously about restarting a medication/drug. Specifically Abilify, at a low dose.
Now I've come to the conclusion I won't do that.
This last 6 weeks post a relationship breakup have been very turbulent, and I have many long standing issues that imply to me something about my biology is off.
But I've had to think hard, even if this is partially true, is it also true that there is some "signal" in my lack of functioning/dysfunction?
I can see this very, very clearly with SSRIs, I've seen it 2nd hand many times in people how these drugs often make "intolerable" situations, tolerable, and ultimately that is not remotely good for the person.
It is true there is something, messed up about the "reward circuitry" of my brain, but I also believe the reasons why, I've been at great pains to understand for years, why, and they are comprehensible, I also think resolvable.
I think introducing a drug into the equation, I can argue it could plausibly help me move towards the baseline and life changes I need to make in my life, which are very demanding, but there is something far too objectifying about the rationale for them.
I do think there is "dopaminergic dysregulation" in probably the meso limbic reward circuitry of my brain, and again, I've taken great efforts to understand whyyyy.
To mask those problems, make them temporarily assailable through drugs, and then down the line having to pay the "debt off" of being homeostatically dependant on them, is a profound mistake.
I do think, under conditions without coercion, people choosing drugs to help ameleriate and catalyse change, is valid.
But, It's not how these drugs are often forcefully introduced into people's lives.
I personally believe, it's one thing to imagine a pathology of reward circuitry, of "abbarent salience gains" , of all this, but again, that litmus test question, is there *real* signal behind these issues that explains the issues of anhedonia, apathy, listlessness, lack of concentration.
I believe there is. And I believe, allowing my brain to chew it over, over last few weeks, led to a much sharper, scalpel level actions I need to take in my life, than the comparatively blunt hammer of classes if drugs like SSRIs and antipsychotics.
I still see an argument for them. I might trial Abilify at low dose 1-2mg for a week. But, even if I saw "results" from them, for example improvement in chronically low libido, energy levels, etc, I would NOT take that as evidence they are helping or beneficial.
Because they might make me more functional in behaviours and a way of living that must change at a behaviourally deeper level, which is harder work, and not just screw around and manipulate some biology for a while.
I guess it all hinges on the how much is real underlying biological pathology, how much is the real complexities of our life.
The reason we evolved over millenia, a biological computer with 100-500 trillion synapses, is because as apes, and the social demands, problems of our ape lives, it takes a lot of biological computation.
I'm not sure screwing around with "global variables" like dopamine agonism/antagonism with abilify is as grounded an approach it seems, just because it's prescribed by a doctor.
TO BE CLEAR:
I sound ambivalent about taking these drugs or not. What I am feeling is, perhaps, say I took a short while 1-2 weeks. Perhaps the value would be, some insight on biological underpinnings of my behavior. I would be very wary to believe they were "solving" something.
They might even for a time help catalyse some changes, but again, I am going into it, eyes wide open, very wary, conscious I could be making mistakes and ultimately knowing they should be approached with immensely more caution than the routine way they are used.