May 20, 2007

This is what it means

I've spoken before about the close but conflicted relationship I have with my antidepressants. I mentioned in that post that not taking your meds when you're supposed to leads to withdrawal symptoms.

Well, here we are again. This time, I'm in withdrawal (actually just starting to come out of it) because my psychiatrist, scatter-brained to the point of really worrying me sometimes, didn't call in my prescription - despite the fact that I had e-mailed him two weeks before I was due to run out to schedule another med consult (no answer), and then spent an entire week without meds having his office page him once or twice a day. In the past, it's happened because I was too in-denial to keep taking them even when I very much needed to, and once because I had neither the health insurance to pay for them nor the $90 to spend out of pocket.

The why, though, is neither here nor there at the moment. Today I'm talking about the what. When I say "withdrawal," what does that really mean? (I'm tempted to describe what "depression" means for me, too, but honestly I'm still too fragile at the moment to try that.)

I found a partial list of known symptoms online; they include "sweating, fever, abdominal discomfort, suicidal thoughts, anxiety, headaches, insomnia, nausea, vomiting, and hallucinations," and I have (to some degree) experienced most or all of these over the past week, along with irritability, extreme weepiness, lethargy, and - oh right - the depression that I wasn't being treated for.

Sounds a little unpleasant, right? Problem is, it's a damn sight more than a little unpleasant - listing the symptoms doesn't even come close to conveying this.

When I say "sweating" and "fever," imagine a muggy night of summer, but without all the sort of sexual tension that lends it charm in movies. Nah, this is one of those oh-God-let-me-peel-my-skin-off nights, where you wish you could float an inch above the bed because even your crisp cotton sheets are unbearably hot against your skin. Not that they're crisp anymore, since there's a person-shaped blob of sweat soaking through them to the mattress. And add to that the fact that it's not a muggy summer night at all; this is all happening in the spring, when your building very sensibly still has the central heating turned on for the comfort of everyone who isn't coming down of psychoactive medication. Yay for them, I say; but it's just one little additional misery.

As for "abdominal discomfort," let's go ahead and class this with "nausea" and "vomiting," shall we? Not that they're synonymous - abdominal discomfort, to my mind, also covers having to go the bathroom every couple hours so that anything you've been able to eat since last time can come streaming back out of you like Montezuma's Revenge. It means being able to keep food inside you just long enough to absorb the calories but never long enough to feel full, which is a recipe for overeating and weight gain if I ever heard one. (And yes, I've gained weight this week. A little over five pounds, actually.) It means being acutely aware of how far you are from a toilet at all times so you don't shit your pretty little pants in the middle of class. As for vomiting, not only is it the same story from a different angle, so to speak, you get the additional thrill of being mistaken for drunk when you have to beg a bus driver to pull over so you can get out and barf. The joys of nausea in a college town.

"Suicidal thoughts" are, for me, an interesting category. I am, thankfully, not a terribly suicidal depressive; the most proactive thing I've ever done to end my own life was to cross the street without looking and hope that Things Took Care Of Themselves. So for me, suicidal thoughts (and their much more frequent companion, the more general "thoughts of self-harm") are more like catalogue-shopping, albeit against my will. The images flash through my head - some part of my body bloodied, perhaps, or a group of people at my funeral - and while I may stop at the ones which are particularly noteworthy, there's no sense that what I'm seeing in these pictures will ever necessarily be mine. So no, I'm not planning to kill or otherwise harm myself - but I'd be lying if I said that the thought hadn't crossed my mind. A lot.

After all, what else is there to do when you're stuck with insomnia, which is not the next little beauty on our list but might as well be? Actually, that's not true - there's plenty to do when you can't sleep, so long as you have internet access. A world of Flash games awaits the insomniac, and I have actually come into a psych clinic and said, "I've been playing too much Block Breaker and Bejeweled - there's something wrong." There are also new blogs to read and become temporarily obsessed with, online window-shopping to do, and ceiling tiles to count. I mean this last part metaphorically, since my ceiling is of a quite smooth plaster, lacking not only tiles but cracks, paint splotches, and anything else that might be countable or at least visually interesting. Trust me. I've spent nights looking.

Insomnia's particularly isolating, by the way, because unless you live with someone and that person is also an insomniac, you have tangible evidence of your aloneness. There is an hour, even here, where the streets go quiet and the pigeons aren't yet awake, when there is no dorm noise and nobody starting flamewars online. Hell, even the spammers aren't awake. Nor am I, really, at least not in the sense of having the brainpower to do anything. I'm just not asleep, is all, and that particular twilight time is when it's the worst.

I am exhausted right now. Not sleeping, being depressed, being in withdrawal, and writing this post have exhausted me. I'm sorry, I promised you more - perhaps a story about weepiness meaning that I saw a picture of a military dog online and burst into tears at the thought that it might die in battle - that would add some color to the whole thing, wouldn't it? Well, sorry to disappoint - which seems to be all I ever say anymore. Sorry to let you down, but I'm just too bone tired to talk anymore, or to type - let alone packing for my upcoming move, preparing for next week's in-class presentations, or studying for a qualifying exam I'll probably fail.

I'm just too tired. And that's part of what it means.


icarus said...
This comment has been removed by the author.
icarus said...

The co-pay for my prescription is $20. I have $13 in my bank account. And Harvard won't let me termbill anything because I'm graduating, so I'm on day 2 of withdrawal right now. Sucks.