At the Crossroads of Life and Death

May is National Mental Health Awareness month. I meant to have a blog post announcing this at the beginning of the month, since this is supposed to be one of my primary themes. Ironically, I've been sidelined by issues related to - you guessed it - my mental health.

I have been diagnosed not once, not twice, but three separate times by completely independent psychiatrists with Type II Bipolar Effective Disorder. I highlight this fact to illustrate how badly I wanted someone to say I had been misdiagnosed, that they had made a mistake and that, maybe, I just have a few issues that can be worked out in therapy.

Instead, the collective expertise of these mental health professionals guided me towards a regimen of medications that do an excellent job of controlling my symptoms. These past few years have been the happiest and most fulfilling in my life.

There is only one problem.

One of the medications I'm taking appears to be slowly killing me.

Seroquel (also known by the generic name of quetiapine fumarate) has been proven to be highly effective in controlling symptoms of people diagnosed with bipolar and schizophrenia. Unfortunately, like so many anti-psychotic medications, it has a long list of side-effects. Some of these side effects are pretty horrible if you are among the unlucky individuals to have them.

Since starting this medication, I've experienced incessant weight gain, developed hypertension and - just confirmed by my last check-up - impaired kidney function that is expected to get worse unless I stop taking the drug.

I've been on medication for my bipolar close to five years. Not a month goes by without me pondering going off my medications. Each time I've raised this possibility with my psychiatrist, she has strongly discouraged me from doing so. Before the impact on my physical health began to manifest, while I may have toyed with the thought of going off of my medications, the peace I enjoy on them made my decision a no-brainer.

Now I'm faced with the choice of having heart disease and possible kidney failure versus being mentally healthy. Sadly, the dilemma I face is all too common among individuals trying to control the symptoms of their illness.

So many people have to choose between symptoms that are well managed and stopping the toll the drugs are taking on their bodies. When it comes to controlling the symptoms of mental illness, our medical knowledge is still in the dark ages. Doctors will tell you no one really knows how these drugs actually work. They were discovered to be effective treating certain symptoms through the process of trial and error, not an intimate understanding of brain chemistry. The intricate mechanisms of the brain are still largely a mystery. At this point, there is no precision laser surgery, vaccine, targeted gene therapy, or mental illness sniffing dog that can detect and treat bipolar, only clumsy blunt instruments used to whack away at the symptoms.

Today is Monday. This morning, I will call my psychiatrist's office to schedule an appointment. I will insist she start me on a prescription schedule that weans me off my medications. I am about to do the very thing I have repeatedly advised others not to do who have sought out my advice in the confines of an online bipolar support group I started some years ago. I'm sure she'll recommend alternative drugs - but my mind is made up. My plan is to commit to weekly talk therapy, continue my low-glycemic diet with exercise, and reliance on the observations of friends and family to maintain my self-awareness regarding symptoms. I will also rely on my own transparency to inform others about my struggles, trusting their support will guide me through the rough patches.

I'll be honest. I am scared. My fear is rooted in the knowledge of what I am capable of if I return to the "before" state of mind: the obsessive thoughts, the uncontrolled fits of rage, the soaring euphoria, the risky addictive behaviors, the passive death wish, the memory of my wife threatening to leave me unless I get help.

Scary stuff indeed.

I am encouraged by the fact that, after much discussion, Jackie stands with me in this decision. I find it humorous that this time next year, she will graduate with her Master of Social Work degree. In her professional life that follows, she will no doubt be dealing with people who struggle with similar issues. How blessed I am to have her at my side as we begin this new phase of our journey. I only hope she isn't burned out by facing the same drama at home as she does at work.

I stand now at the crossroads between life and death. I pray I haven't confused one direction with the other.

7 Responses

  1. That's a very tough spot to be in, Brent. Thanks for sharing your thinking behind this decision and plan for next steps. As you said, I'm sure others are struggling with (or watching their loved one struggle with) the same dilemma and can benefit from hearing your story.
    • Brent Watkins Brent Watkins
      I hope so. That's the goal of this blog anyway. Thanks Courtney.
  2. Since I was prescribed medication for depression and GAD 10 years ago I have learned many coping skills which have helped me mange my mental illness and therefore I need less medication. You can do this, too. I have two suggestions 1) go to in-person peer groups. Mental Health of America has groups for Bi-polar. 2) Take a W.R.A.P. class. It will be helpful to both you and your wife.
    • For more info on W.R.A.P. go to
    • Brent Watkins Brent Watkins
      Thanks for the tip. I have an excellent mental health counselor that I haven't been seeing much since the medication was so effective, so as I mentioned in my post, I'll be seeing him much more regularly. However, one component therapy can't address is the fact that without the Seroquel, I can hardly sleep. I will try a sleep aid, but many people tell me ordinary medications for sleep don't work very well for people who have bipolar. With Seroquel, I sleep like a baby. That benefit alone is almost worth the health risks.
  3. I can't begin to imagine how difficult it had to be to come to this decision. I am scared for you, for you all, but also know you're doing this with awareness that it may go bad - and hopefully with a willingness to pull back, if needed. I've been on anxiety meds for close to 10 years now, and the one time I thought I could take myself off them my withdrawal manifested into symptoms mimicking MS. I made the easy decision to go back on them - but my meds weren't trying to kill me. Good luck to you in this part of the journey, Brent.
    • Brent Watkins Brent Watkins
      Thanks so much for your encouragement Molly. There's some good news that warrants an update, I suppose. They re-tested me Monday to confirm the initial test results. I just got word the second tests showed my kidney levels to be what they were prior to last week's test. Elevated - but not alarmingly elevated. I was looking for any excuse to stay the course and this is it. I'm going to kick the can down the road a bit and hope for the best.

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