09 August 2011

How did you respond to anti-depressants?

by Soledad (short), Pastor Jayne, and Nia (long)

Soledad: Anti-depressants, strangely enough, did more to mess up my system than to help it. I tried just about every one (the serotonin re-uptake inhibitor types). And they all left me sleepless, like I had drunk an entire pot of coffee. When I asked the doctor about this strange phenomenon, she said that she had never heard of that reaction before. Yet I have two personal friends that report the same sleeplessness on these drugs.

I know that sleeplessness, or any break in my normal routine, does more to dash my mood than anything. I am a nice person on sleep, and am more of a devil on a less than optimum amount. So you can imagine that living with me during the brief time I took these pills was less fun than a barrel of monkeys.

I don't recall feeling any less depressed, just less rested and lousier.

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Pastor Jayne: I did a lot of research before getting on an anti-depressant. It helped that my husband's friend was a psychiatric pharmacist. One of my main concerns was that I not gain 15-20 pounds as I'd heard can happen. (I was finally getting my body back now that the kids were 5 and 7!) Also, I'd heard that anti-depressants could affect your sex drive, and I didn't want my hubby to end up depressed so I wanted to avoid that renowned side effect as well. I eventually chose Celexa (Lexapro) because I learned it was a cleaner drug: (1) fewer side effects, (2) effective at a lower dosage, and (3) a shorter on-ramp. I found all of that to be true. The first two weeks I was incredibly sleepy, but after that I slept more normally than I had in a year, and felt much more like my old self. The fountain of tears also (mostly) turned off -- I no longer cried during Swiffer commercials.

One piece of critical advice my husband's friend (the pharmacist) gave me: even if the doctor suggests a certain dosage as you titrate up, if you are simply too drowsy to function, then titrate up more slowly. So I cut the pills in half and titrated up at half the dosages the doctor recommended. For my body type, weight, medication tolerance, etc. it worked better for me that way. TGFAD! (Thank God For Anti-Depressants!)

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Nia: I started Zoloft in May of 1996, two months after quitting my job in Los Angeles to avoid being fired for my deteriorating performance. I also quit because I'd run out of ideas for solving my 15-odd years of depression, and was basically saying screw it, universe, you take over. As my friend Dennis phrased it, I was looking for a paradigm shift, but I had no clue how to go about it.

In May I picked up Listening to Prozac, recognized myself in the patients the author described, grabbed the Yellow Pages and called the closest psychologist I could find in my neighborhood. After a 20-minute appointment, I had a prescription for 50 mg of Zoloft. The doctor told me to start at 25 and to not expect much for six weeks. I took my first dose when I got home. When I woke up the next morning, I felt different. And anyone who wants to tell me that was the placebo effect, let me kick you in the shins.

That thing they warn you about where strangers approach you for directions -- that happened a few days later on the sidewalk. Soon after that, I was asking a hardware store clerk about stepladders when an actor on the other side of the store called out to tell me where I could find them. Admittedly, actors are not the best gauge of normal human interaction, but still, that sort of thing never happened to me. I looked forward to waking up in the morning, talked more, went outside more, accepted more social invitations, started drawing again for the first time since junior high. It was an effing miracle. I experienced for the first time since I was in grade school what it is to be normal. I told everyone how much better I was feeling, and for a while thought my problems were over.

My sleep immediately fell to two hours a night from my usual three, and my already-terrible ability to concentrate got even worse. Upping the dose made it even more so, so I never went past 25 mg. But I was so happy I didn't care. However, after three job interviews on the Rx I realized I couldn't function well enough to work. I concluded that my life was the problem, that I was in the wrong place with the wrong friends, and I moved to Seattle. Sadly, the only change was in sun exposure, which tanked my mood and made me eat a lot more, and my weight increased 15% in 40 days.

A new doctor suggested my response to the Zoloft indicated I might be bipolar and that a different type of drug might be more helpful. (This sounds moronic to me now.) After 18 months of upheaval, with resumption of a normal life nowhere in sight, I asked my parents if they could take care of me until I figured this out.

At my parents' house, I saw two different doctors, got an Rx that made my eyebrows fall out, and stopped it, but continued to investigate the bipolar angle. One night I visited a local support group, professional adults with careers and families, plus two high-school students, who were gracious and welcoming and shared their experiences and histories. They were also the most wretched group of people I'd ever met -- and I'd met refugees from Argentina and Iran whose relatives had been tortured and murdered. They were not getting better; they just got a new prescription when their symptoms or side effects became unbearable. One woman, who rocked in her chair incessantly and talked like a machine gun, was on five different prescriptions. May Whoever Is Up There forgive me, but I thought I'd rather die than identify with them. I decided to exit that path of inquiry, and lost whatever faith I had in doctors who prescribed psychiatric medication.

I think it was around that time that I started tapering off my Rx, which I think was still Zoloft at the end. I had had a growing sense for several months that the meds were a Plexiglas-like bridge over the huge chasm of my mood, that the chasm was getting deeper and deeper, and that if I didn't get down to ground level, no matter how bad it felt, I would never be able to...something. Stop it from distintegrating completely, maybe, or figure out what the cause was.

It might have been during the tapering off, or soon after, that I experienced the sensation that Elizabeth Wurtzel describes in Prozac Nation, where she lay in bed screaming from the mental pain. Picture your brain as a NASA photo of the world at night, and all the lights are your neurons doing their neuron-y thing. North Korea, with no electricity, is that part of your brain that is depressed. Or causes depression. Or whatever. Somehow what is a void becomes a solid, energy-sucking, space-warping mass. In your brain. Or, alternatively, it's like having a faceless, shadowy, hooded wraith pinning your mind to the floor in a wrestling hold.

So that was fun.

Eventually I read an article in the Cleveland Plain Dealer describing celiac disease and listing depression as a symptom, which sent me down another road that finally paid off (despite the fact that I had tested negative for it back in Seattle). Without that Zoloft, though, I really doubt I'd have made it that far. For all the side effects, at least I got an idea of what life could be like.

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Image: photo of Chewbacca is copyright Lucasfilm Ltd. who I can say with a fair degree of certainty will never give me permission to use it but let's just see what happens shall we? Remix by M. Rhea.