A long post about my brains.

As some of my faithful readers will recall, a few months ago I went off of Effexor, an effective if somewhat problematic antidepressant. Effexor, as I wrote, has a shockingly brief half-life, and because I was on a miniscule dosage (as I am a delicate flower and can only manage light sprinklings of medication) if I was even fifteen minutes late in taking it I headed into scary Effexor Withdrawal Land, a place no one wants to be. If you’re wondering what Effexor withdrawal feels like, rap on your temples with a meat tenderizer while spinning around in a swivel chair and sucking furniture polish through a straw. There you go!

Anyway, because the Effexor was meant to help me through post-traumatic stress, I decided that I would only go on it for a year because after a year apparently your brain forgets all about the bad things and goes back to humming little songs to itself and thinking about pudding. I conveniently forgot, when I chose to go med-free, that my brain is primed for things like PTSD. (There were many, many other people on the street that day, and not all of them spent the subsequent weeks cleaning their cabinets at 4 a.m. and shrieking STOP LOOKING AT ME LIKE THAT at their dogs). I also chose to ignore the years of depression and anxiety prior to the car-crash incident. I was all better, I decided. No more pills for me!

Can you see where this is going?

I remained drug-free for ten of the darkest weeks in recent memory. Here’s a tip: if you’re going to go off of medication, don’t do it in the winter, right smack dab in the holidays, when you’re financially strapped and trying to buy a house. (Actually, if you’re me, the lesson should probably be: don’t do it at all.) As I approached the lowest of the low moods I wrote this post, and told the world about my filthy pants and oversized shoes and in doing so sounded like a pervert clown, and yet was rewarded with many, many people’s boundless sympathy and support. Shortly after this I had what some might call a breakdown, if they were feeing melodramatic, or an attack of neurasthenia, if they were in a Victorian mood. Whatever it was, it felt neither colorful nor historically relevant. All I remember from the Worst Day Ever is that I called Scott and said, “If you knew how bad I felt, you’d come home right now.” And he did.

I felt that I was strong enough to go without drugs, but after a few days of complete misery I cried uncle and ran to my psychiatrist. I didn’t want to see this psychiatrist again. The biggest reason was that she doesn’t take insurance. When I had first seen her this wasn’t so big an issue; I was making money at the time, her rate wasn’t all that astronomical, and anyway I only saw her twice a year. But then as the years passed, and my insanity showed no signs of abating, I thought twice about seeing her. First of all she always called me Linda. I think the psychiatrist’s credo should be Know Thy Patient’s Name. Also she took notes about me into her voice recorder while I was in the room. “Linda has a long history of depression, marked with secondary anxiety. Also, Linda is wearing clown shoes. And should really have showered before leaving the house. What was Linda thinking?”

Despite my misgivings about this doctor and her new THREE-HUNDRED AND FIFTY DOLLAR charge for each session, I went back to her. “Why on earth!” I can hear you shrieking. I think you’re also wringing your apron with both hands, and you just dropped the freshly baked pie all over the linoleum.

I went back because I knew her, and I didn’t have the energy to find someone new and go over the whole story all over again. I went back because it was easy, and as much as I’m poor and cheap, I was also lazy and sick.

It was a mistake, though. She decided, during our (expensive) session, that in fact I was bipolar. She had been hinting at my potential bipolarity for a while. ( “My Potential Bipolarity” will be the name of my rock band. Mine mine mine. Don’t you steal it from me.) The bipolar diagnosis is a difficult one to make because the sufferer is more likely to seek help when depressed than they are when in a manic swing, so they’re diagnosed with depression. But she was smarter than that! Oh, she was so proud of herself!

Here’s why she thought I was bipolar. Are you ready? One, my grandfather might have been (according to her), and two, my heart raced at night. I don’t see anything in any of the literature on being bipolar that talks about nightly heart-racing as a symptom; I had rather thought that if I were bipolar I’d be out all night gambling or having sex with shop clerks in dressing rooms. I know I’m generalizing, but sheesh! If you’re going to call me manic-depressive, can’t I have some fun first?

And sure, my grandfather had more of the colorful madness that the rest of us boring crazy people only aspire to: all-night carousing! Writing his own biblical texts! Conversing directly with God! But I’m not my grandfather, and thank goodness for that because I don’t think Scott would want to be married to a 100-plus-year-old Italian guy who also happens to be dead.

So I disagreed, but she was insistent, and put me on a medication called Lamictal. And then I was off to Amsterdam, and didn’t think much about what this would mean, this traveling while on a brand-new drug.

Here’s another tip: don’t go on a new medication before traveling. The best I can say about the Lamictal is that it didn’t work. The worst I can say about it is it made me intensely, miserably ill. For the entire trip. Every morning I had to get up early to drink gallons of water just so that the nausea would abate enough so I could leave the room. I felt awful all day. I wanted to go out and carouse, as our sponsors were (I guess) expecting us to tell of our adventure-filled days and liquor-soaked nights, but I could barely manage one museum before a nap, and then at dinner I could manage maybe one beer. And Melissa would pat me on the head and say, “It’s okay if you're not a partier,” and I would try to say, “I'm not, it's true, but this is a little weird,” only I couldn’t get the words out because I was falling asleep. My dad wondered why I needed to nap every afternoon as much as he did. I mean, a 70-year-old getting over heart surgery, sure! Nap all you want! But a 37-year-old? That’s just sad.

Then I got home and told my psychiatrist what happened. Her response: “Oh, you can’t drink with Lamictal. I didn’t tell you that? It causes extreme alcohol intolerance. Oh, no no no no. That would make you quite sick.” She then posited that maybe, hmm, I wasn’t bipolar after all, maybe I had one of those, what do you call them, anxiety disorders. Yet somehow, instead of kicking her in the teeth, I handed her another three hundred and fifty-dollar check and got out of there.

I didn’t want to write about this on the blog for a few reasons. Sometimes I wish I had never opened up this particular can of brain-worms. The more I’ve divulged, the more I’ve felt pressured to continue this level of intimacy, and that sometimes makes me want to hide under my bed. Also, writing about mood disorders tends to bring out, well, the mood-disordered, and then they write to me and ask for advice. And I don’t give advice to people I don’t know. I don’t believe it’s helpful. I don’t want that responsibility. And I can barely manage to email my friends, much less strangers in crisis.

On the other hand, not writing about it has brought on some kind of weird blog-malaise. It’s hard to push past all the stuff I don’t want to talk about to get to anything else that’s fun or interesting. And even if I haven’t written about this directly, I’ve read my past few months of posts and I think it’s evident that I have not been at my sunniest. So I needed to get this out there.

I kept waiting to write about all this when I was on the other side, when I could look back and laugh about what a mess those few months had been. It’s still pretty messy, though. It’s not as bad as I was, but I’m not 100 percent. And I know I could go back on medication, but I don’t want to. I’ve had enough of side effects. I don’t have prescription drug coverage. And I just don’t want to.

I’m fiddling around with nutritional therapy, and I would say more about that but I’d bore you to tears. (Don't believe me? Amino acids! No more sugar! STOP CRYING!) Although nothing’s offered a dramatic, Effexor-style cure, I do feel better. And I know this is an unsatisfying post that could really use a triumphant finish. I do wish I could give you one of those.

Comments

[Tina]

Alice, I'm rooting for you.

[Ashley]

I just wanted to write and say I wish you all the best with improving your life.

I sincerely hope that sometime soon you find something that will help.

--Ashley

[Jennifer]

Warm fuzzies from over here too.

You know we'll read anything you care to write about.

Best wishes for a long-lasting solution.

[Amy]

I'm rooting for you, too. Good strong vibes heading over to New Jersey.

[pagalina]

Thank you so much for sharing. I've really missed you. And here I thought you were busy getting Brazilian Bikini Waxes in the suburbs! :) I hope you feel better!

[molly_g]

I love your blog. Thanks for writing.

[Phc]

Ok, I'm going to go ahead and be all California New-Agey over here, and suggest that if you do have PTSD, or even if you can pinpoint your reason for anxiety, EMDR (http://www.emdr.com) can be an effective, non-medication treatment. You do have to do some work to lead up to the actual treatment, if you are working with a good therapist, and, like everything, it works a lot better if you BELIEVE it's going to work.

Anyway, it might be worth a shot.

[Em]

God, our fucking brains. They make me tired.

XOXOXO.

[waterlilysage]

o hang in there ms.slippy. thank you for this post. no more checks to crazy psychiatrists to mutter at you.

[Dorothy]

The universe frequently reminds me that I am more emotional and sensitive than other people. I think this level of focus and observation is rather handy for a writer, but has the unfortunate side effect of mind malaise.

I've been on Zoloft since the little angel stopped sleeping through the night at 16 months. I posted about going off a few weeks ago, then got bitch-slapped by life for even thinking such a thing.

My best friend told me, "live the life in front of you." Such a strange thought for me, who likes to imagine all the horrible or wonderful things that could happen instead of what is really happening. I don't know if it works - I haven't been able to do it yet.

You, though, are witty, intelligent and insightful no matter how many naps you take or suburbs you inhabit.

[Andrea]

Thank you for sharing this. It's brave. I hope you are able to find what you need to feel better, whatever the shape it takes.

After all that about your therapist, I'm left wondering if your searching for someone new, someone not so overpriced and who can remember your name. As for your history, it's YOUR history. Perhaps you could ask your expensive therapist for your files and just take it to your new therapist (if you're looking for one) so you don't have to do as much backstory. Just a thought.

[jenn]

my son suffers from a pretty terrible anxiety disorder. he is only twelve and I have spent the last nine years or so trying to find out what is wrong, and what to do about it. so far we have found that some meds work and some don't, that some dr's work and some don't. we had to shop around a lot until we found the right combo. but he went from not being able to leave the house (he missed almost a year of school) to an honor roll student. we still have a lot of trouble but things did get better.

[Vaguely Urban]

Wishing you balance (in nutrition and in moods). you deserve it.

[Bertha]

I'm so glad you're beginning to feel better! You can do it Linda! ;)

[Carrie]

If you have a good regular medical doctor that you trust, you could get a dx and medication from there as well.

I recently (~3 months ago) started Lexapro which treats depression and anxiety.. after working for years to curb it via diet, lifestyle changes etc. I hit a dark moment, caved and went to my doc to get the Rx. It's worked really well for me and my quality of life has imporved 10 x and continues to improve every day. I continue to monitor my diet and lifestyle habits.

I hope you find something that works for you. Anxiety is a really, really tough thing to live with. I appreciate the post.

[Gina]

I think you are so very brave to open yourself up to the world, even though it makes you feel so vulnerable. Which it should. Nothing crazy about that!

I wish you the best.

[Claire]

And even through all this you are funny and insightful. Having your life ruled by medication is a horrible trap I know well - hope you can find your way without it.

[Trena]

Good luck with the therapist. I've only been to two thus far and frankly, I've just decided that it is easier to live with the depression and neurosis than to try to explain to yet another person all of my excess emotional baggage.
More power to you as well for staying off the meds--not that I am advocating no meds (no no no...medicine is a good thing) but for all of the different types of meds that I have tried, the eventual plateau/side effects and then super-fun withdrawal symptoms...well, again, it has just been easier to make friends with the voices (ha ha...okay so there really haven't been voices, but you know what I mean). I've been off the drugs for a little over 3 years now and sometimes it is easier than others. I don't know if it will ever be all 100% better. I guess you just have those weeks where you function well and other weeks where...you don't and you manage it.
Good luck and know that many out here know the exact road you are traveling along (not that that makes it any easier/better).

[Lisa V]

Oh, Alice. I'm thinking of you. And sorry for the journey you are no right now. But you are still such a damn good writer. It's a joy to read your words. It makes me feel guilty to enjoy what you write. What kind of heel enjoys it when someone talks about their mental health problems? But you tell it well, and I am hoping it continues to improve.

[Jonniker]

I'm on Buspar for an anxiety disorder, and it's brilliant, and I feel great most of the time and I'm not in any sort of crisis when I say this to you.

There. Full disclosure.

Anyhoo, my therapist told me somewhat recently that "bipolor" is a *very popular diagnosis* right now. Can you believe that? Diagonses are *TRENDY!*

That seems...so wrong on every possible level, doesn't it? I've been haunted by her mentioning it (thankfully, she said it with disdain, or I wouldn't go back), and have truly known 2 people (now three!) who were diagnosed incorrectly with it since she said that. It boggles my mind and makes me a little sick when I think about it.

Trends. In psychiatric care. My God.

[Jonniker]

Bipolar, that is. Gah. Spelling. Fast fingers.

[Stacie Penney]

United Way in some states offers a discount program for prescription drugs. I found out about it here

http://www.familywize.com/

It was 20% for my state, but anything helps.

[Lulu]

This post could be every experience I've had (albeit second-hand) with bipolar disorder, Effexor, Lamictal, expensive therapists, $350 checks, misdiagnosis and confusion. Good luck with everything, smart ladies always make things work. :)

[margalit]

ALice/Linda, I think it was quite brave of you to step outside your comfort zone to write about this. I don't write about my issues with anxiety and depressions because it causes even more anxiety and depression to think about how anxious and depressed I am. Talk about a vicious circle.

I wonder, if Effexor worked so well for you, are you unwilling to try it again because of the withdrawal issues? I've been on Effexor for a couple of years now, and it's literally saving my life. I can't imagine functioning without it. I know that new meds come out all the time, and I've been offered a change, but effexor works so well, I'm afraid to change.

Your shrink sounds horrible. I think it's time for a change.

Good luck. I know how hard it is to be living with darkness.

[Imperfect Mommy]

Just like almost everyone else it seems, I definitely have issues with anxiety disorder. And mine are definitely hormonally caused... when my hormones are straightened out, my anxiety lessens. It never goes away, but I usually feel better on the pill or while I'm pregnant. And I happen to be 8 mos. pregnant right now, so as you might guess I am scared shitless for postpartum time. Think hormones impact yours??

Keep trying. And like I just read on another blog, don't just keep trying to be happy (it's pointless). Just try to be a good person. And keep talking about it all -- it has to help.

[Kathryn, dym]

Your earlier effexor posts really helped me to help a friend in a similar position. I had a doctor suggest I was bipolar because before I had the post partum depression, I was a super-go-getter type A personality. It was likely that my entire life up to the birth of my second child was just a giant bipolar upswing. Yah-huh? I appreciate your openness and I thank you for not posting your daily food journal, but if you find something natural that really works well, please sum it up for the rest of us.

[Mimi]

I also struggle with depression and have been working up the courage to blog about it! Hugs and prayers and you are awesome.

[sweetney]

love to you, sweets.

[Meg]

Alice, you have this incredible way of making me laugh like an idiot and then bringing out my inner mom with a desire to kick the ass of anyone who would charge you tons of money to call you by the wrong name and misdiagnose you and not give you the counterindications on your meds. For the love of PETE.

But thank you for being honest, for walking through a process that sucks wildly for you in a vulnerable way with your readers, and for doing what it takes to take care of yourself.

[coco]

I know that this was not the point, but the having to pay for drugs thing is very stressful and does influence your decisions about what kind of alternatives you want to try when you are un(or under) insured. I buy my drugs from www.canadiandrugstore.com and get them shipped from canada. legal with a prescription and cheap cheap cheap.

Hang in there and trust your own feelings (i.e. don't go to that doctor if you don't feel that she is the right one for you!) - You will find the right kind of help, it is out there!

[KateC]

While this might not be a priority, have you tried negoiating cost with your Dr.? My neurologist (ADD) charges me a reduced rate as my insurance doesn't cover him, and I'm not always flush. Many physicians would rather you keep seeing them, than have you wander off. If you're embarrassed to ask, well, $350 is a goodly sum for pride.

[Megan]

I had a terrible time getting off Lexapro, which probably isn't as intense as Effexor. But, but! I really do feel ok now. Better than when I was on it, certainly better than before I went on it, and obviously better than the nauseau and plummeting depression of withdrawal.

I hope the same is true for you eventually - I think it will be.

[mainja]

what's worse? people asking you for advice, or people giving you unsolicited advice?

i have to say, i don't understand the not being on medication as a strength thing. why is it weak to treat an illness? the thing i've always heard is 'would you refuse insulin if you had type 1 diabetes?'

[bs]

If you have periods of feeling 'normal' interspersed with periods of feeling depressed, you may be 'unipolar cyclical'.

Some pharmaceutical companies will give you free medication if your financial situation qualifies.

Thanks for writing this post. It is comforting to know that I am not the only one struggling with finding the right medication and the explanation as to why I suffer from depression.

[Elleana]

Whatever help perfect strangers on the internet can provide, just ask, and we shall provide. Maybe all we can do is say, like many previous commenters already did, that we're rooting for you. Because we are.

[Monica]

Aw, Alice. I just hope you can start feeling better soon.

[Kristin]

Ditto on rooting for you, hoping you feel better, and reading whatever the hell you want to write.

[Molly]

I know that place, all too well. I had "fun" because I have PMDD (Pre Menstrual Dysphoric Disorder) and I also happen to be one of the special people for whom birth control causes extreme depression. So there was the three months straight of extreme depression, and when I refused to continue with that, I "just" had the monthly depression. Every month.

And I had a doctor thinking that I was bipolar (except, fortunately, people who are bipolar don't rotate so fast between depression and not, so that was out). Never got the point of taking a medication for that, though. And then there was the fun of finding a good anti-depressant. The only good thing I can say about the numerous ones out there is that we no longer have to stop eating/drink any milk products (including chocolate!) while we take them. Because seriously, that would make anyone depressed, wouldn't it?

Anyway, I'm not asking for help, just letting you know that I know that place, and I hope you're in a better place soon. But maybe, just maybe, knowing one or two of us have been somewhere similar (and come out the other side!) will help.

[Stefanie]

I'm forwarding this to a close friend who went through a year of hell from her withdrawels.
Her blog is here: spider21.blogspot.com, and if you are willing to look through the archives, you can see how bad things got.

[Kelly]

Call me crazy, but it seems to me that you being on the road to good mental/physical health is all the triumph any of your readers want or expect, or hope for!

Huge hugs.

[Tildy]

Wow, this post sounds really familiar to me - enough to push me out of my usual lurking place to comment. Ive been on medication for mood stuff for over a decade now; about five years in, my therapist told me that it usually takes three different medication attempts before somebody can find one thats a good match for them. Lo and behold, my third prescription change (to Wellbutrin, which is the best drug ever) made me feel hundreds of times better.
I hope you find something that works for you, in fact I know you will. Youre smart enough to listen to your body and able to measure your emotions in a clear way, two very good skills to have when youre shopping for psychotropics. :) Sorry this is so long, I'll stop now. Good luck.

[leahpeah]

xo
xo
and also,
xo

[melissa f.]

add my pompom to the pep squad. you can do it!

(triumphant entry endings are so last year.)

[Claudia]

You're really brave to take on a move to NJ right now. Really. Brave. Take it easy on yourself. I hope the nutrition therapy works for you. We're all here to support you!

[Nicole]

Nothing to add except to say that you are not alone and that medications that work and don't make you feel worse are a Very Good Thing. I don't care if they're for depression or diabetes.

Also, I have been hearing a lot about biofeedback lately. That might be worth a try...?

Thank you for writing so well about such a difficult topic. I am, as always, in awe of your staggering ability to make me want to laugh and cry at the same time.

[Kelly]

Oh my God, Effexor withdrawl.

It was always one of those things I had such difficulty describing. "Like my eyeballs are coming unattached." "Like the room, um, it's kind of spinning or something, but not really, while someone is hitting me hard on the back." "Please kill me, now."

It was one of the best anti-depressants I've ever been on, though.

I hope things improve for you. You write incredibly eloquently.

[Meghan]

This winter was perhaps the darkest most awful hovel of a winter ever. I didn't have the curlies to write about my own trip down "chronic low grade dysthymia" lane. I think you are terribly brave for sharing your own experience.
My sister has anxiety and panic attacks and she went on a no caffiene / low sugar diet and it helped loads. I hated the medication too, and am now off it. Let the chips fall where they may!

I hope you are feeling more like your happy self again soon. I agree that its hard to write without feeling false when you have big things going on that you arent sharing. If you ever figure that one out, please share with the rest of us. In the meantime, you are lovely, with a captial "L" with sugar on top.

[Jerri Ann]

Alice, I could sit here all day telling you of my experiences, but I write openly about it on my blog and you shouuld really take some time to read it. I too have tried effexor (which helped me none) and lamictal (which helped me none) and have found a nice combo of things that don't cost an arm and a leg and I'm doing rather well right now. I also have a new secret weapon and it is combatting sleep deprivation that I knew I had, but didn't know to what degree until I had it evaluated. Honestly, my blog is much better with this stuff, looked under the category Big J and/or Health and well-being. I know you are busy but I think you will see yourself in many of my posts. I suffer from anxiety mostly, some depressino and my doc and I experiment with a drug for bi-polar'ism (is that a word) that is benefiting me very much.

Please, just give it a read when you have time!

[Sonia (DDM)]

Thank you for sharing this. Also, for SO PERFECTLY describing Effexor withdrawal. I went back on a different med a few months after my Effexor withdrawal nightmare. I didn't get the immediate "Ah. I'm back!" that I got with Effexor, but a gradual, easy return to *normal*. I'm hoping that should I decide to go off this one, that the tapering off goes as well as the tapering on.
Good luck, I wish you the very best! And again, thanks for writing. I just adore your blog.

[Jennifer]

I'm among the mood-disordered, but I don't want advice. I just want to tell you that you are far from alone. Although you know that, I'm sure.

Rooting for you, too. For all of us, I guess.