Monday, April 25, 2011

Hello, Old Friend

I have lived with clinical depression for most of my life. It is hereditary, and it runs rampant in my family, though I'm the first to be open about it. It hit me early; I can remember having symptoms by the time I hit puberty. No one ever took me to a doctor, and I suffered alone with my feelings until I was 23. At that point, I was having moments of extreme rage that felt like spontaneous combustion. The feeling only lasted a second, but it was damaging my relationships. And because I often experienced the feeling in public or in traffic, I became afraid I would do something violent. My doctor ran several tests. Finally he asked me, "Do you have a family history of depression?" I think he was taken aback when I started laughing; I never knew that depression can manifest as anger. It happens more often in men than women (maybe I got that symptom because I'm a redhead), but it's fairly common.

At that point, I went on medication, and my life improved dramatically. The first drug I was prescribed, Effexor, worked extremely well for me right out of the gate. I had few to no side effects, and we arrived at a stable dose in short order. Over the next several years, I did well. My doctor and I occasionally made changes to my dosage, or added different medications, but I had side effects with other meds. We later added Abilify to the Effexor, and I was level.

In the fall of 2007, I left my job, and for the next four years, I had health insurance only sporadically. I went off the meds in spring 2008; stopping these meds cold turkey is a bad idea, but I did it and dealt with side effects for several weeks after. In the spring of 2009, I had insurance, and went to my then-doctor to get back on my medications. I was not living in Dallas, so I chose a doctor off my insurance. At our first meeting, I was pleased with her, but that opinion changed rapidly. I gave my new doctor a medical history, and told her the cocktail of Effexor and Abilify had worked well for me for many years. She prescribed both, starting with a low dose. The Effexor was quite expensive, so (with the doctor's permission) I started the Abilify first, with the intention of adding Effexor about a week later. That didn't happen. I had immediate side effects with the Abilify.

I was aware that for many people, taking medication for depression is not a quick-fix. It can take months or even years to find a cocktail that works and then to stabilize a dosage. I knew I had been lucky in the past, and I had assumed I would continue to be lucky.

The initial side effects were not severe, and I thought my body just needed time to adjust. I stayed on Abilify alone for approximately six weeks. The side effects grew worse, and I asked my doctor to try something else. She prescribed Topamax, which I had taken years before and tolerated fairly well. Again, I had side effects - and this time, they were worse. I asked to try something else after only a week. The third drug, Lamictal, lasted one day. Immediately after taking my third dose, I had a panic attack. At work, at my desk. Lovely.

I'd decided to go back on the meds as a preemptive measure. I know that depression is something I will deal with the rest of my life, so even though I was doing well, I wanted the meds to help me stay at that level. After experiencing such severe side effects, I'd had enough. I decided that I would go without the meds and take my chances. I was doing well, and I know my own body and mind well enough to see it coming before the depression really takes over. For the last two years, I've taken no medication, and I've done very well.

However. This morning, I had to admit to myself (and to J.) that I'm not ok. It's back.

I've always experienced two or three days of anxiety and moodiness each month. Since I'm on the pill, it was easy to see that these days were always at the same general point in my cycle. The feelings were not severe, and always passed quickly. About three months ago, I noticed that the anxiety and moodiness were happening at different times during the month, and they weren't passing as quickly. I began to see that I was more stressed, even though my life was stable. I started to get irritated with J. more easily, and I snapped at him several times (which I had never done before). Around the first of April, my mood began to swing. I felt out-of-sorts and just generally not myself. I chalked that up to my approaching 35th birthday. At about the same time, allergy season kicked into high gear. I was not feeling well physically; I felt tired. I took a sick day from work because the thought of getting dressed and driving to work was so exhausting that I cried.

J. and I had a nice weekend. I got a lot of things done, which always feels good. But yesterday afternoon, the melancholy came back. And this morning, in the shower, the tears flowed again. I can't keep telling myself that I'm just run-down, or feeling lousy because of allergies, or tired from my long commute. I am sliding downhill again. I know this disease is going to be with me forever, and I know it can be stabilized. I can (and will) feel normal again. But it's still frustrating to be where I am right now.

I made an appointment with my doctor for this afternoon. He has been my doctor for about 14 years, and I love him. I think he's the best doctor in the world, and I don't know what I'll do when he retires. I know we'll make a plan together, and I will get better. And at least I'm taking the first step now, instead of waiting until it gets worse.

1 comment:

RoseAnn said...

{{{Hugs}}}. I'm so glad you're being proactive and going to see the doctor! I hope together you can find a plan that works for you.