Afraid to Medicate - Depression/Chronic Pain

[LeendertHasABox]

Hi all,

New to the forum, so apologies if this is a repeated topic. I'm very bad at writing about myself. I'm going to try for some brevity here but feel free to ask me any questions that might help lead to better feedback.

My question for the forum is twofold:

1. I've been afraid of taking meds basically my whole life. The reasons are many, and ranging from my parent's use of them, my own weird, weak sauce philosophical stances on meds, my very real fear of a host of side-effects, and of course waking up to find that my sensitive, creative, human self has been replaced with a robot.

I'm about at my wit's end with talk therapy not panning out for me though, and constantly thinking about my stance on this again. I don't know enough to know if the ideal success story for meds begins with a willing and enthusiastic participant (I know how stupid this might sound), or if it's more common that you need to power through all of these anxious worries and fears to get to the greener side of the fence.

For reference, I suffer from a range of things, not limited to but including severe depression, anxiety, CPTSD and my arch nemsis, chronic pain (for which I've been diagnosed with a mind/body syndrome after physicians striking out with me for several years). The thought of meds makes me even all the more anxious which at the moment feels like the last thing I need.

2. Assuming I get some med-positive feedback here (sorry, just making a calculated guess), I'm curious if anyone else has any experience with their depression being overrun by a chronic pain syndrome that seems to run your entire life, and what kind of experiences they've had physically with different medications.

To be honest my list of feared side-effects is long and a little silly. To list a few, I don't want to gain any more weight than I already am, and I don't want my sex drive to dry up more than it already does sometimes. I'm also afraid of the robot thing. And I'm definitely afraid of how many of these meds purport to cause muscle aches/stiffness (the last thing I need) and other such physical side-effects. I know I'm asking a lot. And I know your experience is obviously not going to mirror my own.

I'm worried that too much trial-and-error experimentation will cause me to get disheartened and just give up after a little while like almost everything else I do in life. If if turns out I've been wrong this whole time and there's some benefit to me trying medication, I'd really hate to fuck it up by simply being impatient and looking in the wrong places. Any advice based on similar experiences would be greatly appreciated.

Thank you so much

[brownblob]

Hi Leender,
I don't have chronic pain so my situation is different. I've dealt with depression my whole life. There are reasons to be nervous about taking meds, but if they don't work for you or the side effects are too bad you can stop taking it. I don't think you have to be enthusiastic about taking them. I doubt many depressed people can muster enthusiasm for much of anything. It is more about enduring the trial and error of trying different meds until you find something that works and you can tolerate. For me, the side effects never bothered me that much. I just had a hard time finding anything that helped. I'd try them and feel nothing. I had to try a lot before I found one that helped. The way I looked at it I had nothing to lose. I was miserable without meds and they were the only hope I had. For me, I believe there is a biological cause behind my depression and meds are the only solution to that.
I wouldn't worry that much about turning into a robot. You will still be whoever you are.

[oak]

Hi! Thanks for posting. I'm glad you did.

In the last year or so I've taken buspirone (10 mg day) and been in anesthesia for wisdom teeth.

Both were, IME, at best necessary evils.

Both made me zombie-like:

Even at 10 mg/day (which is one-sixth of what some people take) of buspirone I was woozy.

The anesthesia from my wisdom teeth, a month ago, affected my cognition.

Were I to make a suggestion, it would be to weigh carefully what you are getting into, should you decide to try medication.

I also encourage you, kindly and gently, to take your experiences and feelings seriously. Everything you describe is not-silly.

What you describe is important. I encourage you to find a team. Keep telling people what you are experiencing, until someone cares.

Good luck. Keep us posted.

[LeendertHasABox]

Hey there,

My insecurities in full swing, I didn't expect such fast and thoughtful replies after my first post here. Truth be told I thought I might see an email alert about them too, which I guess I didn't, but either way I decided not to start compulsively checking back here so tried to push it to the back of my mind for a couple weeks.

Anyways, much like whenever I listen to the podcast, I still find myself in a sense of wonder at how many friends I have out there, how much support there is to be given and taken, and what a great community this really is. You both gave me some good things to consider that I really intend to take to heart. Seeing multiple responses within a day of posting makes me feel heard, and a little less defective than usual. Thank you both for that

I've decided to stop wasting my good energy trying to predict the future and see a psychiatrist this week (got some recommendations from my therapist), but I haven't committed to anything. At least I feel willing to talk about it with an actual expert finally.

Will keep you posted if things change, for better or for worse. If nothing else, it would really feel good if my struggle can be of help to others out here, like so many of yours have been an inspiration to me.

- As for my chronic pain issues, I'll keep looking for more appropriate existing threads or may get my own started. I could really go off on a huge tangent otherwise that has nothing to do with medicating. But if I have anything relevant to report here I sure will.

Sending out some love to everyone here,
Thank you for the warm welcome

[oak]

Great!

Keep us posted!

[LeendertHasABox]

My first week on meds:

I really like the doctor I saw. My lid had been loosened so much from all I'd been working on in weekly therapy that I did a pretty solid job trying to explain myself to her in the hour's time that we had. She gave me a few suggestions and did her best to help me weigh the pros and cons but in the end I basically deferred to her judgement.

Her bedside manner was great enough to help me with my side-effect anxiousness. Reminding me the obvious, that it is different from person to person. Telling me that the bulk of the heavy side-effects are experienced more when coming on/off the drug than during prolonged usage. And that the weening off can be substantially lessened by a smooth transition to a new drug, if we need to, and she'd help me with that.

Almost none of this goes along with the horror stories I read online, but I want to believe her. I'm using all the resolve I have to focus on me here, and not what other people have gone through. I'm pretty sure no matter what I may have been prescribed I could have found my fair share of people who did not have an easy time with it online.

Anyways I was given Venlafaxine (Effexor XR), a SNRI that I understand maybe packs a little more of a punch than your average SSRI, meaning it tends to come on strong and not leave very willingly. Was given 37.5mg extended releases pills and told to try just one for a few days and up it to 75mg if I'm not struggling with the side-effects too much. On day 6 here and my week's been pretty up and down so far.

I took my first pill Tuesday around 7am and by 11am that same day, I was either feeling its effects already (or I was under a strong placebo influence). My energy was positively brimming. Almost uncontainable. Well - ok, let's be fair. I am usually a total slug, can barely move or function. I may not have been Roger Rabbit-bouncing off the walls-peppy, but it was definitely a palpable change from the norm. Other than some mild indigestion and a little jitteriness I wasn't feeling too bad. I even plopped right comfortably into bed that night around 10:30. At 12:30am I woke up with zero grogginess, and a burning sensation in my chest/esophagus that was unlike any stomach discomfort I normally have. It was a disaster but at least heartburn is something I'm used to dealing with and did not immediately discourage me from anything. Anyways I ended up laying there until 5 in the morning, going back to bed for an hour or so somehow, and again, waking up. Did not feel like I'd lost any sleep at all.

Fortunately I woke up that morning with the heartburn feeling subsided and took another dose, this time with even more energy throughout the day. And more jitteriness. And a little of that burning feeling coming and going throughout the day but never sticking around for too long. Probably not helped by me not eating during the day usually. Oh, and perhaps one of the most important thing - my chronic pain, head to toe, was reduced by 50%, easy. That NEVER happens for me! And that alone is enough to make me want to keep going. At this time I'm feeling pretty lucky having such dramatic and fast acting positive (generally) effects on my first try with meds.

Aside from the occasional blurriness, grogginess, lots of yawning, and bouts of light-headedness, everything in between seemed a little easier, a little more manageable, I felt more focused, and was definitely being more mindful about myself and others. That night I managed to sleep all the way until 3 or 4am I think, and again woke up in total darkness ready to pop out of bed and start zipping around.

Now the jitts and shakes I was feeling were kind of intermittent, and I was really enjoying the boost of energy and mojo for the most part, but I still had some majorly conflicting emotions with how I was feeling that I'm still having trouble wrapping my head around. In a nutshell: I'm a former meth addict. I was a teen when I did it, 16 years ago now, but still consider myself in recovery. I used to go days, sometimes weeks, without proper sleep, and I reveled in it. Ever since I quit when I was 16 my whole life has been a downer. I haven't known the kind of energy I had as a child (much less as a tweaker) since then I don't think. It's not necessarily the reason I have depression or anxiety, but I definitely had a major shift. Now this feeling...I don't know what to do with it. I feel bad and guilty and ashamed for feeling this way- for feeling more normal, even, peppy, and willing to do things. My sex drive has also been soaring and my erections almost priapic, not something I've seen many others share. I found myself needing a drink, a little extra bud, and more than the usual cigarettes to take the edge off throughout the day too.

Anyways, this problem I'm having feels more like it's got to do with my unresolved memories from my drugged-out years than it does like the energy is too much for me to handle. Still, I spent most of the week on very little sleep. Friday night I finally slept all night but then woke up with the migraine headache to end all migraine headaches. I spent all day trying to nurse it, and it took about 10-12 hours to subside. My immediate thought was "I'm glad I didn't increase the dosage yet, maybe I shouldn't? I certainly don't want this headache to get any worse."

And so that's where I am today, Sunday, day 6. A little more rested and even than I was yesterday. I'm still at 37.5mg and have read that many people need up to a week before they can double the dose. I also read from plenty who decided to stay at the lower 37.5 and it worked great for them (75 being too much).

I am not sure my theory makes sense that side-effects like what I've experienced will only increase with dosage, or if that's counter-intuitive at all. But that was my fear. Basically, I was bouncy but containable the other day, and very worried that doubling my dose might send me bouncing off the walls. Or worse yet, I'll have that same feeling I used to get when I was gacked out of my gourd on speed. And of course I'm not sure if that's a rational fear (of course, it's not the same kind of drug at all!). But then after yesterday I felt a little more valid in that concern thinking that I don't want any worse headaches to deal with either.

I figured sticking at a low dose for now makes more sense than increasing it, then going back down shortly after. Part of me really really really wants to double up today but in the interest of making sure I make it safe and sound to work tomorrow, I think I'm going to stick with the one pill, and maybe get my new doctor on the phone for a few minutes to talk this through. I've wanted to call her ever since Thursday to describe this feeling and have been feeling bad about bothering her outside of our scheduled session, despite knowing I can call her at any time, so I think I've still a little work to do on the anxiety-front but so far, this could have gone much worse than it has I guess, and the parts that I am feeling good about, are pretty nice.

I'm still scared, but I'm going to try to stick this out and assume I should probably expect some more changes as I get into weeks 2 and 3.

Thanks for the encouragement

[brownblob]

It sounds like it's doing something for you. It's fine to go slow and see what the effects are before increasing the dose. As far as the side effects increasing with the dose, I would think so. Sometimes your body acclimates to a med and the side effects kind of subside and other times they get worse. It's unpredictable. It sounds like you are using common sense and taking it slow.
Not trying to scare you, but when I took Effexor the weening off of it wasn't pleasant. It was not a nightmare but made for a few unpleasant weeks. I am glad to hear that it seems to be helping you.

[oak]

Hey, look at you, using your words!

Great stuff. Great great.

We're only as sick as our secrets, and I'm pleased that you had the courage to admit that you used to take meth. Not only do I not think less of you, I am glad you were able to get away from it. Others were not so lucky.

Heck, I'm not a doctor, but here is my two cents: before increasing your dosage, I encourage you to get some baseline data over several weeks. Various days, various weeks: good days, bad days. I also encourage you to be careful about big changes right before Christmas: getting in to see a doctor between Christmas and new years is not something to count on!

In general, I am really pleased by your post, for several reasons: (1) Using your words! (2) trying medication (3) describing your feelings. These three things are what winners do.

As a playful exercise, guy to guy, I kindly challenge you to do this: IF your doctor gave you any encouragement to "call anytime", I encourage you to call tomorrow! Go for it. Just go use your words. Challenge yourself, man.

(I say this because it took courage for me to call my EAP today. If I did it, you can do it.)

That being said, you are enough. There is nothing you have to do, and nothing you don't have to do. You're enough just as you are.

I admire your boldness in advocating for yourself.

In the meantime, if you start to get scared or your mind starts to race: post here, pm me, call a friend, call 211, call your doctor, call your EAP. Lots of people want to see you succeed.

Keep us posted. Great, great stuff.