Better living through chemistry (part 2)
My new medication (which isn't quite so new anymore) does more than make me less anxious. Or perhaps the way it makes me less anxious isn't what I expected.
I'd assumed that this medication worked in some mysterious molecular fashion to change my emotional state but now I'm not sure that the mechanism is so subtle. There are physical effects and I don’t mean the usual list of side effects (nausea, cramps, the infamous sexual side effects that - so far - I've avoided). As I said earlier - I sleep better and dream more fully. Whether it's the fact that I actually relax when I sleep or something else I'm in less pain than I have been since I was a young child.
My partner says my body looks better - though I've lost no weight nor made any particular effort to work out. But my shoulders aren't hunched; my face (he says) is more 'open'. I don't either pull my head down or thrust out my chin like I'm trying to take a blow.
I'm more adventurous - willing to try new things, go places I wasn't willing to go before. For my partner, who is much more active than I am, the change has been a huge relief. I've been willing to take more emotional risks as well, able to talk about long term relationship stresses that I wasn't willing to discuss before.
All of that made me wonder just what made me so unhappy before. Was it - as I'd assumed - some uncontrollable biochemistry that a little pill can fix? Or - collections of physical problems that resulted in a constant strain that made me feel anxious, unhappy and depressed?
Most likely, both.
As anyone who suffers from chronic insomnia can tell you, or people with post traumatic stress syndrome - not being able to sleep well does much more than make you tired the next day. Getting through life is hard - the world seems less predicable, any little extra strain seems impossible to bear. Chronic sleep loss makes it hard to want to take risks.
The medication affects seritonnin uptake, I'm not quite sure how but one of the side effects seems to be much less physical tension and joint pain. It wasn't until the pain was gone that I realized that I had been in pain, for a long time, and that everyone didn't feel that way. It wasn't 'normal.'
And what does the body think about pain? It's a signal that something is wrong. My whole body tenses up to try to deal with it, which has the result of increasing my pain. Pain makes anyone afraid, the body is sure there's some threat out there, it throws you judgement off. If I'm always worried that I might develop a migraine, might become exhausted, how can I go someplace new where the environment is unpredictable - where I can't be sure the environment won't tip me from chronic discomfort to acute misery?
My partner had a coworker who had chronic, life threatening asthma and her temperament made it very difficult to work with - she always seemed on the verge of some terrified or furious outburst. My partner just assumed she was the office asshole until he got a respiratory infection that made it very difficult to breathe for about a week. Suddenly, he was always on the edge of terror or rage - a fight or flight situation - the body's reaction to the sense of constant suffocation. He realized that his coworker wasn't just mysteriously an asshole; her body was telling her that she was close to dying - every day of her life.
In those situations, it makes perfect sense to withdraw, to resist change, to refuse to add to what is already a burdensome life. With less fear of pain, I have the emotional energy to spend on other things.
So, am I really depressed and anxious? Or simply physically uncomfortable to the point that I'm anxious and depressed?
It really made me wonder how much of my own mental state is related to my physical one. Am I biochemically predisposed to depression or disposed to problems that increase my pain level - which makes me depressed? If a physical problem reduces your ability to sleep (such as something as common as sleep apnea), does that mean you are genetically pre-disposed to anxiety? Do all those 'female' hormones made women moody and grumpy for a few days a month or is it because the hormonal changes create pain through cramps and muscle spasm that create PMS?
I don't believe in genetic mediation of behavior but - genes do affect your physical health so where does behavior modification cease being 'genetic'?
Does it matter?
I think so. According to studies, a huge number of Americans are on anti-anxiety type medications. Not incidentally, other studies show that Americans are chronically overworked and hugely short of sleep. The average working mother gets something like six hours of sleep a night and the actual human average should be something like nine. People are also increasingly overweight - with all the physical discomfort that causes; strain on muscles and bones, affecting posture, ability to be active and so on. The prepared foods we eat so much of are short of a lot of critical vitamins - things like B's, which affect muscle tension and nerve impulses.
Would people be less anxious and depressed if they were sleeping better? Would we be less rigid as a culture if so many of us weren't functioning under an assortment of chronic pains?
Would the pharmaceutical companies be making so much money if we got a little more sleep and ate our vegetables?
It makes me wonder too if I'm somehow weak. I could be more active; I could do something to manage my pain better. Do I really have to take a pill? On the other hand, I've been trying to make those kinds of changes for years - and I've been too tired and too miserable to do them. And - I also resent the realization that I have been in so much pain for so long, unable to find a way to deal with it myself and because it's not something obvious like a broken leg, having to spend my limited energy on crap like my job.
And - over the past week or so the effect I felt the first couple of weeks on my medication is fading. I'm at a very low dose and I'm desperately tempted to increase the medication. Now that I know how I can feel - I want to feel that way. Is the pill a crutch? Should I be spending my hours maintaining my body like it was a troublesome car?
Is the medicine a shortcut or a necessity? Am I a coward for using it or taking reasonable care of myself?
I don't know how to answer those questions. I don't even know if the effects I felt were nothing more than a placebo effect that faded over time. And I don't know if that matters either.
I'd assumed that this medication worked in some mysterious molecular fashion to change my emotional state but now I'm not sure that the mechanism is so subtle. There are physical effects and I don’t mean the usual list of side effects (nausea, cramps, the infamous sexual side effects that - so far - I've avoided). As I said earlier - I sleep better and dream more fully. Whether it's the fact that I actually relax when I sleep or something else I'm in less pain than I have been since I was a young child.
My partner says my body looks better - though I've lost no weight nor made any particular effort to work out. But my shoulders aren't hunched; my face (he says) is more 'open'. I don't either pull my head down or thrust out my chin like I'm trying to take a blow.
I'm more adventurous - willing to try new things, go places I wasn't willing to go before. For my partner, who is much more active than I am, the change has been a huge relief. I've been willing to take more emotional risks as well, able to talk about long term relationship stresses that I wasn't willing to discuss before.
All of that made me wonder just what made me so unhappy before. Was it - as I'd assumed - some uncontrollable biochemistry that a little pill can fix? Or - collections of physical problems that resulted in a constant strain that made me feel anxious, unhappy and depressed?
Most likely, both.
As anyone who suffers from chronic insomnia can tell you, or people with post traumatic stress syndrome - not being able to sleep well does much more than make you tired the next day. Getting through life is hard - the world seems less predicable, any little extra strain seems impossible to bear. Chronic sleep loss makes it hard to want to take risks.
The medication affects seritonnin uptake, I'm not quite sure how but one of the side effects seems to be much less physical tension and joint pain. It wasn't until the pain was gone that I realized that I had been in pain, for a long time, and that everyone didn't feel that way. It wasn't 'normal.'
And what does the body think about pain? It's a signal that something is wrong. My whole body tenses up to try to deal with it, which has the result of increasing my pain. Pain makes anyone afraid, the body is sure there's some threat out there, it throws you judgement off. If I'm always worried that I might develop a migraine, might become exhausted, how can I go someplace new where the environment is unpredictable - where I can't be sure the environment won't tip me from chronic discomfort to acute misery?
My partner had a coworker who had chronic, life threatening asthma and her temperament made it very difficult to work with - she always seemed on the verge of some terrified or furious outburst. My partner just assumed she was the office asshole until he got a respiratory infection that made it very difficult to breathe for about a week. Suddenly, he was always on the edge of terror or rage - a fight or flight situation - the body's reaction to the sense of constant suffocation. He realized that his coworker wasn't just mysteriously an asshole; her body was telling her that she was close to dying - every day of her life.
In those situations, it makes perfect sense to withdraw, to resist change, to refuse to add to what is already a burdensome life. With less fear of pain, I have the emotional energy to spend on other things.
So, am I really depressed and anxious? Or simply physically uncomfortable to the point that I'm anxious and depressed?
It really made me wonder how much of my own mental state is related to my physical one. Am I biochemically predisposed to depression or disposed to problems that increase my pain level - which makes me depressed? If a physical problem reduces your ability to sleep (such as something as common as sleep apnea), does that mean you are genetically pre-disposed to anxiety? Do all those 'female' hormones made women moody and grumpy for a few days a month or is it because the hormonal changes create pain through cramps and muscle spasm that create PMS?
I don't believe in genetic mediation of behavior but - genes do affect your physical health so where does behavior modification cease being 'genetic'?
Does it matter?
I think so. According to studies, a huge number of Americans are on anti-anxiety type medications. Not incidentally, other studies show that Americans are chronically overworked and hugely short of sleep. The average working mother gets something like six hours of sleep a night and the actual human average should be something like nine. People are also increasingly overweight - with all the physical discomfort that causes; strain on muscles and bones, affecting posture, ability to be active and so on. The prepared foods we eat so much of are short of a lot of critical vitamins - things like B's, which affect muscle tension and nerve impulses.
Would people be less anxious and depressed if they were sleeping better? Would we be less rigid as a culture if so many of us weren't functioning under an assortment of chronic pains?
Would the pharmaceutical companies be making so much money if we got a little more sleep and ate our vegetables?
It makes me wonder too if I'm somehow weak. I could be more active; I could do something to manage my pain better. Do I really have to take a pill? On the other hand, I've been trying to make those kinds of changes for years - and I've been too tired and too miserable to do them. And - I also resent the realization that I have been in so much pain for so long, unable to find a way to deal with it myself and because it's not something obvious like a broken leg, having to spend my limited energy on crap like my job.
And - over the past week or so the effect I felt the first couple of weeks on my medication is fading. I'm at a very low dose and I'm desperately tempted to increase the medication. Now that I know how I can feel - I want to feel that way. Is the pill a crutch? Should I be spending my hours maintaining my body like it was a troublesome car?
Is the medicine a shortcut or a necessity? Am I a coward for using it or taking reasonable care of myself?
I don't know how to answer those questions. I don't even know if the effects I felt were nothing more than a placebo effect that faded over time. And I don't know if that matters either.