Wednesday, February 12, 2003

EffexorXR Cold-Turkey

BTW... when I quite smoking 5 or 6 years ago, I did that cold-turkey, using the nicotene gum only when I absolutely couldn't stand it and was about to go nutz on someone (I think I used 1/2 of the box... when the prescribed regimen is something like 3 or 4 boxes over 2 months). So yeah, I've been there done that with regards to cold-turkey.

That, of course, is not to say that it's a fun walk in the park... anything but that. (Which is why I'm getting my refill tomorrow - mostly as mental assurance, hopefully not to need to take the medicine.) And I still have a week or so supply of the sleeping pills (which I'm about to take soon - I only got 5 hours of sleep last night).

Again, the goal of this is to see whether I can function without the medications. If so, I'm good to go and off and running, if not, it's back to the doctors to re-evalulate and try another medication.

I don't expect to ever sink as low as I did last May. The big reason is that I no longer fear therapy. My biggest fear last spring was that they were going to lock me up in the padded cell and that I'd then have a mess of a time trying to explain to my co-workers where I had been for the last few days/weeks. However, I passed the initial screening questions (where my PCP checked for plans to do immediate harm to myself or others) and was allowed to go home, EffexorXR in hand. I was scared to death on that drive over to see my PCP - felt like an emotional pinata at the time. However, by the time I had to go see the pharmacologist and the therapist - it was more of a social anxiety fear (what if someone sees me walking into a mental health clinic, they're gonna think I'm nutz!). (chuckle) that last thought fits in with Dr. Burn's list where he defines 10 aspects of the cognitive disorder.

Back to the point - as I put it to my therapist - the idea of going for treatment is now a known quantity. I know what to expect, I know who the players are and what parts they play in my treatment. (Pity my therapist who had to defend her job to me in our first session as I was very skeptical about the efficiacy of mental therapy.) So the wall / barrier for me to obtain further treatment is much lower then it was. I now know how to get from being sick, to feeling better, instead of having to suffer the depression, feeling like there is no hope and that I'm not going to get better. (Granted, I hope that I can remember that with some clarity in the bottom of the next episode and not toss it aside as a "but if it worked, why am I depressed again".)

Where was I...?

Oh yes, in additon to knowing the path to treatment (I was in such a daze during the first go-round), I also have some flag conditions and self-tests that I can use to determine whether I'm well or sick. (The big test is the Burn's Depression Checklist - that 25 question survey that I scored something like an 85 on last May, which is really bad, and only a 10-15 when I took it again this past December.) When I'm well, I'm creative, bright, curious.

Curiosity - ah, that's what I missed the most this past year or two. To give you a concrete example, it took me 4 months of visits to the clinic before I noticed that there was a rather large rose bush in the large grass area off to the side of the entrance. Prior to that I had tunnel vision, unable to take in more then the minimum amount of environmental input. I constantly felt like I was being overwhelmed by the environment, too much going on for me to keep track of - I was doing all I could just to move from point to point during those initial doctor visits. That's one of the markers that I used to tell myself that I was truly getting better - when I started looking around and noticing details that I had missed before.

Bleh, lost another thought... maybe it'll surface tomorrow... oh wait, here it is rounding the bend again....

Remember that on my drive over to the PCP, I was concerned about what co-workers would think of me if they knew I was seeing a shrink? (Now there's a telling turn-of-phrase... using the word "shrink" is typically diminuative as opposed to saying the more neutral "therapist" or "doctor".) Again, it's another bit in cogntive therapy (mind-reading, labeling). Well, part of my healing was being brutally honest with my closest co-worker and then slowly working my way outward. My group knows what I was going through, why I took 4 weeks off last August, why I was sometimes not dependable last year. So I short-circuited the issue of feeling that I had to keep my visits to the mental health clinic a secret or risk people thinking bad things about me. Not sure if it was a conscous tactic or not - but I had to clue my business partner in about my condition so that he could adjust schedules and demands. From there (that was a difficult first step), I've gradually become more and more open about the fact that I suffered from depression-the-disease and that I was undergoing treatment. Heck, a quick glance back through the 2002 archives will show that pattern... I didn't even write about it here (where I use a pen-name) until a few months after I had started treatment.

Now I would have to say that I'm almost the opposite of shy when it comes to discussing the topic if it comes up. Which is a good thing, it means I've integrated the experience and it's now a part of who I am, whether the other person likes it or not (sticks out tongue). Ah, but the strategic value is probably the best - I've now "walked a mile in those shoes". I know more about the disease then I did before (and I read a lot about depression in high school) and I can see the footprints from my battles with it over the past 20 years (hind-sight is 20-20, ne?).... but having been on the inside, it's much easier to identify the markers in other people when I interact with them. Which lets me tailor my interaction to them (establish rapport).

Life hands you a joker... it's up to you to figure out how to play it (or when or in what situations).

posted by Wuphon's at 11:17 PM