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kevbo's avatar

How do I better cope with and manage my chronic illness, a consequence of which is addict-like thinking?

Asked by kevbo (24307 points ) October 13th, 2009 from iPhone

I’ve had zero thyroid function for almost 20 years. Treatment for hypothyroidism is relatively simple—taking a dose of synthetic thyroid hormone on a daily basis. This is coupled with annual checkups and bloodwork to adjust dosing as needed. My dose has been about the same this whole time. It is a relatively high dose due to my thyroid’s complete lack of function. The dose is supposed to be taken in the morning on an empty stomach an hour prior to eating. Simple, right?

I have probably never in my life gone more than three months following this routine, and I would bet much shorter. As a result, my mood, ability to think, outlook, energy, etc., take regular nosedives into the garbage can. My head gets foggy and hurts. I can’t think. Most everything becomes meaningless, and it puts a strain on my relationships. Despite having above average intelligence and academic achievement, this problem has really suffocated any career aspirations I might have had not to mention just making a plain old working life difficult.

So on one side of the equation is the very obvious suffering I endure by neglecting to follow the simple regimen. It is as predictable and reliable as anything. If I don’t take the pill, I suffer and that suffering gets progressively worse until I die of natural (but preventable) causes or blow my brains out.

On the other side are a mélange of factors that add up to me deprioritizing the need to follow the regimen. Most relevant is my resentment. I resent having to buy it, and I resent having to take it. I resent that I literally cannot live without it, and I resent that it’s supposed to be my first waking concern. You might say “what’s the big deal just take the damn thing and move on.” I don’t know how to adopt that perspective. I think “I’m a slave to this fucking pill, and I don’t want to be dependent upon it.” This is probably exacerbated by my “altered” state of mind which is really my natural state of mind. So that’s another conundrum—a natural, medicine-free kevbo is a miserable sop and a submissive and compliant kevbo gets to be a “normal” person.

I am also really bad with routines (such as taking care of this business first thing every morning), which I also deep down resent and deem “unnatural” although I do recognize their utility. I’m sure it’s partly to do with my creative bent.

So the reality seems to be that I need follow the routine (or push my doctor for some other routine that will work for me, although I’ve never heard of one). How then do I overcome the resentment and prevent it from eclipsing my perceived need to take the pill, especially when it’s easy to fall into the trap of “I’m feeling fine now, so I’ll stop taking it.”

If you are puzzled by the addiction tie-in, it’s that my “own best thinking” is not working for me in this situation.

Being made to feel fortunate that this is my only problem or that I am blessed with some wonderful qualities doesn’t help resolve this problem for me.

Thank you for your responses.

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22 Answers

nikipedia's avatar

Are there any drug delivery systems that operate continuously, so you don’t have to take the pill every day? Like getting a depo shot instead of taking a daily birth control pill?

kevbo's avatar

Idk but will look into it.

trailsillustrated's avatar

you need to tell the dr. that treats you for this everything you have just told us. He will probably refer to some sort of therapy. You need to call the urgent number and talk to your health care provider now. Messing with your thyroid, as you know, is really hard on your other organs.

dpworkin's avatar

Quit fucking around and talk to a cognitive-behavioral therapist so you can dispense with the maladaptive behavior and figure it all out later when you are taking your meds every day.

kevbo's avatar

@pdworkin, I have done exactly that in the past, and that was more effective. I’m a couple of steps removed from access to care at present, but your suggestion is a correct one.

dpworkin's avatar

Every county has a mental health clinic. What removes you from access to care? I think that’s just more self sabotage, especially if you know I’m right.

RedPowerLady's avatar

Is there a way to couple the routine of taking the pill with a more enjoyable routine?

For example a spiritual person may believe that taking water and saying a prayer in the morning is very important. They sincerely enjoy doing this. So they take their pill with the water and it is a non-chore. Could you create something like this for yourself?

To deal with the resentment I also suggest a therapist. There are therapists that assist the entire range of income levels so it should not be too difficult to access. Other than that it could be very helpful, although quite annoying, to write these feelings down. I would call it ‘journaling’ but I sincerely hate that word.

Another option is to provide yourself with a home-care worker. You could ask the state to pay if you are low-income (i know many people who have this). Or if you don’t qualify as low-income you could just pay someone yourself for an hour a day. Their primary job would be to come and give you the pill in the morning and make sure you take it. Since you pay for an hour they could also say do the dishes while they are there or perhaps something more health-related. Or perhaps they’d enjoy getting paid for an hour when it is really a five minute job.

markyy's avatar

I noticed one sentence standing out from the crowd: I think “I’m a slave to this fucking pill, and I don’t want to be dependent upon it.”

You say that you don’t want to be dependant on the pills but your actions imply otherwise. By not taking the pill you are reminded of the consequences day in and out. You’re condition becomes an issue in your daily life. You allow yourself to spiral down into this way of thinking. sounds to me as if you are not addicted to the pill but addicted to staying the miserable sop Kevbo.

kevbo's avatar

@RedPowerLady, your first suggestion is something I never considered and right up my alley. Thank you.

kevbo's avatar

@markyy, if my description wasn’t clear, your point is more or less what I meant. I would say being miserable in this way has represented a level of normality for me (that is a long time in the making and the result of some ignorance in taking care of this problem). The solution to that, of course, is some degree of therapy as has been mentioned.

RedPowerLady's avatar

@kevbo you are quite welcome :)

marinelife's avatar

When I was first diagnosed as hypothyroid and given medication, I was not told nor did the prescription say that it had to be taken on an empty stomach. So I never did.

When I did learn about that some years later (new pharmacist), I had the same problem you did. Taking a pill first thing in the morning was not intuitive for me, often I forgot, other times I resented I had to fast afterward.

I finally got better follow-through by moving my pill to night. If I have not eaten within the requisite time, I take it right before bed. If I had a snack, I put the pill and a water glass on the bedside table. When I wake up in the night, I pop the pill, and then go back to sleep.

kevbo's avatar

@Marina, good suggestion. I’ve tried the bedside routine, and the bottle inevitably migrates somewhere else. Time to try again.

lloydbird's avatar

Magnesium Chloride (transdermal) is strongly reputed to be of benefit to the conditions that you describe. There is a very good article by Barbara Bourke with Walter Last, on the subject called :- Magnesium Chloride for Health and Rejuvenation.
Hope it helps and get well soon.

srtlhill's avatar

I agree with Marina and use that method for my medicine. I put extra pills near my bed so that I don’t have to get out of the bed searching for them at nite. The funny thing is I’m usually waking up at about the same time every morning so it has become a habit, and I haven’t eaten.
Thank you for all your past helpful answers to questions and I am sure you will find a solution to this ass ache. Good luck and continue to remain strong.

augustlan's avatar

Oh Kev, I feel your pain. I’ve been taking synthetic thyroid hormone for 25 years, since I was 17 years old. I’ve gone through what you’re describing several times, and I think the real problem was depression. I’ve even toyed with the idea of suicide by non-compliance with my meds! It’s fucking ridiculous.

Ironically, what finally made the difference for me was accepting that I’d have to be on anti-anxiety drugs for the rest of my life. An even harder nut to swallow. Once I got over that hurdle and completely accepted that fact, I’ve not had a problem since. I take all my morning meds together, and all my evening meds together. I do still forget to refill them until it’s absolutely imperative that I do so. I haven’t figured that one out, yet.

kevbo's avatar

@augustlan, as much as I don’t want to hear about someone else dealing with this, it helps to know I’m not the only one who gets caught in the circled reasoning. I’m looking for that kind of revelation to settle the internal debate for myself.

wildpotato's avatar

Do you breathe? And eat food and drink water? Then you are already dependent on stuff that is not you for your continued existence.

You will probably not like it, but I have the suspicion that augustlan is right on the money about the anti-anxiety drugs thing. The depression/mood changes caused by the lack of thyroid function may be affecting your ability to be OK with taking your thyroid medicine. My mom had half her thyroid removed a few years ago, and started on the thyroid medicine as well as some mood regulators. Suddenly she’s not a screaming bitch most of the time. It’s awesome. It’s really interesting how taking certain pills can alter your perspective on taking pills as a practice.

kevbo's avatar

@wildpotato, for the sake of argument, food, water and air are universal requirements that are universally provided (even at that, I have had problems, uh… “digesting” that need). And I could probably do a lot of things to make myself more convenient to other people, but obviously that’s not a compelling enough reason to change. As much as anyone can sympathize with your perspective, hopefully your mom has other motivations as well.

wundayatta's avatar

Sounds to me like you have not finished your grieving process regarding your alien nature. By alien, I mean you are not like almost every other human being because few other humans share this problem. You, as human, have died, and you, as alien, remain. It’s a death that requires mourning, but you seem stuck in the anger/denial phase of grief.

I don’t know much about the stages of grief, other than there are stages that have been popularized. It seems like a reasonably common pattern of behavior, though.

So the question is how do you get through the bargaining and other phases of grief to come to acceptance. I suspect that once you do that, taking the pills won’t be nearly as much of a problem. Right now, though, you rebel against it, because it is an every day reminder that you are not human. Which sucks.

Totally.

I’m not human, either. Every other schmuck in the world has to worry about preventing pregnancy if they don’t want it. For them, procreating is as easy as falling off the proverbial log. Me? Fuggedaboutit! I don’t have the plumbing I need. I’ve got the equipment, but not the plumbing. I was born that way. It’s actually a symptom of a mild form of cystic fibrosis.

Anyway, it separates me from the rest of humanity, and it sucked to find out about. I had to mourn the death of all the children I would never have. I could no longer feel like I was a member of the human race.

Eventually, I got through it. What helped was working on the problem and finding ways around it.

As far as I can tell, you do have a work-around. What you haven’t yet done is come to an inner peace with the way you are different from most of the rest of humanity. It seems so unfair. How come you have to take a pill every day in order to live, and others don’t?

Well, if that’s your subconscious thinking, you need to let your subconscious know that millions upon millions of people can’t survive another day without one pill or another. You’re not all that fucking unique, I hate to tell you. I’m sure you know this.

So then the issue becomes why do you hold yourself separate from humankind? Why do you maintain this difference? It seems to enable you to feel angry, and to give you an excuse for self-destructive behavior. Low self-esteem? Duh!

Ok, so here’s my mindlessness advice. Stop me if you’ve heard this before. Maybe CBT doesn’t work for you. You can’t control your thinking on this. If that’s the case, then give up. Just stop trying to not feel what you feel. Instead, you can try to distance yourself from your idea that your thoughts about your feelings are so fucking important.

Your thoughts are just thoughts. They really don’t change who you are in any noticeable way. You don’t have to be so attached to your thoughts about who you are. I mean, when you think about it, isn’t kind of ridiculous to be so self-destructive? If it weren’t so pathetic, you’d probably laugh at yourself. Right?

Naw. This is just like a dog chewing the same bone for years. Give it up, already. You don’t have to suck that bone any more. You’ve got other things to do, I’m sure. Focus on what’s in front of you, and these distractions won’t seem so distracting. And that’s all it really is: a distraction. Your anger about being different is just distracting you from life. In fact, it could well kill you.

I guess I’d try to figure out why lamenting the unfairness and wrongness of your situation is something you are so attached to. Although, the reason hardly matters. You can change your behavior without knowing why you behave the way you do. Just do your best to ignore your self-destructive impulses, and focus on what you really want to do. When the self-destruction becomes less of a focus, and less important in your life, it will be a hell of a lot easier to just take your meds. No fuss. No big deal. Just something you do, like getting out of bed each day. Or taking a crap.

You’re kind of constipated, if we follow that metaphor. So take some kind of enema, release what you’re holding onto, and get on with life. Just fucking do it!

galileogirl's avatar

@daloon has it right. I have several conditions that require medication and specific behavior. I know that failure to follow my regimen could cause greater disability and early death. Still every once in a while I “forget”. or “get too busy” or do things I know I shouldn’t “just one time”. It’s really a form of rebellion against being told what to do. We just have to recognize what we’re doing and deal with it.

captainshalfunit's avatar

Oh kev, I do feel for you. I was diagnosed with a disease, lupus, 41 yrs ago. I was given 5 yrs to live. But I’m still here. I remember refusing to take my meds when I still lived at home (I was only 15 when diagnosed) and my poor, dear Mom was beside herself that I would die. I started feeling horrible, it scared me and went back on my meds.

Its not fair that some of us have to deal with chronic illnesses and take meds. It sucks. I hate it. But when I don’t take it, I feel horrible which effects what I can do, which effects my home life, my relationship with my friends, etc. If you can’t take the med for you, take it for those who love you. I took (take) and this is silly, my meds for my dogs because they need me and no one can take care of them like I do. I also have a hubby and daughter, 28, who love me and need me. My friends would miss me. I have thought of suicide either by not taking my meds or taking pills. But I can’t because of the above reasons. I know you have people who love you and are heartbroken over your behavior. So do it for them. Maybe that would help your frame of mind! I sincerely hope some of the above helps you without being condenscinding or patronizing.

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