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.
Sage Burning 
Oh my dear friend, I know just what you are going through. I have tons of medication and I hate taking it so once again I have stopped thinking I can find an alternative solution. But I haven’t. And change my diet? My will power is just not there. Something I really need to work on. I also average 5-6 hours of broken sleep. I pray things start to balance our for you and you start feeling better!
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I’m sorry you have so many of the same issues. It can so hard some days, especially without enough sleep. But, can’t give up, right?!? I am going to think more about how I might be able to do better with food, even if I can’t manage everything Tabitha is recommending.
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Yes there are some hard days but I just plug along through them. What else can we do, right? I hope the combination of eating better and Tabitha’s stew (lol) helps soon!
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I thought the same thing….i used to run around taking care of my daughter and all of her friends and cooking for all the kids in the neighborhood and now I am laying in my bed thinking about which medication will ensure i can at least sleep! And last night I did open a bag of doritos!! And those things are garbage.
My daughter has a nutritionist so we haven’t had soda or sugar or gluten in the house in over 6 months. I told my husband i just plain and simply needed some doritos. Which wont help a darn thing! But i ate them anyway and they tasted good while i ate them 🙂
I’m glad you left the links. It’s informational.
My daughter can eat all the fruits and veggies she wants but no dairy either. I think if most people just cut the junk , like doritos, and soda, and fast food, they would be so much better off. But sometimes I rebel because after eating all organic perfectly for so long and feeling like crap i just eat a little junk. Oh well. I have totally rambled on your blog!!!!!
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It’s not “rambling;” it’s just responding and connecting it all to your own experience!
Like you, I get the sense that if I eat healthy most of the time, a little bit of “cheating” with junk food is survivable. The question is what constitutes healthy. Does it really make sense to cut carbs so drastically? Tabitha thinks I have a lot of inflammation going on, which shows up as joint pain and also as fatigue and depression. She thinks that if I follow a very strict diet for 1-2 months, I’ll see a big difference and then can gradually add back in additional healthy carbs. I might try it. I just can’t keep changing so many things all at the same time; I feel so discombobulated.
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This diet started slowly and it was for candida and inflammation. It started wth the biggie no gluten. It wasn’t about carbs. She said a peach isn’t going to affect inflammation but a piece of bread and noodles will. So we stopped gluten and sugar first. Then she stopped dairy because that is also inflammatory. Then we stopped soy just to see if that was an allergen and it was. I think healthy is different for different people. For most, not eating fast fried food and avoiding fried chips and cupcakes and soda is a great start. But for those of us who already don’t do that then just choosing foods that are not inflammatory foods. The diet was just planned for one month. Then we took out dairy the next month. Then soy the next month. Then added back in the gluten to see what happened and the first day was fine but the next it wasn’t. Head fog and depression and fatigue and joint pain are all treated, our girl,said by removing gluten. Maybe just pick a starting point with what you think is doable. I mean it has to be realistic. It can’t be so unrealistic that you don’t do it.
I would do what you are comfortable with. If she says no carbs for a month then add them back slowly and you are ok with that. But obviously you have to be ok with that. We had a very open conversation about what was just too much for me and so we didn’t make it strict. We went 80/20. So 80% no carbs and 20% carbs which lowers inflammation substantially. Just some thoughts
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I talked with a friend today who has also moved herself to a much stricter diet in order to improve how she feels, especially to deal with joint pain and inflammation. She feels she can’t do 80/20 and still benefit. For her, cutting all sugar (meaning essentially no processed foods since as I’m sure you know, ketchup for example has sugar, and most peanut butters, etc.) has made a huge difference. But she has to do it perfectly to feel better. She said for her, the first two weeks are hard because she only feels deprived and doesn’t feel any benefit. Weeks 2-4 get a bit better, with a lower sense of deprivation and some benefit, but it takes her six weeks of being very strict to fully feel better. I almost wish she didn’t tell me this because it seems quite daunting! But it does tell me something, that you can do 80/20 and benefit, and she can’t. I need to figure out what I am willing to try and then just pay close attention to my own experience in my body, rather than following someone else’s plan and assuming it will help me.
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That’s very insightful. I’m glad you have a comparison. And are listening to your own intuition.
When we tossed the sugar and junk , for three weeks I was miserable and craving everything. And that was just with sugar and chips out the window.
I’m really glad your friend has found such healing. That is wonderful.
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I’m going to go through this bit by bit if that’s ok.
I can relate to feeling ‘better’ but still very dissatisfied, because my previous ‘normal’ was so high-achieving that my current state is pathetic in comparison. My experience here is that journalling and charting is very helpful in having some sort of concrete reminder of the progress you have made. As well as no longer being bed-bound and suicidal, don’t forget that you’ve made a huge amount of progress recently in terms of creativity and emotional/spiritual growth.
Drugs: the electric zappy sensation is typical of antidepressant withdrawal, and if this is the cause of the symptom then the answer is to taper more slowly (even what may seem to be ridiculously slowly, with weeks in between teeny weeny dose decreases). The Surviving Antidepressants online support group is really good for advice about this.
I’m not a fan of the approach of prescribing multiple psychiatric drugs (including natural remedies) to try and chase ever-increasing side effects. Having said that I’m not expert enough in psychiatric prescribing to give a professional as opposed to a purely personal opinion. I do think that unless you’re getting side effect which are actually dangerous or just too unpleasant to tolerate that it is worth persisting for at least a few weeks with each new thing as it can easily take this long to reach a stable situation – the drug levels themselves take about 5 half-lives to reach steady state, but the biological effects are not solely dependent on the drug levels (there are flow-on neuroendocrine and receptor effects) and it may take much longer to notice beneficial effects and develop tolerance to side effects. It is a big pity that natural remedies/supplements don’t have sample packs to try out before committing to large and expensive pack sizes.
Exercise: it takes at least 21 days of consistently doing something every day for it to become an established habit, and it is easy to lose that habit if you miss a few days in a row. It is important not to see missed days as “I’ve failed, I might as well give up” but to plod on regardless, and if you are struggling on multiple days, to set smaller goals such as just changing into your walking shoes and going nowhere or going out for even 5 minutes, or setting up your yoga mat and just doing a short meditation or something, and setting things up so it is less effort when it comes time to do the actual activity – it’s all about maintaining the habit so you’re not starting from scratch when you feel more energetic. As someone who hates exercise and never used to exercise regularly at all, I’ve definitely found this approach has worked for me with my aqua fitness classes (and also with my creativity project).
Diet: I think there are potentially a lot of benefits from dietary changes, but I also think Tabitha is asking for an awful lot in a short time. Again, I’m not an expert so this is all my personal opinion and you can take it or leave it. I have found that I feel worse when I’m eating diet high in sugar and carbs and sweet or fried junk food (I tend to live on tea and toast, potato chips and sweet snacks when I’m feeling depressed) and better when I take the time to prepare and eat more healthy food. I personally count rice or mashed or baked potato as healthy (compared with eating hot chips anyway) and would eat as much fresh fruit as I feel like because it is still streets ahead of eating sweetened canned fruit, ice cream, cake, biscuits and lollies. I have found some useful compromises as far as healthy vs junk – I love dip and chips, and hommous or homemade guacamole with flat bread or microwaved pappadum (or occasional corm chips) is still way better than cream cheese based dips with potato chips. There are high-protein subsitutes for rice/potatoes e.g. mashed butter beans or canellini beans, or maybe you two could precook enough rice/potatoes for several meals just for your husband to have. Finding enough energy to think about and actually cook in a new pattern is likely to be the biggest problem for you. If you were only going to focus on one or two things I’d say cut down on sugar overall and try to gradually reduce you caffeine (diet coke) intake because this is likely to have a really beneficial effect on your sleeping pattern.
Sorry, very long comment.
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Thank you for this thoughtful response. I have a lot of things to think about. I told E yesterday that I feel kind of overwhelmed by all of this, and she also encouraged me to just take a smaller piece and focus on that first. So that is what I am thinking. Meanwhile, I feel very groggy in the mornings from my latest med change, and I’m kind of discouraged, but I recognize that this is temporary and everything should get easier with time.
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Q, I want to share with you something said to me yesterday when I told her I felt like I was failing – “you’re doing the best you can right now, and that’s amazing.” This applies to you too.
I recently cut out dairy, gluten, red meat, and eggs. I was feeling a ton better but then hit a depressive spiral in the last week and ate cheese and nachos and all that. I went to my naturopath and was like “I didn’t do it” and she said “sometimes we need to have cheese.”
You’re doing the best you can with what you have. And while I don’t know enough about prescription meds I do think that with food Tabitha is asking an awful lot really fast.
What convinced me to cut these things out was blood work, when I saw lab results that indicated inflammation I was like – alright, I can do this.
Long story short, I hope you feel better soon, and remember that it’s okay to try and then change your mind. You’re doing the best you can with what energy you have ❤️
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So hard to remember that on days I’m tired or discouraged! But if I look at the big picture, yes, I am doing the best I can, and it makes sense that some days will be easier than others.
I really appreciate your encouragement, PD. xxoo
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I’ve been thinking a lot about this post and going back and forth on whether or not to comment…Often times you don’t give yourself enough credit for how far you have come! The mere fact that you haven’t self harmed in months is HUGE! You express yourself beautifully and you show up to therapy in spite of wanting to curl up under the safe covers of your bed. You, my dear, have showed vulnerability! And vulnerability is risky and courageous. Vulnerability can also be super uncomfortable at times but that doesn’t mean you are weak. You are not weak at all! You showed strength and self-compassion the day you quit your job, the day you went on the women’s retreat, the days you’ve self-disclosed to your hubby and to E. Everyday you show up and that takes courage.
So I am wondering if it is the meds that are helping or if possibly it is all this being vulnerable and therapy and movement you have been doing. Possibly they all work together but like you said you aren’t sleeping and there are other side effects but you aren’t who you were 3 years ago. You have grown and changed and I don’t know but it’s maybe worth it to see who you are without all the meds?
And don’t feel overwhelmed by the foods, it could be life changing as well! You might be surprised at how a home made pot of chicken soup helps with depression (studies have actually shown this). Was it Hippocrates that said “let food be thy medicine”
Love you ❤
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Thank you for this comment. It means a lot to me. When I read it over, I have to agree with you: I have made lots and lots of progress over the past three years. The fact that I feel stuck or overwhelmed at times doesn’t negate all that progress. And if it takes a while to get the chemicals and food and exercise right, well, then it takes a while. That’s okay, right? ❤ Thank you.
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The fact that you get stuck sometimes makes you human. We all ebb and flow. Be kind to yourself. Everything takes as long as it takes. 💜❤️💚💙
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