Category Archives: medication

career

I can’t believe it’s almost been a month since I last blogged. So much has happened.

I’m still on the Nardil, which is going really well. Depression is in check as well as the anxiety for the most part. The worst side effect is the fact that I can only sleep about 5 to 6 hours a night. I get so tired during the day, yet I still can’t get enough sleep at night. I either can’t get to sleep or I wake up and can’t fall back asleep. Fortunately, my body has adapted to it. But sometimes it’s hard to function during the day. It’s a side effect though that I’m willing to live with. Nardil has been amazing thus far.

As the title of this post suggests, I’ve been thinking a lot about my life. As many of you know, I am in graduate school for library and information science. I am also working at an accounting firm. I started work at the firm thinking that it would just be temporary until I graduate; however, the work has ignitated a fire inside of me that I haven’t felt in a long time. But now I’m left not knowing what to do. Should I finish school or should I just scrap library science altogether and get into an accounting program to get my CPA?

I am still passionate about libraries, but I love what I’m doing right now. I have four more classes to take until I graduate. I can only manage taking one class a semester, so I wouldn’t graduate until Decemeber 2012 at the earliest. That could be a lot of wasted time and money and effort if I’m just going to go right back to school after I gradate.

Logically, I tell myself that it’s four classes–I should just finish. But my gut is telling me to pursue accounting, no matter the costs. I’m constantly thinking about this which is probably adding to my sleep problems.

That’s a brief summary of what’s going on right now with me. I’ll post more later this week. I miss you all, and I hope all is well. 🙂

Oh and my tattoo is finished. Email me if you’d like to see a pic.

nardil blues

I’m really tired. One of the nasty side effects of Nardil is insomnia. It usually happens at a higher dose than the one I’m on now, so when the insomnia hit me earlier this week it caught me off guard. I’ve always been one to get at least 7 to 8 hours of sleep a night. This week, however, I’ve been getting between 4 and 6. It’s starting to take it’s toll on my system.

It’s hard enough being overworked, underpaid, and undervalued at work but when you throw insomnia into the mix, it just makes it all so much worse. Last week I felt so great. Both the depression and anxiety lifted. I was euphoric. Everything seemed to be going well. I felt like I was going in the right direction.

Now the depression has really swept back in and the anxiety is starting to creep back as well. I’m starting to lose a little bit of hope.

On a lighter note I got my tattoo finished last Sunday. The session went great. I’m running a half-marathon this Sunday, which should be interesting due to my fatigue. I have been training fairly consistently over the last few months but this past week I’ve sort of given up a bit but that’s okay because I should be resting this week anyway.

I’m really stressed about my job and school situation. I have four more classes to take to graduate. My original plan was to take two classes in the Fall, one in the Spring, and one in the summer. I’m making very little money at this point at work so getting financial aid would help, but I really don’t know if I can handle taking two classes in the Fall plus work full time. (I have to take at least two classes to be eligible for aid.) I also desperately need to get some experience in the library.

So I am thinking about taking one class in the Fall plus volunteer at a library, and then one internship in the Fall and one in the summer as well, and then take my final course the following Fall. So I won’t graduate until December 2012. This seems ideal, but I’d like to find a new job that pays more. I started looking for jobs earlier this week, which always puts me into a foul mood to begin with, but the insomnia and subsequent depression has kind of put a damper on that.

Ugh. I’ll stop complaining.

nardil update

Wow! It’s already been two weeks since I last posted. So much has happened.

I’ve been on Nardil for about a month now. I’m currently taking 45 mg a day, which is still considered a small dose. It seems like the “magic” dose is 60 mg. I say magic because most people say that unlike most anti-depressants, you actually know when it’s working; it’s not a subtle change.

Although I haven’t experienced anything dramatic, I still have seen some benefits–

  • The best thing about Nardil so far is that it’s kept me from binging on food or alcohol, namely because I don’t eat out and have to avoid many foods or else I could go into a hypertensive crisis. I no longer suppress my negative emotions with food and/or alcohol. This has helped break the binging cycle I used to feel trapped in.
  • I’ve also noticed a slight decrease in anxiety and depression. I don’t over think things too much, which helps with the anticipatory anxiety. I’m also doing things I wouldn’t have done in the past because of my anxiety, like get a tattoo, and saying things that I would normally keep to myself.

The side effects haven’t been that bad so far. I have experienced afternoon tiredness, restless sleep, and loss of libido–all of which are normal–but they’ve all been fairly manageable. I’m scared about increasing my dose, though, because after reading a lot of peoples’ experiences on Nardil it seems as if that magic dose–of 60 mg–is when the major side effects hit, which include weight gain and insomnia.

I’m scared of both of them, but I am mindful of the fact that those side effects are not nearly as bad as the side effects from suicide. I just need to hang in there.

I hope everyone is doing well. 🙂

no direction

There’s no way around it: the depression has lifted. Unfortunately, now that I’m no longer depressed, I have to deal with the triggers as well as finding preventions so I don’t get trapped again.

I feel good so far about Nardil. I’m still in the early phase, so I’m on a very low dose and experiencing no side-effects (but no benefits either), but I do feel hopeful about this drug. I’ve never felt good about medication in the past. I question it. I think about it too much–Is it working? Is this me or the medication? Etc. But I’m not doing that this time. I have faith, I guess.

The bigger issue for me is what direction should I go in career-wise. I feel stuck. I don’t like my accounting job–and I dislike my boss even more–but I could stick it out just because it’s easy if it paid more. My boss, on the other hand, believes I want more from the job. He wants me to eventually take over running the business. Again, I have no idea what he sees in me. Regardless, the work is not something I particularly like doing and I don’t feel like the work helps people–so I’m not fulfilled at the moment.

Then there’s my education. For those who don’t know, I’m in graduate school, training to become a librarian. I have 3 classes left to take. I guess this is the ideal path for me because I may get more enjoyment out of the work and it definitely helps people. But I’m worried that I won’t be able to find a job after I graduate. I wish I could just push my worries aside, let things happen, and worry about finding a job when I’m actually finding a job .. but that’s not me.

So, at the moment I feel lost. When the episode of major depression hit, I had just started my accounting job. I cannot ignore that. I think that when you’re already dealing with mental health issues, dissatisfaction with other life circumstances–i.e., my job–can make it seem like your issues are even more insurmountable, which exasperated my depression.

I have no answers right now, and I probably won’t have any answers for a while. One day I may be content with my circumstances, just not today. I guess that’s okay for right now.

starting nardil

I just picked up my script. I’m scared. This drug is old and nasty and has terrible side effects, but apparently it really reeeally works. It seems like it’s the last line of defense, medication-wise, for depression. It’s also supposed to be really reeeally great for social anxiety.  But there’s so many food restrictions–http://www.dr-bob.org/tips/maoi.html

I have to eliminate so much from my diet. I’m vegetarian, and I can’t have soy products or protein shakes or nuts. I guess I’m going to start eating meat again.

Aside for the food restrictions, there’s, again, really reeeally bad side effects, which apparently according to my research mysteriously go away after a few months and you’re left in bliss. With my history of medication, though, I’m not feeling very hopeful.

I just want something to work. I just want to feel better. I’m not expecting a miracle or a quick fix, just a little relief.

If the ends justify the means ..

does your mother know?

So, on the way home from therapy on Tuesday I took an overdose of Ativan. The session itself was difficult, as we discussed my recent suicide attempt and the fact that I found a new therapist and would like to start seeing him next month. I also tried to ensure my therapist that the events are mutually exclusive. ( I thought this was very important.) In other words, I’ve been contemplating a change in therapists for some time now (which is true).

Furthermore, I was dreadfully scared of having to go back to work yesterday, so instead of addressing it proactively–by either talking to my therapist or boss, trying to go on disability or something, etc.–I felt it best to OD. That will grab attention, I thought; and it sure did.

Without doing much damage I skipped the emergency room and went right to my psychiatrist’s office. He suggested I spend the night somewhere safe at a urgent care clinic, which I did (which wasn’t so bad), and then possibly go on disability leave from my job. There’s also plenty of options for low-cost inpatient care treatment here in San Francisco (we love our social services here!), so that’s an option. But to be honest, I really think I just want to switch anti-depressants–to Nardil–and go back to my normal routine.

I’m proud of myself because I told both my parents what’s been going on with me over the phone, and they were both very supportive. I also texted my boss. I haven’t given him all the details yet–I just told him I couldn’t come in because I had a psychiatric emergency. He’s provided support, and he wants me to call him–and I will as soon as I get up the courage.

I am feeling loads better. I see my psychiatrist again today to hopefully get on Nardil. I am also no longer feeling suicidal. Yay!

going home

Before I start, I just want to preface this post by saying that I am experimenting with a higher dose of Ativan at the moment, and I am feeling quite stoned. So, just keep that in mind. 🙂

***

I’m going home on Friday. Actually, I shouldn’t call it home. San Francisco is my home; Kansas City is where I grew up. Anyway, on Friday I’m going back to my hometown to see my family for the holidays. I’ll be there a total of ten days, which is probably seven days too long!

I have plans to see a few friends, but other than that, I’ll just be hanging around my family–which actually could be difficult because of the letter I sent them a few months back (part 1, part 2). I don’t know what to expect; or, what I want to talk about. I have no agenda, in other words. I guess that’s good. I’m not expecting to make deep connections with my family, but I would like to talk about the things in the letter a little more in-depth. I do want to have closer relationships with my mom, dad, and brother, but I also want to relax and have fun at home, as well. I don’t want it to be a constant therapy session. On the other hand, if nothing is talked about, I will be greatly disappointed in myself. I just need balance. Regardless of what is said–if anything is said–we are already closer because of that letter. I have already accomplished the things I wanted to accomplish (I just feel pressure to keep moving forward), and my trip is a victory in and of itself.

One thing I am starting to stress about is seeing my relatives (on my mom’s side) for Christmas. I haven’t seen them in years, and I know they all really want to see me. My cousins are all around my age, and they have husbands and wives, and each of them have two kids. I’m a little behind. My aunt and uncle are really religious, so I know they disprove of me and my lifestyle–and so I know they’ll be judging me negatively.

Actually, let me step back: They may not be judging me at all. Maybe they’re proud of the things I’m doing. They know how passionate I am about helping people and how much I want a career where I can make a difference in this world. But then again, they know I am somewhat of a nihilist, as well. I do believe there is meaning in the world, but it’s subjective. That is, beyond science and reason, everybody has their own beliefs. Those beliefs are not right or wrong. I think in my aunt and uncle’s situation, though, they are so attached to their beliefs, they have become truths.

Anyway, my point is is that I have no idea how they view me or what’s going through their head–I am not a mind reader.

So, in the past, I usually got flooded with anxiety around my aunt and uncle and my cousins and their families. I’ve never really interacted with their children (because I didn’t know how and was afraid of being judged by the adults); and so, I just ignored them. I feel pressure to make more of an effort to engage with them.

Plus, I know the attention is going to be on me most of the time, as they haven’t seen me in years, which I do not like. But, it will be okay. I will slow down and use some of the cognitive techniques I’m learning to ease my anxiety. I’ll also be able to fall back on my meds if things get a little too rough.

I’m trying to remind myself that the present is not the same as the past. In the past, I may have been flooded with anxiety around them, but that’s the past. I will probably handle it better. It will be all-right, regardless.

in a safe place

For longer posts, dealing more with theory, I usually start writing them three or four days, sometimes weeks, before I post them. I have an idea in mind, and I like to watch it grow, like a piece of art. As of late, though, my moods have been fluctuating so much that I often times abandon my original idea altogether or change it so much that it barely resembles its original form–which is the case for this post (the latter issue, that is).

***

Put simply, I had to give two class presentations this past week. One on Thursday, and the other on Sunday. I haven’t had to do any sort of public speaking in over a year, so I clearly was very nervous/anxious going into it. I decided to try to get some of my thoughts out to help not only understand the anxiety (and where it’s coming from), but alleviate it as well. What you’ll soon find out is that the presentations went well. Sure, I was nervous, but I did fine, probably better than most people, in fact.

Anyway, here are some highlights–

Anticipatory anxiety hit me on Wednesday: I feel like shit. My stomach is tense and wound up in a knot. I’m having trouble swallowing. I’m sweating. I feel like I should take an Ativan or something, but I sort of feel like I’m becoming dependent on them. But none of my relaxation strategies are working. I’m sick (with a cold), so I can’t go running. I don’t know what to do.

Honestly, I’m mostly worried about the questions after the presentation. What if I won’t be able to answer them because I’m flooded with anxiety? What if I sound nervous? What if I fail?

I eventually calmed down, but anticipatory anxiety returned before my presentation (no surprise there): My presentation is in less than 3 hours. I’m in denial (sort of). I just ate, took an Ativan (1mg) and a Propranolol (10mg), and went over my presentation again. My stomach is tense. I’m sweating pretty bad, especially under my arms, and I feel an impending doom. I know the negative thoughts are hidden under this doom, but I’m scared to see what’s under there. I wish I had therapy tonight–and I wish even more that I hadn’t skipped therapy on Tuesday (because I was/am sick).

Again, the presentation went fine: It’s over. It didn’t go bad at all. I got hung up on one question, but overall, it went really well. I feel stupid for making a big deal out of nothing. About five minutes before the presentation started, I chatted with the professor and the other students. I then stood up, shook my body all over, and then went to the mirror and smiled (to make sure I still could). This helped to calm me down. I can now strip off my sweat-stained undershirt and move on.

Anticipatory anxiety started again on Sunday, about seven hours before my next presentation. I’m starting to feel a bit nervous. I feel that impending doom again. It’s scary because I don’t know what lies beneath. It’s unknown. Thoughts, on the other hand, are tangible, while this feeling is not. I can hold thoughts. I can touch them. They are real. But I’m too scared to find those thoughts.

Then two hours before the presentation depression hit: I’m depressed, and I DON’T GIVE A SHIT ABOUT THE PRESENTATION. I don’t know where these feelings came from or why I’m having them. Maybe they’re connecting with this doom feeling?

The depression wore off for the presentation, leaving me with anxiety, but it came back immediately after: Well, the anxiety  pushed the depression into the background. I took an Ativan (1mg) before the presentation. Again, the presentation went well, and, again, the anticipatory anxiety was much worse than the actual presentation. I feel good about the week, but depression is hitting me again. I’m scared.

***

By the end of the night I was really low. I binged on food, drank a big beer, and had a cigarette (the first one since the wedding)–nothing helped. I woke up feeling even lower. What’s going on? I asked myself. I had a fairly good week. I mean, I not only got through the presentations, I did really well. I should be feeling good. I should be feeling great. As always, though, there’s much more going on than what meets the eye.

Actually, depressions usually hit me after successful social situations because that part of me that wants to be messed up–that part that likes having social anxiety, that part that I know, that part of me I think is me–flexes his muscle and brings me down. He, my anxiety, wants to maintain control. Does that makes sense? However, I still think there’s more there.

I’ve been triggered by quite a few things this week, namely this post and this post and this post and the movie Black Swan.

For the sake of length, I’ll try to not go into too much detail.

As some of you know, I’ve been dealing with this question as of late–Without social anxiety, who am I? The answer is a resounding I DON’T KNOW!, which is exactly why I’m so scared to find out, which is exactly why I sometimes like my anxiety–and even fuel it. My illness is warm and fuzzy; it’s familiar; in some ways, it’s all I know about myself.

There’s also my perfectionism, my need to always be perfect. I can’t make mistakes. I can’t have any flaws. I have to anticipate every move. I have to always be on the guard. And yet, perfectionism, is about mistakes, because a perfect human is flawed. Thus, by not allowing myself to make mistakes, I prevent myself from not only being perfect, but knowing what it means to be truly human. There is a part of me that does want to let go, but I’m still wrestling with the question of what exactly that means–and how to go about doing it when all I know is rigidity and repetition and compulsion.

But maybe I got a glimpse of what it was like to not be hindered so much by anxiety or my perfectionism this week? I engaged with people and was able to give two presentations without feeling too much anxiety. I also let go (somewhat) during them. I allowed myself to fail a bit on the question and answer section afterward. I could of been more thorough. I could have answered them better. But, frankly, I didn’t give a shit. I also have a huge, 15-page paper–30% of my grade–due on Thursday that I haven’t even started–and, again, I don’t give a shit.

I’m wondering, am I feeling depressed because I’ve seen a glimpse of myself in a new light–without so much anxiety and perfection–and not liked what I saw? Or is my ego (my anxiety) just flexing it’s muscle, wanting to maintain control?

***

Finally, without my anxiety, I’ll have to deal with deeper issues–

I really hate this system I’m living in. As reminded here, we’re just living a joke (capitalism) and our lives are the punch lines.

Here, I’m left with the difficult question of how do I fill this void inside of me? I’m continually looking to the future for happiness. That is, my next goal, my next achievement, my next cure, etc. What happens when there is nothing left to cure? What happens when I actually have to start living, and what if I really don’t believe there is any point to living besides not dying?

Finally, here I’m reminded that these feelings I’m having are temporary. In fact, I’m feeling much better now–but even that is temporary.

How did I know that someday–at college, in Europe, somewhere, anywhere–the bell jar, with its stifling distortions, wouldn’t descend again?  ~Sylvia Plath, The Bell Jar

i am the norm

I came across this “artwork” in a cafe yesterday, and, even though I’m on a cocktail of drugs, I found it funny–and quite fitting.

happy thanksgiving

I had a good Thanksgiving. My girlfriend and I stayed the night at her brother’s house on Wednesday. On Thursday, I got up early, went for a short run, popped an Ativan (plus my normal medication), and started cooking.

It was a relaxing morning, spent with my girlfriend and her brother and sister-in-law. I felt calm and at ease. I’ve been spending more time with them as of late, and thus am feeling a lot more comfortable around them. I wouldn’t say I’ve connected more with them; it’s more like I’m easing up a bit around them and overall less tense because I’ve been seeing so much of them lately (see my issue on constancy for more info).

I took another Ativan before the rest of the family arrived, and when they arrived (10 in all), I tried to stay as busy as possible–I helped in the kitchen, played with the cat, set the table, etc.–and, honestly, I felt good. In all, it was a success–and I actually enjoyed myself!

The medication really helped. Unlike in the past, I took it preemptively. That is, I took the Ativan as soon as I felt an inkling of anxiety in my body, instead of waiting until I was flooded. This helped to break the anxiety cycle. By taking the medication early, I didn’t allow the anxiety (thoughts and physical symptoms) to build on itself. In other words, I broke the cycle before I reached a point where nothing, not even numbing myself on alcohol, can bring relief.

I noticed a huge difference in my thoughts, as well. They weren’t as negative. More neutral, I guess. This can be attributed directly to CBT. It’s really starting to help, especially when coupled with medication. I’m breaking up the negative thought patterns and experiencing less anticipatory anxiety.

Speaking of which, this past week or two, I’ve been able to manage my anticipatory anxiety better. Writing, exercising, working on school, that sort of thing, has helped me to avoid my negative thoughts. Instead of wallowing in my negative thoughts, I’ve been active.

I mentioned in a previous post that I wanted to approach Thanksgiving as a social experiment–to see if I could avoid becoming flooded. Well, I succeeded, and I am proud of myself. I also felt very connected to people, and I do believe (for now, at least) that the people around me care about me and my well being. At the dinner table, we all went around the table saying what we were grateful for. When it came to be my turn, I said–

“I’m grateful for being surrounded by such wonderful people who care about me.” In my head I told myself that I was grateful for just being able to connect with my thoughts in a group social situation–and not feeling flooded from talking in a circle. (Usually when there’s a group circle where people go around introducing themselves or something, I get flooded. I DO NOT like those situations at all.)

Finally, as weird as this sounds, I’m actual looking forward to future social situations to see how I fare. I want to build on this success. I want to experiment more.

I want to say more, but I’m really tired (I’m sure that’s reflected in this post) and need sleep. So, I’m off to bed. Good night. I hope everyone is doing well. 🙂