Saturday, November 25, 2006

Look Out! He's Off His Meds!

I recently decided to phase off of the antidepressants pills that I had been taking. My decision revolved partly around a desire to see if my brain chemistry had gone to a state of self-regulation. The other part involved my pure laziness of not wanting to go through the hassle of finding a psychiatrist in Boston. Yes, I am really that lazy.

Don’t worry, though. I still have enough Xanax to immobilize a small rhinoceros or enough to make a large rhino feel pretty darn good about his life.

I have gone through different periods of needing the ol’ head meds. While in grad school, I found that I suddenly had some serious anxiety issues. “You, GayProf?” I hear, “No, you are so calm! Nothing suggests that you are predisposed to an anxiety disorder. You never worry about anything.” Shut up, sarcastic voices in my head.

By anxiety, I don’t mean, “Oh, gee, flying makes me feel little queasy.” Rather, I mean, “How many years in jail will I spend if I force this pilot turn around the plane so that I can get out of this flying tube of toothpaste?”

During that time, I found out that depression and anxiety involved the same chemical processes in the brain. This information made me both sad and worried.

Going through the stress of a divorce and a quasi-hostile work environment only brought these feelings back once again post-grad school. In both instances, meds proved critically important to keeping me functional. Well, they kept me as functional as I ever could be.

I bring this up because in my tours around the blogosphere I have found that there is still a major stigma associated with antidepressant medication. Other bloggers have discussed either their decision to go on or off meds. While well meaning, time-and-time again they get commentators who claim that they “should try to be stronger” or that “meds are just a crutch.”

This type of thinking leaves me cold and prevents people from obtaining some valuable treatments that can improve their life. Just a crutch? Um, don’t crutches help keep people mobile? Would you say that the guy with a broken leg is better off just laying on the floor? Better he be an immobile blob than use a crutch. Using a crutch, after all, is a sign of weakness.

In other circumstances, the same well-meaning people suggest that I and others should try “natural” solutions. Um, okay, that’s akin to the Vatican’s stance on the birth-control pill, which they see as "unnatural." Both the pill and antidepressants work with the body’s existing chemistry. Of course the “natural” rhythm method proposed by the Catholic Church has also earned the nickname “Vatican Roulette” due to its level of effectiveness. Such “natural” cures for medical depression have the same dubious results.

Look, I take pretty okay care of myself. I eat more than I should, really. As a result, I also spend a good amount of time at the gym. Most times fruits and vegetables make it in my diet somewhere. I also make sure that I am always in bed by ten. Of course, I don’t get home until one, but that’s another issue.

At this point, we should all know that serious depression and anxiety occur from physiological irregularities. My body simply breaks down from time to time in its ability to regulate the level of serotonin in my brain. If I can take a pill to make that work again, don’t sweat me, man.

As with all medication, I understand there are people who abuse antidepressants. There are also doctors who wrongly prescribe them. These, though, are the minority of cases.

Comprehensive studies on antidepressant use have not yet materialized. From the information available, though, use of antidepressants are on the rise in the United States. Most people, though, report initial hesitancy about starting such a drug, largely because of the social stigma or that it is a sign of “personal failure.” Yet, most people who start antidepressants also phase off of them within a couple of years. They usually report that the drugs helped return a sense of balance during the period of use.

Contrary to popular belief, the drugs do not end one’s emotional consciousness. Rather, they provide a space to both balance one’s internal chemistry and also come up with strategies for living.

Of course, the drug companies are not helping matters. In a quest to sell ever more of their product, they trivialize the seriousness of depression or anxiety. Instead, they imply that simply taking a pill will solve your greatest problems from shyness to bankruptcy. There are also legitimate concerns about giving children medication created and tested on adult physiologies.

Still, a myth continues to exist that if you need an antidepressant then you are slothful, lack self respect, and are probably self-indulgent. Over and over again, we are told that a “successful” human would simply walk off the pain and just get over it. Quite frankly, that’s not always possible.

That’s why I am not inclined to obscure my use of antidepressants. As I phase off them now, I know it is likely that I will need them again at different points in my life. Like an asthmatic sometimes needs an inhaler, antidepressants have kept me in the game. And I am not alone.


Earl Cootie said...

Hurray for modern medicine! I could probably go for some anti-anxiety meds myself, but I'm too anxious to see a doctor about it. So I bum from my partner when I feel the need urgently - usually before social engagements. I remember the first time I took Xanax, the wave of calm that washed over me. When later, I recounted the feeling to a friend, he ribbed me with "That's how normal people feel all the time."

I tried the St. John's Wort, but that never did it for me. Though my partner swears by it. But he also claims to feel a wave of wellness (hate that word) whenever he eats large quantities of basil. (We're fond of pesto chez Cootie.)

So med away! Or not. That's for you and your doctor to decide.

Earl Cootie said...

PS - That was not an endorsement for self-medication btw. Because I totally abhor that practice.

Doug said...

I am always in bed by ten...I don’t get home until one...

Woo hoo! You go boy! ;)

In all seriousness...

Where others perceive a stigma, I perceive a badge of honor. Taking medication for my problem shows I'm strong enough to admit I have a problem and to seek a solution. Those who dismiss depression as something to be "walked off" are ignorant, plain and simple.

As far as natural solutions, I have tried several and found none as immediately and completely effective as synthetic drugs. I keep trying new things as I discover them, because the drugs also have their side-effects, but so far I'm still with Effexor.

And no, you're definitely not alone. If you ever feel like you're alone, contact me.

Cooper said...

Good luck with the phasing-off, I know it can be a rough process.

As for the stigma of medications: I am able to completely disregard people that are willing to take psychiatric advice from the likes of Tom Cruise. They seem like the crazy ones to me...

ZaPaper said...

I have had some problems with anxiety--not sure if it's "real" or just a natural side-effect of grad school--but have been scared off Xanax etc. by the potential side-effects. Sleepiness and memory problems would be really bad for me as I'm borderline narcoleptic and in a field where everyone expects you to be a walking encyclopedia. Have you noticed that kind of side effects? Is the "wave of calm" thing worth it? I've never actually tried it, I confess.

r said...

Gayprof, how do you say what I think so much more eloquently than I ever could?

No one has to apologize for having
cancer, or a broken leg, nor are they expected to "snap out of it." Somehow, depression is supposed to be something different.

I'm not now taking any of the five different meds I once took, for depression, anxiety and sleeping problems, but every time I start thinking my "bad thoughts" I worry that the cycle is starting all over again.

It really is a part of ourselves we don't understand.

Do whatever it is you need to do, but don't go cold turkey; that's just not the way to go. And prof? Find a doctor now, when you don't really need to. Much easier than waiting until a crisis happens.

Just sayin'.

dykewife said...

i've been on paxil generic for nearly 5 years now. were it not for that medication i wouldn't have changed jobs (and thus been laid off or had my pay cut drastically) nor would i be in school. i have depression accompanied with anxiety. the anxiety is related to being out of my house and around groups of people. you can see how that would have been somewhat detrimental to returning for an education at a crowded university.

of late, though, i'm finding that the anti-depressant isn't doing what it should. my thinking is cloudy and i'm having trouble concentrating. i'm tired all the time and leaving the house is a major fight. however, gaining the motivation to get the the dr is hard. i have a sneaky suspicion that i'm going to be pretty much writing off this term as a lost cause and making sure that i get to the dr. soon to change or up meds. :(

i hate that people think of depression as laziness. even my dad does. next time i hear "buckle down" or other shit like that i'm going to ask him if he tells that to my schizophrenic step-nephew.

enough of me. thanks for your entry

GayProf said...

Earl: I don't know, I think Xanax is extra calming. I am not sure it is the way most people feel all the time. Otherwise, why would people take it?

Doug: Yeah, the natural solutions never worked for me. Nor did increasing or decreasing exercise.

Cooper: Tom Cruise is just the most extreme case. Who knew that I would side with Brooke Shields over anything?

ZaPaper: Xanax is usually just an occasional use thing for moments of extreme panic. It will make you sleepy for sure.

My regular drug, Lexapro, did not have the side-effects that you mentioned. It had others, though. It's often a question of balancing the side-effects with the need for the drug.

Rebekah: Yeah, I know I need to get a doctor. I also need a dentist. One day I will be a responsible adult. **Sigh**

DykeWife: You might give Lexapro a shot. Paxil never worked for me, but Lexapro basically banished almost all of my anxiety problems.

It's funny how each different drug really works on people in unique ways. They all are based on the same principles, but they are distinctive.

Delta-Eighteen: Yeah, if I spent more time writing and less time reading blogs I might just get tenure.

Marcelle Proust said...

Totally with you on the crutch thing--when you need crutches, of whatever variety, you need them. When you don't, you stop using them, usually slowly. Xanax makes me sleepy in larger doses but not in small ones--ZaPaper, you can cut pills in half or quarters and experiment with small amounts.

Anonymous said...

I hate it when people think "just get over it" is an acceptable response to anything. The stigma of mental illness cuts across all social groups. I think we need to remind ourselves that, directly or indirectly, some form of mental health problem affects every one. Prescibed drugs is an effective tool just like wearing glasses when you need them, or as you said, using crutches.

"Normal people"... who are they? I'm an anxious, insecure, over-analyzing worry-wart, and I think I'm probably more "normal" than not.

Anonymous said...

It's funny you should write this around the time I'm considering going on Prozac at the recommendation of my therapist, but it's good that you did, as you made my decision to go on easier.

Anonymous said...

I suffered a major bout of anxiety/depression in my junior year of high school. I was prescribed Paxil and I didn't even think of not taking it. I never felt any social stigma attached to it and, even if I had, I wouldn't have cared. I felt so awful I would have done anything to feel "normal" again. And it helped! Though still riddled with neuroses, I'm a much happier and well-adjusted person than I ever was as a child or adolescent. Only problem is, I can't seem to get off of it! Whenever I go off Paxil, even for just a few days when I forget to call in my refill, I get terrible headaches and I dream so damn much that I can't get any rest (I think it has something to do with the serotonin levels).

Regardless, though, I thinks it's crazy not to take advantage of any tool you can to get well. And when you are, or they just aren't right for you, nothing wrong with going off them.

Anonymous said...

Better living through chemicals! (or not)

There might be a stigma attached to psychotherapeutic pharmaceuticals in other parts of the country, but in California, at least in the nineties, they were all the rage. Of course, academia is made for psychotropics (what with everything one must deal with in the Biz), and a good two-thirds of the doctoral candidates in my program were on something during my time in school. I think the tide has turned now, and they've moved on to Estrogen or "T." The times are a-changin'...

Just like Bonnie Franklin, you gotta take it one day at a time, and if that means a pill for breakfast, a pill for lunch, and a sensible dinner, well then God bless your soul.

Oh, yea, the depression as laziness/sloth thing is absurdity, as anyone who has faced depression can attest.

If your phase-out doesn't go right, hopefully you can have a Nelly O'Hara-like convalescence! "I beat booze, pills, and the funny farm!" You Go, Gurl!

tornwordo said...

I would wager that those who disparage antidepressant use have no experience with them. Further, those same people must have (the utterly wrong) conclusion that everybody is

In related news, did you catch 60 minutes last night? There's a new drug on the market that cuts the emotional connection to traumatic memories. Memories that often trigger anxiety episodes for years. There is an ethical debate going on similar to the one you described at the beginning of your post.

Anonymous said...

Brilliant, as usual, GayProf.

Alcoholism, depression, serious eye disorders and heart disease gallop through my family.

Ain't I lucky?

It seems I've dodged a bullet on alcoholism, and so far heart disease isn't a problem. I am, however, blind as a bat. Ah well, one out of four...

Except in my early 30's. I spent 18 months caring for a dying parent and when she finally passed I was completely lost. Couldn't function. Six months later I went to a psychiatrist and was diagnosed with social anxiety disorder and depression. I wasn't convinced the diagnosis was correct, and I'm still not, but I followed orders of therapy and medication. The medication helped but the sleeping side affect was really bad for me. Thankfully the people I worked for at that time knew what was going on and we're totally supportative of me - even when I fell asleep sitting upright in meetings. They handled it, and me, with compassion and humor because I kept them in the loop.

I didn't care that other people knew I was in therapy and on medication. A month into the medication some jackass made a crack about me needing a crutch. I looked him dead in the eye and whispered "you should be grateful I don't have a crutch with me because it would be sticking out of your head right now." He backed away and STFU. I went off paxil after six months and was able to leave therapy after a year. It got me over the hump and it was one of the best things I've ever done for myself.

As Rebekah said, no one apologizes for having cancer - or heart disease or diabetes or anything else. Depression is a fact of life; not dealing with it is not a good idea.

Our own minds are the last great frontier.

Artistic Soul said...

My partner is going in today to get back on meds after a long lapse, and this is exactly what he and I needed to read this morning. Thank you.

Helen the Felon said...

Yeah, totally with you. You covered all the bases of argument here. I had to stop taking Zoloft because it made me into a complete robot (which was kinda nice for me, but evidently not so much for everyone who had to deal with me. Pussies.)

I've found Cognitive Behavioral Therapy to be much more effective in combating my cyclical depression, but sometimes the meds are needed to get a person (okay, me) up to enough of a functional level to do the work the therapy requires. This last go-round took a lot longer to get through, sans meds.

Yes, meds are crutches. But crutches, as you pointed out, are valuable tools. (Unlike Republicans, who are just, you know, tools.) The danger, I think, is meds without therapy. A person on crutches needs physical therapy to walk again...same principle applies with anti-depressants.

Boy, that was a lot of babbling. I think I'm sliding into a manic phase. Sweet.

Charles CĂ©leste Hutchins said...

GayProf, your gravitas is a shining example for us all!

I've read, however, that anxiety and depression are not caused by a lack of seratonin. SRIs like zoloft cause our brains to be flooded with excess amounts of seratonin. This makes us relaxed and happy (when we aren't sad and worried about what the long term effect of seratonin flooding might be).

I'd like to stop taking zoloft, not because it's a crutch but because it's expensive and I hate having to see doctors and finally because I worry about long term effects. However, in the mean time, I've got a 4 month supply and don't have daily panic attacks anymore.

Heh. I am also messed up from a stressful gay divorce. Lying exes who tell many lies really suck. And not in the good way.

GayProf said...

Marcielle P I actually like the sleepy side-effect of Xanax.

Marcus: Given that both of my parents have had semi-rare thyroid conditions, this information is of great interest to me.

Cooper: Well, we all think that we are normal. Perhaps, though, we all are.

Chad: Good luck! Remember, if Prozac doesn't work for you, ask your doctor to try other drugs instead. Sometimes it requires a bit of experimentation.

Frank: I agree. If your life is better with the meds than without, why worry about getting off of them?

Oso: Like Nelly, I take the blue ones.

Torn: No, I missed that report. What is the ethical debate? People should feel the pain of traumatic memories?

Laura Elizabeth: I never had the sleeping side-effects that other people seemed to have had. Then again, I fall asleep in meetings regardless of meds.

Wiccachicky: Good luck to your partner!

Helen: Yep, therapy is also critical. It's damn hard to find a good therapist, though.

Sometimes I have also wrongly ignored the advice of therapists. All the way back in grad school, two different therapists suggested that I get away from Liar Ex (Who Told Many Lies) years before he actually dumped me. Damn their Cassandra-like insights.

Les: Yes, Liar Ex's (Who Told Many Lies) do suck. I am here to tell you, though, that your life is going to be much, much, much better without a Liar Ex darkening your home.

Margaret said...

I love my drugs.

That is all.

The Persian said...

I have been thinking of starting something soon, I have had anxieties pretty much my whole life. I guess I keep putting it off because you can't usually drink while on them, and I won't have any part of that! :)

I am convinced they would enable me to take part in more of activities I know refrain from because I get stressed, such as going to a mall or attending social activities where I do not know the participants very well. Hell even dating more often.

I have had an Effexor prescription sitting in my bathroom cabinet now for about 3 months. Perhaps I'll start taking them soon.


looking_down said...

"During that time, I found out that depression and anxiety involved the same chemical processes in the brain. This information made me both sad and worried."

That line was the funniest thing I've read all week. I'll be your dentist anyday, Gayprof.

Anonymous said...

Good grief! Is anybody not taking them?

Courageous topic that obviously struck a chord. I salute your candor. The range of emotions expressed in your history of posts shows that you still do feel, but, for me, both anti-anxiety and antidepressant medications squelched too many other emotions. On the antidepressant I was no longer depressed, but I no longer felt creative, curious, compassionate or much of anything. Rather than helping me to tackle problems, the medication allowed me to ignore them. I opted for talk therapy. Although skeptical, it did work.

I also gradually cut my dosage of Paxil. On it I no longer felt anxiety, but I was no longer angry at George Bush. What? I found that to be an unacceptable trade. I never realized that fear and anger could be so entwined. Fight or flight, I guess that makes sense. While anger can be a destructive emotion, without any I was too complacent to fight back. I am not holier than thou. I still take a daily, miniscule quarter of a pediatric dose of Paxil to keep from spinning off and have an emergency supply of Xanax for those flying toothpaste tubes. (GayProf, me, too!)

I found anxiety and depression to be two very different beasts, although the two can occur together. When an individual is truly clinically depressed, s/he should take the medications available, no argument from me, but the percentage of people on antidepressants in this country is alarming. Isn’t there danger in soothing our collective depression instead of attempting to fix the problems that cause it? I’ve produced some dots, including control, that I really don’t want to connect. The world’s a f##ked up mess. Depression and fear are understandable reactions. Should I medicate myself into complacency? The jury’s still out, but I’m hanging on to my emotions for now.


Anonymous said...

Amazing insights, as always ... I can't seem to bring myself to get to a doctor (for all sorts of reasons) though I've come to realize (because it's so blatantly obvious) that I have some sort of anxiety disorder. What works incredibly well for me, though, is a homeopathic remedy - Boiron's "stress" combo, called Sedalia. It costs all of about $8 at pretty much any natural foods store, works for me within about a day, has no side effects or drug interactions at all, and I can start/stop at will. (And no, I'm not getting kickbacks and don't have stock in Boiron or any such thing!) Of course, being the anxious sort, I worry that if I take it too often I'll develop a tolerance and it will stop working so well for me -- but for now, it's my over-the-counter miracle drug. The whole world looks different to me when I'm taking that stuff, and it helps me recalibrate longer-term. Perhaps a good stop-gap option for those weaning off "standard" meds, or an alternative short-term fix? (And for the record, another Boiron remedy, Oscillococinum (sp?) is the best thing around for flu ...)

Anonymous said...

I really hope that things go well. I would feel very frightened myself. Although, yes I am also that lazy about finding a doctor who will solely do medication managment (why is that so difficult? aren't there any psychiatrists who just want a quick buck? I thought they were supposed to be the sons of perdition!). Hopefully it goes well, and I appreciated your very insightful remarks. Better living through chemistry I say. There are so many ways we alter the "natural" or "authentic" life. Hell, we should all turn off our electric lights with the sun so we don't mess up our brains sensors and dopamine and seratonin levels. Once again, best of luck (and it is true that I know so many people that took them for a short while and then stopped, well, that's probably an indication of not having the same sort of need as others do).

Elizabeth McClung said...

Wow, this subject really does bring out a lot of opinions. I do find it interesting that people tend to talk about anti-depression meds when they go OFF them - which seems to say a lot about the stigma.

I personally believe that a) anti-depession meds are the best invention since insulin and b) anyone involved with them or doctors who prescribe them should go in with thier eyes wide open (meaning, if every time you go to your doctor with a chest cold, he prescribes prozac because he says it is "stress induced" - get a second opinion).

My other feeling is that because in our society depression is so little talked about and hidden, that people feel free to say really stupid and ignorant things to people who have lived with the condition for say 20 year and know what is what. (I am imagining a conversation between Van Gogh's brother and a neighbor - Neighbor: "Has he tried bee's pollen, I hear that works?", Brother: "He just cut off his EAR!"; Neighbor: "What about ginko?")

I have been there when someone told a friend that thier depression could be cured by acupressure - of course they didn't know that 1/2 of her family had already killed themselves from depression. I dunno, I guess sometimes people forget that for some people depression and other linked disorders are a potential life threatening illness - yet again, one which is treated as if it is a "lifestyle choice" - Until the suicide rate drops to 1/10 of where it is now I say, ON WITH THE PILLS (and therapy)!

Anonymous said...

I have gone through a part of my life when anti-depressants helped me considerably BUT (there always is one isn't there?) I began to feel I was being buoyed up artifically and it was also affecting my decision making at work as a lawyer.They become a crutch to the extent that it feels like going on the flying trpaeze without a safety net when you first come off them. The other problem with them is that they take a while to start to take effect when you are first prescribed the medication and for you to come off them completely so that the medication leaves your body.So what do you do? You have to bow to the power of the medication and take advantage of the benefits but after 3 months or so I think you should be seriously thinking about reviewiing your medication and thinking about coming off it if you can. I had a phase where I thought I did not need the anti-depressants and then began to deteriorate and was told to increase my dosage.So think carefully and try to find a doctor that you can trust to be able to talk it through carefully.

One other issue as a lawyer is that I dare not disclose my illness of clinical depression to my professional indemnity insurers and in fact I have made a few quite bad mistakes during my depressive illness upon which claims have arisen. I know if I were to disclose all this there would be problems for me. I am relying on my previous unblemished history of professional negligence claims so that it will appear to be some sort of blip.

Anyone else in this situation?