Me 3.0 – Now With Triple The Effexor

Back in March I wrote about my ongoing struggle to manage my chronic depression and anxiety and how my doctor prescribed 37.5 mg. a day of Venlafaxine, the generic form of Effexor. 37.5 mg. is the lowest dosage, and for a while, it was enough.  Since I was first diagnosed with chronic depression in my 20s, my depression has always been seasonal. I needed medication from around October until around May and skip it in the summer.

 

Well, this past summer showed me that my depression is no longer seasonal.  Things were so bad this summer that I couldn’t even blog about it, because I was just trying to get from one day to the next.  I was a mess. I couldn’t sleep more than a few hours a night, which I know didn’t help.  I was just angry, all the time, about everything.  The slightest thing could set me off, I was yelling, and constantly bursting into tears.  And it took me WAY too long to ask my doctor for help.

It never even occurred to me that the problem was not enough medication.  There I was, fighting with my husband every day, constantly feeling like he didn’t understand me,  to the point where I was worrying that he would move out, or ask me to, because the fighting was unbearable.  I felt like I was in quicksand and sinking fast.

I hate that now I know that all I needed to do was take more medication.

The reason I had only been taking 37.5 mg. is because when I tried taking 75, it made me feel jittery, like I was crawling out of my skin. So I told my doctor about the fighting, and the crying, and how I just felt like something was wrong, but I wasn’t sure how I would feel if I took a higher dose. I didn’t want to end up chronically disheveled and hooked on internet bingo or something. I had been taking a 24-hour extended release capsule, but my doctor had a better idea.

She switched me to tablets that last 12 hours, and suggested I try taking one 37.5 mg. tablet in the morning, and then two 37.5 mg. tablets at night before bed, with the idea that the initial jittery feeling would happen while I was already asleep, so I wouldn’t notice it.  And people, it WORKED.  In a way I never ever expected.

By the beginning of the second week of the new regimen, I realized I no longer felt anxious all the time.  Not only did I stop feeling like I was sinking into a hole I wouldn’t be able to get out of,  I felt…normal.  Like, this is what normal, non-depressed, non-anxious people feel like.

I stopped assuming that every glance and gesture from my husband was some sort of personal slight. I stopped bursting into tears because something didn’t go right when I was cooking dinner.  It was like I woke up to my own life.  And something else happened that I never would have thought I just needed more medication for -

I’m losing weight. I’ve lost my craving for fast food and junk food.  I looked it up in Google, and the chemical Serotonin which is mostly found in the body’s gastrointestinal tract, contributes to feelings of well-being and happiness. Carbohydrates also increase the body’s serotonin level. I was trying to raise my own serotonin by overeating carbs like breads and crackers and chips.  Effexor helps my body use it’s own serotonin more efficiently, which means I’m no longer craving carbs.

I’ve lost just over six pounds in two and a half weeks.  I eat regular meals, but I don’t feel like snacking at all.  We had McDonalds for dinner last night as a treat for the kids, and it didn’t even taste all that good. I ate half a hamburger and half an order of small fries and that was enough. The old me would have eaten all of it and still had a snack later.

I’m sleeping much better at night, too.  I know I’m sleeping more deeply because I’m not having weird, vivid dreams all night long, and I can actually get right up when the alarm goes off. This is huge for me.  I’m trying not to beat myself up over the fact that all I needed to do to avoid all the hell I put my family through was tell my doctor and get a higher dose of Effexor/Venlafaxine.

I’m so lucky that Chris and the kids understand that it wasn’t my fault and have forgiven me for everything. And I know that medication doesn’t solve everything, I still need to figure out how to recognize when I need to ask for help.  And I’m so grateful that this dosage of Venlafaxine is working.  I’m so grateful that I’m out of the quicksand and living a real life.

 

 

 

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Struggling.

Effexor XR 37.5mg / 75mg 2 weeks sample pack front

Image by gloom via Flickr

It used to be that when I saw a character in a TV show having a meltdown and it turned out that it was because they weren’t taking the medication they needed,  I would think to myself “jeez, how hard is it to take a pill every day?”  Hypocrite, thy name is Elizabeth.

I certainly don’t wake up in the morning and decide that I just won’t take my medication. The bottle sits on the kitchen counter in plain sight. But since we went down to one car, the days that I do have the car are spent running around trying to get errands done that can’t be done on Tuesdays and Thursdays when I’m house-bound.

For newer readers, back in February of 2007 I had three moderately severe anxiety attacks. My doctor changed my antidepressant to the generic form of the  antidepressant/antianxiety medication Effexor.  If I take it every day, the fog I would walk around in otherwise lifts, and I can participate in and enjoy life.  Problem is, I get to a point where I’ve been feeling good for a while so I start skipping pills. I’ll be okay for as long as a week, then I’ll realize the fog is creeping back in.

To make matters worse, we had a problem accessing our Health Savings Account.  Chris has money taken out of every paycheck, pre-tax, and deposited into an account that we can use to pay co-pays.  They mailed us new cards at the beginning of the year, and somehow, we lost them, so Chris called and asked for a new set to be mailed to us. Two months ago.

Now, I could pay out of pocket for a prescription refill and then fill out a form on the Health Equity website to be reimbursed, but a full 30 days of Venlafaxine is not cheap. So I’ve been having the Target pharmacy sell me two weeks’ worth of pills at at time,  and then I ran out of those. It’s a stupid excuse, I know. My mental health should be my top priority.

But come on, Moms know, it’s hard to make yourself the top priority when you have a husband who commutes and three kids and have to keep your blogs updated so the ad money doesn’t dry up and your daughter needs new pajamas to wear to the Read-In at school because it would be too embarrassing to send her in the worn out ones she normally wears and etc. etc. etc.

So, I’ve been struggling. That’s what’s been going on with me.

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Got my head shrunk. Felt weird.

As part of the pre-Optifast testing I went through, I had an hour and a half consult with a behaviorist named Richard. I forgot to ask him if he was a psychiatrist or a psychologist, googling the word behaviorist made it seem like it could be either. Before the appointment I filled out a 12-question questionnaire, so he had that, plus the 15 other pages I filled out about my perssonal, medical, fitness, and weight loss history.

The questions I answered were about my mood over the seven days previous, and I had to say whether they had been less likely, more likely, or extremely likely to occur. Questions like “I felt irritated at my family and friends”, “I felt hopeless”, “I found myself getting angry easily”. Of the 12 questions, I answered that four of them had been “extremely likely” to occur. I don’t even remember which four, although I’m happy to say I answered “less likely” to the feeling hopeless one.

What amazed me is that from my answers to those questions plus a couple he picked out from the 15 other pages, Richard was able to pretty much figure me out exactly. He knew, even though it wasn’t a specific question, that my Dad had been emotionally distant and wasn’t home much while I was growing up. He knew that the beginning of my weight gain coincided with my moving out of my parent’s house, that I felt like I had to grow up too fast. I don’t know what I was expecting, but it wasn’t for him to figure me out that precisely.

He said I was a perfectionist, compulsive, and have “interpersonal hostility” tendencies. He’s not wrong.

Despite being treated for chronic depression since my mid-20s, I’ve never had counseling or therapy. Insurance doesn’t cover it, and I always felt like nothing I had been through was really that big of a deal that it needed professional help to get through. According to Richard, I’m wrong about that. Twice during our session he suggested a find a counselor and get some help to work through some issues. Imagine my surprise at hearing that.

The thing is, there was something that happened to me when I was a child that I’ve always known has affected me throughout my life. I’ve never written about it here because I…well…I don’t know. I don’t want to be looked at as some kind of victim, I don’t want the label. I feel guilty because there are people who have been through truly horrible things as children, and my tiny, one-time-only thing seems so insignificant compared to that. Who am I to whine about one thing when others have suffered so much?

Does that make any sense?

Here’s the thing about the session with Richard that also surprised me – as I sat there walking him through my life from childhood to now, telling him all my deepest secrets, I felt better. He said things like “I’m so sorry” and “you were right to do that” and “that must have been so hard for you”. I never knew how good it would feel to have a professional hear me out and let me know that it’s okay to feel bad about the mistakes I’ve made, and that I can overcome them.

That I do not have to be defined by who I was.  That I can start from right now and be better.

I have a long, long way to go, people. I have at least 65 pounds of fat to lose in order to just be “overweight” and not “extremely obsese”.  I’ll have to confront my feelings about food, and hunger, and comfort. I’ll have to deal with how being a smaller size makes me feel.  I’m terrified about all of it. My fear of failure is so great that I can’t even believe I’ve gotten this far, and I haven’t even really started.

It helps to know that all of you are out there.