Tag Archives: medication

Taking Medication On Vacation

We went to Hawaii for my grandma’s 90th birthday, which meant lots of plane rides and 3-hour time difference. It also meant plying myself with lots of pills in order to stay as functional as possible. What are some ways that I managed this?

Tip #1: Stick with number of hours between pills, and not actual time

I usually take my first pill between 10:30 – 11:30 am, but during travel, the time changes. Instead of focusing on the actual time of day, I just paid attention to how many hours had passed between pills. At night, it resets, so I started taking my pill about an hour after I woke up, around 10 am Hawaii time.

Tip #2: Dramamine is amazing

I was worried about feeling sick on the airplane and all the car rides, so I took the less-drowsy formula about two hours before getting on a plane or in a car. It completely reduced any nausea I might have felt. A few nights, I would start to feel nauseated randomly – probably because my body was adjusting to a different pill schedule – and Dramamine would help with that, too.

Tip #3: Always carry food and water

I never went anywhere without my water bottle. Staying hydrated is key to not feeling ill in heat, whether or not there’s medication involved. I always tried to carry food with me, like a protein bar, because my second pill of the day would fall around 2pm, which was after we had eaten lunch and before dinner. Depending on what we were doing, going to get food wasn’t an option, so I had to have something with me.

Tip #4: Don’t forget how many pills you’ve taken

This is a weird problem I have sometimes, where I will forget if I just took a pill or not. It’s become so automatic, when the alarm goes off, I act on reflex. Sometimes I eat before, and sometimes I eat after, so that doesn’t help me remember. One day, I forgot if I had taken the pill, and not wanting to risk the withdrawal from a missed dose, I took the pill. I’m pretty sure I ended up double-dosing myself, which resulted in a headache. Thankfully, taking two pills wasn’t nearly as bad as three (which would make me instantly sick), and I was able to walk it off and drink lots of water to feel better.


All in all, having to take three pills a day didn’t interfere with the vacation too much, and I was able to relax and enjoy everything that went on. There was only one major miscommunication with the family about it all, which reminded me that other people need to be privy to my schedule. That isn’t a problem I’ve encountered before, because usually I have an identical schedule and only take my last pill of the day with others around, and it’s usually just Chris and we’re at home.

when fear asks the wrong question

The greatest disagreement Chris and I have had in our relationship is children. He’s always wanted kids, and when we got married, he knew I wasn’t too keen on the idea, but I was very young, and we both assumed I would gradually come around to the idea. I haven’t. In fact, I’ve become more resistant to it.

We’ve had a lot of tough conversations. There have been lots of tears. It seemed like the question we both had to face was, “Do I have to choose between the person I love or the life I always imagined having?” For Chris, that life meant children. For me, it meant not having children. We reached an impasse.

I knew something was wrong with the question we were asking. I’ve always been very analytical and self-aware, and any question that seemed designed for heartbreak made me suspicious. I fully believe that there is no fear in love, and to be so fearful meant there was something going on.

I’ve had to ask myself a million times, why don’t I want children? It always comes back to my mental illness. The idea of pregnancy terrifies me. The medication I’m on has such a bad rap that there’s a thing called “Effexor babies,” where women have sued after being on high doses while pregnant, and having children with birth defects or who died. Of course, the healthcare system insists the risk isn’t too bad, but they have a horse in the race. Reading stories from actual women has convinced me that any kind of strong antidepressant is going to mess with the natural development of a child. However, the other option, going off medication, is just as scary and risky. Severe depression can affect a fetus’ growth just as much as a drug.

My fears don’t stop there, though. No matter what route I go, that’s just 9-10 months. It’s doable. But, then the baby is born, and it’s here for the rest of my life. It’s overwhelming. I’m at a point where I can just care for my own mental state, how on earth can I be expected to take care of a kid? Another human being, who is essentially a sponge? And then there’s the increased risk of the child also developing a mental illness, so that’s another layer of responsibility.

In going over my reasons, I noticed that Chris was entirely absent from my thought process. And then I realized that the reason I’m so overwhelmed is because I imagine dealing with all the complexities of parenting + mental illness by myself. I don’t have confidence that Chris would know how to deal. I’ve never imagined my life with kids because I’ve never known my life free from the ever-looming presence of mental illness, and I’ve never known what having a real partner in the fight is like. That doesn’t mean that Chris doesn’t support me or is unhelpful. It’s just that depression/anxiety has always been my “thing” that he comes in and out of, it isn’t something he lives with like I live with it. If we’re going to be a real team, we both have to live with it. If we were truly united, I wouldn’t feel so overwhelmed about the idea of kids.

The real question isn’t choosing between us or a kid. It is, “How do we get on the same team when it comes to mental illness?” That’s something a counselor can help us with, and has lots of solutions both practically and spiritually. It’s a question we can tackle without feeling like we’re just butting heads. Fear always likes to ask the question that only has one, usually horrible answer, but that’s not how love works.

Falling into Routine

It’s been a busy three months (give or take). We’ve been on a lot of walks, I’ve taken a lot of pictures of trees, and I’ve packed in a lot of life work: getting medications, seeing doctors, and getting an Oregon driver’s license. We’ve been to Portland and Lincoln City. I started growing parsley, which is now in full bloom and edible. Baxter’s skin is no longer super dry, and he loves having his own room to be super loud in. Chris loves his job, he feels he’s doing important work, and is always in a good mood when he comes home.

It’s nice to fall into a routine. We shop at Fred Meyer, I eat frozen cherries most nights to help me sleep, we go for longer walks on the weekends, and my work load has been pretty light. That means more time for working on my novel, painting, reading, and keeping the house organized. It also means more time for naps, which I still take probably too often, but I’m learning to give myself a break from fretting over that. The fact that my medication changed from caps to tablets has kind of helped with that, because I have to take one pill three times a day, so I have to be awake at certain times to take it. That schedule also helps keep me asleep at night, too, which is weird.

In terms of mental health, it’s been a relatively smooth transition. The only reoccurring blip has been feeling really isolated and kind of at a loss about how to make friends. Chris has been scouting out churches, looking specifically for ones with young people and groups, but I’m still not really interested in going to church. I would definitely join a group though, that just hasn’t happened yet. I tried going on Tinder to look for friends, and chatted with a few people, but after a few messages, that just fizzled out. I recently tried Bumble, which has a better friend-finding feature, and found a person who I’m hanging out with soon. Since I’m just a naturally intense person, I have to keep myself from thinking, “This is my new best friend! Kindred spirit! We’re going to do everything together!”

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Being away from everyone I’ve ever known has forced me to get better at communicating with people and work on old friendships. It’s also made me more appreciate of friendships in different stages, and not neglect someone just because we’re not as close as we used to be, or if there are certain things we don’t talk about. I guess distance does make the heart grow fonder.

Things I Like About Salem:

Rainy days
Having a huge park close by
Having basically every restaurant close by
Fred Meyer and their incredible organic/natural options
So much green
Dogs everywhere
Being closer to Erin (and seeing her twice already since we moved!)

New Things I’ve Baked/Cooked:

Walnut-fig scones
Chocolate pudding
Quinoa salmon bowl
Chicken enchilada bowl
Butterscotch + dark chocolate oatmeal cookies w/ brown butter

 

With Unexpected Speed

I did not expect to be dealing with all this so soon.

I had recently passed my two-year anniversary and was looking out the car window at the blur of fields and barns. Occasionally we would pass clumps of trees, but they would fly by so fast, it was like they had never been there at all. When I tried to focus on a small detail like a single branch or house in the distance, it would immediately bleed into the oddly-linear hues of gray, green, yellow, brown, and blue. My mind was wandering. It had only been two years since I signed a piece of paper, said goodbye to my dog as he left for his new home with my in-laws, and woke up a married woman. In a lot of ways, it seemed like yesterday. However, it also seemed like forever ago. In those two years, me and my husband have dealt with mental breakdowns, horrendous medication withdrawals, a crisis of faith (ongoing), employment turmoil, sexual identity questions, loneliness, relationship doubts, and looming financial challenges. I was not naive when I got married. I knew all this and more was part of the deal; I just didn’t expect it all to happen so soon and so quickly.

Isn’t marriage supposed to have a honeymoon period? You know, that brief time when everything is rose-colored and you’re just happy to wake up next to your person every morning? I’m not saying I’m unhappy to be waking up with my person, but there was never a time when that happiness wasn’t mixed with anxiety and questions chewing on my brain like termites.

Is my unemployment a burden to this clear-eyed, optimistic, occasionally goofball-ish man I’ve yoked myself to?

Will the pharmacy screw up my medication again and disrupt my entire week with crippling muscle pain, headaches, and frantic doubts about everything? Are those bone-shaking doubts just symptoms of an unstable mind, or legitimate concerns I should be listening to?

Should I have gotten married when I did? Am I too young and immature? 

Will I ever be in a place to have kids? Do I even want kids? What happens to us if I don’t want kids? 

Even before we got married, we were faced with having to give up our dog Yoshi and the distinct possibility he would never be adopted. Thankfully, Chris’ parents took him back to Indiana with them, but that raises its own issues, like feeling the self-inflicted internal pressure to make enough money to get a place where we can take him back.

Do other married people have these problems? I’m sure they do. And I’m positive that couples have faced worse unemployment, worse debt, worse mental illness, and so on. I want to always be aware of the privilege I have, but I’m selfish and self-pitying. I see other couples with Instagram-perfect lives and go between feeling glad I’m not a fraud, and then furious that we’re not them. I see other couples having or planning babies, and I’m flabbergasted that they aren’t freaking the f*** out every minute of every day. I envy identity/orientation confidence. I envy white-picket fences and Tuesday date nights and dishwashers. But mostly, I fear.

I fear I will never be happy at the same church as my husband.
I fear 9-5 jobs and “work shoes” and imperfect bosses.
I fear eternal debt.
I fear little pink capsules and inefficient pharmacies.
I fear loneliness because I don’t dare get close to other women.

I fear God and His timing, which is so unlike our own, that to Him nothing is “unexpected, “too soon,” or “too late.” 

God of the Tar Pits (Part 2)

While seeing depression as a result of spiritual frailty or sin has become outdated, there’s still some odd Christian teachings about it. Depression is viewed as a season and something that – with time and prayer – can be overcome. All my life people have told me to be patient, that they were praying for me, and that I would one day know the freedom and joy that only Jesus can bring. The longer the depression stayed, the less people talked about it. They got tired of telling me they were praying, and I got tired of hearing about it. Believing that depression is a sign of spiritual weakness is not popular, but if you suffer from prolonged depression, people start to wonder.

Depression “success” stories are remarkably popular. Christians devour personal tales of fellow believers suffering from crippling anxiety and depression who have been transformed by God and grace, whose marriages have been saved, who have found peace, who have overcome brain chemistry and been “freed” from medication. They were lifted from the tar pits by Jesus and as one of those Christians who have depression, I was encouraged to pray for similar redemption. At a conference, a friend told a story about a young man who went to be prayed for and was healed from depression in that moment.

“How did he know?” I asked, confused.

“He just…knew,” she replied.

“That sounds like bull crap.”

“Do you not believe that God can do miracles?” she probed.

I didn’t know how to explain to her that that wasn’t the issue. It wasn’t that I didn’t believe God could heal me from depression, it was just that I knew if it happened, it wouldn’t be with just the snap of a finger. I had never seen God work that way. He didn’t seem to really be into that whole instant gratification thing. When I had that conversation, I was at the point in my life where I didn’t even want to be healed from depression. I was beginning to learn that it was just something I would have to live with, like a scar. Sometimes it would act up and interfere with my life, while other times I could almost forget it was there. I didn’t want to overcome; I wanted to persevere.

When I recognized that depression was going to a permanent fixture, I stopped struggling. The discovery came in stages, but was punctuated by the end of my second year of college, where things were going so well that I stopped taking my medication. From the outside, my life looked perfect. I had gotten into my dream school, was doing well, and making friends. I was also part of a faith community that emphasized spiritual warfare, and I believed that I had successfully conquered all my demons. Then a childhood memory rushed brutally to the surface and my brain broke. I locked myself in my room for three days straight and didn’t move. People had to bring me food so I wouldn’t starve. It was finals’ week and all my hard work seemed wasted. It seemed like I had won against depression, but it came back with a vengeance, like it had never left, or like it had been gathering strength. When summer came, I went back to my psychiatrist and was put on the highest dose of a new medication. For the first time, I accepted it gladly.

Antidepressants are notoriously tricky. The most prescribed class of medication for people like me with major depressive disorder and anxiety are SSRIs (selective serotonin re-uptake inhibitors). These were created based on the belief that depression and a host of other mental illnesses like anxiety is caused by a lack of serotonin – a neurotransmitter responsible for feelings of happiness- in the brain. The reason they are controversial is because of the nearly limitless side effects that have been reported, like loss of sexual interest, vomiting, headaches, dizziness, and insomnia. They are also labeled with a “black box,” which means a side effect of taking the medication might increase suicidal thoughts and tendencies. When I first started taking medication in high school, I was required to see a psychiatrist once every two weeks and tell her if I was experiencing this side effect. I can’t say if these sorts of thoughts increased because of medication, but many of them did little to reduce my depression while also gracing me with flu-like symptoms, severe exhaustion, and muscle pains. On particular medication I took over a summer made me sick every morning for two weeks.

Constantly adjusting medications that didn’t seem to help much, but succeeded in making me ill was frustrating, but when I had that breakdown sophomore year, I knew I needed medication. No amount of prayer alone could fix brain chemistry. I was arguably in the best place I had ever been spiritually, I knew I wasn’t possessed, but still my head reeled and I couldn’t will my body to move. That experience taught me that I can’t pretend my depression is gone just because I feel okay. I have to anticipate it, plan for it, accommodate it. That’s what medication is for. Finding one with minimal side effects was worth it and when things are going well, I may be tempted to stop taking it, but when the other shoe falls, medication is there to balance out any craziness the body throws at me.

Once I realized that depression was going to be a part of my life in varying degrees, my expectations changed. Instead of trying to match everyone’s achievements, I came to terms with the fact that I wasn’t like “everyone else.” Certain things will never be easy, like making a phone call, getting to class every day, or hanging out in a large group. There are things I will never do, like travel alone, go completely off medication, or hold down a high-pressure job. It’s a good week if I get out of bed every day. And that’s okay. That is just who I am.

There are also things I know that other people don’t because of the depression. I understand hopelessness. When people ask why anyone would commit suicide, I have the answer. I don’t have a neat, happy success story, but I have a story that says, “Depression never goes away, but it doesn’t have to control or define you.” I can see where traditional mental health services failed people, especially religious ones, because it has failed me. What I learned most from depression is that it’s the place where I met God. He wasn’t in a counselor’s office, where I was given lists of mood-boosting activities, or in a required chapel where I felt completely alone while surrounded by other Christians. He wasn’t in books or sermons.  He was- and still is – in the tar pit.

It would be understandable if I had abandoned my faith at some point during my struggles, but something kept drawing me back. Some of it was fear, yes, fear of venturing off into the unknown, but most of it was because I could see the marked difference between how my fellow Christians saw mental illness, and how God seemed to see it. The Bible is so full of references to persistent, bone-crushing sorrow that it can be overwhelming and triggering to read. People are constantly weeping, renting their clothes, pouring ashes on their heads, and lying on the ground, unmoving, for days. Jesus himself prayed with such agony before His death, that his sweat had blood in it. He is described as “a man of sorrows and acquainted with grief.” The one verse that has stuck with me most is from Psalm 34: “The Lord is close to the brokenhearted and saves those who are crushed in spirit.” I used to be frustrated with this. I understood the first part, but what about the second? Where was the “saving me” bit? When I accepted my depression as something that was just with me, my definition of “salvation” changed. It didn’t involve being pulled up from the tar in a bright beam of light and suddenly “knowing” I was “cured.” It didn’t involve some big success where I suddenly become someone I’m not. It’s the little things, like being loved. It’s having insurance for medication. It’s graduating from college, no matter how long it took. It’s finding people who understand. God had been saving me every day, bit by bit, keeping my head above the tar.

I should make it clear that not all of life is being in the tar pit. Good medication and healthy choices help keep me grounded and productive. It’s just that no matter how good things are going, that tar pit is never too far away. There’s no real rhyme or reason to why I fall in. Sometimes it makes sense, like the death of a family member. Other times it’s random, like the wind changed directions. I used to be terrified of that movement when I felt the tar rising up my legs, pulling me down. I would struggle and berate myself.

“How could you be so stupid?”

“Why did you let your hopes get up?”

“You know you can’t push yourself too far; why did you try?”

The voices are quiet now. The tar pit doesn’t frighten me as much. I just keep breathing and let it happen. Eventually, the tar thins out and I’m free from it for a while, with renewed focus and gratitude. Life goes on, and I have two choices: look back with regret, or keep moving forward with hope. I choose hope.

Sleep Reality

I am a sleep expert. I know light sleep, deep sleep, sleep in cars, sleep in planes, sleep in my own bed, in hotels, on the floors of friends’, in classrooms, on fountains in Europe, in a museum…in the latter, I was awoken by a curator who asked if I was ok, and then told me to not sleep there. I awkwardly sat up and did my best to stare at a painting like I was interested in it. The struggle was real. 

I’ve heard voices while I slept and felt sleep paralysis. I’ve slept through alarms and phone calls and knocks on the door. Sleep and I have been good friends and bitter enemies.

I dream A LOT. Like, more than normal people, at least in terms of how much I remember. I used to keep a dream journal but I stopped because I was recording two dreams every day and I couldn’t keep up. I dream at night and whenever I take a nap, even if it’s really short. Dreams have provided the inspiration for more than one story. 

I see friends in dreams, friends who with whom there’s been a kind of tension, or conflict, and it hasn’t been resolved. Friends who are no longer friends. Even if I don’t actively think about them very much, they make their way into my dreams. Sometimes there is actually a resolution, where we talk about what happened between us. Other times, they are just there. The dream is either set in the past when they were in my life, or we’re in a bizarre situation like fighting a war against vampires or what not. 

What’s weird and unsettling about these dreams is how vivid they are. Having vivid dreams in general is an effect of the antidepressant I’m on, so the people in my dreams are always very clear, look like themselves, have the right voices, and everything. It is like they are really there. The dreams have gotten more vivid, so I’m at the point now where I hesitate before acting in a dream because I am not sure if I’m dreaming or not. Even if the dream is set in an impossible reality, in the moment, the dream world is very real.

In the dreams, I’m always happy to have some kind of resolution. With some of them, I tell them how much I miss them. How I wish things were different. When I wake and realize none of it was real, disappointment follows me the rest of the day. Sometimes longer. Because with some of these people, I know resolution will never happen. Except in a sleep reality. 

Change of Plans

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Instead of lowering my medication dose like I planned, my therapist has suggested I stop messing with it for now. She said there might be a “better” time, but pessimism tells me that no “good” time exists. It’s basically trying to anticipate the pitfalls of lowering medication (withdrawal, depression and anxiety coming back stronger) and plan life accordingly. If I’m in a job, that could be tricky.

My therapist is retiring, too. I had my last session with her. So now I have to find another therapist at a time when the depression and anxiety has actually been increasing again. Liz even said she feels that she isn’t finished working with me and that I should definitely keep seeing a counselor. Merg. I have a couple names, but starting over with a therapist is always kind of exhausting.

 

Junkie

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This is not a happy post. If you’ve seen my Facebook statuses, you have permission to not read this as it is essentially more complaining about the horrible withdrawal that Effexor causes.

I ran out of my pills and while waiting for the pharmacy to refill them, missed half a dose, and then a whole dose. It has been one of the worst ordeals of my life.

First came the mania. I was feeling good. Too good. I was dizzy, but in a kind of tipsy, happy way. I knew it was the beginning of withdrawal, but I didn’t know what to do about it. I went to bed. Then the random crying started. I was sad about a friend, and then all these crazy scenarios about Chris dying played in a loop, and then I started crying about the movie “The Book Thief.” Then the tremors. The shaking. The cold sweats. The insomnia. When I woke up, I could barely move and my mouth was so dry I could barely breathe. I knew I wouldn’t be going to the first day of class, the one class I had decided I could take this semester, after taking two and half semesters off. I cried some more.

The sleep paralysis was really bad. I couldn’t really move until 3 in the afternoon. My vision was blurry and I would not stop crying. I finally just called Chris and sobbed into the phone until he came home. I managed to calm down a little from the incessant shaking when he called the pharmacy and learned that they would be ready soon. The end was in sight.

When I got my meds, I also ate food. I hadn’t had any appetite all day, and I knew not having any nutrients was not helping at all. I couldn’t make anything, we didn’t really have anything, so I thought a basic Subway sandwich would be ok. It was not. I was almost instantly ill and had to retake my meds.

The vomiting has been continuing all evening and into the night. I don’t even feel nauseated, but my body is rejecting anything and everything, it seems.

This can’t happen again. And I’m furious at medication and the mental health corporations and my psychiatrist. This feels like poison. I’m definitely going to ask her to lower my dose. And demand she be upfront about the side effects of doing that.

The Pill Fiasco

ImageYesterday was not a good day for someone with phone anxiety. Luckily, the anxiety isn’t as bad when I know exactly what I need, and I needed pills.

The issue started yesterday when I called the pharmacy to see why they hadn’t refilled my Effexor. They said there was a problem with the insurance, which was weird, since I switched in May and had gotten three refills just fine before this. The next step was to figure out the insurance, so after sitting on hold for a half hour, I went online and found the claims section. According to that, my current insurance had only paid for my newest prescription. Did that mean my old insurance was still paying for stuff? Even though it’s impossible to be on two separate insurances? What was going on??? I called the pharmacy again and confirmed that they indeed had the new insurance on their file. They did. I called the clinic where my psychiatrist is and they said there was a problem with the information on my file and that I should talk to billing. Chris called billing and they said everything was fine, even though it looked like they had been sending bills to the old insurance.

Everyone had the same information at least, so I had done everything I could about that. Now my focus shifted to just getting my drugs, which I desperately needed. The pharmacy said that the doctor needed to authorize a refill. I called the clinic. They said they had authorized it. Called the pharmacy. They said that now they needed the insurance to verify that I actually needed the medication and that they would pay for it. I called the clinic again and they said they had contacted the insurance company, but wouldn’t hear back for 1-5 days. My heart sunk. I start feeling withdrawal from my pills if I take it only an hour late; what would happen to me if it was longer? My psychiatrist’s nurse called me and took the reins. She spent forty minutes on the phone with the insurance company and found out nothing. Knowing that I needed the meds right away, she just called in a totally new prescription.

Yesterday was frustrating. Nobody seemed to know what was going on and we still don’t know why most of my claims weren’t appearing on my current insurance. I’m still glad I have insurance though, obviously. I could see the full price of everything and if we were paying just out-of-pocket, all of our money would be going toward my mental care. Not even kidding.

Storms Prove Anchors

ImageThere are two types of anchors that water vessels use – temporary and permanent. Temporary anchors are the type we usually see in movies, where the sailors are frequently moving the anchor up and down, usually dripping with seaweed and decorated in clam shells. Permanent anchors are rarely moved and are used because they have stronger hold and don’t hurt the ocean environment as much as temporary anchors do. They hold the ship through all kinds of weather, including terrible storms.

Permanent anchors come in various styles, some are shaped like mushrooms and others are just heavy blocks with chains. The type of seabed (soft sand, coarse rock, etc) determines which type of anchor is best.

I went to see my psychiatrist yesterday and she put me back on on the anxiety medication I used about a year ago. Instead of taking as needed, which I was doing before, she told me to take one half twice a day before moving up to two tablets a day. A temporary anchor just isn’t enough to keep this ship from drifting.

When it came time to go to bed, I took my first half dose. The effect was oddly instant. I felt safe in the bed; the covers didn’t feel clingy and strangling like they usually do. I felt a comfortable weight in my chest where usually there’s a manic butterfly that keeps banging up against my ribcage. It was like there was a tiny anchor rooting me down into my body, keeping me present, calming my thoughts.

I’ve been fascinated by anchors for a while now; they make frequent appearances in my art. I’ve been searching for a way to ground myself, to become stable. Anxiety and depression is like being on an out-of-control Ferris wheel because there are so many highs and lows. Right now, getting back on anxiety meds is a permanent anchor. There will be other anchors as the seabed of my life shifts so it’s best for me to keep an eye on the ocean horizon.