I recently had another moment of clarity it my long journey with anxiety. The truth of the matter is I am beginning to miss the klonopin. I am hesitant to say that out loud because saying it is the first step towards using it, and I know that would be a bad choice, but for ten years it squelched the anxiety so effectively that I have come to understand that much of the psychiatric treatment I sought out in that time was to counter the depressed mood the benzo was causing. What I thought was depression was mostly a side effect of the Klonopin which had completely masked the true enemy anxiety. Continue reading
A year ago tomorrow I sat down in front of an empty computer screen and scratched out a post I titled “Why I Am here” in which I expressed some doubt about my ability to actually maintain an active blog, and in which I declared my desire to share my own experience fighting the demons in the dark corners of my mind. I had recently come to understand that there was strength in sharing and important things to learn from the experience of others. I had been reading a couple different mental health blogs and while I couldn’t always relate to the specifics of a person’s experience I still felt a kinship with many of these writers and realized that despite the differences there are still things we talk about that only others who have tread down the same dark paths will ever be able to understand.
As it turns out I have had a very active year in terms of mental health. Topics have ranged from reflections on the darkest days of my life back when this all started many years ago, to my current struggles. In between readers have been blessed with some attempts at humor and creative writng, my taste in music, observations on the impact of entertainment on mental health, weight loss, and one long political rant. The most important posts for me came shortly after this blog was started when last December I was pushed into a very difficult position and made the decision to discontinue use of the benzodiazepine Klonopin. I had been using the drug daily for ten years and for a couple months this space focused on little more than me surviving benzodiazepine withdrawal. Nearly a year later I am still getting used life without this chemical buffer, and trying to get some balance back.
I would like to sincerely thank all those that have stopped in to read this blog, and in particular those that have taken the time to comment or “like” my posts. Without your support I would likely have stopped writing here many months ago. Knowing people are reading and care has been a wonderful experience. When I started this I didn’t realize I was stumbling into such a supportive mental health community. That has been the single most pleasant surprise of this experiment.
In the event some are curious I will share a few behind the scenes details. My blog is pretty modest by most standards. Less than 100 posts to this point, less than 100 folks following, and not quite 3,000 page views. I have been very surprised by one stat in particular. My most viewed post has nothing to do with the topic of this blog. Back in the spring I wrote a couple snarky posts about trying to get a decent coffee out here in the sticks. In the spirit of those posts a put up a couple funny coffee related photos. That photo post has three times the individual views of the next closest post on this blog. It also has very few “likes” and no comments. It makes very little sense to me. The post with the most “likes” happens to be my very last post, a poem about insomnia. Be careful folks… too much encouragement and you may be subject to more poetry of questionable quality.
I have two posts that I would call my favorites. The first is actually the least viewed post on this blog. I may have titled it badly, but Downeaster Alexa includes a brief reflection of the impact of the sea on my life. It isn’t the most profound thing I have ever written, but the subject matter is near and dear to my heart. The second post is a piece I wrote on men and depression. It sparked a pretty good conversation in the comments section when it was written, and the ideas put forth are still things I feel strongly about.
In the future I plan to keep going as I have been, mostly writing about my day to day life with the occasional offbeat submission. I have really begun to appreciate music as a powerful medium for expressing emotion and I may increase the amount of music I share here. I added a page to the blog called the Tiptoe Soundtrack that will display all the music I share in individual posts in a central location.
I would like to offer on last thank you to all those that have supported this project and I look forward to seeing you here in the coming months!
Disclaimer – I have said in the past that I have limited time to write in the summer. This was written in a small window of opportunity during which my 3 year old repeatedly got up from his nap and interrupted my train of thought. If I tried to proof it thoroughly it would never have been posted, Please forgive the typos, misspellings, and odd sounding sentences that are undoubtedly everywhere.
When I last checked in just after the 4th of July I was still struggling mightily to get a decent night’s sleep. The Friday before this past, the 6th, I again went to bed with the knowledge that the alarm would be sounding at 4:00am which is about the same time I had been getting to sleep. The pressure of needing to sleep was the trigger that set this all off in the first place, and predictably sleep that night was not going to come easy. The stressor had been needing to get some sleep prior to getting up early to go work with my father. This work is something I both enjoy and need for additional income. I had canceled the previous two times I was supposed to get up because of the insomnia. This time I decided to take a different approach. Going into Friday night I had slept reasonable for a couple nights. I decided that no matter what happened overnight I would get up and go fishing. The day we had planned was going to be easier than normal and the weather was to be ideal. I figured if I took away the sleep requirement for going it may help. When sleep came hard I reset the alarm for 5:00 to give myself a little time, but held firm on my commitment to get up no matter what happened. Some time after 3:45 I drifted off and I woke again before the alarm around 4:55 and got up.
The day started grey and foggy both in my brain and on the water. The drive to the boat was pretty bad and the first
couple hours work were equally horrible. My brain was moving slowly but I was functioning. Finally around 9:00 the sunchased the fog away and the warm rays of my skin cleared the cobwebs from my mind. The rest of the day went pretty well. That night I stayed up until 10:00 and when I hit the pillow I could not sleep. I was very very tired and as we all know when you are that kind of tired the little voices in the back of your head get louder and more forceful. By 10:30 I was experiencing high anxiety and in pretty rough shape. Even my anxiety couldn’t overcome the level of fatigue I was experiencing and sometime after 11:00 I slept. It was a toss and turn kind of night, but I did sleep.
As the new week began sleep again became a more regular part of my life. Getting there was still a bit of a struggle taking an hour or two each night, I got a lot of reading done, but sleep was coming. When Friday rolled around I had a follow up visit with the shrink concerning my restart of Wellbutrin and the sleep problems. During the visit we increased the Wellbutrin dose from 150mg to 300mg, and talked about adding a drug to ensure nightly sleep. He indicated that my prolonged use of the benzodiazepine Klonopin would likely make sleep aid such as Lunesta and Sonata ineffective. I found this an interesting observation and wished he had elaborated as to why. In the end the conversation boiled down to two old antidepressants with sedative side effects Mirtazapine and Trazodone. I am not looking to take a lot of pills and was encouraged by the improvements to my sleep over the course of the week. The Mirtazapine was a drug I would have to take on a daily basis, but the Trazodone was something I could take an a more as needed schedule. I really wanted to see if my sleep kept improving so we decided I would take and prescription for Trazodone and use it if I needed it.
Friday night I was again facing and early alarm, and all day I was wrapped pretty tight about it. The week before I had proven that I could go fishing with no sleep so I again decided that I would gt up no matter quality of quantity of sleep I got. At bed time I could feel the anxiety in my body when we turned the light out at 10:00. By 11:00 I was no closer to sleep that when the light went out so I got up took some of the left over Buspar for the anxiety and read for almost an hour. Sleep finally came around 1:00, and I got up at 4:00 when the alarm sounded.
Yesterday we fished our biggest day of the season. I was on the water for over 11 hours in 90+ degree heat. My stomach gave me some trouble over the course of the day so I didn’t eat, but I drank about 50oz of water. I didn’t feel great, but I again functioned effectively on minimal sleep. I am hoping that by breaking the cycle of not going when I don’t sleep my brain will begin to realize that there is nothing to get all worked up over. By taking away the negative consequence (not going fishing) I hope that sleep will become less a big deal and therefore come easier on these nights. We will see what happens next week I guess. I would really like to keep those pills in the bottle.
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.
About three weeks ago in a post titled Weighing Changes I spoke about my concern related to high levels of anxiety in my new chem free existence. This is a growing problem that I fear will eventually sabotage my chance for success living a medication free life. The frequency and intensity of these anxiety attacks is building. At least four of the last five days have been impacted negatively by what amounts to my overactive imagination.
In the short time I have been living without the chemical safety net to which I had become accustomed I have been reintroduced to some of life’s simpler pleasures. I have written here a couple times about my Latte misadventures, and commented on my increased libido, but I have yet to mention my gentle reintroduction to adult beverages. I have never been a big drinker. I used a lightly abused alcohol for a brief time in college, but my by senior year I pretty much volunteered to drive whenever we decided to go out. In the ten plus years that I took Klonopin I may have consumed ten alcoholic beverages, but I doubt it. The drugs magnified the effect of the alcohol and I have written at length about my intense fear of vomiting so it was simpler to stay away.
A week ago after a long hot day of yard work we all went to the grocery store to do the shopping. The beer cooler is at the end of the last aisle and my wife commented on the ice cold bottles of Woodchuck hard cider. It was a drink I remember from college and it the spirit of my new found freedom I put a six pack in the cart. That night my wife and I each enjoyed just one cold Woodchuck, and they were just as good as I remembered, dangerously good actually. Over the course of the following week I had a couple more, and then last Friday night came around. I had had very little to eat all day and dinner turned into burgers on the grill much later than we would usually be eating. With a plate full of raw meat in hand I grabbed a Woodchuck and retreated to the porch. In less than the time it took for the burgers to do their thing I consumed the entire of bottle of hard cider. Now I am a big guy and one bottle of any beer type beverage is not going to knock me over, but the dehydration and lack of food combined with the relative virginity of my liver left me feeling a little buzzed. For me a huge anxiety trigger is the sense that I am not in control and there was nothing I could do to stop the dizzy sensation in my head. I could feel the tightening in my chest and then I had a flutter in my stomach. This sensation had nothing to do with my alcohol consumption; rather it was just a passing pain that is a regular occurrence for me throughout the day. The truth of the discomfort didn’t really matter as my anxious brain was already teetering on the brink. When the anxiety is triggered I need to move, think the flight part of fight or flight, so I excused myself from the table where I could gather myself out of my toddler’s sight.
Over the weekend I had a couple mild occurrences of anxiety, but the Tuesday return to work brought the worst day yet since the Klonopin withdrawals. I am generally effected by the amount of light outside and as I was driving today through a rainy gray overcast I began to encounter small embedded thunderstorms. As I passed through each it became twilight dark and of course the rain was heavier with the associated lightning and thunder. This is an anxiety trigger I don’t fully understand and is relatively new in recent years, but I have apparently become uncomfortable with thunderstorms. What is ironic and troublesome about this is that with my interests in aviation and the ocean I am something of a weather junkie. I l-o-v-e weather, and have always marveled at the process by which weather is created. It is physics you can see, and geeky as it may be I think it is one of the coolest things going. I could sit down and pound out several pages on what makes a thunder storm happen, and I know that the comparatively week storms we experience here in the Northeast are generally nothing to be worried about. I knew the storms I was experiencing today were of no real concern. So given the strength of my background why the hell do they make me nervous? The truth is there is no real good answer to that question. Like most of my anxious moments it is nothing more than the rapid movement of illogical thought processes. These anxieties take loose correlations to real dangers and blow them up to irrational fears. After the fact I am often uneasy talking about them out loud because I know they don’t make any damn sense. The only thing “real” about them is the fear they create. The sensations they create are as real as if somebody had a gun to my head. Fear feels the same whether based on a quantifiable threat or the gobbledygook that more commonly runs around my brain.
The real trouble with today’s challenges was the length of time over which they occurred. For two or three hours this morning I lived with unacceptably high levels of anxiety that occasional spiked into the sensations I have no desire to EVER feel again. These were the sensations that I spent ten years on Klonopin to avoid and that I endured for several weeks over the winter for the promise of Coast Guard documents and a better life. Today I discovered that I have a very low tolerance for feeling this way. I simply will not live my life this way. It terrifies me to even put those words, “will not live my life this way”, on paper, but I am not yet ready to give up on living without medications.
In the comments section of the Weighing Changes posting referenced in the first paragraph my most loyal commenter, Lady J, told a story about her experience with her children in Cognitive Behavioral Therapy or CBT. She described a technique for externalizing the anxiety where the kids treat their anxiety as an entity separate from themselves. They give it a name and a personality completely separate from their own selves. My own admittedly limited research on the topic revealed a lot of medical mumbo jumbo but I found a couple articles that explained the premise some. The idea is not to say I am scared or I am fearful because you are not, you are you. You feel scared, fearful, anxious etc. The distinction is subtle but important. (If somebody who actually knows about this stuff happens to read this I apologize for hatchet job I just committed explaining and undoubtedly complex idea, but this working knowledge is what I am moving forward with.)
So Lady J and her kids have named their anxieties and she said in her comments that it is remarkably helpful to her. I was intrigued by the idea and have played with it in my head some, but today I went all the way. The prolonged almost sin wave nature of my anxiety today as I passed from storm to storm allowed me some time to reflect on what was happening. I began talking to myself, if your thinking this sounds a little schitzo so did I at first, but I began asking myself if what I felt was real. I knew it was not and by forcing those ideas to the front of my brain I was able to overcome most of my day. The truth is that I also took steps to shorten my work day and remove myself from the stress, but while I was in the thick of it I was able to force myself to function by telling myself the truth about my circumstances. Not my anxieties truth, but my truth: “these are very small thunderstorms embedded in a larger weather system. The atmosphere does not contain the energy required to build them into even moderately strong storms”, or something like that. The anxiety level stayed pretty high no matter what I told myself, but the horrible spikes stopped.
This afternoon I have had some time home alone and been able to reflect further on the day. I am left unsettled by the experience, but there is hope that these new tactic will be helpful. I hope it will become easier and more helpful with time. I have decided to go all in and introduce to the world my not so friendly acquaintance Freakout Freddie. Freakout Freddie’s favorite phrase is “what if” and he runs around thinking the sky is falling. He likes to take single snowflakes and push them around until he creates a ball of ice so large it can run you right over. Freddie is not an altogether bad guy. He will undoubtedly let me know when I have crossed into a danger zone, but it is up to me to decide if what Freddie is saying makes sense or if he had just gone off the deep end again. Wish me luck.
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.
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.
Forgive me blogosphere for it has been thirty two days since my last entry. It has been an amazing month, and with the notable exception of my employment circumstances things are looking up around here. The truth is my urge to write peters out when I am feeling good. When I have no real angst I have no inspiration.
A regular theme throughout the life of this blog has been my experience with the medications used to treat depression and anxiety. Anybody who has done much reading here knows I hate these drugs with some passion, but have also relied on them to get through the last twelve or thirteen years of my life. In that time I have never been completely drug free. For over a decade I have gone through each and every day of my life under the influence of at least one and most often two or more drugs designed to effect my mood. I hardly remember what it feels like to function without these pills.
Over the winter I went through the long ordeal of withdrawing from over ten years of daily Klonopin use. The last pill was taken December 30th and it was probably the third week in February before I began to feel in anyway normal again. At the end of February I had an appointment with the shrink and I asked about the possibility of getting off the Buspar and Wellbutrin. He told me I could drop the Buspar anytime and drop my Wellbutrin dose by a third from 450mg daily to 300mg if I felt up to it. I had been taking the Buspar twice a day prior to this appointment, but beginning to next day I only took it at night. After a week of the “only at night” dosage I quit altogether. Other than a mild hiccup in my sleep, which was probably all in my head, I didn’t even notice the drug was missing.
I was feeling very encouraged by the successful drop of Buspar. For many years I had used the Klonopin as my crutch. I never forgot the way the panic and anxiety felt, and I was fearful of returning to those days. During the withdrawal I was reminded of why I was scared as the experience was highlighted by two months of increased anxiety with several days spread out over the period that were nearly intolerable. With the Buspar gone I was living clear of any drug whose sole purpose was to control my anxiety, and I was functioning fine. For some time now I have been nagged by a vague awareness that the Wellbutrin isn’t really doing anything for me. With the Buspar gone it was time for the next hurdle so I cut the Wellbutrin dose as I had been directed. It has been about three weeks since I dropped the dose. I don’t remember the exact date/day, which I honestly consider a good sigh unto itself, if I can’t remember exactly when than I must not have been obsessing over it too badly. I am feeling very good, better than I remember feeling in a very very long time. Truthfully I feel better than I ever remember feeling. I left a message with the shrink this afternoon asking how to make the next drop. I am scheduled to see him May 2nd and I would like to have made the next drop a few weeks before then so if things do start to get weird I will have the checkup already on the calendar.
My wife and I committed to another change a couple months ago as well. Somewhere on this blog I once listed my weight at 250 pounds. I was lying. You know you are self conscious when you put the things in print I have put on this blog, and you can’t tell the truth about your weight. My weight maxed out at 266.6 pounds on my 5’11” frame. I remember the weight because the last three numbers struck me. I am not a terribly religious person, but I knew I was too heavy and the 666 stuck in my head as a bad sign. I had settled to 263ish when my wife decided she needed to drop some weight. I watched her get started and she was doing well. She bemoaned my cooking constantly as she struggled to lose, but lose she did. A couple weeks after she started I followed. I didn’t make a lot of noise about, and didn’t even tell her. My motivation was twofold. First my son is 2 ½. If I am going to be able to play and participate in his life I better get some of this weight off. The second is probably the greatest motivator for all men. Sex. My wife and I have always had mismatched sex drives, and one of the effects of dropping the Klonopin was a sharp increase in my drive which was already way ahead of hers. I had heard complaints from her that my weight made sex uncomfortable, but for some reason it took the light bulb a while to go off in my head. I finally decided if I wanted more sex I needed to take responsibility for making myself more appealing, and the act for comfortable for her. By the time I last posted a month ago I was down to the 250 number I had claimed to be. I wanted to brag, but how do you brag about being at the weight you told people you were already at? This morning marked two consecutive days at 238 pounds making my total weight loss from the start weight 25 pounds, and from my max weight almost thirty pounds. My pants used to fall down my ass like they do on all fat guys. They are still falling down my ass, but now it is because they don’t fit.
Weight loss is a real chore for me. I don’t want to get into all the details here so maybe I will put together another entry talking about that, but I can say the work is paying off. When I hit 245 my wife commented that the sex was better, and she was right. She has dropped about 17 pounds and the combination has made for a noticeable improvement. With the Buspar gone and Weight and Wellbutrin lower the biggest change I can see other than my general mood is my sex drive is off the charts. The mismatched desire has always been a problem in our marriage, but recently she has made more effort to participate and I tried to do some little things to keep her interested. We talked about it last weekend and I told her that in a perfect world I would be looking for sex four times a week. She was a little taken aback by this. Last year we averaged every 10 -14 days with several instances where we approached 30 days between sexual encounters. This year has been once every 7 -10 days, and lately I am noticing we are pretty steady on a once on the weekend pace with the occasional extra thrown in. This is an amazing improvement over where we have been, but I think she was shocked to discover that I am only getting about 25% of the sex I actually want. Will this foster more understanding of where I am coming from? The drug free me is finding the urge stronger than ever so I certainly hope so. I am hopeful that this rapid change in my desire wont cause us any problems.
The past month has seen many more changes as well that I simply don’t have time for here, but maybe they will give me an excuse to write here a little more often. As a parting word I would ask for forgiveness for any typos you may find in this entry. I really want to get something posted, and I am rapidly running out of time so my editing will be quick and sloppy.