Ruminating on drugs

IMG_2211

My bestie Lou and my boy

I went to Australia, as planned, with the boy, as planned.  It was even more awesome than I was hoping.  Brisbane was wonderful, sunny, warm and pleasant, while back at home Auckland was hit with a weather bomb.  (Sadly, we didn’t entirely escape it, but I at least was both home and indoors for what remained).  The trip was solely so I could attend Jesus Christ Superstar, starring Tim Minchin as Judas, and the show was amazing.  I’m still singing the songs – and I’ve pre-ordered the DVD recording of the show so I can watch it again.  And again, and again.

The whole trip was a much needed breath of fresh air.  Yes, the boy was still slightly under the weather, but he was already improving before we started the trip, and has continued to improve steadily.  At the moment he’s mostly back to full health, with only a minor lingering occasional cough.  But for me, the trip was a break.  An experience of running away, without any of the consequences of unplanned running away.  Escapism at it’s best.  I took my bestie with me, ostensibly for help with the boy.  She was a huge help to me, too, though.  Just the chance to relax, and giggle, and travel, and share the experience with another adult.

I have to admit, too, that I expected more of a come-down effect.  Normally, particularly when a blast was had by all, I get a sucker-punch of the mundaneness of normal life once we get home, but so far this time I’ve managed to escape that.   That said, I’ve had it pretty easy – one day by myself looking after the baby, with minimal interruptions from the girls due to the help of their Gran, and the rest of the time the husband has been home.

It does leave me wondering about the drugs, though.   I started the paroxetine (Paxil) roughly six weeks ago.  (By which I mean, I have no idea how long ago, but it was likely more than a month, so six weeks sounds right.)  All the literature on the drug advises to give it six weeks to kick in – so, therefore, it should be fully in effect now.

So… the verdict.

I haven’t been so desperately hopelessly low since a week or so after starting the drugs.

I am still having anxiety – mostly around caring for the boy.  I know I’m capable of it, and in practice I just get on with it and do it, but there’s a part of me that still hates being alone with him, because there’s a part of me that still very much believes I’m not capable, and that something will happen.

On the flip side of that, I’m bonding much better with him.  Whether this is truly due to the drugs I can’t say – it’s coincided with him a) being off dairy so being happier and b) starting to laugh and giggle, and respond to actions / faces – generally being more interactive and social himself.  Much easier to love, bond, and care for a jolly wee soul than a squally screamy thing that at best is serious, but more often than not is exercising his lungs.  And – probably like most mothers – at 3am when he’s waking for the umpteenth time wanting to use me as a dummy, I still would prefer someone ELSE look after him.  For at least a few more hours so I can SLEEP.

But….

Scarily vivid dreams, often nightmarish, that I’m finding it hard to wake up from.  And even when I AM awake, they haunt me.

A general numbness to life.  I got in a semi serious car accident (we’re fine – car’s only cosmetically damaged – but the other guy’s car is totalled.  Broadsided – me into him.  His fault.) and haven’t cried.  Sulked a little because my shiny lovely ‘new’ car (which we’ve had a year, but is still ‘my new car’) is all banged up and ugly (though functional!) now.  Pouted.  But, not cried. Not gotten the shakes like I usually do afterwards.  And quietly terrified of where the logical, and sensible emotional response to such an obvious shock has gone.  They say with (illicit) drug addicts, that because the drugs mask the feelings and are an escape, that during recovery all those masked and postponed feelings will both come up and need to be dealt with. I really worry that instead of dealing with anything, I’m merely shoving everything aside til later.  Not fixing the problem, just delaying.

Which leads of course to the “medicated for life” issue.  Which still haunts me and I don’t think I’ll ever be able to get truly out of my brain, at least not while on the damn drugs.  If the drugs simply push away any real emotion… maybe the only way I’ll be able to cope is to simply never quit them.

And, possibly due to the above numbness, an impulsiveness that freaks me out – in part just because it’s not like me.  But the drugs lend a sort of “devil may care” attitude to me… as in, I’m not really feeling, and thus things like guilt are greatly lessened… so normally I might think X was a bad idea, but when on drugs – who cares!  Sounds good in the moment, let’s go with it.

Then of course there’s the psycho bitch that appears should any doses be missed or reduced, deliberate or not.  She’s so much fun to live with – even funner to be.

But the thing I hate most about the drugs is possibly hardest to explain.  I don’t feel like “myself” when on them.  It’s marketed – at least unofficially, when urging me to start them again – as NOT making me a different person, just helping me be the best, and happiest, me I can be.  I would think the above would illustrate this isn’t true… but it’s more than that.  It’s a subtle feeling like my body’s been taken over by someone else and the real me is trapped inside but merely an observer.  Added to that, that everyone around me is so pushing for me to go on drugs, and so happy with me when I do.  My body and soul has been hijacked by my twin – and they like her better.  I have lost the only popularity contest that ever really mattered.

A bit of a catastrophe

The past three or four days here have been a bit of a catastrophe.

Outwardly, nothing big or dramatic has happened. However, inwardly, it’s been turmoil.

I am on Paroxetine (generic brand of Paxil / Aropax) and have been since feeling the onset of Post-Natal Depression (PND) start approximately 2 months after having my most recent baby, now nearly 11 months. The drugs have been good – they’ve most definitely been effective, they keep me on a much more even keel, and make it much easier to find the motivation, that get-up-and-go-ness, that is absolutely essential to being a mum. They give me the joy to see my child smile at me, even when that smile comes in the shadows of 3am and I gently try to coax her back to sleep. They give me the motivation to just get on with it, when “it” is the endless routine of planning meals, cooking meals, picking up toys, picking up rubbish, refereeing, taxiing, reminding little princesses of manners, washing clothes, collecting clothes from various ingenious spots throughout the house…. you name it.

But not everything about the antidepressants is rosy. I’ve known this for awhile, as I had the same issues when I was taking the same drugs after the birth of my first child. This week, the dark side of the drugs have made my life a living hell.

At the beginning of this past weekend, I finished my active strip of the drugs. I had two more strips around, so I wasn’t concerned in the slightest, and put it out of my mind. But, with the distraction of the weekend, and having thrown the used strip out (thus out of sight) I completely forgot about taking the medication at all. Sometime on Monday I remembered, and had a brief look for the box containing the rest of the medicine, but couldn’t find them quickly and easily then got distracted, as mothers do, with the incessant calls of children.

By last night I was feeling truly terrible. I’d been getting dizzy spells all day, some extreme enough that I was concerned I would faint if I stayed upright. I had on and off nausea. I’d been up most of the night the night before, with a combination of a good book and not feeling particularly tired, then not having much luck when attempting sleep, plus of course being woken when I was finally asleep by the baby. Then I went to the store for the ingredients for a last minute snack to be cooked at home, spent the very last of my money until payday, came home, and ruined the late dinner / snack when attempting to cook it. I would have been annoyed in any case – but with the combination of everything, I was beside myself. Overnight, I managed around two hours of very broken sleep, most of which was obtained just as the sun was starting to rise. Lack of sleep didn’t help the situation any and this morning I felt nearly out of my mind. With no money left to pay a doctor for a prescription refill, and as I was sure I had no refills left on my current prescription, I figured I’d have to bear with it until payday, when at least I should be able to get a new prescription if the meds hadn’t appeared yet.

However, the husband – obviously thinking clearer than I was able to – popped into the pharmacy to check, and found that I did indeed have one refill left on my current prescription, so brought it home for me…. after which, of course, the originals turned up very near to one of the places I thought was highly likely they were.

Oy vey.

Paroxetine states in the literature about the medicine that one is not to stop taking the drug suddenly. In other literature I’ve found on the Internet, GlaxoSmithKlein admits that “up to 7%” of patients “may” experience “discontinuation syndrome” on suddenly stopping the medicine. In my personal and anecdotal experience, that figure is MUCH higher. Everyone I’ve known who’s taken the drug has had issues coming off it, even when slowly lowering the dose as recommended, and not just being an idiot like myself and stopping unintentionally. The discontinuation syndrome, in my experience at least, is drastically worse than the depression was in the first place. I know this about the medicine, and indeed, knew it before I started back on them this time (after having similar issues coming off them the last time). The problem is, Paroxetine has a very short half-life, the shortest of all SSRI style antidepressants. This is the cause of the withdrawl / discontinuation syndrome – and it’s also the reason why I’m on this particular drug. A short half life means very little medication transferring into the breastmilk, and thus best for baby. The longer the half-life, the longer it’s in the mum’s system, and the more it gets into baby’s.

When all goes to plan of course, the drugs are taken regularly (as in, within the same hour or two each day), and side effects are minimal. There are a range of side effects even under proper use of course – I alone have had excessively vivid dreams, a sleepy feeling after taking them, light nausea that comes and goes. It’s similar to feeling like I’m constantly in the very early stages of a pregnancy. (And NO, I am definitely NOT). I also strongly believe that although my moods are much more level, it also eliminates the true joys as well as the true sorrows of feeling, having a general numbing / dulling effect on life really. There is a big portion of me that feels like, when I’m on the drug, I’m not 100% myself, that some essential essence of me gets castrated whilst taking the drug. That, as well as being hard to put into words, is also quite unscientific, and thus hard to add to a list of side effects. But it adds up, and in my mind is definitely a negative side of the drugs.

However. The discontinuation syndrome kicks my ass, very thoroughly. Doing a quick and fairly unscientific read around the Internet last night, and the main recommendation for those having severe discontinuation syndrome (when legitimately intending to discontinue) is merely to resume taking the drug. Discontinuation syndrome does not mean that the depression isn’t cured or past yet. It merely means that the drug is now so essential to the system that it has become a necessary for the system to function… much like other well known addictive drugs.

I didn’t intend to come off Paroxetine this week, and thus, am back on my regularly scheduled dosage, hopefully to be all evened out within a couple days. However, the past week’s experiences have highlighted that I may well be on this cursed drug for the rest of my life – or at the very least, until significant medical advances have been made in the area of depression and the medication used to treat it.