Medication Management pt. 3

It was my first full week of being on Cymbalta, two small capsules every morning at 9 am when my alarm went off. I was rather impressed by my success in remembering to take the medication a the same time every day, and even more so that I had found a time that didn’t seem to interfere with everything. I, of course, had the occasional time I turned off the alarm, planning to finish this one thing or waiting for someone to leave my office before digging my daily pill container from my purse to realize an hour had gone by and I have never popped those two little pills. Side Note: Medication management has become a new favorite thing, pill organizers are like school supplies… but not.

My transition week onto the Cymbalta had gone fine, I guess. I was at a half dose of Zoloft and a half dos of Cymbalta. Nothing really felt different, or at least not enough for me to speak up. On day 8 I was to say farewell to Zoloft (abandoning my dreams of becoming a happy snowman) and double up on the Cymbalta – so I did.

What changed? Overall, from the day-to-day I couldn’t say. The crippling chest pain continued, I had just as little energy as I did before. I could not sit still. I guess I became irritable, snapping a lot at minuscule things. But, that was to be expected, the warning sheets said that was “normal.” I think most of the day-to-day is a blur because the dark moments reign so much stronger; because it is the dark moments my brain likes to play on repeat.

Somewhat Important Side Note: For what feels like agonizing months, but has really only probably been weeks, my body has felt like an upset  and confused mess. My head feels like a gloomy mess, lacking drive, ambition and clarity. My chest feels like it is collapsing. My heart hurts with more love than it has known and the trembling fear that is is all going to end. And my lady bits – my vagina – is more driven and excited than I have ever known it to be. The thought of Kevin leaves me day dreaming of his body and sex. Certain ways he looks at me makes me want to tear his clothes off, and it takes a great deal of restraint when those clothes are off. I feel like I am more sexually attracted to him then ever before, which would be fantastic if it weren’t confusingly coupled with my desire to curl into a ball and cry…

It was my first weekend on the full does of Cymbalta, eventually Keven and I made our way up to the shower, stripped down and got in. The arousal was an instant set in. I swear this must be what a teenage boy feels like, and it fucking sucks. Kevin has been struggling with his own physical demons – an arm with injured nerves, a stomach that likes to put him through hell, agonizing headaches – so when my body is screaming GO! his is struggling in pain. Writing this and rationally, I totally get why sexy time coupled with an upset stomach or nerve pain is a bad idea, but in that moment I don’t get any of that. I am frustrated that I feel this way and wont be satisfied. I feel sick to my stomach that I can’t overcome my sexual desire. I hate myself for having such an attraction when I feel so terrible. I feel guilt, shame and disgust. To top it all off, I am pretty sure I make Kevin feel bad for saying no each time.

I sat on the bench in the shower attempting to focus my gaze on the toilet, the vanity, the towels, the wall… anything other than his naked body and penis that were both right there. I was disgusted with myself for the way I felt. How dare I want to have sex with him or touch his body when the only other thing I felt like I wanted to do was die. At what point had I become such a sex crazed slut. As I sat their restlessly, with my right leg bouncing up and down uncontrollably, I shamed myself, I hated myself, I knew that I shouldn’t and felt bad that I did. There was no winning, no thought that could pull me out. So I sat there spiraling downhill in silence.

My turn to shower came and I transistioned to being under the water. Usually the shift of my weight and move to standing was enough for the restlessness to stop, or move somewhere less obvious. But, this time it wasn’t. My leg continued to bounce, shake and move uncontrollably as I stood under the water attempting to wash my hair. I wanted it to stop and told Kevin how it wouldn’t.

I don’t remember showering. I remember I was washing my face and running my fingernails across my cheeks, wondering if I could scratch my face off. Lathering the shampoo into my hair and tugging my hair to pull it out more than massaging the shampoo in. I kind of remember crying in Kevin’s arms and later standing under the shower telling him how I had to get out.

From the shower I dried off, put on a bra and underwear, and sat on the edge of the bed. My mind was elsewhere, but still lost in a mixture of lust, love, disgust and pain. I looked into the mirror and couldn’t stand to look at the reflection staring back at me, so I moved to the other side of the bed.

Kevin says I had a full on panic attack in the shower, and once I was out of the shower it escalated from there.

I felt like I lost control of my body. I couldn’t stop my hands, which were ricocheting off my legs and into my face. My legs trembled. I was angry, sad and scared. Part of me was pissed because it knew this killed any chance of sexy time. My body screamed at me, but I couldn’t make out what it was saying. My rational mind kicked in, telling me I didn’t really want to hurt myself and moved a pillow into my lap – I hit harder. I could feel the struggle in my hands, of wanting to continually smash into my face, reminding me how stupid I was, and not wanting to cause any further pain.

My gaze landed in the closet, where my eyes locked on to the new Christmas sweaters Kevin and I would never get to wear. “I am never going to get to wear that,” I thought, sure I was going to die before Christmas.

20170712_203431

The Legend of Zelda Christmas sweaters I was convinced we would never get the opportunity to wear.

Kevin held me trying to help bring me back down and my mind drifted to day dreams.

We’ve been planning on marriage, starting a family, buying the print shop, and growing old together. I often day dream of working in the front end of the shop with a tiny little one on my hip; a young man in a highchair, or the perfect little lady in a bouncing chair. This time, my mind wandered to the print shop where I had this perfect little girl, not more than a year or so old, in adorable bright pink overalls with a white undershirt covered in tiny pink flowers. Her dirty blonde hair was pulled into messy pig tails. She meant so much to me, I could feel so much love for her. Then I moved her from my hip onto the floor, I told her how much I love her, how sorry I was, and then walk out the door.

It was so vivid, it felt so real. I hated myself for what I was putting my imaginary child through. Where did I go? My best guess is to die.

Week one of my full does of Cymbalta and my mind drifted to things that I might include in my suicide note, things that despite being morbid, kind of made me laugh…

“So babe, did my tongue hang out of my mouth when I died? Was my playing dead actually really accurate?”

My mind determined that the one shower rod we have in the house was most likely not strong enough to hold my body, so attempting to hang myself was out. It wondered if I crashed my car and died in it, would the Gap Insurance cover the rest of the bill?

July 26, 2017

Hi Dr.,

I have been on the new medication for two weeks now (one week at 1/2 dose and one week on full dose) and I am not seeing any positive changes from it. Rather, since making the change I feel like I have fallen in into grater depression. The suicidal and harmful thoughts have been more reoccurring and harder to counter. My restless fidgeting has continued, if not gotten worse, and I am finding myself having to make decisions to place my self out of harms way. I have had episodes where I felt like I cannot control my body or what is going on. I have been washing my face and had the urge to scrub so hard my skin would come off. While washing my hair I have wanted to pull it all out. My arms have gotten so restless I have to use all the power I feel like I have to stop them from continually hitting myself in the face. I have had to put something in my lap to stop from slamming my fist into my own legs. I have been questioning what reason there is to live and hating that I am doing that. I am having a struggle with myself and am worried that the side telling lies might persuade me that it is telling me the truth.

I am not sure what the next steps are, but I am hoping you can help me figure it out. I think I would also like to do the gene test. I will be in the office on Thursday for a therapy appointment, if there is any way to do it then.

Thanks in advance for the help.

Heather

That weekend I was close to asking Kevin to check me into the hospital and later found out that the thought wasn’t too far from his mind either.

June 27, 2017

Hi Heather –

Sorry to hear all that you are experiencing. Please tapper off the Cymbalta – reduce to 30 mg in the AM x 7 days then stop. You may experience mild discontinuation symptoms – fatigue, dizziness, tingling sensations, headaches. This will pass.

Please let me know when you are feeling better.

If your suicidal feelings persist please call the Medical Advice number for immediate assistance or go to the nearest ER for assistance.

Unfortunately I will not be at the WB center on Thursday. Let me know if you can walk in on Friday 7/7 for the gene swab.

Best – Dr.

By July 5 I was 100% off another medication. I was struggling to maintain my focus at work. I wanted to cry all the time. I had the withdrawal – dizziness, headaches… I felt separated from my body and everything else. Over a week later, and I still do.

I didn’t feel like the medication was having much of an impact and wondered if it would be easier to go back to navigating this shit on my own. Turns out it isn’t. It sucks. Everything is a million times harder and crying feels like a daily event. I’m sad with no real reason, I get irrationally mad and uncomfortable. I hate myself for not having the strength to stand up for myself in social situations. I hate that my focus is on me and feel like it has lead me to be a really shitty friend.

I know I haven’t found the magic answer to my problems, but I do feel more confident that some mixture of medication will be right for me after all.

My mouth swabs samples have been received by the gene test and they are processing my results. Like everything else, it is not a fool proof answer, but hopefully it will help. In the meantime, here is to hoping that Lorazepam (Ativan) will help and not become some terrible habbit.

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