Meds and DID?

Sorry to be creating so many new topics, but I am new to this (potential) diagnosis and also have a lot going on right now that I need to sort out.

I have never been on meds in my life. I barely even take OTC meds unless I REALLY need them. I'm sensitive to meds of all kinds, so much so that I had to go off BCP when starting therapy, because the increase in mood swings made it unsafe...and during labor, they overdid my epidural (once I finally caved in to having it 14 hours in) to the point where I couldn't even take a step for 20 hours. I am scared to death to go on meds...but, my husband has a business trip abroad next month, I have a young daughter and there are a lot of spells of very unsafe thoughts that have been disturbing to both me and my therapist. So, we agreed I would call a psychiatrist that works out of his office and is on my HMO (my therapist is not and I can't afford any more out of pocket costs). The therapist took nearly a week to call me back. I almost didn't share the dissociation stuff, but I didn't know if that would be dangerous, so when he asked about therapy and symptoms, I mentioned dissociation and when he asked me to elaborate, I told him that my therapist and I were working with a possible DID diagnosis and that my symptoms were on "that end" of the spectrum. He asked a couple of clarifying questions and then told me he couldn't help, that I need a psychiatrist that also specializes in dissociative disorders. All sorts of internal reaction to that as us being unhelpable, a freak, he thinks we're lying, we're a liability, we're "too much work," being rejected...blah. He even mentioned asking HMO about psychiatrists who focus on psychosis (so he probably thinks schizophrenia, which I know it isn't, as I have a friend who was diagnosed schizophrenic 10-years-ago and that is definitely not the same). Anyway, so I called my HMO to see if they had anyone and they said that I should just find anyone I could in my area and ask for a single case exemption. So, here are my questions:

1) I've heard different alters can respond to meds differently. Is that a really big problem? So much so that I couldn't just go to my GP and ask for something without mentioning dissociation?

2) Parts are like, "F--- it!" about the meds, because we didn't want to go on them in the first place and our therapist won't make us. Some think it will annihilate them or mute them a bit and then we won't be us anymore. Like, when I quarantined my younger parts to get by in my life for several years, I couldn't do my creative writing anymore. I "lost" that ability by shutting them down. So, there is a lot of fear that certain aspects of our "me-ness" will get lost. I've also heard that meds don't really help with dissociation, so it shouldn't change us, right?

3) Should I just forget about it and try to work through it without meds (which my husband and I are both more comfortable with, but I also have to prioritize my safety above my comfort, I know)?

4) How do I go about locating a psychiatrist in my area with experience in dissociative disorders?

1) Yes, different alters will respond differently to meds, but how big a problem that is depends on the system. For my system, it's manageable (we were put on a few different things for other things before I found out that alters can respond differently).

2) At worst, this sounds like it's a temporary plan. Meds can't make alters go away - even if some of them feel effects they don't like, when your partner is back or you are all more stable, every alter will still be there.

3) I think that's one you need to talk about with your therapist and husband. They and you know what the dangers are of you being on them vs off them.

4) Your therapist may be able to find someone who specialises for you, or you can search online for psychs in your area and see if they have any experience or knowledge of dissociation.

Could your therapist say to that psych you've already spoken to "this is the problem, this is what I want yakusoko on"?

1) Different alters can respond to meds differently. I have an alter in my system that is completely unaffected by my meds. Needless to say while we were all sleeping from the sleeping meds she was out and about having fun. No wonder I was still so tired!

2) Meds don't stop switching. Anti-anxiety meds might calm the system down and make them less reactive, but switching and your alters are not something that are suppressed by medication. I've found that only anti-anxiety and a gentle anti-depression show any benefit for me, I've been on loads of different classes of medications. They won't be going anywhere don't worry.

3) If medicine makes your day a little easier to cope with while you're working through your trauma okay. But if you're having bad side effects or it stops your progress altogether it's given that it's a no. If you can handle it without the meds that's up to you. It may or may not be harder, the meds may actually give no benefit. It's up to you to figure that out. As my boyfriend likes to say "There are no medals for making life harder for yourself".

4) Maybe get your therapist or GP to ask around and find one that is experienced with DID.

I am on several psych meds, and they help my depression and suicidal ideation, they don't do anything for dissociation whatsover. That's Cymbalta, Lamictal, and Seroquel and I am neither bipolar or psychotic (DID, PTSD, MDD)- it's just taken a lot for my depression to get (somewhat better). I don't like being on all this medication however desperate times call for desperate measures I suppose. For the record my cognition is better than ever and any deficits they gave me (if any) certainly aren't with me any more. I know other people don't have the same response though. Seroquel also helps my anxiety a lot (I'm on a ton though, 400mg and I have 50mg ones to use as needed like a benzo like xanax or ativan might normally be).


After three years of med combos and severe suicidal ideation and occasional self harm behavior, this combo is really starting to help me. But again, not with dissociation. The only thing it may help with is suicidal ideation across all alters, because it all pretty much got better at the same time. Other than that I am not aware of an good or bad reaction from other parts of myself.

So, first psychiatrist said I needed a specialist in dissociation.

Second one was a specialist, but said he only sees patients for psychotherapy and if I want to keep my therapist, I can't see him for just meds.

Haven't been able to find a third one that specializes in it and don't want to start cold-calling psychiatrists just to be told no repeatedly and stir up rejection with the kiddos, who get very triggered when "no one will help us" help ourselves. So, anyone have a good resource to look up psychiatrists that do dissociation? The ISST-D seems only to list therapists.

yakusoku wrote:1) I've heard different alters can respond to meds differently. Is that a really big problem? So much so that I couldn't just go to my GP and ask for something without mentioning dissociation?

It depends on your system... It can be a really big problem... You definitely need to mention the dissociation. Otherwise there might be more problems with the meds than solutions. It's very important to mention the dissociation so that it can be monitored how all of the personalities are responding to the meds, to make sure the meds are helping and not making some personalities more ill...

yakusoku wrote:2) Parts are like, "F--- it!" about the meds, because we didn't want to go on them in the first place and our therapist won't make us. Some think it will annihilate them or mute them a bit and then we won't be us anymore. Like, when I quarantined my younger parts to get by in my life for several years, I couldn't do my creative writing anymore. I "lost" that ability by shutting them down. So, there is a lot of fear that certain aspects of our "me-ness" will get lost. I've also heard that meds don't really help with dissociation, so it shouldn't change us, right?

No you won't lose any of your "me-ness". The meds may make it harder for some parts to switch out but they won't have been annihilated or anything. You will still be yourselves...

yakusoku wrote:3) Should I just forget about it and try to work through it without meds (which my husband and I are both more comfortable with, but I also have to prioritize my safety above my comfort, I know)?

Safety first...

yakusoku wrote:4) How do I go about locating a psychiatrist in my area with experience in dissociative disorders?

Hmmm.... I was going to suggest the ISST-D but I see you've tried that... Could you perhaps go to your GP tell them about your situation and get the GP to call around psychiatrists until finding a suitable one? In Australia, people always go to their doctor to get a referral for a specialist...

Thanks for the input. I send a message to my GP. Just was kind of hesitant to have it be part of my medical record...I don't know why.

I don't have too much full-switching as far as I know (lots of minor blank periods, I guess, but not a lot of evidence of me doing stuff I wouldn't have done without "witnessing" it), so switching becoming more difficult not my major concern, unless it impedes therapy.

Yakusoku, if you do try medication then I think you do need to be working with a psychiatrist who understands dissociation and psychosis. That is because the medication target is not you, the host, but your alters who are having problems. These problems may include psychosis. You need a psychiatrist who will work together with your regular therapist. You need a psychiatrist (a kind of MD) because only an MD can prescribe these medications. Your therapist should be making calls to find someone who fits the bill.

Thanks for your input, Una+.

I have been keeping my therapist up-to-date with what a hard time I am having finding anyone (including discussing it with him yesterday) and he didn't volunteer to help, just said we could back off for now if it's getting too stressful for me...so I'm guessing he's probably as clueless as I am when it comes to how to find someone (especially since he lives and works a few hours away Wednesday through Friday and is only in my area Monday and Tuesday. My therapist has had one DID client and knows a lot about dissociation, but he's not a specialist or expert or anything. I think I am definitely his most "demanding" client, in that way, at present. Maybe I should call a therapist who specializes in dissociative disorders (there are a couple on my HMO) and ask them if they have a psychiatrist they usually work with? I feel so alone in this. Husband is not helping me. Therapist is not helping me. Insurance company isn't helping me. The psychiatrists I have contacted aren't interested in referring me. We'll see what my GP says. I'm kind of at a loss. I know it's "my job" to work this stuff out, but I am feeling kind of lost and just want to give up at this point.

In my family I am the one in charge of all medical decisions. Sometimes I want to be taken care of by someone else, like I take care of them, but that's not how it works.