Antidepressants

Lexapro. Klonopin. Prozac. Paxil.

Over the last two weeks, how often have you been bothered by the following problems? Not At All, Several Days, Over Half the Days, Nearly Every Day?

Feeling nervous, anxious or on edge? Not being able to stop or control worrying? Worrying too much about different things? Trouble relaxing? Being so restless that it’s hard to sit still? Becoming easily annoyed or irritable? Feeling afraid as if something awful might happen?

Little interest or pleasure in doing things? Feeling down, depressed, or hopeless? Trouble falling asleep or staying asleep, or sleeping too much? Feeling tired or having little energy? Poor appetite or overeating? Feeling bad about yourself, or that you are a failure or have let yourself or your family down? Trouble concentrating on things, such as reading the newspaper or watching television? Moving or speaking so slowly that other people could have noticed? Or the opposite, being so fidgety or restless that you have been moving around a lot more than usual? Thoughts that you would be better off dead, or of hurting yourself?

If you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people? Not difficult at all? Somewhat difficult? Very difficult? Extremely difficult?

They eventually combined the questionnaires for me and there were times I had to answer a separate Suicide Severity Rating Scale. Simple yes’s and no’s, no eye contact, and suicide safety plans. Identify reasons to keep living. Identify responsibilities. Identify support networks.

Do you have a plan?
Do you have intent?

They returned my automatic answers with kind and understanding smiles.

Lexapro made the thoughts worse. I was honest at my check-up when she asked if I’d gone off. Klonopin followed, with urine tests to monitor and protect against abuse. I was an exhausted, unfocused, walking zombie, with no memory of life before. Nothing felt real. I went off again between visits and took a year off to try counseling.

She’s good, even if you just need a sounding board to bounce things off of,” reassured my primary.

Depression and Anxiety had never left my side. Sleep was a constant struggle. I was hitting a wall again, had stopped counseling suddenly, and the sun began to show itself less and less each day. Enter: a little blue pill. It only took a week before I felt drastically different. I was in love.

Prozac made me burst with energy; focused and outgoing. I was productive, so very productive. No need to worry about insomnia or nightmares when you don’t need to sleep. A few hours a day kept me going like the energizer bunny. I was happy. I was excited. I talked too fast and rambled on too long, but I enjoyed it. I enjoyed it for weeks before the first crash. A day or two in bed, wondering if I had ever felt so terrible before. The phone, a lead weight, was too heavy to even check on my mother when she came home from the hospital. Once rested, it was back to the races.

What we might be looking at here is a little bit of bipolar,” my primary shrugged.

I didn’t care. If all I needed was a few days a month to crash, I could handle it. The new psychiatrist experimented with Trazadone and Amitriptyline to help with sleep. I worked full-time with commission work on the side, the house was spotless, there were comments on my good mood, and I was up early to make my boy breakfast most mornings. I was thrilled.

Agitation started slow, morphing out of slightly manic excitement, as my head began to feel fuzzy more often than clear. Crashes came more frequently and, rather than sleeping, I became jittery, irritated. I drove to the walk-in clinic, pacing when the practitioner walked in. I didn’t know her, but I was honest, up front, struggling to control my racing thoughts and words. The psychiatrist gave me Vistaril for anxiety. I threw out the bottle when it turned me into the walking dead. The agitation grew larger and darker, a cumulonimbus looming overhead. The answer: Increase the Prozac dosage. I was reluctant, at best.

In only a few weeks I begged the secretary at the walk-in to let me wait until my new primary was available. I couldn’t sit in the waiting area, crawling out of my own skin. I paced and rocked and fidgeted in a side hall, rubbing and squeezing my arms until my name was called.

Oh honey, ” her brow furrowed into a worried expression. I didn’t try to sit and talk. I kept pacing. I kept rocking. “I really think it’s time for you to get some more help. You can’t go home like this. Upstate has great facilities. We really need to get you checked in…”

Her voice trailed off as my body tensed. I begged her not to send me. I promised I’d be fine in a day or two. I just needed help getting off this little blue pill. Please help me get off this little blue pill. I can’t do this anymore.

By Christmas, I had weaned, and my numbers were terrible. I couldn’t sit still. I couldn’t look her in the eye. I left with a prescription for Paxil, the perfect middle ground. The depression was kept at bay, but I wasn’t manic. I was anxious, but not having attacks. My numbers were good, for me, but then worsened slowly with each visit. When ideation was hitting several times a week, I started weaning myself off. It was a slow and ugly progress.

Phase 1: Did I have the flu? Headaches, fatigue, muscle aches, chills.

Phase 2: Electrical brain zaps, pendulum moods, unsteady tremors, stomach issues, dizzy spells. Pushing to work through lightheaded stumbles.

Phase 3: I’m no longer an addict, but the nightmares are back. I shake and shiver during regular conversations. I float off away from my body to cope.

Phase 4: A year later, I clean out a cabinet to find a bottle with three pills left. I stare at it for an hour, open it, close it. I force myself to throw it in the garbage and leave the house and drive and drive and drive until I’m so tired that I forget that I ever found it.

Phase 5: TBD

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