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How to Endure and Possibly Triumph Over the Adorable Tyrant
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Thursday
Jul132006

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.

Reader Comments (189)

Fucking doctors. When I started having symptoms of depression and anxiety (AND fucking store clerks in dressing rooms), I was diagnosed as menopausal even though I was only 44 and still having periods. I was put on HRT and fucked more store clerks, when I actually ventured out of my house.

See, I really AM bipolar. But it took a long time (and several inept doctors) for me to get properly diagnosed.

I relate to the Effexor withdrawal, because that's what Paxil withdrawal is like. I had a newfound appreciation for heroin addiction. And what's with antidepressants that cause you to GAIN TWENTY POUNDS? That's like breast cancer medication that causes you to get uterine cancer. It's like Jews for Jesus.

Anyway, this is my virginal visit to your blog but I've been meaning to come for ages. Those damned store clerks got in the way.
July 23, 2006 | Unregistered Commenterpanthergirl
I can't imagine you actually read all these comments, but I have BEEN in Effexor withdrawal land and have come out ALIVE! I thought I had the flu. Oh..the DIZZINESS! And it just got worse and worse until we had to turn on the radio to block the voices I was hearing outside the window. Good luck to you!
July 24, 2006 | Unregistered CommenterLisa Connor
Hi Alice,

I doubt that you make it all the way to comment 178 but in case you do, I wanted to thank you. It's nice to see someone expressing a lot of the same feelings as I have over a similar medication (love/hate/fear). I'm also currently deciding to pull myself away from Effexor. The 35mg was the half dose for me (was on that for two weeks), and now I'm down to adjusting granules (not quite counting them yet).

My symptoms usually emerge as complete anger and frustration with everyone. When that runs out, I just curl up into a ball and shoo everyone away (pre-effexor actions).

Interestingly enough, I've also decided to go on a low carb diet. So, I find the last comment you made about Ammino-acids and no-sugars very comforting as well. If that kind of diet is helpful for people who require Effexor, then I just may have incentive for staying on this diet past loosing the weight.

I've already promised my wife that if I lash out at her and the girls for more than a week or find I can't get off the couch for two weekends ... I'll go back on. I'm mostly not a fan of the $35/month/bottle with insurance.

You should also know that you're the 4th site down on Google when entering "effexor wearing off". A lot of people must reference you ...

Good luck with everything,

Paul

July 25, 2006 | Unregistered CommenterPaul V
no doubt you have hundreds of blog well-wishers and I'm not so different. But I did want to say thank you thank you thank you for making me feel like I'm not the only one. I've been afraid to open up on my blog too! Everyone will hate me and so on...
July 26, 2006 | Unregistered Commentermeridith
I know you from the old neighborhood. Near Flatbush. As the world would say, I had no idea. BUT - from my own experience and that of friends, I find it beyond astonishing what you have to got through when you're depressed or whatever and trying to navigate the shoals of the psycho-medical world. Words to scream come to mind. Lordeeeeeeee. I hope you're doing okay.
July 28, 2006 | Unregistered Commenterelizabeth
Delurking to say that you should know Prozac is now generic, and probably more likely to help than nutrition or herbs (well, in my opinion). Also many other antidepressants (Elavil, etc) are also generic, though have more side effects than Prozac. Haven't had time to read the many many comments, so my apologies if someone else already pointed that out.
July 30, 2006 | Unregistered CommenterNoelle
And Zoloft also just went generic, which apparently is great is you don't mind losing your interest in sex. So there's that.

In other unsolicited advice: never underestimate the cheap, free, doctor-ignoring stuff, like getting regular exercise, avoiding sugar and white flour, and maybe St. John's Wort?

Good luck!
July 31, 2006 | Unregistered CommenterPoppy
i am completely depressed, anxious, anti-social, have been missing doctors appts, and been generally very suicidal for a few months. extactly a year after a serious failed attempt. i am 32, but my parents have $ so that helps - am also married but want to be alone like 95% of the time (and he still loves me???) Rambling.. sometimes i wish that i was poor. living on my own again... because then it was sink or swim - and i was a kick ass swimmer. I would dread work all day but still go. when i started working w/ family i just started calling in sick. Its harder faking it around family and others that have known you for like 20 years. i eventually got fired but got to live in their vacation condo- now i am just floating. I feel even worse for feeling this way and having $. I feel it is such a waste. there are people w/ real problems and my only problem is inside my head; so it seems like a good idea to get rid of the problem sooo often. but i cant hurt people like that again. god - how many times have i written those words?? sorry, at this point this should be on my blog...I just wish i could stop feeling sorry for myself for nothing. wish my brain would wake up and realize that life can be good. wish the meds would work. wish i could get off them so i could start a family. wish i wasnt so terrified that i would crap out w/ PPD. i am so scared of having a child w/ a suicidal mother; just not fair to them. but everymonth husband asks me think about getting off meds for family. he forgets i am barely holding on as it is... OK - I feel better :) just letting shit out where others wont read it. thanks for the outlet.oh yeah - bout effexor - i tried to kill myself about 3 times (very lame tries - not real) when i was coming off, tried to walk home 10 miles in miami in august in heels b/c i got in a fight w/ mom/boss; reignited a fight w/ a highschool friend; got fiance to break up w/ me DURING A VACATION - just an entire 2-3 weeks filled w/ unreasonable behavior compounded by my period.Bleah
August 3, 2006 | Unregistered Commentermish
Mish, please seek professional help, right now.
August 3, 2006 | Unregistered Commenteralice
Oh God....the right, really smart psychiatrist is so important...My first and worst informed me that I was "incurably mentally diseased and will have to spend the rest of your life on medication to lead a relatively normal life"...after spending 15 minutes with me... I, the good patient, was just that for 2 years. My second, and savior, said, after spending hours with me, that he saw no indication of that but it took me a long time to believe him. With him I had traditional once a week therapy for 5 or 6 years paid for by my husbands union...I am eternally grateful. The third and current is excellent, I see him every 4-8 weeks for ADD (if only I knew that decades earlier) depression and anxiety. He does take insurance, he does give sample meds, he is available when needed. In short find a good doctor.
August 8, 2006 | Unregistered CommenterJO

Where you so for a long time were gone?

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April 8, 2011 | Unregistered CommenterJoshua

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April 12, 2011 | Unregistered CommenterMyFWord

Wow... OK, I know this post is from almost five years ago, but I think your old psychiatrist has been giving lessons to my new psychiatrist, who, no joke, is also hanging onto a potential bipolar diagnosis because (1) two of my grandparents may have had it and (2) I am often really anxious as well as depressed, which she, in her infinite cleverness, believes is evidence that I am in a bipolar mixed state. Never mind that I have never in my life shown any other symptoms of bipolar disorder; never mind that I've been anxious along with my depression for THREE YEARS, which would break the record for a mixed state by quite some margin. And never mind that Lamictal didn't help me even a teeny tiny bit. Who needs evidence when you've got, um, opinions?

(Most gallingly, she keeps asking me, "So, you're still not sleeping well at night, right? You're having periods when you can't sleep much at all?"--which CAN be a bipolar symptom--and I keep telling her, "NO, actually, I've always slept pretty consistently because I can't function well on less than eight hours a night." And then she either doesn't believe me or selectively forgets to write it down because she keeps coming at me every week with questions about a sleep disturbance THAT I DON'T HAVE. She's leaving my student clinic in a month, thanks be to God, and here's hoping I get transferred to someone who isn't quite so captivated by the present-day trendiness of bipolar diagnoses. What is it with these doctors? Bipolar is "in" and the scientific method is "out"? *Sigh.*)

In any event, I got to this post by clicking through on your "Depression" tag, and I'm sending all my prayers and best wishes for you to make a speedy recovery from this most recent bout of brain troubles! Thank you so much for your honesty and wit and perceptiveness... viewing mental health struggles through the eyes of a gifted writer is a real comfort to those of us who also struggle. Especially on the days when we feel incapable of stringing two words together to tell anyone how we're really feeling. :o)

May 28, 2011 | Unregistered CommenterNaomi

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