March 16, 2009

The Devil You Know, Part the First.

Posted in Adventures in brain chemistry at 9:19 pm by the Green-Eyed Siren

Yesterday I finally pulled the Big Bag O’ Drugs off of the shelf on which I’d secreted them away, but only after talking through the issue again—first with Mr. Unfocused, and then with my mother. Tell me again, do I really need to do this? Might I have been exaggerating out of agitation when I unloaded this problem on my doctor? Are we sure about this? The answers came back: Yes. No. Yes. Please choose happiness, just this once.

Regular readers will note that when first I publicly stated my intent to secure pharmacological support for my ailing soul I committed to taking whatever the doc gave me, no questions asked, no due diligence. But I lied. I cannot start messing with my mind in this way without fully understanding what I’m signing up for. It is not in my nature to live the unexamined life (as you have undoubtedly figured out by now). Plus, that was when I was coming down off of a Phentermine high.

Oh, did I fail to mention that when I was most unglued it coincided with my decision to put myself back on the weight loss drugs? (Yes, they were prescribed by my doctor, and used with his supervision until about a year ago; or perhaps I should say they were used with his supervision until two weeks ago when I decided I couldn’t go back in for a checkup until I lost some of the weight I had gained back.) I had fifteen pills left, only about a year old, and took one for each of three consecutive days. Gotta love Phentermine. I run at twice my normal speed, get a ton more accomplished, and never eat a goddamn thing. I lost seven pounds in the first two days; Mr. Unfocused returned from a two-day business trip and was somewhat stunned by the transformation. Yep: LOVE Phentermine. Except that, being speed, it makes me, you know, a total freaking nut case. Apparently.

So I stopped the Phentermine again and the rational brain started to reassert itself, but I was quite shaken by the whole losing-my-marbles experience, and thus felt like I should still tell my doctor about the problem. When he made the determination that this was not simply a temporary blip, but rather a chronic failure—basically saying your brain is, and has always been, broken—it required a certain adjustment of my self-understanding.

Not just quirky. Not just different. Broken. These are the exact words we heard through the teacher-speak and decried when it was not me being referenced, but our daughter; the exact words that caused me and my husband to rise up in defiant agitation to defend her right to be brilliant and unique (which she is, and for which I am deeply grateful); the exact words which daily motivate me to take her to a school where she can be among peers, despite the personal cost to myself. Why would I be so fast to find the right solution for her, no medication necessary, yet be willing to turn myself over to the wonders of chemistry so readily?

So onward, ever onward, to the research. Due diligence is a bitch. Wikipedia knows too much.

Having finally opened the bags, I decided to take a deep breath and read about what the hell these drugs do to make miracles happen. First up: Zolpidem (more fetchingly known as Ambien). It was the drug I was least emotionally invested in, and thus the easiest to research, because I shouldn’t need it all that often. Yes, I am far slower to fall asleep than my husband, and yes, I do spend way too much of my sleep time dreaming (I woke up yesterday morning to the odd sensation of my mouth furiously forming silent, angry words as I hollered at someone in my dream), but in general my problem is making the decision to turn myself off for the night—and not to do just one more thing or click just one more link. Ambien is not going to prep the kids’ lunches, or the coffee pot, or the rice cooker oatmeal; it will not lift me and carry me upstairs; nor will it brush my teeth for me, or lay out my pajamas. Being the pill I’m least likely to take, Ambien made a safe study topic.

And, whoa—it sure is fascinating! Did you know that the United States Air Force uses it to help their people “come down” after missions? Or that it dramatically increases frontal lobe brain activity in comatose patients, sometimes raising them from a minimally to a fully conscious state? How about that it has been associated with incidents of what I’ll call “sleep-living”—driving, binge eating(!), sleep talking, and performing other daily tasks so well that no one around you can recognize that anything is amiss—all while you’re asleep? Now, I have to tell you, this little tidbit set my alarm bells off. I could possibly see working something out on the sleep driving front (multitasking nirvana!); however, if I am going to do any binge eating, I would like to at least have conscious enjoyment of such an activity (after all, there are still two boxes of Girl Scout Thin Mints in the pantry), rather than only its painful consequences to my waistline.

Perhaps I will reserve Ambien (oh, all right, Zolpidem) for the recreational use so enticingly described by the helpful Wikipedia editors. I can assure you there is little that would give my family greater pleasure than to see me, the straitest of the laced, misbehaving in such a fashion. Unfortunately, I believe the drug’s side effects will dissuade me from attempting any mind-altering explorations. Here’s the official lineup: Anterograde Amnesia! Hallucinations (although I suppose that’s one of the upsides)! Delusions! Poor coordination (not that you could really tell the difference with me)! Euphoria (yay)! Disphoria (boo)! Oh, and can’t forget about Death!

So no Ambien for me, at least not until I hit the 3 am anxiety shakes.

One down, two to go.

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9 Comments »

  1. Beta Reader said,

    I took Ambien a number of times while traveling on business to avoid the never-sleeping zombie state (see Lost in Translation). It helped me sleep, and little else.

  2. Beta Reader: Then apparently you weren’t trying hard enough.

  3. bb said,

    Regarding the mental health of women our age in general:

    — did your doctor check your hormones?
    — your thyroid levels?

    Also, a subjective but also more general comment re. Conditions Like These:

    It’s helped to identify my own depression/dysthymia/hatefulness/dreadfulness/social anxiety as it’s own entity. It’s not what makes one oneself, rather it’s an annoying, occasionally paralyzing, anxiety-producing condition that impinges upon our identities and holds us back from the awesomeness of which we are capable and also the sense of peacefulness that we can create and inhabit.

    By giving it up, by separating your worst feelings of doom, dread, mania, what-have-you from your truest self, you’ll be free.

    Easier said than done, but man the pills (Zoloft) helped. It was an altogether subtle experience, except for that one pill (Wellbutrin) that made me feel even worse but going off of it had the immediate result of calming me down.

    xo bb

  4. chel said,

    If after all of this you decide you can’t bring yourself to face the pills or even if you do… the therapist working with my daughter for anxiety disorder and panic attacks recommended the following book: Anxiety, Phobias, and Panic by Reneau Z. Peurifoy . Each chapter comes with a series of exercises you are to work through as a means of overcoming your anxiety. Can I say that it’s working? Not yet but at 17 do I believe she’s doing these activities between school, plays, forensics team etc. …. not really. But I trust her therapist and if she recommends the book then it may be helpful. We are also trying a SSRI for the first time. She took her first dose Monday.

  5. Jeanne said,

    You are confirming what I’ve always heard (and observed) about diet drugs–just say no!

  6. Daisy Duke said,

    Hormone imbalances can exacerbate many things when you’re hovering around 40, such as seratonin shortages (estrogen plays a role in its processing, I think). Knowing your hormone levels can be useful, and it was definitely good info when I was going through a similar crisis a year ago. You’re still left with the question of how to manage your mind, however. I was the queen of self-help and other-help (i.e. therapy) and still had crazy spells that were clearly correlated with my cycles. I was sane for a week, crazy for two or three, the crazy would abate over the course of a week, and the cycle would start again. So my therapy followed a similar ebb and flow: I was great, I would seriously regress, I’d gradually get a grip, etc. So there are a few options: 1) keep going as you are; 2) see if it’s your hormones and play with those, which has its own set of risks; 3) try to adjust seratonin levels and see if that makes a difference. After trying #1 for over a year, friends and family talked me into trying #3 for at least a few months. I did it for them. I didn’t like how it made me feel the first week, but that went away–and three weeks in I finally had my rational mind back. No drugged feeling, just me once again for the first time in a few years. (And the pharmacist said I could have an occasional glass of wine, too, as long as my drinking was light.) I’ve been on prozac for 6 months and can now make rational decisions about how to proceed–do I try to increase seratonin naturally? Do I stay on the SSRI? Do I stop everything and see if my body can keep it up on its own? I can totally relate to your hesitation, because that’s exactly how I felt. Here’s the unsolicited advice: I’d put the anti-anxiety and sleep meds in the “break glass in case of emergency”‘ category and commit to trying the SSRI for a month. At that point, you’ll know if it’s working, and if it’s not, it won’t be a big deal to stop taking it at that point. You may find that taking one obviates the need for the others.

  7. Green Eyed Siren's Mom said,

    I heard an interesting report on the radio last night. Scientists at some English university did a study in Canada, the US Midwest and South and in China.

    Apparently, thinking about money affects the way we deal with pain and with our general ability to cope. Thinking about money in a positive “got to get me some” kind of way increases our motiviation, our ability to withstand pain, and our overall sense of well-being. Thinking about it in a negative way as in regretting financial decisions we have made in the past decreases our pain threshhold and our general well-being.

    Given the current economic climate, I am sure that we all are thinking about the shoulda’s, woulda’s and coulda’s that might have been. This kind of thinking is probably affecting all of us in a negative way. Given your hormone/chemical issues, it probably affected to a much greater degree.

    Like I have told you, I applaud your decision to address this issue and look forward to seeing a happier, healthier you.

    Love,
    Mom

  8. Brown-Eyed Girl said,

    My God, Siren! I’ve been on FB for like 9 months without finding your blog. Or Unfocused’s blog. I had no idea you were on this, cookie thing! You’re quite a challenge to keep up with.
    My own Midlife Crisis began at the end of March, 2008 with a mini-nervous-breakdown from which I somehow couldn’t bounce back physically.
    I felt rather more like a hamster than a person. Last summer (2009), after visiting everyone from endocrinologist to acupuncturist, I finally settled on a cocktail of Rx meds, hormone replacement and dietary supplements that has me feeling more human. Thoroughly drugged human, but a lot more functional than I was during the first 15 months.
    Now I’m in Phase 2, which consists of trying to pull mind and body together and begin again. In order to begin in a Different way, instead of the Same Old Way, I’ve started a new course of psychotherapy with a PhD who mainly works as a career counselor/author. I also see a personal trainer twice a week, as exercise has likewise become a whole new ballgame.
    There’s a lot left to learn, but I’m starting to catch on. Glad to have your “company” on the road.

  9. Thanks for sharing your experience, Brown-Eyed Girl. I’m really sorry to hear you’ve been going through this, but I’m glad to know you’re doing the stuff you need to do to be healthy.

    Depression sucks. It was worst for me over the summer, but now I’m doing considerably better, especially in the last month or so. At least I’m doing a better job of dealing with it. I still have bad days or weeks, but the lows aren’t quite as low at the moment. Baby steps…


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