May 31, 2006

Roof repair

Today I’m seeing Dr. Two-Fifty (as in hundreds of dollars per session). She’s not my new therapist; she’s the shrink the therapist is sending me to for meds for the Other D.

I’ve thought and read and fretted a lot about taking this step. This kind of internal debate is a cliché of postmodern American life, yes? Medicate the problem vs. staying with it (whatever that means) in search of personal growth or insight or at least some nonchemical cure. There’s a faction out there that posits the choice of medication for depression as the easy road, a turning away from the harder, worthier path of dealing with one’s shit head-on and with authenticity.

I thought about personality (what is it and why and whether medicating my brain will undermine some essential Violetness that I won’t want to lose and whether, if I do lose it, I will be able to get it back). I thought about how, before resorting to medication, I should probably explore exercise or yoga or at least not lying around on the couch all the time. I thought about how an antidepressant could mess up my BGs--from what I can learn, almost all of 'em have the potential to do so, though they often don't. (Cymbalta, one of the newer ones that does not, is a "step" drug on the NIP formulary, meaning that Dr. Two-Fifty has to try me on other drugs first and turn to Cymbalta only if they don't work.) I read about the myriad other side effects to which I can look forward, depending on the drug of Dr. Two-Fifty’s choice and my body’s personal, idiosyncratic response thereto.

Then I thought about my other thoughts, the nonbloggable ones, and I came to understand that sometimes you reach a moment when you have, say, a large and gaping hole in the roof of your home, caused maybe by the antics of squirrels or your roommate's fondness for illegal fireworks or the mediocrities of bargain-priced shingles or the little kid next door who likes to hit his baseball up onto your roof several times every Saturday--the cause is not the point; the point is that the hole is there--and outside the thunder is clapping and the lightning is sparking, and you know that the rain on the way is not just any ordinary storm but the kind that generates Significant Media Attention. At such a time you do not look into your toolbox and say to yourself, I will work alone, using only the small nails and the small hammer to repair this hole because by doing so, I will grow immeasurably in my knowledge of carpentry, and that will make me a better person. No, you pull out every tool that might help, small, large, and in between, and you give one to your roommate, another to the kid next door, and whatever remains to the squirrels, and you all go to work on the damn hole.

In other words, you Take. The. Freaking. Drug.


  1. Hey Violet,

    Been there, had these conversations about taking drugs to deal with depression in the past. It's the same thing as being diabetic: you don't talk yourself into trying to feel better without insulin; your body doesn't make it, so you just take it.

    With depression, either acute or chronic, it's the same thing. The brain isn't processing a certain chemical it needs to process, so you can take it via pill and get what you need to feel better.

    For what it's worth, Lexapro did not affect my blood sugars when I took it a few years ago.

    Good luck.

  2. I wish there was a test we could take to make these decisions clearer. When you check in to the hospital and your blood sugar is 800, the doctor doesn't ask whether you think you need insulin, whether you want to try to just work through it...

    For what it's worth, zoloft doesn't affect my b.s.

  3. I have been taking brain meds for a long time too.

    I felt really "weird" about starting them - I had always thought myself to be a very upbeat and "cup half full" kind of guy!! So totally NOT the kind of guy that needs brain meds!

    But - any chronic thing can force depression on the most optimistic of us. For what it's worth, I am still an upbeat and optimistic guy - regardless of the fact that I sometimes need help staying that way.

    Depression can come in many forms, and it makes you no less of a person or one not willing to grow when you seek help. In fact, your ability and willingness to try something says a lot of you.

    I struggled with a number of meds before finding something that worked well - and that process totally sucked. Ramp up on this drug, doesn't work, ramp down, ramp up on this new drug, doesn't work, ramp down, ramp up on drug choice "C", works Ok, leave it as is.

    Just because you typically aren't supposed to start/stop cold turkey, the process can take a long time. Then when you find something that you think is working - you wonder if it really is working, or if you're tired of the process and are settling for just mediocre.

    Brain drugs are weird, but I know that they are necessary for me. And I noticed no adverse effects on my BG's.

    You have also gone through a lot of change recently - diagnosis, big move, total change of surroundings. It can be tough - but you will get through it. You are a fighter, and will do what you have to do in order to "get right".

    Peace & Love from your old stomping ground.

  4. Hi Violet......I think that before you take any pharmaceutical agent (which will always be available), try some of the other "tools" first, which you even mentioned. Increasing your Serotonin levels and Endorphin levels can have a profound effect on how you feel. This can be accomplished by a lot of aeorbic exercise on a daily basis. Feel Better.

  5. Thanks, everyone. I appreciate the input. It's really good not to feel alone.

    Scott, I very much think of you as the guy you describe. That's one of the powerful things about your blog: it's very honest in reflecting both the highs and lows. The optimism is there, even when buried.

    Art, hello, how good of you to visit me. I like the analogy you and Lyrehca use about insulin. Mr. Brooklyn, my boyfriend, has been experiencing some guilt over where I am mentally right now, as I moved here to be with him and undertook a lot of stress in the process, etc. I explained to him that this would be like my trying to take responsibility for him getting an earache.

    bettercell, I totally get what you're saying. My conclusion is that I need help getting to a point where I can do something like use exercise. That path is something I would like to try as a management tool once I get through this. But I'm also open to the possibility that I may be more like Scott and need to stay on a medication; this is true of my mother.