The trouble with medicine…

Ugh!

It’s almost 3am, and I’m sipping Sleepy Time tea and writing this blog. Because I’m wide awake! I’ve freaked myself out, and need to calm down before the Sandman might dare to reappear.

When I woke up this morning – I mean yesterday morning – I felt a little off. A little funny in my skin, but I didn’t really know how to describe it. But by bedtime, it was a raging all-over-body itch. Like I’d just rolled in long grass and my skin was tingly-itchy, even inside my mouth. No visible rash, but definitely needing a scratch. As we were going to bed, my husband said, “Maybe it’s a withdrawal symptom.”  And I’ve been freaking out ever since.

Last week, I discovered that I had missed the “expiration date” on one of my medication refills, but figured it wouldn’t matter, since I was seeing the doctor on Friday, and I would tell him then. I mentioned during the appointment that I was going to run out, but neither he nor I grasped the potential significance of that statement. As I knew he would, he wrote me a new prescription, then gave it to one of his staff to send in – I get my meds by mail. That was Friday.

I got a notice today – Thursday – almost a full week later – that the prescription-filling company has received the doctor’s order and they are processing it to be filled and sent on its way.

In the meantime – two or three nights ago – I ran out of those pills.

No biggie, they’re on their way. But wait, I’m heading out of town on Saturday for a week, so they’ll arrive while I’m gone. Again, probably no biggie – it’s just a med I take to help me sleep.

I’ve been on a very low dose of this med for 10 years.  Tonight I learn that it’s a benzodiazepine – a central nervous system depressant. (Shame on me for not exploring this sooner.) My original psych doc first prescribed it when I was struggling with the anxiety portion of my depression, and I was having trouble getting to and staying asleep. He assured me that there was no problem taking the med at such a low dose. And I needed the sleep in order for my brain to heal from the depression and serotonin toxicity.

That was 10 years ago. Two psych docs since, and I’m still on this med. No one ever mentioned any concerns with it. Over time, I’ve considered coming off of it, but why? It works so well, I’m sleepy within 20 minutes of taking it, and I rarely struggle with insomnia; I can usually get back to sleep pretty easily if I wake in the middle of the night. I have no ill effects in the morning – I can get up just fine without any residual tiredness. On a couple of occasions, I looked into the process of coming off the med – just reading “how to” on the web – and saw several stories of horrific troubles with reducing the dose. But I figured my dosage was so low, when it was time, it would be no problem.

But here I am. Itchy all over. Woke up after an hour’s snooze and can’t fall back to sleep. So I googled this medicine and withdrawal symptoms. And there are all those scary stories again. Itchy body is very mild, when you consider hallucinations, loss of appetite, return of depressive thoughts, panic attacks, insomnia, muscle tightness, headaches, seizures – I think pretty much everything that could happen, could happen! And the process for weaning off – with a doctor’s supervision – is very slow – like 6-12 months to get off 1 mg. And I’ve accidentally gone cold turkey!

I’m honestly not sure what to do, besides call my psych doc first thing in the morning. I’m not sure what he can do for me, as I already have a prescription in process. Will I be allowed to have a few pills to tide me over? Will he help me get off this horrible drug, weaning me off properly?

Will I sleep at all tonight? Can I pray and breathe my way through my increasing anxiety as I consider the potentials while I’m out of town next week, without this med?  The “what-ifs?” are so scary at night, anyway. And they just got more terrifying as I read all about this med on the web.

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Semicolon;

98D74ADA-9F2F-44E3-8BFD-9EFAFECAA27E(TRIGGER WARNING – suicidal ideation)

I got this tattoo a week ago. I’ve wanted one for years, and finally decided to just do it! I incorporated the semicolon; it’s in response to Project Semicolon. “The goal of the project is to restore hope and confidence in people who are troubled by addiction, depression, self-harm, and suicide.” The idea is that instead of a period, where life would end, there’s a semicolon – life continues. Like their website says, “Your story is not over.”

Back in 2009, the medication I was taking that caused the serotonin toxicity made me think lots of suicidal thoughts (suicide ideation), to the point of having a plan of how and where (but not the detail of when). While I was never truly suicidal (my level of suicide risk was not high enough – I didn’t have all the markers), at the worst all I could think of was that I didn’t want to live in pain anymore, didn’t want to be “here” (in this life); I just wanted it over.

I had those “death thoughts” for days and nights and weeks, increasing in frequency. It reached an intensity that the idea of death ran through my mind constantly, even in the background when I was busy with other distractions like work. I was so incredibly miserable, so hopeless, and I couldn’t imagine that I was ever going to feel differently. The ache in my chest was all-consuming, and felt like it was eating me from the inside out, wearing me down, gnawing at me. My plan was to take all my pills, but when I was driving I would fantasize about plowing head first into a large on-coming truck or driving off the edge of a cliff. I had these thoughts, but the plan never went anywhere because I couldn’t imagine putting my family through the aftermath-pain. I never got completely to the point where I assumed everyone would be better off without me. I thought it a few times, but quickly pictured faces of family and friends crying, and knew I couldn’t do that to them. So technically, I wasn’t suicidal. But it sure felt like it to me.

One evening before bed, I poured a handful of my sleeping pills into my palm and looked at them all. “How easy,” I thought, “to simply take them and go to sleep and not wake up. ” I scared myself a little by having them in my hand, and so I poured them back into the bottle, all but those prescribed on the label.

Several days later, I called my therapist and told him that I was feeling very out of sorts, rather hyper, and that I wanted to hurt myself. He asked if I had a plan, and I told him yes; then he made me tell him what it was. I told him that I would take a huge handful of pills, probably all of my sleep meds, and just go to sleep and not wake up and the pain would all be over. He asked me where I was. “At work.” He told me to call my husband, at his work, and tell him to go home immediately and gather up all of my medications and hide them – he would be the only one allowed to give them to me. I promised my therapist, hung up, and sheepishly called my husband and told him what I needed him to do. I think it was the first time I had to openly admit the seriousness – the depth of pain – of my illness to him. My husband put all of my meds in our safe in the closet, and carried the key with him from then on.

The suicidal thoughts felt very real – they were in my head – but my therapist and psych doc and husband and friends kept reminding me that they weren’t my thoughts. They were caused by the wrong medication and resulting chemicals in my brain. They would eventually go away as my system got used to a different med and as I began to feel better. I didn’t believe them, but I trusted them, and so I started telling myself that when I would begin to think hopelessly. And it did work – took awhile, but eventually I could see that the thoughts were caused by the meds and the depression, and were not really my own.

But I wonder sometimes if they ever go away. Completely I mean. Once I’ve had those thoughts, they are somehow a part of me. I have to be cautious to fight to keep them away when depression comes and brings hopelessness. And even though I still have those safe-guards that will keep me from following through (concern for those “left behind,” promise of God’s Presence – my personal faith in Jesus, fear of the physical pain, and the shame that would remain – I’d be worse than just depressed, etc.), I know the thoughts could come again.

I later became friends with a person who had tried to kill herself with meds, and I learned that my plan would most likely not have worked, but would have made me incredibly painfully sick, perhaps throwing up blood as I tore apart my insides and in a coma with breathing difficulties. I would have had a whole other layer of shame to deal with – not just the shame that often comes with depression, but shame that comes from putting loved ones through such trauma as a suicide attempt.

I now look back on this time and thank God for saving me, for putting my husband and therapist and doctor and friends in my life who didn’t give up on me, even when I kept thinking about giving up on life. I thank God for different medications, for keeping me safe, for His Presence. I thank Him for the semicolon, and for the way He can use my depression now in helping others because my life goes on.

2 Corinthians 1:8b-10, personalized
“I was under great pressure, far beyond my ability to endure, so that I despaired of life itself. Indeed, I felt I had received the sentence of death. But this happened that I might not rely on myself but on God, who raises the dead. He has delivered me from such a deadly peril, and He will deliver me again. On Him I have set my hope that He will continue to deliver me, …”

Remembering Sadness: A Christmas Party

I was telling my therapist yesterday that I want to go back and read my old journals, written over the past 9 years, covering the times where I’ve been in and out of depression. But after I blogged about my stay in the hospital psych ward, I read about a work Christmas party that happened shortly after my release, and found myself crying. Sometimes, the stories are sad.

Typically on Holiday Party day,  I would work longer into the afternoon, and we would help Leanne in getting ready for the evening. She would have planned every detail of this party for weeks. She’s incredibly creative and clever, and she chooses the menu and theme and creates the fun game time for the annual event. We’d get tables set up and decorated, gather and set out supplies for coffee (the meal is catered), fluff the Christmas tree and check its lights, set up the sound system, move the piano out, and do whatever else we could to help her with preparations. The party is for Board members present and past, and the staff is invited to attend. I liked going, and my husband and I often served beverages before the meal. I had discovered this as my favorite way to meet and thank Board members without making tons of small talk! I don’t think I fulfilled this service in December 2009, and I’m sure that’s a good thing.

Looking back, I had no business being there that evening, not with my mental health fragility and the physical exhaustion I was experiencing as I was recovering from the serotonin toxicity. I wish someone had told me I couldn’t go. But I’d always attended before, and felt like I needed to this year, too. I think I just wanted to prove to myself that I was back to normal, even though that was far from true. My husband agreed to meet me there when he got off work.

I honestly don’t remember many details, but I do remember catching my reflection on the way to the bathroom. What I saw shocked me.

There was a short round woman, hunched over a little, her body being pushed hard toward the floor by gravity, her feet splayed for balance. Her hair was messy, but not cute-messy, and her face was drawn and tight. Her eyes were flat, and her lips turned downward. She looked horrible. And then I realized it was me.

I don’t think we stayed longer – I wanted to get out of there before anyone else saw me. I cried as we drove home – so sad for the woman I used to be. I didn’t think about how I would be her again someday – standing taller with confidence, attractively dressed, smiling with eyes sparkling. I could only be sad that at that moment she was gone, and in her place was this woman who had been beaten down and showed it.

Healing from the serotonin toxicity took way longer than I expected – months of me not feeling back to myself. My psychiatrist kept urging patience, reminding me that I had been through a major traumatic event. Everyone but me seemed to understand that I wasn’t weak, just healing, and it was going to take lots of time and rest for full recovery.

I cried a little as I retold this story yesterday to my therapist. And I realized that even though I really want to re-read all of my journals, it will not be easy. I am inviting myself back into sadness and sad memories, and I will mostly likely cry. She encouraged me to take my time – I don’t have to hurry – and I can stop at any point. She even offered that I could bring the journals to our appointments, if I feel that I don’t want to handle the emotions by myself.

At least I know what to expect. Some tears, definitely. But I’m also eager to read the evidences of God’s faithfulness, about the tools my previous therapist gave me, of verses of Scripture that sustained me. I will read expectantly, with my heart soft and ready to absorb the written emotions again, yet reading the journals with strength, knowing that I have come through difficult times and am the person I am today because of them. And I will cry.

Psych Ward, part 3

(I don’t remember much about my four-day stay in the Inpatient Behavioral Health Unit at the hospital, but I do have some “pictures” in my head to help me recall pieces of it. Even today, lots of it are just fuzzy memories.) 

I checked into the psych ward on Sunday. I know that on Monday, I went to the nurses’ station near the Commons area. This area was enclosed by glass windows, and there was always someone standing outside of it, like a guard. I asked to use the phone and called my church. I think I told the receptionist that I was in the hospital and asked if Pastor Andy could visit me. As clergy, he wasn’t restricted to visiting hours, so he came and met with me later that day, I think. There was a small room off the Commons area where patients could meet “privately” (with as much privacy as is allowed in a psych ward, anyway.) My pastor met me there; I have no idea what I said. I asked him a few weeks later, just to be certain that I hadn’t done or said anything to embarrass myself or him. He assured me that I hadn’t. I had wanted to see him so that he could assure me I would be ok, that Jesus understood and was with me, and I’m sure he prayed for me.

I had two friends who visited one evening. They brought me cozy fleece pants, and confirmed to me that I was doing the right thing by getting help. I remember feeling very comforted by good friends who cared enough to see me in an uncomfortable place.

My husband came for every visiting hour.

And my kids came once, I think one of them came twice. I don’t remember asking my husband to bring them, but it seems that I did. Very quickly, I regretted that I had. I still wish they had never seen me there. The trauma of going through two locked doors was too much – and my flat affect, my lack of energy or any enthusiasm whatsoever – I don’t think they had known how sick I was, but they couldn’t miss it when seeing me on the psych ward. It must have been pretty awful for them. I’m very sorry I put them through that.

At some point, I remember seeing Dr. Larson. It might have been the first or second day – I’m not sure, since time blurred together. He was in my room, and I was looking right at him but couldn’t see his face because he was leaning up against the window and all I could see was his silhouette as the sun shone through from behind him. He was completely in shadow. But I know it was him – I knew his gentle voice. He was telling me about the different medicines we were trying. I remember thinking that I just wanted to go back to sleep. I’m still not sure what I said “Yes” to.

My last night there, I had a roommate. I was in bed when she came in – she laid down and was crying. I tried to say Hi, and she responded, but I ended up leaving the room for a while so she could have some privacy. When I came back in, I packed my things and went to bed.

I slept almost the entire time I was in the hospital. I later learned that’s exactly what has to happen for the brain to heal. The over-saturation of serotonin created a type of brain injury – there is no way to help it get better without sleeping. Dr. Larson gave special permission (Karen told me this later) to sleep all I wanted – no more group attendance requirements. No wonder everything blurs together – I think I slept through it all. But I know I didn’t dream it.

I don’t regret going to the psych ward – I think it was the best thing I could have done for myself. I actually tried to go several years later, when another medication caused a negative brain chemical reaction. Because I had been helped the first time, I knew it was the right thing to do. (I was unable to enter the ward because all of the beds were full – but that’s for another blog post.)

Psych Ward, part 2

(I don’t remember much about my four-day stay in the Inpatient Behavioral Health Unit at the hospital, but I do have some “pictures” in my head to help me recall pieces of it. Even today, most of it is just a fuzzy memory.)

I checked into the hospital on SundayThe rest of the four days are blurry: I slept a lot. 

I had to go to “Group” – twice, I think. The first time, Group was me and a young man, meeting at a low round table with a nurse who read through some pages and a booklet. All I heard was Charlie Brown’s teacher: “Waa waaa wa waaa.” The second time I went to Group, it was just me and the nurse, hardly a “group.” When she asked if I understood, I said, “Yes” so that she would let me leave and go back to bed. It was weeks after getting out of the hospital that I reread all of the materials I was given from my stay. As I was reading, I had a vague recollection of sitting at the table with her. Blurry memory, though.

I recall being awakened once by a nurse who seemed irritated that I was sleeping; she told me I had to get up and go to Recreational Therapy. As I stepped out into the hall, I was completely surprised to see Karen walking by – she was the Rec therapist! I greeted her like the old friend she was, and wondered if it shocked her to see me in the psych ward. We had become friends through our daughters and story time at the library 13 years before! I hadn’t seen her in a very long time – probably 4 years before this. It ended up being ok that I had to go to Rec Therapy, because Karen and I got to talk, filling each other in on our daughters’ lives. The young guy was there, too. I made a small stuffed fleece pillow – the tie kind (I gave it to my dog when I got home). Karen sought me out later in the day and gave me my lip balm (it had my name on it) – she had found my little pouch.

I remember a couple of meal times – my goodness, it was an odd bunch in the Commons. I didn’t see the young man, but I remember an older woman, an older man, a middle-aged lady, maybe another man, perhaps a total of six of us. I think we sat with two or three of us per round table, but I also remember being alone. Or maybe that’s just how we all felt – alone in the group. The TV was on, but no one was really watching – not even the nurses – I think they had their own TV. There was someone yelling, then screaming – down the hall. People rushed in his direction. Maybe it was the young man.

One time that I was out of my room and in the Commons, I tried to do some coloring. I think I worked on a puzzle too, but it was too hard to concentrate, and I couldn’t see well enough for the detail in the pieces. The young man was there, with people who I’m assuming were his parents, and he was crying hard. The man with him looked angry. The boy ended up yelling at them.