Wednesday, June 02, 2010

Today's post is brought to you by the letters "M" and "H"

I feel like I talk about this a lot, but I think it is important to acknowledge that people are human and sometimes need help. I know a lot of people who are uncomfortable with that statement- I know I have been in the past. Sometimes it is really hard to admit your perceived "shortcomings" and do what you need to do to become a better, healthier person. More specifically, a mentally healthy person.
I'm not sure why there is such a stigma surrounding mental health issues. If a person got cancer it's not like you would expect them to suck it up and get over it. They need help- physical and mental and maybe even spiritual- to make it through the difficult process of treatment and recovery. If you get a sinus infection no one bats an eye when you take antibiotics. When you get the flu you are expected to stay in bed for a few days and feel like total crap and take your medicine. But when you are depressed... then what?
I am amazed that in this day and age when so many people are on mood stabilizers and a host of antidepressants that mental health is still handled with secrecy and shame. Yes, Shame. The general opinion for so long was that people who are depressed are weak. That they are reacting to environmental pressures that a "normal" person would just deal with. Or maybe that depressed (or bipolar, or whatever) people are a time-bomb. They might go crazy and start a shooting rampage in the office because they "snapped".
While there are some people who absolutely need to be hospitalized and medicated, and receive whatever help can be had until they are better, there are probably many many more of us out there who are walking a fine line. Who are clearly not "crazy", but maybe deep down know something is not right. We're normal, fairly well adjusted, balanced people who know that the level of anxiety we live with is NOT normal. We know that living from day to day in a dulled cloud of blah is not really the way to live a happy life. We're certainly not going to hurt someone or ourselves, but there is a problem with coping skills that hasn't been resolved.
And it turns out that it isn't coping skills, and it isn't that we need an attitude adjustment- it's chemistry.
I have been in therapy on and off since I was in college. I first went 11 years ago when I was having problems dealing with day to day school stress and pressure (and generally not caring about anything). And then there was the fact that my boyfriend was 8 hours away and my parents were getting divorced and I hadn't been in a school setting much before that and my roommate was a partier and I was a book worm and the list went on and on. I felt like a complete failure because I couldn't handle everything! And there in a nutshell is my main problem with myself- why can't I handle it? Why can't I handle normal conflicts with my parents? Why can't I handle an interstate move and a job change? Why can't I handle buying a condo and grappling with whether or not I'm doing the right thing? I feel like I should be able to handle everything- I am a smart, independent, successful person who can do anything when I set my mind to it. A little stress shouldn't throw me they way it does.
The big secret: not being able to handle all of that alone is completely normal.
Another secret: my body doesn't handle stress quite normally.
Insomnia and panic attacks have been a part of my life since I was 13 or 14 years old, maybe younger. Anxiety has always been there, along with some really negative internal dialogue. Occasionally I get the blahs where I can't get the motivation to do anything, even the things that usually make me happy, although I'm not really sad. I have bouts with IBS and headaches. I clench my jaw when I sleep. And I internalize everything- so if you know me you might never know that all of that goes on.
And for the past 18 years I have firmly believed that I SHOULD BE ABLE TO HANDLE IT. I should get over it, grow up, get a grip, snap out of it, get my shit together, and be this amazingly controlled person who doesn't feel like the world is about to crash down around her.
I have tried deep breathing and meditation, supplements, diet changes, yoga, music, all kinds of things to stop my mind from racing and get the panicky feelings to stop. I have tried so hard relax and let go (the control freak trying to control how much she can chill out... oh boy). But it just doesn't happen for me, and ultimately that lack of success makes me feel like a failure. The only thing that doesn't make me feel like I'm failing is daily exercise, but the lack of motivation part can make that really difficult.
I found myself sliding into some pretty serious apathy (again) 3 weeks ago. I talked to my therapist and told her that I was feeling fat and unhappy and dissatisfied. I was having trouble focusing at work and I just didn't care about anything. I didn't want to go out with friends, I wasn't eating, I was sleeping even less that usual... something just wasn't right. I was tired of living my life this way, always having to work so hard to feel normal. What was normal anyway?
The crazy part? I didn't even think that I sounded that depressed. Honestly.
So my therapist starting working around the edges of what was going on. There wasn't much happening to me that would be making me feel this low. I was still upset over the loss of my cat, but that wasn't enough to start this spiral of self-loathing. I was getting plenty of sunshine- so it wasn't seasonal. So if what I was feeling wasn't environmental... perhaps it was chemical. Maybe, just maybe, it was time for me to at least consider an antidepressant and see what happened. And I was so tired of feeling bad that I finally decided she was right. Enough was enough. I started Zoloft that night.
(I have to add that I tried Zoloft for about 3 days back in December, but the combination of things I was on made me so tired that I was afraid to drive my car and I quit all of them. However, I figured it was worth another try.)
I started with a half dose (25mg) for a week on a Tuesday. That Friday I was laser-beam focused at work. I knocked all sorts of things off of my to-do list, followed up on projects that had been languishing, and felt like I could actually do my job, and do it well. Just over a week after I started taking it (upped to 50 mg), I started sleeping in a way I haven't since I was a little kid. I would lay down in bed, tell myself it was time to sleep, and fall asleep. That has NEVER happened to me that I can remember. I went to see my friend (another Heather) last week and not only was I not nervous about flying, I wasn't obsessing about what I had packed, or what would happen if I didn't get my suitcase back or what it would be like staying in a different house or sleeping in a different bed. I was oddly calm. Calm in a way that I love- it's like someone turned down the dial on all of the worrying, the anxiety, and the self-talk. Why did I wait so long?
I have to add that this is NOT what I was expecting. (Actually I'm not sure exactly what I was expecting in the first place.) You hear about people being on happy pills and acting like zombies and not being able to cry or feel anything at all- this is not the experience I am having. It is much more subtle than that.
And I haven't had an IBS attack since I started taking Zoloft. Zoloft is an SSRI- Selective Serotonin Re-uptake Inhibitor- meaning basically that your 5HTT receptor sites have a little more time to soak in serotonin (Zoloft does the same thing with dopamine too- but that's not related to the IBS). Your intestines have tons of serotonin receptors, and some people think that a cause of IBS is a serotonin imbalance. I am starting to think that they might be right. Or it could just be that I am less anxious in general and therefore not experiencing stress through my gut.
So why am I writing this? There are a couple of reasons. First of all, depression and anxiety shouldn't be shameful topics. They shouldn't be dark secrets because they are normal and people need to share their stories so others don't feel that they are alone out there. Second, blogs like Heather Armstrong's and websites like crazymeds have helped me so much, and I want to make sure that my initial experiences with an SSRI are here for anyone who might be looking for help or reassurance about antidepressants or mental health. Google me. I'm here.

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