Tag: mental health

Is This the Right Time?

           I picked an interesting time to stop taking my antidepressant! About two months ago I started the process of weaning off Zoloft. Two weeks ago, I completed the process. I was on it for years – certainly more than a decade. I began to consider stopping about a year ago. I noticed that I felt ‘flat;’ I wasn’t experiencing pleasure in moments that I expected to, like being with my granddaughter or going on vacation. That isn’t to say I didn’t enjoy those things; I did but I wasn’t fully engaged. I wanted to feel more, even sadness. I understood that Zoloft was likely protecting me from real lows, but I wasn’t sure it was worth the tradeoff anymore.

            The reason I started taking medication in the first place was not because of depression, per se. I am fortunate in that I have never experienced the debilitating effects of clinical depression. My problem was that I would ruminate – I lived in my head, and I was tired of it. I remember telling my therapist that I felt stuck. I would ruminate about unsatisfying social interactions or relationship problems. Sometimes I would get stuck on fears, even silly ones. A low point was when I was on the teacup ride at Disney with Leah and instead of enjoying it – she was – I was imagining the headlines when it crashed. Anxiety was more of an issue for me than depression.

            All these years later, when it dawned on me that I was kind of numb, I thought maybe it was time to try life without Zoloft.  Even with the craziness of Covid, which has introduced another layer of challenge for our mental health, I wanted to give it a try.

            In one sense it was a good time to consider the possibility of going off the pills. When things started getting harder managing Mom and Aunt Clair’s health care about six months ago, I returned to therapy. After a few sessions I posed the question: Could the medicine be stifling my emotions? Was the dullness I felt caused by the drug? I wondered if, by virtue of being on Zoloft for so long, my brain had rewired itself. Maybe the pathways that led me continue to re-live the same conversation a hundred times had been rerouted – not to stretch the metaphor too far. She said that the flatness I was describing was a known side effect of medication and it was possible that my brain changed such that I would be less susceptible to ruminating. We discussed the process of discontinuing the medicine and what I should be on the lookout for in terms of side effects as I went forward. I also checked in with my primary care physician since my therapist is not a psychiatrist – my primary care doc actually prescribes the medicine. Having consulted with the two of them, having a plan in place, I decided to do it.

            With all that continues to go on with my mom and aunt (not to mention the relentlessly negative news from the world at large), it might not have been the wisest time to do this experiment. I think, though, it is also important for me to feel the pain of this part of the journey. Though I am only a couple of weeks into this, instinct tells me that it was the right step to take. I may change my mind – I haven’t disposed of the remainder of my pills – I reserve the right to go back on them. But, I think this feels more natural. I should feel sad that Mom is not herself. I should get angry and frustrated at the failures of our health care system. I should feel joy when my granddaughter runs at me to hug my knees, turning her bright, beautiful face up to mine, flashing a huge smile that melts my heart. I want to feel those emotions.

            It has been a dramatic welcome back to the world of emotion. People sometimes talk about oscillating between one feeling and another. My experience is more like the hour hand of a clock sweeping across an array of them – fortunately it isn’t the minute or second hand! That would be unsustainable. Anger, confusion, frustration, love, hope, despair, powerlessness, appreciation, grateful are all part of most days.

            As expected, anger is prominent. There is a lot to be angry about, and I have a shorter fuse now. I’m not sure that is a great development. Since Gary is often the one igniting the fuse, I have checked in with him to see if I’m being unreasonable. So far, we’re managing, or should I say he is. Isn’t he lucky! Seriously, though, I am working on handling my temper. It hasn’t been a problem, but I do notice a difference.

            Another expected emotion – sadness. Each time I am faced with the fact of my mom’s new limitations, I feel it. I am still not a crier. I wish sometimes I could get that release. Oddly, I find it comforting to be sad. Being numb to what is happening isn’t living. If I don’t dwell there too much of the time, I think it is healthy.

            If the last two weekends are any indication, the joy has ramped up, too. I spent time with my children and granddaughter two weekends in a row! One of those weekends was my birthday and we managed to combine all my favorite things: family, nature and art. I was more fully present. So far, so good.

My Gallery of Joy:

  • late summer flowers
  • sculpture made with cello bow hair
  • Leah’s band
  • Gary looking into the abyss
  • Granddaughter imitating her Dad

            I do notice some increase in anxiety. Stray thoughts about unlikely accidents (like my teacup ride) creep in, but they aren’t taking up residence. They aren’t getting in my way. At least not yet. I am hoping they won’t.

            Some may wonder why I am sharing all of this. It does feel a little weird to put this out there. But I want to ‘walk the walk’; I believe we need to destigmatize mental health issues and how can we do that if we don’t bring it out into the open? Maybe we’ll get to the point where it becomes a nonissue, then I’ll stop. We aren’t there yet. This is part of my journey, and I am choosing to share it. Hopefully it will help others who may be experiencing some of the same challenges. And, if not, maybe it illuminates what it feels like for those who have not been down this road.

Note: If any reader is considering stopping medication, please do so under the direction of a doctor and/or therapist. There can be serious side effects, especially if it is done abruptly, that need to be monitored.

Life’s Little Ironies

Random ironies I’ve been thinking about:

The thing you most need to do when feeling lonely or depressed is the one thing that is hardest to do: call someone, reach out to another person. Taking that step requires more energy than I can muster in those moments.

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Money makes money; the more money you have, the more you can accumulate. The system is unfair and conspires against those who don’t have it. I was struck by this, in a small way, when I went to the bank to get certified checks (bank checks?) for our closing the other day. As a perk of being a ‘privileged’ customer, I didn’t have to pay for the checks. There was a woman being served by the teller next to me who didn’t have a checking account and needed to get a bank check. She was charged – I think it was $5.00 per check. There’s an irony there. The person who could afford it wasn’t charged, the person who could least afford it was. I know why the bank does that, from a business perspective it makes sense. From an ethical perspective, perhaps another model would be better for society. What if bank customers with the financial wherewithal paid more for their services so that people with less resources paid less? Is that blasphemy in our capitalist economy?

Another example – a person with great credit and solid savings gets a low rate on a loan to buy a house. That person pays less for their house and can continue to save and build their financial resources. Another person, with a less strong credit history and less savings, gets a higher interest rate on their loan. They pay more and are likely to continue to struggle to make ends meet. What would happen if the system was reversed?

I can’t imagine the system changing given the vested interests in keeping it the way it is. And some might think it is fair the way it is – they may believe that the rich have earned their perks. I’m not so sure.

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I think she was just trying to be helpful, but she wasn’t. A woman was explaining to me how she manages her diet. She limits her carb intake, loads up on fruits and vegetables, virtually eliminates fats and makes sure she gets her 10,000 steps daily. I was nodding along. She is rail thin, I am not. When new information comes out about diet and exercise, she incorporates it into her routine. I think she was sharing her approach in hopes that I would see the light. As if I didn’t know all of that stuff.

For some of us, eating is mostly about fueling our bodies. Gary is able to approach it that way. That’s not what eating is about for me. Hunger has little to do with it. It is about comfort, boredom, frustration, grief, and joy, too.

Maybe I’m being unfair in assuming that it is easy for the rail thin woman. Maybe she is working hard – actually, I’m sure she is. But, the discipline of regulating her eating comes more naturally. Perhaps it is another of life’s little ironies – those of us who most need to separate emotions from eating, have the hardest time doing it.

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I came across a post on Facebook, from Julian Lennon, though I don’t think he wrote it himself:

Life is so ironic, it takes sadness to know what happiness is

Noise to appreciate silence and

Absence to value presence.

 

It seemed to fit with the way I’ve been looking at things lately.

No Judgment Zone

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Sometimes I think too much

We know the old saying, ‘you can’t judge a book by its cover.’ We know this applies to people, yet we do it anyway; we judge. Looked at another way, is the idea that you never know what is going on with another person, unless they share it with you. I am going to share, with the hope that it helps others.

I take Zoloft and I have for many years. Some may read that and think, ‘Big frickin’ deal! Doesn’t everyone?’ Others may be surprised since my life is so charmed (and it is). And some may wonder why I would share something so private.

It is that last one that motivates me to write this post. Struggling with depression and anxiety is no different than other illnesses. I think there are some who view having cancer or diabetes or high cholesterol as a private matter – but not out of shame.

I hesitate to label myself as mentally ill. I have never been clinically depressed, as I understand that term. I have suffered only one panic attack that I recognized as such, and that was when I was a teenager. But, I have struggled my whole life with persistent melancholia. Whether that qualifies as a mental illness according to the DSM, I will leave for a doctor to decide. The label doesn’t matter, I was struggling through my life. It took a few things to get me to finally seek help.

One significant trigger was my son. When he was an adolescent, he asked me why I was always so unhappy. That opened my eyes to the impact my moods were having on my children, and that maybe it was getting worse. I also realized that I was fed up with ruminating. When things would go wrong, let’s say a family member said something that hurt my feelings or an interaction at work was frustrating, I would replay the incident in my head for months, imagining what I should have said in response, or how I would talk to them about it, only to do nothing. I would get stuck in that place and time, I couldn’t get out of my own way. One more factor led me to reach out and that was my daughter was approaching college age and she would be leaving home. I wanted to prepare myself and I wanted to handle the stress of that process better.

I asked my internist for a referral to a psychologist. I wasn’t thinking that I needed medication. I thought talk therapy would be sufficient. The referral worked out well – the therapist was a terrific match for me. She took a cognitive approach and we agreed that we would look at adding medication down the road, if we thought it would help.

After a number of months of weekly visits that were useful, I still wasn’t progressing the way I hoped, we revisited the medication question. We decided that I would try Zoloft (my internist actually did the prescribing). It was the right decision. It hasn’t been a miracle drug. The big difference I noticed was that I wasn’t in my head all the time. I could move past the aggravations and hurts that are a normal part of life, but previously I was not able to let go of. It didn’t suddenly fix my self-image problems, or remove all anxiety or regret, but it made it less of a struggle.

After a while, having learned some strategies and having better insight into myself, I thought I would try stopping the drug – I discussed it with both my therapist and my internist. I weaned off of it. After about a year, I realized it wasn’t a good move. The aftermath of my father’s death was a particularly challenging time for me. I also came to the realization that whatever it was about my brain that led me to ruminate was still there – it wasn’t going away. While I may have been able to manage it behaviorally, it took so much mental energy to do it that it was exhausting. I needed to come to peace with taking the medicine for the foreseeable future.

I write this because during all the years that this was playing out, I had numerous occasions where people commented on how lucky I am, or how happy, assertive, or comfortable (insert positive characteristic here) I seem to be. I am those things, some of the time, and not without considerable effort. If only they knew, better living through chemistry! Now they know!

So, there are three points in my sharing this. First, don’t make assumptions based on what you see. There is an internet meme that says you never know the battle someone else is fighting. Every time I see it, it resonates. Start with compassion. Second, it shouldn’t be a thing for someone to share that they take an anti-depressant, anti-anxiety or any other medication that helps to regulate mood. We shouldn’t sit in judgment. We may be moving in that direction, but we aren’t there yet. Lastly, I hope it is helpful to someone to know my story.