Every year, I dread February. But March usually brings some relief. Even though it’s still winter, the days are obviously getting longer, and spring is coming. March is a often sunny month here in Winnipeg, and most years, I start planning my garden, spending a bit more time outside, and generally perking up after the February slump.
This year, though, I just kept sliding downward despite the longer days, the mild weather, and the promise of spring.
There have been lots of difficult things in my life over the last few years. After sixteen years together, I got divorced from the person I honestly thought I would grow old with. The lifelong difficulties with my dad and my stepmom culminated in total estrangement from them and from most of that side of the family. A couple of bad incidents at work of inappropriate behaviour directed toward me by “superiors” resulted in a sick leave and union involvement. In the middle of it all, one of my health issues (hyperthyroidism) flared up again, so there was a year and a half of med adjustment, blood tests, and appointments with the endocrinologist. Last spring, I abruptly quit therapy, not because I felt I was ready, but because after not meeting several commitments he had made to me, the therapist said something to me in session that I felt was a “last straw” of unprofessionalism; I was too overwhelmed by everything else going on to address it, so I just walked away. In the fall of 2014, my house had a sewer backup that rendered my basement tenant homeless and led to half a year of frustrating renovations and asshole contractors.
But I dealt with it, you know? I have some good, wonderful, supportive friends. I hate asking for help, and I seldom have over the last years, but just having them in my life has made a huge difference to me. I have tried hard to make art consistently (“a doodle a day keeps the crazy away”), to spend time with friends, to also spend enough time by myself, to eat well (this month will be three years as a vegetarian), and to spend time walking the dogs to get some exercise. Although I had to stop taking university courses because of the financial consequences of the divorce, I’ve taken other classes and learned new things and read lots of books, but I have also said no to over-committing myself or doing things out of duty or guilt or “shoulds.”
So this year, even though February was hard, I reminded myself that this happens every year and that things would get better in March.
But then March came, and there was no relief. I was still glued to the couch every night bingeing on Netflix shows, eating chips-and-dip for dinner and neglecting my house and my pets and myself. Sure, I went out and did a few things, but my heart wasn’t in it and I felt like I was just going through the motions. By mid-March, I was getting concerned. What if the February Blues just weren’t going to go away?
For about a year now, I have been considering going back on antidepressants. I had been on sertraline in the past, and that worked well for several years, but then my insomnia “broke through” and other symptoms started coming back; I quit the meds cold turkey in 2007 or so. I don’t recommend this! I had lots of withdrawal symptoms, the worst being the sensation of dozens of bugs biting me, or little electric shocks on my skin, for days.
But for the last while, I have sometimes wondered why I am trying to do this on my own without going back on meds. With everything that has happened over the last few years, there have of course been days and weeks and even months when I have felt utterly overwhelmed. There have been nights when I went to bed thinking how nice it would be to not wake up (“for a week or so,” my anxious brain would add. “I don’t actually want to be dead,” I would try to convince myself). But especially during my divorce, being dead—or, more accurately—“not being”—seemed like the only way out of all that confusion and pain and rage. My clever, self-protective mind dealt with this by just dissociating a lot of the time, but that’s also a state of extreme discomfort for me, and when I’m there, I struggle really hard with wanting to self-harm as a means of trying to “get back into my body.”
Still, I feel that I have done really well. I have not been actively suicidal (no plan or intent or gathering of means). I have not lost my job or lost my friends or lost my mind. In the times in between major stresses, I remember that the key is to get quiet, get grounded, listen to the Good Animal Voice inside me, my trustworthy and accurate instinct. And the way to do that is through art, through connection with my cats and dogs and friends, through regular sleep and not drinking alcohol and eating lots of veggies.
But sometimes it’s just so hard to remember why these things are important. And my insomnia was getting worse. I was waking up at night and starting into the dark for hours, anxious and agitated, going over everything that could possibly go wrong in my life, everything that had gone wrong in the past, and every humiliating or shameful incident I remembered. Even zopiclone would only guarantee five solid hours of sleep. Then I had a couple of full-blown panic attacks: tight chest, palpitations, feeling like I was choking, breaking into a sweat, nearly blinding terror that I was having a heart attack and about to die. And I thought, you know what? I need some help. Which is why I’ve been thinking about the meds.
Here’s the thing, though. I am a big believer in meds and therapy and taking care of your mental health. I am all about the anti-stigma aspects of mental health activism. I am always quick to suggest to people that they consider all options, including meds. But because of my own history, I hate asking for help in any way, and after having been shamed so much for being on meds in the past, after being ridiculed for being weak and needing help, after being taunted for making mistakes and not being perfect, it is really, really hard to believe that it is okay for ME to use antidepressants. Now to be clear, I feel the same way about the blood pressure pills I am on, but I’ve been on them for so long that I don’t really think about it anymore. In mid-March, as I got ready one morning, I looked at the tablet of atenolol in the palm of my hand and realised that once I’ve been on antidepressants for a while, it would be this easy. Part of my morning routine. And just as I finally gave in and took the anti-hypertensives because it was a matter of my long-term health, I decided to call my doctor and go back on antidepressants—because it is a matter of my long-term health.
First I did my research. I work with psychiatrists, and the reference materials available to me are excellent. I made a few lists: one of my symptoms and diagnoses, one of the side effects I was unwilling to tolerate, and one of the meds that would meet my criteria. I finally narrowed it down to citalopram and venlafaxine, and walked over to my doctor’s appointment prepared to advocate for my choice. My nurse practitioner heard me out, and wrote a prescription for venlafaxine without any argument, which was a relief but also a tiny bit disappointing since I was so prepared to convince her if she disagreed!
I walked my prescription over to my lovely neighbourhood pharmacy (where they let me take the Fluffy Dog right in as long as he behaves) and picked up my venlafaxine. Then I walked home and took my first pill right away, before I could have second thoughts. My nurse practitioner had warned me (and I read in my reference books) that venlafaxine can have pretty bad withdrawal symptoms, so I knew that once I started, I was pretty much committing to this. I know it’s usually four weeks or so before any real effects can be noted, but I am generally pretty sensitive to meds so between that and the placebo effect (read: my relief at starting meds for a problem), I usually start to notice effects pretty quickly.
The first thing I noticed was that within an hour of taking that first pill, I felt extremely nauseated and my head started to hurt. I took gravol and painkilers, and tried to tough it out. Most side effects go away within a week, and I really wanted to give these pills a chance. The headache and nausea lasted for close to three days, and then stopped. They returned on the seventh day when I doubled my dose, but only lasted a day and a half, and weren’t as bad.
The capsules are filled with tiny pellets and they make a little dry, hissing sound as they go down my throat, which is somewhat disconcerting. For the first few days, I took them in the evening, and by the end of the first week, I noticed that I was already less anxious when I was awake in the middle of the night—BUT—I was still awake in the middle of the night. The pharmacist had said that it can have a sedating effect, but it could also cause wakefulness, so I decided to move my dose to the morning to see if that made a difference. It did. So now I’m on 75 mg daily and will go back to see my NP in a couple of weeks.
I’m glad I’m back on meds. I’m mad that I waited so long. I’m hopeful this will be helpful. I’m sad that even though I am a proponent of meds for treating mental illness, I feel so much ambivalence and shame and resentment and anger and weakness about needing / using them myself, and about talking about it. It’s so stupid: I 100% believe this is a good thing to do and try—for OTHERS. But I myself am supposed to be strong enough and healthy enough and perfect enough and “together” enough not to need them.
It reminds me of the last time I saw my dad, before he and my stepmom stopped talking to me altogether. Dad and I were lunching together to try to discuss some of the difficult issues we’d been trying to address via email. I thought I was being very clear and logical and making a good fist of explaining how I felt, when he suddenly pointing his finger in my face from across the table and interrupted me: “There was nothing wrong with your childhood!” I froze, stunned, the proverbial rabbit in headlights, and he repeated, slowly and with great emphasis: “There was—NOTHING—WRONG—with your childhood.”
That’s the voice I still hear. Not necessarily his, although that’s one of its faces. But all of the people who have told me that my experiences didn’t happen, that I don’t feel what I feel. That the abuse is all in my head. That I have no reason to be depressed, or anxious, or to have flashbacks, or to be fearful of people. That the problem is ME. The voices of authority and judgement and punishment, telling me how I am allowed to feel, what I am allowed to remember, who I am allowed to be. And somehow this translates into me being ashamed of my own pain and my need for help. This translates into me being ashamed that my dad won’t talk to me and my stepmom shamed me and my grandfather touched me, because obviously I was a very bad kid if even my own family doesn’t want to love me. The problem is very clearly ME.
This translates into me being ashamed of going on antidepressants, because “obviously” I have no reason to need them. Even though I know—I KNOW—that mental illness does not necessarily have a clear cause or reason, any more than cancer does. Sure, sometimes the cause is obvious, but just as often it isn’t. Someone on Facebook shared a quote today saying maybe we should call it “mind cancer” instead of “mental illness” because people might take it more seriously.
I’m just so tired of trying so fucking hard to be strong all the time. I just want a little help. And I asked for it, and I got it. So baby steps.