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How to Endure and Possibly Triumph Over the Adorable Tyrant
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« Preschoolers can be fun! | Main | I have separation anxiety. »
Tuesday
Oct042005

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.

Reader Comments (140)

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. ;)
October 4, 2005 | Unregistered CommenterMir
There was an ask.metafilter question about this exact thing. http://ask.metafilter.com/mefi/20094
October 4, 2005 | Unregistered CommenterBeth
The dictionary can be a wonderful companion! Me and the Thesaurus, we're good buddies. (Buddy; syn: associate, chum, comrade, mate, peer, sidekick.)
October 4, 2005 | Unregistered CommenterUndisclosed
Oh wow. I can't imagine any way in which that would be fun. Good luck!
October 4, 2005 | Unregistered CommenterNire
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.



October 4, 2005 | Unregistered CommenterRobin
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.
October 4, 2005 | Unregistered CommenterRebecca
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/
October 4, 2005 | Unregistered CommenterCricket
we -- meaning i -- love you.

more coming in a non-publicish forum...
October 4, 2005 | Unregistered Commentersweetney
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.
October 4, 2005 | Unregistered CommenterAmieable
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.
October 4, 2005 | Unregistered CommenterC
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!
October 4, 2005 | Unregistered CommenterKelly
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?
October 4, 2005 | Unregistered CommenterLaura
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!
October 4, 2005 | Unregistered CommenterEm
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.
October 4, 2005 | Unregistered CommenterAngel
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.
October 4, 2005 | Unregistered Commenterredfox
Since my husband broke his back and pelvis, he has taken all of the following drugs for extended periods of time:

OxycontinAvinzaHydrocodoneBaclofenCelebrexAmbienEffexor

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!

October 4, 2005 | Unregistered Commentermadge
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.
October 4, 2005 | Unregistered CommenterBelinda
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.

October 4, 2005 | Unregistered CommenterJack's Raging Mommy
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.
October 4, 2005 | Unregistered CommenterCandy
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.
October 4, 2005 | Unregistered CommenterSandra Parker
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.
October 4, 2005 | Unregistered CommenterKathryn
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.

October 4, 2005 | Unregistered Commentermehitabel
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.
October 4, 2005 | Unregistered CommenterMagrak
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.
October 4, 2005 | Unregistered CommenterTitanKT
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.
October 4, 2005 | Unregistered CommenterJenn

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