People often ask me about antidepressants once they learn I've taken them. I've been on a few, actually, and one thing I've noticed is that not only do they affect different people differently, but they affect me differently in the times I've taken them. The first time I was on prozac (for PTSD) it worked extremely well. The one memorable side effect, by the way, was extremely long and intense orgasms. Go figure? I was on it for about six months, during regular talk-therapy, then tapered off as the symptoms disappeared. Within about a year I was finished with therapy as well. After Jesse died, I had no problem asking the new psychiatrist to prescribe it again, but my response was totally different. It didn't really help. I felt a little better, but the insomnia was wearing me out. I had no appetite, and problems thinking clearly. Instead of switching me to something else, the new psychiatrist added amytriptaline (elavil), trazadone, and gabapentin (neurontin). I gained 20 pounds. I couldn't drink at all, not even a beer. My mouth was dry all the time. I lost interest in sex. On the plus side, the neurontin made my sensitive skin invulnerable. I could wear a wool sweater without an undershirt and think it was cotton. At one point the stress caused one (yes only one) shingle. I didn't even feel it, although shingles are supposed to be painful for months. Hope that means I'm done with that for the next 40 years.
At any rate, I began asking to go off the antidepressants after about six months (just like the previous psychiatrist's protocol), but the new doctor would not let me. I had to threaten to go off them without her help to get her to tell me how to ladder down. It wasn't until 18 months that I finally got off all of them. I fought to lose five of the 20 pounds I'd gained, and I'm still uncomfortably big-- and unable to lose it without getting sick from lack of eating. I've never had a problem like this in my life.
This fall, I ended up on zoloft, but not for depression. It's off-label prophylaxis for migraine. It did lift my mood, and doesn't seem to negatively affect my sleep, but it does cause some nausea. It helped me to restart my teaching sideline, and it's been a huge boon in social situations. Growing up shy and introverted, I have had to learn as an adult how to be a social person, so group activities can stress me out to the point of exhaustion. Gearing up to do a lecture or lead a workshop took months of practice and anti-anxiety strategies. With zoloft, negative emotional states feel, well, padded. Buffered. Kind of like neurontin for my inner skin. It's helped a little with the migraines, but mostly it's helped me suffer less, and over shorter periods, from the loss of Jesse, and allowed me a couple of moments of actual everyday happiness. Not euphoria, mind you, I don't think I'll be there for a while. But that mundane joy in being alive. I'd forgotten what that was for a long, long time.
Unpacking Someday
2 years ago
I've done a lot of work with people suffering from PTSD, Depression and Panic/Anxiety issues and have spent a lot of time trying to explain the efficacy of various medical protocols along the lines you've outlined.
ReplyDeleteThe drug itself is not the cure. It is an attempt to re-align or re-balance what MY body sees as balance or alignment. That is different for everyone, and different for me depending on what my body perceives as missing.
I believe that our body/mind strives for a kind of balance or wholeness ... dealing with our life events much like a tree deals with a strike of lightning. There is damage, yes. And for some it may be damage that will not ever be anything but hugely obvious.
But there is also something that pushes for life. For living. And that is, to me, where the healing can take place. So if a drug is going to work it is going to support wherever the body/mind is striving to grow.
It can take time to figure that out. But it is possible.
(I'm glad you've found something that works on that inner skin)
I don't necessarily disagree. The accepted idea behind combined med/talk therapy is that the brain actually creates a neural "track" for depressive thinking.
ReplyDeleteThe medications derail the train of thought that leads to depression, and the talk therapy allows the specific nature of the problem to be rethought, laying new tracks, giving new skills to prevent the thought process from spiraling into despair, and circumventing the physiological, reinforcing effects of depressive thought patterns.
That said, in research, the six month course of antidepressants itself is as effective as the same six months of therapy alone. So in a sense, it is the cure, because it does what we can't do by will alone.
True. I think what I meant was that so many of the people I work with believe they can take a pill and continue on (with the fretting, worrying, catastrophic thinking, alcohol and weed as self-medication, no sleep, eating crappy food) and that somehow that magic little pill is going to make it all better.
ReplyDeleteTo me, there is often some kind of engagement with change that has to, or should, occur as well.
I would guess that the spiraling down itno the same old despairing thoughts is one of the worst parts of depression. That's how I remember it from my experience. That there just was no chink of light in the darkness that it could/would ever change.
I did a short (six week) course of Lexapro under supervision of a physician when I was last suicidal, and that chemical restructuring, even for that short an amount of time managed to give me what I needed to avoid that same pit again, several years later.
ReplyDeleteI'm so glad to hear that the Zoloft is helping in unexpected ways, and I'm sorry to hear that the therapist didn't want to let you ladder down from the Prozac the second time around. :-)