Course of Treatment: The Treatment Roller Coaster

Here’s the way psych treatment goes in the movies. You’re suffering through some serious shit when you get taken in hand by a quirky doctor with a love of life and some magic pills. Under the doctor’s tutelage you embrace life again, and the magic pills restore you to healthy mental state, where you live happily ever after with the love of your life. The end.

Ask anyone whose been in treatment for mental illness their opinion of this baloney. I dare you.

Let’s imagine just for a minute that you do find a quirky doctor who shakes you out of the hopelessness and self hatred that often come from years of living with mental illness. Let’s further imagine that this doctor manages, on the first try, to prescribe the perfect pill to cure your symptoms. Here’s what happens next:

  1. You and your doctor gradually experiment with dosage levels (weekly or monthly blood tests being very much a thing) while you find the right amount of medication to give you the maximum help without too many side effects
  2. You need to relearn to live life as a mentally functional human being.
  3. You need to rebuild relationships that were damaged by your mental illness and learn/re-learn how to have healthy relationships
  4. You need to watch out for and learn how to live with whatever side effects your new medication gives you.
  5. In 6 months or 2 years or 10 years, the medication stops being effective. You need to repeat steps 1 and 4, or find maybe find a completely new medication. (Here’s hoping your doctor can get a hole in one twice)

Now, keep in mind that even the best psych treatments on average a 30% success rate (success meaning “creates significant improvement”). All psych treatments (with the exception of as needed meds for panic attacks and the like) require time to take effect and establish whether they work or not. This applies to psych meds, talk therapy and he vast majority of alternative medicine approaches. You’re usually looking at about a month to figure out if a treatment is working at all.

I tapped someone with better math than I have to find out that given a 30% success rate, you are looking at two attempts, on average, to find a treatment that works. This means that even the most effective treatments it will take an average of two months to find a treatment that works. First off, that’s an average. Some people will get lucky and find something on the first try, some will take three or four or six tries.

Second, and more importantly, if the more effective treatments don’t work, you are looking at the less effective treatments, at trying combinations of treatments, at finding treatments that work, but come with side effects that are nearly as bad as the disease they treat, so you need to decide do you stay with what you know works, or try to find something else, that might not work as well, but won’t destroy your liver in the next ten years.

Some people spend over a decade trying one treatment after another, searching for something that works.

Polyamory and the Treatment Roller Coaster

Unsurprisingly the treatment roller coaster is stressful on relationships. The stress can be short term–the treatment you’ve been using stops working, you go to your doctor, up the dosage (either increased therapy sessions or larger pills or both), maybe trying a new treatment, get back under control, adjust to new side effects and schedule changes, and you are good to go.

Or the stress can be long term, trying a new medication every few months, and dealing with first withdrawal symptoms from the old med, then the adjustment period for the new med, then side effects of the new med, then finding the new med doesn’t work, and start over. Over and over again. One therapist or style of therapy isn’t helping, you seek out a new therapist, find one that is promising, but doesn’t click or you can’t build a rapport, or they do something that damages your trust, or their approach to therapy just doesn’t work for you, and you seek out a new therapist.

The stress ans strain on the person trying to get help will definitely reverberate through the polycule, but stress also lands directly on poly partners. The first psych med I tried left me feeling numb. I had energy. I wasn’t depressed or sad anymore. I just didn’t feel anything anymore. If I’d been dating anyone at the time, they probably would have thought I completely lost interest in them. I was more myself in the depths of depression than i was on this medication. One of the first anxiety meds I tried made me extremely irritable, snapping people’s heads off over nothing. These kinds of adverse affects are really hard on poly partners.

It’s even harder on a new relationship. You’re just starting to get to know one another, and suddenly your poly partner changes completely. Are they showing a side of themselves they’ve kept hidden until now? Is it a reaction to a new medication? Are they just stressed about that thing at work? How do you tell? And are you willing and able to stick around and find out?

A common side effect of some psych meds is reduced libido. This means the treatment roller coaster can also be the sexual roller coaster.

Speaking for myself, my hormones are whack jobs so I’m on a sexual roller coaster already, but (thank god) my roller coaster is pretty damn predictable. the effect of psych meds on libido…not so much. Having your (or your partner’s) libido drop through the floor when they start a new med, then skyrocket when they get off it, stay level for the next med, but drop again when the dosage increases….

And all of this doesn’t begin to take into account the hell of watching someone you love struggle to find something–anything!–that works while feeling helpless to make a difference. (Reminder: you’re not)