Tuesday, February 3, 2009

That's it! I quit!

(I posted last Friday but it looks like it got stuck back in December of 08 when I first started drafting it. For those of you who missed it you can read part three of my series on Support Where You Need it the Most.)

No, no, no, I'm not quitting blogging. I'm quitting my medicine. Well, maybe.

For those of you who have been reading for a long time now, you'll remember that last summer I had a Prozac poop-out. (I was on Lexapro, so technically it was a Lexapro poop-out, but you can't link to that term so what's a blogger supposed to do!) I met with a friend-of-the-family psychiatrist out in Utah during our family reunion. It was awkward but free so I went for it. She explained the Prozac poop-out phenomenon to me and recommended I switch to Cymbalta. She said it would do a better job at nipping my intrusive thoughts in the bud. I had reached the point where I was nervous to be alone with the kids so when I got home I dialed up our family practice doctor and she wrote me a prescription.

And it worked. It was a little rocky at first but it worked. I still get nauseous if I go too long without eating and I still nap 3 out of 5 days and since it's still winter I don't worry too much about my increased sweatiness--I just go without a coat--but most of the time I'm not depressed. That feels good.

Except for when it doesn't.

I have to admit those little blue and white pills are starting to annoy me. I hate having to remember them every morning. I hate having to call in for the refill. I hate how much they cost. I fantasize about how much I could get done if I didn't have to nap. I'd love to be able to lose my muffin top but the urge to snack is too strong. And, well, it's still winter now but it will be spring and summer soon enough and I don't want to have to carry around a pack of tissues just to soak up my extra perspiration. It's gross!

Of course, the real reason I want to quit my antidepressant is well, I want to quit being depressed. I want to quit having a mood disorder. I want to quit feeling less than normal because I have to take medicine every morning. I want to know if who I am now is who I really am. I think it is but how can I be sure when I'm popping this pill all the time? I'm just tired of being that girl.

I've gone off my meds before. I wean off them before getting pregnant. I tried to quit my Lexapro last summer (before it quit me. If I could argue with my medicine we'd totally have one of those "You can't fire me, I quit!" conversations). It's always ugly. My patience disappears and my anger comes back and then the guilt sets in. My intrusive thoughts get all noisy. I have to pray myself out of bed in the morning.

But this time is different. The first time I quit my meds I'd only been on an inadequate dose of Lexapro for three months--which research shows is too short a time and actually leads to worse depression. (I can't find a link to cite that last bit, but I know it's true. Ask your doctor!) The second time I weaned off was after eight months and a lot of the environmental factors of my depression hadn't changed.

So how is this time different? Well, I've been pursuing treatment that includes off-and-on therapy (the insurance only covers twenty visits a year so I've got to use them wisely) and SSRI/SNRI for over 18 months. I've actually been working with my therapist for over two years. Come to think of it, I should have sent her flowers for our anniversary last November!

I guess the big thing that hasn't changed is the environmental stresses. I still have three little ones, who are bizarrely unable to sleep through the night, and my husband is still in grad. school and working full time. He graduates in May so maybe I should hold on to those little pills until then.

It is such a wearying truce to strike. I'm so sick of having to act like I'm sick just to prevent the sickness, you know? It doesn't make sense to keep taking Nyquil just to make sure you don't get a cold. But depression isn't a cold. It's not something I can just get over. My body doesn't have a response system for this. Depression is a disorder that I will have to be aware of and manage for the rest of my life. That's what that pill means. And that's why I hate taking it.


Charlotte said...

Such a good post! I loved this line"I'm so sick of having to act like I'm sick just to prevent the sickness, you know? " I DO know! I can totally relate. It's a rotten choice to have to make. Have you discussed going off with your doctor? You've got my support no matter what you decide to do!

mom of boys said...

This is part of the reason why I'm trying to manage this w/out drugs. I can't stand the thought of needing medication the rest of my life and the withdrawal symptoms when I stop are so horrible that it just seems best to avoid it. Plus, I'm not convinced that I'm so severe that other options wouldn't work. And of course, nothing I've tried has worked very well anyway so I don't have much motivation to try again.
Right now I'm starting an exercise routine to see how much that helps. I have lots of other ideas too, unfortunately depression seems to suck the desire to do anything right out of me. It's such a complicated issue.
Good luck to you, I hate drugs so I really hope it works out for you and that you have the support you need. Unlike me, your husband is probably aware of your depression. Perhaps telling mine would be a good place for me to start!

sarah louise said...

When I chose to go off medication I had all the thoughts you did. It is a very frustrating, confusing road.
What helped was that I had a friend who's husband had gone off his meds a year before. She was able to walk me through all of the withdrawl symptoms I was experiencing. That helped to know what I was going through was normal.
I have to warn you that you won't feel very good for probably a year after you get off meds. Everyone else I know who has gotten off them also agree it took about a year to feel somewhat normal. That was a very hard year for me and I often wanted to go back on my meds.
But it has been about 2 1/2 years now and it feels good that I can now manage my depression without meds. It isn't always easy, but it was worth it for me.
Good luck, and please know that others are here for you in your journey.

Misty Lynne said...

I know it's different, but my husband can't stand the idea of taking meds for his ADD or OCD issues either. He likes being who he is, not what the drugs make him, and he hates the dependence as well. It's not easy, but we have found coping mechanisms (exercise, diet, support, clocks everywhere . . .)

If you're serious, go for it. And don't worry about dumping your kids with me if you need. They keep mine happily entertained.

Laura said...

Thanks all!
Charlotte--Yeah, yeah, I should talk to my doctor :)

Mom of boys--it might be good to talk to your husband. I would never consider trying to go the med-free route without a lot of support from those around me. Oh, and exercise totally helps. You can do it!

Sarah Louise-- that's good to know that it took a year to get back on track.

Misty--I'm dying to know how clocks help! Seems like that would only make him more nuts.

Misty Lynne said...

Laura, part of ADD is hyperfocusing on non-important things, like blogs, video games, etc. He'll get distracted by them, and then hyperfocus. Next thing you know, a couple hours have flown by, and nothing "productive" has been done. Clocks help him break away from that. Not perfect. He still has to break away enough to look at the clock, but it does help.

Michael said...

I worry about you Laura.

I've been through several medication failures and they're not pretty and I certainly know what you mean about not wanting to be sick any more.

It makes me so angry that insurance companies can get away with not paying for treatment just because the part of your body that's sick is your brain. It makes as much sense as them saying they'll pay for problems with your right foot but not your left.

Before attempting to go off your medications you need to get rid of every source of stress in your life that you can. Obviously you can't get rid of your children or husband but everything else is fair game. That includes any church callings you may have. Even if you enjoy them they are a source of stress. They require you to be there whether you feel like you it or not. You have much bigger priorities in your life. If I were your husband I would have talked to the bishop a long time ago and told him that you were to have no callings until you are all better.

Hang in there.

Stella said...

my own mother dealt with this her whole life. she is still dealing with depression and as her daughter, I am dealing with it via her. While I've never suffered from the disease, I do understand how hard it is to make these decisions and to get your life to the place you want it to be.

Beautiful post.

Total Delights said...

Hang in there and know that you aren't alone there are many of us that have the same challengesprov