Thursday, July 15, 2010

Jagged Little Pill, part 2

I recommend getting your heart trampled on to anyone
I recommend walking around naked in your living room
Swallow it down (what a jagged little pill)
It feels so good (swimming in your stomach)
Wait until the dust settles 

You live you learn
You love you learn
You cry you learn
You lose you learn
You bleed you learn
You scream you learn

I left Nebraska for college. I wouldn't have wanted it any other way, because I did make (and even keep a few) good friends there and, of course, moving to Texas allowed me to meet Ross. But I didn't know that freshman year. I just knew I was homesick, and school no longer came easy to me. Anatomy and Physiology was a Junior-level class and the School of Nursing used it as a weed-out class from freshmen. I loved A and P in high school, and I loved learning in the classroom in college! But I had no discipline and the sheer volume of information combined with my habit of procrastination overwhelmed me. I spent time on the phone with my long-distance boyfriend instead of studying and meeting people beyond the first few weeks of school.

One afternoon (late fall or early spring of my freshman year at TCU), I ate almost an entire bag of Oreos by myself on my top bunk and realized I needed help. I made an appointment with Student Health and the doctor there put me on 75 mg of Effexor XR. Zoloft is a Selective Serotonin Re-uptake Inhibitor (SSRI) which means that it allows serotonin to remain in your nerve synapses longer, therefore enabling it to last longer and act as if I had more serotonin circulating. Effexor is an SNRI, meaning it works on norepinephrine in addition to serotonin. It worked better on my dual symptoms of depression and anxiety.  I started feeling better again and was able to meet new friends. Best friends.

I was so happy! Yet somewhere in there I'd turned my 75 mg of Effexor XR into 150 mg to quell anxiety.  And there I remained. I was literally maxed out an a very strong drug and my mood and attitude started to worsen again. Notice a pattern here? Short of switching to sedatives, I felt there was nothing else I could really do (although that my have been my warped all or nothing attitude talking).

I recommend biting off more then you can chew to anyone
I certainly do
I recommend sticking your foot in your mouth at any time
Feel free
Throw it down (the caution blocks you from the wind)
Hold it up (to the rays)
You wait and see when the smoke clears

You live you learn
You love you learn
You cry you learn
You lose you learn
You bleed you learn
You scream you learn

Some people hate being on antidepressants because they "don't feel anything" or "can't cry" when they want to. I did not have this problem. I had 1,000 thoughts swirling around my head at any given moment and couldn't focus on any of them. I had terrible mood swings (not manic, but definitely swinging between "life is great" and "I hate my life" day in and day out to the point of exhaustion). I still cried, often on the phone to my boyfriend or my parents. I quit trying for months at a time. If not for the Effexor, I probably wouldn't have been able to get out of bed and go to class some days. Even with the meds it was a struggle.

I was so focused on the idea that my eating disorder in high school was the root cause of my problems, not realizing that every day I burrowed a little deeper into myself was compounding the real root of my problem: depression. I thought I was still running from my high school problem and it took me a while to realize I was adding to my list of regrets as I stumbled forward while focusing so intently on what was already behind me.

The best of times were when I reached OUT of myself and made friends.

I miss college for the sheer fact that it was a built-in community of people with like interests, and most lived within walking distance! No parents, no curfews, and not even 8 hours of class a day like high school! But I rarely took advantage of this. More than not studying abroad, more than not earning the grades I know I could have, more than anything my biggest regret from college is not making many friends and not keeping the friends I made. I either lost touch with friends I made the first two years of college, or I burned those bridges through stupid, selfish decisions.

I graduated college still taking my Effexor XR and found a great doctor in Fort Worth. We talked about the possibility that my anxiety could possibly be stemming from ADD as well. I seemed to fit the criteria-- not the sterotypical hyperactivity, but the more subtle symptoms: a terrible memory, a reputation as a scatterbrain, lack of organization, procrastination, shutting down when I was under too much stress... the symptoms fit me to a "T." However, after trying 2 different medication with no success, I quit. One psychoactive drug at a time was enough for me!  A little niggling thought had been worming it's way around in the back of my head and I realized I'd been medicated for my entire adult life. I didn't like that.

By 2009, nursing school was far enough behind me, I was on day shift at a job I loved, my wedding had come and gone, and I realized I was using my medication as a crutch. My doctor (thankfully) said that stopping my Effexor was a bad idea since we had a big move coming up and just because I was done with school didn't mean I wasn't in the midst of a number of stressful events.

We decided to compromise by weaning me from 150 mg (which I'd been on for 5 years) down to 37.5 mg.  This took about 6 months of gradual weaning accompanied by nausea, dizziness, and vertigo every few weeks. But the encouraging thing was that my mood wasn't necessarily worse. Yes, I cried easier the weeks I moved to a lower dose, but my day-to-day functioning wasn't affected. This supported my suspicions that Effexor was a security blanket for me by that point. Even as I remained at 150 mg, my symptoms went up and down over the years and the medication seemed to have less of an effect as time went on.

I was so proud of myself for lowering my dose so dramatically (Effexor is one of the hardest prescription drugs to come off of, and the risk of lifelong dependence increases after 5 years). When I was comfortable on 37.5 mg, my doctor and I decided I'd stay on that low dose through our move. Then I stayed on it because being back on night shift was so unbelievably stressful.  This spring when I turned 25, day shift was near and I felt that it was time to grow up. I really need to be crutch-free and face my issues upfont. No more denial!

A week before my birthday this past April, I started taking my 37.5 mg pill every other day. Two weeks later I moved to every 3rd day, two weeks after that it was every 4 days. After about a month and a half, I was off mood-altering drugs for the first time since my 18th birthday!

As long as I can still get out of bed in the morning (a fairly obvious litmus test for day-to-day funcioning), I will remain off of my medications. I'm focusing on exercise as if it were a prescribed medication and I'm eating more plant-based foods. A huge percentage of serotonin is produced not in the brain, but in the intestines. Clean food has more to do with a good mood than we originally thought.

Yet I am still facing an inordinate amount of anxiety and melancholy. And it's scary to face these things head-on and alone. I have a sneaking feeling that this is all one big life lesson. Indeed, it's THE big life lesson. God has taught me that I cannot rely on medicine for happiness. He's currently teaching that I cannot rely on myself, either. Although this one's taking a while to learn thanks to my stubbornness (Can I ever do just one thing right?! No). I suspect that the big secret here is that I don't have to face it all alone. I know (I've always known) that He is the answer, but I'm wasting so much energy trying to prove to myself and others that I can face my own fears and get through them, even as I'm coming to the realization that I can't.

Augustine says, "Thou hast formed us for Thyself, and our hearts are restless till they find rest in Thee." I know God has taught me that I cannot rely on medicine for happiness. And He's currently teaching that I cannot rely on myself, either. Although this one's taking a while to learn. I know (I've always known) that He is the answer, but I'm wasting so much energy trying to prove that I'm a big kid. We all know I'm not. I'm nothing without Him.

A. W. Tozer says:
God made us for Himself: that is the only explanation that satisfies the heart of a thinking man, whatever his wild reason may say. Should faulty education and perverse reasoning lead a man to conclude otherwise, there is little that any Christian can do for him. For such a man I have no message... I speak to thirsty hearts whose longings have been wakened by the touch of God within them... Their restless hearts furnish all the proof they need. 

...God formed us for His pleasure, and so formed us that we as well as He can in divine communion enjoy the sweet and mysterious mingling of kindred personalities. He meant us to see Him and live with Him and draw our life from His smile. But we have been guilty of that `foul revolt' of which Milton speaks when describing the rebellion of Satan and his hosts. We have broken with God. We have ceased to obey Him or love Him and in guilt and fear have fled as far as possible from His Presence.

If you've stuck with me for this entire post, thank you! Please continue to stick with me as I face my fears and anxieties and learn to give them to God, one by one. It's time to face some healing that's about 7 years overdue.

 Wear it out (the way a three-year-old would do)
Melt it down (you're gonna have to eventually anyway)
The fire trucks are coming up around the bend

You grieve you learn
You choke you learn
You laugh you learn
You choose you learn
You pray you learn
You ask you learn
You live you learn  

("You Learn" by Alanis Morissette)


  1. Of course we will stick with you!!! Unfortunately that is a lesson we all have to keep learning daily is to trust God is in control. We love you!!!

  2. Thank you! Ross and I are so lucky to have parents who raised us with God at the center of our lives.

  3. Good for you for at least making half of these choices on your own. Most people use Depression medications as a cop out or excuse for why their lives are what they are and in that.....are not using the medication correctly!

    I'm proud of you for getting into new, healthier habits and using them as your new resources to get back on the right path you think you need to take.

    You have our love and support and just know you already took what is for some people the hardest step to take and that's getting off the medication as a crutch!