Month: June 2018

Fluoxetine: Day 2

Bones

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Fluoxetine, also known as Prozac, is one of the generic “catch all” SSRIs that are often tried first and foremost, unless there is anything that would indicate another medication would be the best starting point.

I have just started it.  Last night I took my second dose of 20mg Fluoxetine.  I’m on ondansetron – although protip:  do not take this combination if you have a heart problem, and be aware that it does increase the risk of seratonin syndrome.  I’m taking this combination because, if I don’t, I will vomit.  I’ve taken ondansetron before, and it works incredibly quickly as an anti-nausea, and I was not going to be taking anything with a side effect of nausea without an anti-nausea and anti-emetic.

So far it’s quite a pleasant trip, and it really is a trip.  It’s like being permanently lightly high on MDMA – everything feels a little different, positive emotions are more colourful, and the filter that usually exists between your brain and your mouth (or in this case, the fingers) is largely absent.  Thus the rambling.

I have had minor excessive salivation.  I have had hyposalivation (drymouth) – which is handy because it makes me drink more.  I have had gastrointestinal cramping (honestly fairly typical of my GIT system with anything new).  I have had headaches.  I have had fairly intense nausea (thank you ondansetron).  I have had moments of light dizziness.  But overall I’ve had a sense of … relaxation.  Looseness.

I have also had a couple of small, but intense … anxiety / overstimulatory / wrong stimulation attacks.  I don’t know what they’re called, and I don’t know quite how to describe them, other than the visual and auditory stimulus is not something I like, want, or am interested in, and it is in such a way that it is … uncomfortable.

But overall, the first two days have been … loose, relaxing, verbose, cuddly, and not bad.

PTSD Awareness Day

Bones

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I didn’t even realise it was today, yesterday, the 27th of June.  PTSD awareness day.  We should all be aware of it, and realise that it is occasionally a sequellae of trauma, a bit like how reduced kidney function or renal disease is occasionally a sequellae of an acute kidney event.  Some people only need a bit of an acute event for their kidneys to be severely impacted.  Others need more.  It can be managed, but it often cannot be cured.

Well, that’s the same with PTSD.  People are individuals, and it is not your perceived level of the trauma the person went through that indicates the impact it has on the person, or the validity of the impact it has on that person.  Rather, it is the level of severity of the impact on the person as they experience it.

I have PTSD.  I was with a narcissist for many years in a romantic relationship.  I’m talking narcissistic personality disorder here, complete with impacting every area of his life, not just your regular old arsehole.

I have a moment I can remember and identify as a PTSD flash back.  This happened while I was on holiday.  I’m sure there were many before this, lost in the haze of ‘dealing with it’ (before I even vaguely understood what was going on inside my own brain), but this is the one memory I can pluck from my brain and say “see this, this is a PTSD flash back”.

He was, as many narcissists are, obsessed with the perception of power and wealth.  “Keeping up with the Joneses” style.  One of the things he loved to do was go to fancy hotels, have a luxurious full meal, spend a bit of time in the casino, and stay the night.  It was like a “stay-cation”.  It was all very posh.  Sometimes he would dress me up.  Later, he would insist I wear things that would make me appear unappealing and unattractive, or awkward in such a setting.

While on holiday earlier this year, my travelling partner and I briefly checked into … okay, it wasn’t that fancy of a hotel, but it was on par with what he used to like to go to, decor wise.  I was waiting in like for the desk to check in.  My travelling buddy was waiting with our bags.  I was tired, a bit over stressed because of wanting to get checked in and get some sleep before the next leg of our journey.

It hit me like a brick to the face.  I would turn around and it would be him standing next to the suitcases.  My stomach dropped, I wanted to vomit, and I’m pretty sure if I had opened my mouth it would have been my heart that came up.  I was shaking.  I forced myself to turn around, knowing that as soon as those suitcases were in sight … it wasn’t him I saw.  Instead it was the amazing, loving, equally tired human being I was on this mad journey with and I welled up with tears of relief.  It took a bit to stop myself from crying then and there, and even longer for the shakes to subside.  I was back to crisis control – everything is fine, nothing is wrong, it’s all okay, everything is fine.

It wasn’t okay, and it’s not okay, and it will probably never be okay, because every time I see someone who looks like him I want to vomit.  I have nightmares that this new life I have built for myself is just a figment of my imagination.  I will not enter certain places to eat because they are affiliated with him in my mind.  I will not act in certain ways because those ways were associated with him and the abuse.

Words cannot express how much this trauma has impacted me, how PTSD affects my life even now, almost half a decade since it all ended.  There are many more years of slow healing in my future, assisted by amazing human beings, animals, good music, medication, and a whole load of therapy.  Even then, I suspect there will be some things that I will just never be able to do, or experience.  And that is totally okay.  Because there are other things that I can do, thanks to being free of him.

Anxiety: Everything Is Fine … Until It Isn’t!

Bones

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I saw this picture and came up with a truly terrible analogy for my anxiety.

It’s like you’re walking along through the bush, and everything is lovely and serene, and you’re on nice flat land so you’re just loping along comfortably.  Then you hit stairs.  Except you didn’t know there were stairs there, and you can’t see them, and you don’t really know you’re on them, all you know is your heartrate is up and going forward is hard.  But everyone else is still loping along quite comfortably at their own pace.

Okay, so maybe anxiety is more like quicksand.  Or something like that.

All I know is that I’ll have moments where I’m fine, totally chill, totally okay with life, the world, and everything – pfff, I don’t have anxiety, I’m fine, I don’t need anything.  And then for no reason I’ll get the internalised panic, jitters, heart rate climbing, breathing getting tight.  Every muscle will be tense and my shoulders will climb towards my ears.  Even once I’m over the initial influx, I’ll be tense for the next few hours, fingers twisting, head ticking, breathing short and tight.

In my role, I just keep working through it.  I channel that nervous energy into output and clamp down on the rest of it (because everything is fine, nothing is wrong, everything is always, always okay).  It’s hard to deal with it, because my historic way of dealing with it was simply ‘push it to the side’, so if I’m wanting to ease it (for example, by meditating), I have to be very conscious not to just shunt it out, but rather ease it.  I can’t yet do that.

It’s all a big work in progress, and I’m learning things every day.  I’m hoping the fluoxetine will help reduce the anxiety – I start that in two days – and next year when I have access to free therapy, I’ll be able to really implement some better behaviours for dealing with the anxiety.

Restlessness

Bones

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I went to the doctors last week to get some extra medical oomph.  As part of the consultation, he presented me with a quiz sheet, with various questions and a “none of the time” to “all of the time” ranking.  This was for depression, and so it absolutely baffled me that “restlessness” was a question all to itself!  Restlessness is something I have never even considered as being a symptom of depression.

Because depression is an overwhelming sadness, an inescapable inability to do anything, right?

Apparently I thought wrong.  But as it is also a symptom of generalised anxiety, I don’t know how much is the depression, and how much is the anxiety.  All I know is that, at times, the restlessness is physically painful.

It’s a feeling of wanting to be anywhere else, doing anything else, than where you currently are and what you are currently doing.  It can be a sense of lacking achievement, feeling like you’re behind the curve and that you have to do something about it.  It’s an intense fidget that allows your brain to throw out all sorts of ideas that you never follow through on.  I will often start a new project during one of these moods, or spend hours looking at projects I could do instead of working on any existing ones.

I have yet to figure out how to get out of one of these moods.  Meditation doesn’t help, neither does music or doing things.  I’m not entirely sure if the supplements have reduced the incidence or severity of these moods, as I never remember when I last had one, or how severe it was … or think to record them.  I am, however, hoping that the fluoxetine will help with these moods.

Winter SAD

Bones

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It is the shortest day of the year, which means it’s winter.  Winter where I am means shorter days, more clouds, rain, cold, a lot of wind, and no snow.

To me, winter also means depression.  I get up and it’s dark.  I get home and it’s dark.  The dog gets a walk in the dark (and by walk I mean I let her loose in a paddock while I feed up).  I don’t want to do anything.  My weekends are filled with lie ins and days cuddled up on the couch.

Seasonal Affective Disorder is an encroaching depression that exists in autumn and winter and alleviates in spring and summer.  It’s often characterised by a change in sleeping patterns – typically to sleeping too much.  Some people have a craving for carbohydrates and an increase in weight, others will lose their appetite and lose weight.  Many still will have feelings of uselessness, an unwillingness or no desire to do things they once found enjoyable, and intense restlessness.

To me, winter means exhaustion and an overwhelming feeling of sadness.  It means sleeping more, a reluctance to move or get out of bed, or do anything at all.  It means days of intensely painful restlessness where I want to get in my car and drive anywhere it doesn’t matter but an inability to do so.  It means a longing to move, to uplift my entire life and disappear off into the mountains, or by the sea.  All this, and a feeling of hopelessness.

It’s agonising.  It is physically painful.  I twitch a lot, and it is one of the few occasions where I vocalise with little hums or grunts.  I’m not as able to regulate my anxiety as I normally can, and auditory input easily overwhelms me.

This year I’ve taken steps to reduce the effects of SAD, with daily vitamin D and magnesium supplements.  I spend a bit of time in my noise cancelling headphones with happy music on, and make sure I’m relaxed enough to go to bed in good time.  The addition of 5 minutes of meditation first thing in the morning has helped me regulate myself a lot better than the last years.  It’s not got it under control – that will be because it’s simply exacerbating a pre-existing depression rather than existing by itself – but it has improved things enough that I can manage.

There are other treatments out there – light therapy is one of them, and I know a number of people who are looking into the proper light set-ups.  Cognitive behaviour therapy does help (with the right therapist for you, which may not be the therapist you’re seeing, you’ve just seen, or who your friend is seeing).  So does medication.  If you’re struggling through winter and you just want to be an amorphous blob, take a tiny step and next time you’re at the supermarket (and can afford to), pick up a container of vitamin D pills and take one with dinner each night (do not take it with or around caffeine).  It may give you just enough energy to be able to get more help.