effexor and jodi

I suppose it's significant to share what happened after the anniversary party.  I contacted my doctor and told him that my panic attacks were, if anything, worse on this drug, and I wanted to go off meds completely and see what happened.  After all, I was ON meds when I developed this panic disorder. He instructed my how to taper off the med. With what I experienced you would think I just stopped taking it cold turkey.  Extreme vertigo and nausea is what I remember the most.  Moving at all was a challenge. 

However, the decision to go off of meds led me to the best decision of my life, so I can't possibly regret it.  I was in therapy for a short while in early 2007. Once I bought my first house, I felt so happy! I didn't feel like there was a reason to be in therapy anymore.  A few months after I stopped seeing Nancy I got a letter from her that she was retiring, and if I chose to begin therapy again, I should contact a therapist in St. Matthews that she recommended. It was months before I decided to go back into therapy, but luckily I held onto that letter.

Once I decided to stop taking meds altogether, I decided that it would be smart to get some help getting through that.  Talk therapy, let's give it another try. So I called Jodi. 

My first session was December 17, 2007.  Just about 5 years ago. I actually had a mild panic attack on my first visit because I felt "trapped" for that 45 minutes in her office. It wasn't long before it became a safe place.

It was around Christmastime, and I recall that year I was getting my sister some books. This was back when I would shop at the actual mall at Christmas and I was at a bookstore when I decided to look for books on anxiety.  I found "The Idiot's Guide to Controlling Anxiety" and decided that I should give that a try.  That's when I first read the definition of agoraphobia.  

At my next session with Jodi, my second, I told her what I had read and that I thought I might have agoraphobia.  She informed me that she had already diagnosed me:  Panic Disorder with Agoraphobia. The OCD, depression, and generalized anxiety diagnoses would come later as we worked together.  But on my second session, she had me pegged.  I knew at that moment that she would help me. I was resistant to talk therapy for years. Even in my teen years, when my mother would suggest that I talk to someone to get through my angst, I would fervently resist. 

Don't be afraid to get help.  The stigma around therapy and meds is just the ignorance of people who don't understand. There is nothing wrong with getting help.  You could save your own life.

fight or flight

When I first suspected something might be "wrong" with me, I went to see my doctor and was put on my very first SSRI:  Zoloft. Which worked for a while, and then I completely felt numb.  That wouldn't do, I need to feel things. It's vital. So then there was Lexapro for a while but then I started having panic attacks.  Let's try Effexor.

I found out pretty quickly that I have no tolerance for SNRI's which are similar to anti-depressants but also affect how your brain processes norepinephrine in addition to the Serotonin. I went on Effexor in July of 2006. It didn't seem to do much for my budding anxiety disorder. Give it time, we said. Then I ruined my parents' 25th anniversary party.

Ok, maybe I didn't ruin the entire party. But my panic disorder, with which I would soon be diagnosed, took over that night and I have felt regret for that night for years now.

The evening had been lovely.  Mom and Dad renewed their vows at their church with their favorite priest. A reception was planned at the country club where most of our big events took place. It seemed like it was going to be a great evening. Great friends, great food, and celebrating the two people I love and admire most in this world. Then we sat down to dinner.

Since I didn't yet understand what my triggers were, I had no idea how to cope with them. I sat at a large, round table with my siblings and one of my best friends, Whitney.  Somewhere in the conversation, it started. The knot under my ribcage that spreads and becomes a cold, burning sensation all over my body. Yes, cold and burning. I realize how that sounds, but it's the best way to describe how it feels.  My entire body was tingling, I could even feel it inside my nose.  It's like I wasn't even there for a moment.

Then, I realized my sister was telling a story. I tried to focus.  She was talking about a stand up comedy routine she'd seen on YouTube.  It was a funny story.  But I just stared ahead.  She would later tell me she knew something was wrong at that moment.

Strange things happen when I have a panic attack.  Besides the tingling and the out of body feeling, it's like my brain stops working. I can't think of the simplest things.  And the worst is when it upsets my stomach.  I excused myself to the ladies room to try and shake it off. Deep  breathing.  Be present. Focus. This night is important.

It didn't work. Must escape, need to leave. At least for a little while. What can I do? I pulled my mom aside and I remember telling her I needed to run home and get my glasses, which I'd chosen not to wear that night. But I was getting a headache and dizzy from not wearing them. Yes, having my glasses on would help this stop.  I took a Xanax, the smallest dose possible. At the time, I expected that to work.  It didn't occur to me that I could take another of such a small dose and possibly stop the panic attack that wouldn't end.

Whitney and I decided to run to my house and get away for a few minutes.  Then, there was a CD that we had to go get. My parents didn't have their song to dance to! We went to Target and I found a Barry Manilow CD that contained the song.  By the time we did that and went to my house, we'd been gone over an hour. I missed them cutting the cake. I missed so much.  My older brother was convinced I'd just run off with my friend, and blown off the party. My family was worried about me. This was extremely out of character.

The evening wasn't a total loss, but I will never forget what I missed that night. Nor will I forget the stress I put on my family members who were either pissed or worried that I took off.  I don't blame them.  They didn't know. How could they? I barely did. I didn't know how to cope so I did the one thing that I knew to do. I escaped.

I at least was able to make a short speech as we (my siblings and I) presented my parents with their anniversary gift. I don't remember the speech in entirety, especially since it was off the cuff. But I do remember telling them that I was lucky enough to have not only parents, but friends, who were there for me no matter what. This couldn't be more true.

Later that evening I remember sitting outside with my sisters and my brother in law, talking about what had happened.  It helped to talk about it. But all in all, I'd say I was in panic mode for about an hour, and recovering for a while after that. I was exhausted.

That night was one of my top 5 worst panic attacks, which is why I am sharing it now. I was utterly agoraphobic. I am not sure what triggered my panic that night I guess the lesson in this was don't be afraid to talk about it. Take away it's power.  Fight the instinct to flee. Don't let agoraphobia win.

meds

March 15, 2009. I had been off meds for 18 months following a rough bout with the SNRI Effexor. Effexor is one of those meds that affects your norepinephrine and your serotonin. These meds are not for me, but I'll tell that story later.

I started with my current therapist on December 17, 2007 after deciding to go off of Effexor. She explained to me that my issues were largely based on my chemical imbalance and that meds were probably going to be necessary, and sooner rather than later. I resisted, for the same reasons everyone does, I suppose: I don't feel like myself on that med, I don't want to be reliant on a psych med to get through my life, therapy will help me, etc.

Christmas 2008 was the first really bad panic attack I'd had in over a year.  My nephew, Zach, was five weeks old. I had cut some people from my life that were more than unhealthy for me. I was living in my first house that I bought and signed the papers for myself. Life was pretty spectacular. The only thing I really struggled with was my weight.

I had decided that, despite being 25 years old and having my own house, that I would spend the night at my parents' house on Christmas Eve. My older sister was there, in from Seattle, and it was fun to stay at home, even if it wasn't the house I grew up in. Let's face it, Santa knew where to find me.

That night was wonderful. We did our traditional sibling gift swap and took turns holding the baby. Everything was great. Until bed. I got ready and curled up in one of the guest rooms on the second floor of the house. I was cold, I couldn't shake it.  I was curled up in sweats under the covers, and couldn't stop shaking.  I got up and asked my sister, who was in the other guest room, if she could turn the heat up a little, as there was a separate thermostat on the second floor. And yet, I couldn't stop shaking. At some point I realized that I was not cold anymore, but still tense and shaking. Like a couple years before, I immediately assumed I was getting sick.  The thought of being ill, with the flu even, and not being at home propelled me into a state of panic. I cannot describe why, to this day, this is a trigger for me, but it is. All I could think was that I was going to miss Christmas, because if I had the flu, I couldn't be around the baby. I was enamored by him... still am to be honest. I couldn't bear the thought of getting him sick.

Finally, after what felt like a few minutes sleep, I took a Xanax around 3:00 in the morning.  After what had happened on the plane, my doctor prescribed a limited amount for emergencies just like this. I finally slept a few hours, and when I woke, I felt fine.  This time, I wasn't in denial.  I knew it had been another panic attack.

Things progressed a bit from there. I experienced anxiety on and off throughout that winter. I continued to resist meds, being the stubborn Taurus that I am. Until March.

It was a Sunday night. I had been doing somewhat well, considering I was feeling symptoms of panic somewhat regularly. I thought I was getting better. As I lay in bed that night, my mind was filled with dread about having to go to work the next day.  Thoughts raced: This really is what I have to do for the rest of my life? I hate it there. I don't get the respect I deserve, and I work so hard. I feel like I'm going nowhere and I am going to be stuck there for my career. Stuck. Trapped. Unable to escape. That's how it started.

Because I was not on medication and was still terrified of the things I felt when having a panic attack (I guess that's why it's called "panic"), it progressed throughout the night. My stomach was a mess, I was terrified to be in my own house, in my own mind. I slept a few times, for a few minutes each, it felt. I felt all the same things I had felt before, only for hours on end. And then I had what I consider my first suicidal thought. No ideation, no attempt, no consideration of doing anything about it. But I had never before thought about it.  And without warning, the thought invaded my mind: "If this is going to be the rest of my life, maybe I don't want to live the rest of my life." I shot from a 10 on the panic scale to about 100. This completely debilitating fear continued until about 6 am.  Below is something I wrote that night, around 11 pm:

i just need to release what's in my head for a few minutes. my panic disorder has been so bad the last few weeks. i feel so lost and incapable of dealing with everyday life. the thought of going to work tomorrow is getting me worked up. most of that is because i can hardly stand to be in the building anymore. i feel really hopeless right now. like there is no light at the end of this tunnel. i have definitely made the decision to go back on an SSRI. i cannot handle this anymore, i have to get some treatment. i hope so much that it works. i need to change some things to get to where i want to be. i am so far from happy right now. i have good days, okay days, and right out bad days.... but more bad than anything lately. Sundays used to be my day to chill and now it seems to be the worst day of the week because of the sense of dread of the week ahead. i just have to make it to Thursday when I go see Jodi. we'll decide which med i should be on and i will get it taken care of. i can't keep these thoughts inside my head, i just had to get them out. they "ruminate" and i get even more freaked out. why did this have to happen to me? i just want to be happy.

I called my mom at 6:00 the next morning and told her that I thought I had had a nervous breakdown. Don't laugh at me, I pleaded. I explained what happened. I called and left a message for my therapist that I needed to see her that day if at all possible.  I decided that night to go back on meds.

Within 48 hours, I was taking Prozac. Later that week, it started to happen again, only this time I knew I could take a higher dose of the Xanax (I had taken the smallest possible dose on Sunday). I finished dinner, took the pill, and managed to sleep that night.  The next day, Friday, I completely broke down at work. I decided to spend the weekend at my parents house as an escape - just to ignore the world for a couple of days. Sunday night when I went home, I felt scared instantly.  My house was no longer a safe place. It was a scary place. For no reason other than my mind was imbalanced.

I spent a majority of that spring and early summer basically living with my parents. I was afraid to be alone, in my own house. I had, until that point, loved living alone.

I came home every day but I couldn't sleep there. It took months to recover, even though the Prozac was working about 5 weeks after the panic attack.  I went on intermittent FMLA from work, to cover any absences that occurred because of my issues. Lucky for me, I had a boss who was neither compassionate nor compliant with the rules of FMLA and treated me like a slacker.

Meds may not be for everyone.  For some, they are a temporary solution.  For me, I know that at least for the foreseeable future, I will be reliant on an anti-depressant. It is the only thing that keeps the panic at bay, even if it isn't a cure-all.

There is nothing wrong with taking psych meds, if they help. A person with high blood pressure takes medication for that, and there is no stigma against it.  So why should there be for a drug that helps people manage their lives in the midst of panic, depression, schizophrenia, bipolar disorder, OCD... the list goes on. I ask you to consider that.