What did you say?

After some back and forth with the doctor's office, I have been given the official "OK" to stop Paxil. This is good, although honestly I'd have stopped it without that approval. "It's my body," and all that.

What's not so terribly great is that my doctor says there's really no "one best way" to stop the drug, and that most people experience withdrawals from Paxil to some extent. So, I should just start weaning myself off it by reducing the dosage as fast or slow as seems to work for me. No recommendations. Just, "Call if you have problems or questions."

I like my nurse practitioner a lot more than I like my doctor.

Now, a bit of research on potential withdrawal symptoms has me a little ... worried. Yeah. I know. I'm supposed to be trying not to worry so much, and I am trying. But, well ... I don't really want to experience loss of balance, sleep disturbances, "brain swooshes" (not my term but apparently an accurate one), and oh yeah — auditory hallucinations.

I could probably handle everything but that last bit. I don't want to hear things that aren't there, just like I don't want to see things that aren't there. There is a good reason I never took up the junkie/tweaker lifestyle. My imagination is flamboyant enough on it's own; I think I'd pee myself if I actually saw or heard some of the beasties I think up and draw.

Six-Year-Old-Me remembers some of her wilder imaginings and agrees. I've always been on the slightly morbid side of things. Not that I don't like nice things like unicorns and bunnies and teddy bears and such. I just prefer my unicorns to be the black Night Mares, or my own version of the Corrupted Night Mares (see below). And OK, yeah, bunnies and teddy bears are pushing it. Point: I like dark things. I like light things too, so long as there's some sort of dark twist to them.

And really, I don't want to see or hear this, ever:

    "Night Mare Carnivale" © C. Vandever, 2006

... or this:

    "Night Mare Quick Sketch" © C. Vandever, 2011

Yes, I drew both of those, and yes, Six-Year-Old-Me approves (I used to be enthralled by the covers on horror movies at the movie store, even with the latest beloved Benji movie tucked under one arm). See what I mean? Can you just imagine the slobbery, wheezy, scratchy, hyperventilating breathing of one of those lovies sneaking up behind you, all horsey and brimstone-y and undead?

I can. I don't want to hear that. I think that would freaking paralyze me.

Now, what I don't know is if these auditory hallucinations are that type of sound, or voices, or if it's just weird buzzing/tones. Either way, I'm not interested. Voices would be freaky, too, and weird buzzing and tones that are random and the source of which eludes me drives me batshit. So, paranoid or merely annoyed, I'd still be unhappy.

But that's a possibility I have to accept. My own doctor claims nearly everyone getting off Paxil experiences some form of withdrawal. But in my research some other "medical expert" claimed that only about 20% of people experience withdrawals. Being ever the realist, I'll hope the latter is correct, but prepare for the former.

With no actual guide for getting off this stuff, I just have to figure it out on my own. I am tempted to make a darkly sarcastic remark about the medical system and usefulness, but I'll refrain. So, how do I do this? I have an idea ...

When I started the drug, I was instructed to begin at 10 mg for the first week, then alternate between 20 and 10 mg for the second week, and then just go right on to 20 mg, my current daily dose. Since the drug had to build up in my system before "kicking in," I'm guessing it won't be as simple as just reversing that to get off it. Here's my five-week plan for dosing down:

Week One (starting tonight): Alternate 20/10 mg
Week Two: 10 mg
Week Three: Alternate 10/5 mg
Week Four: 5 mg
Week Five: Alternate 5/0 mg

Week Six, toward the end of May, should be when I'm done ... if all goes well. If it doesn't, I'll stick with the same dosage steps, but double the time for each to two weeks. So I am (perhaps naively) hoping to be Paxil-free by the end of June at the latest.

Six-Year-Old-Me thinks it's a good plan. 30-Year-Old-Me tries not to think too hard about six-year-olds not being optimal at medical advice. 30-Year-Old-Me remembers just how often I fell and got scraped up, and felt no need for cleaning up the blood and dirt. And band-aids? Pshaw. They're for sissies.

So tonight I'm cutting my dose in half. Wish me luck. Heck, at this point I'd settle for non-audible strange dreams, so wish me those, too. And yes, I promise to blog updates on my progress, especially with any drawings of invisible things that creep up and say "Hello."

Change

Yeesh. Did three months fly by just like that? Apparently.

Well, not just like that. I finished that accounting class and despite my desperate fears, I still have a 4.0. Granted, I withdrew immediately after the class ended to take a break, because anxiety and stress were making my heart palpitations return despite the beta blocker I'm on, which usually keeps things pretty normal. I will be returning to classes in July, and for some silly reason I had thought that between the end of that class and July, I'd somehow "get things in order," and not be stressed anymore. Or at least not as badly.

Six Year Old Me rollls her eyes at that and chuckles, wiser than her six years ... Hell, wiser than my 30.

I started taking Paxil for anxiety. Yes, I'll admit the Big Bad Dark Thing: I live with depression, and between that and the amount of stress I've been dealing with over the last three or four years, I've developed a bit of anxiety. Well. Maybe more than a bit. About a year ago I came to a hard decision that despite not liking the idea of putting man-made drugs into my system to alter my mood, I didn't want to be depressed anymore. So I asked my doctor to prescribe an antidepressant.

It worked, but I began having what later turned out to be entirely unrelated heart palpitations, which scared me, so I got off that antidepressant and tried another one. That one worked even better, to the point that I could feel it "kick in" during particularly stressful situations and make me nicely distant and calm.

Guess what? Driving is a really big stressor for me. I can't help it. I just can't seem to get used to the idea of jaw-droppingly bad drivers nearly killing me on an almost daily basis. This meant that this second drug would kick in while driving and calm me down. It was nice at first, even welcome, but then it became more random, and stronger.

Then one night, driving home from a show with Matt (have I introduced Matt? I will), I felt very little stress, but suddenly that nice comforting distance kicked in ... a lot. I felt as if I were not actually driving, but rather sitting in my own head watching my body go through the motions. I kept asking Matt, who has been in several auto accidents and who is generally paranoid when anyone but he or I drives, if I was driving ok. He said I was doing fine, but oh boy, did I not feel fine. I wondered, "If something happens and I have to react quickly, will I be able to? Will I react correctly, or make the situation worse? ... Will I react at all, or will I simply watch the accident happen, distanced and calm in the knowledge that 'This is really going to hurt?'"

I eventually pulled off the road and made Matt drive the rest of the way home. The next day I called my doctor and axed that antidepressant as well, and decided not to try for a third time. I'd just deal with the depression, just as I'd been doing for years. It wasn't worth dying over.

Those heart palpitations that I'd thought were caused by the first antidepressant returned several months later and proceeded to worsen. Since heart problems run in my family (my grandfather would still be alive otherwise), I thought it prudent to get it checked out. After a scary time of EKGs, echocardiograms and stress tests, it turns out my heart is fine. It's in pretty darn good shape, actually, and so is the rest of me, according to blood results. Unless I become morbidly obese, I will never have cholesterol problems. Good to know.

Apparently, although some arrhythmia (the palpitations) is caused by bad stuff and means bad things, some of it is like a natural cowlick in your hair: no reason to be there and aside from being annoying, not harming anything. That's what I've got. My heart has simply decided it doesn't want to beat normally all the time. Apparently, normal is boring. How fashionable.

However, this same kind of arrhythmia can be brought on or made worse by stress. This is also the case with me, as my palpitations would be worse on those days and in those situations that my stress levels were higher. So now I'm on this nice little beta blocker that keeps my heart rate regular and a little slower than normal. (Note: the very first night I took the beta blocker I hated it and was totally freaked out by the distanced, hazy feeling combined with the odd sensation of two me's in one body, one slightly foreshortened and "floatier" than the regular one. The greasy feeling sucked too. Day two was much better, so I stuck it out an am glad I did.)

A few months ago, approximately one year after stopping the second antidepressant, my stress level became so high that I had a minor breakdown. I say minor, but really, it was fucking scary. I was crying, cringing, wringing my hands, absolutley desperate for some solution, some end, to the problems I'm facing, and nearly hyperventilating. And I couldn't stop it, and part of me was OK with that.

That scared me more, and part of me was OK with that, too, which of course scared me more.

I say it was minor only because although I couldn't seem to control myself for a little bit there, I managed not to break anything, hurt myself, or end it all. And no, I'm not trying to make light of the situation or of the tragedy of suicide, just stating the truth. It scared the shit out of me and I don't ever want to feel anything like it again.

The next day, I called my doctor again. Now I'm on Paxil.

With recent developments, now I want off Paxil.

See, both Paxil and the beta blocker I'm on make me sleepy. I was prepared for this, and so I take both pills at night, shortly before bed. The awesomess? I now sleep better than I remember having ever slept in my life. Literally. I have always had problems falling asleep and then staying asleep. I can't remember having slept easily or well even as a small child, as far back as my memories go.

Now, I am routinely dead to the world at night, quickly, and stay that way unless something intervenes to wake me.

And therein lies the problem. I have a finicky body. My body likes to have to pee a lot at night, even if I haven't had much liquid before bed. My ears are attempting to qualify as super-human, hearing even low-volume noises easily, and my brain, being over active always, is unable to ignore what my ears hear. Ear plugs and a fan are necessities for me to sleep, and I can still usually hold up my end of a conversation while the plugs are in. Yeah. Super-human.

My body severely disliskes heat, but my blood is apparently part lava. I get really hot really easily. This wakes me up. My orange tabby cat, Goblin, likes to (see: insists on) sleeping on my legs at night, whether I need a personal heater or not. This leads to hours-long battles between me kicking him off the bed and him peeking up slyly over the side of the bed and watching until my breathing evens out with sleep, then jumping back up and making himself comfortable on my legs again. Matt, who usually stays up later than me, has witnessed this stealthy move many times.

Nights like these, despite the beta blocker and Paxil, while my sleep is great when I'm actually sleeping, I don't sleep well due to being woken again and again. This results in my being extremely sleepy the next day, and I mean more than just coffee can fix. I end up groggy, moving and working slower than usual (bad, very very bad), and making considerably more mistakes than normal (I usually don't make mistakes, period, after a learning curve).

At first I thought it was an acceptable trade-off: mostly fantastic sleep, resulting in feeling awesome the next day (and relaxed), in exchange for the occasional groggy zombie day.

At first, the zombie days weren't so bad.

Now, not only has the zombie-like state intensified drastically, it's happening more and more as the weather begins to warm up and nights are not so nice and cold anymore. Caffeine now not only does not help to break through the fog as it did at first, it actually makes me feel sick and shaky. So I'm a nauseous, weak, shaky zombie who can't keep up and do simple things correctly (not horror movie material, certainly).

The last two weeks have been particularly Hellish, and I've decided it's no longer an acceptable trade-off, because now I'm trading in my functionality and efficiency for no guarantee of good sleep. So, enough. Although I never want to deal with another break down, and I'm really fucking sick of being depressed, I'd rather risk depression and anxiety again than lose what makes me human.

So I called the doctor's office again tonight and left a message asking how to wean myself off the Paxil. I know it's not something to quit cold turkey, and it can apparently have some pretty nasty withdrawal side effects. I'm not particularly happy about that, so I'll take it as slow as needed to avoid further unpleasantness, and just warn the people around me about my zombie-like state. My boss knows what's going on and supports my efforts not only to live happier, but to realize when the happy pills aren't working, and stop taking them.

Matt supports me in everything, always. I love that man.

30-Year-Old-Me doesn't know what comes next in this chain of events. She's scared that without something to dampen the stress, she will have another break down ... Or worse, a heart attack or stroke (both run in the family, after all). 30-Year-Old-Me doesn't know what to do after getting off Paxil and being left to reality again.

Six-Year-Old-Me wants to say it will all be OK, and that I'm stronger than I think I am. It was easier to believe that when I hadn't broken down yet. Now, I'm uneasy, and looking for more natural and productive, active and healthy ways to de-stress. I want to take up yoga or tai chi (I tried tai chi before and it was awesome), but can't afford the classes. I want to start walking everyday, but there is nowhere safe to do so that does not require driving more than 10 miles to get to, and gas isn't exactly cheap. I want to exercise, but can't afford a gym membership and there is no room at home for it.

I want ... but.

I'm tired of the "but." I want to turn my life around, get healthier and in shape, be happy again. So, damnit, I'm going to.

Along with getting off Paxil, I'm going to be stopping birth control (because my depression started right around the same time I started that whole regimen, as I was cautioned could happen). I'm going to eat more things that help to slow the effects of arthritis, and more things that help support my brain and heart. I'm going to try to avoid taking pain killers when my arthritis kicks in (nothing new there, as I've always preferred to try to ease the pain with heat wraps before resorting to pain pills, and it usually works). I'm going to be more cautious of any medications prescribed me, such as antibitotics, and do my own research on potential side effects that aren't typically talked about, and how to avoid them.

And I'm not ever taking any mood-altering drugs again. If I'm depressed, I'll get over it. If I'm stressed, I'll take a long, hot shower and a nap. I still want to believe that I'm stronger than I think, and I'm out to prove it, and break-downs be damned. Six-Year-Old-Me hasn't been as much of a guide lately as she used to be, and I want her back. I want my childhood joy and confidence back.

I want me back.

So I'm going off to find me again. ("If I should return before I get back ..." and all that, wink, wink, nudge, nudge, knowwhatImean?) Seriously, though. It's beyond time to wake up; no more sleeping in.

Six-Year-Old-Me smiles. She always smiles. I should learn that trick.