Tag Archives: anxiety

The Pill Problem, Revisited


I’ve been on antidepressants for months now. At the time, shortly after I was prescribed Lexapro, I wrote about the experience, and especially about the odd and slightly disconcerting feeling of not being able to tell if my general good feeling was a genuine good feeling or whether it was the result of the pills. And while that problem hasn’t gone away, I can say it hasn’t really bothered me in the intervening months. (Of course, that, too, falls into the “is it for real or is it the pills” trap, but that’s sort of the point of all this, so…)

I’m going today for an appointment with my doctor because my prescription’s out, and since we’re dealing with mental illness here, it ain’t the kind of thing they want to give you just for calling on the phone. No, they want to see you face-to-face, ask you questions, make sure you’re not contemplating purchasing guns or rope or Herbalife or converting to Scientology or some such crazy crap. Not that I’m afraid or nervous about speaking to them about what’s going on with me. I haven’t had any of the terrible feelings that sent me to the doctor in the first place at all in the time since then. Which is awesome. Life is good.

And because life is good, I’m bullish on thinking that things in general are good. So when I told my wife that my pills were almost out and I had to schedule an appointment and that I was keen to start tapering off the meds toward a goal of getting off them entirely, she gave me the skeptical eyes. And the skeptical eyes from my wife are usually a sign that I need to pump the brakes and think a little harder about what I’m charging into.

“You’re talking about mental illness,” she told me, “and that’s not a thing you just stop taking medication for.”

Which is absolutely right, of course. Intellectually, I know this. Because mental illness is about chemicals, and more importantly, chemical imbalances, and as a result, medication for mental illness is about rectifying chemical imbalance by creating new balance. Taking meds out of the equation, then, is like taking your thumb off the scales — it throws things out of whack again.

But I was doing the classic “crazy person” thing (and I know that crazy is a term that shouldn’t be bandied about when talking about the mentally ill, I use it here only as shorthand) of thinking, “well, I’m fine, so I don’t need those pills anymore.” Like a true red-blooded ‘Murican, my thinking was:

  1. I have this malady.
  2. I took these pills.
  3. Malady appears to have passed.
  4. No need to keep taking the pills.

Because that’s how medication tends to work in any other arena. Got a headache? Take a few Tylenol and lay down for a bit. You don’t take Tylenol for the rest of your life. Just came through surgery? Here, take these pills for the pain until the pills run out.

You get sick or injured or otherwise out of whack, you go to the doctor, they straighten you out, end of story. Close the book on that chapter.

Which is very much how my brain wants to view this issue.

Because that’s the insidious nature of pills that mess with brain chemistry: you can’t really feel them working. You feel “better”, but you don’t know why. Put another way: you have a headache, you take Tylenol, the pain tends to evaporate within a few hours. You have a cut on your arm, you put some ointment and a bandage on it, and a few days later, the cut is gone. Empirical signs of the efficacy of your treatment. With anti-depressants you don’t have that, because the symptoms fade out gradually, like an 80s rock ballad that just repeats the chorus again and again until you change the station. There’s no healed cut to behold, no relief of throbbing pain to point to, just general dread and unease that don’t seem to be hanging over every little thing so much anymore. But could that really be the result of the meds you’re taking? Seems hard to believe. And were things really that bad before? Probably not. Do I really need these pills, then? I should be fine without them.

Image by rawpixel from Pixabay

The medication doesn’t make you feel differently, it makes you perceive differently, and when you alter your perception, you alter everything, including your ability to perceive that your perception has been altered.

In short, as is so often the case, I think my wife may be right, and I may be a bit overzealous about getting off the pills.

Here’s the heart of the struggle, though: I don’t want to need the pills. I sort of have this image of myself that’s, while certainly far from perfect, generally pretty solid. Reliable. Not broken, not malfunctioning, outside perhaps of a relatively benign proclivity for swearing and a running addiction. I shouldn’t, in other words, be the sort of person who has to gulp down a cocktail of pills, tablets, and capsules just to get through the day. I very specifically do not want to be that kind of person. Maybe it’s the tree-hugger I try to pretend doesn’t exist, or the anti-healthcare-monolith conspiracy theorist thinking I can’t quite put out of my head. But I don’t want to need these pills. I want to be normal without them. I should be normal without them.

But then I think about what normal was for the months before I admitted something was amiss and went to the doctor, and here I go into a spin cycle again. Because I don’t want to be that either — going to tears while heading to work in the morning, fighting just to get out of bed in the morning, drifting away from the activities that I once enjoyed (and have been enjoying again since!).

And the choice between becoming that again or popping a tiny little pill every night? That’s not a choice at all. “Wants” and “shoulds” are generally useless — we have to deal with the world we’re presented with, not the world we wish we lived in.

So I’m heading to the doctor in a few hours. I’m going to ask about scaling back on my dosage, because I want to see if I can be okay with less pills before I try to jump back to having no pills at all. But if they think I need to stay where I am, I guess I need to be okay with that, too.

To do otherwise would be, well, crazy.

Advertisements

Past baggage


We’re out of town and away from computers this week, but I can’t not share this, so I’m posting from my phone, of all things. Blasphemy! My typing speed is hamstrung, but that’s a testament to my shookenness.

I picked up a copy of Dale Carnegie’s How to Stop Worrying and Start Living on the recommendation of Tim Ferriss (thanks to my previous post) and 5 pages in I can already tell this one is a keeper. I’m sharing with you, then, an excerpt from the opening pages.

A few months before he spoke at Yale, Sir William Osler had crossed the Atlantic on a great ocean liner where the captain, standing on the bridge, could press a button and -presto! – there was a clanging of machinery and various parts of the ship were immediately shut off from one another – shut off into watertight compartments.

“Now each one of you,” Dr. Osler said to those Yale students, “is a much more marvelous organization than the great liner, and bound on a longer voyage. What I urge is that you so learn to control the machinery as to live with day-tight compartments as the most certain way to ensure safety on the voyage. Get on the bridge, and see that at least the great bulkheads are in working order. Touch a button and hear, at every level of your life, the iron doors shutting on the Past – the dead yesterdays. Touch another and shut off, with a metal curtain, the Future – the unborn tomorrows. Then you are safe – safe for today! Shut off the past! Let the past bury its dead … shut out the yesterdays which have lighted fools the way to dusty death … the load of tomorrow, added to that of yesterday, carried today, makes the strongest falter. Shut off the future as tightly as the past … the future is today … there is no tomorrow. The day of man’s salvation is now.

Waste of energy, mental distress, nervous worries dog the steps of a man who is anxious about the future … shut close, then, the great fore and aft bulkheads, and prepare to cultivate the habit of a life of ‘day-tight compartments’.”

We – and by we I mean I – carry so much of the weight of yesterday and tomorrow that it gets in the way of today. But the fact is, yesterday is over – whatever will come of it is out of my hands. And tomorrow will come, or it won’t – and very little of that is within my compass either.

Worry over the past or the future, therefore, is worry picked up for its own sake. Maybe think twice before picking up all that baggage.

Put another way…


The Pill Problem


So.

It’s been a little while, no?

And I see that, in my sabbatical, WordPress has gone and added some fancy new features to its editor. But I’m not here to mess with that, yet. And I’m also not here to kvetch about my time away. I’m just going to point out the current quandary, which is this:

Pills are a problem.

I want to disclaim, first of all, that I can’t officially speak as a member of a “community” or anything like that. I wouldn’t feel right doing so. I don’t have a diagnosis, I’m not in treatment. What I have is a touch of something like depression or anxiety or ennui or just a particular flavor of something like a mid-life crisis. But I don’t think I have capital-D Depression. That being said, I did go and see a doctor. And that doctor gave me pills.

And, I have mixed feelings about pills, because I’m a skeptic about a lot of things, and a cynic about even more things. On the one hand, here in America at least, I know we over-hype the focus on pills. There’s a pill for everything, and then there are pills for the side effects of the first pills, and then there are pills to level you out from the side effects of those pills. Something like 50% of the population is on some sort of medication all the time, which seems bonkers to me. We can’t possibly be that broken. So when the doctor reached for her prescription pad, I felt a certain resignation. I don’t want to be broken.

On the other hand, I also know that full-on, capital-D Depression is a real thing caused by real chemical imbalances and the way to correct chemical imbalances, in many cases, is simply to medicate. So: cynical about our society’s obsession with pills, and not happy to become part of that subset, but also willing to trust the doctor and attempt a chemical solution to what could be a chemical problem.

TL;DR, I started taking Lexapro, and have been on it for basically the length of my unintended hiatus, which is at — what — something like a month now? Maybe a little longer.

And here’s the headline. I feel better! Since I’ve been on the meds, I’ve had not a single “can barely force myself out of bed in the morning” morning,  zero “inexplicably breaking into tears when asked what’s wrong” moments, and a significant decrease in the sense of general existential dread (though I imagine I’ll never get rid of all of that because a) I’m still a self-doubting writer and b) just look at the world). Life, in short, looks brighter than it did, for whatever reason, a few months ago. In fact, things seem to have turned on a dime once I owned up and admitted that something was wrong, opened up about it a little bit, and sought out some treatment. I daresay that, today, and for the past week or two, I’ve felt darn near normal.

But here’s the thing: the medication is supposed to take time before it takes effect. Again, I’m hardly expert in such things, but I was told to expect as much as 4-6 weeks before I should expect to see results. But I was feeling quantifiably better the very next day after taking my first pill. Of course, I’m a good skeptic. The simple act of taking action may have been enough to create a placebo effect; moving towards a solution may itself have been the first part of a needed solution. But now I’m a month in, and wondering whether it’s the pills that have me feeling better, or just the fact that I got it off my chest and have managed to relax a little somehow. Or some combination of the two.

Or, who knows? Maybe my funk was just a passing funk that was never going to affect me for longer than a month or so in the first place.

The end result is, now I’m on medication and feeling mostly fine again, which has me thinking maybe I don’t need the medication anymore. Of course, going off the medication could screw up my biology regardless of any underlying issues I might be having. So I both desperately want to not be on medication any more at all because I think I may not actually need it, and desperately want to keep taking it lest I relapse.

This is the pill problem.

And it’s unfortunately a problem without a visible solution in the short term. Because as much as I want to not be on the meds, I’m not enough of an egomaniac to think that I’ll be the exception, and be just fine if I go off the stuff.

I’ll keep popping my little pill at 9 pm, even though I feel a little silly for doing so. Because I’m supposed to. And because I’m afraid of what might happen if I don’t.


It’s Like This


It’s like this.

I have this jacket.

It’s a lovely jacket. Feels good on me, looks good on. Dapper, sharp, all the good things. I feel comfortable in it. More myself, maybe. I try it on and I like it so much I start wearing it all the time.

Til it happens; I get this spot on the jacket. Not sure what the spot is. It’s orangish, brownish, reddish, blackish. Just a spot, but one I can’t ignore. Given all the things I’m into, it could be poop. Or dirt. Or blood. Or just a slimy speck of something that may once have been, but is definitely no longer, food.

And well, it’s in this really conspicuous spot. Very, very obvious to anybody looking in my general direction. Like a tiny martian on my sleeve singing Glory Hallelujah at the top of its little green lungs.And I don’t have a way to clean it. I first try to fold up my arms just so, which works to cover it, but I can’t keep my arms crossed forever, not to mention I look like a standoffish SOB. And I assure myself (because it’s true, and this I know inwardly even if I have to convince my lizard brain) that nobody will actually notice it if I do uncross my arms, it being tiny and inconsequential and all.

So I uncross, and nope, it’s there, and there’s absolutely no denying it’s there. I rub and pick at it in a futile attempt to clean it, but it’s well and truly sunk into the fiber like blood into a shag carpet. Also I’m drawing even more attention to it with all the rubbing and picking, so it’s time to take it off. Into the corner it goes, fhthump.

Except now, see, there’s a new problem, because the whole outfit I created? This entire look, entire ensemble? It doesn’t work without the jacket. I mean, shirt, pants, shoes, belt — it’s all doing a job, but the jacket was central. And now it’s not only stained, it’s also crumpled up and hoovering dust off the floor. And worse than that, now I feel like a heel because what was a simple stain is compounding thanks to my neglect and frustration. And worse than that, this is all just ridiculous. This is all because of a stain. A tiny one. A pinprick of an imperfection. A rounding error compared to the jacket as a whole. Honestly, it’s probably not even visible if you didn’t already know it was there.

But there’s the rub, innit? I see the speck. And the wrinkles. And now, the dust. And how long has that speck been there, anyway? For that matter, is the color of this jacket really as bright as I thought it was to begin with? Does it even tie the outfit together like I thought? Maybe the thing looked terrible all around and I didn’t know it. Chroist, probably it’s just as well the jacket got ruined. Now it looks outwardly like crap, to go with the fact that it was always crap from the get-go.

I should probably just chuck it. It’s ruined now anyway. Can’t believe I ever thought I looked good in it, to be honest.

All that?

That’s what my particular flavor of depression looks like … or anxiety or malaise or seasonal affective disorder or whatever the hell it is that’s going on with me. Except substitute for the jacket my job, my role within the family, my creativity, my entire sense of self.

So… um.

I’m taking Lexapro now, so there’s that. Have been for about two weeks.

And I know I’m being a little bit silly. Even a lot silly. And I know that the jacket can be cleaned. And even if it can’t, there are other jackets.

But that stain is still pretty large in my vision right now.


Simmering my Brainmeats in a Fragrant Crockpot of Creative Doubt


My Flash Fiction from last week is enjoying a bit of success over at terribleminds.com.  So good, in fact, that I stand to win a free e-book off the back of it (yay free stuff!).  That thread is here:  Three Sentence Stories.  And it got me to thinking, which is a bad habit I have.  Because I love these little Flash Fiction challenges; I take great pleasure jumping into them with both feet no matter how difficult or ridiculous or outside of my comfort zone they may be.

If you’re going along with this post, you might want to check out my series of stories from last week, because I’m stewing over them right now.  Simmering my brainmeats in a fragrant crockpot of creative doubt.

Writing the last one — I should say the last set, since I expanded on the topic and wrote way more than I perhaps should have — was instructive, because the development of the stories was so strange to me.  With only three sentences to tell a story, I agonized for the weekend over what story I could tell, what characters I could bring to bear, what possible development and twists I could effect within such a short period.  My first story was good but fell into my typical vein of the dark and somewhat horrific account of a more or less mild-mannered somebody taking part in senseless violence.  It’s a little bit of a motif with me, I’m afraid, and I’m just not sure how effective it really is.  It wasn’t bad, but the moment I wrote it, I realized just how much of a step into an old shoe it was, which is why I decided to write another one.

So I rebooted, kept my central idea and parameters, and brought in new characters, new conflicts.  New perspective, new story, new twist.  And v2 was better, I think, though it still fell in the same dark, depraved vein of the first.  But twisting the idea in my brain felt refreshing, so I tried again.  If the first story was a cruise down a familiar highway, the second was a short detour on a quaint exit ramp for a franchise burger.  A bit different but nothing incredible.

So for the third go-round, I decided to take a hard left into the ditch.  Rather than characters, I characterized inanimate objects (more or less), let them talk and explore human emotions and ideas, and … end up at the same dark murderous place.  Hmm.  The new take on characters was like a fantastic little food truck discovered set up around the corner from my office.  Totally new and exciting food in a familiar and comforting setting.  I knew I was getting warmer.

On the fourth go-round, I struck gold.  I re-imagined the central idea once again, personified an inanimate object and used my scenario to describe a situation that happens every day.  Not an earth-shattering revelation about everyday, just a little thought experiment on what might be happening when the vending machine at the end of the hall rejects your dollar.  Somehow, it felt like gold.  An ostensibly ridiculous premise with an endearing (at least, I think so!) character whom you don’t expect, giving an unexpected perspective and staying light and upbeat.  So it was a bit out of my comfort zone, a bit funny, a bit ridiculous, and very much me.  As I was writing it, before it was finished (yeah, that quickly, even before I could finish three sentences), I could tell it was the best one.  That “magic” was happening, that crazy feeling where you feel like you’ve tapped into the magical mind-juice of the universe and your pen (okay, your keyboard) is acting as a conduit for the timeless universal stories that speak to everybody.  You know, a good writing session.

The fifth attempt felt a little forced, so I pulled the plug after that one.

So, to reflect, I wrote one story in my usual vein, a second with one foot out of the vein, a third with an eye on a different horizon, and a fourth that struck out toward that horizon and — by all accounts — seems to be resonating with folks who read it.  So now, I’ve got another prompt in front of me for the weekend, and I’m all in my own head, wondering if I need to write three junk stories before I get at the “real” one.  For that matter, I’m working on an extended short story and boy oh boy, does it feel awkward and forced.  Like I’m in touch with the central idea, and I’m enjoying the premise, but I can tell as I’m writing it that I’m not telling the story the right way.

Do I need a few crap attempts at the topic to “clear the pipes” so that I can get down to writing the story that I want to write?  If so, how far do I have to carry those stories out?  When I wrote Rejected v1, it felt like a pretty good story to me, but in retrospect I can see that it’s awfully derivative.  The current version of Powdered Chaos, at about 30% completion, already feels crap.  Do I need to carry it to is conclusion before I take another stab at it?  Or, having written about 4000 words on it already, can I legitimately realize it’s crap and start over without crashing my creative process?

In short, just what the hell is my creative process anyway?  This is seriously bugging me, and it’s bogging down my writing hard while I’m trying to carry my momentum through this lull before I jump into editing Accidentally Inspired.

Need to figure this out.  Anybody else have anxiety like this about your drafts?  How do you attack it?  Do I just write the crap to clear the pipes or do I resist the urge to waste time on the crap and hold out for the good ideas to strike?


%d bloggers like this: