Chemicals and me.

When will I learn that I CANNOT DRINK COFFEE? I love it. I love the coffee. But I am a delicate flower who trembles uncontrollably after half a cup. HALF A CUP. Then I start to write in ALL CAPS.

This morning I had two caffeinated beverages. TWO. And OH MY GOD MY HEART. It can’t take it. I was out with my friend and our children were not there and we were so happy! So happy, and so drinky-drinky with the coffee! And now I am trying to find the right keys on this keyboard thing and it’s hard because my hands are a blur!

Speaking of chemicals in the body…

One year ago, the above-mentioned friend and I and both our children were standing on the corner, being neighborly, when two cars collided. We screamed at the sound of the crunching metal and screeching and then we ran out of the way when it looked like one of the cars was coming right for us. Then we stood there, trying to comfort our crying children, as everyone around us screamed and ran for help and we realized that the people in the cars—who were right there, the shattered glass was at our feet—were in bad shape.

But we were okay. We were safe. We backed away; we showed our children that the firemen and the ambulances were coming to help. We retreated to our homes to regroup and try to make sense of what happened.

That night my heart began to race. The next day it was still going at breakneck speed. My heart wouldn’t slow down; my hands wouldn’t stop shaking. I jumped at every sound. I kept thinking about those cars. If I had been at the corner a second earlier, the car would have hit us. If my friend hadn’t been there, I might have been crossing the street. If, if, if. I began to think about how my son wasn’t safe here, living on this busy street. Who knows what would happen the next time we crossed it? Indeed—who knows what will happen, period? There was no way I could keep him safe! Ever! In life! Because life is unpredictable!

I began to think about death. As in, all the time. Death! It happens! No stopping it!

So I began to clean, all the time. Clean clean clean. The cleaning wasn’t really working at drowning out the constant worrying and crying, so I strapped on my iPod while I cleaned and wept and I tried to think about something, anything else.

When I couldn’t wear my iPod or clean, I read the dictionary. You think I’m kidding, don’t you? But the dictionary was the only thing I could read that didn’t depress me in some way, that didn’t bring up some intimation of death. Or life—which just leads to death, as we all know.

My husband told me to go to the doctor, and I was furious. You don’t get it, I shouted! We’re all going to die!

I felt like I was surrounded by the pod people; like I was the only one fighting off sleep so that they wouldn’t come and take my brain. I had to keep up my frantic pace of worrying and fretting and weeping and cleaning, or else.

Finally, when my parents had to come and take my child away for a couple of days so he could spend a few carefree moments not worrying why Mommy wouldn’t stop crying, I thought, hmm. Maybe a doctor isn’t such a bad idea.

The doctor took one look at me and said, ooh, hello, post-traumatic stress lady! You’re nuts! (She may not have said “nuts.” Maybe.) She prescribed two things: A breathing/meditation course, and an anti-anxiety drug. First I took the breathing/meditation course. Which, oh lord, was the silliest thing I have ever done, but the first night of that class? My heartrate went down for the first time, from around 150 (I had been obsessively checking it ever since it began racing) to 65.

Although the course worked wonders for me (I would be happy to share details about it with any of you, if you want to email me), she still wanted me on the medication. So I, the obedient patient, took it. I didn’t notice any dramatic changes, but then, I was already cured, or considered myself to be.

So now, a year later, we’ve both agreed that I should go off the medication, which happens to be Effexor.

Here’s the thing. Effexor has the worst withdrawal of any of these drugs. (Except we can’t call it “withdrawal”! It’s “discontinuation syndrome”!) I have taken it before, and I have gone off it before, and I know what can happen.

But because I’m on a minute dose (see above, re: “delicate flower”) my doctor won’t acknowledge that I will have any problems, or that I need to wean myself slowly. Even though going off this drug cold-turkey is a terrible idea, a surefire recipe for physical and emotional misery, she insists that this is what I should do. Even though all evidence points to her being a moron.

So! I am now going to wean myself. And in the interest of public service, I am going to document here my weaning process. (Not in painful detail, you understand. I will try not to bore you overly. )

I’m nervous, but ready. I know what to do. I have done the research, and I am cheaper than my doctor.

Here’s hoping no more cars crash around me in the meantime.

Comments

[Kel]

Please please! Get a massage (or two or three) while you're doing this. And hey, forever after, if you can, like once a month. They are expensive, but can be like changing the oil in your car before the engine goes.

I do massage therapy for a living and the results are wonderful. (I started by getting therapeutic massages for my headaches) Like the meditation course, it can do wonders for putting your body into parasympathetic/quiet mode.

Hugs hugs hugs! and good luck.

[Simon]

Hey I get to comment first, cool!

Well, Jenn at Breed 'em seems to like you and I've been reading a little bit here lately so I think it's HORRIBLY RUDE to do so and not say HI, whether it be in all caps or a more subdued cursive type salutation.

So, "Hi."

Best of luck with the weaning thing. A doctor is only as good as the patient who doesn't listen blindly to what he has to say, eh?

Cheers.

[Whoorl]

In regards to coffee, I feel your pain. Sounds like you might be naturally-caffeinated as well...

[Jenny]

I get easily over-caffinated as well. It's fun, for a short while.

Here's hoping that everything stays calm and zen-like around you as you transition.

[Lulu]

I COMPLETELY agree with you on the weaning off thing. Any time you take something with regularity and stop it abruptly your body will get a little mad at you, right?

Good luck on doing it- I swear we all are a little smarter than doctors sometimes. Can't wait to hear how it goes. :)

[braine]

Okay, right, this is an embarassing thing to put into comments, but following my own major anxiety attack (not brought on by such a traumatic experience, but by...life), I too noticed just how sensitized I am to caffeine. And I did a bunch of things to combat stress, etc., and (here's the embarassing part, because I too am hip and cynical and smarter than this, but) one of the most effective was to buy and read "Don't Sweat the Small Stuff (And It's All Small Stuff)". There. I said it. I recommend it. Ease your mind and your heart (literally) will follow. Good luck.

[Effie]

I had a similar experience yesterday--about 3 years ago I was in a horrible car accident--the people in the other car died and I will limp forever--and I saw an ambulance attendant pulling someone out of a crushed up car and putting him on a stretcher--I freaked out and had to pull over. I couldn't function for a good 10 minutes. Right after the accident I'd had to go to a therapist who specialized in working with people who'd had automobile accidents--I thought it was a bunch of hooey--but it helped. Good luck with the weaning--much better idea than cold turkey!

[Anita]

Definitely let us know how the weaning process goes. I'm also on Effexor--have been for about a year after the whole panic attack episodes of 2004. I told my doctor that I'm feeling great, would like to go off, etc and she told me that most people stay on for a minimum of a year and often much longer. "But I feel fine!" I said, anxious to be free of this stuff (especially of the feelings I get when I forget 2 doses in a row...). "Maybe it's because of the medication" she said. "how do I tell the difference then?" "you don't" Oh, great. Anyway, good luck with your weaning. I begin mine next week.

[bihari]

Stick to your guns with the gradual separation from the Effexor! I have had lots of patients on it, and while it's a great drug, it's not one you want to drop like the proverbial hot potato. When you've had a beautiful relationship with it for a year, you definitely want to aim for one of those slow, drawn-out breakups and not a "well, goodbye!" walkaway. Best of luck to you, and congratulations on not needing it any more!

By the way, what is it with the cleaning? I find the tenser I get and the more out of control my life is, the tidier I must be. MUST be. After our second child my husband gently (and correctly) suggested I might have some postpartum anxiety and depression issues going on, and when I snapped, "Why?" he pointed out that perhaps emptying and sorting out the diaper bag five times a day was not the most efficient use of my time, what with having a newborn and all. He was right.

All hail drugs. And gradual withdrawals from same!

[reenie]

I remember when you went away for awhile last year. I'm sorry you went through that. Yes, I agree with the weaning. It's not good to yank our own chains when it comes to medicine. Especially if you're sensitive to it.

I witnessed a crash Sunday night. It was two cars in front of us and a minivan ran a red light. The car was spun around and ended up on the grass and the car behind him had to slam on the brakes, and the car behind HIM, etc. We were next to the car behind him and I've never been that close to an accident like that. You, of course, know how you start to think things...like what if I had passed that car back there? What if I had left two seconds earlier? That minivan would have smashed into my son.

It messes you up.

Good luck with the weaning...and try decaf. If you get a vanilla latte, somtimes, if you try really hard, you don't even notice the difference in taste.

[HollyRhea]

I wonder if babies have withdrawals when they wean.

[Hope]

I take anti-anxiety meds too. I started just after my noiw ex-husband said he wanted a divorce and to be his own person (then moved in with his girlfriend who was one of his students).

Anyhoo, I've been on them for a year and a few months ago I thought I didn't need them anymore and quit cold turkey. It didn't end well. So I put myself back on. I thought if I felt 'fine' on the medication then it must not be doing that much but hoo-wee I was wrong!

Good luck!

[Eulallia]

Holy smokes, good luck girlfriend. I hope it goes smoothly for you!

[Meghan Townsend]

That accident sounds terrifying. I was much like that with the crying and the hand wringing death type stuff after I had my daughter Madge. The panic literally made my blood feel cold, and my knees would buckle. It passed thank God but I will always empathize with people who have anxiety or panic. It's very real and it's very awful. Trust your gut my dear. You know what's best as far as getting off the meds. Good luck to you.

[crabby]

i work at a drug company(not the effexor co).
now i feel bad that we make chemicals that do this to people. we mean well, but... i guess it's just an imperfect world.

good luck with the weaning!

[Sonia]

Ooooohhhhhh. WHAT a time for me to become a faithful reader of your blog. I am in the throes of the tapering off of Effexor too. I have been writing about it myself, and I wish you the very best luck, the biggest hugs, and the yummiest lattes to ease the pain.
I would not have been okay if I hadn't gone on the drug. I don't regret going on it. I do regret not googling the words 'Effexor' and 'withdrawal' prior to starting the drug. I'm a pharmacy technician, I read all of the available information I could find, including the pharmacopeia. Not. A. Word. was written about the possible withdrawals, only warnings about tapering for the sake of your psyche. I'm not opposed to trying another drug in the future, but I will be so much more selective in the choosing.
Also, while I'm babbling.....coffee in large quantities is one of the things that is helping me deal with the electric shocks to the brain, the hallucinations, the nausea from the vertigo and various other *ticks*. I'm not trying to scare you. Just know that this might be tough, and there's a few of us floating around out here that are doing and going through the same and are here to commiserate. I am now much more prone to try 'natural' alternatives, because I don't ever want to feel this bad for this long again. And I'm angry. Dig-your-eyes-out-for-looking-at-me-funny angry. Which is not my favorite look on me.

[honestyrain]

i have no option but to comment in alphabetical point form, this post brought up that many things fot me to say.

a) egad! that ccident would have totally sent me into crazy obsessive world

2) i am not suggesting you were crazy or obsessive

3) i switched from alphabetical to numerical point form

d) and back

e) i am going to email you for that relaxationy informationy

f) i took effexor once a verrrrry long time ago and no one told me to not go off of it suddenly. and i did. and i wonder if that's why i started chewing on walls and poking myself in the eye all the live long day?

h) best of luck with the weaning process and yes! no more crashes of any kind oh my god.

[wavybrains]

Delurking here--I've been on Effexor before, and yes a taper is absolutely right--I tried several times cold turkey and it always ended disasterously. You can even open up the 37.5 mg pills and taper even more gradually by mixing half a pill with applesauce or just taking the beads inside. The slower you do it, the better, IMHO. I ended up switching to Wellbutrin and am now in the proccess of tapering off THAT.

Thanks for being so honest and sharing this process with us!

Also, Why, why, can't I be one of those people who cleans and organizes when anexiety hits :) Now, that at least would be a little bonus.

[Ashlie]

I feel for you. I've gone through "dis-continuation" syndrome with paxil a couple times. You feel like your complete heroin addict. Sucky, very sucky.
Good luck! Like your blog, I just started mine..... good inspiration. Thanks!

[Cam]

Also on Effexor ... looking forward to hearing about it. My research also indicates going off of it slowly is the key. Half a dose every day, then every other day. Hope to learn more about it through you. I tried to go off recently, cold turkey and it was not good. Best of luck!

[mainja]

wow, you have a doctor who is not willing to listen to you on this? me thinks maybe it's time to find another doctor. i mean, you know your body best. they may be the expert in medication and anatomy and so on, but you're the expert on *your* body.

i guess the thing that i can't get over on the not willing to facilitate you weaning off of it is, well, what harm is there in doing it?

in fact, if i were a doctor (which i oh so obviously am not) i would be worried if you were telling me you wanted to go off cold turkey and would fight that. but if you wanted to do something that wasn't going to harm you any more than what i was suggesting, even if i believed it wouldn't harm you any less, then i'd say go for it.

hmmm. i wonder if that made any sense. i'm very sick right now and my brain is a bit fuzzy.

[Ellen]

Christ, I feel for you. I thought I was going to go crazy when I stopped Effexor - I felt all headachy and like I had constant vertigo. I t was like, "Great, I don't need this medication anymore but now I feel like shit physically!" I wish I had some great piece of advice for you but all I can say is that you will feel better in a month or so. Hang in there! :)

[lizpenn]

is it totally, deeply wrong that i'm looking forward to the series of posts about alice weaning herself off of effexor? i really hope all goes well and smoothly and sans anxiety, but i admit that my first thought on reading this post was just how juicy and interesting it will be to read her thoughts on the process. am i bad? well, it's her fault for being such a good writer ...

[Julie]

I thought about the same stuff a lot when I was still working in the city. I'd hear about an innocent bystander being stabbed outside Penn Station, or a car careening onto a sidewalk, killing several people who were merely waiting for a bus, or a cinder block would fall onto someone's head and send them to the hospital, and I'd think - my god, that could happen to me, I have to walk these streets every day, I love it here but it's so dangerous, what if I have my girls with me, what if they get hurt...and on and on and on...

The worst that ever happened was getting caught in the middle of a pepper spray fight between two jerks on W44th St. I was just trying to cross the street, and the two of them went at each other with their pepper spray dispensers, and I got caught in the crossfire. I count myself lucky.

And I can't decide whether it's scarier to think about weaning myself from my meds or to think about being on meds for the rest of my life. I weaned myself when we were procreating, but I felt so shitty that I had to go back on when I was 20 weeks along. I don't know if I can face trying to wean myself again.

I wish you the best. What a terrible experience, but I'm glad you got the help you needed.

[clickmom]

I witnessed a car crash in 1982. The seat belt wearing driver walked away, the non seat belt wearing passenger lied on the road having the glass picked out of her face while waitiing for the ambulance. I clicked my seat belt on that day and have worn it every car ride ever since.

Good luck with the withdrawal.

[Mir]

I'm pretty sure I've taken every SSRI known to man at one point or another... except Effexor. I refuse to take it. I've heard too many horror stories about withdrawal, er, discontinuation syndrome, with it.

And you KNOW that I adore you and Henry and I am delighted that neither of you were squished and also that I am very pleased you've recovered from your PTSD and all of that, but when I am anxious/depressed it becomes very very important for me to sit very still and watch television. Not to clean. So, should you find yourself having a relapse, or something, please come over because my house is often quite dirty. Thanks. ;)

[Beth]

There was an ask.metafilter question about this exact thing. http://ask.metafilter.com/mefi/20094

[Undisclosed]

The dictionary can be a wonderful companion! Me and the Thesaurus, we're good buddies. (Buddy; syn: associate, chum, comrade, mate, peer, sidekick.)

[Nire]

Oh wow. I can't imagine any way in which that would be fun. Good luck!

[Robin]

From one post-traumatic stress disorder lady to another, I salute you and initiate the secret PTSD handshake, which is really just a lot of crying and shaking.

Earlier this year I went through cognitive-behavior therapy after a lifetime of PTSD (my traumatic event was when I was 4, and I'm almost 33). It's hard stuff, and I commend you for getting treatment so quickly. Good luck with the weaning. It can be rough, but it's brief.

[Rebecca]

As someone who's suffered from both panic attacks and clinical depression, and have weaned myself off more drugs than I care to mention, I truly wish you well. Decreasing the meds, or stopping them entirely is one of the scariest things that you will do--not because of the physical effects, but what your brain will gibber about at two in the morning while you stare at the ceiling. Meditate, get a massage, hang out with good friends, spend time with an engrossing book or movie, cuddle with your husband and Henry, and treat yourself well during this time.

[Cricket]

I love the name of Effexor. My brain always says it EEEfeeexxxxORRRRR in that big monster truck voice. I also understand muchly about coming off stuff to where I absolutely refuse an SSRI b/c I 1) know it won't work and 2) have to suffer side effects coming off. I am side effect queen.

Further, I am exactly the same about caffeine. In fact, that is part of the description for a personality type, a not so uncommon wiring, called the Highly Sensitive Person. I qualify, as does my son. Reading the website is great for self-validation: http://www.hsperson.com/

[sweetney]

we -- meaning i -- love you.

more coming in a non-publicish forum...

[Amieable]

My rookie comment!

I don't know why doctors "pooh-pooh" the withdrawls from these kinds of drugs. I went off Paxil a number of years ago as per my doctor's orders and went batshit! I ended up in the emergency room needing to get a big-ass shot in the butt to make the world stop spinning. When I told her of my saga, she shrugged and declared that she had never heard of that.

So I agree to listen to your own body. Medical professionals are needed, but in the end we are the stewards of our health.

I love your blog and thank you for continuing to write it.

[C]

At one point I was under the care of an extremely nutsy psychopharmacologist who had me on extremely high amounts of Effexor, to the point where the drugstore would call every time the prescription was filled saying, "hey did you know that this is double the highest recommended dose..." Anyway my current wonderful, responsible, therapist weaned me off slowly. I had some real physical side effects and had to make some adjustments but after a short time, I felt really great and it was totally worth the withdrawal.

[Kelly]

I have that death phobia, badly. I wake in the middle of a panic attack about dying every single night at the same time. its programmed in. I cant stop it coming on, I am asleep!! Would love to find a course like yours near me (in aust.) will have to keep an eye out. Its so good to know, I am not the only one!

[Laura]

Dear one! I de-lurk to comfort. I went from thirty milligrams of Effexor to ten, and death did not follow. Now I'm inching my way from ten milligrams to zero-zip in the interest of impending conception. The famed head-spins and electronic brain-zaps will probably plague me at some point, but here's the thing: Ignore your doctor. Wean yourself off SLOWLY. Nibble those ten-milligram pills in half and then, eventually, in half again. Take a couple of months.

In fact, my own doctor recommended I wait to completely wean myself until spring. The longer hours of daylight supposedly help suppress the symptoms.

Best of luck. And please please please write a book soon. You've got a contract, yes, because there is justice and beauty in the universe?

[Em]

Remember 9/11? Being in NYC, I bet you do. I was 30 weeks pg and all of sudden feeling like the war was HERE. So the hormone fairy messed around with me for a while. Then the answer to the question They kept throwing around: "Why does the world hate us" turned out to be "because you Americans are so selfish and stupid and have no idea what is going on in the world". So I decided to start keeping up. I made sure I understood the suffering that was going on in the world and stop being a stupid, selfish American. You know what, though? The world is totally fucked up. I'm telling you this because I feel like I was exactly where you were in terms of anxiety. I CANNOT keep my kids safe, what if what if what if (and I could go pretty wild with that - afraid of pretty farfetched scenarios), I would imagine some of the horrible things that happen to children in the world happening to my children and as you can imagine it can drive one around the bend. I didn't clean (unfortuneatly), just pray like a mofo, worry, fret, frown, obsess and freak out. Only recently have I decided to kind of go back to being a selfish stupid American. I just can't handle it any other way. If being stupid doesn't work, seeing the doctor is on my list (but way down for other stupid American reasons). Thanks for sharing how you resolved your anxiety.

BTW, I don't know how effexor comes but if it is an extended release or long lasting, etc., you may just want to check on whether it is safe to divide doses.

Let us know how it goes. I wish you well with it!

[Angel]

Personally, if you think you should wean slower, DO IT. Doctors are not my favorite people.

One Coke at lunch can keep me up til 4 a.m. LOL

((((Hugs)))) I hope the weaning will go gently for you. Anxiety really does suck.

[redfox]

I also am guiltily looking forward to reading all about this exciting process. Also, I am going to take a moment, as I periodically do, to contemplate how much I love my doctor. I don't know how I got so lucky, but man, she's great.

[madge]

Since my husband broke his back and pelvis, he has taken all of the following drugs for extended periods of time:

Oxycontin
Avinza
Hydrocodone
Baclofen
Celebrex
Ambien
Effexor

He frequently forgets his pills or lets them run out and goes several days without one or the other. BY FAR the worst withdrawal is Effexor. And, some of those other ones ARE BASICALLY HEROIN!

Taper off! Taper off! Taper off!

[Belinda]

I think that you, knowing your body better than anyone else, even someone having an M.D. after his name, are doing exactly the right thing. If you haven't discovered it yet, there is a wonderful website, http://www.crazymeds.org, with all kinds of info, and bulleting boards in which most people will advise doing exactly what you are planning on doing. Good for you.

[Jack's Raging Mommy]

Effexor BAD. Effexor SO VERY BAD. If I'd known you were on it I'd have been begging you to find something else. Good luck. I lived through any withdrawals. I was in a hospital, but still. I'll be thinking of you.

[Candy]

I, on the other hand, have been known to fall asleep mid-way through a cup of coffee, and awake to find it cold on the coffee table next to me.

You're right to wean yourself. Everything in moderation, even cessation.

[Sandra Parker]

Wow... all I can say I that I was skimming through the blogs here and this one stuck out to me... I'm very glad that you and your family were not hurt! I know that feeling all too well though... after I was rear ended (my car totaled, no injuried thank goodness) I couldn't drive for a few days without crying and couldn't keep my eyes off the rearview mirror. You're right, though... those near-death experiences make you really love life all the more.

[Kathryn]

Good luck. I tried weaning off my Post Partum anxiety meds a tad too soon and then the hurricane hit, watched Oprah's coverage, blah blah blah, back at full strength. I'm proud of you for doing it. Follow your gut and keep us updated. I really need to hear a success story and I'm sure yours will be.

[mehitabel]

I've done effexor withdrawal and it was as unfun as advertised. I later whinged about it to a psychiatrist pal who said tiny concurrent doses of prozac ease the process immensely. The neuro-pharmocological explanation now escapes me (though there was one), but I'd strongly advise prodding your doc about the strategy.

To a smooth landing.

[Magrak]

Hey - I just went through withdrawal from a closely related medication and had two really bad "cold-turkey" attempts in a row featuring insane levels of rage (never a symptom before or sense) that seriously imperiled my marriage.

Finally, my doctor allowed as how the pharmacist could actually make up a liquid suspension of any medication, including this one. The suspension, measured out in a tiny syringe, allowed me to bring my dosage down at a very teensy, gradual rate -- believe it or not, 5 mg to 4 mg/day was the hardest step of all!

Just thought I would share.

[TitanKT]

What does Heather have to say in the way of advice? I'm just interested because I get the impression from her blog that she has experience with this kind of drug and I'd just be interested to hear her thoughts on going cold turkey off that stuff or what. I'm betting everything I own she'd also say not to go cold turkey, though.

I'm a fan of your blog... which effectively means I'm a fan of you. Which means I'm more sorry than I can say about the accident you witnessed and the feelings you've had to deal with since then. I also wish you... something... it's not luck you need... er, support and best wishes (?) in your withdrawal endeavor.

I've never taken Effexor and if anyone ever recommends it to me, I will proceed with extreme caution. In otherwords, things will have to be PRETTY bad for me to agree to take something like that... but my real point is that the only thing I've ever had to really withdraw from is cigarettes. And that was bad. Real bad. But I haven't smoked for more than four years now and I've become one of those horrible reformed smokers who think smoking is intolerably stinky and gross now.

Anyway, I'll be checking your blog frequently with my energy focused on you and your withdrawal.

[Jenn]

Sending many, many good luck vibes your way. And the weaning, that is good. I had to go off Paxil cold turkey--because it started making me seriously ill after I'd been on it for eight months--and Paxil and Effexor are very similar in their awful withdrawal symptoms. It was pretty darn miserable. I hope the weaning helps, despite what your doctor may say, and that you can see it through to the other side.