Catch-22

I’ve always been, well, not exactly a morning person, but someone who doesn’t sleep very much.

I wake up early by necessity, and have for a long time.  The alarm is set for a nice, round 6.  The job I had before this, dough cook at a pizza restaurant, required me to start at 7, and my alarm was even earlier.  I stay up because I get busy doing things, or because I am too anxious and upset to sleep.  There have been several incidents in my life where, rather than go to bed at a reasonable hour, knowing full well how early the alarm for the next morning was set, I stayed up far past midnight, or later, because I was simply too anxious to sleep.  Usually I would play video games until I was so tired I literally could not keep my eyes open.

On clonazepam, I am happy as anything, but I want to sleep all the time.

The 6 am alarm is now problematic.  Going to bed after ten is now problematic.

 

My appetite is awful.  Recently, after the event that has crystallised everything into Something Must Be Done, I went a week and a half hardly eating.  I simply couldn’t; I was afraid that forcing myself would make me vomit.  I would look at food and suffer a hideous contraction of my stomach.  At times I felt light-headed with hunger but it was an effort to eat because my stomach was so knotted I did not feel hungry at all.

This does not help the case of those who, not knowing exactly what’s going on with me right now, believe I have an eating disorder.  When you lose sixty-five pounds and then suffer some sort of mental breakdown at work, people tend to make connections.

And then the Wellbutrin, of course, didn’t make it better.  One of the side-effects of Wellbutrin is appetite suppression.  I was no longer fighting a stomach clenched with anxiety, but I simply didn’t feel hungry a lot of the time, either, and had to constantly remind myself to eat.  It would be better for a few days, and I would eat normally, and then I would have a Bad Day and be unable to eat and it would take me several days to get back into the swing of eating normally.

I’m no longer on the Wellbutrin, of course.

But this morning, I am looking at a piece of homemade honey-wheat bread, with chunky peanut butter.  I have a big mug of poor man’s mocha — coffee and hot chocolate mix.  It should be delicious; I can barely stomach it.  I have two pills to take: the clonazepam, and half of a tablet of Cipralex.

Cipralex is, of course, the long-term drug, the one I am waiting to work so that I don’t have to take clonazepam.

Cipralex must be taken with food, or it makes me very ill.

And I cannot get any food into me this morning.

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Talking to the mongoose

My youngest sister is significantly younger than me.

I am the oldest, she is the youngest, there are two between us (including the aforementioned Florence).  I was just shy of fourteen when she was born, and I’ve lived ever since with being mistaken for her mother everywhere we go.  Although, she’s thirteen herself, now, and that seems to be stopping.

She is one of the most vibrantly, vivaciously alive people I have ever known, enthusiastic about everything, genuinely empathetic, creative and intelligent and full of energy, a born performer who loves to be the centre of attention.  For this, and for a similarity between a real nickname of hers and a certain character from Kipling, I append to her the pseudonym of the Mongoose.

The Mongoose has forever been very mature for her age, in ways, partly due to the fact that she’s grown up surrounded by so many adults.  She walked early and talked early and she is a born mimic.  People outside the family used to be very struck with how grown-up she sounded when she talked, and really, this came down to the way she copied the way everyone else around her spoke.  I love her to death, and in defiance to what people tend to expect, I’m probably closer to her than I am to my other sisters.

She is rapidly becoming a young woman.  Of course, we still think of her as the baby of the family.

I let myself into my father’s house last night, and crept downstairs to find Mongoose on the computer, killing time before Mom picked her up.  I scared the crap out of her, because I have never, ever let myself over in that way, and she wasn’t expecting anyone else to be home.  She was thrilled to see me.  I was feeling amazing, this being the first full day on the clonazepam, and despite the side-effects I was giddy with the relief of not being twisted in knots of anxiety for the first time in years.

Because we think of Mongoose as being the baby, no one tells her when these things go on, but she was there when I broke down in tears at Florence’s birthday, she was there the next morning when, in my dad’s kitchen, I cried my eyes out, out of terror and frustration.  She could not fail to have noticed.  She is a very smart person, but at the same time… I suspected no one had thought to say anything to her, and knew her well enough to suspect she hadn’t asked.

I asked her if anyone had said anything about what was going on.  She told me no.  She said, “No one tells me anything about these things until after I’ve already figured it out and then Mom goes, ‘I don’t know if you’re aware of what’s happening,'” her imitation of the tone mom uses for patient explaining was perfect, “but I already know by then.”

So I told her.

I told her that I had been on various antidepressants, on and off, to little effect since I was seventeen.  She was very surprised by this.  I told her that, very obviously, I hadn’t been doing well for a while, but that I was going to go to a psychiatrist (which she found hilarious — “You get to have a shrink!” — she shares the typical family sense of humour), and that the doctor thought I was actually dealing with an anxiety disorder which was making me depressed, and that I was feeling better that day for the first time in years.

The Mongoose was thrilled I was feeling better, and, I think, relieved to finally know what was going on.  She added to me, I think in an attempt to let her big sister know that this is okay, you’re okay, and I get what this is about, that she has a friend that she just found out has obsessive-compulsive disorder.

“Just diagnosed?” I asked.

“No, new friend,” she said.

I am glad I told her.

It’s possible that I may get some criticism for discussing this so frankly with a thirteen-year-old, but I doubt it.  She’s very smart, and she’s very mature for her age in some respects.

Today I am on drugs.

The clonazepam, while it lifts the anxiety from me to a point where I feel like I can think, for the first time in years, has some unfortunate side-effects.

I’m supposed to take it twice a day, morning and evening.  The morning dose makes me decidedly loopy.  Sort of a half-a-beer-drunk-too-fast sort of feeling, not really drunk but decidedly impaired.  I’ve worked two days like this, no problems.  I would not want to drive in this state, but then, if you’ve seen what the streets here are like, you’d understand that I wouldn’t be keen on driving, period.  I don’t own a car, actually.

Actually, the similarity of effects here may have a great deal to do with why I’m the happiest drunk in the world — alcohol does the same thing to me as clonazepam does, making my brain shut up for a while.

The evening dose mostly just puts me to sleep, but that’s all right.  The problem, I’m finding, is that I need to take it around supper — if I take it much later, I am groggy as fuck in the morning.

My mother is a social worker and works in mental health, particularly geriatrics, particularly elder abuse and… wait for it… addictions.   She is transparently very anxious about me being on a habit-forming drug, even temporarily.  She is quick to remind me of the negative aspects of the drug, and eager for me to try cutting back past what the doctor prescribed.  Today there is a blizzard, and my place of employment is not even opening, so to humour my mother, I’m skipping the morning dose.  Because it’s a quick-acting drug, this isn’t going to screw me up the way skipping an antidepressant would, and because I’m not working, because I’m not sure I should even leave the house today at all, I can see how it goes.  If it gets unbearable, if I have a panic attack, I can take one.  Little is risked with this experiment.

I’ve been up for an hour.  I can feel the tension building in my muscles already.  It starts in my legs, and then my arms.  It doesn’t bode well.  I will try to relax.

Most of the rest of my family has been joking for a couple of weeks now, as I go through this, that I really just need to smoke pot.  At this point, I’m wondering if that wouldn’t be a better solution.  Relaxing?  Potentially less addictive?  Get me a vaporizer and a medical marijuana license, please.   I’d hate trying to buy it off of anyone around here.  It’s all so skeevy.

My sister — and for the sake of clarity, because I have several sisters, I will give her the pseudonym of Florence since she’s a nursing student, also because I think she’d be righteously annoyed and amused at being called Florence — takes a different view, which is one I sort of need to hear right now.  She’s honestly interested in the entire diagnosis, because, well, this is what she’s learning, this is what she’s passionate about.  She worries about me, she says (perhaps more so because it was her birthday party I broke down at), observed that I don’t talk to people about this, but she has a great big drug guide and she can look up clonazepam and is more likely to see it as a useful tool than a potential addiction.

And I think I need to hear that input right now.

I am still reeling.

What a lot can happen in the course of a few days.

The evening I wrote my virgin post,  I went to my sister’s birthday party.  This was good, I thought.  My family will be there, I love my family, there will be pizza, there will be cake, I have been feeling down and miserable since that panic attack of doom of Friday, this will be good.

And initially, it was.  Until, near the end of the evening, I went off to the bathroom and found myself bursting into tears for no reason I could name.

I cried in the bathroom for a while, until I thought I had myself under control.  The last thing I wanted to do was to come out sobbing when this was my little sister’s day.  When I thought I was all right, I came out and sat down again.  I guess that I didn’t look quite as good as I hoped, because my father moved to come sit beside me and put an arm around me.  And I burst into tears again.

I don’t remember, now, exactly what it was I said.  I told dad about Friday, where I was up and on top of the world and could not stop moving, and then crashed into this panic attack and hadn’t really picked myself up from it.   I said that despite my talk of “there are good days and bad days” I really wasn’t doing as well as I was saying.  I’m aware that I try to screen my family.  I’m not sure why I do it.

I was denied permission to return home alone.

After some discussion between my parents, it was decided that I would spend the night at my dad’s, since my mom’s house is quite a ways out of town.  I didn’t sleep much last night.  The next day I went to work for a very brief period of time, just to do some necessary paperwork.  I wept often, seemingly unable to stop.  And I went to my doctor’s appointment.

I had been taking Wellbutrin.  This is never one of the first antidepressants they put someone on, ever,  but I hadn’t had a lot of luck with others.  For some the side effects had been so bad I couldn’t deal with them (gaining sixty pounds — I will have those stretchmarks forever — or the complete and utter cessation of sleep for several days, to give a few examples) or they just really didn’t seem to, well, do anything.  I had been completely disillusioned with antidepressants.  I only agreed to the Wellbutrin when it was pointed out to me that I was so very, very depressed and that I had an unknown wait until counselling and there really should be something in between.

Well, the Wellbutrin was not working.  Conceivably, it was making things worse.  So no more of that.

Four things came out of this doctor’s appointment.

  1. We are no longer tossing around the word “depression.”  We have been trying to treat “depression” on and off for over a decade, and nothing comes of it, long-term.  My doctor is now of the opinion that the problem is not that I’m depressed and that it’s making me anxious, but that I’m highly anxious and it’s making me depressed, that this is an anxiety disorder and the depression is secondary.
  2. Anxiety disorders are somewhat out of her realm of expertise, and she’s writing me a referral to a psychiatrist.
  3. She replaced my Wellbutrin prescription for escitalopram (brand name Cipralex, apparently).  I have been on citalopram, but that “es” at the beginning is apparently important, because this one is an antidepressant that is extremely good for patients with anxiety disorders.
  4. Antidepressants take a long time to work, and I am on the line of barely-functional-with-suicidal-thoughts right now, so for the short term she has given me a prescription for clonazepam, a benzodiazeprine.  Clonazepam is a  muscle relaxant, anti-seizure, and anti-anxiety drug.  It is also dependency-forming and addictive.

This last one.

I recognise that I can only been on clonazepam for a short period of time.  I recognise the possibility of dependancy and withdrawal syndrome, and these are scary things to think about.

But it has given me my life back.

Two days ago, I could not see how I could ever possibly manage to carry on any further.  I was so exhausted, so drained, in so much mental agony that I wanted everything to stop, to go away, to end.  Within a very short time of taking the first dose, Monday night, all the muscles in my body that had been taut and tight with tension miraculously relaxed.  I relaxed.  I went to bed, and I actually slept.  When I woke up in the morning, my father looked at me and said, “You look better.”  I went through my day, worked the longest day I have since I came back from my sick leave, and it was fine.  Things happened that would have upset me terribly, but I was fine.  I went home, briefly, had a nice conversation with one of my housemates, and went back out.  I caught the bus out to my dad’s, something I have never done.  I do not know the route, I am not entirely sure where to ring the bell, and the bus that goes out that way, being a not-very-highly-populated route, runs once and hour and uses one of the handicapped-equipped handi-DART mini buses instead of the full citybus, which I have never ridden on.  The reason I’ve never actually gone out to my father’s that way since realising it was possible is simply that it scared the crap of me, that trying to plan it out swept me up in an unstoppable vortex of agony and anxiety and nerves.  Yesterday?  None of that.  I even rang the bell at the wrong time, and it didn’t matter, and I even joked about not knowing where I was going to the bus driver, and I did not agonise about it for hours afterwards.

It’s not that the anxiety is not there.  It is; it’s just that it doesn’t consume my thoughts entirely, and I’m able to think about other things.  And despite that it makes me sleepy and the fact that there’s a lingering feeling of having drunk half a beer far too fast, that feeling of being free from that constantly, oppressive anxiety… it’s like being able to think clearly for the first time.  I feel better than I have in months.  Possibly in years.  I am over the moon.

This is like being forced to breathe only through a very thin and narrow straw.  Sometimes that’s fine, but if you want to get up and do things, take a brisk walk, clean vigorously, run a marathon — you can’t do it.  It bcomes difficult.  You can’t get enough breath.  Suddenly having this experience is like suddenly having the straw taken away, and being allowed to breathe through my mouth.  I did not know it was possible to think like this.

It is, alas, temporary.  Hopefully the therapy, the psychiatrist, the antidepressant will be doing a good job by the time I need to stop taking this.

But, my god.  What a difference.

I muse upon a beginning.

I am beginning to hate the term “mental illness.”

It’s a very broad term.  It carries a lot of stigma.  And I hate the fact that I am beginning to think of it as applying to myself, without really knowing what it is that I’m defining, either.

There is a little bottle of pills.  It is sitting on my desk as I type, in its place next to the monitor.  The bottle is blue and white, the pills inside are also white.  I take one once a day.  I don’t know if they do anything.  Some days I think they help, and some days I think they don’t, and some days I think they actually might be making things worse, but I take the little pill every day, because my doctor tells me to, and I will take them and tell her what happens until she tells me not to.  That is a lot of trust there.

It is also, frankly, insane to be blindly taking pills that alter your brain chemistry because someone else tells you to when they can neither predict how it will affect you personally nor entirely grasp what is going on your head because you have no way of describing it.

I tried recently to describe a panic attack to a friend of mine, and found I couldn’t.  I can describe the physical aspects of it, sure.  I can describe my inability to breathe, the pound of my heart, the shaking, the tunnel vision, the anxiety, the fear that I am losing my mind, but there are no words in the English language to properly express the oppressive and all-encompassing despair, the misery that is so strong that it is very nearly a physical symptom, despite all logic, like a million tiny hands are pressing outwards from your skull and that your head might very well explode.  I cannot explain the thought process that leads me to seriously consider banging my head on the wall or inflicting some other injury upon myself in the hopes it might stop that feeling — I haven’t done this, but I think about it.  When I’m having a panic attack I know that’s what’s happening, but that doesn’t mean I can make it stop.

And what brought this panic attack on?

Nothing.  Merely the come-down from an exhausting and inexplicable rush of energy and good mood and productiveness.  I have felt like shit since.

I’ve been diagnosed repeatedly over the last decade as severely depressive.  They give me antidepressants, but they don’t seem to change anything, and in the last three cases have been worse than not taking anything.   I have a counsellor, albeit a temporary one, who is finally listening when I talk about the crippling level of anxiety I am experiencing, that I drive myself to work through somehow in an exhausting and self-defeating fit of stubborness which leaves me depressed and limp and crying, and that in turn serves to only make the anxiety worse.  It’s a terrible vicious cycle, and I can’t explain it, and I can’t break it, and it all builds until I break down.  I lash out, because when I am screaming and irrationally angry, then at least I can’t feel anything else, at least I don’t hurt anymore.

“Depression” is a weighty enough label to live under, but at this point… I’m wondering if all of this is leading up to a diagnosis of something more, because it’s a little more complicated that that.  I don’t know how I feel about that.  I’m waiting on an appointment at the health unit.  I have been waiting over a month and have weeks to go.  Sometimes I feel like I won’t make it.

I feel crazy, and possibly I am. I feel broken and I feel a failure on some intrinsic level that I can’t deal with my own brain without help.  There are good days, and there are bad days where everything is a struggle, everything from deciding what I will have for breakfast to using the newly-introduced style of bus pass to grocery shopping to making it to work, it’s all so insanely difficult to accomplish.

My brain is my own worst enemy.  I’m trying to commit that to paper.

But this is a beginning.  It will get better — I have to believe that, because the alternative is to go on like this indefinitely, and that’s an unbearable thought.

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