05 March 2008


I don't usually sleep well. This is something that I've bitched frequently about, as proper sleep is so important to being healthy. Not just your physical health, but mental health too. Depression makes it tough to sleep or makes you want to sleep all the time, yet another lovely paradox of the disease.

When the depression got really bad, before I got any treatment for it at all, I was sleeping about 3-4 hours a night. When I started getting help, it improved a little bit, to 4-5 hours a night.

In the last week, my sleep habits have improved pretty drastically. I've been taking Ambien for my sleeping trouble for a long time, nearly every night. I'd hazard a guess that I've been taking that on and off for about a year. So I can't attribute this recent improvement to the Ambien.

In October of 2006, I started working out 6 days a week in an effort, initially, anyway, to get better sleep. That didn't help my sleep. I lost weight, and I was hopeful that being more healthy physically would help me sleep more. It didn't, really.

Today, I'm 43 pounds lighter than I was in October of 2006, with about another 20 pounds left to lose. Undoubtedly, I am in far better shape than I was, physically. My whole lifestyle has changed, my eating habits have made a 180 degree turnaround from where they were. I can't attribute the better sleeping to the lifestyle changes, because I would have been sleeping better a long time ago, not just in the last week.

I'm sleeping between 7 and 9 hours lately. Not an un-interrupted 7 to 9 hours, that would be apparently far too much to ask, but un-interrupted two to five hour bursts, and enough of them to get what I consider nearly adequate sleep. Finally.

See, when I was a kid, I slept 10 to 12 hours a night. I need my sleep. My family can attest to the fact that without enough sleep, I'm supremely unpleasant to be around. I've never been ashamed or embarrassed to admit that I simply need the proper amount of rest. Eight hours is good, ten is preferable. Six is about the bare minimum of acceptability. So you can imagine what it was doing to me to get 4-5 hours for just about 2 years. Devastating me, essentially. I have no doubt that my mental health suffered even more because of the lack of sleep.

(When we're listing reasons Lucy doesn't have kids, sleep is up there on that list. Baby=no sleep.)

What's changed? The only thing that's different is the Lexapro. My job stress is just as bad as it was at the non-profit, although it is a different sort of stress, it is just as high or higher than when I knew that the non-profit was on the verge of closing. I'm exercising less lately than that gold standard of 6 days a week. (It pains me to admit that. I'm not sure what is the de-motivational factor there, but I need to get the fuck over it and back to a regular 6 day a week schedule to lose those additional 20 lbs and to get in shape for the May 2 race I'm going to run in, a 10 K.)

Dr. H gave me samples of the Lexapro with instructions to take 1/2 of a pill daily, 5 mg. He also told me that when I had a handle on whether or not that was going to help (a week or so) to adjust the dosage up or down as I thought necessary, as long as I kept in touch with him so that he knew what I was doing. Half a pill was helpful, but damn, still not enough to push me over the edge into being able to get out of bed and be back to being me. So I upped it to a whole pill, 10 mg. About a week ago.

Isn't that interesting?

So Wellbutrin+Lexapro+Ambien=sleep.

A friend who is a nurse reacted with alarm when I told her about the addition of Lexapro to the Wellbutrin. She told me that over time, those medications work less well, something that I think I can attest to, as I've needed to up the dosage on the Wellbutrin several times to get it to the right place. She also warned me that sometimes the side effects of the meds can become permanent, and that they're often very difficult to discontinue taking, when you think you're ready to get off of them. My one and only lingering side effect is the hand tremor, which is worse some days than others. I'd rather that didn't become permanent. It makes me look nervous when I am not, and it makes me feel like I've got Parkinson's. She asked if maybe the cure isn't worse than the disease.

Emphatically, no. Unconditionally, no.

Getting the proper amount of rest has been unbelievably helpful. I wake up feeling still tired for a little while, but about an hour after I get up, I'm refreshed and nearly ready to face the day.

The addiction to the Dunkin' Donuts iced coffee might be something we need to talk about, though, because before that cup o' decaf joe, facing the day is unthinkable.

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