skylar taylor-barrickthey/we/y'all

A Journey to Medication

Anxiety is really frustrating. Things that I know are good for me - socializing, cooking at home, going on dates - feel impossible for reasons I can't really define. It's painfully irrational, causing spirals of self-loathing that can take days to get out of.

I've been in therapy two or three times now, and while each time has been helpful in various ways (my work with my current therapist being the most so) I haven't been able to overcome anxiety in every aspect of my life that I'd like. I have to spend a lot of time working myself up to daily tasks that most don't struggle with, and I'd like to reduce that activation energy so I can do more.

Over the years, I have tried a lot of psychiatric medication and never had a good experience. The downsides always overweighed and completely clouded any benefits. Here's some of the issues I've encountered while trying at least five medications over the years:

These experiences caused an aversion for medication in general, to the point I even stopped taking HRT for many years. I really regret that, as I've basically had to start my 'medical transition' over at an older age.

My new therapist introduced me to something called GeneSight testing, which is a genetic test that can provide indicators on what medications may work best for you. It took me a few sessions of being reminded about it, but eventually I talked to my doctor about it, and got the swab done. I didn't know it, but that was the easy part! Waiting for the results was tough.

I'd like to briefly detour for a rant about healthcare (and ultimately web design, somehow) now. It took five weeks from when the lab received my sample to getting my results. I called my doctor plenty asking for updates, and they assured me GeneSight can take this long - nothing was wrong. Eventually I got a bit desperate and decided to call GeneSight directly. I got an automated message: "The entire company is currently in an all-hands meeting and will be back later. Goodbye."

How bizarre! It took me a few days to work up the energy to call again, but this time I got through to someone. They informed me that they received the sample, but the paperwork was incomplete - no one had me sign the consent form needed, and the lab order form was completely missing. So many times I called and asked a nurse to look into why it was taking so long, and each time they assured me it was "in progress" and everything was normal.

I was able to do the consent form directly with GeneSight through DocuSign, which was great. The other form had to come from my doctor, so I called them to ask them to send it over. I couldn't help myself though - and had to ask why they had insisted it was just normal processing delay when it was explicitly on-hold with the lab. Surely they were notified?

When I mentioned earlier they said the order was "in progress", that information was coming from a web portal GeneSight provides to healthcare providers to follow up on samples and retrieve results when complete. That text was shown on an overview screen for all of the samples they had submitted, with no context or state indicated - no bold text or status light. When they clicked into the detail view? It showed the test was on hold, and the documents needed to release it. It was there the whole time.

I could've started medication an entire month sooner. I wouldn't have had to survive one of my darkest weeks ever. I lacked hope.

Because of some shitty UI?

Honestly, it was difficult for me not to be angry at my clinic's staff for not having paid more attention. But I think it's reasonable to assume "in progress" means that things are moving along normally. GeneSight probably should've reached out directly to the provider for the needed paperwork anyway, instead of relying on someone checking a portal. I got a SMS when they recieved the sample, why not tell me?

I guess it doesn't really matter, after all. I'm still here, thankfully, and it seems the worst has passed, for now at least. Starting medication was difficult, but with the help of Ondansetron to remove nausea, I'm feeling decent. Better than any other attempt at starting medication.

My partner and I can't help but keep saying that it seems that this should be the default course of treatment when a doctor thinks psychiatric medication is needed. Do the test, prescribe something it suggests. I've tried so many medications. Every drug I have tried was listed in either the 'Moderate Gene-Drug Interaction' or 'Severe Gene-Drug Interaction' column in the report. It's hard for me to understand how I hadn't heard of this sooner. How is it not immensely popular?

If I had gotten GeneSight five years ago when I first sought out mental healthcare in San Francisco, how different would my life have been? I was still working, maybe I wouldn't have burnt out? Maybe I could've kept us afloat financially and we wouldn't have had to leave. That would've been nice.

What if I had known anything at all about mental health in college, and hadn't been propagandized by my family and friends into believing it wasn't real? What if I had gotten treatment then? Dropping out of college is something I deeply regret. I was suffering through an un-diagnosed mental health condition, an un-diagnosed developmental disability, and such severely repressed trauma that I am only now starting to actually realize it even exists. I can't even blame myself. Can I blame anyone? Would it help?

It's so fucking hard thinking about what could've been. I feel like at so many points I did my part by seeking care, and was let down by this country's shit healthcare system. Even now, I'm having to put in administrative and research effort toward guiding my doctors. I'm nearly thirty years old and only really now figuring out basic things about who I am, how my brain functions, and ways to build a healthy life for myself and those I care for.

And yet, I have to try to shove all these feelings down and look forward, because ruminating is what got me here in the first place. I'm feeling pretty okay right now, all things considered! I've been doing more around the house, feeling more motivated. This is real progress, and it is better to make it now than never. That should be my focus.

It's only been a few weeks so far, but compared to the month before that? What a difference.

postscript:

I wrote the first half of this toward the end of July, before my mental health took a nosedive I hadn't experienced in a long time. I had no idea that my results would take so long, and that waiting would affect so severely. The entirety of August was a blur.

Feeling so close to some sort of answer and potential relief was miserable. I slipped into serious depression and stopped caring for myself or my home. I was counting on getting medication to get me out of it, which is not often successful. I really don't like taking pills (not that you could tell, as I take 10/day now) so this felt counter-intuitive to acknowledge.

I wasn't prepared to be in a place where I was begging for any amount of relief, even from something I don't like. It was humbling, in a way. That's a topic I'll write more about soon.

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Mental Health Neurodivergence Personal Life