Better living through chemistry... ah, those were the days... It is truly amazing and awful at the same time to understand and feel the effect of brain chemistry -- serotonin & norepinephrine -- on emotions as starkly as I have over the past week or so. The newly Effexor-Free Me isn't a very happy camper!
In early 2003 (even after two years of social work education, several years of working with individuals with a wide range of chronic and persistent mental illnesses, and personal experience of depression and anxiety among close friends) it came as rather of a shock that I might actually be so depressed that I should consider taking medication. It had taken me a good two years to even come to the realization that I could be depressed. After all, I had a great education, a great job, a beautiful home, a significant other, a supportive family, etc. With all that, what could I possibly be depressed about?
I just felt sorry for other people who didn't have all the great things that I had. So sorry, in fact, that when I heard their stories on NPR, I would get teary-eyed. There are lots of these stories on NPR. You'd be amazed how many fit into a ten-minute commute. In retrospect I'm probably lucky I never crashed the car in the midst of all of those blurry, teary-eyed rides to and from work. Even once I conceded that I might be depressed and started seeing a therapist, it was still surprising that insight alone wasn't going to be enough.
The actual effect of taking an antidepressant was amazing to experience. The "on a scale from 0 to 100; 0 being the worst you could ever imagine feeling and 100 being the best you could imagine feeling" test showed a marked improvement within just a short time. A further adjustment of the dosage and wow! 100 here I come! Bye bye hopelessness, bye bye loneliness, bye bye crying jags. (Oh, the stories on NPR were still touching, injustice still made me angry, and there is still a lot of tragedy out there--but my fellow drivers and I were definitely safer without the blur of tears.)
After nine successful months it was time to see if I was "cured", so to speak. I carefully weaned myself off the medication under the direction of the psychiatrist and all seemed well...for a while (two months? maybe three?). Really everything was fabulous -- my beautiful house was even more beautiful after a great kitchen renovation; I had met the love of my life and was about to get engaged; I'd had a very smooth coming out to my parents and friends; I was feeling accepted, loved, and supported! So why was I bawling? Crying hopelessly and uncontrollably? Give me back those meds!
Fast forward two years. I waited til the last possible moment before we are to start trying to get pregnant to figure out what to do about the antidepressants. Stay on and have a more stable/less stressed mental state to take you through this inherently stressful and emotionally trying process? But of course you want to avoid any possible harm and expose a fetus to as few chemicals and medications as possible. We wanted to weigh all of the evidence, discuss with the psychiatrist, read all of the warnings, etc. I was taking a Category C drug: animal studies have shown an adverse effect (very small animals taking very large doses?) and there are no adequate and well controlled studies in pregnant women. What inadequate reports there have been don't seem to indicate a large risk (a different antidepressant was recently down-graded to a Category D), but nonetheless... Ideally I will be Effexor-free during the entire pregnancy and during breast feeding. At the very least we should try for the first trimester and again in the last weeks. Ok, here goes!
The Effexor-Free Me: feeling cruddy, sad, less than optimistic about the possibility of actually getting pregnant; more irritable and snappy than usual; barely able to drag myself out of bed in the morning but equally unable to go to sleep at night (check the posting time!); crying at NPR stories (definitely!) and while singing hymns at church and over lunch and when reading about fertility and at the slightest sentimental notion. Probably the worst part right now is feeling the difference to a week or two ago so intensely--knowing, logically, that nothing has really changed (I am still just as blessed and loved as I was then) and knowing that these feelings will pass again; but feeling intensely powerless over the feelings themselves much of the time. Conclusion: my brain is broken!
So please bear with Effexor-Free Me and read this brief warning: expressing empathy for my situation or offering to help reduce my stress or cheer me up will surely drive me to tears! Don't be alarmed: you may see me tear-up but I'll also be chuckling at this catch-22. And thanks.
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