Popping Pills

Trigger warning: This post contains mentions of suicide and suicidal ideation.

It’s still Mental Health Awareness month and we are still making progress.

Are you still with me, stigma fighters?

You’ve come down a long road. Pushing past what others might think and finding help for your mental illness is a major step. Good job! Way to show up for yourself! Now it’s time to talk about treatment options.

In my previous post, I mentioned that people should not have any shame when seeking treatment. It is the correct thing to do when something feels wrong in your body.

Have you ever tried moving on your own? You might start okay, but you’ll get overwhelmed with the sheer number of boxes you have to pack and organize.

“When did I buy this coat rack?”

“What is in this box that’s been under the bed for three years?”

“Whose pants are these?”

You might also hurt yourself in the process of trying to save a couple of bucks. You’re better off just calling movers to help you pack and unpack your shit. Professionals who know what they’re doing can not only get the job done but can do it faster than you ever could on your own.

See where I’m going here?

People should feel good about the form their treatment takes when dealing with mental illness.

Many people get talk therapy and that’s all they need. I believe that everyone needs a relationship with a professional therapist. Therapy is not only for crises, but you can learn valuable coping skills that will help you to avoid a crisis altogether. Everyone needs help coping with life at times.

For others, talk therapy isn’t enough. Medications can be used to ease the symptoms of various mental illnesses. I know that there is an entirely different stigma related to medication, but we have to push past this as well. Remember what I said before about doing what is best for you? That advice still applies.

Medication was the right decision for me. My depression and anxiety were making my life unlivable. I have such a hard time functioning when I’m unmedicated that I seem like a different person. I don’t care for that other person when she shows up. The person that doesn’t care about herself to the point that eating for survival seems stupid and pointless. That girl who can’t find the value of her contributions to those around her and the world at large. She’s not a fun person to be.

It can be daunting if a medical professional decides that medication might be part of an effective treatment plan for you. You might begin to think terrible things about yourself. That you are “crazier” than you thought, or you can’t be helped any other way.

Stop that immediately.

You internalize negative messages much easier than positive ones. Do not consciously set yourself up for failure right out of the gate. The human brain is amazing and can be convinced of almost anything, with the proper help, of course. I know it’s scary and hard, but it’s worth it. You are worth it.  

I’m not a medical professional and this advice is just that. A suggestion that might help you make your own decisions. You should rely on advice from medical professionals to make informed medical decisions.

I am, however, an expert on my own life and experiences. Medications can have interesting side effects and it might take some time to figure out what meds will work for you. You might need more than one to level you out and that’s okay. Your doctor can work with you to find the right mix and it may take some trial and error. I can tell you that my journey with medication has been an interesting and long one. Here’s a highlight reel of the past twenty years of my experiences with anti-depressants.

Lexapro (Escitalopram Oxalate)

You never forget your first.

I had been in therapy for a couple of years before I started taking meds. I was 18 and my therapist believed that it was appropriate to incorporate medication into my treatment plan. Just talking wasn’t working anymore and the anxiety surrounding high school graduation and college was kicking my behind. It’s a known fact that anti-depressant medications can cause suicidal ideation in teenagers, but we decided that it was worth the risk.

I didn’t have any measurable side effects with Lexapro. I was on a low dose and things seemed to be doing okay. Things went so well that I deluded myself that I didn’t need to keep going to therapy as long as I could keep taking my pills. I stopped going regularly and I stopped getting regular prescription refills.

Things fluctuated like that until I got pregnant at 20. I stopped taking all my meds cold turkey and fought off my emotions alone for the sake of my unborn child.

Let’s stop here for an important PSA: Please, do not, under any circumstances, stop taking your medication because you want to. Many SSRIs (Selective Serotonin Reuptake Inhibitor) alter your brain’s chemistry to the point that a chemical withdrawal can happen if you just fall off the wagon. This withdrawal and relapse of symptoms can be worse than anything you have ever experienced with mental illness and may prevent you from seeking treatment again in the future. Don’t do this to yourself, loves. Your doctor can help you gradually reduce the amount of medication you are taking if a change is necessary, but don’t take that chance on your own.

I tried to go back to Lexapro after my son was born, but it didn’t help anymore. My body chemistry had changed, and Lexapro wasn’t welcome at the party anymore. It was time to switch it up.

Celexa (Citalopram)

I call Celexa, “Lexapro’s older cousin”.

It’s another SSRI that is used to treat clinical depression. When I met her, I had been away from therapy and meds for about three years. Things had gotten bad in my personal life and I was having a hard time with single parenthood. Having to hunt for another therapist wasn’t helpful either. My previous clinician had “gone to join the choir invisible” and I was back at square one.

My new therapists weren’t anything remarkable but the last one did manage to get me on Celexa. Things were looking up for a little while. I wasn’t having unmanageable side effects, some weight gain, and trouble sleeping for the most part.

Until my face started itching.

I have mildly sensitive skin. The wrong laundry detergent makes my skin dry out. Add my PCOS diagnosis and I never know what my hormones will do to my skin. However, the itchiness was new and irritating. I didn’t think anything of it until I noticed the rash. Large, red hives were taking up residence on my face. My forehead and the area around my eyes burned and ached. There was no relief in sight, so I saw a dermatologist. They determined that the Celexa was the culprit of my skin inflammation and I was ordered to stop taking it immediately. My face cleared up after a few days, but I was off my meds again.

The Lost Years (No meds, no help)

It was at this point that I dropped therapy completely. I just waded through my life, choosing apathy to get through my days. Feeling nothing was better than wallowing in my sadness. I had a child to take care of. I needed to work and put food on the table and he was not taking “Mommy was sad this week.” as an excuse. I sunk into a deeper depression, but I had learned to be functional for the most part.

I didn’t enjoy my life. I was merely surviving. I was keeping myself alive to be a cog in someone else’s machine. This suited me fine until I realized that my child was watching me. I noticed that he could tell when I wasn’t doing great. He could tell when I wasn’t being the best mom I could be. As he grew up, he was picking up my unhealthy coping mechanisms. I never wanted that for him, and I needed to do better. After eight years, I decided that I had to do better for his sake. For both our sakes.

Wellbutrin (Bupropion HCL)  

The new girl in town.

I had started seeing my current therapist at this stage. We have built a good relationship when she suggested that I try medication again. I told her that I was willing but apprehensive. She knew what I had gone through with medications and suggested something different. Wellbutrin is in a different class of antidepressants called Norepinephrine and Dopamine Reuptake Inhibitors (NDRIs). Loosely, this meant that it was doing something different in my brain compared to the other medications I had tried before.

It worked just as well at first, but the effect waned over time. I took Wellbutrin for around two years and I didn’t notice the change until things were bad again. The meds came with my normal side effects of weight gain and a little lethargy. I could deal with that easily. However, I wasn’t doing the best I could with my moods. I could push through my bad days, but I was very sad as well. I was barely functional. I made it to work every day and fulfilled my obligations, but that was it. Self-care and self-love never entered the equation. Additionally, my trouble sleeping evolved into full-blown insomnia.

I should have noticed Wellbutrin wasn’t working anymore. It must have been a common issue as Wellbutrin has been discontinued in the US.

Trazodone (Desyrel)

My sleeping assistant.

I welcomed the addition of something that would help me get to sleep at night. I would go for days on end without getting a decent night’s sleep. If I slept at all, I was plagued with nightmares. Trazodone comes from another class of antidepressants, Serotonin-2 Antagonist Reuptake Inhibitors (SARIs). It is used to treat insomnia associated with clinical depression.

My mood changed because I was sleeping again. I felt better about continuing to be alive. I believed that this combo of drugs was helping me achieve the remission I was seeking.  For a while, things were good until the Wellbutrin stopped pulling its weight. I only took Trazodone at night, but my days were still a struggle. Plus, the additional stress of the pandemic and returning to work in person had pushed my anxiety to a level that I had never experienced before. Time for a shift change.

Wellbutrin + Trazodone + Paxil (Paroxetine HCL)

A bad time in a bottle.

Friends, if you enjoy consciousness at any level, do not do this to yourself without consulting a doctor first. I couldn’t stay awake for more than an hour or two at a time and the nausea was abysmal. Let’s take a step back.

Paxil (Paroxetine HCL)

Fun while it lasted.

After cutting out Wellbutrin and Trazodone, the Paxil could stop fighting for space in my bloodstream and thrive. Another SSRI, Paxil was designed to combat anxiety and depression at the same time. With Paxil on my side, I’d been able to take steps to make positive changes in my life. It had only been a few months, but I felt like a person again. I had goals that I was making progress towards and I felt like a better human than I have been in ages.

The trade-off was a couple of weird side effects. The heartburn was aggressive and nearly constant. Coupled with the acid reflux that resulted from my gastric sleeve surgery, my throat was on fire constantly. It was difficult to want to eat because it hurt so much afterward. I had to take Prevacid every day to be functional, but that was an acceptable consequence.

Other side effects were not so easy to dal with.

I also acquired an odd tingling sensations in my right arm. Just in my right arm. It feltlike my arm was going numb at random times during the day. It was scary at first because the warning labels tell you to consult a doctor immediately if this happens. It could have been a symptom of serotonin syndrome; a nasty little ailment that I wanted no parts of.

The weirdest thing that happened to me was the occasional “eating things in the middle without my knowledge or consent.” Paxil has a side effect of an increased appetite, which was annoying when I’m trying to sleep. However, sleep eating is unacceptable.

Once, I woke up eating peanut butter out of the jar. With my fingers. I woke up with a mouth full of peanut butter, clutching the jar against my chest.  I have since stopped keeping snacks in my bedroom and asked my husband to keep an eye on me during the night.  

After discussing the side effects with my regular doctor, I had a decision to make. The tingling sensation was something to monitor over time and it did improved some, but I could pick a new medication if I wished. Did I want to risk my newfound happiness to try a new medication or remain with what I have despite the intense side effects? For me, the decision was to take my chances with something new. I was addicted to feeling like a functional member of society and I need that feeling to continue for as long as possible.

Effexor (Venlafaxine)

X gon’ give it to ya

The first couple of weeks with Effexor were like floating around in a pink haze. I didn’t think I could have been in a bad mood if I tried. A good portion of the haziness was because of my daytime drowsiness. I took Effexor before I went to bed and I was still tired well into the mornings. No amount of caffeine helped. I could get to work and handle business, but I was full of yawns until around lunchtime.

I talked to my doctor and she basically suggested that I hang on for the ride. My system was throwing me curveballs while weaning off the Paxil and adjusting to the Effexor. My new rose-colored life was interesting, to say the least. The sleep was exquisite.

After six weeks or so, things regulated. The numbness and drowsiness subsided and I haven’t slept eaten in ages. I was able to function like a person with normal moods. I could laugh and make jokes without forcing myself. My gamble had paid off.

The decision to take medication to address mental illness is not one to be taken lightly. It involves continuous self-monitoring and checking in with medical professionals if something seems amiss. It can be a lifetime commitment, depending on your diagnosis. Medication can be temporary as well. Something you need to get you through a hard couple of months or years. Either way, my advice to you is to keep an open mind about the use of medication and those who have to make that decision.

Everyone is deserving of love, respect, and dignity. There is no room in love for stigma and shame. Mental illness should not be a barrier that prevents others from treating you the way you deserve. The road to good mental health can be long and hard. The journey doesn’t have to be awful on top of it. A little love and respect can go a long way.