Adventures in Anxiety and Depression: Switching Meds

After I filled you in on my med change decision in  The Search for Normal: A Struggle With Anxiety and Depression I felt I needed to give an update. I am almost a week into my journey of changing anxiety and depression medicine after getting my results back from Genesight. Overall, the week has gone smoother than I may have thought, but there have definitely been bumps.

Some of those bumps of course are self created. During my appointment with my psychiatrist we decided I would move from taking 20mg of my current medicine (a full dose) to taking 10mg for four days and then taking 5mg for four days. We hope by then we would be ready to start the new med.

I gotta tell you that first night I went ahead and took the full 20mg again. My husband seeing me take the 20mg pill just looked at me and said, “Aren’t you supposed to be weaning down?” I replied, “Yeah, but we have a lot going on tomorrow, I’d better go with 20mg tonight.”

If you can’t read between the lines, I’ll  just tell you I was scared of weaning down. Scared of how it would make me feel. Scared of how I would react.

The next night I didn’t feel much braver, but the hubs looked at me and said, “Take the 10mg. It’s labor day weekend. We’ll be around with you for days.”

Sidenote: I really love my husband. He should be made a saint or something. 

So I opened the 10mg sample bottle I was given for just this task and took the leap. Then I chased it with my nightly dose of Klonopin and went to bed. Best not to overthink these things.

The first couple of days were not that bad. From time to time I could feel myself “checking my emotional temperature,” but nothing catastrophic was happening. I was a little cranky and anxious but I think a lot of this came from my own nervousness about the endeavor.

For here is one of the horrible truths about anxiety. You are often your own worst enemy. Since I have had bad experiences going on a new med before (read previous Search for Normal post for Paxil nightmare story), my mind and to some extent my body remember this trauma. They tense up and brace for it to happen again. The fear that is created by the dread is enough to make me feel worse. It is a self perpetuating cycle.

So I tried to simultaneously keep my self busy and be gentle with myself. There was a lot of movie watching and reading and cuddling kids and dogs. Mostly I just pressed on with it all. Two days of 10mg down, two to go. Just keep swimming.

All this while I know there is another step coming. My doc told me to drop off the prescription at the pharmacy right away as she knew there would probably be some dance between her and my insurance company on getting them to cover it. She thought that since we had the genesight results and my reports of side effects from my current med that we should be okay.

Well, let me just tell you. It was not okay. After haggling back and forth my insurance company told her that they were refusing to pay for my med. Even though it was on their formulary. Even though Genesight called it one of my best. Even though she has seen patients do great on it, recommended it for me and asked for me to be given the drug.

They refused to pay.

Why? Because the drug is expensive and they want me to try every cheaper option first. Even if it is not the best drug for me. Even though there is a chance the cheap drug will either not work as well or give me difficult side effects.

After losing the fight with my insurance company my doc called me and left me a message that we were going with a new drug that she thought my insurance might cover and to stop by to get the script so I could drop it off right away. Because of the dance.

But instead I had a panic attack. Because it had taken several minutes of my Doc giving me a pep talk on how she felt good about this new drug and how it was going to be great for me and how it wouldn’t cause horrible side effects like I’ve endured before or even the less horrible side effects of weight gain or loss of labido. . . .

(Okay, let’s just pause a minute and let it soak in that I’ll tolerate gaining 50 pounds and having to be talked into being intimate with the love of my life because both the experience of acute anxiety/depression and the side effects I’ve endured from other meds, yes you Paxil, were so bad that being obese and unsexy seemed like workable and even preferable options.)

It took this five minute pep talk to convince me this new drug was going to be okay. That I was going to be okay. Because I could trust the science of the Genesight test. Because I can trust my Psychiatrist. There was a lot of trust that went into me agreeing to change to this new med.

And then. Then my insurance company goes and blows all that trust building and bravery out of the water by refusing to cover this new med. And to pay it out of pocket would cost $200 a month. Or $2,400 a year. We could do that. But why should we have to? When I have an illness and there is a drug that will treat that illness but my insurance company just doesn’t want to spend that much money on me even though I pay them a buttload of money in premiums each month for just this sort of thing.

So after getting the phone message from my Doc I am crying and having a panic attack in the bathroom where my children can’t see me, frantically looking up this new med. A med I have not had a five minute pep talk about. A med that was not the first one my Doc pointed to and said, “I really like this one. This one will work really well.” And as I’m reading reviews on the new med which I know nothing about they are very mixed. Some people had horrible reactions, for some people it just didn’t work, and some called it a life safer.

Because here is another horrible truth about anxiety and depression. Even though there are wonderful meds out there that can help treat the illness, finding the right one for you is really a crap shoot. The drug that saves one person’s life causes another to fall into a suicidal hole. The drug that calms one’s person’s raging fear can ramp another up into a nightmarish fit of anxiety and irritability.

I cannot even describe to you what some of the side effects of psychotrpic drugs feel like. I can only tell you that the experience of them was so bad I would not wish them on my worst enemy. The best I can approximate is that it is like a drug trip gone VERY wrong. And my experience was not even worst case scenario.

And the worst thing is you are not experiencing these roller coaster rides as a strong, healthy individual. You go in already weak and broken and then the drug messes you up even that much more. 

Until you either ride out the first few weeks of your body adjusting to the drug and finally hit stability and then healing or you find the right med that works for you with no bad stuff on the side.

And then it is like a miracle. Because you suddenly feel so much better. And you never had to feel so much worse to get there.

And that was the real hope of the Genesight test for me all along. That I would find the right drug that made me feel so much better without having to deal with so much worse. Not even 50 pound weight gain and decreased labido.

After a talk with my husband (saint I tell you) I work up the courage to drop off the second drug at my pharmacy this morning. Because Genesight said it was good and my Doc choose it second. And I have to believe she wouldn’t send me home with anything that was bad for me even if it isn’t best.

And as I’ve typed this post I’ve gotten not one but two automated two from my pharmacy telling me they cannot fill this med until they get prior approval from my doctor. As if her prescription were not approval enough.

And while I wait for my Doc and my insurance company to agree on SOME medicine I can take for my illness, not my inconvenience nor my personal problem, but MY ILLNESS, I press on. I keep taking the 5mg of my old drug for a few more nights even though I can feel a difference now. It is nothing horrible or unmanageable. I can just feel that this net that was keeping me lifted up above the abyss of sadness and angst is slowly loosening its hold. It takes less to irritate me or work me up now. I feel a little more fragile. I cannot do as much in a day without coming to the end of myself.

So I’ll keep reading fiction and watching movies and drinking herbal tea and breathing deep and singing along to the radio loud and doing the hundreds of things I’ve learned through years of therapy and trial and error that keep the abyss at bay. And I’ll hold tight to the family and friends that surround me in a delicate time and hold me up and push me on and keep me going.

But there are moments when I am just so angry. Angry I have this disease of anxiety and depression. Angry that science and medicine are still so clumsy in treating it. And I’m furious at my insurance company that when I need them most they do their job in providing for me the least. That they refuse to do their job so they can improve their bottom line. That they take sick people’s lives which are already hard and make them even harder.

I pray that one day mental illness will get the treatment it deserves. Both from good science and research and from insurance companies who do their damn job.

Until then friends, just keep swimming.

 

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Letting Go of Controlling Other People

In the realm of learning to let go of things, letting go of controlling other people is a biggie.

Even if we are not particularly controlling people, there are certain people and certain times where we just want to put a pause button on what folks are doing, re-wind a little, and replay scenarios making changes in actions and behaviors.

Most of the time this is for the folks in question own good. Lots of time it is for our own good. People hurt us. People’s actions hurt us. Watching our loved ones suffer hurts us.

But guess what? We are not in charge of them.

This is a big issue in my house right now as I have a soon to be teenaged daughter and a son right on her heels entering puberty even as I write. Oh My Lord. They are doing a lot of things that don’t make sense to me. Frankly, they are doing a lot of things that get on my last nerve.

And technically, I am still within my rights to punish them for their actions and “make them” do things. But my goal is not to be in charge of their life, even if that means they make better choices. My goal is to raise them to become self-sufficient, well functioning adults. And for that to happen they are going to have to suffer the consequences of their own actions for a while.

Not that this is easy. It drives me crazy to watch my daughter go out in winter weather in nothing but short sleeves, a pair of jeans, and some flip flops. So crazy I can even hear my Grandmother complaining in her grave. It makes me angry to watch my son continue to have a zero for a homework grade in math because he did the wrong page of problems and he is too stubborn to admit he made a mistake. KIDS DO CRAZY THINGS AND THEY CAN MAKE PARENTS CRAZY TOO!

To help my sanity and yours too, I am going to repeat the best piece of advice I’ve heard in some time,

“They gonna do what they gonna do.”

Okay, I saw this advice on a dubious marriage “therapist” flyer on facebook, but let me tell you when I read it I clapped and cheered for I knew it to be true.

Right now my kids are gonna do what they are gonna do. And I can punish and nag them to death. Or I can let them suffer the cold, suffer the bad grade, suffer their own consequences. For in truth it is better for them to suffer these small mistakes now than big mistakes they might make if I cut the cord after controlling them for ten more years.

Not that I totally leave them to their own devices. 

No, we are still called to lead by example. (You’d better believe I wear my coat when it is cold). I still give advice one time and let them choose to follow it or not. And of course if they make a big bad choice they will be punished and counseled.

But I think in the meantime it might be best if I keep loving them at a small distance while they figure things out.

Because that’s how God seems to operate in my life. I am not controlled or micro-managed by God (frankly, sometimes I wish I were). But no, God gives us room to make our choices. Knowing that if we suffer enough from a mistake we might have the sense to turn around and follow God’s lead.

And thankfully if we don’t figure it out God in infinite mercy still sends in rescue teams to drag us out of our pit.

But when we just piddle around making less than smart choices that make our life harder than it has to be, I think God just shakes the Almighty head sadly and mutters,

“They gone do what they gone do.”

And God keeps on loving us still.

Identity Crisis

So as I’ve mentioned before in this Lenten series, my family is in the process of moving from one house to another.

If any of you have moved recently, you may have gone through the practice of staging your house. Since when I do something, I do it all the way, I have been staging away for weeks.

Let me just tell you up front that I live in a house with two tweens, two dogs, and two funky grownups. We all have our special things that we like and apparently none of these things fit into the category of appropriate house staging.

Normally this is totally fine. We are a pretty eccentric family with an eclectic house and we just roll with whatever.

My husband’s large icon collection. Cool. My daughter’s duct tape decor. Cool. My son’s Lego/paper airplane/origami/stuffed animal collections. Ok. His ball of fur leftover from the clippings of our beloved dog that has now passed on. A little weird, but if you keep it under the bed, okay.

As long as our house was our own, pretty much anything was acceptable as personal decor.

But then the clock started ticking on the day we would take pictures of our house and put it on the market. They day we would let strangers come in to see our home. Strangers we wanted to like our home enough enough to pay good money for it.

And then we started having awkward conversations with each other about how most American Southerners don’t consider icons of bleeding people cheerful decor. Even if the guy bleeding is our Lord and Savior on the cross.

I was pretty good at dishing out the “You’ve got to box up your icon collection/duct tape collection/furball collection” news flashes. However, I wasn’t prepared to eat what I was serving.

The day my husband informed me most 40 something women don’t display rock collections in their bedrooms or extensive shell collections in their bath, I was really taken aback. How could anyone not love a rock collection? I mean these were some pretty cool rocks!

So bit by bit we started boxing up the stuff that expresses our identities.

We started putting little bits of ourselves away so people would like us better.

And it was really painful. The kids both stopped talking to me for a day. I stopped talking to me for a day. I began to question my identity as a capable wife and homemaker.

If I had been so wrong about rocks and shells and acorns and leaves being beautiful home accents, what else was wrong with me that I didn’t know about?

The painful removing of quirks and eccentricities continued until one day my son said enough. After putting up his 50 paper airplanes, half of his lego sets, and all animal sheddings, he finally drew the line at our icon of St Francis that hangs right by our front door.

When I took down St Francis to put him in a box, my son firmly grasped the large icon, looked me in the eye and said, “NO. This is who we are. It stays.”

So he hung the icon back and there it will remain until it hangs in our new house.

And I am so glad. Because the fact that I love rocks is one thing. But the fact that I love and follow Jesus is another. And dear St Francis reminds me that my identity doesn’t lie in money or things or even nature, but in loving Jesus so much it affects everything I do.

And in the end it doesn’t matter if the people who come in to see our house like or approve of me. It doesn’t even matter if my friends and family like or approve of me.

All that matters is that God loves and approves of me, just as I am. No matter what. Because I am God’s beloved child. And my true home is in God’s loving arms.

Holding onto that identity is enough to see me through any circumstance, even this crazy move.

So this Lent, if you have to let go of something you love or feel a part of yourself shedding off, take heart. The core of your identity remains and will always be firm.

You are God’s beloved child. Your home is with Christ. Nothing can change that.

And a home that beautiful needs no decoration.

 

 

Anxiety and Depression

Anxiety and Depression

For many people who suffer from anxiety, depression can be an added struggle (two mental illnesses for the price of one!!)

I know that when my anxiety flares high I often have a bit of depression as well. This is one reason that SSRI drugs like Zoloft can be so helpful.  Not only do they treat the anxiety at its root, but they ease the depression as well.

I am not exactly sure why depression and anxiety go together so frequently. Apparently this is even more true with panic, possibly because the drama and exhaustion that come with panic attacks leaves us so drained and discouraged.

For me I know that with great anxiety comes a loss of abundant life. High anxiety is just plain limiting in a way that makes you feel your life is slipping away from you.

This loss of abundant life and ability for me leads to grief. Grief for the life I had before anxiety hit, grief for the way I wish life could be.

In addition to the grief I think there is often self blame. We can feel like failures for struggling with anxiety disorders. We may blame ourselves for not being able to “just get it together.”

For me the combination of grief and self blame can lead to depression. Once I can get some traction and see some progress in healing, the depression often begins to lift.

Another big factor that seems to link anxiety and depression is that they both are fed by and perpetuate negative thinking. The negative thoughts that come with one disorder can play right into the other.

When I asked my therapist husband about the relationship of anxiety to depression, he suggested looking into learned helplessness research. My understanding of this theory is that after someone has suffered a negative outcome so many times (in this case anxiety), they begin to lose hope on things being any different. They just give up and relent to the unpleasantness of their circumstances with no thought of things being any different or better.  If you want to know more about this you can click here. Be warned though, in the experiment they detail the researchers doing not so nice things to dogs, so if you are like me, that might upset you.

The biggest thing to remember about the anxiety and depression combination is that they are both very treatable.

In fact as I mentioned before the same medication and also same  talk therapy interventions help both.

So whether your anxiety led to depression or visa versa, know that it can get better.

There is always always hope for better.

So hold onto hope. And may healing come to whatever struggles you deal with.

Ancient Hebrew Stories: Taming the chaotic deep

Some of my favorite stories to read when I need to calm my anxiety are the ancient story of the Tehom.

Hebrew mythology tells that before the earth was created there existed Tehom.

Tehom is the dark, deep, chaotic waters that covered what was to become earth. When I imagine the Tehom I imagine churning dark waters filled with sea monsters and other dangers. Much like the churning dark of our subconscious it is a place that is home to many of our fears.

One of God’s first acts in creation was to tame the deep. God’s breath blew over these waters of chaos and separated them. Some were tamed to become the ocean and some were pushed up to become the waters of the sky. God created a dome to separate these waters creating a safe space in the midst of the chaos for people to live.

The next time we hear of the deep in the Hebrew Scriptures is in the story of Noah. In this story the waters of the deep are unleashed to destroy creation. Such is the power of the deep. But in the end of the story of Noah, God promises to never ever unleash the deep dark Tehom upon God’s people again.

The image of Tehom and God’s taming it come up again and again in Scripture.

Isaiah tells us of God’s promise

“when you pass through the deep waters, I will be with you; and through the rivers they will not overwhelm you.”

My favorite story of God taming the deep comes from the Gospels. Jesus and the disciples are in a boat on the Sea of Galilee when a storm comes up.  The chaos of the deep unleashes itself upon them with whipping wind and crashing waves. The disciples begin to panic with fear for their lives.

About this time they notice that Jesus is missing. When they find him sleeping below deck they ask him, “Lord do you not care that we are perishing? And Jesus does two things. He calms the wild deep with a word. And then questions the disciples, “Why are you so afraid? Do you still have no faith?”

ancient stories calming the deep

When I read this story (which is actually the story our anxiety management class is named after) I am comforted by two things.

There is one who has ultimate power over chaos.

I can trust this person with my life.

I know there will still be times when the deep threatens and the waters creep up around me. And there will still be times when I am afraid.

But the creator of the universe and restorer of my life reminds me gently and with compassion that I need not fear. I can trust the one who holds up the dome of the sky.

The waters will not overwhelm me. My God is with me even in the waves and I will not perish.

I wish for you calm seas tonight. But if the storms of fear begin to rage remember: You are not alone. You will not be overtaken.