Thursday, October 6, 2011

Listen to me!

It was now early spring, just a few weeks before Easter. It became clear to me that my elevated anxiety was at the heart of my most recent and lengthy depressive episode. For some time, I had suspected that my medications might be at the root of my problem. Maybe my system had built up a tolerance to them overtime? Maybe they were never the right combination of meds to begin with? Whatever the case, I was at a point where I knew I was feeling no different. It made me wonder why I was taking them at all.

At this time I was taking Wellbutrin, a unique anti-depressant that I had been on for over a year. I was also on Buspar – an oldie but goodie – for my anxiety, but looking back now, it never worked that well for me. If I took the highest recommended dose, I felt sick to my stomach. I tried to tell my psychiatrist on more than one occasion that I didn’t think my meds were helping me like they should. His next step was to prescribe Levothyroxine – a thyroid hormone that when taken at a very low dose was said to help elevate mood. When I contacted him again after several weeks hoping for yet another option, he told me we were running out of choices. Knowing that my body did not respond well to SSRI’s (Prozac, Lexapro, Zoloft), he said our next step might be a low dose of Lithium.

I never called him again.

I may have been depressed, but I knew there had to be other options out there before we pulled out the big guns. Lithium? Now that IS crazy!

I asked my therapist for a referral, explaining to her that I just couldn’t believe Lithium was my last option. She agreed. I knew there had to be another way. I knew my doc just wasn’t listening to me. I was screaming out to him: “Treat my anxiety! Treat my anxiety!” and his solution was to prescribe a drug normally given to patients with bi-polar depression. I had always known I was not bi-polar. My depression just never worked that way. It didn’t happen in extremely high and low fits. I never had the urge to stay awake for days or find myself maxing out my credit cards. It was more like a constant, undulating pulse that weighed me down – some days more than others. I only wanted to sleep. Besides, my therapist assigned me a formal diagnosis of Major Depressive Disorder (MDD) back in February. (For more information on MDD, check this out:

My therapist eventually put me in contact with a psychiatric nurse at a local mental and behavioral hospital. Finally – a new plan! The only drawback was that she was booked until mid-May. One evening when my anxiety was particularly horrible – racing thoughts, short of breath, pacing, etc. – I gave in and drove myself to an immediate care center. I told them every med I was on and my entire mental health history. I asked to be put on something that would help calm me down until I could get in to see this new psychiatric nurse.

No help whatsoever. They wouldn’t prescribe me any anti-anxiety medication and proceeded to inform me that if I needed further treatment I would have to go to the local hospital, admit myself, and stay overnight for evaluation. I was seething mad and completely discouraged – again. I just needed some help. I felt like no one was listening to me – again. Even after the doc inquired if I was suicidal, which I have never been even in my darkest moments, she still turned me away. Unbelievable. I knew I couldn’t go home. I would be alone with my thoughts and I wouldn’t be able to calm myself down. When I managed to finally pull myself together again, I took myself to a concert at the music school. A three hour event, it helped soothe my anxiety and lifted me up to a better place. I knew I could return home to an empty apartment and maybe get some sleep. I was going to be okay.
*                       *                       *
Since seeing my psychiatric nurse, who took my complete mental and family health history in handwritten notes, I was prescribed a drug called Cymbalta. Ads for it run on TV all the time: “Depression hurts. Cymbalta can help.” In my case, this is true. Cymbalta is in a class of drugs known as SRNIs, which target serotonin and norepinephrine. I began at 30mg daily, and eventually worked my way up to the full 60mg dose without any problems and minimal side effects. At 60 mg, Cymbalta is said to treat the symptoms of GAD, or Generalized Anxiety Disorder. She also prescribed me a daily low dosage of Klonopin, commonly known as a “benzo,” to further aid in the treatment of my anxiety since I told her I thought this was my most immediate problem. I was told to take a pill in the evening before bedtime; the idea being that I would wake up a little less frazzled and edgy.

So I had a new med cocktail that overtime proved to be effective for the treatment of BOTH my depression and anxiety. All of this arrived at a very providential time in my life. By early May, I had been on my new meds for about two and a half weeks. I also graduated from school – finally – after nine years of work. I even attended the ceremony, which I didn’t do as an undergrad. I felt it would help bring closure to what seemed like an unending chapter of my life. I woke up every morning and could breathe just that much easier knowing that I would never have to go back to this particular school. No more pressures of academia, no more constant evaluation, no more grades assigned to my art. This chapter was done. Over. FINITO!

Some weeks later, my husband and I decided to relocate to the small town in which he was teaching. We found a small house to rent, which for someone who has lived in apartments for the last nine years, this was very exciting! Around this same time, I found a great part-time position at a Methodist church about 35 miles away from where we had chosen to live. I felt so lucky to have found meaningful work during this time of transition. Moving to a small town immediately begs the question: “What the hell am I going to do around here?” But I had been given an opportunity, and for that I am grateful.

Most importantly, it was summer, and I decided to make it a REAL summer vacation. After all my husband and I had been through, after all I had been through between doctors and meds and recitals and this and that, it was time for my mind and body to heal themselves over. This meant no recitals. No conferences. No special projects. I limited myself by taking a very part-time job at a local ice scream shop to give myself a little something different to do during my last few months in town. I spent time with friends and family. I read and caught up on all the stupid TV that I missed during the school year. I joined the local YMCA. Some days, I gave myself permission to stay in my PJs until dinnertime. Big deal, I thought. I earned this. I also kept up on my therapy through individual and couples sessions, still journaling like crazy. I even tried writing some poetry. On the whole, it was a great summer. Without challenges? Of course not. But these challenges were all the more bearable now that I had an advantage over my depression. I had finally – with the help and support of my doctors, my husband, and my family – found a combination of drugs that worked for me.

It took over a year and a half, but we found each other.

To our health,
"The moment you can visualize being free from the things that hold you back, you have indeed begun to set yourself free."---Unknown

Sculpture by: Zenos Frudakis "Freedom" 

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