Shiny New Magic Happy Pills

You may remember I had a rather extended internal debate over the merits of changing my medication; as the title of the post indicates, I did make a decision and I have started on some new antidepressants.

Just over a week ago I caved to The Boyf’s logic [which I would have done anyway, it was just a matter of when; he was right I was just being stubborn about the whole thing] and sourced myself my third GP of the year.  This one has a gawky science teacher vibe about him and is exceedingly upbeat for an NHS employee.  He treated me like I have a brain and I know how to use it.  He didn’t just write me a new prescription and send me on my way; instead he explained all about the new medication, what it would do, how it works and he did it all in a way which I understood without making me feel stupid or talked down to.  Then at the end he offered me a sticker with a smiley face on it with a caption about being good during my visit to the doctor.  I declined, but only because I didn’t want anyone to ask me why I had been to the GP.

I did end up getting spotted by a great number of people who knew me while waiting for my prescription [three out of five of them knew me] but none of them spoke to me, so that was okay. [Just because they know me doesn't mean we're talking acquaintances, it's a small town almost everyone knows everyone].

My new magic happy pills – Venlafaxine – are a soothing shade of pink, the colour of bubblegum Jelly Bellys, to be precise.  What is even more impressive than the delightful hue is that they work; they work with – touch wood – no side effects.  I still feel the same – emotionally – as I did with the Fluoxetine, which was the plan, but there’s a lot more day now.  I don’t seem to fall asleep the second I am left unattended or sat down in front of the TV.

I haven’t yet had a fair trial to compare the level of crying [my usual catalyst is parting from The Boyf, but since the new magic happy pills I've only seen him for a flying visit, so the test conditions were less than fair].  I don’t think they are going to cut out the crying altogether [I think I would worry more if I just stopped crying completely], but I do hope that it will be toned down to welling eyes and a lone tear running down my cheek as opposed to the heaving sobbing mess I used to get into.

I could deal with the single discrete tear, even if it is a bit sending-your-man-off-to-war.  I’ll never need that look for sending my man off to war – he’s a pacifist – I might as well use it for something else and save on the heaving sobs, after all they are ever-so exhausting.

The only down side to Venlafaxine is the so-called “brain zaps” when you try to come off it.  Apparently it is like a static shock in your brain.  The Boyf was worried that if he told me about what the side effect actually was I wouldn’t have taken them in the first place.  The truth is, that in six, twelve, eighteen months when I do eventually come off these, the slightly masochistic part of me is kind of looking forward to a little brain zzzzzap.

The Side-Effect Conundrum

When I was first officially diagnosed with depression I was given an anti-depressant [Citalopram], which didn’t work.  It didn’t make me feel any better, it made me dizzy, it made me nauseous and – in short – it was horrid.   In order to counteract the side-effects I had to take an additional over-the counter anti-emetic; but even cancelling out the side-effects was a pointless endeavour as I wasn’t getting the primary benefits.  Essentially, it was not the SSRI for me.

After a  jaunt back to my GP to categorically state I would not be continuing with the dizzy-make-sick-non-happy pills I left with a new prescription, this time for Fluoxetine.  First impressions, this was better.  They were capsules for a start, none of that powdery malarkey that leaves a bitter taste in your mouth, no matter what you do.  Then, as the weeks progressed, they did what they promised.  Serotonin re-uptake was indeed inhibited and the word “woop!” re-entered my everyday vernacular.

Of course, like most things in life, the good things are always accompanied with a side order of bad.  To get to the mochi you’ve got to eat the harusame aubergine; to get the Pixar animation you’ve got to sit though the angry-yet-condescending piracy threat; to get the happy you’ve got to put up with the tiredness and the incredibly low crying-threshold.

Although the tiredness is more than a little pesky [days are only fifteen hours long at the most, but I'd have them down to thirteen if it were practical] and the crying has meant I’m single-handedly responsible for the destruction of a chunk of rainforest the size of Wales to keep me in tissues, I feel so more emotionally robust.  The depressing thoughts haven’t been air-freshnered into the background, they’ve been Febreezed completely away [or at least, camouflaged beyond recognition].  In a Utopian world the side effects wouldn’t even be there [actually in a Utopian world, I wouldn't be taking anti-depressants] but as it stands, I think the benefits out-weight the disadvantages.

It has been recommended that I discuss my current medication with my GP with a view to changing them to something with fewer side effects, or at the very least, less intrusive side effects.  I see two issues with this:

Firstly: I don’t actually have a GP at the moment.  I am currently exhausting my stock of pills my previous GP prescribed before booting me out and telling me – in the politest possible terms – that I was unwelcome in his surgery until such time as I actually live within his catchment area.

I could, quite easily, re-register with my old family GP back in the sticks; I could just as easily discuss my current situation with said GP.  However, it’s the administrative side of this which scares me I’m not so keen on.  It’s a small town, everyone knows everyone, and everything is everyone’s business.

This isn’t just reductio ad absurdum, it’s based on my experience.  I trust my family GP, I have no problem going along and telling him what’s up.  I have problem with everything else:  it’s the administrative staff and the other patients in the waiting room who recognise you as so-and-so’s granddaughter wondering what’s up with you, because it’s not obvious, you’re neither sniffling nor have your leg in a cast so what is it?!   It’s the dispenser in the pharmacy looking at your prescription and then looking you up and down, seemingly silently judging you. [This one comes from the fact that when I was in high school and taking acne medication which can also be used to treat syphilis [my use of it was the former, before you jump to any conclusions] and it was soon known at school that I had syphilis because a girl at school had a Saturday job in the chemist and it got chinese-whispered out of proportion].

It was just easier in the big city, no one knew me and even if they were silently judging me, then our social circles didn’t overlap for the judgement to be shared around.

Secondly:  What if I try something new and it doesn’t work as well as the Fluoxetine?  I don’t want to go backwards.  I’m content to put up with the side effects because I’m getting the benefits.  I know it’s possible that I could try a different anti-depressant which works just as well but has less side effects, but it’s just as likely that I’ll try a different one which causes me to suffer from more side effects, or the same side effects but without the magic-happy element.  Call me staid, boring and risk-averse but I think I’d rather stay here in It’ll-do-ville instead of moving out into The Valley Of The Unknown.

I Haz A Theory

I have a hypothesis, actually it’s more than a hypothesis for it has evidence to back it up; I may be so bold as to call it a theory.

At the same time every night I take my magic little happy pill which causes serotonin to spew forth into my nervous system and fill it with it serotoniny goodness.  Okay, for the past two weeks or so it hasn’t been that gushing with the joyousness, but there is a very distinct period in my day when it’s worse.  The four hours before I take it and the two hours after I take the magic little happy pill I am a blubbering mess, I doubt I’ve cried so much in my life as I have in the last fortnight.  Ugggh.

For the most part there is nothing specific that sets me off; I can get the BSOD which eats a blog post and I’ll be fine but then a random lolcat will set me off.  I don’t even do well with crying, I don’t do well with other people crying and I don’t do well with myself crying.  I hate crying and I especially hate it when I don’t have a reason, which is all the freakin’ time.

Anyway back to the theory, it’s probably not medically or pharmacologically sound and all in my head [oh! I made a funny!] but could my serotonin levels be that sensitive that as the daily dose dissipates, 20 hours after taking it, I dip below the threshold and it party time in my tear ducts? Could I really be that sensitive or is it all just psychosomatic?

Emotional Retard

I’ve been feeling really rather rubbish recently; more so than usual.  This probably has something to do with the fact that – as the Boyf helpfully reminded me – I am clinically depressed.  As if I could forget something like that.

The thing is I know that; I know I have depression and I know that plays a part in me feeling like I’m rubbish.  If anything it makes it slightly worse because I know I’m feeling rubbish because I’m depressed, but because I know why I feel rubbish then I think I should be able to counter-act and reason with it.

There’s not just that though.  I know that on a scale of emotional-retardedness I lean more towards the imbecilic end than average people.  I don’t know if emotional retard is exactly the correct word, perhaps it’s more emotional simpleton.  If something falls outwith one of my standard emotional responses I default to silence; which I think is sometimes a worse response than an inappropriate response.  Of course, because I know that I haven’t reacted accordingly to a situation, it makes me feel rubbish and then I’m feeling rubbish and less likely to react “normally” and so on and so on, the cycle continues.

Recently I found myself in a situation where I knew I had to be reassuring and supportive, but I didn’t know how to go about it.  The thoughts were all there, but the synaptic process of verbalising those thoughts and feelings wasn’t working.  I couldn’t formulate the emotions into coherent words, phrases and sentences.  When I was in that exact moment my thoughts were: it’s better to say nothing than to say the wrong thing or say the right thing in the wrong tone or to just wjgop uinoeuinojfp opwiftrh.  Before, after, now I know and believe it’s better to say something, anything than to Marcel Marceau it up.

It’s one of the things I would change about myself [along with chronic indecisiveness and my irrational phobia of bellybuttons] but I don’t know to go about it.  Is there an online course to take?  Are there evening classes at the local church hall?  Do I do little warm-up emotional maturity exercises?  Will I be assigned homework?  And most importantly, do I get a certificate with gold stars when I graduate?

Zooooom Zooooom

Day two at the same slightly-too-fast speed, I did stop last night but it’s digital not analogue.  I just stop I’m either on or off, no come down, no slow down just fast and irritating myself and then zonk, asleep.  Twelve hours of zzzzzz and then back up and then everything’s slow again.  TMI: this morning while peeing I was annoyed by how long my bladder was taking to empty, it seemed to take for-freakin’-ever.

I’ve not been doing anything particularly different, no change in diet or anything but no.  I’m just as caffeinated as I’ve ever been, if anything there might be a bit less sugar but if anything that would cause a hypoactive state instead of this somewhat hyperactive one.  The other thing could be that the fluoxetine just took longer than the citalopram to kick in and this is me having reached the stable dosage rate.  If this is it then it’s too much.  I’d rather be miserable and lying in bed all the time instead of these polar extremes from 3am-wanna-be-dead to 11am-high-as-a-kite to 3pm-shut-the-hell-up-you’re-irritating-yourself.  Can’t concentrate, everything takes too long and none of it is interesting enough.

Zoooooom

I think I need to go back to the GP.  There are new and interesting side effects – rapid mood swings.  Three am this morning I wanted to be dead or at least have a hot poker driven through my temples.  Right now I feel, I don’t like to use the word manic – ‘cause it’s not actually manic in anything other than the incorrect and most commonly used definition, but I am leaning towards …..  Concentration?  What concentration?!  Hurry up world, keep up with me.  I’m at a speed where I’m irritating myself.  That’s an awkward place to be in.

Oh! The Hilarity!

So, another jaunt to the GP this morning [okay, early afternoon if you're going to be pernickety about it, but anything pre-lunch is morning to me, noon be damned!].  He actually told me that normally in this stage in the anti-depressant-prescribing cycle he would hand out a repeat prescription and let the patient get on with the day-to-day living.  “Normally” being the key word.  Apparently I don’t fit into the normal category and I get to trail myself back there every four weeks. Joy of joys.

He believes I’m more stressed than I let myself believe and that instead of dealing with the stress I turn it into a joke.  It took him five years of medical training and twenty plus years of experience to tell me that?! Any drunken monkey could’ve figured that out!  Although in fairness, perhaps the most helpful answer to the question “do you feel more stressed?” isn’t, “only the normal amount for someone on the receiving end of a death threat”.