Chasing rabbits
May 31, 2011Let's talk about the meds. The MEDS. Goddammit.
Here's a brief overview of what's been going on, medication-wise.
In December, the Prozac I had been taking, successfully, for years, decided to stop working. Just like that! I took to my bed.
A few days later my doctor put me on Remeron, because it's fast-acting. I had never heard of Remeron. Scott said it sounded like Scooby-Doo saying "Enron," which sounded about right.
The Remeron worked great--SO GREAT IN FACT that in April, my doc suggested I go off the Prozac. Since it wasn't working, right?
Then, a few weeks later: ruh roh. The depression returned, but even worse, like it was all mad at me. My doctor put me back on Prozac--but since the Prozac takes a while to kick in, he upped the dose of Remeron. He did this twice, until I was no longer feeling completely and utterly sick and like my life was draining from me. So that was good.
But then I started having these…episodes. In general I'm a little lightheaded and spacey, nothing too dramatic, but enough that I need to hold onto handrails and should not operate heavy machinery. As if I ever should. But the episodes are far more dramatic. When these hit, I get so lightheaded I am about 99% sure my life is ending, imminently. My vision gets fuzzy, my limbs feel like they're not mine, I'm nauseated and shaky, and in general I feel as awful as I've ever felt in my life. Like I'm just bathed in awful.
Unfortunately the first time this hit, I was taking a nice long walk to visit my psychiatrist's office, which is about 4 miles from my home. How cheerfully I set out on my mission! There I was, happily marching across the Gowanus Canal, when my vision started winking in and out and I felt like I was floating and my arms weren't mine. Unfortunately every time I stopped to sit and regain full consciousness, it became harder and harder to stand up and get my limbs (the ones that clearly belonged to someone else) moving again. So the breaks became more frequent as I neared my destination, until I had to sit at pretty much every block. Sometimes just right there on the street. (Well, against a building. I didn't just plop down in the middle of the sidewalk.) An intelligent person would have tried to get a cab at this point, or sought out the nearest subway stop, but, you know.
I told my psychiatrist about this when I saw him, but by then I had had some water and some quality sitting time in his waiting room and actually felt fine. So maybe the extent of the awfulness I felt didn't come through in my retelling of it. He responded with something noncommittal, about keeping an eye on it, etc. Then it happened a few days later, and then again, and then another time, and each time it seemed even more likely that I might face-plant on the sidewalk. (Why always outside, Brain? Can't you do this when I'm near a fainting couch?) I thought maybe it was low blood pressure, but it feels also an awful lot like how I felt when I became anemic during pregnancy. Or maybe it's some thrilling combo of the two.
At any rate I Googled, as one does, and the Googling brought up a lot about Remeron and passing out, and I called my doctor, who recommended I stop the Remeron for a couple of days and then restart at the original dose. Of course there's a withdrawal syndrome for Remeron, of COURSE, but the danger that I might black out is more pressing, to my doctor's way of thinking, than my temporary discomfort. Which means that I might feel awful for the next few days, and I wouldn't even mind this so much except that I'm going to my college reunion this weekend. I apologize in advance, my Wellesley sisters, if I throw up into a flower arrangement. I probably won't. Probably.
The other problem with the Remeron is that I can no longer sleep. This is sad, as I enjoy sleeping. Remeron is supposed to help you sleep--in fact, it's often used to treat insomnia. In my case, I have to take it when I am on my way to slumberland, or I get a case of the Restless Legs that's so bad there's no way in hell I'll sleep that night. It seems, somewhat not surprisingly, that taking a pill, washing it down with some water and then squeezing one's eyes shut while thinking "OH MY GOD I NEED TO FALL ASLEEP RIGHT NOW OR ELSE" is not the most relaxing way to drift off. So I worry, and if I'm lucky I fall asleep anyway, but even if I do I tend to wake up every hour or so with some INCREDIBLY URGENT THOUGHT in my head. A few nights ago I lurched out of bed because I Had To Print An Email! And Read It To Scott! For instance. If I don't fall asleep, which usually I do not, I lie in bed twitching and dying and considering calling the Church to see if they'll give my legs a nice long exorcism.
While the Remeron gives me trouble when it comes to sleeping, my doctor has assured me that going off of it will cause (wait for it) sleeping problems. But then the Klonopin might help with that, being a benzo and all. It's getting very Go Ask Alice, around these parts. Maybe I'll wash these Bennies down with some LSD! What? Don't be such a square!
UGH. I can't believe I just wrote all this about these drugs. And now I'm going to publish. And you're going to read it. And I'm going to get an alarmed call from my mom. AGAIN. My poor mom.
Reader Comments (98)
Hi Alice. I have the exact same episodes, except mine always happen in grocery stores or in the car. Awesome. They are the absolute worst, like I am absolutely sure I'm dying. I also used to get the restless leg thing. I hate to throw yet another suggestion into the mix, but the two things that have made a big difference for me were magnesium supplements (this was huge) and pro-biotics. Restless legs completely went away with the Mag and my sleep got a lot better as well. Sorry you're going through this crap. I understand how awful it can be.
*love* *admiration* *respect* *hugs* *thanks*
That's all.
My biggest fear is that something shitty will never end. I am sure this will end at some point. Just like labor. The baby is gonna come out at some point, in some way... that's what they told me at hour 38. It was true, even though I almost killed many people along the way.
You are inspiring to me and so many others with your honesty and bravery and sense of humor. If you can do it...
I hope you are comforted by all of the love and support coming your way... you deserve it!!
Been there. Done that. Depression sucks. However, Yay you! For keeping on, keeping on!
I hear your frustration and KNOW that pain and extent of your suffering! But, WOW, you have such a handle on what I call RULE NUMBER ONE... KEEP GOING!
One foot in front of the other. Get up. Get dressed. Get food. Get exercise. Take care of you and most importantly keep putting one foot in front of the other and you CAN and WILL feel better!
Pat yourself on the back and be proud of yourself for taking such good care of yourself! BRAVO!
Have you had your thyroid checked? This all sounds so much like what my mother went through a few years back (shaking, blacking out, sleeplessness, basically thinking you're going insane; also weight loss, weird carb cravings and hysterical laughter, which was the only fun part) and she finally discovered she was severely hyperthyroid. Just a random musing, there. Sorry! I'm glad you're (starting?) to feel a little better!
I know that telling you that you are awesome will not make you feel better, but you are very AWESOME! Do what you need to do to feel better again. I'll be cheering for you and sending you good, non-depressed and anxiety riddled, thoughts,
Oh Alice! Here's to finding the right mix, and soon. Restless legs are the worst! I want to say hang in there, but I don't know if that's helpful or incredibly cliche.
Ugh, that's just the worst. It's so hard that these meds are so finicky- you have to just use trial and error, slowly ramping up dosages, etc. etc. meanwhile feeling like total crap. I'm so sorry!! The psychoendocrinologist sounds like a great idea! My sil manages her bipolar depression with hormone therapy, so I know second hand how powerful a role hormones can play. Best wishes!!
Ok, the person I'm seeing is an MD who specializes in (get ready) Psychoneuroendocrinolgy, Medical Psychiatry and Psychopharmacology. I live in the Bay Area in CA and she's in the East Bay. She costs a small fortune and of course doesn't take insurance. In my case, my insurance will reimburse me for 70% of the cost.
I'm not sure I've ever met anyone as smart and logical as she is. She is slowly making a ton of sense of my crazy hormones and how those affect my mood, depression etc. She's wonderful to talk to; she is funny as hell and clearly loves what she does. If anyone wants her info, send me your email to silbersm@yahoo.com.
In the meantime, we've doubled my estrogen and I'm OUT of pristiq, while my insurance co. is taking a couple of days to approve a refill (WTF?). So right now, I'm sitting on the couch feeling brutally nauseated, sobbngi over the movie "Valentine's Day" (have you SEEN that pile of crap?) while my boobs grow bigger by the minute and my heart palpitates every few seconds (thank you to whomever posted about that side-effect of stopping Zoloft). LOL!!
That sounds absolutely frustrating. I couldn't even imagine. :(
I have absolutely no experience with the meds, but my first thought in reading your post was "hormone/endocrine issues with a magnesium deficiency". (I got my medical degree from Google.) I know you didn't ask for advice, but I'll throw mine in: get thee to the endocrinologist and get your magnesium and vit D levels checked as well. Magnesium is the magical mineral that should help your restless legs and sleep issues (it's a natural muscle relaxant), moods (often found in PMS formulas), and what sounds like migraine symptoms (the dizzy, the numb, the episodes, etc.) You didn't say so in your post, but did you happen to track when (i.e., what time of month) these episodes happen?
Thought I'd throw it out there.
I am so so very glad to have you back in the blogosphere and healthy enough to share with us your journey. You have been missed.
My sympathies - I once ended up face-down in a mud-puddle-ridden sidewalk due to Remeron, so I know what you are going through...although, many many years later, it turned out that it was just hormonal - and no birth control and high doses of advil took care of the pesky hormone problems that caused the unending depression. sending you positive thoughts and hopes for decent television to watch while you wait for improvements...(the bachelorette can't count as decent, i figure...)
Welcome back! SO glad you're feeling better. I agree with other commenters that this all sounds exhausting! I hope there is resolution very soon for you with a good med balance. In collegiate solidarity, I type this on my way to my college reunion! Hope ours both are very fun!
You were right. You wrote it, and I read all of it. I unfortunately, don't have much to tell you besides I hope you get the right cocktail of meds figured out so you can be happy again. :(
When you say "episodes" I hear it, for some reason, in the narrator's voice from YaYa Sisterhood... maybe I need to up my dose.
I heard lots of bananas helps the leg restlessness. It's potassium (or is it magnesium too?) that helps with the leg cramps/restlessness...
Either way, I'd just quadruple whatever daily vitamin you're taking and see what happens ;) No, I'm not a doctor! Yeah! Medical advice from a complete stranger!
I'm really glad you wrote this, Alice. I have never suffered from long-term depression. I have suffered a few bouts of clinical depression, which were painstakingly recovered from via therapy and various other methods. But I am close friends with someone who does, and is on meds for it, and this really helps me more understand her battles. I remember, before I ever walked that path myself, not understanding why she didn't "want" to feel better, why she didn't "want" to do something about it...until I couldn't get my crying arse out of my own bed. Since then, I've learned a lot more about what it means to physically be depressed. But when she talks about meds all I can do is kind of nod and wonder what she means. This piece helps me understand. Thank you. And I'll keep my fingers crossed they find the magic balance for you.
Two things: One, soon there is supposed to be a blood test that will accurately say "Yes, you ARE depressed" that can be taken and the results shoved up the whatever of anyone who tells you to "just get over it".
Second, I recently read that orgasms are a surprisingly effective cure for restless leg syndrome. So take two and call me in the morning. You're welcome.
Hi Alice -- I had to comment even though I hate commenting late as I'm always trying to drive traffic to my own conniving mom blog, but I am commenting simply to tell you I feel you sister. In 2006 I came down with the worst case of Irritable Bowel man has ever known. I won't go into the details (on the toilet 25 times a day and still feeling little turds just sitting at the rim of my anus, inflamed, insomnia, rectal hell)
My butt doctor sent me to a psycho-pharmacologist which pissed me off as I've had about 100 years of therapy for my screwed-upedness, but I went. She listened to me for 30 seconds and said I needed "Drugs, and lots of them."
Currently I am almost symptom free and am on Cymbalta, the old-school Elavil and an Ambien every freakin' night. I had the woozies initially but my tolerance level has increased. Menopause is around the corner and I'm afraid it'll imbalance this freakin' cocktail in my blood. Anyhow, I am sending love vibes to you, dear Alice. You are not alone.
Alice - I have been thinking about you as you've bravely powered thru the past two months. I have nothing profound to offer in the way of wisdom, but know that you have all my love and support. xo - Katie
Hi Alice. I've been cowering in the corner (yup, that's me) b/c, when you did the crossfit post, I was all like jeez, forget about how you look doing it already and just do it! (speaking of course as someone who would dearly love to do crossfit but cannot, due to back problems).
And little did I know that that wasn't really the point. The point was, well, all this. And my cmt may have sounded like it came from someone who doesn't understand that beating depression is not simply a matter of Getting Over It one day upon awakening after a refreshing night's sleep.
I just wanted to say that I DO understand that- my best friend suffers from depression and once I was clued in (through my own reading and keeping up, so you know it's really coming from a place of love!) I realized that my cmt was perhaps a little insensitive-sounding. I hoped perhaps it would remain unnoticed among all the judgment-free love notes. But just in case it didn't, I wanted to say sorry and that I am much wiser now... we don't know each other (although we both live in Brooklyn and sorta know someone in common) so I'm probably totally making this awkward, for which I apologize, BUT, I feel better for saying sorry. For being a little knowitall beeyotch. Will try to keep cmts on a sounder footing in future.
And- hang in there. And- if you DO happen across any of those treatments for Hysteria, I hope you'l post those too & play them for laughs. Maybe Freud's long-lost readheaded stepchild or whoever that pendulous knuckledragger was could cough up a few while he's making you laugh, ha!
Dear Alice, I too suffer from long term depression. Thank you for writing this post.
A couple of months ago my meds too suddenly stopped working and I fell into a 'below the sea-level' place. I am on an entirely different mix now, and it seems to be working a little bit. Still room to move up though, so my god, I understand how you feel, at least a little. The frustration. The bad bad thoughts. Please hang in there.
Karen, thanks for reaching out! I wasn't offended by your comment--I can appreciate being frustrated by what I was saying. (Although my original point wasn't about how I looked, but my long-held insecurities over being capable. I am totally happy looking like a dork, and often do, much to my son's chagrin.)
Sorry the side effects are so so crappy right now. That's bad enough stuff to be have to cope with when you are otherwise feeling great and optimisitic, let alone when easily overwhelmed by everything.
I had my own selection of (less extreme) side effects when I was on SSRIs. For me, they calmed down after the first few weeks to merely I could really do without this, as opposed to absolutely fucking awful fidgety shaking vomiting insomnia. Well, some recurrence when I increased dosage, but managable in between. Hope yours are the kind of meds with an expectation of rough lead in period which says absolutely nothing about what its like to be on them really.
Glad you feel able to talk about the crap that you're going through, because feeling like you have to hide it all and be ashamed of it adds another layer of horror to it all. I know you sometimes (erroneously) feel like you're self centred right now. Looking after yourself in a crisis! Following medical advice! Writing about your own experiences on your own blog! What outrageously selfish behaviour! Hmm, maybe not.
Oh and MustangSally's advice appears particularly sound to me - a hormone treatment with only positive side effects. Got to be worth trying.