This is yet another post about the ever-changing mix of medications and supplements I am taking to (try to) manage my depression.
Tabitha is the witch brewing the magic potions. In reality, she is a psychiatric nurse practitioner with a lot training in alternative medicine. She likes neurotransmitter and genetic testing, and she likes Ayurvedic techniques like oil pulling. I absolutely accept that there are a lot of things beyond traditional western medicine that can be good for our health. I also have a lot of training in the scientific method and therefore carry a certain skepticism about things that don’t have a solid body of research behind them. It’s been a little difficult to balance my belief and skepticism, but in general, I have tried to accept and follow Tabitha’s recommendations so far.
And what has it got me? A mixed bag: I am much better off than I was in January, when I first went to see her. At the time, I was so depressed that I could barely get out of bed. I was intensely focused on suicide and self-harm. Those days are gone. I haven’t harmed myself since early April. I sometimes still have suicidal thoughts, but they don’t last; they come for a visit and then wander off again.
On the other hand, I don’t sleep well. That was somewhat true before, but it’s become a defining characteristic of my life in recent months. I probably sleep an average of six hours a night, often with many interruptions. I routinely feel “electric” pulses running under my skin, especially in my arms and legs. I am somehow overstimulated, jumpy. I have muscle contractions, twitches, especially in the morning. I still wake up quite depressed many mornings and then start to feel better as the day goes by.
Tabitha has adjusted my chemical stew many, many times to try to make it easier for me to sleep. I have a rather large collection of medications that I have tried for a few days or a few weeks and then abandoned. I have expensive bottles of supplements and in some cases have only taken a few capsules from them. Tranquility, for example. It seemed like something that might help me sleep at night. And it did, but then I couldn’t wake up and get going in the morning. So we give that up and try something else.
I end up wondering: am I being oversensitive? Am I giving up to easily? Maybe if I kept taking Tranquility for a week, I’d get used to it and then I’d be able to wake up properly and everything would be fine? And what about the Calm PRT, which I took for probably six weeks, but which we recently set aside? Good or not good? Is it the source of the electricity in my muscles? Or does that come from slowly, continually reducing the Effexor?
There are so many things in the mix that it’s impossible for me to tease out what is helping and not helping. In the morning, I take a taurine supplement in the morning, before I eat anything; it’s supposed to help me produce my own serotonin, which has been very low. After breakfast I take the (slowly declining) dose of Effexor, along with some Wellbutrin (also recently reduced), and Vitamin B12 and methylfolate and Vitamin D and a probiotic and fish oil. I was also taking a small dose of Zoloft but just discontinued that this week. Then at bedtime I take magnesium, NorLox Ultra, and a tiny dose of lorazepam (Ativan). And now I’m adding nortriptyline, to replace the Zoloft. [Note: I am including links to things I am taking, not as either promotions or critiques, but just to give you an idea of what all
Is this crazy? Or is this a detailed approach to figuring out exactly what it good for my body? Instead of seeing Tabitha every two weeks, should I let a month go by between visits and give my body time to adjust to whatever is going on? I can’t figure out how to think about this.
Lately, she has been pushing very hard on exercise and diet. Exercise, yes, I agree. I even had a week or so of successfully taking long, brisk walks with my dogs and going to yoga. But all it takes is a little bad weather or a day of severe depression, and it all falls apart.
And diet, yikes. Tabitha wants me to eat a diet of mostly chicken, fish, and vegetables for a month. Paleo-like. No fruit or almost no fruit (really? right in the middle of summer, when there are finally peaches and apricots in the market?). No grains. No sugar. And no diet soda, extra hard because I think I am addicted to it. I have made some changes, but so far I have resisted.
It’s all too much for me. It feels so overwhelming to go to therapy twice a week, to see Tabitha every two weeks, to see C every 3-4 weeks, to be working more than I was, to create and stick to an exercise program, to research a new way to eat and shop for it and cook for it (especially given my husband’s idea that rice or potatoes go with every meal and we should have something sweet every night after dinner). And I have a meditation practice and need to make time for self-care.
Suddenly I want to say, ugh, never mind, and I open up the bag of tortilla chips and a can of Diet Coke.
Then I read back those last couple of paragraphs and wonder what has happened to me. I used to take care of my boys plus a couple of exchange students while working a demanding professional job, cooking a lot more than I do now, and keeping up a regular yoga practice. I even used to get up early to exercise before I got the boys ready for school. I often felt stressed, but I got a lot done.
Now I take a ton of pills and sit on the couch and wonder who I am.
That’s not fair, I know. I had a lot of unaddressed emotional challenges before. I am much better equipped to deal with memories and the aftermath of trauma than I used to be. I accept myself more. I have let go of a job that was making me sick. I have made genuine progress and shouldn’t talk as though I haven’t.
Still, I am very confused about my next steps and whether or not everything in my chemical stew is serving me well or not.