Saturday, April 21, 2012

No to Effexor, Yes to Wellbutrin

Effexor is just not good for my blood pressure, so it is down to 300mg again. Since going down from 450 to 300mg, I have slowing been getting more and more depressed. And I don't want another pill to be the answer. Damn it, this feels like it is about something!

 I remember the first time I felt an antidepressant clearly "kick in," after a couple of months of severe, life-altering depression. While a part of me was grateful, a part of me was mad. Wasn't this about something? Didn't this mean anything? Was is all about some chemical glitch in the system, and all I needed was this tiny pill?

 And that is what I have been telling myself this time- this isn't just some biochemical glitch. This depression is about something. It is about the plateau that my life has been at the past couple of years. It is about the fact that while I managed to get off of disability, 7 years later life isn't getting any easier. There is no longer a feeling of progression. And it is about the fact that I am questioning the very medication that I have for so many years believed in, and now am facing head on what I always knew the Zyprexa (especially) is doing to my health and my brain. And yet, I seem to have to keep taking it. 

And I feel trapped. I want my life to change, I just don't know how to do that. I have been trying for so many years, but is seems to take up every bit of effort just do do what I manage to do. I know that I jumped on the anti-medication story because I wanted an excuse. I wanted a reason that I haven't lived the awesome life that I wanted to live. And I wanted something I could fix. If my meds are holding me back- just take less meds, and I will be able to do more. But it isn't that simple. And I'm trying to find a scapegoat for what are really my failings, my shortcomings. I know a lot of it is my learning disabilities- it makes work so hard for me, as well as managing every day affairs. And combine that with my moods, and it is a wonder I do anything at all. Getting off meds won't change this. Figuring out how to work with my brain, and how to pick my battles- I can't do everything, but maybe a few more things- is what I have to do. Plus there is plenty right about what about the questioning of medication. I am sure meds made me worse for several years of my life. I'm sure they made me bipolar. I know Zyprexa is cutting years off of my life with all of the weight gain, and isn't so great for my brain either. But there were years I never expected to live this long. I was sure I would have killed myself by now. So maybe I am living on borrowed time anyway. Wanting to live a long, healthy life is a very recent wish for me. I used to try to bargain with god, please just give me a few good years without depression! Then you can kill me.

 But I can't ignore the fact that my depression has started to get out of hand again since I cut down on my Effexor. But I have been feeling too stubborn to admit that (especially since it was my decision to do it), and to do anything about it. This is real. This is something I have to figure out. This is something I don't want to medicate away. I have to decide for myself if life is worth living or not. Granted, I was already heavily medicated, but I didn't want to add to the mixture! By the end of week I was trying to decide between taking a leave of absence from work- or from life. I just didn't want to go on, didn't feel like I could go on. I felt so depressed I felt like I would collapse while standing or walking, I was holding on to things. And then- an interesting patient, a conversation with a surgeon. And I perk up. Suddenly I want to be around the next day for work. I'm still deeply depressed, but I realize that I don't need to give up on life. I want to live. I want to work. And if work is the only thing I am capable of doing at the moment, well damn it, that is at least something, and something I care about.

 But if I want to keep my job, I had better get this depression under control very quickly. So I go home, and up my Wellbutrin. If I need a little pharmacological help, so be it. I will use meds. That is what I have decided. I'm not going to give up my job, my life, just so that I can be able to say that I am med-free. My work gives me sanity, and my meds let me go to work. I had to figure this out for myself. I'm actually glad that I didn't just decide I couldn't take it anymore earlier in the process, and just decide to pop a pill to get over it- and never have reached any sense of closure with this, or the deep realization that I really am invested in this life. I do have something to live for. I also have a niece and family. And I have my dream of hiking the Appalachian Trail. Meds and all. Perhaps my trail name will be "Medicine Woman." To seal the deal with myself, I bought myself a new backpack- it was on sale, deeply discounted, last year's model. I am excited. And it is black, which is perfect for this city girl at heart. Now all I want is a 300 dollar sleeping bag... Well, maybe next year.For now, I will suffer under the extra weight of my synthetic bag.

 Today a delicious day at home, as I really ramped up the Wellbutrin. Not too much food in the house, as I have been unable to go grocery shopping, but enough that I didn't starve: coffee, canned milk, a protein bar, peanut butter out of the jar, and brown rice mixed with a can of tuna and some cheese. Wellbutrin has always worked very quickly with me- always within a couple of days I feel much better. And I do feel much better. But I also know that I am better because of what is going on in my mind. But tomorrow I need to go in to work to do a marathon day of paperwork, if I want to keep my job. And I do- I really do. And not just because of the paycheck. I love what I do. Except for the paperwork.

 Next week I have an appointment with a new psychiatrist. I'm looking for someone more local, as I still have my Manhattan psychiatrist even though I have moved away. I hope this guy is okay with my meds. I hope he is okay with me "adjusting" my own meds. I hope he can respect the fact that, after 26 years on meds, over half of my life, I am my own best expert.

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