Adding Amitiptyline

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Yesterday my doctor undertook the ‘prod test’ for fibromyalgia.  I reacted to some of the control points (I’m not surprised, my muscles are always tight) and really reacted to enough of the fibro points that he’s sent me off for bloods to rule anything else out.

There’s one point, 2cm caudal to the femoral trochanter that he only had to brush against and I was howling.  The other side, he didn’t so much find it because he knew where it was but because I would start yelping when he got there.

The upside is he’s given me amitriptyline, which has been identified as better than placebo in some trials with regard to fibromyalgia pain.  I’m now on fluoxetine in the morning, and amitriptyline in the evening.  Because they interact, I have to be careful of serotonin syndrome, which is a very serious problem involving too much serotonin.  Fortunately I am almost always around someone who knows what I’m taking, which is so important while my body gets used to the new balance.

So far it’s made me very sleepy in the evening, which is great, because sleep was one of the big problems I have been having.  Fluoxetine is a stimulant and has really taken my easy sleeping days and turned them upside down.  Add the discomfort from fibromyalgia and you’ve got me waking up 5-6 times a night, and that does not make for a happy bunny in the morning.

In the mornings, however, moving is hard.  My muscles don’t quite want to work.  They’d much rather remain in a relaxed state.  My legs wish to retain their noodly ways.  My balance is a little off.  My brain is sluggish and prone to going completely blank.  My reaction times feel a bit slower.  It’s similar to how I felt when I first started fluoxetine, just quite a bit less severe, so I’m interested to see how this progresses.

I had my blood taken today for testing, which is never a fun experience.  I’m very not okay about needles.  They always hurt, the sensation makes me want to jump out of my skin, and I’ll occasionally faint.  Today was no different, although hooray, there was no fainting.  I warned them I’m a sometimes fainter and sometimes puker, and they were very good about putting me on a bed and using the tiniest needle, and keeping me talking all throughout to distract me.  It still hurt quite badly, I still went very fuzzy (and would have fainted if I hadn’t been horizontal), and the site is still incredibly tender.  Because my body has realised it’s been ‘injured’, the rest of the elbow has also flared up and become somewhat painful.  The joys of being tender, I suppose.

Now I just sit tight and wait for a few weeks.  I’ll hopefully know whether or not I likely have fibro by about this time next month.  In the meantime, I get to adjust to amitriptyline!

 

Settled In Fluoxetine

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I’ve been on fluoxetine (prozac) for about 6 weeks now (maybe 7).

The first week was amazing and weird – I felt like I was high all the time, and I fell asleep less than an hour after I took it.  I decided to take the fluoxetine at night so that I could sleep through the worst of the side effects, if there were any, and it seemed to put me to sleep really quick.  It was a good choice for me.  That first week I felt what it was like to have no anxiety or depression, and it was incredible.

The second week was okay.  I had a clear mind, I was more awake and alert, and overall I had more energy.  I just didn’t want to do anything, and that was fine.

The third week was pretty shit.  I had all that clear mind and awake and alert and a shitty brain.  My thoughts were very negative and anxious and I couldn’t shake the mood.  It didn’t impact my body the same way it normally does, though, I didn’t feel completely exhausted and wiped out.  I still wanted to be an amorphous blob, but I at least had the energy to do what I needed to do.

I did discover, part way through the second week, that my sleeping patterns were turning to crap and I wasn’t getting solid sleep (thanks Sleep Cycle), and I was tired.  I wasn’t achingly tired, but I was wired and tired.

Fourth week I realised I was getting back to me, the sassy little sasspot I used to be before I was wrapped up in narcissists.  I was no longer desperate to please people and to be non confrontational.  One of the people at work said something passingly racist about one of the people I work for, and instead of doing my usual pinchy-smile and feel uncomfortable, my first reaction was anger, and I let it show.  I couldn’t vocalise it, but I could at least show it in my face.  This was a huge moment for me, because I hadn’t done this in almost a decade.  I have been conditioned and abused hard to just not.  People please.  Make no waves.  Submit.

It was at the start of week five that I switched my fluoxetine to morning – I did a 6 hour step each day for two days to shift my medication taking the full 12 hours.  My sleeping patterns began to improve, although they are still not quite back to my usual solid sleeping.

Fifth and sixth weeks have been good.  Really good.  I’m much happier, I’m much sassier, I’m much more honest with myself and others about my needs.  I am more able to say ‘I just need to check out a bit’ when I’m in a situation that is overstimulating.  I am more able to say ‘no’ to people and situations that are not good for me.

I still have anxiety.  I still have depression.  I still have PTSD and panic attacks and meltdowns, but they’re more manageable.  I have enough headspace to take action to make my severely anxious days … less shit.  The depression doesn’t suck the life out of me.

And I will say this:  I wish I had been on prozac a decade ago.  

If you are thinking about medication, talk to your physician about it.  Organise your life so you have absolute minimal to-do for the first couple of weeks.  Go to absolute bare minimum, and let people around you know what’s happening so they can check on you.  And then take the plunge.  You may need to try a few different ones – everyone is unique, and every drug affects people in different ways.  Talk to people about your side effects, any quirks you’re having, and take their input on board, and give your physician honest feedback.  Don’t be afraid to say, after 3 weeks, ‘this isn’t quite working for me, can we please try something else’.

You are worth enjoying your life.

Conflict Avoidance

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I have been conditioned to avoid conflict.  I have been punished, ignored, cold shouldered, berated, insulted and put down whenever I rose to a conflict instead of rolled over, whenever I voiced an opinion that was contrary to what was being said.  I didn’t realise it was happening – it started off small, and phrased like a concern for me “you shouldn’t argue with people on the internet”.  By the time it was blatantly “don’t do that, that’s rude” it was too late, I was hooked into the narcissist and I wasn’t getting out.

Despite the many years I’ve been away from Him, I am still not free.  I have identified an immediate aversion to conflict, to the point where I will go along with things that I do not like, things that I feel are unkind, because I cannot deal with the conflict.  If someone says something unkind about someone else towards me I’ll smile and play along – doesn’t matter who it is, I just shut down, go into conflict avoidance and people please mode, and my brain disconnects.

I never used to be like this.  Back in high school (a friend of mine reminded me of this) I was sitting at a group of desks and another girl came over and said she wanted it.  I politely said no, and when she persevered, I told her to fuck off.  In exactly those words.  I had no issues telling two girls who were harassing me at home to fuck off and never come back again.  I had no problems standing up to bullies.

I am now into my fourth week of fluoxetine, and I have discovered an amazing effect.  I’m getting my backbone back.

Today a colleague was rude about one of the people I provide support for.  This particular individual is Chinese.  The rest of the office is not.  This particular colleague asked me to tell the Chinese woman to see her “once she’s done with her jabbering”.  Instead of my usual response – a polite, mincing smile and a churning of discomfort in my gut – I felt immediately angry.  While I couldn’t vocalise it properly, I certainly let it be shown in my face and posture.  This colleague was being very rude and racist about another colleague, one who she works with, and one who works harder than damn near everyone else in the office.

And for once, my first response wasn’t conflict avoidance.  I was, and still am, intensely proud of myself for that.  I feel more like me than I have in a decade.

A Not-Really Inspirational Depression Blog

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I have a fairly simple policy with my writing in all forms.  I will write for myself, and just hope that there will be other people in similar situations or of similar mindsets who may enjoy and/or benefit from what I have written.

I have depression and anxiety (amongst other things).  While I’m being medicated for it, the medication doesn’t stop me from being anxious or depressed.  It just makes it … less severe.  I still have negative thoughts, I still have panic attacks, I still have episodes of acute anxiety to stimulus, but I have a bit more mental clarity.  I have that tiny bit more headspace, alertness, ability to cope with it.  I think.

But I still don’t really have that much motivation, and I’m very deliberately not launching into ‘I’m totally going to do this, this and this all the time because it’s good for me’.  I have very limited energy right now, so I’m carefully selecting and doing really small things that help build me (from the ground up) into a healthier, more positive space.  If I can’t do that thing one day / week, that’s fine, I cut back to basics and wait until I have energy again.  I’m not going to suggest going out for a hike, or taking up yoga, or drinking kale smoothies because I don’t have the energy for that, and I know most other people with depression don’t either.  I’m not going to suggest taking a long bath, or cleaning your room, because when just having a shower is exhausting, cleaning your room is going to be too much as well.  Eating well is all well and good, but that also requires effort, energy, and thought.

It’s important for people with depression to realise that it’s okay.  It’s okay to not be okay.  It’s okay to not get out of bed for days.  It’s okay to not go outside.  It’s okay to not do dishes.  It’s okay to not do washing.  It.  Is.  Okay.

Take it right back to basics.  You can get up to pee?  Take a glass of water back to bed with you.  Can’t make a meal to eat?  Cereal and milk (if you can, chop a banana or another easy fruit that you like on top) is a perfectly acceptable meal (I’ll often do oats, flax seed, a sprinkle of LSA and a chopped banana).  Can’t do the dishes?  Buy plastic plates.  You are allowed to do things to make your life easier!  You are not required to do all these things you are “supposed to do”!

Be kind to yourself.  I don’t just mean pamper yourself, or love yourself, because if you’re ambivalent about yourself while you’re depressed you’re doing well.  I mean give yourself permission to not do things.  Spend a few minutes every few hours assessing your energy levels and how much you feel you can expend.

No energy?  That’s okay, cuddle back into bed or back onto the couch and nap.  If you can, a cuppa tea is often warming and comforting.  I personally love Earl Grey if I want caffeinated, or rooibos tea (with milk and honey) if it’s later in the day.

Little bit of energy?  Cool!  Next time you get up to pee, do a little thing.  I’ll often take a couple of mugs that I have inevitably forgotten on the arm of the couch into the kitchen and put them in the dishwasher when I get up for any reason.

Got a bit more energy?  Neat!  Is there one thing you would really like to start on today?  Wiping down one bench top is enough!  Picking up tissues and putting them in the bin is enough!  If you feel you are able to do more, that’s awesome!  Be sure to not just use that energy on cleaning or cooking, but also on yourself.  Having a shower and putting on fresh undies makes a world of difference.  Clean sheets are luxurious.

It has taken me a very long time to realise and even longer to accept that I can’t do everything, and that’s okay.  It took reading it, over and over again, for me to get the picture.  It’s hard, I’ve actually got a lot to do and a lot to organise and a lot of associated anxiety with it.  But I’m making decisions to make my life easier – like paying someone to clean the crate I haven’t cleaned in over a year that’s been living in my garage and I really need to return to the person I borrowed it from.  And asking friends to help me do tasks I just can’t bring myself to face, like sort out my wardrobe and get rid of all the shit I don’t wear (which is about 90% of my clothes).  It turns an insurmountable task into a fun, manageable one with two pairs of hands, some chocolate, and some good music.  And most of the time, we say ‘yeah we’ll totally do that’ and then end up vegging out on the couch, and that’s also totally okay.

So please, if you’re reading this and you’re depressed, just remember, it’s okay.  

Fluoxetine two weeks in

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I’ll have been on fluoxetine for 2 weeks as of tomorrow.  It’s been an interesting couple of weeks.

The first week was like I was lightly high on MDMA the entire week.  My words would trip over themselves falling out of my mouth, and my usual filter was … absent.  My brain would skitter off while I tried to concentrate on checking my work.  But I was completely anxiety free.  I was walking on cloud nine.

I also experienced increased thirst (which is no bad thing, as I live in a permanently dehydrated state), my kidneys were sensitive if I didn’t drink enough water, I had quirks of thermoregulation (I’m typically a lizard human but found myself overheating at work!) and difficulties focusing my eyes.

The second week has continued much the same as the first with regard to physical side effects, but the mood has not been quite as sunny.  I’m managing to concentrate better, which is good, because the work I do is quite reliant on speed and accuracy.  I have more energy during the day, and I’m more alert, so I don’t rely quite as heavily on caffeine to keep me moving.  I still can’t quite make words play as well as I used to, but I’m hoping the more time I spend writing in this new headspace, the more words will come back to me.

But now I’m in that irritating phase where I have a bit more energy but not the anti-depressant bit.  So I’m angry and I’m agitated and I feel like I’m stuck in the same spot pushing the same shit up hill.  I want to be anywhere but here doing anything but what I’m doing right now.  I want to be an amorphous blob.

I still experience anxiety, as well.  I still have some generalised anxiety, and oh boy do I still have specific situation anxiety, but it’s a bit more muted.  I experience it more in my head and less in my body, if that makes any sense.  My gut doesn’t drop and my heart rate doesn’t skyrocket, and I don’t start shaking, although I do notice I perspire more when I’m experiencing acute situational anxiety.  I still need to twitch, I still need to fidget, I still have my muscle ticks, but the threshold is a lot higher.

I’m hoping the third week starts picking the mood up a bit.