I have been burdened with side effects since the day I took my first psychotropic medication some 13 years ago. At that time the medication I was on made it impossible for me to be awake, pretty much ever. I had no idea how much hell I was in for and my doctor didn't seem to believe me when I told him about it. So I did the responsible thing - I just kept taking the medication, hoped the treatment would work and that the side effects would go away. But that's mostly because I didn't know what I was doing. Today I know that severe side effects are something that we choose and are not something that is thrust upon us. We choose what we can live with, even tacitly, always have, always will.

Last week I wrote about how psych meds can make you feel boiling hot or freezing cold. And, of course, they can. What surprised me is the number of people who wrote in here and on Facebook about how they didn't know that. Not only did they not know it, but it had been happening to them and they didn't know it. They didn't make the connection and in some cases the doctor said it wasn't possible (like mine did). This brings me to something I always say: An effect that occurs after starting a medication is a side effect until proven otherwise.

Everyone who takes psychiatric medication is aware of side effects. Common side effects include things like dry mouth, headache, nausea, fatigue and so on. I've been a cluster of side effects longer than I can remember. (My very favourite is the one where I couldn't open my eyes in the morning and I thought I was blind. Ah, but for another day.) And one of the side effects I have had several times with medications, particularly antipsychotics, is temperature dysregulation. In other words I'm always freaking cold (or way too freaking hot).

I recently wrote about the myth that you can be "too smart" to have bipolar disorder. I wrote about the prejudicial and false thought that if we were "smart enough" we wouldn't have bipolar. This, of course, isn't remotely true. A couple of people requested more about bipolar disorder and intelligence. But I'm sorry to say, the truth is, people with bipolar disorder are actually cognitively impaired compared to the average individual.

Recently I switched from antipsychoticX (aX) to antipsychoticY (aY). I despise changing medications; however, this change was necessary due to the general lack of success of the previous cocktail. And in spite of the fact that given the tiny doses there shouldn’t have been any dramatic effects from this change, naturally, there were. A medication change is pretty much always pain on a stick (that hits you, a lot).

Antipsychotic medications were so named as they were initially used to treat psychosis in disorders like schizophrenia. Antipsychotics include medications like Haldol, Thorazine, Seroquel, Abilify and Zyprexa. These medications are now being used, more and more, in the treatment of other disorders like bipolar disorder and major depression. One of the major problems with these medications is a side effect called tardive dyskinesia. Tardive dyskinesia is a disorder involving involuntary muscle spasms and can be (but isn’t always) permanent – even if the medication is discontinued. How can you and your doctor look for the signs of tardive dyskinesia?

Some people believe that being crazy makes you creative (perhaps brilliant) and being creative makes you crazy. Similarly, along this line of logic is that taking medication makes you uncreative and perhaps, un-brilliant. Well, pish-tosh I say.

I’m a science gal. I practically drown in the stuff. True, I have a natural curiosity for pretty much everything, but also, I try to keep abreast of what’s happening in the research areas of mood disorders and psychopharmacology. Yes, it’s a lot of work. I certainly don’t catch everything, but one thing I did catch a while back was this, “Study Finds No Difference In Nonsuicide Mortality Between Two Anti-Psychotic Drugs.” Basically, neither Zyprexa nor Geodon will kill you more. But is that actually what the study showed?

As I mentioned last time, many doctors feel that antidepressants actually make bipolar disorder worse. Some specialists, in fact, will routinely take people with bipolar disorder off of antidepressants when the bipolar is doing well. Like I said, it’s a matter of perspective. And I get asked all the time about getting off of antidepressants and other medication. So, exactly how should you get off an antidepressant and what should you worry about when doing so?

While many people with bipolar disorder have and continue to be treated with antidepressants along with many other medications, there is a controversy in the medical community as to whether this is an appropriate approach. In bipolar disorder there is some risk of antidepressants inducing mania or perhaps worsening rapid-cycling. But is this true? What evidence is there that antidepressants work in bipolar disorder? What evidence is there that they will make bipolar disorder worse? What do you do if you can’t take an antidepressant?