Tweaking the Meds

On Monday I had an appointment with the doc that manages my medication. I went in having firmly decided to do something with the drugs. My world is definitely getting smaller and the process seems to be accelerating somewhat. There was a time when I eagerly sought opportunities to do things that I now find uncomfortable and anxiety provoking. I have been troubled by these changes as they have reached a point where they are really chipping away at my identity, and I had come to the conclusion that it was time to put the brakes on this process. Continue reading

Wandering Through The Haze

The last couple weeks have been a confusing time for me. I have found myself in somewhat unfamiliar territory emotionally and physically. About three weeks ago I made a casual observation that my mind had become somewhat muddied. My cognitive processes seemed much slower and my memory had gone to pot. I was having a great deal of trouble recalling names from the previous chapters of my life, and I couldn’t seem to remember to do anything. Theses memory problems were most troublesome because I work as a salesman and forgetfulness is bad for business, but as time passed they worried me a little more.

Along with the mental cloudiness my temper was getting much shorter and as time passed my wife and I barely spoke without ending up making some sort of short, frustrated, and angry comment toward each other. About a week ago I began to notice I was doing things that made no sense, like forgetting steps of repetitive tasks I have completed thousands of times, and was becoming distrustful of myself which in turn was causing a marked increase in my anxiety levels. I had just come to the realization that I was beginning to slide downhill quickly when this weekend the tension with my wife exploded into a real open argument. She basically asked me what the hell was going on that I was repeatedly doing things that made no sense, or failing to do things that were obvious. It seems the greatest source of frustration on her part was that I had turned into a complete idiot. Continue reading

Wellbutrin Doubts Answered

I took Wellbutrin for years. It was originally prescribed to try and mitigate the unfortunate personal side effects of the SSRI medications I was taking and it just never really went away. In the back of my head I was never really sure it was doing much of anything. A couple times over the years I would get fed up with the side effects of the SSRI and stop it. This always led to a slow decline in the stability of my mood. The first indicator that something was wrong would be chronic stomach upset. Before my actual mood deteriorated I would get tired of feeling sick all the time and end up back on the SSRI.

A little over a year ago I stopped the SSRI medications again and until recently my mood and stomach have behaved nicely. Over the winter I survived benzodiazepine withdrawals without the help of and SSRI and actually felt really good for awhile on the Wellbutrin alone. I suppose in hindsight I should have left well enough alone, but I had this nagging doubt that the Wellbutrin was doing anything and was excited by the prospect of a drug free existence. I worked my way off the Wellbutrin and by the end of May I was living with no chemical safety net. Within a month things started to decline. I was flirting with the idea of calling the doc when the recent insomnia hit and I had little choice but to do something.

About the same time the insomnia popped up I was beginning to lose myself in my own head. The anxiety was dripping off me. I worried about everything and just generally began to feel fearful. I was worried about the big questions in life. What are we doing here? What happens when we die? Big stuff with no real answers, but that caused me to spend way too much time in my head. I tried to stop myself from having these internal conversations, but my brain just went there on its own.  About a week after I started the Wellbutrin I noted a slight let up in the overriding sense of unease, but I still couldn’t get out of my own head. When I last saw the doc we increased the Wellbutrin dosage from 150mg to 300mg. About a week in I finally found some relief from these dangerous internal though patterns.

I guess the question is answered. The Wellbutrin is doing something. The question now is if it will be enough. I travel around and work with the public. Twice in the last week or so I have had a customer point out that I look unhappy. I don’t feel particularly unhappy. I am tired. Sleep has been better, but not perfect, and even when I get a good night’s sleep I feel tired in the morning. I know that is not a good sign, but there have been improvements in my sleep over the past week so I remain hopeful that the fatigue will pass. I have also experienced some of the milder side effects of the Wellbutrin restart which include occasional dizziness and feeling cognitively slower. Some of these symptoms are letting up, and I wonder if the fatigue may be part of that as well. In the past when I have taken SSRI medications I have felt pretty good. At this point on the Wellbutrin I wouldn’t say I feel good I would just say I don’t feel bad. I am most certainly not on solid ground

A Better Day

I would like to tell you all that I slept like a baby last night, but I did not. I was tired and stayed up a little later than I should have watching nothing of any importance on the television. I think we were both mostly just putting off what has quickly come to feel like the inevitable pain of another sleepless night. I was feeling sleepy enough when we did turn out the light around 11:00 that I figured I would try sleeping without the prescribed pills that had done so very little the first night.

I don’t really recall much after the light went out, but I woke up around 1:15 and I remember thinking to myself “Christ it’s been two hours and I’m still awake”. I immediately decided to pop a pill, but as I walked to the bathroom I began to realize that I may have been asleep. I took the pill anyway and returned to bed. The next thing I know its 3:15 and I have definitely been asleep, but I need to use the bathroom. I returned to bed and slept through to 6:00. As the day winds down I am again feeling pretty tired, but it was nice for awhile today to feel human again. The sun was shining and I actually felt pretty good for a significant portion of the day.

A few days ago I mentioned that I had made the call about getting another prescription for Wellbutrin. Last Friday the prescription was filled and took the first dose. It has been seven days now and the stuff should be just about starting to take hold. It will probably be another week or so before it is at full strength, but maybe some of the lifting today has to do with the medication. Wellbutrin has never helped with insomnia in the past, but I have never had Insomnia like this in the past so maybe it will get better. The pills prescribed for sleep were actually clonodine which is a blood pressure medication rather than sleeping pills. Apparently is has a relaxing sedative effect without all the baggage that comes along with actual sleeping pills. After my recent experience with Klonopin I was relieved that they were “light weight” sleep aids, but of course they weren’t the most effective solution either. In the light of the day at this moment I am again hopeful that things are improving. I felt so good for a short period of time, and my fingers are crossed that I can get back there and maintain that place.

Nobody Told Me There Was Going To Be A Test

Do you suppose that there are times in our lives when we are just more sensitive to the challenges that lie before us? Or are there just times when the numbers of challenges we face multiply compounding the stress in our lives exponentially? I am two and a half weeks removed from my last antidepressant medication dose. During the last two weeks I have been faced with an endless barrage of challenges that pick away at one of biggest anxiety vulnerabilities: illness.

I have written at length on this blog about the paralyzing fear I deal with when faced with the urge to vomit. Even after hours of therapy sessions spent talking about it, and hundreds of words written here about it I still feel ridiculous talking about it; however, the truth remains that it regularly effects my day to day life.  I can get pretty paranoid about various stomach upsets, but I also tend to get worked up about your day to day cold type problems. Over the past two weeks I have been forced to deal with not only a nasty flu like cold rampaging through my family, but also a couple of the less common infections. I think we are finally nearing the end of this round of illness and none too soon.

It started early last week at the dinner table. My wife who was sitting at the head of the table begins talking about how one of the kids at day care has conjunctivitis. While she is telling the story I am watching my son who is sitting across from me. As the story continues I notice a little deposit of goop in the corner of his right eye. Had she not been telling this story I would have assumed it be little sleepy seed or something, but in the context of our current conversation I point it out. She wipes it away and within a half hour it has returned. She wipes it away again and a few minutes later comes the two year old sniffle “my eye hurts”. The next morning his mom rousts him to make it to the walk in hours at the pediatrician’s office, and yells into our room that there is nothing in his eye. Hearing this my two year old proudly reports that he “already picked the lint out of his eye”. I closer inspection of the bed reveals a pile of dry crusty nastiness next to his pillow, and in good light it is clear that his eye is red and swollen. The doctor confirms the diagnosis and we begin seven fun filled days of putting medicated drops in the eyes of a fighting, and surprisingly strong, toddler. Of course I, having just a smidge of hypochondriac in me, begin to have an itchy eye before we are away from the dinner table. My itchiness persists for several days to the point I seriously consider visiting the doctor, but I don’t and it passes.

During this same timeframe my father, whom I have been helping get ready for another commercial fishing season, and my mother both catch and awful cold. My wife and I have been spending a lot of time there lately as I work with my Dad and by the end of last week she is laid out by it.

As I am tiptoeing around eye gunk and snot my Dad develops a spot on his forehead. He initially says he hit his head on the boat and I don’t really worry about it. Several days of us working side by side go by when last Friday he finally asks my mother to take him to the ER. My dad is one of those goes who never sees a doctor so when he asks to go you don’t ask questions you just take him. That evening I get a call from my mother in the Hospital reporting my father has shingles and that because he had been picking at the rash it has become badly infected and they have started and IV antibiotic. She also tells me to keep an eye on my boy because you can catch Chicken Pox from Shingles.

So here is the thing. My two year old has had the Varicella vaccination. He is fine. My 35 year old self on the other hand has never had them. In my twenties I had a coworker get them and after I didn’t catch them I had a blood test to see if I was immune and I was not. Shortly after I had a vaccination shot. Ironically it wasn’t more than a couple months ago that I was casually reading something and stumbled across information that the adult vaccination consists of two shots six to eight weeks apart. I only had one. I figured on mentioning it to my doc next time I was in the office. I didn’t figure on my father getting shingles. My dad and I had planned to go out fishing over the weekend. Saturday was shot so he could return to the hospital for another IV, but Sunday looked good. I figured I had been pretty heavily exposed to the Shingles for nearly a week before I even knew what it was so I went ahead and went with him Sunday. I also saw him Monday though my exposure was quite limited. I haven’t seen him since and Sunday being the last day I had any real exposure it looks as if that I may be in the clear. Another couple days should tell the tale.

The result of all these happenings had been a marked increase in my anxiety. Monday was really bad and I had to fight off a few mild anxiety attacks. I could feel the panic rising in my chest, but I kept it in check. Tuesday and Wednesday saw the return of my gastrointestinal challenges, a problem I haven’t dealt with in months. Today was better, and I suspect that each day that passes without contracting  an illness will lead to improved anxiety levels.

At this point I am not entirely sure how to feel. Dealing with all the sickness drama did not go as well as it would have when I was fully medicated with Klonopin, Wellbutrin, and Lexapro. On the other hand I am not sure it went a whole lot worse. There were a couple times when I felt things slipping, but I was able to reign things back in. At this point the good still far outweighs the bad, but if there was going to be a test to see if I could hack this I wish somebody would have told me

Adjustments

I am officially spooked. Waiting for the other shoe to drop would be the appropriate cliché. About three weeks ago I posted the news that I was going to make an official stab at living my life free of psychotropic medications. The very day that I wrote that I spoke to my doctor, his nurse actually, and asked what the best way to proceeded would be. I had dropped my daily dose of Wellbutrin from 450mg to 300mg and under their direction I dropped from 300mg to 150mg.

Wellbutrin XL

Wellbutrin XL (Photo credit: Wikipedia)

I was told to do that for a month and monitor my mood closely. I had already scheduled an appointment with him for May 2nd so the timing was about right to be ending the pills when I see him next. I had a bunch of 150mg pills already, so I made the dosage drop immediately. Today is the twenty first day and I only have two pills left. I am not going to refill the prescription so by the start of next week I will be done. So what’s the problem? I feel really good. Not perfect by any means, but well. Sure when I stop my body will still have to process the remaining drug in my system before I will be really free of it, but I am doing ok. It just doesn’t seem possible that from December to now I could remove all these regulating forces from my life, and not have it turn into a disaster.

I actually started this blog in an attempt to avoid returning to SSRI’s. I had been off them for several months when I started writing here, but was having a hard time keeping myself out of the darkness. I needed a place to process my thoughts and I was desperate to avoid returning to that particular type of drug so with a little encouragement from the blogosphere I began to share my experience. I was only a month into it when I was faced with the challenge of not only staying off the SSRI, but dropping my ultimate crutch; the Klonopin. That experience was chronicled in a number of posts starting here. At the time I simply hoped to survive it. I never dreamed it could be the start of something much bigger. For years my shrink had been telling me that the Klonopin was a mood depressor and that I would do well to get off it, but he never really pushed the issue. As I began the withdrawals it became clear why he never really forced the idea. If you don’t come to the conclusion that you want off that drug on your own, if you’re not committed fully, I am not sure anyone would stick it out. It took awhile to feel normal again, but it appears he was right.

There have been definite changes as my body has adjusted to less and less medication. Most notably I have moods again. I get sad, happy, and angry. I used to just be mellow. I am cautiously excited by this new development. Of course feeling happy is a wonderful new experience, but anger is not as wonderful, and sadness I am all too familiar with. I am fearful of both these emotions. Sadness is natural, but when you have suffered from depression each time you feel it you wonder if this is the beginning of the end. Will I have to go back on the pills? With anger I just worry about managing it. I haven’t had too for so long that I fear I have forgotten how. It sounds strange to say, but I want to be angry. It is a natural emotion and it is healthy. On the other hand unchecked it can be very destructive. In the past I have become irritated, but rarely did I give voice to my angst. I didn’t want to fight with my wife, and I swallowed it down and carried on. Recently I have been more than irritated and my anger has boiled over and caused arguments. I am not comfortable with it yet, but after a short, but fiery exchange with the Mrs. last night I felt no more hostility when it ended. In the past after I would swallow it down I would be pissed for hours. Related to these arguments I have noted that my verbal filter seems to have bigger holes in it. In my teens I never lacked for an opinion. “Painfully honest” was the term once used to describe me. If I thought it I said it. I wasn’t entirely tactless, but I wasn’t afraid to speak my mind either. I never really noted the change, but as an adult I have been less that way. I chalked it up to maturity, but in the last couple weeks some of that directness has returned. Maybe this is related to the drugs and maybe not, but since I am still under their influence it will be interesting to see how that particular characteristic develops over the next several weeks.

The other emotion or feeling that I learning to live with again is anxiousness. I am not going through my days scared of nothing, which is an improvement over those days before the Klonopin, and the more recent withdrawal experience. That said when I was on the Klonopin I was rarely anxious about anything, and I never really worried about mild sensations of fear because the drug kept a lid on it. Now I no longer have the chemical buffer, and the only thing that keeps a lid on it is my own cognitive efforts. Before the need for the Klonopin arose I didn’t often feel scared. I was a pretty typical late teen early twenty male. I didn’t take as many chances as most, but nobody would have accused me of being a pussy either. Prior to taking the drug feelings of fear and panic consumed me, and now that I am off the drug, I find myself somewhere in the middle. I am certainly not feeling bullet proof, but I am not scared of living either. I suppose I should not expect to feel the same. While under the Klonopin umbrella I have matured from a 23 year old college student to a 35 year old father and husband.

I so hope that this experiment is successful. I have been off and on SSRI’s multiple time, but I was always on the Klonopin when I was trying to quit the SSRI. I don’t know for sure, but it has been about a year now without the SSRI’s which is without a doubt the longest stretch ever. I hope this works, and I hope my wife and I will both like the new me.