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How to Endure and Possibly Triumph Over the Adorable Tyrant
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Thursday
Jul132006

A long post about my brains.

As some of my faithful readers will recall, a few months ago I went off of Effexor, an effective if somewhat problematic antidepressant. Effexor, as I wrote, has a shockingly brief half-life, and because I was on a miniscule dosage (as I am a delicate flower and can only manage light sprinklings of medication) if I was even fifteen minutes late in taking it I headed into scary Effexor Withdrawal Land, a place no one wants to be. If you’re wondering what Effexor withdrawal feels like, rap on your temples with a meat tenderizer while spinning around in a swivel chair and sucking furniture polish through a straw. There you go!

 

 

 

Anyway, because the Effexor was meant to help me through post-traumatic stress, I decided that I would only go on it for a year because after a year apparently your brain forgets all about the bad things and goes back to humming little songs to itself and thinking about pudding. I conveniently forgot, when I chose to go med-free, that my brain is primed for things like PTSD. (There were many, many other people on the street that day, and not all of them spent the subsequent weeks cleaning their cabinets at 4 a.m. and shrieking STOP LOOKING AT ME LIKE THAT at their dogs). I also chose to ignore the years of depression and anxiety prior to the car-crash incident. I was all better, I decided. No more pills for me!

Can you see where this is going?

I remained drug-free for ten of the darkest weeks in recent memory. Here’s a tip: if you’re going to go off of medication, don’t do it in the winter, right smack dab in the holidays, when you’re financially strapped and trying to buy a house. (Actually, if you’re me, the lesson should probably be: don’t do it at all.) As I approached the lowest of the low moods I wrote this post, and told the world about my filthy pants and oversized shoes and in doing so sounded like a pervert clown, and yet was rewarded with many, many people’s boundless sympathy and support. Shortly after this I had what some might call a breakdown, if they were feeing melodramatic, or an attack of neurasthenia, if they were in a Victorian mood. Whatever it was, it felt neither colorful nor historically relevant. All I remember from the Worst Day Ever is that I called Scott and said, “If you knew how bad I felt, you’d come home right now.” And he did.

I felt that I was strong enough to go without drugs, but after a few days of complete misery I cried uncle and ran to my psychiatrist. I didn’t want to see this psychiatrist again. The biggest reason was that she doesn’t take insurance. When I had first seen her this wasn’t so big an issue; I was making money at the time, her rate wasn’t all that astronomical, and anyway I only saw her twice a year. But then as the years passed, and my insanity showed no signs of abating, I thought twice about seeing her. First of all she always called me Linda. I think the psychiatrist’s credo should be Know Thy Patient’s Name. Also she took notes about me into her voice recorder while I was in the room. “Linda has a long history of depression, marked with secondary anxiety. Also, Linda is wearing clown shoes. And should really have showered before leaving the house. What was Linda thinking?”

Despite my misgivings about this doctor and her new THREE-HUNDRED AND FIFTY DOLLAR charge for each session, I went back to her. “Why on earth!” I can hear you shrieking. I think you’re also wringing your apron with both hands, and you just dropped the freshly baked pie all over the linoleum.

I went back because I knew her, and I didn’t have the energy to find someone new and go over the whole story all over again. I went back because it was easy, and as much as I’m poor and cheap, I was also lazy and sick.

It was a mistake, though. She decided, during our (expensive) session, that in fact I was bipolar. She had been hinting at my potential bipolarity for a while. ( “My Potential Bipolarity” will be the name of my rock band. Mine mine mine. Don’t you steal it from me.) The bipolar diagnosis is a difficult one to make because the sufferer is more likely to seek help when depressed than they are when in a manic swing, so they’re diagnosed with depression. But she was smarter than that! Oh, she was so proud of herself!

Here’s why she thought I was bipolar. Are you ready? One, my grandfather might have been (according to her), and two, my heart raced at night. I don’t see anything in any of the literature on being bipolar that talks about nightly heart-racing as a symptom; I had rather thought that if I were bipolar I’d be out all night gambling or having sex with shop clerks in dressing rooms. I know I’m generalizing, but sheesh! If you’re going to call me manic-depressive, can’t I have some fun first?

And sure, my grandfather had more of the colorful madness that the rest of us boring crazy people only aspire to: all-night carousing! Writing his own biblical texts! Conversing directly with God! But I’m not my grandfather, and thank goodness for that because I don’t think Scott would want to be married to a 100-plus-year-old Italian guy who also happens to be dead.

So I disagreed, but she was insistent, and put me on a medication called Lamictal. And then I was off to Amsterdam, and didn’t think much about what this would mean, this traveling while on a brand-new drug.

Here’s another tip: don’t go on a new medication before traveling. The best I can say about the Lamictal is that it didn’t work. The worst I can say about it is it made me intensely, miserably ill. For the entire trip. Every morning I had to get up early to drink gallons of water just so that the nausea would abate enough so I could leave the room. I felt awful all day. I wanted to go out and carouse, as our sponsors were (I guess) expecting us to tell of our adventure-filled days and liquor-soaked nights, but I could barely manage one museum before a nap, and then at dinner I could manage maybe one beer. And Melissa would pat me on the head and say, “It’s okay if you're not a partier,” and I would try to say, “I'm not, it's true, but this is a little weird,” only I couldn’t get the words out because I was falling asleep. My dad wondered why I needed to nap every afternoon as much as he did. I mean, a 70-year-old getting over heart surgery, sure! Nap all you want! But a 37-year-old? That’s just sad.

Then I got home and told my psychiatrist what happened. Her response: “Oh, you can’t drink with Lamictal. I didn’t tell you that? It causes extreme alcohol intolerance. Oh, no no no no. That would make you quite sick.” She then posited that maybe, hmm, I wasn’t bipolar after all, maybe I had one of those, what do you call them, anxiety disorders. Yet somehow, instead of kicking her in the teeth, I handed her another three hundred and fifty-dollar check and got out of there.

I didn’t want to write about this on the blog for a few reasons. Sometimes I wish I had never opened up this particular can of brain-worms. The more I’ve divulged, the more I’ve felt pressured to continue this level of intimacy, and that sometimes makes me want to hide under my bed. Also, writing about mood disorders tends to bring out, well, the mood-disordered, and then they write to me and ask for advice. And I don’t give advice to people I don’t know. I don’t believe it’s helpful. I don’t want that responsibility. And I can barely manage to email my friends, much less strangers in crisis.

On the other hand, not writing about it has brought on some kind of weird blog-malaise. It’s hard to push past all the stuff I don’t want to talk about to get to anything else that’s fun or interesting. And even if I haven’t written about this directly, I’ve read my past few months of posts and I think it’s evident that I have not been at my sunniest. So I needed to get this out there.

I kept waiting to write about all this when I was on the other side, when I could look back and laugh about what a mess those few months had been. It’s still pretty messy, though. It’s not as bad as I was, but I’m not 100 percent. And I know I could go back on medication, but I don’t want to. I’ve had enough of side effects. I don’t have prescription drug coverage. And I just don’t want to.

I’m fiddling around with nutritional therapy, and I would say more about that but I’d bore you to tears. (Don't believe me? Amino acids! No more sugar! STOP CRYING!) Although nothing’s offered a dramatic, Effexor-style cure, I do feel better. And I know this is an unsatisfying post that could really use a triumphant finish. I do wish I could give you one of those.

Reader Comments (189)

I'm with Bob. Not in real life, though the story of his wife sounds much like my own.

I wish you well, Alice. For you are wonderful.
July 14, 2006 | Unregistered CommenterGraceD
Thank you for talking about this. It's such a scary intimate topic I know it must be hard to blog so openly about it.

I'm bipolar and take epilem which is actually an epilepsy medication for a few days when I find I'm sliding too far either way. I haven't taken any for 3 years but it's been close a few times.

I should add that my psychiatrist told me that I needed to take it every day for the rest of my life and I haven't seen him since he said that.

I hate being medicated and I'm severly allergic to pretty much antidepressent on the market and only developed anxiety issues after being medicated, but with the medication and my awareness of where I am on the psychometer I've found a method that works for me.

I hope the nutritional therapy goes well and you find a way to be healthy soon.
July 14, 2006 | Unregistered CommenterSassy
I read this post with a heavy heart as I, too, am in the middle of some of these things myself. I wish you very well and congratulate you on taking the necessary steps and trying the right things to get healthy and well. You are very brave for writing about this, and as you can see by the number of comments (and guess at how many haven't commented) you certainly are not alone, though your pain and struggle are your own. My best wishes go out to you.
July 14, 2006 | Unregistered Commenternoshowmo
Alice my dear, you're a gem. I wish you the very best.
July 14, 2006 | Unregistered CommenterJ
Please know we love you and are rooting for you to get to a happy place in your life, and be able to enjoy your new digs with your family asap.

You truly have so much to be thankful for, we just need to find a way to settle down that over-active brain of yours so you can enjoy it!

Big hugs! :)
July 15, 2006 | Unregistered CommenterChristieNY
I read you all the time, but never comment because I am lame like that. So many people comment that I figure who wants one more. I just wanted to let you know that I sympathize with you. My husband had been taking the evil effexor for 7 years when his new doc told him she thought it was not a good drug and he should stop taking it. No biggie, he agreed. WHOA The withdrawls are so horrific they defy explanation. He has been off of it for a month and is still feeling some freaky withdrawl effects. Good luck. I know it sucks, although from the other side.
July 15, 2006 | Unregistered CommenterKatherine
I haven't read the other comments, there were just too many, so I apologize if I'm repeating. But I've been through the same roller coaster that you've been through. I too have been diagnosed as bipolar even though I never got to experience any of the fun mania episodes. I had a hard time with the diagnosis for a while and then finally sucommed. Get rid of the therapist who doesn't know your name. There is help out there. Don't stop trying.
July 15, 2006 | Unregistered Commenterstella
Please know that your honesty and courage are amazing. I can relate to the uncomfortable feeling of divulging intimately personal information. It's a scary thing, because you never know who is reading. But I am so glad you did tell us. I often wonder if I have little neuroses that require medications. But then my husband tells me, if I think I need them, I probably don't. What a dork he is.
July 15, 2006 | Unregistered CommenterDana
I too went off medication because I hated paying for it, but then I couldn't stop thinking about being dead. Zoloft changed my life, a couple of times. As God is my witness, I will never go off it again.
July 15, 2006 | Unregistered Commentercapacious
Can't decide if posting a note to you is "more depressing" (cuz knowing so many of us are on antidepressants is a pretty gloomy fact) or uplifting (you've got some hilarious readers). I guess if I were you, I'd just want people to say.... WE WANT TO HEAR WHATEVER YOU WANT TO TELL US.

And try not to think of us as an anonymous blob in the blogosphere -- we're moms and wives and people with imperfections just like you. And while posting about your innermost secrets may or may not help YOU, I can definitely tell you that it helps ME to know that you exist and that you can put words to your feelings (so many of which I share).

Kisses and hugs from the fogtown, San Francisco,Sally
July 15, 2006 | Unregistered Commentersallyman
Alice, this could easily be my story as well. I was on and off so many damn meds for my depression/anxiety I can't even remember them all anymore, and I was suicidal for MONTHS trying to get off Effexor. I'm not on anything right now and want to stay that way, and I am rooting for you incredibly. Also, bipolar is very very very overdiagnosed these days. Trust your own instincts about your body/mind. It's too easy to forget that doctors make mistakes all the time, too.
July 15, 2006 | Unregistered Commentermissbanshee
ditto... this could be my story, minus the car carsh, $350 an hour therpist, tavelling, and misdiagnosed bipolar disease... hmmmmmmmm. Guess it's not my story at all! But I have also ben though the hell of finding the right meds, then loving them, then hating them and trying to live without them (all while just having a baby and dealing with financial and PPD problems). It's so hard to figure out!

I hope you can gain some personal insight and relief from sharing with us. Perhaps it will ultimately give you some much deserved peace!
July 15, 2006 | Unregistered CommenterKatie Kat
I'm trying to do it without medication. The more regular life can be, with comfortable and pleasant routines, the easier it is. When sleep or meals are irregular, I feel worse. Medicine might be an easier solution, but it scares me worse than the challenge of trying to solve it myself. For my friend, the challenge is scarier, so medicine is a good solution. Everyone is different.

You can be happy, and I believe that you will be happy every day. You're working things out, writing it down clearly, trying to make things a bit better. Small steps of that kind will eventually take you someplace great. I know you can do it!
July 15, 2006 | Unregistered CommenterSuzy
Thank you for writing this. I'm wishing all the best for you.

July 15, 2006 | Unregistered CommenterAndrea
I really just want to say thank you; but this might turn into a bit of a ramble (the jist is to thank you - so Thank You).

I find myself avoiding the "d" word on my blog; it doesn't come up directly, but I do dance around the edge of it. My life was turned upside down when I started medical school and now that I'm in my fourth year I hope that it will start to even out (at some point). The stress of classes, (failing) tests and now being on a pager brought out the worst in me, and the ptsd from a car accident a few years ago suddenly became disabling. My not-so-type-A personality was already having a hard time with the competition and my truely crazy no'bedside'manor classmates, so everything else just tipped me over the edge.

About the time you were ending your run with Effexor, people were suggesting I try it. Up until that point I'd managed to stay away from the drugs I'd hear horror withdrawal stories about, but nothing seemed to work and in order to keep on track with my schooling I needed to do something; I have bookmarked your entries on tapering and will revisit them when I start my own de'medication journey. (knowing that I will someday stop needing pill(s) to get through a year is one of the only things that keeps me taking it, ironically enough)

thank you for sharing your experiences, and for writing with honesty and humor. Even though I intellectually know that I am not the only one, it's comforting to read about ways that others are handling their diagnoses.

(or mis-diagnoses, as the case may be. That "oops" would have been enough for me to run screaming from her office but I do understand what it takes to find a new doctor and start the story over from the beginning. On the flip side, I know what it's like to set up an appointment with a new patient and so I try to keep in mind when they come in.)

thank you.
July 15, 2006 | Unregistered CommenterKristen
I stopped taking my medication a few months ago also.

I have nothing constructive to add or advice to give, other than to say I am there with you. I am so there with you.

And even though you are sounding frighteningly Tom Cruise-ish I am curious about this nutritional therapy.

I am hoping maybe it means I could drink diet coke and eat pie all day. Is that it??
July 15, 2006 | Unregistered Commenterchris
Awesome. I mean, it's hard, but it's great to hear that your trying out your options. And that they may be having a positive effect. And this is the most boring comment ever. Everyone else already said you go girl.
July 15, 2006 | Unregistered Commenterschmutzie
I too, have had times in my life that required meds. I'm on none now, don't know whats different this time, but its a beautiful gift.

If you are trying out nutritional stuff, I have had my son on the vitamin pills put out by Truehope.com, and really feel they've helped him.

Good good luck to you!
July 15, 2006 | Unregistered CommenterRobbie
Best of luck to you. I think you're a really talented writer. If I knew you in person I'd take you out to coffee AT LEAST once a week. And pay for the non-child-hitting sitter. Who would probably be a good friend of mine so we could be sure about that non-child-hitting thing.

Hang in there. You've got half the internet behind you, and you deserve every bit of its support.
July 15, 2006 | Unregistered CommenterEmily G.
The first time I tried Zoloft in 1998 it felt so wonderful - I felt like a different person. After awhile it stopped working its magic and I tried Effexor. I would rather have my eyebrows plucked while simultaneously undergoing an endometrial biopsy for six days in a row rather than go thru that withdrawal again. Ghastly. I tried prozac for a spell but had stomach difficulties. Back to Zoloft - which is still not working and I might as well eat dirt. What bothers me is that I have chronic pain issues that are clearly linked to severe spinal degeneration and yet because I am a female there just has to be a "depression" component. I keep fighting as much as my medical insurance and funding will allow - hoping to find a compassionate and brave psychopharmacologist willing to work on whatever alchemy will work some magic - at least for a spell. I hope you can do the same - and I hope you find one.

Elle

July 15, 2006 | Unregistered CommenterElle Frerotte
"My Potential Bipolarity" is a kick-ass name for a rock band. I hope you find a good balance soon.
July 15, 2006 | Unregistered CommenterAnnie
I am going to be the one commenter that does not comment on your actual post, but who comments on the comments.

Until I read these comments, I never realized how many, many people there are on meds for depression.

And those are just the people that chose to comment openly.... I wonder how many people in the USA are suffering from depression? That's a very real commentary on the status of our world right now.

I wonder if the depression happens because of what actually happens to us during our lives (bad experiences, abuse, etc.), or because of our expectations - what we think should be happening to us, or what we think we're missing out on, or some unrealistic expectation of perfection from ourselves.

Also - I think you might have the only blog in existence that can have a million comments that all come from intelligent, concerned people.... not one single random commenter who says bizarre or mean stuff. Unless you moderate your comments and weed them out...

I wish you peace and wellness, and that the right doors will open for you precisely when you need them.

- M
July 16, 2006 | Unregistered Commentermarcheline
On the other hand, not writing about it has brought on some kind of weird blog-malaise. It’s hard to push past all the stuff I don’t want to talk about to get to anything else that’s fun or interesting.

Yes! I so know what you are saying. I hope whatever treatment you are trying works soon. Hugs and good thoughts.
July 16, 2006 | Unregistered CommenterColleen
When I first started on the Effexor it was great. It wasn't until I missed a dose and came down with a major case of the spins that I realized something was wrong. It got to the point that I couldn't be 1 hour late in taking it (think NO sleeping in on the weekends) or I would be ragingly ill. Finding out I was pregnant was horrible. I had no choice but to stop cold turkey. I don't think I will ever know if the sickness I experienced for four months was more due to the meds or the baby. As for being bipolar, the best indicator is if you take an antidepressant and then have episodes of very manic behavior. Me, I cleaned and scrubbed and felt like I had more energy than a super hero. The lamictal got rid of those highs so that I could experience honest good old fashioned happiness. There must have been some kind of discount at the Lamictal convention though for all the people I have met who were diagnosed bipolar who IMHO were not.
July 16, 2006 | Unregistered CommenterMelissa
going off effexor was the worst trip of my life - i think i would prefer daily root canal. i am now on prozac weekly - and it is much easier...

thanks for reminding me to take it!

and thanks for having a great, real, honest blog!
July 16, 2006 | Unregistered CommenterJill

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