OH MY GOD IT'S THE LONGEST ENTRY EVER
So. Both Sam (the pomeranian) and Sister Girl are sick. Sam has a hacking cough (we thought at first he'd chewed up something and caught it in his throat, but no, the vet says he has actual sinus drainage. Which reminds me, did I ever tell you the story about how we gave Sam a pill in some peanut butter the last time he had a cough, so he went around after he was well coughing very pointedly in the direction of the cabinet?), whereas Sister Girl has another case of the Death Flu. She called on her way back from the doctor in tears because she was almost in too much pain to drive herself home--she felt hot and cold and like she had "arthritis all over." So definitely the Death Flu; we all backed away and held up the sign of the cross, because none of us have the time or fortitude left to get sick. Of course, I think Sister Girl has a relatively low pain threshold; the last time we all had the flu, I sat in the bathroom groaning into a bucket every now and then, but I could hear her over from her room in a sad, endless cycle of "Barrrrrrrrrf *sob* *sob* barrrrrrrrrrrf."
Meanwhile, it was Valkyrie's birthday earlier this week (she was my first roommate in college; here's the e-card I sent her), so we all met up at New York Pizza today for lunch in her honor. I got there a little early because we went to see my grandmother first, and my mother was like, "Hey, I can just swing by and drop you off there on the way home." So I get out, and there's a gaggle of college students (I mean, I guess; about that age) getting into an SUV a few yards away, and then I hear this godawful crunching sound. I look over, and there's my mother, who attempted to swing back into traffic so carelessly that she neglected to see a curb, my God, a long wedge-shaped bit of curb jutting out and she is driving over it, scraping the entire bottom of the car with reckless determination, oh God, oh God, they're all laughing at her and they're looking at me I am going to die right here Mommmmm why are you EMBARRASSING MEEEEEEE No! NO! You are better than this! Pull your shit together!
So--I think maybe the adrenaline of horror made time slow down a little bit--I decided to
1) shoot the car a look of wry surprise;
2) chuckle indulgently to myself (silent chuckle! don't overdo it!);
3) smile warmly, not avoiding eyes of college kids;
4) walk down the street to the restaurant as if I was having the best day of my life;
5) go inside, buy my inner thirteen-year-old a Coke, and tell her to shut the fuck up.
Yes, it probably came off fake as all hell, but forcing myself to pretend like it didn't matter really made it matter a good bit less, and I didn't compound the humiliation by getting my drama on. So the Carefree Smile is going into my survival kit with the Reese Witherspoon Grin-Shug and the Julia Roberts Horselaugh. And if you have cause (sadly) to practice them often enough, you can actually pull them off with sincerity after a while.
So, pizza: four of us ended up splitting a Fire Island Fajita pizza (with bowl of salsa on the side) that was v. v. good, and then the more intrepid among us started trying to figure out how we were going to see The Dark Knight. With shows potentially selling out like crazy and roughly five dozen of us all trying to go together, this may be difficult; an expedition to Trussville on Saturday morning has been mooted. I'm just glad people even want to give opening weekend a shot, quite honestly, because my feeling is that it's going to be insane. People laugh at me when I get overcautious about these things, but I figure, either I'm right and we'll all be glad I saw it coming, or I'm wrong, we've lost nothing, and in a weird superstitious way I feel like my worrying actually warded the dreaded outcome off. Rigging it so you win either way is a good way to go through life, I guess.
So, meanwhile: I'm feeling a little too good about myself right now, so let's sidetrack into a grim revelation I had the other morning. I had another one of my crazy run-on sentence dreams, and I was so pissed off by it that I woke up and immediately wrote it down in my diary, even though it was four-thirty in the morning, and it went a little something like this (with some editing so that it's coherent for a third-party audience. God, I can't even believe I'm sharing this):
Oh. My GOD. I’m so disgusted that yes, I am actually writing this down in the middle of the night. I never get to have hot dreams about good-looking celebrities, never, and I finally have one about this bizarro giant party-it shifts from varying levels of formal throughout the dream, but mostly it’s local society “stylish,” like a church formal, almost, with people of mixed ages; at one point I had a giant spiderweb run in my stocking that everyone could see (right shin, if it matters symbolically) but I decided not to care, and the fact that I was wearing a skirt and stockings should tell you something about the formality level right there, and there was some hapless older French woman who had a giant run too, and I was telling her how I didn't even care about mine at all, I was just going to go have fun-and for some reason, I was on the hunt for (Hot Actor) the whole time. [Note from the waking present: it doesn't matter who it was. I even called him "(Hot Actor)" in the diary entry. Even when celebrities do wander pointlessly through my dreams, it's almost never the same one twice. Except for Brad Pitt. But it wasn't him.] I wandered through clubs, dives, restaurants, art galleries and then back to the party looking for him, and he was always there, just ten steps ahead wherever I went looking, just out of my reach in the crowd. But I was not going to give up until I caught his eye somehow, and I felt this huge despair that I was never going to manage it (much like with guys in real life, I suppose), and [the Lovely Emily] was cheerfully also trying to hook him, but neither of us actually got very close, and then there was some kind of weird sit-down buffet dinner in a school cafeteria (my old middle school? Those long tables with the attached stools? Like it was a reunion held at a school decorated for the occasion or something?) that was just bizarre in terms of going off on a dream tangent, and I was trying to wander a little nearer (Hot Actor)’s table when I got cockblocked by old grade school friends, seriously, what the fuck, and ended up having to sit with them [I identified the friend in question in my diary-there was a weird history of not-but-almost dating in high school there]-a larger group of grade school people were waving to me and I barely knew them, but they seemed desperate to get my attention, maybe one weedy guy in particular [identified as well, a strange little bit of history there too], and [Weird History] was determined to steer me over to his smaller group instead, and I very much got the sense that he was planning to hit on me After All These Years and didn't want to lose me to the other group, and because it was my dream, for fuck's sake, I was probably right and I wasn't happy about it (like, now he wants to make a move, are you shitting me)-and the dream got sidetracked by some girl who I’ve never seen before at the table behind us who was angry about her parents having been killed or something and was I involved (I wasn’t), I don’t know, I managed to extricate myself from that and then it turned into me being in some room, like we all had hotel/motel rooms to spend the night, I guess? And my roommate (?) was some fratty guy I’d never met before preoccupied with his own frattiness and getting ready to go out again? And there was some black and white movie on TV about John Dillinger, of all people (I’d seen the tail end of a History Channel thing on Dillinger last weekend, I think was where that came from. And also, I think Public Enemies had turned up in the linkspam the day before) and I ended up having some weird in-color tangent about gangsters getting ambushed in our hotel-motel room but like it was a historical flashback and not actually happening at that moment, and finally I just left the hotel-motel as well-I remember clearly that I was wearing an oversized button-down shirt at that point (white with blue pinstripe?) and I decided to leave it open but I was wearing a long pink sweater on top. Possibly no pants, I’m not sure. Kind of like a sweater dress… with shirttails hanging out. Hot. (In my defense, I had great legs in the dream-I sort of cast myself as my Ideal Me.) There was some kind of midnight pool party (?) going on at the end of a long grassy slope, like behind the houses, only the very coolest people from the bizarro formal party, I could just vaguely see it, and somehow I knew he was there, and even though a pool party was the last effing place I should ever be, I was determined to go down there. In my sweater dress. With the shirttails hanging out. My fine unpanted self. I don’t even know what I was going to do. Just catch his eye and see what happened, just look for his face, be in the same social space with him, I don’t even know. And I’m walking down a driveway-honestly, this was cast a little bit as if the pool was way far behind my grandmother’s old house on [Childhood Street], and I was walking down our own [Childhood Street] driveway to get to it, very crowded and tight with cars, so spatially it was stretched out to even be able to get two and three cars across crammed in there-and I walked past a black car that registered as “our car” in the dream, maybe one Em and I had driven there in, and he was there, in our car, in the driver’s seat, in the dark, as if he’d been waiting for me to come by, which was kind of scary hugely rewarding, obviously-someone I’d been hopelessly tracking, someone I’d thought didn’t even know I was alive, and now he’s left the party and waiting for me. And so we ended up hiking up a hill to some… cabin? Tiny cabin? It was suddenly morning? It was a Cabin of Booty, that's all I know. And I am serious, I am so about to get some hot celebrity dream action like everyone else gets in their dreams, finally, and in the dream, IN THE DREAM so it is totally MY OWN FAULT, my MOTHER bursts in and asks where Sam is and how I managed to lose him. I am at A PARTY, an ALL-NIGHT PARTY, and now I have gone off to HOOK UP WITH A GUY, and here is MY MOTHER asking me WHERE THE DOG IS. OH MY FUCKING SHIT, YOU ARE FUCKING KIDDING ME. I then WOKE UP, I was so angry. What THE FUCK. It’s not like she woke me up in real life, which would have been bad enough and I probably would have killed her; my own subconscious sent her in there to stop the fun. Oh MY SHIT. In fact, “My mother interrupts to ask me about the dog, which I am somehow responsible for even when I’m out trying to have fun LIKE AN ADULT WITH A REAL LIFE” is probably the biggest statement about my life that my subconscious could try to make. It’s not even subtle. It doesn’t even need interpretation. How could I do this to myself? How? Why would I not even feel like I could escape in my dreams? Is it just that I’m not used to it? My subconscious has just fallen into the habit of orienting my life around the goddamn dogs and my mother, God bless them? Am I going to have to retrain my own subconscious to stop cramping my style?
Y'all, there are some changes that are going to have to be made in my life.
Okay, I am trying to figure out how to segue into this next part without some cheesy transition about "and now let's talk about the medication that may or may not help me make those changes!," but: the whole back story on the Zoloft that I was going to tell you about the other day. What's happened is, now that I've cut my dose in half (again: doctor supervision), I'm starting to see what it was actually doing in the first place. After a great deal of thought and discussion, what I'm realizing is that it was acting as a kind of control or inhibitor. And when I started taking it in college ten years ago, right after my parents' messy, horrible separation, "inhibition" was a good thing. I felt like all the seams were unraveling, I was suffering severe, crippling anxiety, and I was obsessive-compulsive (mostly in a pack-ratting and obsessive collecting kind of way, not in a hand-washing or oven-checking way or anything). Zoloft was like someone taking me by the shoulders and saying, "Look, let me worry about some of this for you for a while. Not all of it, but enough that you can get on with your life." I felt kind of "held down" at first, like I was a little too mellow about things, but eventually that wore off and I just felt able to function. I had a great sophomore and junior year; I had a double major, I organized poetry readings, I edited the school literary magazine. For the first time in my life, I was reasonably active and confident. I was even able to do some public readings (some in Spanish and French, no less) with a minimum of anxiety. (The second half of my senior year was horrible, but that was event-related depression, not the medication.)
So, ten years later, here we are. particle_person made an interesting suggestion a couple of medication-themed entries back, which was that either your brain chemistry could just naturally change on its own, or that taking medication over a long period of time could cause it to change (either or both could be possible), and that it might be instructive for someone to go off their meds entirely every few years just to see what the state of the nation was, so to speak. My first reaction, which I kept to myself mostly, was a panicked one of OMG NO DUN TAKE MY CANDY, but the more I thought about it, the more I began to wonder if maybe I don't need to be on Zoloft at all anymore. Which was actually my doctor's suggestion--that I might should (this is perfectly acceptable grammar in the South, shut it) taper off Zoloft and possibly Wellbutrin and stay on Lamictal only, particularly as our diagnosis over the years has changed from straight depression to bipolar...ity, because if you have both depression and mania/hypomania, an antidepressant could possibly unbalance that, whereas an anti-seizure drug like Lamictal is more about evening out the bipolar cycling. More importantly, where I felt like I was unraveling before, and a sense of something holding me down, holding me in, was a relief, I'm starting to feel now like a plant that's outgrown a flower pot. Instead of Zoloft calming me down enough to get things done, I feel too "mellow," too anxious and apathetic, to get out there and try.
So here's the thing: now that I've gone immediately down to half the dosage I was taking (while slowly tapering up the Lamictal), I immediately noticed what Zoloft was no longer doing for me. For one, it wasn't suppressing my appetite (before, I'd had a hard time motivating myself to actually fix meals), and I wanted to eat the entire house. I enjoy going off on hyper/happy/caffeinated tangents here, as y'all have seen, but now I was starting to feel a little giddy. It reminds me of being a teenager again, like I'm not quite moored to the ground, and I might reel away from the earth the next time I laugh (or cry, for that matter. And on Zoloft, I almost never cry, even when I want to). It's a very mild version of that giddy feeling, though. But if I completely go off antidepressants... what if it stops being mild? It's true, you could say that Zoloft is "in control" of me rather than me being in control of me, but what if the alternative is being out of control? And sure, it's good to feel good, to feel better than you used to, but the flip side of that, of being bipolar, is that it's almost inevitable that you'll feel worse than you used to at some point. And I have had prolonged moments in my life where I have felt really, really bad. "I hope I don't wake up in the morning" bad. So you look out from the perspective of "Things are okay if I fight the not-caringness, or they could be really-really better or worse depending on a roll of the dice," and it's not that easy a decision.
And then discogravy linked me to this: One of the first cracks in the chemical hypothesis of depression came from a phenomenon known as the "Prozac lag." Antidepressants increase the amount of serotonin in the brain within hours, but the beneficial effects are not usually felt for weeks.
This led neuroscientists to wonder if something besides serotonin might be responsible.
[...]
It is jarring to think of depression in terms of atrophied brain cells, rather than an altered emotional state. It is called "depression," after all. Yet these scientists argue that the name conceals the fundamental nature of the illness, in which the building blocks of the brain - neurons - start to crumble. This leads, over time, to the shrinking of certain brain structures, like the hippocampus, which the brain needs to function normally.
In fact, many scientists are now paying increased attention to the frequently neglected symptoms of people suffering from depression, which include problems with learning and memory and sensory deficits for smell and taste. Other researchers are studying the ways in which depression interferes with basic bodily processes, such as sleeping, sex drive, and weight control. Like the paralyzing sadness, which remains the most obvious manifestation of the mental illness, these symptoms are also byproducts of a brain that's literally withering away.
"Depression is caused by problems with the most fundamental thing the brain does, which is process information," says Eero Castren, a neuroscientist at the University of Helsinki. "It's much more than just an inability to experience pleasure."
This new scientific understanding of depression also offers a new way to think about the role of drugs in recovery. While antidepressants help brain cells recover their vigor and form new connections, Castren says that patients must still work to cement these connections in place, perhaps with therapy [they also mention exercise]. He compares antidepressants with anabolic steroids, which increase muscle mass only when subjects also go to the gym.
"If you just sit on your couch, then steroids aren't going to be very effective," he says. "Antidepressants are the same way: if you want the drug to work for you, then you have to work for the drug."
And I'm not dealing with chronic depression, really; I'm dealing with a bipolar disorder. Maybe it's time for me to ditch the antidepressants, which I may have naturally grown out of anyway, try to rely on the Lamictal alone to even out the bipolar cycling and that "out of control" feeling, and look into more exercise (maybe some therapy, maybe a full spectrum lamp for the winter) for the downer end of the cycle. The reason I wanted to segue from the dream to this subject, basically, is that there are some changes that need to be made to my life, to my own priorities and needs, that can only be made by me, and that I'm not sure Zoloft is helping me do that anymore. So.
Meanwhile, it was Valkyrie's birthday earlier this week (she was my first roommate in college; here's the e-card I sent her), so we all met up at New York Pizza today for lunch in her honor. I got there a little early because we went to see my grandmother first, and my mother was like, "Hey, I can just swing by and drop you off there on the way home." So I get out, and there's a gaggle of college students (I mean, I guess; about that age) getting into an SUV a few yards away, and then I hear this godawful crunching sound. I look over, and there's my mother, who attempted to swing back into traffic so carelessly that she neglected to see a curb, my God, a long wedge-shaped bit of curb jutting out and she is driving over it, scraping the entire bottom of the car with reckless determination, oh God, oh God, they're all laughing at her and they're looking at me I am going to die right here Mommmmm why are you EMBARRASSING MEEEEEEE No! NO! You are better than this! Pull your shit together!
So--I think maybe the adrenaline of horror made time slow down a little bit--I decided to
1) shoot the car a look of wry surprise;
2) chuckle indulgently to myself (silent chuckle! don't overdo it!);
3) smile warmly, not avoiding eyes of college kids;
4) walk down the street to the restaurant as if I was having the best day of my life;
5) go inside, buy my inner thirteen-year-old a Coke, and tell her to shut the fuck up.
Yes, it probably came off fake as all hell, but forcing myself to pretend like it didn't matter really made it matter a good bit less, and I didn't compound the humiliation by getting my drama on. So the Carefree Smile is going into my survival kit with the Reese Witherspoon Grin-Shug and the Julia Roberts Horselaugh. And if you have cause (sadly) to practice them often enough, you can actually pull them off with sincerity after a while.
So, pizza: four of us ended up splitting a Fire Island Fajita pizza (with bowl of salsa on the side) that was v. v. good, and then the more intrepid among us started trying to figure out how we were going to see The Dark Knight. With shows potentially selling out like crazy and roughly five dozen of us all trying to go together, this may be difficult; an expedition to Trussville on Saturday morning has been mooted. I'm just glad people even want to give opening weekend a shot, quite honestly, because my feeling is that it's going to be insane. People laugh at me when I get overcautious about these things, but I figure, either I'm right and we'll all be glad I saw it coming, or I'm wrong, we've lost nothing, and in a weird superstitious way I feel like my worrying actually warded the dreaded outcome off. Rigging it so you win either way is a good way to go through life, I guess.
So, meanwhile: I'm feeling a little too good about myself right now, so let's sidetrack into a grim revelation I had the other morning. I had another one of my crazy run-on sentence dreams, and I was so pissed off by it that I woke up and immediately wrote it down in my diary, even though it was four-thirty in the morning, and it went a little something like this (with some editing so that it's coherent for a third-party audience. God, I can't even believe I'm sharing this):
Oh. My GOD. I’m so disgusted that yes, I am actually writing this down in the middle of the night. I never get to have hot dreams about good-looking celebrities, never, and I finally have one about this bizarro giant party-it shifts from varying levels of formal throughout the dream, but mostly it’s local society “stylish,” like a church formal, almost, with people of mixed ages; at one point I had a giant spiderweb run in my stocking that everyone could see (right shin, if it matters symbolically) but I decided not to care, and the fact that I was wearing a skirt and stockings should tell you something about the formality level right there, and there was some hapless older French woman who had a giant run too, and I was telling her how I didn't even care about mine at all, I was just going to go have fun-and for some reason, I was on the hunt for (Hot Actor) the whole time. [Note from the waking present: it doesn't matter who it was. I even called him "(Hot Actor)" in the diary entry. Even when celebrities do wander pointlessly through my dreams, it's almost never the same one twice. Except for Brad Pitt. But it wasn't him.] I wandered through clubs, dives, restaurants, art galleries and then back to the party looking for him, and he was always there, just ten steps ahead wherever I went looking, just out of my reach in the crowd. But I was not going to give up until I caught his eye somehow, and I felt this huge despair that I was never going to manage it (much like with guys in real life, I suppose), and [the Lovely Emily] was cheerfully also trying to hook him, but neither of us actually got very close, and then there was some kind of weird sit-down buffet dinner in a school cafeteria (my old middle school? Those long tables with the attached stools? Like it was a reunion held at a school decorated for the occasion or something?) that was just bizarre in terms of going off on a dream tangent, and I was trying to wander a little nearer (Hot Actor)’s table when I got cockblocked by old grade school friends, seriously, what the fuck, and ended up having to sit with them [I identified the friend in question in my diary-there was a weird history of not-but-almost dating in high school there]-a larger group of grade school people were waving to me and I barely knew them, but they seemed desperate to get my attention, maybe one weedy guy in particular [identified as well, a strange little bit of history there too], and [Weird History] was determined to steer me over to his smaller group instead, and I very much got the sense that he was planning to hit on me After All These Years and didn't want to lose me to the other group, and because it was my dream, for fuck's sake, I was probably right and I wasn't happy about it (like, now he wants to make a move, are you shitting me)-and the dream got sidetracked by some girl who I’ve never seen before at the table behind us who was angry about her parents having been killed or something and was I involved (I wasn’t), I don’t know, I managed to extricate myself from that and then it turned into me being in some room, like we all had hotel/motel rooms to spend the night, I guess? And my roommate (?) was some fratty guy I’d never met before preoccupied with his own frattiness and getting ready to go out again? And there was some black and white movie on TV about John Dillinger, of all people (I’d seen the tail end of a History Channel thing on Dillinger last weekend, I think was where that came from. And also, I think Public Enemies had turned up in the linkspam the day before) and I ended up having some weird in-color tangent about gangsters getting ambushed in our hotel-motel room but like it was a historical flashback and not actually happening at that moment, and finally I just left the hotel-motel as well-I remember clearly that I was wearing an oversized button-down shirt at that point (white with blue pinstripe?) and I decided to leave it open but I was wearing a long pink sweater on top. Possibly no pants, I’m not sure. Kind of like a sweater dress… with shirttails hanging out. Hot. (In my defense, I had great legs in the dream-I sort of cast myself as my Ideal Me.) There was some kind of midnight pool party (?) going on at the end of a long grassy slope, like behind the houses, only the very coolest people from the bizarro formal party, I could just vaguely see it, and somehow I knew he was there, and even though a pool party was the last effing place I should ever be, I was determined to go down there. In my sweater dress. With the shirttails hanging out. My fine unpanted self. I don’t even know what I was going to do. Just catch his eye and see what happened, just look for his face, be in the same social space with him, I don’t even know. And I’m walking down a driveway-honestly, this was cast a little bit as if the pool was way far behind my grandmother’s old house on [Childhood Street], and I was walking down our own [Childhood Street] driveway to get to it, very crowded and tight with cars, so spatially it was stretched out to even be able to get two and three cars across crammed in there-and I walked past a black car that registered as “our car” in the dream, maybe one Em and I had driven there in, and he was there, in our car, in the driver’s seat, in the dark, as if he’d been waiting for me to come by, which was kind of scary hugely rewarding, obviously-someone I’d been hopelessly tracking, someone I’d thought didn’t even know I was alive, and now he’s left the party and waiting for me. And so we ended up hiking up a hill to some… cabin? Tiny cabin? It was suddenly morning? It was a Cabin of Booty, that's all I know. And I am serious, I am so about to get some hot celebrity dream action like everyone else gets in their dreams, finally, and in the dream, IN THE DREAM so it is totally MY OWN FAULT, my MOTHER bursts in and asks where Sam is and how I managed to lose him. I am at A PARTY, an ALL-NIGHT PARTY, and now I have gone off to HOOK UP WITH A GUY, and here is MY MOTHER asking me WHERE THE DOG IS. OH MY FUCKING SHIT, YOU ARE FUCKING KIDDING ME. I then WOKE UP, I was so angry. What THE FUCK. It’s not like she woke me up in real life, which would have been bad enough and I probably would have killed her; my own subconscious sent her in there to stop the fun. Oh MY SHIT. In fact, “My mother interrupts to ask me about the dog, which I am somehow responsible for even when I’m out trying to have fun LIKE AN ADULT WITH A REAL LIFE” is probably the biggest statement about my life that my subconscious could try to make. It’s not even subtle. It doesn’t even need interpretation. How could I do this to myself? How? Why would I not even feel like I could escape in my dreams? Is it just that I’m not used to it? My subconscious has just fallen into the habit of orienting my life around the goddamn dogs and my mother, God bless them? Am I going to have to retrain my own subconscious to stop cramping my style?
Y'all, there are some changes that are going to have to be made in my life.
Okay, I am trying to figure out how to segue into this next part without some cheesy transition about "and now let's talk about the medication that may or may not help me make those changes!," but: the whole back story on the Zoloft that I was going to tell you about the other day. What's happened is, now that I've cut my dose in half (again: doctor supervision), I'm starting to see what it was actually doing in the first place. After a great deal of thought and discussion, what I'm realizing is that it was acting as a kind of control or inhibitor. And when I started taking it in college ten years ago, right after my parents' messy, horrible separation, "inhibition" was a good thing. I felt like all the seams were unraveling, I was suffering severe, crippling anxiety, and I was obsessive-compulsive (mostly in a pack-ratting and obsessive collecting kind of way, not in a hand-washing or oven-checking way or anything). Zoloft was like someone taking me by the shoulders and saying, "Look, let me worry about some of this for you for a while. Not all of it, but enough that you can get on with your life." I felt kind of "held down" at first, like I was a little too mellow about things, but eventually that wore off and I just felt able to function. I had a great sophomore and junior year; I had a double major, I organized poetry readings, I edited the school literary magazine. For the first time in my life, I was reasonably active and confident. I was even able to do some public readings (some in Spanish and French, no less) with a minimum of anxiety. (The second half of my senior year was horrible, but that was event-related depression, not the medication.)
So, ten years later, here we are. particle_person made an interesting suggestion a couple of medication-themed entries back, which was that either your brain chemistry could just naturally change on its own, or that taking medication over a long period of time could cause it to change (either or both could be possible), and that it might be instructive for someone to go off their meds entirely every few years just to see what the state of the nation was, so to speak. My first reaction, which I kept to myself mostly, was a panicked one of OMG NO DUN TAKE MY CANDY, but the more I thought about it, the more I began to wonder if maybe I don't need to be on Zoloft at all anymore. Which was actually my doctor's suggestion--that I might should (this is perfectly acceptable grammar in the South, shut it) taper off Zoloft and possibly Wellbutrin and stay on Lamictal only, particularly as our diagnosis over the years has changed from straight depression to bipolar...ity, because if you have both depression and mania/hypomania, an antidepressant could possibly unbalance that, whereas an anti-seizure drug like Lamictal is more about evening out the bipolar cycling. More importantly, where I felt like I was unraveling before, and a sense of something holding me down, holding me in, was a relief, I'm starting to feel now like a plant that's outgrown a flower pot. Instead of Zoloft calming me down enough to get things done, I feel too "mellow," too anxious and apathetic, to get out there and try.
So here's the thing: now that I've gone immediately down to half the dosage I was taking (while slowly tapering up the Lamictal), I immediately noticed what Zoloft was no longer doing for me. For one, it wasn't suppressing my appetite (before, I'd had a hard time motivating myself to actually fix meals), and I wanted to eat the entire house. I enjoy going off on hyper/happy/caffeinated tangents here, as y'all have seen, but now I was starting to feel a little giddy. It reminds me of being a teenager again, like I'm not quite moored to the ground, and I might reel away from the earth the next time I laugh (or cry, for that matter. And on Zoloft, I almost never cry, even when I want to). It's a very mild version of that giddy feeling, though. But if I completely go off antidepressants... what if it stops being mild? It's true, you could say that Zoloft is "in control" of me rather than me being in control of me, but what if the alternative is being out of control? And sure, it's good to feel good, to feel better than you used to, but the flip side of that, of being bipolar, is that it's almost inevitable that you'll feel worse than you used to at some point. And I have had prolonged moments in my life where I have felt really, really bad. "I hope I don't wake up in the morning" bad. So you look out from the perspective of "Things are okay if I fight the not-caringness, or they could be really-really better or worse depending on a roll of the dice," and it's not that easy a decision.
And then discogravy linked me to this: One of the first cracks in the chemical hypothesis of depression came from a phenomenon known as the "Prozac lag." Antidepressants increase the amount of serotonin in the brain within hours, but the beneficial effects are not usually felt for weeks.
This led neuroscientists to wonder if something besides serotonin might be responsible.
[...]
It is jarring to think of depression in terms of atrophied brain cells, rather than an altered emotional state. It is called "depression," after all. Yet these scientists argue that the name conceals the fundamental nature of the illness, in which the building blocks of the brain - neurons - start to crumble. This leads, over time, to the shrinking of certain brain structures, like the hippocampus, which the brain needs to function normally.
In fact, many scientists are now paying increased attention to the frequently neglected symptoms of people suffering from depression, which include problems with learning and memory and sensory deficits for smell and taste. Other researchers are studying the ways in which depression interferes with basic bodily processes, such as sleeping, sex drive, and weight control. Like the paralyzing sadness, which remains the most obvious manifestation of the mental illness, these symptoms are also byproducts of a brain that's literally withering away.
"Depression is caused by problems with the most fundamental thing the brain does, which is process information," says Eero Castren, a neuroscientist at the University of Helsinki. "It's much more than just an inability to experience pleasure."
This new scientific understanding of depression also offers a new way to think about the role of drugs in recovery. While antidepressants help brain cells recover their vigor and form new connections, Castren says that patients must still work to cement these connections in place, perhaps with therapy [they also mention exercise]. He compares antidepressants with anabolic steroids, which increase muscle mass only when subjects also go to the gym.
"If you just sit on your couch, then steroids aren't going to be very effective," he says. "Antidepressants are the same way: if you want the drug to work for you, then you have to work for the drug."
And I'm not dealing with chronic depression, really; I'm dealing with a bipolar disorder. Maybe it's time for me to ditch the antidepressants, which I may have naturally grown out of anyway, try to rely on the Lamictal alone to even out the bipolar cycling and that "out of control" feeling, and look into more exercise (maybe some therapy, maybe a full spectrum lamp for the winter) for the downer end of the cycle. The reason I wanted to segue from the dream to this subject, basically, is that there are some changes that need to be made to my life, to my own priorities and needs, that can only be made by me, and that I'm not sure Zoloft is helping me do that anymore. So.