Better Living Through Chemistry

I think the time has come for me to discuss my relationship with psychotropic medications. In my last post I wrote in some detail about the spiral I found myself in with anxiety and depression compounding one another until I reached a point where I simply could not pull myself together. I credit medication for ending this spiral, but that does not mean I believe these pills are the magic bullet for curing depression.

I fought the use of medications for a long time. I was a pilot and taking these drugs meant the end of a career that was just getting started. I had spent four extremely difficult years in college working towards the goal, and spent well over one hundred thousand of someone else’s dollars to complete my degree. The idea of throwing it all away was more than I could bear. It took consecutive events in airplanes to convince me it was time.

I was well trained and qualified to fly in bad weather. I actually really enjoyed flying when I couldn’t see. It required a level of precision that the perfectionist in me got a great deal of satisfaction from. I was training to teach others these skills when I lost control of an airplane in the clouds. I am not sure I actually physically lost control of the airplane, but my mind convinced me there was a problem and the instructor had to take control of the plane from me. The experience scared me, and the next day I went flying in good weather alone to try and shake it off, but I was terrified from the moment the wheels left the ground until touchdown. I knew something bad was going to happen if I continued so I parked the plane walked into the Director of Flight Operations office and told him I needed to be taken off the schedule because I was medically unfit to fly. I stood in front of a man who had over 600 hours of combat flying experience in Vietnam and worked as a test pilot on the F-16 program and told him that I was afraid to fly. I had tears in my eyes and have never felt as small as I did that day.

I followed this good butt painful decision with a poor one, but one that I sure many others have made. I went to my primary care physician rather than getting a psychiatrist recommendation from my therapist. I am sure my doctor meant well, but she had no business messing around with these drugs. I don’t even recall the names of the first few she tried, but they are not names most would recognize. I do remember I got no benefit and a pile of side effects. I recall one drug made me horribly dizzy and made my vision weird. I went into the bathroom looked in the mirror and could watch my pupils change size from larger to smaller and back again. Other side effects included fatigue and feeling mentally sluggish. I was dismayed that I had lost my career to experience this.

Finally she landed on the SSRI Celexa. No freaky side effects were immediately apparent and after a week or so I noticed an unbelievable improvement in every area of my life. I truly thought I had found the silver bullet. The catch was soon to be discovered. When I started these pills my future mother-in-law was staying with us. She and my future wife were going to Florida together, and she had arrived a few days early. The size of our apartment and the presence of “mom” precluded any activity of a physical nature between my girlfriend and I. When they left and I had the place to myself I settled in to let off some of the pent up energy. I was more than a little disturbed to discover that something was terribly wrong. I felt aroused, I could get hard, but orgasm was another matter. At this time I was probably about 23 years old and had not had sex for a week. I should have been able to masturbate to orgasm in minutes if not seconds. It took over thirty minutes, required aggressive stimulation, and the end result while technically being and orgasm was less than satisfying. It was my first experience with what I came to call the pleasureless orgasm. The physical response could be made to happen with a great deal of effort, but sometimes I felt almost nothing.

Having my life back was enough for me to accept the side effect, and life moved on. My future wife was extremely understanding about the side effect even after it became clear that I would never be able to orgasm through intercourse. She always did whatever I needed to get over the top. There were times when this would go on for forty-five minutes or more after we gave up on intercourse.

The initial experience with medications had led me to make an appointment with a psychiatrist, and even though the Celexa seemed to be doing the trick I kept the appointment. He kept me on the Celexa and added Klonopin. The Klonopin was for the anxiety, and made it nearly impossible to have a panic attack. In the rare events that the panic did break through I could take another pill and in twenty minutes or so things would settle down. This drug can be habit forming and I was told would show up on drug tests making any thoughts I may have been having about lying to the FAA about my condition and flying anyway mute. I stayed on this combination of drugs for a long time.

Eventually after having felt relatively normal long enough the sexual side effects of the SSRI became annoying enough that I asked what could be done about it. The first attempt the psychiatrist made was to give me a coupe sample packs of Viagra. Other than erections so hard I could have chiseled marble I got no benefit from the little blue pills at all.

The next attempt was to switch me over to a newer drug called Lexapro. This was supposed to be a purer form of the Celexa and have fewer incidents of unwanted sexual side effects. That too had no effect. Next they added Wellbutrin which acts on norepineperine and dopamine rather than the serotonin targeted by the Lexapro. I was told that adding Wellbutrin to regimes of SSRI’s had helped with the side effects. Again I got zero benefit from this combination. Over time my body adjusted to the SSRI a little and post intercourse hand jobs that had been lasting forty-five minutes or more got down to twenty minutes or so. Adding pornography to the equation would speed things up further, sometimes I could even come through intercourse with porn in the background, but we only did this rarely. I did not want to become dependent on pornography.

For years this was as good as it got. I took Lexapro and Klonopin, and dealt with the side effects. After I had been married about four years the side effects really started to bother me again. By this time I was in a different state so I sought out a different psychiatrist who decided to try adding Wellbutrin again, and again I got nowhere. The next step was to build up to a maximum dose of the Wellbutrin and wean off the Lexapro. This led to my first experience with serotonin withdrawal. The symptoms of dizziness, headaches, and confusion were unpleaseant, but were plenty tolerable and only lasted a few days. The upside was that within a week of being completely of the SSRI my sexual function was completely back to normal.

For awhile life was good. We conceived out first child during this time, and things were generally normal. I don’t recall exactly how long I was off the Lexapro, but in time symptoms returned mostly in the form of constant stomach upset. I put up with the stomach aches and the building depression for a long time, but eventually I felt I was getting too close to dropping into a deep funk, and I started the Lexapro again. Within two days of taking the first pill, well before I felt any benefit, I was again suffering from anorgasmia.  The doctor decided to add Abilify to the drugs I was taking to see if that would help both my mood and the sexual dysfunction. I got no benefit either way, but I did experience the unsettling side effect of feeling like my skin was alive. It gave the term “my skin is crawling” a whole new meaning. It was an awful side effect that didn’t seem to be getting better so I dropped the drug.

I stayed on the Lexapro for a year or so when a growing difference in sex drive between my wife and I led us to seek out some help. During conversations about this it came out that the marathons were wearing thin and adding to her lack of interest. I decided to try dropping the Lexapro again, and this time the withdrawal syndrome was awful. I suffered from dizziness, vertigo, confusion, and these awful feelings like electric shocks in my brain. I little research on my part turned up what they call “Brain Zaps” as a withdrawal side effect. These effects lasted three weeks before finally passing.

Today I am on Wellbutrin and Klonopin only. I have tried to drop the Klonopin in the past, but the results were not good. Over time tolerance builds to Klonopin and I have found the frequency with which I add a second pill to my regular dosage increasing. I have been off the Lexapro for about six months and I am again feeling the steady creep of depression and increased anxiety. The stomach discomfort has been back for several months already. This is the cruel reality of using medications for the long term treatment of depression. I have to choose between two significant quality of life issues. I either take the pills and destroy an already strained sex life, the effect of which will add to my depressive mood, or I don’t take the drugs deal with the symptoms of depression and anxiety to make the most of my sex life. The jury is still out this time around. This blog is one effort to keep from having to take the drugs again. If I go back on them I don’t know what will happen to my sex life, and the thought of facing the withdrawal syndrome again to come off them is more than I can bear.

To those that are in a real bad place the benefit of these drugs is undeniable, and they can be great for giving you a chance to reset, and for many who don’t experience these side effects they may be the ultimate solution. For the rest of us the decisions we make are going to be deeply personal and extremely difficult. Ironically the cruelty of having to make this decision feeds into my depressive mood as there is a significant feeling of loss with either decision. There is no right or wrong here and what works for a person may change over time as the circumstances of life evolve.

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10 thoughts on “Better Living Through Chemistry

  1. Your posts seem to arrive in my inbox at the same time I sit down in the morning. I want to say something because what you’ve put here deserves validation, but I don’t want to say the wrong thing. And, I don’t want to make it about me either. I read this, and I feel something on a visceral level. I put myself in your shoes, and I feel your persistance. Your drive to continue onward. And, I relate to it. I also see the profound frustration and, for lack of a better phrase, lack of fairness. What amazes me, and I do mean amazes, is how two so very different life experiences can lead to such similar inner experiences. You know my story. I know I’m snarky and probably a little obnoxious on the “sexy” blog, but in person I’m an introvert with most people. I spend a lot of time watching other people and struggling and just living day to day. To read your experiences with anorgasmia touches this sore, aching part in me, and I don’t know what to do with it. It doesn’t really matter what I do…I feel utterly powerless to fix it. Something was foisted upon me, and I just have to live with it. But, I keep trying anyway. I may be talking about something entirely different from depression/anxiety, but it applies, doesn’t it? Injustice is injustice. Living with it, I think, feels the same or similar, anyway. Nonetheless, I really appreciate your “voice” and your post. Thank you, C, for writing this. In this case, I’ll say it encourages me to know that I’m not the only one in the world “alone” because the only blogs I’m finding are the ones where people are “coming three times in a row”! And, that just leaves me feeling deeply inadequate and profoundly discouraged regardless of how I arrived here because there are days when it feels like I’ll never be leaving this place. Today would be one of those days. Thanks again (Well, shit. I think I made it about me again. Gnnnnnnn…..)

    • I wouldn’t worry much about saying the wrong thing. Short o hurling blatant insults back at me I am not going to be offended. I am not that sensitive. I often try to put myself in a position to see something from another perspective. Often what we see when we do this or hear from others is not what we necessarily want to hear, but that doesn’t make it invalid. Feel free to speak freely here of what you think about what I have written. The conversation is part of the healing process for both the writer and the reader so don’t worry about making it “about you” either. This is the point of the exercise isn’t it?

      After reading a handful of these blogs I was struck, buy the same but different nature of these personal struggles. The sources of the pain are all different, and some symptoms that manifest in some don’t in others, but still much of the feeling is the same. At least it is similar enough that you can read sombody’s writing and empathize on a level deeper than most. In some cases as you noted the exterior triggers can be very different, but the experience of living it can be shockingly similar. I obviously know about some of your struggles, but wasn’t thinking of that when I wrote the entry. The sexual dysfunction component is sourced differently, but I don’t think I have ever spoken candidly with anyone who has experienced it regardless of the source. I think you are right living with something that does not seem fair probably feels very much the same regardless of the reasons why.

      I do not feel that I know your story, only the bits of it you have shared in your blogs since I found them. I have read some previous entries, but to say I really know your story isn’t accurate. You are more than the things that you share here. You pointed out your frustrations at reading these blogs about women coming over and over. I can see how that would drive you crazy, but I at the risk of offending you I would suggest you keep it in context. Sometimes when I read these first person sex diaries I begin to think that I am reading erotica that is just written in the first person, kind of like “Letters to Penthouse”. This is not how everybody is believe me. Wives are not all laying in wait for the husbands with carefully picked undergarments looking to pounce and finding instant ecstasy. I think many more are too damned tired from work and kids to even be interested in sex, and probably try their best to make themselves available to their partner because they know they should, not because they really want to. There are two sides to every coin. I know it is hard but try not to let faceless nameless people on the internet make you feel inadequate. You are on your own journey and you will find your way beyond this with time. It may not feel that way every day, it doesn’t have too, but that doesn’t mean it won’t happen.

      • I thought you would find the irony in this situation strangely relatable. For the first time in my life, I actually contacted my doctor about yesterday’s and this morning’s panic attacks. A close friend of mine suggested that perhaps I shouldn’t be putting up with the “Help! I’m dying” feelings. I was suspicious, but I gave it a go. My internist had the nurse email with a note stating that I was to pick up a scrip for Celexa and to come in next week. CELEXA!!!!! Hell, no! 50-70% of people have those nasty sexual side effects! What’s more, I’m not depressed. I’m not even chronically anxious. Oy… It’s ass-tastic. And…how is Celexa going to help in the here and now? I’m “dying” today. Celexa will reach effectiveness in a few weeks. sigh…But, hey, perhaps if I go on Celexa, I won’t care about anorgasmia anymore, right? I won’t care because I won’t even want to have sex because my libido will have gone the way of the Dodo. And, when I do get around to it, I won’t feel much anyway, I won’t be able reach arousal, and what will be the point? Orgasm? Ha! Just a faraway dream…sort of like Oz. I’ll be stuck in Kansas forever. And, that *would* normally cause me great sadness, but I’ll be on an antidepressant so I’ll be fine. “You’ll be fiiiiiiiine!”” Pat, pat. I may as well give my husband a big bottle of Astroglide, a sock, and some films. So, I guess I’ll be “dying” for a while because I’m just not going down SSRI road. I just find it ironic that you just blogged about this very thing, and, today, I’m sitting in the very same boat. I think that I don’t like it. I think that this boat sucks, C. Hmph.

      • I think that I would agree with you that the SSRI road would be counterproductive for you at this point, but there are other options out there that may be helpful. Nobody wants to see you suffering. Not your friends, your blog readers, and least of all your family. I mentioned in my blog that I really screwed up by letting my primary care doctor use me as a living chemistry set while she tried to sort out what drug was the “answer”. Maybe your therapist could recommend a psychiatrist? I know that first visit really blows while the “evaluate” you, but at least then you would be talking to someone who deals with these drugs and their effects every day. You could voice your concerns and they might be able to find something that will actually be helpful.

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