Medication Roulette

Over the years, multiple physicians, as well as a few friends and family members, suggested that I try medication. I adamantly refused every time. In my mind, relying on medication meant weakness, failure. Medication wasn’t an option because failure wasn’t an option. Even after I had come to terms with the fact that I needed help and that accepting help was not equivalent to admitting defeat, medication remained off the table.

After about a year of really working on myself, of trudging through the anger, of sitting in the hurt, I had another breakdown. The pandemic was in full swing and it was becoming increasingly more difficult to keep my head above water. I found I was no longer able to actively work through anything because all of my energy was being tunneled into just surviving. That voice telling me to run away, to escape, became a deafening yell. I eventually succumbed and fled to my family cabin for a few days of peace. This is, and always has been, my happy place. It is home. All my life, it has been my secret weapon, my sanctuary. I believe it has actual healing powers. Even when my world was at its craziest, I could always count on finding peace at the cabin. If the cabin couldn’t make the madness stop, nothing could. Well, this time, it didn’t work. The voices in my head didn’t stop, the tightness in my chest didn’t ease. That’s when I knew I was beyond repair; escaping wasn’t going to work. It was time for me to take the next step. I needed to take this head-on. I was finally ready to consider medication.

I thought finally accepting pharmaceutical help would be the hard part. I was very much mistaken. Essentially, you are knowingly ingesting something that has the power to control your thoughts and impact you physically, but there is no way of knowing exactly how it will affect you. You are also entering this process with the understanding that it may take several trials before you find the medication that is going to work for you. Being someone who craves control and has a strong aversion to inefficiency, this was my nightmare. Every medication also comes equipped with its own special side effects, which may expose themselves right away, or lay dormant just long enough that you start to think they don’t exist. Oh, but they do. The lines become blurred as to what is real and what is all in your head. Is this a physical side effect, or is my mind creating this physical symptom? It becomes challenging to differentiate between which thoughts are your own and which are being altered by the medication. And this experiment is all taking place while you attempt to continue to work, interact with people and carry on with your everyday life. For those that have ever partaken in mind altering drugs recreationally, imagine doing so but also having to go to work, be normal around people who are not on drugs and basically be a fully functioning adult. Day after day, week after week. Not an easy feat. I will admit that there were days along the way that I just couldn’t cope. Days that I stayed home from work because I felt completely ill and had zero control over my thoughts and emotions. These days were horrible. I felt hopeless, overwhelmed and alone. I just had to sit in it and hope that it would eventually pass. A friend of mine said it perfectly when she coined the process Medication Roulette. It is not a fun game.

In the past, I have had friends decline or cancel plans because they have had to adjust their antidepressant/antianxiety meds. While I was sensitive to this, and definitely didn’t hold it against them, I also never really understood the extent of how awful this can be. Now I get it. Starting a medication, transitioning to a new medication, or even simply adjusting the dose of a current medication, is a complete mind fuck. Each trial is at minimum a three-to-four-week commitment. Your body needs time to adjust before you can know whether or not the medication is a good match. And then there is the process of finding the right dose, which can tack on at least another couple of weeks. For me, each medication trial took two or three months before a definite ruling could be made. There were many points where I contemplated just giving up entirely. I didn’t know which was worse; being unmedicated or being in constant limbo with frustrating, sometimes debilitating, side effects. To make things more interesting, sometimes it was hard to differentiate between a side effect and a symptom of being insufficiently medicated. But the glimmers of hope kept me going. There would be days, maybe even weeks, when the side effects were muted, and the medication hushed the anxiety and darkness enough to allow me to breathe and think. Those times were glorious. I had the capacity to work on my issues and I actually felt like myself again. Knowing that this was possible motivated me to keep trying.

Embarking on this experiment, I refused to repeat my old patterns. This time I was unwilling to hide my crazy. Starting medication was not going to be my dirty little secret. This time, I would not be ashamed. I am so glad I made this decision and I am incredibly grateful to have such understanding and kind individuals in my life. I don’t think I would have been able to persevere without the support of the people around me. Being open and honest about my experience made it feel like we were all in it together. I felt like I had a whole community behind me. I wasn’t alone. I had more energy to focus on getting better because I wasn’t wasting it all on hiding my secret.

When I started my first medication, it knocked me down for a few days initially. Being a person who hardly ever even takes Tylenol, my system must have been blindsided. It felt like I was in a NyQuil induced stupor. Like there was a battle going on inside me. My body felt limp, my heart rhythm felt completely out of whack, and I could hardly think. Even the smallest tasks were exhausting. I remember standing up to fold a single load of laundry and having to lie down and take a rest halfway through. This faded away after a few days but round two was waiting to pounce a couple of weeks later when I was advised to increase my dose. After a few weeks of no dose changes, I felt better. A lot better. I had more energy, I felt more social, my mind was clearer. I felt a lot more in control of my thoughts and reactions. My husband even told me that I seemed calmer, brighter. He said he noticed I responded more rationally to situations that historically sent me into full panic mode.

After taking this medication for about three months, my body began retaliating. It started with the occasional night sweat. I would wake up in the middle of the night drenched in sweat. (Keep in mind, this was January in the interior of British Columbia. Not exactly tropical weather). At first this happened maybe once a week or so, but eventually it became an almost nightly occurrence. By the time it was decided that this was not the medication for me, these sweating episodes had even started happening during the day. Pretty quickly after the night sweats started, I had a couple bouts of diarrhea. Because this seemed to settle down, I attributed it to eating some questionable fruit and tried to forget about it. But these bouts kept recurring, despite me vigilantly avoiding all questionable produce. At first, it would be once or twice a week but over time it was happening almost every day. With the sweating and diarrhea, I, quite literally, felt drained. I also ended up with constant bloating and frequent cramps and my digestive system became quite vocal; very loud and strange noises could be heard coming from my stomach all day long. Even though I felt great mentally, I was a mess physically. Eventually my physical ailments were having detrimental impacts on my life, both professionally and socially. I had to admit defeat. It was time to move on.

A couple of medications later, I had a particularly rough time. Because of the gastrointestinal side effects that kept occurring, I was switched from one class of medications to another. This particular class of drugs was known to cause less GI upheaval. The day after I switched meds, I had a panic attack at work. The day after that I cried, which was something I hadn’t done in months. A couple of days later I lost my appetite, became nauseous and dizzy and had a headache. At this point, I was no stranger to adjusting to a new medication, so I knew I just had to tough it out and let it pass. Which it did. I began feeling better, but this upwards trend didn’t last long. At the three-week mark, I was incredibly irritable. I was just so angry. My fuse was terrifyingly short. I was genuinely afraid that I would snap and hurt someone; either verbally or physically. A crushing sadness crept in as well. I had to focus extremely hard to prevent myself from lashing out and/or crying. I withdrew from my coworkers, even those who I considered good friends. I didn’t trust myself to engage; I felt like I was going to crumble at any moment. I couldn’t even fake a smile or participate in a light conversation. I kept my head down and tried really hard to concentrate on my work. By the end of the day, I felt completely drained. I would come home feeling amped up, like I desperately needed to scream or fight someone, while at the same time feeling completely exhausted. Most evenings during that week, I would work out and then cry. Some nights I could barely even speak to my husband. Despite being completely wiped, I couldn’t seem to get into a restful sleep. I felt like I was in a dark hole all alone. I had this sinking feeling that I was letting everyone down, especially my husband who always took such good care of me. I felt like a burden. I was spiraling fast. This was one of those times where I couldn’t identify the culprit. Was it withdrawal from the previous class of medication? Was it an insufficient dose of the new med? Was it the new med itself? Was it hormonal? (PMS has always been a real struggle for me.) Was it circumstantial (We had been actively house hunting in a terrible housing market for almost ten months and had been heartbroken multiple times either being outbid in bidding wars or discovering deal breaking faults in houses that we had high hopes for. We were desperate to get out of our downtown apartment because of the constant noise, high crime rate and lack of space. Our landlord had recently denied our plea to allow us to have a dog. We hadn’t seen our families in over a year and I had just had to cancel a trip that I had been looking forward to for months with one of my very best friends who I hadn’t seen in several months because of new strict travel orders in response to the ever worsening global pandemic. I felt trapped; like I had zero control over my own life.) Or perhaps it was a combination of everything. Regardless, I saw no resolution. I couldn’t see any light at the end of the tunnel. Ultimately, my Nurse Practitioner concluded that I was “in crisis” and advised me to stop taking the medication immediately. Following this epic fail, I took a break from medication all together. I felt I needed to regroup, and we were heading into summer; things tend to be brighter for me in the summer months anyway.

I wouldn’t say I thrived that summer without medication, but I managed. A few months after going off medication, my gastrointestinal issues hadn’t resolved. In fact, they had become substantially worse. I ended up being diagnosed with Giardia (a parasite most often contracted by means of contaminated water, often coined “Beaver Fever”). Considering I hadn’t been out of the province, let alone out of the country and that I would have picked it up during the winter, I hadn’t been in any rivers or lakes either, I was shocked. That summer also brought big life changes. We bought our first house, which also meant moving about sixty-five kilometers out of town (a forty-five-to-sixty-five-minute drive depending on road conditions). A small sacrifice for the outdoor space and lifestyle we wanted. Two weeks after moving in, we were finally able to adopt our rescue dog. A few days after that, we were put on evacuation alert because of the ever-encroaching wildfires. This meant having a “go-bag” packed at all times and being ready to flee at any moment. Thankfully we didn’t have to evacuate, and the alert was lifted a week later. Adjusting to homeownership, pet ownership and a commute all at once was more challenging than I had anticipated. And the added stress of having to be ready to evacuate didn’t help. As the summer came to an end and the adjustment continued, I felt myself starting to sink again. I knew it was time to take another spin on the medication roulette wheel.

Because I had done quite well on the first medication, prior to the onset of what I believed to be terrible side effects (which I now knew was actually the work of Giardia), my Nurse Practitioner and I agreed that I should give that one another try. This time around, my body seemed to have a much easier time adjusting. I was drowsy and fatigued for the first couple of days, but I didn’t feel completely out of it like I had the first time. As I am writing this, I am still on this medication. The night sweats have returned, but they are less frequent and they haven’t crossed over into my days. On the gastrointestinal side of things, I don’t think the meds have had a significant impact. While I continue to struggle with several unpleasant GI issues, these issues were present prior to restarting medication and don’t seem to be any worse. Nothing like what I experienced with Giardia. While my anxiety remains a major player in my life, I do feel more capable of managing it and my thoughts aren’t so scattered. It seems to be a good fit, for the time being at least. I don’t plan on staying on medication long term, just long enough for it to serve it’s intended purpose of helping me find the bandwidth necessary to feel confident in my ability to tackle my hurt and build up my arsenal of self-care tools.

I think it is important to understand that antidepressants and/or antianxiety medications are not a cure. Had I embarked on my medication journey with the mindset that I would be cured of my anxiety and depression, I would have been devastated. I’m grateful that it was explained to me that these medications are not meant to fix, they are meant to give me the capacity to work on the root cause of my issues. Just as I’ve learned that counseling alone can’t rid me of my demons. I can’t expect anyone else, or anything else, to solve my problems. Mental health doesn’t work like that. There are many tools that can help to lighten the load, but ultimately, I need to put in the work.