The Last Pill

It has been a long week. Not bad necessarily, but long. The night of insomnia has stuck with me over the past week or so. I have had mixed success getting to sleep, but nothing as bad as that night last week. Still I cant seem to get the misery of it out of my head and every night as bedtime approaches I start to get all tight worrying about getting to sleep. Tonight is the final night of klonopin. I take a half a pill before bed and I am done. Tomorrow starts a new chapter of living, and sleeping, without the help of a benzodiazepine. I don’t really know what to think of it. I am glad I have a long weekend to get through the start of it, but so far my experience has been that the worst of the symptoms from each decrease take place Monday through Wednesday or Thursday of the following week. Things should just be getting interesting when it is time to return to work.

The symptoms over the last week have been all over the map. Sometimes a feel okay, but mostly I feel very edgy. My mind has been free to run, and I have moments where I feel hyperaware of myself and my progress through life. I will be looking at my two year old and suddenly he is seventeen and I am in my fifties. It is unsettling. I have spent way too much time inside this week which always makes my brain a little fuzzy. I actually had to go to work for a couple hours this morning which left me feeling a little better and more clearheaded when it was over, but during the drive itself I was feeling a little fuzzy and disoriented. I hate driving when I feel like that. It is as if I am on autopilot and I am acting without really thinking.

My wife has been great over the past week. There has been a lot of understanding and loving behavior. We have been intimate more in the past couple weeks than we have been in the last three months, which has helped keep me feeling balanced. It has also helped me sleep. I am grateful to her for all of the help she has provided. I have had a couple hours to myself this afternoon which has provided time to write this, and rest some. I really need some quiet private time each day, and I have gotten very little of that over the past couple weeks.

I apologize of the rambling nature of this post. More than anything trying to chronicle what it feels like withdraw from the Klonopin for myself and the benefit of any others who follow me an happen to find this. I hope after the first of the year to get some more regular and coherent posting out.

Happy New Year

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Sweet Relief

After the previous nights torment I was exhausted when it came time to turn in last night. I was careful about caffeine and sugar intake in the afternoon, and tried to generally disengage from things as the evening wore on. I had a terrible headache but a couple Advil quieted that down, and my amazing wife saw to it that I got the previously mentioned endorphin rush just before lights out. The result was a blissful eight hours of sleep.

As I have gone through the day I have been feeling tired and am generally unmotivated. Either as a side effect of the antibiotic for the sinusitis or as a withdrawal symptom from the Klonopin my lower GI has not been my friend all week. Yesterday was particularly bad, and today everything is all gurgley (is that a word?) and on edge. I am done working for a week so hopefully that all works itself out before I go back on the road. Of course stomach upset and diarrhea are a couple of the daily physical symptoms I have dealt with for years so that might be hoping for too much. I have not had any real significant reoccurrence of the anxiety symptoms I was feeling Tuesday which I will take as a good sign.

Tomorrow I drop another step in my Klonopin dose. It is not a great day for that as Christmas Eve night involves a lot of time out of my house doing family things. I can feel myself tightening up a bit just writing about it so it should be fun. I have a way out and may just take it. This drop will leave me taking only a half a dose before bed, 25% of the daily dose I took for a decade. If all continues to go well next Friday at bedtime will be the last time I take any Klonopin. At this point I am sort of looking forward to it. The doctor swears I will feel like a new person once I am off the stuff and the withdrawal effects are gone. I feel like I might have gotten a glimpse of that yesterday. Other than the stomach upset and fatigue I felt really good. It was better than I remember feeling in a while. The only other change I have noticed is that I have been a bit more emotional lately. I have felt that emotion pushing up towards my tear ducts several times over the past week. That is not something that is “normal” for me.

Being home with my wife and child all week will make it very hard to write much. I will check in if I can but no promises. I hope everybody has a very merry Christmas, and survives the day unscathed.

Insomnia

Yesterday I had an appointment to discuss where I stand in the process of discontinuing the Klonopin. Prior to the appointment the day had been going very well. The antibiotic from for the sinusitis is working well, and after two doses I was feeling much better on that front. It seems the sinus infection may have been exacerbating the withdrawal symptoms. Other than feeling uneasy and strangely emotional I was doing pretty well. Still after Monday and Tuesday I wanted to talk about the steepness of the taper. He advised me that slowing the taper would probably just prolong the misery and my best course of action would be to continue as we originally discussed. Given that I did feel much better yesterday I agreed.

Last night I was struck with the worst case of insomnia I have had since I started taking the Klonopin ten years ago. One of the worst symptoms of the anxiety was the inability to sleep. I don’t know how it goes for other folks, but for me the inability to sleep becomes like a snowball rolling down a hill. As it becomes apparent that I am not going to get to sleep easily it becomes harder and harder to get to sleep. The anxiousness begins to take over as I calculate the decreasing number of hours between the current time and the time I need to get up. Will I be able t function through the day? What if this happens again tomorrow? Jesus I need some fucking sleep!! And on it goes until some ungodly time in the wee hours of the morning.

When I was using Klonopin on the rare occasions that this process got started I would get up and take another pill. The double dose was always enough to put an end to the problem. Last night that was not an option. I tried everything under the sun. I always find holding my wife in the spoons position to be very comforting. It has helped before, but I recently developed tendonitis in my shoulder and took a fall on the elbow on the same side making lying in the position painful. I tried it for awhile anyway, but it was clear the pain was too distracting. When my mind began racing I tried some deep breathing relaxation exercises. Nope. Then I tried counting, something that seems to keep my mind focused, but I couldn’t seem to make that work. I got up and took some advil to ease the discomfort in my arm, and the mild headache I still had from the sinusitis. Nope. About 1:00 I woke my wife to tell her what was up. I don’t know why, but I was feeling very alone and needed to share. Really kind of a dickhead move on my part. Like a typical guy I am always ready for a nap after sex so for a long time I considered masturbating. My wife was sleeping next to me, and something about that just didn’t feel right so I let that go for awhile. At 2:30 I took anothe dose of Buspar. It doesn’t have the same sedative effect as the Klonopin, but anything was worth a shot.  By 2:50 I had been in bed and awake for nearly five hours and was getting desperate. I pushed the covers back and began to try a little self pleasuring. I figured the endorphin rush from an orgasm would be relaxing enough to lessen my anxiety and let me sleep. How clinical off me. I had hardly gotten started when my wife who had slept through the entire process so far picked up her head and asked if that noise was me. Busted. Shit. I said it was and she was snoring again instantly, but the moment was lost so I rolled over put my head into my pillow and began counting again. It was 2:53 and I resolved to not look at the clock again. I got all the way to 661 before I began losing my place. My mind would wander some, but I could bring myself back. This was a good sign. I think I began to doze but would quickly reawaken and begin counting again. I recall getting over 700, but nothing after until the alarm went off at six. My wife kindly took our son into the bathroom with her while she showered letting me get a little more rest, but by 6:45 I was reading “Mike Mulligan And His Steam Shovel” to a bright eyed and bushy tailed two year old.

Now it is time to get cleaned up some and go to work for the first time all week. I feel pretty good about it though I have a lot to do after taking the first three days off to look after the boy. I am obviously exhausted, but it is a sunny day here so hopefully I can get through the driving, stay awake, and get home before it gets dark. Something that happens way to early around here, but at least we are starting to go the right direction with that. Let s hope for decent night’s sleep tonight, and continued easing of the withdrawal effects.

Let The Games Begin

I am nearly two weeks into the process of tapering off the Klonopin. I don’t really know if it’s going well or badly, but I do know that I am not liking it in the least. I have been on half the dose I had taken daily for ten years since last Friday and over the past couple days I have begun to feel it. The symptoms I have felt Include being easily confused, very slow at cognitive tasks, I cant type for shit, I have been messing up words in my kids children’s books, and my eyes seem to have trouble dropping to the next line when I am reading blocks of text. I have a couple times felt as if my senses have been completely overloaded, mostly sight and hearing. I am extremely irritable, and am trying not to take this out on my wife and child. I have felt the physical sensations that accompany the beginnings of an anxiety attack, and felt generally very uneasy. I have also had a cold that is ending as a sinus infection so the headache, body ache, fatigue, and generally feeling like shit may be the withdrawal and the sinuses. Hard to really tell.

I sat down with my wife last night and explained a little bit of what is happening. She always feels helpless in these situations, and I feel bad for her. I don’t really know what to tell her other than ask her to be patient and supportive.

Today I did something really dumb. I googled benzodiazepine withdrawal. I don’t know why, and I knew I shouldn’t do it, but it is done. I got the shakes reading about it, and they didn’t go away until my boy went down for his nap, and I could lay down for awhile. I have spent the last two days home with him. His daycare provider is sick, and I have been home sick so he has stayed with me. A busy two year old and these symptoms is not a great combination. I am on my proverbial last nerve.

Tomorrow afternoon I have an appointment with the shrink to discuss progress. I am due to drop another 25% of the dose Friday. I may talk to him about the possibility of slowing this down some. I think a 25% a week taper may be a bit quicker than I am going to be able to handle. If I didn’t have a job, a kid, a wife, or a major holiday coming up, and could stay in bed or on the couch for the next three weeks it might work, but I need to be a little more functional than I have been the last couple days. I actually plan to go to work for a few hours tomorrow. I work as an on the road sales guy, and the round trip I must make is four hours in just driving time without counting in any customer visits. The appointment is in the late afternoon, and is an hour from home.

I don’t know why, but I didn’t expect this to be so hard.

Men.Society.Depression.

I have been feeling generally uninspired to write over the last week, and the opportunities have been few and far between anyway. I have recently come to the realization that I need true peace and quiet to write anything worth reading. I can’t have my son pulling at my pant leg interrupting or my wife leaning over to see what I am doing. This never used to be, but I have also never put some of my deepest and darkest thoughts into print before either. I have had some moments to peruse different blogs over the past weekend. I spend some time when I can sifting through blogs tagged with depression or anxiety and have found some very good reading that way. This weekend I was finding things a little thin, but I did stumble across one article I found interesting. It was an Australian current events blog that was exploring some very disturbing statistics on male suicide. The writer discovered that 89 countries keep separate statistics on male v. female suicide rates, and that in all but one of these countries men were killing themselves at a faster rate than women, and the average was nearly four male suicides to every female. He had hard numbers for Australia showing a margin greater than 3:1. I can’t say I was surprised, but still the numbers were eye opening, and got me thinking about what it is like to live under the dark cloud of depression and anxiety as a man. The cold hard truth of the matter is that living with these issues as a man presents challenges and requires choices that are extremely difficult.

The author of this article has a decidedly anti feminist stance, and makes no effort to sugar coat that position in his article or in his responses to comments. While his comments are likely to get under the skin of many there is some truth to what he is saying. His general position is that feminism has made it socially acceptable to put down men, and that there has been a massive efforts over the last couple decades to get health information out to women while male health concerns have been largely ignored. As a man I cant help but tend towards agreeing with him in general terms. Modern society has pretty much emasculated men. Masculinity has been targeted as something to be covered over as if it is dirty or dangerous, while at the same time men are portrayed in modern media as bumbling morons in the domestic setting. It is very Ironic to listen to a true feminist complain that TV commercials for products like laundry detergent and dish soap show women being forced into traditional sex roles due to men’s incompetence as if these media clips of women continually coming the rescue of the useless man is somehow more damaging to the female sex than the male. Society’s message to men is to suppress any stereotypical masculine behavior as they can be seen as aggressive and/or unacceptable socially, but don’t try to step too far into the traditional female domain because you are useless there also. It is a confusing time to be a man, and it is a confusing time to be coming of age as a male.

So what’s the point of this little rant? When it comes to depression subtle signals are important. I can take a scowl from my wife and turn it into a catastrophic marital crisis in my head. People with depressive personalities need a lot of positive reinforcement and encouragement. It is becoming clear that depression is at least as common in men as women, and society is sending the same dangerous messages to men that are sent to women, but nobody wants to talk about it. Anybody can look at the covers of magazines at the grocery stores and see how the development of a young girl’s sense of self worth could be damaged by the images of “perfect” bodies. It is a problem society talks about. There is no such conversation about the things that society is telling its boys and young men that may be damaging to them. I dare say that many who may read this think this notion is ridiculous, and that only makes my point.

Society tells a man that he cant really be strong and masculine, but he cant be vulnerable either. If you sit on the couch and watch football while your wife cooks dinner you’re a misogynist, but don’t grab the laundry basket to help out because you’ll surely fuck that up. On the other hand when you are in a male dominated setting whether it be a locker room, a male only club, or a male dominated workplace the old rules of masculinity apply fully, and any sign of weakness will be ripped apart, so you better be able to go to that guy place in your brain when you need to. Then in the dating world you may find a woman who has bought in to the feminist message completely, or one who holds on to some more traditional ideas of how men behave. It’s truly schizophrenic

All these mixed signals leave men confused. Society tells us we don’t need to be the strong male, but weaknesses are still seen as a flaw. I find it telling that the vast majority of the blogs I read about depression are written by women. Why is that? Women face judgments for their mental illness, the stigma is strong for everybody, but be a man and say out loud for the whole world to hear that you are scared. You have no reason to be, but you go through your days with this vague sense of unease that can be triggered to downright panic over the slightest thing. Or get them to admit that they live with overriding feelings of sadness or question their self worth. You are not going to get most men to say it. It’s socially, and therefore emotionally, way too dangerous. In the world of maleness it’s not acceptable, and in the larger society, even in this supposed era of men being in touch with their softer side, no wants to hear it either. For those that  may be reading this who do suffer from depression and anxiety consider for a moment what it feels like when you are at your lowest and you think nobody cares.

Dealing with depression and anxiety as a man is like walking through a mine field. You never know how the information is going to be received, and society is slowly programming men and women into behaviors that make getting the proper support difficult. Those who have been following this blog may recall that when my tug boating career ended I was accused of misleading my employer about my condition, despite having revealed it openly on yearly company physicals. Nobody gave a shit about the circumstances my “issues” became a convenient scapegoat. Society needs to open their eyes to male depression. When they do they are going to find an epidemic on their hands.

One final thought on the suicide figures in the article that inspired this post. When I first read the 4:1 ratio I couldn’t imagine it was really this bad. The writer implied it was even worse in the United States. Then I began to think about my own experience. From my dining room I can see a bridge that was completed four or five years ago. It is some 130’ above the river it spans and is a regional hot spot for suicide. There have been six jumpers since the bridge was completed. All of them were male, and all but one were “successful” suicides. Now I know that woman stereotypically kill themselves in ways that are less violent, pills, etc, but not a single female jumper? In addition all the suicides that have ever touched my life have been men. I didn’t intend this to become and opinion piece, but one has to ask; why aren’t we talking about this?

Be kind to the men in your life, you never know what may be happening in their heads.

How Full Is Your Crucible?

This afternoon I have had some time to myself, the first that could be counted in more than minutes in some time. I haven’t used it well which is no real surprise. I have been mostly reading about the ills of the world on the internet, and catching up on the details of the NFL weekend, really nothing important. One thing that I did do was cue up some music, which isn’t something I have done in a very long time. As I sifted through my long neglected iTunes library I was picking out the songs that resonated with me most, and recalled a trailer for a movie I saw while flipping channels with my wife last night. The movie was “War Horse”, a new Dream Works production that opens Christmas Day. Suffice to say this is going to be a sad movie, and I reacted to the trailer by telling my wife there was no way I would be watching that movie. It was an odd thing for me to say out loud as we have a two year old, and movie nights are few and far between. As I sat here pondering my reaction to the trailer the music started with a live version of “Life in a Northern Town” followed by Jeff Buckley’s rendition of “Hallelujah”, I’ll spare you the rest of the play but it is an odd collection of tunes, anyway; as the music played I felt something begin to change in my head… I just felt heavy. I recognized the feeling right away and it’s not new. Entertainment, music, movies, tv, can have an astonishingly potent impact on my mood, and at times the impact is not temporary.

War Horse (film)

My first memory of having been impacted by what amounts to pop culture was my sophomore year of college. I was still more than two years from having depression and anxiety take control of my life, but in that particular program the second year was really the make or break year. The academic pressure was high, but I was surviving. At some point along the way the movie “Titanic” was released. I had little interest, but my girlfriend wanted to go so we went. I don’t really remember the whys, but I remember feeling a deep sadness after that movie that lasted for two weeks. It didn’t have anything to do with the movie, but it was a feeling of despair that I would recall a couple years later when it returned in force. At the time I didn’t really think that much of it, and I have no idea what made it finally go away. I suspect it was nothing but time. I can say one thing for certain; I have never watched the movie again. I have seen parts of it, but I will not let myself get dragged into the story.

During the initial years of the fight with depression and anxiety I can’t recall specific instances of a piece of entertainment having that kind of specific long term impact. I do know that in the past I have reacted to the prospect of seeing sad movies the way I reacted last night, and have made an effort to avoid them when I can. In my head I always rationalized it by telling myself I had enough sadness in my life I didn’t need to pay money for a couple hours more. In truth I am sure I have been avoiding the chance for a repeat of the “Titanic” episode. Interestingly however, I have unwittingly found myself watching unbelievably sad movies since (read “The Notebook”), with no long term effect. Still, I don’t like sad movies.

In recent months I have had two encounters with pop culture that are worth mentioning. The first did lead, or at least contribute, to the funk I pulled myself out of just before I started this blog. Oddly enough it wasn’t a sad movie or song, but a violent and intense television program. One evening I was home alone with time to kill, and was surfing through Netflix when I came across the “Sons of Anarchy” a drama that plays on FX. I had heard good things so I pulled up the pilot and watched it. I was fucking hooked. Hard. I don’t know why, but I was drawn into the story, and with access to episodes on demand I tore through the first season, fitting in an episode whenever I could find the 48 minutes I needed. What I didn’t notice was my darkening mood. One afternoon I had several hours free and watched four episodes of season two back to back. While I watched, the sun set, and the house grew dark around me. When I finished and pulled myself away from screen I had fallen to a dreary place. I started snapping lights on around the house, but I was low and there was no changing it. That was about two months ago, shortly before I started this blog. With time my mood improved, and I pulled myself back from the brink of another major depressive episode. I wish I knew how for next time, but for now I am content to know I did. What surprised me is how this television show could have had this impact. I have given it a lot of thought and still am not really sure, but could probably write a couple thousand words on what I think happened. I will spare you the amateur psychoanalysis and just say that while the show isn’t particularly sad it is intense and emotional. It speaks to urges that are primal, and the conflict that arises in a thinking person brought up in such a basic world. Since that night I have watched one episode, last week, and am not sure if I will watch any more.

The second instance came from a song just a few weeks ago. It was a short lived event, but I was overcome with sadness. I am a country music fan, and I was listening to the radio in the car when a song of no particular interest to me came on. The song was “Jesus Take The Wheel” by Carrie Underwood. It’s not a new song by any means, and I have probably heard it a hundred times. I remember it came out when I was college the second time because I guy I used to spend some time with hated the tune. I had really never paid that much attention. I was familiar with the story in the song, but for the first time I guess I really “heard” the lyrics or was in a place emotionally where they resonated. The idea of letting go of my life, of no longer being responsible for myself, of conceding control to a higher power was overwhelming. Several years ago I knew a man who was a recovering alcoholic. He was an old boat captain and he was a wise man. I didn’t have to tell him I was troubled he just seemed to know, and he would often reference the step in the AA recovery process where you admit you are powerless, and there are things in your life over which you have no control. Of course you have to believe it for it to work, and it is a notion I have always resisted. I am not an addict though I think I could easily have been one. I quit drinking during that sophomore year I mentioned above when I realized I was pouring a shot of unmixed rum into a glass and drinking it every night before bed. I don’t know if this is something that needs exploring on my part. I have very little interest in organized religion, and always feel like a fake when I am in church. There is likely an entire blog post coming at some point on religion, but there has got to be a take away from that experience. Or maybe there isn’t and I am just over analyzing, because I have never done that before 😉

So what’s the point here? I don’t know if my experience is common. I suspect it is in part, though no two people process anything the same. Why do I seem to be so sensitive to the impacts of pop culture? First when it comes to my aversion to sad movies I am not sure it is all rationalization. There is truth to somebody with a depressive personality saying they experience the feelings of sadness often enough that they don’t need to make those feeling more acute my subjecting themselves to somebody else’s emotional pain. I think that quite often depressive folks are very empathetic and they feel other people’s pain on a whole other level when compared to a dispassionate observer. I am reminded of reading a book called Stone Fox by John Reynolds Gardiner when I was a child. The story is about a boy and his dog in a sled dog race, and at the end of the race just before the finish the dog’s heart explodes. Later for some reason I was required to watch a movie version of the story and as it got to the end I wanted to stop watching. I remember telling my mother in tears that I didn’t want to finish the movie. I had seen the dog die in my imagination when I read the book. I didn’t need to see it again in “real life”. Just writing these words now twenty five years later is painful. That is a powerful image.

Cover of "Stone Fox"

Back on track here… So after giving it some thought I have come to a conclusion that may be quite obvious to some, but maybe not so much to others. I think a person’s capacity to hold and process emotions is similar to a crucible. The level of emotion in an ordinary crucible varies over the course of a life as does the amount of heat applied, but it would be a rare occasion that the combination of emotion and heat would be enough to overflow. The depressive on the other hand goes through life with a crucible nearly full. Like anybody else’s the level varies with time and circumstance, but it is higher to start and easier to fill. The ingredients are more toxic and less stable than typical so add a little more emotional stress or heat and it would be quite common for their crucible to overflow. More simply stated when you feel more of your own life, and you feel more of the lives around you, it is easy to become overwhelmed.

When it comes to pop culture the intensity of the experience adds to the level of your crucible, and if it is already nearly full it can easily be caused to spill. Once the chemicals for depression in my brain get flowing it can be hard to turn them off. It takes time, patience, and sometimes drugs to get everything reigned back in. I am never comfortable letting these chemicals flow by choice. Life happens and sadness is part of life, but I do not want to voluntarily subject myself to a situation that will stimulate these feelings artificially.

A person who has never suffered from depression may read this and think I have severely overstated the potential impact of watching or listening to entertainment that evokes strong emotional response. On the other hand I have seen folks with no depressive history that I am aware of listen to too much political talk radio and be in a bad mood all day. It happens to me a lot, but if it happens to non depressive types wouldn’t it make sense that those more susceptible to emotional distress would have even stronger negative responses to emotional stimuli? I think so.

The New Treatment Plan

I wanted to make a quick post here to update folks on my status with the Coast Guard and my medications. I saw my shrink Wednesday afternoon, and while I got little in the way of a sympathetic ear, we developed a plan.

Yesterday morning I began the process of weaning of the Klonopin. It is going to take four weeks to be rid of it entirely. In its place I am starting Buspar at a relatively low dose that we can increase as I come off the Klonopin if we need to. I see him again in two weeks so we can evaluate progress. This should all be great fun as we go through the holidays.

I was on Buspar once before. In my earlier post on medications I noted that in the beginning the doctors tried a bunch of different stuff. I couldn’t remember all their names at the time, but when he suggested it on Wednesday I remembered that this was one of them. I only recall that it was not effective. At that time I was in a lot worse shape than I am these days. It is my hope that being in a better place will allow the Buspar the chance to hold the status quo. I know it’s not strong enough to bring me back, but maybe it can keep me from falling in the first place. If nothing else I hope it provides a cushion for the removal of the Klonopin.

My Doctor needs to speak with the Coast Guard himself and advise them of the new treatment plan. He didn’t seem to think the Buspar would be a problem for them.  The letter I received from the Coast Guard indicated that I need to be clear of the drug and symptom free for four to six weeks before my credentials can be reissued. So if this all works out I should have my credentials in three months or so.

I could rant for pages on why taking a situation that has been reasonably stable for ten years and turning it on its ear does nothing to make me more “compatible with maritime safety”, or compare the supposed dangers of the drug to things that happen every day out there, but it won’t change the reality of the situation today. I will save those examples for the letter I am putting together for my congressional delegation.