Monday, April 18, 2011

Paxil, Rebellion, and Talkin' Bout My Generation

Allow me to discuss my experience with anti-depressants, and my current feelings about them.

I started taking Paxil back in the spring of 2006.

I started taking Paxil because work, my first teaching job, was becoming intolerable, and I was having panic attacks every time the principal walked into my room. So I took the Paxil, which smoothed my depression over work and such over remarkably, and all was well.

Well, not exactly, because the jerky, problematic arc of my teaching career continued to be both jerky and problematic, but I was very emotionally contained while several different jobs went to hell in a handbasket. Relatively speaking.

Now, I had been in therapy for a number of years, with a marvellous woman, and had gotten through a lot of stuff, and, in fact, learned quite a bit about managing my depression. My therapist never mentioned drugs, and when I brought it up once, she discussed it with me, but did not seem to think I needed anti-depressants, unless I felt they would seriously improve my quality of life. Which, at the time, I did not.

I fell a bit through the cracks with the Paxil, to be honest. It was some doctor at the ER who put me on it, and when I had to get a doctor to approve a refill a while back, she was fairly horrified that I'd just been casually left on it for four years with no follow-up. She did manage to make it seem as though it was my fault, which I resented.

I tried to get off the Paxil a couple of times, only to discover that getting off Paxil is not exactly easy or fun. I went online when I was first put on the Paxil to read up on it, and was immediately bombarded with all sorts of dreadful warnings from sites with names like paxilsurvivor and mypaxilnightmare. Most of these sites were overblown, at least from my experience, but they did warn me of some things that Kaiser failed to. One of these was 'the zaps', a sensation of electric shock that often accompanies withdrawal from the Paxil. If I hadn't know about the damn zaps, I would have thought I was losing my mind when they started. The problem with getting off the Paxil was that it could be done, but once it WAS done, I started crying again, so I went back on. And stayed on.

Paxil is just plain hard to get off of. I've been told by a couple of doctors that the intense resistance that the medical community has had to labeling it addictive is that they're not actually sure why it's physically habituating. The chemical reason for whatever leads to the zaps and such isn't clear. And so, doctors being doctors, they simply resist the idea that people are actually having symptoms. Doctors are like that.

It was this past fall, though, four and a half years after I went on the Paxil that I finally got off it, with medical assistance. This time, I got a doctor who was an actual psychiatrist, as opposed to the genprac guy who told me to go on a half dose for a week before cutting it out, and I'd be fine. We did an elaborate dance of getting me off the Paxil, and onto Prozac, and then off Prozac.

I did this for two reasons. First, and most immediately, I wanted to get pregnant, and Paxil is strongly, strongly counterindicated for pregnancy. The other reason was a little more complicated--I had had two good years at St. Dymphna's, and I expected a good year at St. Attracta's (HAH!), and I thought maybe it was time to face the world unmedicated. I thought, at the time, that if it didn't go smoothly, I could go back on anti-depressants, but it seemed worth while to experiment.

Of course, St. Attracta's was a housefire of a disaster, and after a pleasant summer and early fall, I simply detonated, and fell down the rabbit hole of my own depression. It was in those days that I ranted to a teacher blog about how miserable I was, mentioning that I was off my meds, and was roundly scolded and told to get right back on the Paxil, pronto. "You know that you need to take your medicine, so do it!" one lady snapped.

Well, on the one hand, that seemed like someone being quite concerned about my wellbeing--and it was followed by many exhortations not be ashamed of NEEDING my medication (I wasn't, but apparently even thinking that you might not need it forever was suspect), and on the other hand, I started thinking of all those movies about 50s housewives drugged out of their minds on tranquilizers. I started wondering how you told the difference between taking a medication that addressed your psychiatric needs, and taking a medication that was covering up for your actual needs in life.

And thinking this sort of thing through sensibly while you're in the grip of a crippling major depression is harder than you might think.

Anyway, I finally did something that was either eminently sensible, or completely missing the point--instead of numbing myself down further, I gave two weeks notice to the source of stress. And I immediately felt much, much better.

I've felt much, much better ever since. Even with the worry of finding money to live on, and a new job, and health insurance, and many, many other things, I'm now back on the barest trace of Zoloft, and I'm FINE.

This is not meant to be a rant against anti-depressants, because God knows, they have been there for me, and great, when I needed them. But anti-depressants are meant to balance your chemistry so you're OK, not up your tolerance so you can handle things that are by no means OK.

Most of my work life for the past five years has been by no means OK. And I am going to fight like hell to get to a place where I am OK.

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