Medication Confusion

I went back to my doctor (regular physician) for a follow-up on my meds on Thurs. I had been on the Celexa for about a month but I was still having some annoying side effects: hot flashes, headaches, and some occasional insomnia (which I never had before). We talked about a number of different meds I could switch to, to see if maybe there would be less side effects for me. I am beginning to feel like there are always trade-offs. There are always side effects. It's just a matter of which ones you feel like dealing with. I seem to be pretty sensitive to the side effects, I guess.

Anyway, he suggested I try switching to Prozac, which I haven't tried before. But I'm a little bit worried because I have read that a common side effect with it is anxiety and nervousness, which I DEFINITELY DON'T NEED MORE OF. And the Celexa seems to be helping my anxiety. So, is it worth risking a change again? I don't know. I filled the prescription for it (yay for $4 prescriptions!) but I had 5 more Celexa pills so I decided to finish it off before I start the Prozac.

He also prescribed trazedone, which is a tricyclic antidepressant, to help me sleep better. I guess at low doses, it is helpful for that. But I think my insomnia was mostly related to the Celexa. So, if I switch to Prozac, I may not need it at all. So I didn't fill that prescription at all. I am always a little wary of adding more medications to counteract side effects of another medication because it seems like then you are just adding more potential side effects and it could just go on and on and on.

But while I'm on the subject, I may as well tell my medication history. I saw a psychologist in 2003 (I think?) and she recommended Zoloft. But, as she couldn't prescribe meds, I went to my regular physician, who thought that Paxil would be better (I think it was a bit of a pharmaceutical push). So I started Paxil and stayed on it for almost 2 years. Got off during my pregnancy (my 4th, by the way). And then decided to get back on something postpartum. I really didn't like the side effects with the Paxil, especially getting on and off of it (weird dizziness, constipation, and feeling really weird, in general). So I wanted to try something different. I was also worried about the meds and breastfeeding (that's another issue I'll talk about some other time). Anyway - first I tried Zoloft. And broke out in a terrible rash. So I stopped it. Then a psychiatrist prescribed Prozac. But with the much longer half-life that Prozac has, it actually accumulates more in the breastmilk and I felt like maybe something else would be better. So then my midwives prescribed Celexa, which I filled, but never took. My baby had a heart defect and I really really didn't want to stop breastfeeding and I just didn't feel it was the right decision at the time to start meds, afterall. It was a really hard decision.

And here I am. My baby is now 2. And I finally decided it really was time to get back on some medication. The last 2 years have been pretty rough in a lot of ways. And I feel like medication might need to be a long-term treatment option for me. We'll see, I guess.
Looks like I have 1 more day of Celexa and then I may switch to the Prozac. Ho-hum. It's always such a difficult decision. What to do, what to do.

Small Success

Thursday I would have to say I had one of the most succesful days I've had in quite some time. First, I went to the Dr. for a follow-up on my meds (more on that later), then I took my 2 yr old grocery shopping. I worked on getting the house clean for my 9 yr. olds birthday party on Fri. And then made dinner while my husband was at a meeting. And I can only say that those are all things I have been unable to do for a long long time. And to do more than one in one day is pretty unheard of. So I felt pretty good about that.

As a stay-at-home mom, I know these are things that most would assume I take care of every day. But I really have not been able to accomplish much of anything for awhile. I have felt incredibly guilty that my husband has had to take over and pick up the slack in so many areas of our family life. And I am incredibly grateful that he has been willing and able to do so (he's always been a better cook than I am anyway). But since I am home, it seems that it makes more sense that I should do more. And I hope I will be able to do more, more frequently, soon. I hope I can pull my fair share again. And be able to feel competant and not so overwhelmed that I shut down and hide away. I want to be able to feel completely "engaged" in my life and not have to just "cope" quite so much. I hope I can get better and stay better. I really hope.

(is it even possible?)

Diving Deep

I feel as though I am just skimming the surface. I'm missing some of the details, I'm just floating along the top. So I'm getting by. But I'm not getting at the deeper meanings. I can't feel things deeply. I can't dive deep to where things make sense. I can get through the motions. I can feel myself moving along. But I don't know what lies beneath. I don't know how I used to feel. And I don't know how to reach deep enough to find it.

Rehabilitation

I had high hopes for getting back on the meds. I had really hoped I would have more energy again. And get things done around my house. Be more patient with my kids. Happier in general. You know, I was just hoping it would help me get my life back on track. I was hoping for a miracle drug.
And it's not happening.
I have noticed a decrease in my physical anxiety symptoms. I don't have the nervousness or the pit in my stomach. I don't feel as depressed. But I still don't feel well. And that's disappointing. I noticed today that I was trying to force myself to smile at my kids. And it feels strained and unnatural. I just feel blah. My house is a wreck and it's discouraging. And I am still tired and getting headachy. And life is still stressful and hard. I still want to cry. But I feel the sort of worn-out numbness that comes after you've cried too hard for too long and there are no tears left. Just empty.

I know I've had to rearrange my life for awhile now. There were things that I couldn't do, and that we had to say "no" to as a family - commitments, obligations, stress - in efforts to manage my depression. I wasn't on meds at the time. And we didn't take care of a lot of things. We tried to let go of a lot of "to-do's" in efforts to just get by. And I'm realizing that it will take time, even with the med, to relearn how to live my life. It's kind of like rehabilitation for someone who has had a stroke or something. Relearning to walk or speak. I need to start over in some ways. Start from scratch. I guess that will take time. But it's discouraging. Hard to realize that I can't just stand up and start running. That I am not better yet. I have a long ways to go. It's hard to take a look back and take stock of all the damage that has taken place. To see how bad it's been. And even though things are getting better, it's going to be a slow recovery. It's hard to still have to move so slow.

Making it

One of the things my husband always asks me on my bad days (when I call him at work in tears, or sit on the line in silence, wishing he could run home and rescue me, but knowing he really really can't), is "are you going to make it?"
Or he reassures me that we are just in survival mode. We make it through the day. We get through. We survive.

But it seems like there are always consequences. Of course, we make it. We wake up alive the next morning and we breathe. But what does that mean? Does it mean that we aren't causing damage to our children and those around us? Does it mean that we aren't losing weeks, months and years to misery? Does it mean we aren't wounded by our experience?

So, is it really surviving?

I guess it doesn't mean much to me for someone to tell me, "wow, you made it through that!"
It's not good enough to know I haven't seriously harmed myself or others (physically).
It's not enough to get through each day still breathing.
I need to live.
And I don't know how.

Trichotillomania

So, one of the problems I've struggled with through my life is this lovely word: Trichotillomania. I hadn't heard of it until my younger sister's college roommate had it and told her about it and then she told me about it. And I looked it up online (this was about 6 years ago) and discovered I had it. It's a kind of anxiety-driven impulse to pull out or pluck hairs. I started pulling out my eyelashes in high school, sometimes to the point of having half my eyelid bald. It's been mostly when I've been under a lot of stress. It's not pretty. And it's awkward to explain to people why I'm missing eyelashes (can I just tell a little lie and say that I have a disease that makes them fall out?). Or I guess I could just tell a part-truth and say I have a disease. Because it is. I just happen to do the pulling out myself. I've sometimes also pulled out armhairs and other places. It actually feels good in a way. It feels like a relief. So it's hard to control. I've read that these antidepressants sometimes help with it - and sometimes don't.

It is also sometimes accompanied by other self-destructive behaviors such as skin picking and cutting. I struggle with those things from time to time as well. I've ripped and torn the skin completely off my heel, leaving it raw and pick at my cuticles, etc. And I had a couple cutting incidents when I was a teenager and into college. Although I've had the impulse to do it again in recent years in dark moments, I no longer have the resolve to actually carry it through (or can't find things to do it with, which is a good thing). Anyway - I used to be embarassed by the scars on my arm. Now they've faded to a point that no one would notice. But I look back and know I had a deeper problem than I probably realized at the time. And I wonder what my life would have been like back then had I actually gotten treatment. How would I have been different? Would I have made different choices? It's painful in a way to try to imagine. It's what makes me realize treatment will make a difference for my future.

Celexa Day 9

Today was the first day taking the full dose of 20 mg. I didn't notice much difference than the side effects I was already having.
And can being more hungry than usual and having to pee a lot be related side effects? It's not on the (long long) lists of potential side effects I've seen, but you never know.
My husband says I seem to be dealing with things better than I have been recently. But I can't always tell because my episodes sort of come and go. It would be nice I guess. I think it has helped my anxiety. I don't have as much of the butterflies/nervousness I had so much of before for no good reason. And life doesn't feel as hopeless as it had been. It's hard to know what to attribute to the placebo effect and what the medicine is actually doing.
And I can't help but wonder, what do normal people feel? How exactly is it supposed to feel to not have depression or anxiety issues? Because it's normal to feel a little of it sometimes, right? So how do I know when I'm feeling normal?