Big Pharma, on the personal

X-posted to Daily Kos

“You're not the same as you were before,” the Mad Hatter tells Alice. “You were much more...muchier. You’ve lost your muchness.”

“My muchness?” Alice replies, confused.

The Mad Hatter pins a finger onto her heart. “In there. Something’s missing.”

– from Alice in Wonderland (2010), with Johnny Depp and Mia Wasikowska

...

I could blame Big Pharma.

I could blame it all on that shitty psychiatrist (heretofore called "Bad Psych") who had me "try on" psychotropic meds like ill-fitting jeans at TJ Maxx. Whose lack of pharmaceutical insight literally landed me in the mental hospital.

In the end, though, the blame falls on me. For seeking happiness in a few pills.

...

150 mg Zoloft/day.

150 mg Lamictal/day.

100 mg Trazodone/day.

And those are just the three meds I've managed to taper off completely. 

I'm still taking 1 mg Ativan per day (0.5 in the a.m.; 0.5 at night). The mental hospital had started me on 2 mg per day, and I've managed to cut that dose in half.

Ditto 75 mg Seroquel per night. The Bad Psych had started me on 150 mg and I've cut that dose in half as well.

The only medicine I'm planning on staying on (for now) is Effexor, which, to be honest, I should've stuck with from the very beginning. 

I should count myself as lucky that I can afford psychotropic medication at all. That, even after being laid off, I have health insurance to have paid for this boatload of benzos and other meds. Millions in America can't afford to even get one prescription, let alone six. 

One reason for this lack of resources for Americans with mental conditions is that our country still treats mental illness as a stigma. Therefore, psychological and psychiatric care isn't available to many Americans, even with health insurance. 

But another, even more insidious and darker revelation about too damned many people in our country—many politicians, and the tens of millions who keep voting for these idiots—is that, unlike civilized countries like Canada, much of Europe, Japan, Costa Rica, Australia, and New Zealand, healthcare isn't considered a right, but a privilege. Too damned many people feel you're a shiftless loser if you don't have a job that grants you health coverage, and they don't want to pay for your lack of responsibility, natch. And some among that lot feel that free, or even affordable, government-subsidized health coverage, equates to "reparations," and those poor, forgotten White Working-Class Voters™ ain't having any of that.

So I suppose I should count myself among the lucky ones, for having the financial means and the healthcare for psychotropic meds to be an option for mental health treatment. Why am I complaining?

Healthcare is a business, and in the American Free Market™, caveat emptor, baby. Let the buyer beware.

(As an aside, I remember caveat emptor from an old episode of The Brady Bunch, not an LSAT or anything lofty like that. But anyway...)

...

I wanted to feel better, and I paid for it.

I've been living with depression, anxiety, and obsessive/compulsive disorder (OCD) for as long as I can remember. Even when I was a little girl, I was shuttled to shrinks to find out "what was wrong with me." I had zero social skills and had trouble making friends. I was moody and sensitive. All qualities I didn't outgrow, even as I grew older.

Until I turned 28, I'd gone through the revolving doors of therapists' offices, trying to figure out myself, my reason for being on Planet Earth, and why and how I felt and behaved the way I did. Nothing the cotillions of therapists suggested or ordered seemed to work. The advice didn't stick, the EMDR practice felt silly, the words of encouragement and self-empowerment seemed to waft into one ear and blow out the opposite. Relationships, jobs, and life in general seemed to crash and burn at my feet, leaving me an emotional mess and my family and friends (those who were left and still tolerated my shit for whatever reason) baffled at my inability to get my shit together.

Then, when I was 28, a therapist recommended that I go to a psychiatrist to see about getting me on a medication. I'd resisted taking medication for the usual reasons: it's a copout; it's depending on a pill to cure my mental state; it's antithetical to the pull-yourself-up-by-your-bootstraps mentality with which I was raised. However, I was turning a corner professionally and I had just started dating who would later become my husband, and I had a tough time with the emotions involved in both. I decided to give it a try, so on Paxil I went.

The effects on my life from that one medication were dramatic. Gone, at least so I thought, were my insecurities about myself and my place in the world, my bitterness about not fitting in, and my constant ruminating about why I was having such a time of figuring out what the late Prince once called "this thing called Life." I could focus on other people and things besides being so absorbed in my own personal problems, my own conditions of depression and anxiety and OCD. The whole lot of those worries seemed to vanish overnight.

Why hadn't I gotten on medication sooner? I thought to myself every now and then. By taking this seemingly magical pill when I was early into college, I could've avoided those stupid decisions, or rather INdecisions, that had plagued my life, education, and career as a result of my neuroses. I could've avoided jumping into a bad first marriage when I was too young and immature to handle even dating. If only I'd much earlier gotten on a regimen of SSRIs (selective serotonin reuptake inhibitors).

Plus, the medication had taken away a huge heartache that had been consuming me through my twenties. While in college, and long after graduating college, I'd always imagined that I'd market a few of my completed screenplays to film companies or agencies and make enough money to get by—not a ton; I knew WGA minimums were pretty paltry for writers just starting out. That income would keep me afloat while I worked on the next few screenplays or on a few novels that I'd started but shelved after boredom and Real Life kicked in.

When life didn't work out that way, I'd get depressed. Like, mortally depressed, as if none of the other thousands of aspiring writers didn't face the same ennui and rejection that I had. During crunch time at my jobs, when I worked overtime to fatten someone else's paycheck, I'd despair in my silent tears and think as I worked, This isn't the life I envisioned for myself...

But after Paxil? No more whining and complaining about not making it as a writer. No more being depressed, or anxious, or obsessive about writing or anything else in my life that wasn't going the way I wanted it. What wasn't to love?

I was more than thrilled that the self-pitying angst of not "making it" as a writer had disappeared. However, along with it came a loss of creativity and an interest in writing altogether. Before Paxil, I'd stay up till 2 or 3 in the morning working away on my latest screenplay or short story; then I'd wake up a few hours later and head to my day job. After Paxil, I'd sit in front of a computer, type a few forced paragraphs of creatively bankrupt crap, and then give up and surf the Internet.

Before Paxil. After Paxil. Before/After. That's what I turned my existence into, a life of Before/Afters.

...

As the Mad Hatter observed in the video clip from Alice in Wonderland at the beginning of this blog post, I lost a lot of my "muchness" as a result of the Paxil. The intensity of my depression and other mental conditions had been taken down a few notches, but so had the rest of what made me me.

...

Several other undesirable side effects became apparent to me a few months into taking Paxil. My appetite increased, and I put on unwanted extra weight. Although my mood had improved and I'd stopped obsessing and ruminating over stupid stuff, I felt tired and sluggish—not motivated to do anything outside of going to work, sleeping, and eating.

I also felt...weirdly numb. Like I'd see a news story about a mass shooting in which a dozen people lost their lives needlessly, and I wouldn't feel anything. Not sadness or grief. Not fear or worry for the state of our broken country and our lax gun laws. Not even callous apathy, if I'd been a sociopath. I wouldn't feel anything. And that alone felt unsettling.

So I made a terrible mistake. I stopped taking the medicine without consulting with my doctor, without being aware that I needed to gradually titrate off the medication bit by bit.

That's when all hell broke loose. I couldn't sleep for days on end. Wracked with terrible anxiety, I felt constantly on the verge of a panic attack. I fixated on the stress of a new job and tormented both myself and my boyfriend in endless conversations that my boyfriend said sounded like they were meth-fueled. I almost lost my job, and my relationship with who was soon to be my husband, over what I'd soon discover was a very bad case of serotonin withdrawal syndrome.

After weeks of living like this, I consulted my doctor, who roundly scolded me for trying to quit the medicine cold-turkey. "You need to taper off Paxil if you want to quit it. And I really don't think you should be quitting it about now." He had me reinstate Paxil, and shortly after I took my first dose, it was as if the withdrawal symptoms had never happened. It was Before/After writ large.

I then resigned myself to living with Paxil's negative side effects, because the benefits outweighed what were reasonably minor hassles. When they became too burdensome, I asked my doctor for a different solution. He then switched me to Effexor, which turned out to have fewer side effects. Most notably, I could have human emotions again. Joy when it was appropriate to feel joy; sorrow when it was to feel the same.

Yet, like Paxil, Effexor dampened my writing creativity along with my enthusiasm for the craft I'd worked for many years to cultivate. For some reason, though, I didn't seem to mind. Trying for years to break into the highly-competitive screenwriting business hadn't given me any returns on investment, so, I reasoned, maybe giving it up wasn't a bad thing. I'd wasted so many years of energy and time writing fictitious stories about people who weren't real, and money on printing hundreds of query letters and an almost equal number of copies of screenplays and mailing them. Why not just chalk it up to experience and move on with my life in, you know, a real job?

Over the years, the Effexor seemed to lessen in its effectiveness at keeping my negative emotions at bay. I'd shellacked over what I'd thought was an impenetrable dome over my writing ambitions, but cracks started to form in the veneer when every lame attempt at "just for fun" slash fiction or membership in a writers' critique group rekindled my interest in what I believed to be my true calling.

So I increased the dose. Can't have those old longings and aspirations getting me in a depressed state once again to ruin everything—job, marriage, family, friendships.

The pills became my catch-all to solve life's problems.

Marriage becoming stale? Take another pill.

Infertility grief taking hold? Take another pill. 

The stress of fostering and adopting children? Take another pill.

Career advancement coming to a screeching halt?

There's a pill for that.

A few years ago, I hit a crisis moment in several aspects of unresolved conflict I'd kept sweeping under the rug. I still felt grief and resentment over not being able to have a baby, coupled with the normal anxieties of going through the fostering-to-adopt process. That put strain on our marriage, even after we adopted our two (wonderful) sons from foster care. Plus, I had a few deep insecurities that became first difficult and then impossible to ignore, and that finally came to the forefront of my life.

So I went to see the Bad Psych. I told her my Effexor wasn't working anymore and asked her opinion on other options.

She put me on Brintellix. That didn't work.

She put me on Wellbutrin. That didn't work, at least not by itself.

She then put me on Cymbalta, which did seem to help a little, but I was scared by an account I'd read on the Internet that Cymbalta was nearly impossible to quit if needed.

So she put me on Lexapro, plus Latuda, an atypical antipsychotic with an off-label use as a mood stabilizer (even though I didn't have bipolar disorder), and augmented these two with Wellbutrin to help counteract some of Lexapro's side effects. I was having trouble sleeping with all of this mess, so she prescribed Valium to help with my insomnia.

Still, this supercocktail didn't work. In fact, I felt worse. My husband noticed that I seemed "off" while cooking at home or driving, and that I seemed distracted easily.

So after a few discussions (one of which turned into a full-on argument), my husband and I decided together that, under the assistance of the Bad Psych, I'd taper off the entire cocktail of meds and attempt to live medicine-free after I tapered off everything.

She tapered me off three different medications in seven weeks. As I've written in another blog post, that didn't work out too well.

Since writing that post about a year ago, I realize now that the woes hadn't resulted merely from Ativan, which is the benzo I'm still on. Seroquel's proving to be a meaner beast to cut, even harder than Ativan. I expect that tapering off the remainder of both of these meds (I'm only halfway there on each) will take at least another year or two, if not longer.

As I mentioned in the blog post above, I've long discontinued visits with the Bad Psych and have since worked with another, clinically more astute doctor who is helping me to very slowly wean off these things. She and I have agreed that I'll stay on Effexor at least in the interim, and we'll see how I handle getting off the Big Two (Seroquel and Ativan).

I just met with her this morning. Because I've just been laid off, we've agreed to hold on tapering any more meds, especially since my brain is in the process of healing after coming off the three psychotropics I've managed to discontinue thus far.

...

Friends, family, and coworkers have told me not to get too hard on myself, not to beat myself up over putting my trust in a bad doctor and pharmaceutical system that let me down.

However, I can't help but thinking that I did this to myself. No one force-fed me the pills. I was well within my rights to do more research on these meds, but for whatever reason—laziness, an undeserving amount of trust in my doctor—I chose not to look into the small print.

Caveat emptor.

My husband, who is a saint for having had to live with me during this ordeal, and for having to live with someone who has depression to begin with, recommended that I try to manage my mental conditions with cognitive behavioral therapy, or CBT. So I'm writing my way through a CBT workbook now, in the hopes that I can use my mind to overcome my mind, or at least overcome its weaknesses and perceived hurts.

I wish I had a more compelling, unifying way to conclude this blog, but all I can say is that I'm newly a skeptic of all things psychotropic.

And shame on me for ever wanting to find happiness in a damned pill.