Tag Archives: medication

Day 16 on 75mg

If I wrote this yesterday like I planned, it would have been a more cheerful blog. Today, however, has been unexpectedly rough. I think my first mistake was eating a breakfast with too much sugar and caffeine. I had leftover nectarine crumble and a chai latte with my new blend. I was careful to not add too much sugar, but within ten minutes or so, my head felt like it might explode. At the same time, I was struggling with an article’s images and trying to get pics in a high enough resolution, and that made me really angry for some reason. So I was frustrated, in a lot of pain, and walking the clock, because I was supposed to have a doctor appointment.

That didn’t happen. Chris ended up having to cancel it while I lay in bed, clutching my head, praying for death. It hurt to think, but thoughts still pounded through. These last few days I’ve been getting increasingly angry with the Brett Kavanaugh situation as more allegations emerge along with  revelations about how Republicans knew and have been trying to rush the nomination process anyway. A lot of Christians (like Franklin Graham) have been trying to shrug off what Kavanaugh did or just say outright that the women are lying. It’s been making me feel physically ill.

These extreme emotions are new to me and I don’t really know what to do with them. Writing them down in my journal helped, but it doesn’t feel like enough.

Aaaand now I’m feeling nauseated, so let’s end there.

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Day Eight On 75mg

Oh boy, has this been a rough week. I don’t even want to reflect on it. Let’s just say it’s taken every ounce of will power to not explode like a balloon of puke and pain.

It’s every day. Pretty much all day in varying degrees. Again, mornings are the worst. I dread them so much, especially since I wake up feeling great. Then I have to take my pill, eat something, drink my ginger tea, and wait for the nausea and crushing head pain to start. It always does, and then I lie down in a fetal position for a few hours until it passes and I can start writing.

A few hours more and then the head pain gets really bad again. I think of it as a giant fist trying to open inside my head, but there isn’t enough room, so it’s squeezing against the inside of my skull. Tylenol doesn’t really do anything about that kind of pressure.

Haven’t been able to focus on anything for very long. Haven’t touched my book this week. Barely cleaned or cooked or exercised. Barely think in complete sentences.

Going Into Week 3

Tomorrow, I will have just ended two weeks on a lower dose of Effexor, and my patience is thinning. Looking at the positives is important – I only have to take Tylenol about once a day and I haven’t been throwing up in the mornings anymore. This weekend, I was at a social event for 4 1/2 hours and didn’t pass out or feel the need to bite anyone’s head off. Progress!

This week is also significantly cooler, I can actually feel some lacy edges of autumn in the breeze, and that really improves my mood. I’m still sleeping a lot and don’t have much of an appetite. Whenever I feel the tiniest bit of motivation for work, I try to churn out as much as possible, because after an hour, I want nothing to do with writing or thinking of any kind. Today, I have done some very half-hearted research for a new cookbook introduction and then fell asleep on the couch for two hours.

As for daily chores like cleaning and cooking, don’t even. I’ve made exactly two dishes these past two weeks – nectarine shortcakes and a salsa, which I’ve turned into nachos for my breakfast and dinner the past two days. I’m also very into this new peach tea I got from Plum Deluxe, an Oregon-based loose tea company. They have a vanilla latte black tea I want to get once it gets colder.

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The withdrawal could be much worse. From reading online, some people experience horrendous symptoms after going down 75 milligrams. I am a little frustrated with my doctor for not talking about the withdrawal. If I hadn’t known about it and done my own research, I would have had no idea what to expect and been a lot more emotional. That seems to be the experience of a lot of people wanting to taper down.

My goals this week are to eat more vegetables, continue eating very little sugar, and get more exercise.

 

 

First Week On A Lower Effexor Dose

I just finished my first week on 150 grams of Effexor instead of 225 grams. How did it go? It was a mixed bag.

Day 1

To ease myself in, I took half a pill in the afternoon and the other half at night. Withdrawal symptoms included lightheadedness and irritability. I couldn’t sleep that night and experienced surges of anxiety about nothing. I felt really twitchy and when I did get to sleep, I kept walking up.

Day 2

Despite a rough night, I woke up feeling pretty good. Ate leftover pasta for breakfast, took my pill, and wrote. I started to feel more tired than usual, so I took a nap. I usually try to nap about two hours after waking up. If I can’t fall asleep, I just don’t take a nap that day. Today, I fell asleep pretty much right away. Had some fatigue the rest of the day and found it difficult to focus on anything.

Day 3

SO MUCH FATIGUE. Felt like a zombie all day, took forever to write just a few hundred words. I’m supposed to exercise to combat the withdrawal, so I managed to clomp about a mile with the dog. That night I had a lot of muscle and joint pain, especially in my head and neck.

Day 4

Nausea strikes! I threw up in the morning and lay on the couch. I drank a lot of water. Couldn’t figure out what to eat. Didn’t feel like eating at all the rest of the day, but I made myself.

Day 5

Saturday! Beach day! Yoshi was super obnoxious on the drive and I felt my patience wearing thinner than usual. Started getting headache and experiencing nausea. Couldn’t really focus, so I just sat on the beach and didn’t think about anything. Took a short nap and walked with Yoshi for a little bit.

Day 6

That’s today. I threw up again and I can feel a headache coming on just above my right eye, like a spreading sunspot. Thinking about going back to bed after I finish this blog. I wrote two work things already, so it wasn’t an unproductive morning. Going to see a movie this afternoon.

OVERALL THOUGHTS: Withdrawal wasn’t too bad this week. I don’t like the fatigue part, because that makes working out SO DIFFICULT. Even just walking feels like my limbs are full of sandbags. Nausea is my least favorite symptom. I haven’t had any weird emotional symptoms yet besides some anxiety, racing thoughts, etc, at night. No weeping spells, which is good. This next week I’m sticking to my current 150g; I don’t want to taper down more until the withdrawal symptoms are completely gone.

What I’ll do differently: I’ve noticed that I’m really sensitive to sugar right now. As in, I’ll have one sugary thing and immediately start getting a headache. Will be avoiding sugar this week. Also making it a goal to get more exercise. Luckily it looks like it will be a cooler week.

Christmas Season 2017

The holiday season thus far has consisted mostly of baking. I’ve made apple cider caramels, applesauce donuts, chai cookies, toffee-chocolate puddle oatmeal cookies, and milk chocolate cookies with orange zest. The process of baking and producing something really delicious makes me feel productive, and I always have Chris take them to work, so it’s something I can do to share, too.

I’ve also made a lot of biscuits and gravy, which I’ve decided is my best meal.  Christmas menu will consist of some kind of pasta dish (possibly salmon or shrimp alfredo), green beans with a miso dressing, crispy potato stacks, and for dessert, an almond-jam chocolate cake I’m super excited about.

We’re at home for Christmas for the first time, which means we actually have to decorate and get a tree. Because we’re in Oregon, that means getting a fresh one. For music, I’ve made a Spotify list of the old standbys: Sarah McLachlan, Avalon, Enya, and Pentatonix. Joining them this year are Johnnyswim,  Tyrone Wells, Dia Frampton, Sia, and Penny and Sparrow.

I’m almost done with Christmas shopping, which is always more expensive than I expect, but that’s because I pride myself on my gift-giving. Chris and I both have birthdays right after Christmas, too, and then it’s Valentine’s Day.

On the less happy side of things, the lack of sunlight is starting to get to me already. I need to get vitamin D. In the last three days, I’ve had naps that are much too long, and they’re those depression naps where I can tell my body is not actually tired, but my brain is so foggy I can’t do anything else. Those naps almost come with strange dreams, too, like Chris getting abducted by aliens and me trapped in another person’s body. I’m still grieving for Baxter. Haven’t cleaned his room yet, though now it’s more just because I don’t want to go to all the effort. I still miss him the most at night when I can’t sleep, and I don’t have anywhere else to go and lie down to calm down.

What else, what else…still grinding away on my novel. I write about 3-4 pages a day in my moleskin. Still writing cookbooks and food books for work. My Gildshire book hopefully comes out soon. That’s about it right now.

 

Taking Medication On Vacation

We went to Hawaii for my grandma’s 90th birthday, which meant lots of plane rides and 3-hour time difference. It also meant plying myself with lots of pills in order to stay as functional as possible. What are some ways that I managed this?

Tip #1: Stick with number of hours between pills, and not actual time

I usually take my first pill between 10:30 – 11:30 am, but during travel, the time changes. Instead of focusing on the actual time of day, I just paid attention to how many hours had passed between pills. At night, it resets, so I started taking my pill about an hour after I woke up, around 10 am Hawaii time.

Tip #2: Dramamine is amazing

I was worried about feeling sick on the airplane and all the car rides, so I took the less-drowsy formula about two hours before getting on a plane or in a car. It completely reduced any nausea I might have felt. A few nights, I would start to feel nauseated randomly – probably because my body was adjusting to a different pill schedule – and Dramamine would help with that, too.

Tip #3: Always carry food and water

I never went anywhere without my water bottle. Staying hydrated is key to not feeling ill in heat, whether or not there’s medication involved. I always tried to carry food with me, like a protein bar, because my second pill of the day would fall around 2pm, which was after we had eaten lunch and before dinner. Depending on what we were doing, going to get food wasn’t an option, so I had to have something with me.

Tip #4: Don’t forget how many pills you’ve taken

This is a weird problem I have sometimes, where I will forget if I just took a pill or not. It’s become so automatic, when the alarm goes off, I act on reflex. Sometimes I eat before, and sometimes I eat after, so that doesn’t help me remember. One day, I forgot if I had taken the pill, and not wanting to risk the withdrawal from a missed dose, I took the pill. I’m pretty sure I ended up double-dosing myself, which resulted in a headache. Thankfully, taking two pills wasn’t nearly as bad as three (which would make me instantly sick), and I was able to walk it off and drink lots of water to feel better.


All in all, having to take three pills a day didn’t interfere with the vacation too much, and I was able to relax and enjoy everything that went on. There was only one major miscommunication with the family about it all, which reminded me that other people need to be privy to my schedule. That isn’t a problem I’ve encountered before, because usually I have an identical schedule and only take my last pill of the day with others around, and it’s usually just Chris and we’re at home.

when fear asks the wrong question

The greatest disagreement Chris and I have had in our relationship is children. He’s always wanted kids, and when we got married, he knew I wasn’t too keen on the idea, but I was very young, and we both assumed I would gradually come around to the idea. I haven’t. In fact, I’ve become more resistant to it.

We’ve had a lot of tough conversations. There have been lots of tears. It seemed like the question we both had to face was, “Do I have to choose between the person I love or the life I always imagined having?” For Chris, that life meant children. For me, it meant not having children. We reached an impasse.

I knew something was wrong with the question we were asking. I’ve always been very analytical and self-aware, and any question that seemed designed for heartbreak made me suspicious. I fully believe that there is no fear in love, and to be so fearful meant there was something going on.

I’ve had to ask myself a million times, why don’t I want children? It always comes back to my mental illness. The idea of pregnancy terrifies me. The medication I’m on has such a bad rap that there’s a thing called “Effexor babies,” where women have sued after being on high doses while pregnant, and having children with birth defects or who died. Of course, the healthcare system insists the risk isn’t too bad, but they have a horse in the race. Reading stories from actual women has convinced me that any kind of strong antidepressant is going to mess with the natural development of a child. However, the other option, going off medication, is just as scary and risky. Severe depression can affect a fetus’ growth just as much as a drug.

My fears don’t stop there, though. No matter what route I go, that’s just 9-10 months. It’s doable. But, then the baby is born, and it’s here for the rest of my life. It’s overwhelming. I’m at a point where I can just care for my own mental state, how on earth can I be expected to take care of a kid? Another human being, who is essentially a sponge? And then there’s the increased risk of the child also developing a mental illness, so that’s another layer of responsibility.

In going over my reasons, I noticed that Chris was entirely absent from my thought process. And then I realized that the reason I’m so overwhelmed is because I imagine dealing with all the complexities of parenting + mental illness by myself. I don’t have confidence that Chris would know how to deal. I’ve never imagined my life with kids because I’ve never known my life free from the ever-looming presence of mental illness, and I’ve never known what having a real partner in the fight is like. That doesn’t mean that Chris doesn’t support me or is unhelpful. It’s just that depression/anxiety has always been my “thing” that he comes in and out of, it isn’t something he lives with like I live with it. If we’re going to be a real team, we both have to live with it. If we were truly united, I wouldn’t feel so overwhelmed about the idea of kids.

The real question isn’t choosing between us or a kid. It is, “How do we get on the same team when it comes to mental illness?” That’s something a counselor can help us with, and has lots of solutions both practically and spiritually. It’s a question we can tackle without feeling like we’re just butting heads. Fear always likes to ask the question that only has one, usually horrible answer, but that’s not how love works.

Falling into Routine

It’s been a busy three months (give or take). We’ve been on a lot of walks, I’ve taken a lot of pictures of trees, and I’ve packed in a lot of life work: getting medications, seeing doctors, and getting an Oregon driver’s license. We’ve been to Portland and Lincoln City. I started growing parsley, which is now in full bloom and edible. Baxter’s skin is no longer super dry, and he loves having his own room to be super loud in. Chris loves his job, he feels he’s doing important work, and is always in a good mood when he comes home.

It’s nice to fall into a routine. We shop at Fred Meyer, I eat frozen cherries most nights to help me sleep, we go for longer walks on the weekends, and my work load has been pretty light. That means more time for working on my novel, painting, reading, and keeping the house organized. It also means more time for naps, which I still take probably too often, but I’m learning to give myself a break from fretting over that. The fact that my medication changed from caps to tablets has kind of helped with that, because I have to take one pill three times a day, so I have to be awake at certain times to take it. That schedule also helps keep me asleep at night, too, which is weird.

In terms of mental health, it’s been a relatively smooth transition. The only reoccurring blip has been feeling really isolated and kind of at a loss about how to make friends. Chris has been scouting out churches, looking specifically for ones with young people and groups, but I’m still not really interested in going to church. I would definitely join a group though, that just hasn’t happened yet. I tried going on Tinder to look for friends, and chatted with a few people, but after a few messages, that just fizzled out. I recently tried Bumble, which has a better friend-finding feature, and found a person who I’m hanging out with soon. Since I’m just a naturally intense person, I have to keep myself from thinking, “This is my new best friend! Kindred spirit! We’re going to do everything together!”

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Being away from everyone I’ve ever known has forced me to get better at communicating with people and work on old friendships. It’s also made me more appreciate of friendships in different stages, and not neglect someone just because we’re not as close as we used to be, or if there are certain things we don’t talk about. I guess distance does make the heart grow fonder.

Things I Like About Salem:

Rainy days
Having a huge park close by
Having basically every restaurant close by
Fred Meyer and their incredible organic/natural options
So much green
Dogs everywhere
Being closer to Erin (and seeing her twice already since we moved!)

New Things I’ve Baked/Cooked:

Walnut-fig scones
Chocolate pudding
Quinoa salmon bowl
Chicken enchilada bowl
Butterscotch + dark chocolate oatmeal cookies w/ brown butter

 

With Unexpected Speed

I did not expect to be dealing with all this so soon.

I had recently passed my two-year anniversary and was looking out the car window at the blur of fields and barns. Occasionally we would pass clumps of trees, but they would fly by so fast, it was like they had never been there at all. When I tried to focus on a small detail like a single branch or house in the distance, it would immediately bleed into the oddly-linear hues of gray, green, yellow, brown, and blue. My mind was wandering. It had only been two years since I signed a piece of paper, said goodbye to my dog as he left for his new home with my in-laws, and woke up a married woman. In a lot of ways, it seemed like yesterday. However, it also seemed like forever ago. In those two years, me and my husband have dealt with mental breakdowns, horrendous medication withdrawals, a crisis of faith (ongoing), employment turmoil, sexual identity questions, loneliness, relationship doubts, and looming financial challenges. I was not naive when I got married. I knew all this and more was part of the deal; I just didn’t expect it all to happen so soon and so quickly.

Isn’t marriage supposed to have a honeymoon period? You know, that brief time when everything is rose-colored and you’re just happy to wake up next to your person every morning? I’m not saying I’m unhappy to be waking up with my person, but there was never a time when that happiness wasn’t mixed with anxiety and questions chewing on my brain like termites.

Is my unemployment a burden to this clear-eyed, optimistic, occasionally goofball-ish man I’ve yoked myself to?

Will the pharmacy screw up my medication again and disrupt my entire week with crippling muscle pain, headaches, and frantic doubts about everything? Are those bone-shaking doubts just symptoms of an unstable mind, or legitimate concerns I should be listening to?

Should I have gotten married when I did? Am I too young and immature? 

Will I ever be in a place to have kids? Do I even want kids? What happens to us if I don’t want kids? 

Even before we got married, we were faced with having to give up our dog Yoshi and the distinct possibility he would never be adopted. Thankfully, Chris’ parents took him back to Indiana with them, but that raises its own issues, like feeling the self-inflicted internal pressure to make enough money to get a place where we can take him back.

Do other married people have these problems? I’m sure they do. And I’m positive that couples have faced worse unemployment, worse debt, worse mental illness, and so on. I want to always be aware of the privilege I have, but I’m selfish and self-pitying. I see other couples with Instagram-perfect lives and go between feeling glad I’m not a fraud, and then furious that we’re not them. I see other couples having or planning babies, and I’m flabbergasted that they aren’t freaking the f*** out every minute of every day. I envy identity/orientation confidence. I envy white-picket fences and Tuesday date nights and dishwashers. But mostly, I fear.

I fear I will never be happy at the same church as my husband.
I fear 9-5 jobs and “work shoes” and imperfect bosses.
I fear eternal debt.
I fear little pink capsules and inefficient pharmacies.
I fear loneliness because I don’t dare get close to other women.

I fear God and His timing, which is so unlike our own, that to Him nothing is “unexpected, “too soon,” or “too late.” 

God of the Tar Pits (Part 2)

While seeing depression as a result of spiritual frailty or sin has become outdated, there’s still some odd Christian teachings about it. Depression is viewed as a season and something that – with time and prayer – can be overcome. All my life people have told me to be patient, that they were praying for me, and that I would one day know the freedom and joy that only Jesus can bring. The longer the depression stayed, the less people talked about it. They got tired of telling me they were praying, and I got tired of hearing about it. Believing that depression is a sign of spiritual weakness is not popular, but if you suffer from prolonged depression, people start to wonder.

Depression “success” stories are remarkably popular. Christians devour personal tales of fellow believers suffering from crippling anxiety and depression who have been transformed by God and grace, whose marriages have been saved, who have found peace, who have overcome brain chemistry and been “freed” from medication. They were lifted from the tar pits by Jesus and as one of those Christians who have depression, I was encouraged to pray for similar redemption. At a conference, a friend told a story about a young man who went to be prayed for and was healed from depression in that moment.

“How did he know?” I asked, confused.

“He just…knew,” she replied.

“That sounds like bull crap.”

“Do you not believe that God can do miracles?” she probed.

I didn’t know how to explain to her that that wasn’t the issue. It wasn’t that I didn’t believe God could heal me from depression, it was just that I knew if it happened, it wouldn’t be with just the snap of a finger. I had never seen God work that way. He didn’t seem to really be into that whole instant gratification thing. When I had that conversation, I was at the point in my life where I didn’t even want to be healed from depression. I was beginning to learn that it was just something I would have to live with, like a scar. Sometimes it would act up and interfere with my life, while other times I could almost forget it was there. I didn’t want to overcome; I wanted to persevere.

When I recognized that depression was going to a permanent fixture, I stopped struggling. The discovery came in stages, but was punctuated by the end of my second year of college, where things were going so well that I stopped taking my medication. From the outside, my life looked perfect. I had gotten into my dream school, was doing well, and making friends. I was also part of a faith community that emphasized spiritual warfare, and I believed that I had successfully conquered all my demons. Then a childhood memory rushed brutally to the surface and my brain broke. I locked myself in my room for three days straight and didn’t move. People had to bring me food so I wouldn’t starve. It was finals’ week and all my hard work seemed wasted. It seemed like I had won against depression, but it came back with a vengeance, like it had never left, or like it had been gathering strength. When summer came, I went back to my psychiatrist and was put on the highest dose of a new medication. For the first time, I accepted it gladly.

Antidepressants are notoriously tricky. The most prescribed class of medication for people like me with major depressive disorder and anxiety are SSRIs (selective serotonin re-uptake inhibitors). These were created based on the belief that depression and a host of other mental illnesses like anxiety is caused by a lack of serotonin – a neurotransmitter responsible for feelings of happiness- in the brain. The reason they are controversial is because of the nearly limitless side effects that have been reported, like loss of sexual interest, vomiting, headaches, dizziness, and insomnia. They are also labeled with a “black box,” which means a side effect of taking the medication might increase suicidal thoughts and tendencies. When I first started taking medication in high school, I was required to see a psychiatrist once every two weeks and tell her if I was experiencing this side effect. I can’t say if these sorts of thoughts increased because of medication, but many of them did little to reduce my depression while also gracing me with flu-like symptoms, severe exhaustion, and muscle pains. On particular medication I took over a summer made me sick every morning for two weeks.

Constantly adjusting medications that didn’t seem to help much, but succeeded in making me ill was frustrating, but when I had that breakdown sophomore year, I knew I needed medication. No amount of prayer alone could fix brain chemistry. I was arguably in the best place I had ever been spiritually, I knew I wasn’t possessed, but still my head reeled and I couldn’t will my body to move. That experience taught me that I can’t pretend my depression is gone just because I feel okay. I have to anticipate it, plan for it, accommodate it. That’s what medication is for. Finding one with minimal side effects was worth it and when things are going well, I may be tempted to stop taking it, but when the other shoe falls, medication is there to balance out any craziness the body throws at me.

Once I realized that depression was going to be a part of my life in varying degrees, my expectations changed. Instead of trying to match everyone’s achievements, I came to terms with the fact that I wasn’t like “everyone else.” Certain things will never be easy, like making a phone call, getting to class every day, or hanging out in a large group. There are things I will never do, like travel alone, go completely off medication, or hold down a high-pressure job. It’s a good week if I get out of bed every day. And that’s okay. That is just who I am.

There are also things I know that other people don’t because of the depression. I understand hopelessness. When people ask why anyone would commit suicide, I have the answer. I don’t have a neat, happy success story, but I have a story that says, “Depression never goes away, but it doesn’t have to control or define you.” I can see where traditional mental health services failed people, especially religious ones, because it has failed me. What I learned most from depression is that it’s the place where I met God. He wasn’t in a counselor’s office, where I was given lists of mood-boosting activities, or in a required chapel where I felt completely alone while surrounded by other Christians. He wasn’t in books or sermons.  He was- and still is – in the tar pit.

It would be understandable if I had abandoned my faith at some point during my struggles, but something kept drawing me back. Some of it was fear, yes, fear of venturing off into the unknown, but most of it was because I could see the marked difference between how my fellow Christians saw mental illness, and how God seemed to see it. The Bible is so full of references to persistent, bone-crushing sorrow that it can be overwhelming and triggering to read. People are constantly weeping, renting their clothes, pouring ashes on their heads, and lying on the ground, unmoving, for days. Jesus himself prayed with such agony before His death, that his sweat had blood in it. He is described as “a man of sorrows and acquainted with grief.” The one verse that has stuck with me most is from Psalm 34: “The Lord is close to the brokenhearted and saves those who are crushed in spirit.” I used to be frustrated with this. I understood the first part, but what about the second? Where was the “saving me” bit? When I accepted my depression as something that was just with me, my definition of “salvation” changed. It didn’t involve being pulled up from the tar in a bright beam of light and suddenly “knowing” I was “cured.” It didn’t involve some big success where I suddenly become someone I’m not. It’s the little things, like being loved. It’s having insurance for medication. It’s graduating from college, no matter how long it took. It’s finding people who understand. God had been saving me every day, bit by bit, keeping my head above the tar.

I should make it clear that not all of life is being in the tar pit. Good medication and healthy choices help keep me grounded and productive. It’s just that no matter how good things are going, that tar pit is never too far away. There’s no real rhyme or reason to why I fall in. Sometimes it makes sense, like the death of a family member. Other times it’s random, like the wind changed directions. I used to be terrified of that movement when I felt the tar rising up my legs, pulling me down. I would struggle and berate myself.

“How could you be so stupid?”

“Why did you let your hopes get up?”

“You know you can’t push yourself too far; why did you try?”

The voices are quiet now. The tar pit doesn’t frighten me as much. I just keep breathing and let it happen. Eventually, the tar thins out and I’m free from it for a while, with renewed focus and gratitude. Life goes on, and I have two choices: look back with regret, or keep moving forward with hope. I choose hope.