Mental Health

I'll assume you mean antidepressants when you say "psych med journey".

I've been on many different medications over the years, and I've come to realize that these medications do not actually normalize you. They only shift the window. They do not suddenly make you feel better. They make the highs marginally higher and slightly more frequent while making the lows moderately less worse and significantly less frequent.

If you find that you are unhappy less often then they are working as intended. Whether you are happy more frequently is only a cherry on top. With that said, you should talk to your psychiatrist or psychologist if you still have concerns. These are good questions to have and you should share them with your doctor.

Hey, this sounds like me in my 20s:

I do NOT have bipolar disorder. I do NOT have chronic low mood. I do NOT have lack of emotions. I do NOT have PTSD. I have periods of extreme, unbearable intensity with periods of normal in between. I have relational trauma. Since my issues are intermittent, I cannot for the life of me tell if I am ever helped by anything.

Which lead me to decades of drinking and smoking weed. Diagnosis-wise, my therapist landed on CPTSD. Which isn't recognized in the US. it's (apologies if this offends any folks diagnosed with CPTSD out there) kind of a catch all for folks whose situation could be described as you've described here. Think of it like the IBS of mental health diagnoses. Anyways, the diagnosis doesn't help much.

I am currently in an intensive DBT program. While it has been a lifesaver when I have "simple" problems, it does not touch the intense pain of others.

Are the intense pains the relational trauma you alluded to? Bc that's normal. Not fun, but normal. I won't praddle on and assume a bunch here, but usually deep hurt leads to maladaptive coping mechanisms which kind of regularly create the "simple" problems. Leaves you feeling stuck.

How can I figure this out?

So, there is no magic pill. There might be a better antidepressant. There might not be. I've been on several over the last decade. Landed on one that works. I know it works because I only cry when I am really really upset but I still tear up and have emotions for things like art, etc. my emotions aren't flat. They're under control. That's how I know. Everyone's different.

Here's where folks give up: there is no magic pill. There is a cure, though. It's exercise. I know. I'm sorry. It's awful.

Finding the right med isn't a magic pill. It will get your emotions under control. They're crutches. Not prosthetics. Once you're doing okay-ish, the only thing that's gonna get us chronically down folks feeling better on the regular is exercising on the regular.

I hate gyms. I hate running. I hate working out near people. So, I hike. I drive to a nearby hill and walk up it. Then I walk back down and drive home.

Just like 30 mins of walking every day will genuinely make a massive difference. My pro tip: walk fast enough that you are forced to focus on your breathing. Leave no space for rumination. If you're still ruminating, find a steeper hill or walk faster.

In my 20s, I would have never even read a response that suggested exercise was a piece of the puzzle I was trying to solve. If I never did, I almost certainly wouldnt have made it through my 30s.

You should bring your concerns to your providers and ask them, and not diagnose yourself via Google, or ask strangers on Lemmy. If they're not satisfying your questions, ask to change providers. Can you ask any friends or family if they've noticed a difference since you've started taking different medications?

In my case, the depression etc. turned out to be caused by a chronic inflammation in the gut. No wonder the antidepressants have been working like shit, except amitriptyline because it also does something to the gut.
https://en.wikipedia.org/wiki/Amitriptyline#Other_indications
Doctors have mostly been useless or harmful. I've met one good doctor during the ~30 years I've been ill, and one good nutrition therapist. Thanks to Mistral le Chat (chatbot) connecting some details that humans failed to notice. The treatment is now focused on killing the invading microbes from the gut wall (again), and healing the gut enough so that it can defend itself instead of requiring more and more courses of antimicrobials.

Well, as a general thing, you'd look at severity of episodes and frequency.

If you get a reduction in either, the med is working. Some issues are harder to medicate, often because a lot of meds are essentially a stab in the dark when the underlying condition isn't well understood. Since you listed a lot of things that aren't your diagnosis, chances are that whatever the diagnosis is, isn't going to be well understood. Not that most psychiatric issues are well understood to begin with.

Since what you did specify is relatively poorly understood, and isn't psychiatric in the same sense as bipolar, it really is going to be a matter of trying shit until something helps. The real treatment for relational trauma is talk therapy in one form or another. The meds are there to give you time for the real treatment to work. It's like taking aspirin to reduce pain while your body heals.

Dbt, unfortunately, takes time. A lot of time with more severe issues.

I guess what I'm saying is that you keep trying meds and hoping one helps. That's all you can do. The meds that might help as a breakthrough option (like benzos) can't be used long term, and actually interfere with treatment when used, so the most you'll get in that regard is something for a few days.

I am convinced that 99% of the time, antidepressants a placebo effect. It's like giving someone a hat and telling them they'll feel better if they wear it. So they put the hat on, and they say they don't really feel better. But then they're told "oh it just takes a few months, and certainly you feel something". And they have to agree, because they do feel something different. They feel a hat on their head when before they didn't. But that feeling isn't really doing anything. And maybe in a few months their life situation will change and they won't be depressed anymore. And if they're still depressed after all that time? Well just try a new hat, or the same one but in a different size! It feels different now, right? Different from the last hat? Maybe that's what they need! Let's check back in a few months and see if that works!