The Year without a Summer

I woke up this morning feeling like I'd been hit by the truck I'd been dreaming about. My body felt like I'd been exercising strenuously the day before rather than the under-the-weather ache I'd felt the last time I'd forgotten to take my medication.

However, I woke up elated. Fresh. Eager to take on the day. Probably a little manic. Something I hadn't felt in quite a long time.

I've run this cycle of manic depression, I suppose, for the last 10 years, and decided about this time last year to attempt a change. I had tried therapy, and stopped, both because it was too expensive and because I'm skeptical of the psychology machine. All of the members of my immediate family, unbeknownst to me, had been taking psychiatric drugs, for a variety of ailments: situational depression, anxiety, clinical depression, bipolar disorder. I wanted to strike some compromise. Between skepticism of psychotherapy, a desire to get help, and a feeling of being victimized by these hereditary ailments. (Hereditary or lifestyle - nurture vs. nature. I'm still not sure which.)

So I visited a psychiatrist. I wanted an easy solution; I didn't want to think too deeply about the fact that I was going against my own long-held decision to find other means than psychotherapy. I was in a new relationship, I was at a relatively new job, I had a new living situation; I didn't want to fuck things up by doubting what I wanted to believe was progress.

The psychiatrist had treated my entire family at one time. I know now that very few psychiatrists or psychologists will do that. They are risking unbiased opinions if they do. Both my mom and my sister had stopped seeing him, and this worried me, but my dad had offered to front the co-pay for me, and in a financially influenced crunch, I went to this doctor.

He quickly and with very little ceremony, prescribed Cymbalta. I had heard of it, mainly from television commercials, and was eager to take the proffered free samples. (I had no insurance; I felt that I wasn't in much of a place to be choosy.)

The first thing I noticed was an increased ability to concentrate. I've always been an easily distractable person, prone to restless movement and mind. The weekend that I started taking Cymbalta, I was schedule to drive to Rochester, MN with my then-boyfriend and his family. I noticed, triumphantly, that I was able to read with very little distractedness, for the entire 4 hour drive.

After that, for the next few months, I felt productive, hopeful and less prone to anxiety attacks. Great, I thought; even if Dr. W. makes me uneasy, I'm not negatively dwelling on things to the point of complete inaction.

My sister warned me that first night I came home with Cymbalta that Dr. W. was too quick to prescribe without discussing causes of anxiety nor side effect of medicating; Cymbalta has some wicked withdrawal side effects, she told me. I had recently started taking a regimen of birth control, and felt confident that I could keep to a schedule of medication that would help me to avoid missing any dosages.

And I was. Able to keep my doses timed, with the help of a phone alarm and a disregard for social disapproval of taking BC in public. Until May, when I missed my first dose - I was at Riversplash with a group of friends and, in a reaction to the crush of the crowd, started bugging out. I retreated into a painful self-scrutiny that no friend and no beer could yank me out of. I got home and took the meds and fell asleep and thought, never again.

Then, in late June, I missed another dose; I was unexpectedly at my boyfriend's house and had forgotten to pack my little plastic box of pills. At his apartment by myself (he was at a rehearsal, and I had gotten stuck with no transportation), I had no crowd to worry me, but my body started aching. I began feeling more and more tense, my head started pounding, and my mouth went dry as a desert. I didn't think much about it except to demand Nic drive me to my apartment when he got home so that I could take my medication before going back to his place to sleep.

I haven't missed it again until last night. I left the Cymbalta at home when I had to stay at work until 9. I kept myself distracted, there was a pleasing mix of interaction and alone-time, and when I got home, I fell asleep shortly, forgetting to take it. Didn't even think about the withdrawal that was sure to come.

I realize now that I may need those manic up moments to accomplish things; Cymbalta had been suppressing the down times as well as the up times, and I hadn't even realized until last month that I'd been feeling glum and grey for the year that I'm been taking Cymbalta and birth control.

I did a little research this morning on the side effects of Cymbalta (please don't think I went a full year without researching this; it's only now that it has galvanized me to action.) Some are far out of my range of experience (auditory hallucinations, brain zaps), but some I was experiencing (nausea, body aches, chronic fatigue) and hadn't realized they were related to the drug.

I spoke with Kate recently about holistically approaching my (mental) health, and have mad appointments in that direction.

What's strange is that I've missed these manic up days. I know, if I stop taking Cymbalta, that withdrawal will be very difficult, and the manic down days will surely suck, but, well... we'll see.