Ingredients

I looked up the inactive ingredients in the generic “equivalents” I had been taking and compared them to the brand name drugs I was prescribed. In the table below, I organized the inactive ingredients list to clearly show which ingredients are shared by the different medications (Zoloft, the generic sertraline HCl I was taking, BuSpar, and the generic buspirone HCl I was taking).

I suspect that ingredients in italics are essentially the same chemical, but with slightly different names. There may be differences between them, but I’m inclined to think that any differences in their biological effects are relatively insignificant.

The ingredient in bold is only present in one medication; interestingly, the medication in question is the generic buspirone HCl. The only explanation I can come up with for why they’d randomly add sodium lauryl sulfate is because they need it in order to get the anhydrous (condensed) lactose to behave similarly to non-modified lactose during production. I find the presence of sodium lauryl sulfate in my medication disturbing, but haven’t found any information to suggest that it might’ve been interfering with the effectiveness of the medication or having noticeable adverse effects.

Ergo it seems likely that if inactive ingredients were limiting the effectiveness of my medications, switching from generic to brand wouldn’t help me much … unless differences in amounts or proportions are significant. I have no idea whether the amounts of the ingredients are the same across the included medications, but each medication had them listed in a different order.

Wakana sat me down at her computer, worked with me step-by-step to find a psychiatrist within reasonable driving distance who takes my insurance, and insisted that I call to make an appointment. I had to leave a message – to which I have yet to receive a reply – but at least I did something. I felt like a huge weight was lifted from my shoulders. And maybe finding out information about other organizations / programs that could help me will be similarly painless … especially if I can do a lot of it online.

One thing I’ll definitely be looking for as I conduct my search for a new psychiatrist will be strong knowledge of how inactive ingredients affect one’s response to a drug, particularly when that may cause significant differences between brand and generic. I need a psychiatrist who will take this concern seriously and be willing to fight to gain me access to the brand drug ze’s prescribing (instead of a generic “equivalent”) if necessary.

UPDATE: I’ve color-coded the inactive ingredients list to indicate possible concerns raised by Disorderly Chickadee in Generic Versus Brand: What’s In That Pill? Part Two. Many thanks once again to DeeDee for compiling the information. Trying to do so myself has been very difficult and frustrating.

Coding scheme:

  • allergen
  • carcinogen
  • toxin, irritant, or other health risk
  • animal product
  • restricted by some religions

Zoloft (50mg)

Sertraline HCl (50mg) Camber Pharm.

BuSpar (15mg)

Buspirone HCl (15mg) Mylan Pharm.

Dibasic calcium phosphate dihydrate Dibasic calcium phosphate dihydrate
FD&C Blue #2 aluminum lake FD&C Blue #2 / Indigo Carmine aluminum lake
Hydroxypropyl cellulose Hydroxypropyl cellulose
Hydroxylpropyl methylcellulose Hypromellose 3cP & Hypromellose 6cP
Magnesium stearate Magnesium stearate Magnesium stearate Magnesium stearate
Microcrystalline cellulose Microcrystalline cellulose Microcrystalline cellulose Microcrystalline cellulose
Polyethylene glycol Macrogol / Peg 400
Polysorbate 80 Polysorbate 80
Sodium starch glycolate Sodium starch glycolate Sodium starch glycolate Sodium starch glycolate
Titanium dioxide Titanium dioxide
  Colloidal silicon dioxide Silicon dioxide
  Lactose Anhydrous lactose
    Sodium lauryl sulfate

Prescription by Dr. Ziya

WARNING: This is a (potentially risky) decision I have made for myself. It does not take the place of medical advice by a qualified mental health professional.

Today I had a conversation with 2 friends that confirmed a few thoughts I’ve been having:

  1. I will not go back to Psychiatrist B under any circumstances.
  2. I need to stop taking my current medications.
  3. Listening to music daily will improve my mood and possibly also my brain’s functioning.
  4. I need to be honest and talk about my disorder more often.

Psychiatrist B didn’t take my thoughts about harming myself and even committing suicide seriously, despite the fact that the drug he was prescribing me can cause such thoughts. He also needed assurance from me that it was worth gaining weight to have the possibility of recovering from a disabling disorder; that my mental health is more important than my appearance! (He also made the typical assumption that fat = ugly, which I have no desire to perpetuate.) As one of my friends put it, there’s a significant risk that if I keep going to this doctor, his problems will have a negative impact on my well-being. It also certainly doesn’t bode well that the “clinic” hasn’t made any attempts to contact me about rescheduling the follow-up appointment I canceled nearly a month ago.

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long-white-pillsRegarding my medications, the bottom line is: they’re not providing the relief I need. Regardless of whether they’re helping “somewhat,” the fact remains that they are not helping enough. And there’s the possibility that they are causing or contributing to some of my more disturbing symptoms. I haven’t been taking them for the past few days and to be honest it’s been a very rocky road. At this point I’m unsure whether I should hold my ground until they’re completely out of my system – or start taking them again in smaller and smaller doses until it’s safer to stop completely (or I run out). Everyone seems to think it’s better to wean myself off them slowly, but I’m concerned about what might happen if my levels spike again after being so low for the past couple days. It’s also a lot easier to just not take them than to try to figure out what doses would be appropriate and remember to take them regularly.

It’s recently come to my attention that I’ve been doing my readers and the companies that make certain brand-name drugs a disservice. I’ve been taking generic “equivalents” of Zoloft and BuSpar (sertraline HCl and buspirone HCl, respectively); prior to beginning this blog I was taking bupropion in place of Wellbutrin. Anyone reading my blog would think I was taking the brand-name drugs and that they were causing or contributing to the undesirable effects I’ve described. This is most certainly not the case. In Generic Versus Brand: What’s In That Pill? Part 1, Disorderly Chickadee sheds light on how generic formulations of brand-name drugs often are not as effective as the brand-name version; in some cases the difference in functioning one experiences can be “like a brain transplant.”

Most notably, there is a huge difference between Wellbutrin and generic bupropion, enough so that one generic formulation was recalled. It’s not the one I was taking, but it still raises some suspicion that I might have done a lot better if I’d taken actual Wellbutrin instead. I’m also wondering whether brand-name Zoloft and BuSpar would be more effective (and safer!) than the generic sertraline HCl and buspirone HCl I’ve been taking.

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bob marleyI don’t usually listen to music, unless you count the background stuff in Oblivion – which either alerts me to the presence of enemies or puts me to sleep. Yesterday I had the very pleasant experience of listening to some of the more upbeat tracks on a CD of instrumental Celtic music. The bass and percussion were very grounding and calming, helping me to feel safe … while the foregound instruments were lively and played complex melodies in compound meter.

MeterI had a lot of fun listening to the music, felt calmer and happier, and thought it was having a desirable effect on my brain. It required enough of my attention that there was little to no room left for disturbing thoughts, and it seemed to help organize my brain. My hypothesis is that the regular firing of neurons involved in listening to the music (which are located throughout the brain) may have provided the stimulation, serotonin, dopamine, and information pathways my brain needed to function more effectively. I might need to experiment a bit to figure out how many times per day and for how long I should listen to music, as well as what types of music will provide the best effects … but overall I’m optimistic that listening to music regularly will help – a lot!

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meep-and-lolz-cropFinally, it felt really good to be honest about what I’ve been struggling with and have my friends accept my reality. They listened and shared their own related experiences, which helped me feel less alone in my struggles. They offered advice – some of which I found helpful – but more importantly demonstrated that they support me in my efforts to take care of myself. “You know you can call any of us any time you need to talk, right?” Yeah, I do; I just need a reminder that there are people who want me to reach out to them in my times of greatest need, when I feel like I’d be doing everyone a favor if I just ceased to exist.

Into Darkness

Today I brought Mom to outpatient physical therapy (PT) for the first time. She kept asking me to go in with her, but was able to operate the handicapped person’s elevator by herself. Other people opened doors for her. As soon as she entered the place proper, she seemed to forget I was there, trying to figure out whether I should help her, and if so what I should do.

Once Mom was happily at PT, Fox and I went to a relatively nearby movie theater to see Star Trek: Into Darkness. I’m going to try not to give spoilers but I will say there were a lot of explosions. Overall, it was an excellent movie and I’m really looking forward to seeing it again. If I do so in theaters, I’m bringing earplugs.

Anyone watching me during the movie might have thought I hated it, though, and seriously wondered why I didn’t just get up and leave. I spent significant portions of the movie clinging to Fox for dear life – much the same way I clung to a previous significant other when we went to see Silent Hill, a horror movie that quite thoroughly terrified (and traumatized) me. Especially during fight scenes (in Star Trek), I was shaking, looks of panic on my face, holding my head in my hands, my body very tense, insisting that Fox hold me. It was, in short, a very strong anxiety reaction. Even afterward, when I went to the bathroom, I started shaking again and felt like I was on the verge of tears.

Don’t get me wrong, I was very immersed in the movie. The acting, the music, the effects, and an engaging plot all came together to really pull me into the overall experience. I could relate to and empathize with the characters; I cared about their well-being. So my physical responses do make sense with what I was thinking and feeling in response to the movie. They were just taken to what I perceive as an extreme that does not reflect my actual degree of emotional response. Nothing in the movie was particularly terrifying or anxiety provoking; I haven’t been traumatized by it; intellectually I knew I was perfectly safe, sitting in a movie theater being entertained. But the way my body responded, you’d think I was convinced my life was in serious danger.

It was extremely loud in the movie theater and I think (hope) that was a significant contributing factor. That said, I think the metallic timbre of the explosion and especially gunshot sounds was the main trigger for my anxiety response. It’s possible the motion (visual input) might have also played a role. It’s hard to say what role the music played because I wasn’t focusing on it during the most anxiety-provoking scenes, but I did notice that at times it was very intense, with loud rapid high-pitched passages played by the string section of the orchestra (e.g. violins). Again, I think my response was “normal” in terms of its quality, but not its intensity.

I’m pretty sure it’s a side effect of the medications I’m on. One of the “infrequent” side effects listed for Zoloft is hyperesthesia – increased sensitivity in one or more senses. Now that I know that, I can save a lot of time trying to explain my experiences to my next psychiatrist and simply tell zir I have “auditory hyperesthesia.” Additionally, an “infrequent” side effect of BuSpar is noise intolerance. I’m not sure whether that’s the same thing / similar / related, or something completely different. But it’s definitely been affecting me in my daily life. Among other things, it’s harder for me to shop for items I need and make decisions because I can’t tolerate the noise (especially music and advertisements) in a lot of stores.

We went back to the PT place to pick Mom up, getting slightly lost in the process. Fox was geekgasming about the movie and its relationship to classic Star Trek. It’s the kind of thing I love to watch and listen to, but find distracting and irritating when I need to concentrate on driving. Then his mom called; I asked him to put her on speaker phone so he could help set up my GPS and I could be part of the conversation. We stayed on the phone with her for a little while after picking up my mom, who quietly complained to me that she had been waiting for us for over an hour. I think she should have been the one to do this, but I stepped up and politely told Fox’s mom I was enjoying talking to her, but let’s continue this conversation later.

Then there was driving around in circles in traffic, shopping, eating at a somewhat noisy establishment, listening to Mom, trying to express some of my needs to her – such as my need for a day (or two) to myself every week – feeling like she didn’t quite catch my meaning, and trying to cope with a splitting headache. By the time we got home I was furious! I think it’s because here I am struggling with all this shit and she just keeps asking more and more of me and no matter how hard she tries to be nice and considerate and show her support I feel like she just sees me as someone to do shit for her. A servant. Is it my hangup or something about her? I don’t even know! It drives me crazy.

But the point is when we got home I was furious. Rat therapy helped me calm down. Fox ended up doing laundry for all three of us while I took a nap; I’m torn between being very grateful and feeling guilty about “making” him do my mother’s laundry. That just seems to be breaking some kind of unspoken taboo.

Wakana had to cancel both our meetings this week because she’s been sick so I can’t even take my frustrations out on the cymbal receive the support and therapeutic experiences I need from her. (I’ll admit I’m a bit annoyed about that, but I can’t believe she’d take a week off from work unless she had a really good reason to do so. It’s not like you can get paid sick days in private practice.) So I get to drive Mom to and from PT tomorrow (and possibly other errands), but I don’t get to have the professional help I desperately need! It’s not fair!

Please help support my blogging habit by buying products related to Star Trek on Amazon.com; you can even pre-order Star Trek: Into Darkness.

Off My Meds

I’ve been off my meds since Thursday, when I discovered I’d run out of Zoloft. Friday was a bit of a mess, to put it mildly. Fox came over and we went to my local pharmacy – I had missed calls from them, which I thought were letting me know my prescriptions had been refilled and were available for pickup. No, they were refill reminders. I didn’t have the mental capacity to deal with the situation that day.

On Saturday I brought my rats to the vet, which basically ate up the whole day. I felt tired and disengaged even when spending time with people I care about. Sunday was my first opportunity to refill the meds; I put in an order online intending to pick it up later the same day. The pharmacy closed early because it was a Sunday. Boo hiss. We were up late last night, so we slept late, so we’re sitting here in our pajamas being internet zombies instead of doing useful things like getting the drugs my brain needs to function.

I hate meds. They make life too complicated. Yet another thing to remember and have to deal with random strangers in order to maintain. I’m tempted to just go off my meds and have one or two daily doses of ZooBorns instead. The adorableness is much better at getting me out of my own head, energizing me, and helping me feel happier than meds will ever achieve. And it’s educational: there are adorable photos of babies from species I didn’t even know exist!

Having Fox around more will help too. Mom officially agreed to his request to move in. So, we only have a few more weeks of the instability that drives the Deserter crazy. Then … well, everything comes with a cost. I don’t know what the cost of Fox moving in will be yet. I just hope the benefits outweigh it.

Yuck. I feel like crying but I probably won’t. I feel like going back to sleep. I need to call the vet because one of my rats isn’t using his left hind foot. I’m not sure if it suddenly started yesterday or has been gradually developing and just became more apparent than ever when I took him out to play. I’m dreading trying to explain the situation, making (and later keeping) another appointment, and the bill … ugh, bills! Why me?

hmmph. It’s time to get back on those meds. Even if they’re not quite right, they seem to be better than nothing – especially if I manage to take them with some semblance of regularity. If I’m taking them, I can give my psychiatrist something to work with. If I’m not taking them … well, we’re all wasting our time and money.

Finding the Right Medication – Part Five

On Wednesday I met with Psychiatrist B for another 2-month follow-up. I told him about the increased depressive symptoms I’ve been having and the situational factors involved. He gave me relatively useless advice on what to do about my relationship with my mother and told me I have to take responsibility for my schoolwork (instead of, say, smashing the clock). I couldn’t get up the nerve to mention my recent suicidal thoughts or the freezing Wakana had helped me label (Using Words to Say What They Cannot). On a rational level I knew if I was going to talk to anyone about those symptoms it should be my psychiatrist, but on an emotional level I just didn’t feel safe doing so.

Psychiatrist B decided to stay with the Zoloft at my current dose (50mg 1x/day) and add another medication that’s used to treat anxiety. I don’t remember how he pronounced it and I can’t read his handwriting, but I was able to make out the first few letters. When I typed them into the search bar on drugs.com, it recommended BuSpar.

Based on the information on the website, my only concern is the risk of interaction between the two drugs, which can result in the serotonin syndrome I believe I experienced near the end of October (Finding the Right Medication – Part 2). At that point in time, miscommunication resulted in an overdose; this time I have very clear instructions on how much of each medication to take, and when. He’s keeping me on a low dose of the Zoloft and having me start on a low dose of the BuSpar, increasing it gradually over the course of 5 days.

The thing is, I have no idea what’s going to happen. Based on user reviews, the effects of the drug seem to vary pretty widely from person to person. It could work great with minimal side effects, or it could make me so dizzy I can’t read for school. And worse.

I’ve spent an inordinate amount of time playing The Sims 3 over the past couple days. I played until the children from Ending a Life grew up into teenagers, then decided I wanted to have family portraits that included the patriarch and recently-deceased matriarch. So, I created a new game and restarted playing this family from scratch – only to have the game barf on itself when I tried bringing my intended photographer to Egypt so she could learn her craft. (World Adventures expansion: visiting Egypt is the only way to acquire a camera and learn photography.) After several repeated attempt I concluded that the save file was corrupted. I had to restart my game again; this time I sent her to Egypt first and everything went smoothly – in the game, that is.

I, the embodied Ziya, have been eating crap, depriving myself of sleep, neglecting my schoolwork and other responsibilities, ignoring the pain in my wrist and shoulders from sitting in a weird position for hours on end, and allowing my space to become (more) cluttered! I’ve put off filling the prescription for the past two days, denying myself a medication that could (perhaps, if I wiggle my toes the right way) actually be helpful!

Confronting the Critic: Taking Back My Thoughts

The Critic is the voice in my head that criticizes me. It goes beyond pointing out legitimate mistakes and tears me apart emotionally, often over very minor missteps or decisions I make that are completely neutral.

I’ve actually been hearing less from the Critic since I started taking Zoloft, but it’s still there. It has been hiding in the form of expectations of harsh criticisms from other people. It wants me to believe that I can hear their thoughts, that they are the ones who think whatever I’m doing is stupid, or wrong, or ugly, or dangerous, or gluttonous, or whatever. They are the ones who question my logic, my motives, my abilities.

It is irrelevant whether the people around me actually think what the Critic is telling me they’re thinking. It is up to them to think it, and to express it – preferably to my face – and then I can respond. I keep telling myself this, but it isn’t easy.

I’ve also been trying to reclaim the Critic as a part of my own mind, while simultaneously confronting it and reducing its power over me. As painful as it is to admit this, the Critic’s denunciations are my own thoughts.

I am the one second-guessing myself, finding flaws in my thought processes, thinking that I could have made a better or healthier choice, wishing I had prepared better, doubting my abilities, etc. etc. etc. When I accept the Critic’s words as MY thoughts, then I have a say in how they’re worded and thus the impact they have on me. I can think through them, learn from my mistakes, and make decisions about how to move forward. I don’t have to be the victim of verbal abuse from my own brain.

I can be a person who thinks through multiple aspects of and perspectives on a situation, including the ones that contradict. I can acknowledge the difficulties I face living as an imperfect being in an imperfect world, making decisions and facing obstacles as best I can and sometimes – often – making mistakes. I can be frustrated when, despite my best efforts, things don’t go the way I’d planned. I can admit to not having all the answers.

Maybe I can even admit that I don’t have control over every aspect of my life. Sometimes, it’s not something I could or should have done better. It’s not a matter of being worthy or unworthy. It just is.

I also need to admit that I feel insecure and worry about what people think of me. I wish I could be above such concerns, not care what people think, be unshakably confident. But the bottom line is, I’m not. I want people to like me, or at least accept me as I am, and on some level I’m constantly worrying that I’m going to do or say the wrong thing. I’m afraid I’ll either hurt someone, or get them angry enough to hurt me. I’m walking on eggshells. I don’t want to be abandoned again.

The Critic lets me externalize these concerns. That’s not me, it’s society being stupid. That’s not me, it’s that person being judgmental.

That’s not me, it’s the mental illness.

I can let the Critic live in my brain for as long as it likes – and keep suffering its abuses.

Or, I can OWN my self-criticisms, doubts, and insecurities.

I can admit that it’s very hard to live in a world where unattainable images of “perfection” are everywhere. No matter how much we try to make ourselves believe we don’t care about attaining them, the message does seep through and become internalized. Several of the thoughts I have in the form of the Critic’s abuses are expressions of my own internalized perfectionism, and of anger at myself for not conforming to it. Maybe now that I’ve acknowledged this truth, I can start to let some of these thoughts go.

I can let go of the pride that dictates that I can – and therefore must – be perfect. Pride lies. The truth is that I cannot be perfect, and therefore I need not strive for it. This is not a personal failing. It is a universal reality.

I can also make a commitment to myself: to work through and overcome my fear of abandonment, to accept myself, and to allow others to accept me as I am.

Finding the Right Medication – Part Four

On Tuesday I had a follow-up appointment with Psychiatrist B. I was very happy to report the following improvements since I started taking the Zoloft:

  • I’m calmer and sometimes feel happy for no reason.
  • Anger and frustration flare up less frequently and less intensely.
  • Any thoughts about suicide or hurting myself also come up much less frequently and are passing. I can much more easily refute, dismiss, and move on from them.
  • My thoughts are less chaotic; sometimes I am just in the moment with no verbal thoughts.
  • Minimal – if any – side effects.

I only had a couple of concerns, which Psychiatrist B was able to address:

  • Sometimes my energy level will drop quite suddenly. I feel tired a lot of the time.
    • Psychiatrist B said that is more likely to be the effect of “residual depression” than the Zoloft.
  • I feel like I’m thinking less and more slowly. It’s not what I’m used to and I’m worried about losing a vital part of myself.
    • Psychiatrist B said that it’s important for me to feel things like anger and anxiety because they motivate me to do things I need to do; it would not do to be overly nonchalant. He assured me that we would take care to continue with a treatment that is helping to reduce the harmful / potentially harmful chaos in my mind while making sure it doesn’t turn me into a zombie.

I have a new prescription for the Zoloft (same dose & instructions) and another follow-up appointment in two months. So far, it seems to be working pretty well.

Christmas Eve: An Emotional (and functional) Rollercoaster

On Christmas Eve, I awoke knowing I hadn’t gotten enough sleep and determined to claim the last hour or two I required. My fiance got up, got dressed, and tried to wake me gently. Eventually I acquiesced, had breakfast, and took my morning pills (Zoloft, omega-3, vitamin B, and vitamin D).

Then we launched into baking cookies. I did most of the work mixing the ingredients while my fiance cleaned and got some Trans-Siberian Orchestra Christmas music playing. We worked together to put the cookie dough on the trays and get the trays in and out of the oven in a timely manner.

I was on top of the world through the whole process. Between the music and sharing a favorite holiday tradition with someone I love, I simply could not imagine anything better. And the results of our labor were some of the most delicious, satisfying, euphoria-inducing cookies I have ever had. I couldn’t wait to share them!

I felt like everything was right again and I could stop taking my medication.

Then my fiance took about half the cookies and left to spend the holiday with his family, an arrangement we’d agreed on days earlier. I worked on a project with my best friend over Skype, an endeavor which was fun and satisfying but also more stressful than I think either of us had anticipated. Once we finished, it was time for me to get ready to go.

The plan was for me to spend Christmas Eve with my best friend at her parents’ house, then go to my mom’s that night so I could spend Christmas Day with her. I felt overwhelmed by the prospect of not only getting ready to visit with people, but also having to plan what I would wear for another day or two and put together an overnight bag.

I’m moving back in with my mom in a couple of months, so she had suggested that I bring some things over with me as part of that transition (which is stressful in its own right). Deciding what items I could live without for a couple of months – and packing them so they’d be manageable to carry, along with the other items I was bringing – was just too much for me to handle. I decided pretty quickly to let that one slide; there will be plenty more opportunities for me to go through things and bring some of them to Mom’s.

I showered, then sat down on my bed with my towel draped over me. It’s an organizing tactic that admittedly slows me down, but feels necessary when I’m stressed about going somewhere. My roommate was watching a movie in the other room with the sound so loud it was making the whole apartment vibrate.

I froze. I couldn’t move, I couldn’t think, I couldn’t tell you what emotion(s) I was feeling.
I was stuck.

All of my energy went into holding my rigid position and taking things in through my senses: I saw the objects within my range of vision, heard the catastrophically loud music and sound effects and walls vibrating, felt the bed under my hips and legs and the towel draped over my shoulders. I was aware of my heartbeat and respiration. That was all I was – that, and a sense that I should be doing something else.

Finally, I got myself to move. I stuck out a leg, suspended it horizontally from the bed, and froze again. My intention had been to get up and start getting dressed, but I became stuck in this new position. My leg shook slightly with the effort of keeping it in place, but I did not move. Waves of fatigue, sadness, and anxiety washed over me.

Eventually, with much effort, I was able to get dressed, put together an overnight bag, remember to bring my viola so my friend and I could play string music together for the first time in seven months, check the weather and decide I should wear my winter boots in case of snow, etc.

I forgot to get gas so I had to drive around in a circle. Then I got boxed in at the gas station. Then when I was about a third of the way to my destination I realized I had forgotten the one Christmas present I’d managed to pick up – my present for my mom. I felt horrible. I was already an hour late for dinner, the weather was getting gross, it was dark, and I was tired. I kept driving toward my friend’s parents’ house, furious with myself for “messing everything up.”

The thought of committing suicide entered my mind, but I fended it off with the conviction that it would be horribly cruel to subject my loved ones to that much sorrow – especially on Christmas Eve.

People were still eating when I arrived at my destination, so I joined their meal and conversation. It was very pleasant. My best friend and I played a few duets, then it was time to exchange presents. I felt awkward receiving presents when I had none to give, but I was happy with the gifts I got and enjoyed seeing the exchanges among family members and friends.

Once the exchange was complete, we went back to making music together, which at least started out as an enjoyable activity. I felt insecure about sight reading, but did my best and had some fun playing Christmas duets.

Unfortunately, I had to stop playing viola before long. I’d fallen back on bad habits, was holding my left wrist in a very awkward position, and had pain shooting down my left arm whenever I moved my fingers. I felt depressed and tired, but my friend was understanding.

We sat down on the couch to listen to some recorded viola music and I fell asleep, occasionally twitching.

Soon after I woke up we watched The Muppet Christmas Carol, one of my most favorite movies ever. I love the music and I resonate with the message behind the story: no matter how much pain you have experienced, you can still find love and cheer if you’re open to it.

I sang along to all the songs and felt fantastic!

Visiting with Mom after that was very enjoyable. She didn’t seem angry that I had forgotten her present. I enjoyed opening the presents she had gotten for me and expressing my gratitude for them. Eventually we went to bed, tired but content.

Today Mom and I were late leaving to visit with family, but otherwise had a pleasant Christmas. Yes, I took my medication. My mood – primarily content – was a lot more stable than yesterday. My energy levels fluctuated from moderate to low enough that I had to fight to stay awake. Speaking of which, this entry needs to end because I’m losing my current battle. Good night!

On the Eleventh Day of Zoloft my SSRI Gave to Me …

I’ve been taking my new antidepressant for about a week and a half now. The first 6 days were half doses (25 mg) and today is my 5th full dose (50 mg). It’s kind of hard to say whether the Zoloft has “kicked in” yet, but I have noticed a few changes:

I’m a lot calmer. I still feel emotions, but they’re not as intense as I’m used to.

My anxiety is basically gone. I’ll still worry about things from time to time, but I don’t feel overwhelmed. It’s easier to take anxiety-provoking situations (such as showing up for an exam at my regular class time to find an empty classroom) in stride. That, in turn, makes problem solving easier. (I looked up the exam schedule and discovered I had two more hours to study!)

It’s harder to think in words. I’m used to having a lot of complex verbal thoughts, sometimes so many it feels like my mind is racing. I’m used to my thoughts sometimes taking more of my attention than the world around me – especially if I’m trying to solve a problem, or to determine which words will best express my perspective in a conversation I anticipate having.

But lately the opposite has been happening: It takes so much effort to maintain a focus on verbal thoughts, I’m having a harder time writing. I can listen to and follow conversations, but have trouble thinking of things to say – especially if there are two or more people talking over background music (or other auditory distractions). Sometimes I’ll just take in the world around me and not think any verbal thoughts at all. Or, the thoughts I do have will be fleeting.

I’m concerned about the effect this might have on my academic performance, because the difficulty concentrating will extend the time I need to write papers and complete exams and may influence class participation. It’s also a significant, disturbing change in how I experience my internal world and my sense of self.

But, I’ll admit, it’s also kind of soothing. It’s easier to focus on physical reality, including my body. I can let go of uncomfortable ideas – which, admittedly, can cause significant emotional distress and interfere with social interaction – and just be.

So, I’m still on the fence regarding whether it’s a welcome change of pace that might actually be healthy … or a blissful annihilation of my intellectual capabilities.

I’m very tired. There are periods of high energy, where I’ll be cheerful, silly, dancing around, and able to immerse myself wholeheartedly into an activity and thoroughly enjoy it. I live for those times. But they can abruptly end and I’ll feel extremely tired, even falling asleep against my will and regardless of whether I got a decent amount of sleep the night before. I think it’s easier to give in to the fatigue because of the blunted emotions and sparser verbal thoughts I’ve been experiencing; I need more (of the right kind of) stimulation from the outside world to remain engaged.

Otherwise it can be like a radio is playing in my head: verbal dialogue (which I may or may not be able to understand) and music (that I may or may not have heard before) fill my consciousness and I get caught up listening to it, drifting away into dreams that can feel more real – or at least more interesting – than reality. The sensation of the sounds is different from the sensation of hearing through my ears, in the same way having a song stuck in one’s head is different from listening to the song on an MP3 player.

I’m pretty sure the “radio sounds” are coming from my own mind, much like the “voice” my verbal thoughts have, though I don’t seem to have any control over the former. To be honest the “internal radio phenomenon” is nothing new, but I’m used to it only becoming an issue when I’m very tired – when I should have gone to bed hours ago. It’s been “turning itself on” more frequently and at less appropriate times since I started taking Zoloft.

That’s about all I can think of right now. Happy Holidays!

Finding the Right Medication – Part Three

(Part One | Part Two)

I have been feeling much, much better since I stopped taking the Wellbutrin. I feel calmer, infinitely less angry. I even feel happy at times for no reason! Part of it is that I was able to do something extremely simple to alleviate my symptoms – all I had to do was not do something I had found difficult, anyway! Part of it is that, while the initial energy boost from the Wellbutrin felt good, the medication was making me irritable.

On Tuesday, December 11th I had my first appointment with a new psychiatrist, Psychiatrist B. He accepts my insurance, so that appointment only cost me $25 – a tenth of what I’d paid Psychiatrist A!

As we talked, I felt like Psychiatrist B was listening to me and really understood why I had decided to change doctors. He said that, from what I was telling him, Wellbutrin might not be the right medication for me. He theorized that, if nothing else, cutting the slow-release pills in half caused too much of the medication to enter my system too quickly, so I kept oscillating between overdose and withdrawal. That is what caused the intense feelings of rage.

Psychiatrist B gave me a prescription to get my thyroid checked. He said it was up to me whether I wanted to try a different antidepressant medication, or wait until I knew whether my thyroid was involved in my symptoms before determining a course of treatment.

Based on the assumption that I am still getting some benefit from the Wellbutrin, even though the side effects have basically ceased, I decided I would rather not risk “sobering up” to find myself with severe depression and no medication in my system to keep me from hitting rock bottom. That could literally be fatal.

So Psychiatrist B wrote me a prescription for Zoloft, a selective serotonin reuptake inhibitor (SSRI) which he called his “favorite.” I probably should have asked him why it was his favorite, but I didn’t. And he gave me very specific instructions: I’m supposed to take half a pill each morning for six days, and then start taking a whole pill once a day, in the morning. If a whole pill is too much I should go back to taking half, but stay with it consistently for at least a month.

You can’t get much clearer than that!

I decided to create this blog late Tuesday night, so I was not able to wake up early enough Wednesday morning to feel comfortable starting with the Zoloft. I’ve spent Wednesday largely focused on setting up the blog, including the About Me and Breaking the Silence pages, as well as this very long, 3-part post. Thursday will be my first time taking the new medication and I’ll admit I’m a bit wary of it. There’s really no way to know what effect it will have on my brain, the rest of my body, and my ability to function in society – until I take it!