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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)

Mad heart be brave.
July 16, 2006 | Unregistered CommenterAllyson Salazar
Marcheline, I don't edit the comments. I'm just extraordinarily lucky!
July 16, 2006 | Unregistered Commenteralice
I've been really fortunate in having found an amazing therapist who helped me deal with a lot of my issues, although I've never yet found a drug that worked for me (possibly because no one was keen to prescribe morphine). Although I did find drugs that made me get fat and stop having sex which didnae help with the depression or anxiety one little teeny bit.

But in between helpful sessions with Nice Therapist I also had years (and years and years) of no help at all beyond long-suffering friends and my own attempts to talk myself down from the ledge.

I find exercise helps me a lot because I have a tendency to overthink things. And I know I can work myself into a major funk by just sitting thinking thinking thinking thinking until everything seems progressively worse and worse and the more I think the more sad and scared I get etc. Exercise is a good way of stopping all that because it gets me off my over-analytical ass and gets me moving and pouring all that excess mental energy into something real and physical and immediate which offers a significant distraction and then all that tiredness makes it really easy to sleep. I'm not a gym kind of person but I've been known to spend half an hour boxing with cushions in my living room to the confusion of the cats.

I also know that I can and do exercise an element of control over my crazy. I am a really anxious person and this is not helped say by the fact that my husband rides motorbikes or likes to cycle to work through heavy central london traffic. I watched my father collapse as a child and I have a vivid imagination that is never shy about picturing disaster so everyday I have to rein in the crazy lest I collapse into a little shaky heap of shaking and beg him never to leave the house again please thanks. I've had a lot of practice in saying "okay, enough" to the crazy inside and whenever I feel my brain running away with me with negative thinking I try and re-route it into thinking of really really good scenarios. I just imagine my husband safe, and everything stressful beyond my control working out just fine. More often than not this actually works and I calm down enough not to spend my days in a little crying heap of melancholy and despair. I still have moods, but they just aren't extreme enough to really impair my functioning, which in turn makes all the difference.

I wish you all the best.
July 17, 2006 | Unregistered CommenterNia
If you live close to a university medical center, many of them have research departments where you can participate in a research study and get meds free. Many studies compare a new treatment with an older treatment. You don't get to choose which one, and they won't tell you until the study is over which one you got. It's worth looking into, even if you decide not to participate. Post-study, sometimes the drug companies will provide free drugs or discounted ones.
July 17, 2006 | Unregistered CommenterEllen
I'm rooting for you, dear Alicinda. If I was braver (or maybe more foolhardy?), I'd go off of Zoloft (been on for 12 years now...) and try behavioral therapy. I have no specific trauma to focus on, so EMDR isn't an option for me -- but before I figured that out, I did a bunch of research on it, and it does seem to have amazing results. It's not like therapy where you Keep Going Until You Die; there's a course of treatment and then you're done. Which may be more affordable and easier to plan for, money-wise. Mainly, I want someone I know to try it so they can tell me how it goes...XOXOXO. - Debl
July 17, 2006 | Unregistered CommenterDebl
The only thing I can imagine worse than a misdiagnosis is not being able to get the proper help you need.I hope you get some answers and start feeling better soon. Living with mood disorder, especially going through a stressful move at the same time is just shitty.Hang in there Alice I'm sending good vibes your way.
July 17, 2006 | Unregistered CommenterTB
Your experience is eerily similar to mine - questionable shrink flounders around and flirts with various diagnosis while you slowly drown. Mine started me with effexor (the time release is better) then told me I was bipolar and added lamictal. I can't believe she didn't tell you you can't drink with lamictal.

On the other hand, not writing about it has brought on some kind of weird blog-malaise.

I know exactly what you mean.

Good luck to you Alice.
July 17, 2006 | Unregistered CommenterCyclothymia
I hope you find what you are looking for.

Depression is a beast that I have dealt with longer than I can even put my own finger on. I just dealt with a recent low back in January of this year.

For the first time ever, I let myself be medicated (Paxil). I *am* having some negative side-effects, but they are gradually moderating. Even when they were at their worst, there was no way I would trade back for those dark days.

Well, once I got past the darkest days and got back to my normal self, I just simply kept moving beyond my old norm. I am now more self-confident than I remember *ever* being in my life. I find myself on a constant quest to improve.

I urge you to stay the course with the meds. Medication, like any technology, has its positives and negatives. For me, it was a godsend, however.
July 17, 2006 | Unregistered CommenterTerry
From someone else dabbling in nutritional therapy - I hear you and I understand, and I'm glad you shared. I can't seem to muster the energy.
July 17, 2006 | Unregistered CommenterVery Mom
good luck with the amino acids. i tried them and could never figure out if it was a placebo effect, or actually feeling better. but it makes sense, in theory (you're reading Mood Cure, right? if not, get it!)

and i agree with everyone else who said find another shrink. i've had three bad ones and two good ones, and if only i had had one of the good ones first i would have known when i got a bad one! (does that make ANY sense?)

hugs to you.
July 17, 2006 | Unregistered Commenterkristin
I work with lots of clients with paranoid and depression laced mental health diagnoses and their docs are all pushing Lamictal. they must have wonderful freebies to give the docs. the psychiatrists all seem to think it works for everything. so know that its not just you she is pushing that crap on.good luck!

July 18, 2006 | Unregistered Commentersara
since you are giving nutritional therapy a go i might suggest you try meditation. i began using it as a way to calm my anxiety. the power it gave thru the practice has empowered me. just knowing that i can calm myself keeps the blues away. keep searching and you'll find your method to health. all the best
July 18, 2006 | Unregistered Commentergwen
I have Complex PTSD, and the best thing I ever did for myself was some EMDR. I don't know how it works, exactly, nor do the experts, but it really does. It cost about $100 a session and helped me find a set of skills to cope with the anxiety and function better in the world.

Good luck, Alice.
July 18, 2006 | Unregistered Commenterfrog
Since about 4 months after the birth of my daughter, I have had some pretty gnarly anxiety. Like, paralyzing anxiety about something happening to her. A loose diagnosis PMDD (post menstraul dysphoric syndrome) was made, and I just dealt with it. There was a very low level of PPD, but mostly anxiety.

In the last 6 months, it had eased up considerably. Then, my husband went and had a stroke (selfish man), and all hell broke loose. PMDD came slamming back, but there was nothing "post" about it. It was 24/7. I finally surrendered and started Zoloft.

I never win anything. I am always fairly mainstream, and rarely does anything unique happen to me.

Well, hell. This time I was in the unfortunate 1-3% of people who have a severe, depressive reaction to Zoloft. 5 days into therapy, I was in bed, crying all the time. It culminated one morning when my husband, a physician assistant, asked me how I felt, and I turned to him, dead pan, and said "I feel like jumping out a window. That's how I feel". Well, alrighty then.

I stopped the Zoloft that day, and within 2 days was feeling 100% better.

How am I dealing with the anxiety now? Well, I exercise, am eating really good food (fish, chicken, veggies, no sugar, lots of healthy protein) and am doing so much better.

I still get that panic feeling here and there, mostly associated with my period. When I feel the welling up, I go for a run or a bike ride. Sometimes it is just to much and Bill and I have a long heart to heart. Talking really seems to help me. As does a couple of cold Tecate.

Zoloft is a fantastic drug, and the moral of my story is not to steer clear of drugs. They have saved many a life and can help people find joy again.

It unfortunately had the opposite effect on me. I haven't talked about it on my blog, as I was afraid I would steer people who needed to be on something, away from trying meds.

I hope you feel better soon and that diet works for you as well. It really helped me. Now I just feel like I have normal ups and downs.





July 18, 2006 | Unregistered Commenterjody2ms
Thanks for your comment, Jody. I felt the same way about posting about Lamictal--I'm sure it's just the ticket for other people.
July 18, 2006 | Unregistered Commenteralice
Hi Alice!

"Zoloft is a fantastic drug, and the moral of my story is not to steer clear of drugs."

I should have worded that as "Steer clear of drugs is NOT the moral of my story."

I think the moral of my story is that I had a bad experience with a med as well and would rather stick needles in my eyes then go through that hell again.

So I totally understand where you are coming from and glad that you posted this.

We were totally taken by surprise by my reaction to the Zoloft. But, man, if feeling less anxiety meant that I would have flat affect and depression, then, bring on the panic. I could deal with that, but the other was a whole new can of worms for Bill and I.

My niece takes Lamictal for her seizure disorder. I did not know they used it for bi-polar disorder.

Do you have any linkies for some of the diet therapy you are trying?
July 18, 2006 | Unregistered Commenterjody2ms
Alice,

I think blogging about this is important, so many of us suffer from some version of it.

I too have gone the nutritional way after years of being on one drug after another and being diagnosed with all sorts of maladies I decided it was just not worth it to not be able to drink a margarita without feeling like I shot up smack or have to sleep during my lunch breaks.

Good luck I'm rooting for you!



July 19, 2006 | Unregistered Commenterbrandy
Egads. I am so behind on my blog reads and then I see THIS.

Thinking only good squishy thoughts for you.
July 19, 2006 | Unregistered Commentercagey
Hello there...This is my first visit and I love your candor.I too have suffered depression and anxiety so I feel your suffering. Hubby too has really been depressed since his father died about 20 years ago. Never got over the shock. We've been on all kinds of meds and he seems now to have found a balance without drugs. It has been a long hard road.I used to be such a happy camper - or so I thought.I love your writing "Linda" - I say as I talk into my tape-recorder....I'll be back....
July 19, 2006 | Unregistered CommenterTori
EMDR--didn't work for me. Therapist who said she couldn't help me unless I made a mental shift to change--didn't help me. New shrink ($70 a visit!) took me off prozac, put me on Wellbutrin at the first visit and my life completely f***king changed. I'm emotional, passionate, blah, blah, blah and finally figured out at the ripe old age of 40 that I'm just not wired up like everybody else and will always need medication. I will beg, borrow, or steal the money to stay on antidepressants.

SHOP AROUND for a new doctor--see what a cheaper one says or get a referral from your family doc or ob-gyn (a phone call for free is all it takes). Look into docs who specialize in psychophamecology. I'm seeing my shrink monthly as we adjust my dose and he gives me enough free samples to last the whole month--ask for them. They have closets of the stuff. Good luck!! I know what your going through and my thoughts are with you, as well as my big, overblown emotions. Keep writing!
July 20, 2006 | Unregistered CommenterBrandon
I love your blog. Have read through most of your archives. I've added your link to mine. Hope you drop by sometime and say hello! :o)
July 20, 2006 | Unregistered CommenterMeena
Yeah, I did that once with Zoloft. I'd be on it for years, my insurance ran out, I figured, "what the heck, I'll be fine!" If fine means feeling like I had a massive hangover/migraine for about a week and got dizzy when I moved (or didn't), then yeah, I was fine.Brutal. I'm hoping you're feeling better by now!
July 20, 2006 | Unregistered CommenterAli Shenk
Good luck with all this. It must be really hard to write about it on teh internets for strangers to read. Pretty sure I couldn't do it. But, from experience I can say that having a psychiatrist you trust -- or at least LIKE -- can make a big difference. I broke up with my shrink, and that was better than all the antidepressants she was trying to feed me.
July 20, 2006 | Unregistered CommenterJennifer
I've never commented before (lurker!), but I just want to say hang in there.
July 21, 2006 | Unregistered CommenterSusie
Another uncloaked lurker . . . Thanks for sharing this. Every now and again I consider going off Effexor because it makes me feel so . . . normal? Of course, missing one little capsule reminds me of what I'm up against. It's scary, but it's good to know none of us are completely alone in finding our way through this maze.

I know you'll find what you need. There are lots of us cheering you on.
July 21, 2006 | Unregistered CommenterKate

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