05 October 2007

There's Beauty In The Breakdown

Well, no, really there isn't, but the line above is from a song I like and it is too cool to not use it for this post's title.

I've been having a bit of a relapse with the depression in the past few weeks, regressing to a stage where it is hard to get out of bed, hard to breathe, hard to move. Yes, I'm still taking the meds, but it really seems like out of the blue one day they just stopped working, leaving me tail spinning.

I made an appointment to see Dr. H, my adorable family doctor, because it is he and not my therapist who prescribes them. I see a psychologist, not a psychiatrist. Anyway, I had a list of things I wanted to discuss with him; not just my anti-depressants, but my skin which is broken out like a teenager's, I wanted him to run blood work to see where my cholesterol et cetera is, and I needed a flu shot. When I was working I could get the flu shot for free from my employer, both the olde evile bank and the non-profit offered the flu shot gratis to employees. As an asthmatic, it is important for me to get a flu shot. Or so "they" say.

One thing above all else that I appreciate about my family doctor is that when you are with him, you've got his undivided attention. You may wait in his waiting room for-freaking-ever while he's with someone else, but I really feel that he LISTENS to me. He's also quick to admit when something is beyond his expertise and refer you to a specialist.

He listened to my concerns about still being on the med and how much it frustrates me that I still need them; even though I haven't been feeling that they've been very effective lately, miss just one day's dose and I'm am nearly paralyzed with misery. We discussed other options; neither of us is willing, just yet, to scrap the Wellbutrin XL that I've been on since April for another med; instead he upped the dosage again. I'm of mixed emotions about that; if it helps, then fine. But what if it stops working just like the last dosage did? That's a scary thought, isn't it? He claims that you can't develop a 'tolerance' for this med; the anecdotal stuff I've read suggests that yes, you can, but for once I'm letting HIM be the doctor and taking his advice.

He noted that if this dosage (the max recommended daily dose of this medication) does not seem to push me up over the edge to a more healthy frame of mind that he next wants to add another medication. I'm not crazy about that idea, actually I hate it, if I'm going to be fully honest. I have no desire to be on more than one medication for a mental illness. One is quite enough, thank you. He tried to ease my anxiety about that by telling me about other patients that are on shed-loads of meds, which was very sweet of him, but wasn't very helpful, frankly, when he told me that both patient examples that he gave me have had numerous hospitalizations for their mental troubles. Yikes.

Then he told me something that was helpful; apparently patients with major depressive disorder who are also OCD end up needing the max dosage of SSRIs. He paged through my chart and reminded himself of my family history; rather than giving away secrets that aren't mine to tell, let's just say that there are one or two of my family who have OCD a weee bit worse than I do.

He seems worried about my anxiety levels; I don't think that my anxiety level is high, but the therapist has also mentioned that she thinks I have a lot of anxiety and since they're the ones with the medical expertise....well, that doesn't mean that I agree with them or want to take their word for it, but for now I'm letting it stand. The therapist is vehemently opposed to anti-anxiety meds like Xanax and Klonopin; Dr. H thinks that they have their time and place. I side with the therapist on that one. Xanax especially has a pretty quick half-life and you can and do build a tolerance to it.

Dr. H says that as long as I am managing to sleep that he'll not insist on adding Xanax; I told him the only time I can sleep is when I take the sleeping pill, but he says for now that is all right.

When he upped my daily dosage of the Wellbutrin from 150 mg/day to 300 mg/day, the change and feeling "better" was nearly immediate. It took just a few days for it to kick in. So here's hoping that a daily dosage of 450 mg/day is the answer.

In other news, completely off topic, I've actually found a few jobs to apply for in the last week and have been sending out resumes like mad. Here's hoping one of them pans out.

Oh, and I've got some massive geeking out posted on MySpace about Supernatural's return to prime time last night.

7 comments:

Dawna said...

Wow, this is so interesting that your blog is detailing much of the same that I've been going through.

My depression dragon is roaring its ugly head, and despite the fact that I doubled it back in late August, I'm slipping, badly, like I'm trying to climb up a water slide. Tonight I even had a burst of rage! Something which I haven't had since May.

I have been tired, excessively tired. And even though you haven't been able to read my blog for the last few days (blame ass whipe), there hasn't been much to miss. My posts come in spurts. 2 one day, none for 3 days, 3 in one day...

My doc will be getting a visit from me next week. My hubby pretty much held me at gun point as I nearly passed out in a parking lot earlier to tell me so. "Your meds aren't working."

My doctor had also reminded me that he has many other patients who take a battery of meds for their depression whenever I disclosed my distaste for taking the two I do take. "Be thankful" he says. I suppose I should considering at least 3 of my family (on my mom's side) have been hospitalized for a variety of mental illnesses. Goody.

Nothing like going to be with the feeling like you're next!

Lucy Arin said...

D-
I have missed your blog terribly. Let's shake a finger or more specifically one finger at him.


I told Dr. H that I'm not suicidal, because he asked. I also told him if I get there, then I will ask to be hospitalized.

My Scandinavian stoicism makes me want to say, "Oh, it isn't that bad" but the doc was very helpful yesterday when he asked if I was all right with continuing to feel the way that I have; when I said NO, most emphatically, then he said, well, then let's see what we can do about it.

All I've got to say is thank whatever you hold holy (um, the Winchesters?) that Tom Cruise doesn't rule the world and these meds are available to us.

Dawna said...

Yes, Dean Winchester (when he isn't a total letch, ugh) is my personal saviour. And we are certainly not alone to be glad that Scientology doesn't rule the world!

John Three Thirty said...

hello. I came aross your blog as a link from another blog. Hope you don't mind visitors.

Reading this post stings the heart. It hurts to see someone crave for normalcy and see these high-falooting medications fall short.

As I read this, I could not help but think throughout "I wonder what the root of her depression is. I see how it's being treated on the surface (with medication), but I wonder what the root is."

I'm very sorry this is taking place.

Take care.

Lucy Arin said...

John33-

First, I welcome comments and love to have new visitors!

Next, the genesis of the depression has its roots in several things...you can click on the 'depression' or 'cornflake girl' tags to see the vast majority of the story, but long story short are about 3 major factors

1. genetics. It runs in my family.
2. the death of my cousin in 2005
3. the slow demise and eventual implosion of my beloved non-profit job, which while I was powerless to stop, I feel very responsible for.

The reason I'm seeing a therapist is to work through some of the issues that are recurring problems. The meds are to combat the physical manifestations, the imbalance of chemicals in my brain. They help, believe me. Without them, I think I would be in a much worse place.

Thanks for your good wishes, it is much appreciated.
~LA

John Three Thirty said...

Lucy,

Thanks for replying back. I have looked over one or two posts and will look through more as time allows.

I see that two of the three things you causally mention have to do with recent events in the last couple of years. The third is a generic reference to family history, which has become a common thing in the last twenty years (causally relate things to genetics).

I'm wondering, however, if the genesis of this did not begin at the time the sexual trauma took place.

I don't know you at all, and since I don't know your story/background I have no idea what specifically it is. It may be a combination of these or maybe just one. Sexual abuse, molestation, rape, abortion. This was an entryway when things went totally berserk down in the depths of you.

What takes root initially, the two big ones, are guilt and fear. They grip, seize and sometimes can even dominate or paralyze your entire being. For years.

Was sexual trauma by chance the genesis of when you got sucker punched emotionally and mentally, causing you to reel and, honestly, still having a deep-rooted grip on parts of you?

There are situations where it's not sexual trauma but rather severe severe emotional abuse that start this black snowball rolling inside of us, that gets bigger and bigger, nastier and more perilous as the years go on.

Does any of this resonate? I looked at your profile and there was not a way to email you privately about this, which was my preference. I have not meant to be so forward, however it is no longer within me to sit on or ignore things when there are fingerprints of sexual or emotional abuse.

JTT

Lucy Arin said...

JTT-

Whoa.



Gimme a sec to process that.




Never been abused. Ever. In any way. Not in denial, either. Had a happy childhood, married my college sweetheart...I don't suffer from any sort of sexual dysfunction.

I use the tag from the Tori Amos song Cornflake Girl because I've always thought the song was more about general confusion than anything else, and depression is nothing if not vastly confusing. I stick the tag 'cornflake girl' on posts where I talk about my therapist and my sessions with her, which are also confusing. No relation whatsoever to sexual, physical, or emotional abuse.

My e-mail address is lucyarinATgmailDOTcom. It isn't on my profile in an attempt to cut down on the spam in my in-box; unfortunately it doesn't work as well as I'd like it to.

As far as the genetics, my maternal grandmother was severely clinically depressed for at least my entire lifetime, and she passed away when I was 19. A maternal aunt has had big trouble with the disease, and more than one of my immediate family have also been treated for severe depression. While I doubt that there are any clinical studies proving conclusively that depression can run in families, i.e. 'genetics', my own history makes it impossible for me to discount genetics as a cause.

Feel free to continue this conversation via e-mail, I agree that the comments box isn't the most ideal venue. :)