Above the Influence v. 2

I started taking Prozac again last Wednesday. I have mixed feelings about it, but it’s still early. Once it starts working again I’m sure my feelings will all shiny happy once again.

Maybe it really is the Prozac

There’s very little to say when it comes right down to it. How far have I come, really? The pain, the loneliness, the jealousy is all still there. I can’t remember why I wanted to stop my medications. I suppose I liked the idea of stopping my medications. I think, though, that the experiment failed, and perhaps it is not such a bad thing to rely on that little green and white pill each morning. I am not quicker without it. I am only edgier and more forgetful, more scattered and ultimately less productive. My migraines and my appetite for junk food have increased while my energy hasn’t.

It is not an easy thing to come to terms with the fact that perhaps you do have such a great personality. Perhaps it really is the Prozac after all. I am still torn about the Lamictal. After all, do I still have mood swings? It would be interesting to stop the Lamictal and see, but I am not sure about its efficacy if I have to restart it, and I my doctor isn’t particularly knowledgeable about such matters. Once again, I find myself needing a good therapist. What an elusive creature that is. Ironic in a city that has more psychologists than bathrooms, I know.

Okay, so it is the Prozac that makes me a nicer person to be around. Is that such a bad thing? If there is something “wrong” with my brain that is somehow corrected with these chemicals, what is the problem? It is an existential question, really, because logically, one does what works.

I HEART my Shrink

My shrink called the other day, and he pretty much said that I would have to go to the Po’ People’s Clinic for my psych meds.

He said I was doing “too well” to stay on as a client. I was glad I was on the phone, because my eyes started to burn. It feels like I’m being punished, and even though that’s totally irrational, I feel incredibly upset about the whole thing. Does he realize that too many more PP’sC experiences and I could have a full-on psychotic break?! The mental health center is going to have a sudden influx (or is it reflux) of people, because my breakdown would not be an isolated incident.

I’m pretty sure I witnessed at least two patients crack up the last time I was at the clinic, and my sister is definitely on the edge.

He asked me what happened to make me so upset about PP’sC and I simply wasn’t able to articulate it over the phone. He always makes me kind of nervous, and today he acted like he didn’t know why I stopped Prozac, which made me feel even weirder, like I was doing something sneaky. Not that I think he was acting. I’m sure he really forgot. (I love it when docs don’t check their notes before talking to patients). Of course, now my thoughts are in order, and I wish I had said that I am concerned about the philosophy of the consulting psychiatrist, to whom my PCP will necessarily be deferring. Dr. J gives me a lot of control over my treatment. How do I know if I will get that from this new relationship? How does this guy feel about the possibility I will stop my medication at some point?

I like my primary care doc, but she is always incredibly rushed. I have trouble seeing her sitting and discussing any kind of med changes that I may need in the future, let alone any sort of med withdrawal. I am trying not to play “Worst Case Scenario”, and act like it is the end of the world, but Dr. J and I have come a long way, and I feel like this is really a setback.

But the worst part, I think, is that I am actually upset about not being able to go to the Mental Health Center. I hate that fcuking place just as much! They are just as screwed up as the Po’ People’s Clinic.

FYI: being crazy may look all glamorous, but let me assure you, it really isn’t as fun as it looks in the movies. Don’t try this at home, people.

Above the Influence: Day 23

People come and go so strangely here. -Angels in America

It has only been a week since I stopped the Prozac completely. It seems longer, and I am relieved it has not been, because it means there is still hope that my mood will level out. I do fear that the Prozac was taking the edge off a few emotions I am now going to have to actually deal with. I know that was the point, or at least part of the reason, I wanted to kick the happy pills, but the irony is, without the serotonin boost, I feel much less able to deal with this crap.

Yet I find myself looking forward to certain things. Clarity, for one. I have been off meds in the past, but it was more like “woo, I’m off my meds, look out!” Certainly not a reasoned, thoughtful choice. What will I be able to accomplish without the slight fuzziness that clouds my brain all the time?

I can’t help but wonder if my migraines will subside without all the psychotropics. If any other little health problems I have are actually side effects. Joint pain, tinnitus, sore throats, stuff like that. (I go to my ED all the time to get this stuff checked out, but the doctors can’t tell me anything.)

One thing that breaks my heart is that I do not have the support of my family. I mentioned to my mom and sister on separate occasions that I was titrating down my Prozac and each of them switched to this “staff” voice (lucky you if you don’t know what I mean). I didn’t even bother to say anything about the Lamictal.

crazy person - mood stabilizer = unstable crazy person

It happens a lot lately, this feeling of not being understood. It’s one of the nasty little feelings that green and white pill smoothed over quite nicely. I know it will get better when I am back in school. This summer is really hard for me, and I am definitely feeling a little melancholy (as in “thoughtful sadness”, not in its clinical context).

I find myself counting the days until summer is over, and I hate to live as if the days are something I just have to survive until better days come. ‘This too shall pass’, and all that rot. What if it doesn’t? What if this is all I get, and I’m wasting it by sitting around waiting for it to be over? That would suck!

I am not an unhappy person (at least not anymore). I may be having a biochemical reaction to an imbalance in my brain caused by SSRI withdrawal, but even when I feel crappy, I still have a lot more in my life that I am proud of and happy about than that of which I regret.

***

Above the influence: Day 16

I didn’t take any Prozac last night. I am really cranky this morning; maybe it’s a withdrawal effect.

Of course, it could be that I’m cranky because one of the foster kittens peed in my bed, and I had to get up at 6 am to change the sheets.

Lucky for him he’s this cute.

***

Above the influence: Day 14

I haven’t been sleeping at night, but I feel like I slept all day yesterday. I haven’t been eating much of anything, either. It could be the heat (or some rare disease, la la la), or it could be the effects of kicking this Prozac. I do feel real spaced-out (is that supposed to be hyphenated?), but that could be the whole not-eating/not-sleeping/oversleeping thing (which seems to be having a deleterious effect on my usage of punctuation as well).

image credit

Above the Influence, Day 3

So far so good. Still waiting for the Prozac level to drop down to where I notice a change. I plan to stick it out no matter how bad it is; if it’s awful I’ll just go down slowly. I want my natural serotonin production to be approaching normal (whatever that is) by Fall. Dr. J makes a face anytime I suggest there may be withdrawal symptoms. Of course, I have kicked Paxil and Effexor, so how bad can it be?

Above the Influence

I started weaning off Prozac today. Cut my dose down to 20 mg. Dr. J told me not to expect much for a few weeks, but I swear I can tell even when I miss a single dose, so I’ll have to see. If I still feel okay in two weeks I’ll either go down to 10 mg or stop all together. Not sure whether to stop the Lamictal this summer or wait until after school starts. I might even wait until school ends.

It’s a weird feeling to even thinking about stopping the mood stabilizer. I have been under the influence of one psychotropic drug or another for 8 years without a break. Of course, it isn’t a decision I can never return from. If I don’t like how I feel, I can always get back on meds. My only concern is that I vaguely recall hearing of patients who did not respond as well to medications the second time around. Not sure that was true for mood stabilizers or just SSRI’s.

I HEART MY SHRINK

the Psychiatrist

I was really excited to see my psychiatrist today, not only because I hardly ever get to see Dr. J, but because he was one of the few people left on the planet who I had yet to tell about my acceptance to nursing school. I think it is actually sinking in a little that I am going to nursing school. The world didn’t get all spinny and overbright when I said the words aloud.

He asked the obligatory: how are you feeling?, and I told him I was actually happy. He asked if I thought the medication was helping me feel that way, I said I thought it more likely came from the fact that I finally have a sense of purpose in my life. Dr. J was very good at not reacting to what was a pretty huge confession for me. It felt weird to be talking about this with him, inappropriate somehow to be talking about happiness in a place where so many people suffer so much.

“I’ve also learned an awful lot of emotional regulation and mindfulness skills in the past few years. ” I added out of respect to his profession.
“Where did you learn those from?” So much for respect for his profession.

“So if it isn’t the medication that is making you happy, do you think you should stop taking your medication?” he asked.
I wasn’t totally sure this wasn’t a set-up. “What do you think?”
“I think that if your mood is related to having a sense of purpose, as well as the benefits of CBT and such, that you might consider tapering off your medication. Maybe the issues you were having in the past were manifestations of a character pathology that you have since resolved.” I must have smirked or something, because he said, “I’m still working on my character pathology.”All this recovery (as we like to call it in the mental health field), has it’s downside. Since each of the MHC docs have had their hours cut from 64/wk to 32/wk, Dr. J wants to transfer my case to the new Po’ People’s Clinic program and have my PCP do my prescribing. I know that just because I respect him as a clinician and I appreciate the way he talks to me like a person and not a patient, and especially that he never once questioned the wisdom of pursuing my nursing degree, is not a valid reason to take one of the limited spaces in his schedule, and malingering in order to stay where things are safe and cozy would exhibit the kind of character pathology that one would expect never to see from me again. So I told him it was fine. After all, I heart my PCP, too.

He asked me what I did for fun. I told him I read about anything remotely medical-related, watch slasher movies..and I write this blog.

“You mean I can just go the website and read it online?”
“If you want,” I said, without mentioning the address.
“I don’t know much about this blogging stuff.”
Really? must be the 64 hour work week. “There are a lot of psychiatrists who blog.”
“Really? What do they write about?”
“Stuff they shouldn’t.” I told him, thinking of our fallen brethren. “Seriously, though, they write opinions about patient care, personal stories, rants and raves…”

I am going to email him a few links, because blogging has become such a special thing and I want everyone to share it with me. I may even include mine (after I reread every post and make sure there is nothing in here that I shouldn’t have been writing about).