Saturday, September 29, 2007

Illin'

TMI Alert - If you're just here for the cute kid pictures, you might as well skip this post.





Are the new readers gone yet?







Over the last six months or so, I've noticed (and repeatedly confirmed) that my body just isn't as happy with my birth control pills as it was before I had the kid. I'll spare you the worst of the details ... suffice it to say that I have been experiencing pretty much every potential side effect that's stereotypically associated with the Pill, including mood swings that made me decide that everyone else on the planet is so insufferably stupid that it's really not even worth it to try to hold a conversation with them, since they're going to be so dense and just piss me off anyway. This usually followed the Productive Days, when sleep is not an option and I get ridiculous amounts of stuff done. And these Why Are You So Fucking Stupid Days usually overlapped the Debilitating Headache days, which I suspect are stress headaches brought on by lack of sleep and poor posture while typing, knitting, and sewing. And all this normally culminated in the Maudlin Days, when I was prone to crying at Hallmark commercials and got all weepy if separated from my daughter for more than about 15 minutes. Yeah, that's normal for me - not.

Since so many of the problems are so obviously tied to my cycle, I figured that it would make sense to try another version of the Pill before trying to treat any of the symptoms ... why go on meds for the "don't mention food or I'll puke" headaches if I can fix all of the problems at once? So I made an appointment with my doctor to talk about it, and I started checking to see if any of the other pills were supposed to cause less severe side effects.

The more I checked around, the more it looked like my symptoms could be classified as PMDD, which is basically PMS's belligerent older sister. And yes, there are treatments for it, including different versions of the Pill, and various antidepressants (a list which does not include my current happy pill, Wellbutrin).

Armed with my idea about what needed to be done, I headed for the doctor's office. Of course, the only appointment they had was on Maudlin Day, not the best time to be talking about my mental health, since probing questions on that subject tend to turn me into a blubbering mess on even happier days.

My doctor's first suggestion was to switch me to Seasonale, a Pill that encourages your body to menstruate once every four months, rather than each month. When asked if it would help with the mood swings the way another (Internet suggested) Pill was supposed to, he said, "Maybe not, but at least you'll only feel like killing your husband four times a year instead of 12." Um, no. The WAYSFS Days are significantly before menstruation, doc, so that's probably not going to help.

His next suggestion was that I should take an antidepressant, either in addition to or in place of the Wellbutrin. But I'm pretty happy with how the Wellbutrin works for me, and I hated the side effects from the Zoloft (one of the recommended ones for PMDD). "It doesn't sound like it's working so good, if you're having these sorts of mood swings." Yeah, well, it works 25 days out of the month, and it sucks for three. So I'm supposed to switch because of the three? Not if I don't have to. And he also suggested that I see a counselor ... the prescription sheet says it's for "adjustment disorder," if I read it right.

We finally agreed that I'd try the Pill that is recommended for PMDD, try to schedule an appointment with the counselor, and we'd check on my progress in six weeks. Oh, and the headaches? Probably stress, but it could be a rare side effect from the pills that sounded like something-something-pseudo-tumor-something, so let's get you a CT scan to make sure. Great.

So I take the pills, call to make sure the counselor is covered under my health plan (but I don't make an appointment, because I'm stubborn and think it's stupid), get the CT scan, and go back to the doctor. The thing is, when you change birth control pills, it takes several months for your body to adjust, so the first few cycles are usually wacky and not an indicator of how it's going to work longterm. So going back to the doctor after six weeks was pretty pointless - I couldn't tell if the pills were helping or not, and the lab had forgotton to send my CT results to my doctor, so I didn't even find out if I had an alien living in my skull. I hadn't seen the counselor (Why should I talk to her if it's only a couple days a month and it's all hormonal and we can fix it otherwise? "Sounds like you're letting your depression prevent you from getting treatment." Dude, I don't want to say it's depression, I want to say it's hormones. Can we move on?) We agreed that I would come back in three months, in the meantime giving the new Pills a chance to even out, and maybe giving them up altogether if I still wasn't feeling well. If I'm not feeling on a more even keel by the next appointment, we'll start monkeying with my antidepressants.

So by now I've finished two full cycles on good old Yaz, which has to be the dumbest name for a medication in the history of the world. Anyway, my body is not digging this stuff. If anything, everything is worse now than it was before, with the side effects as bad or worse (or more prolonged), plus now they're not as predictable as they were on the old stuff. Oh, and an additional annoyance - Yaz supposedly cuts most women's periods down to about four days. Mine's clocking in at a week and a half (and still going strong). Meanwhile, the WAYSFS Days and the Maudlin Days are still around, the Productive Days are all off schedule, the crushing headaches are occurring randomly during the second half of my cycle, and things are generally going to hell in a handbasket.

I'm ditching Yaz and going au naturale for a couple months to see how that goes. That will bring it's own set of lovely problems (example: cycles that alternate between three weeks and eight weeks long - so I have no idea when Aunt Flo is coming to visit, as one of my high school friends so eloquently put it). And I'm going to call the counselor on Monday to set up an appointment, since the WAYSFS Days have segued into overall bitchiness in response to Jason's repeated questions of "Are you okay?" and "How was your day?" and "What's for dinner?" and "Are you sure you're okay?" And I may call my doctor to see if I can talk to him about the antidepressant issue before December, which is when I'm currently supposed to go back.

I hate this.

I hate that my body is reacting so differently to something now, compared to before I had the kid. I hate that a large portion of this is probably stress-related, which means I could make it better if only I handled stress better. I hate that my Wellbutrin doesn't seem to be cutting it anymore. I hate that I'm perpetually grumpy and pissed at Jason and not enjoying things I used to and not looking forward to things I used to (um, yeah, like those aren't classic signs of depression). I hate that I've been avoiding trying to plan things that are supposed to be fun, because it's too much effort and I probably won't enjoy it anyway or I'll just end up sniping at Jason the whole time. I hate that the class of antidepressants I'm going to have to try are the ones that you have to ramp up and ramp down, rather than just stopping and starting, so it can take months to get up to the right dosage and months to stop so you can try another drug if it's not working. I hate that the last time I took it, Zoloft made me feel like an android -not depressed but not happy either, and with a huge case of the daytime yawns and insomnia to boot. I hate that trying to schedule counseling sessions is going to involve coordinating me, the counselor, Jason's travel and work schedule, and/or a babysitter, because I'm certainly not going to take Little Miss Understands Everything She Hears in there with me. I hate that all of this is hitting just as I'm trying to get the etsy shop running and coordinate a kitchen remodeling project and start planning for the holidays and refinish a cabinet and sell off old furniture on craig's list and fix the window wells in the basement and put in a new flowerbed in the backyard and rearrange furniture in our house and ... well, you get the picture.

I hate that I'm sick, and will probably always be sick. It's like I've got asthma or heart disease, something that has to be monitored and treated forever, only my disease is only marginally socially acceptable to talk about. Okay, maybe it's more like herpes - nobody wants to talk about it, I'd rather people didn't really know about it, and it can be managed but not cured. Yep, I've got brain herpes.

I know this is not unusual among depressed people, to have the very fact that they're ill feed into the depression. But that doesn't make it easier for me to short-circuit the guilt relay in my brain, the part that thinks I should be able to handle this on my own, or maybe with Wellbutrin's help, but why should I have to ask for more help than that when everyone else gets along just fine without chemical intervention. Yes, I know that everyone else doesn't really get along just fine without chemical intervention - some of them self-medicate with drugs or alcohol or self-destructive behavior, some of them are medicated but in the closet about it, and some of them are miserable but don't show it enough that I've noticed. But again, not really helpful.

I don't know where I'm going with this, other than to write it down so I can quit planning out what I'm going to say. I guess that, like the kitchen remodel, this is going to be a semi-regular topic, because neither of them is going to be completed anytime soon ... so consider yourself forewarned.

On the positive side: I'm usually a lot funnier when I'm pissed and/or depressed, so it should be a little more lively around here when I drag myself away from the sewing machine long enough to post something.

Oh, and in case you were wondering, I finally got the CT scan back and I don't have an alien living in my head. Shucks, and here I was looking forward to having a tumor to blame all of this on.

5 comments:

Anonymous said...

G: I am so sorry you aren't feeling "yourself" lately. It certainly isn't evident in your blogs, but then again you were hillarious after Liza was born, when you were writing on cookstalk! Don't feel you have to stay unmedicated or mis-medicated just to entertain us :) You might want to try another medication. Several friends and relatives have tried Welbrutin with limited success and none of them were happy with it. There are other new medication for this on the market; if your instincts tell you the doctor is not giving you what you need or not listening to you, change doctors! A pschyiatrist might be better than a GP at recognizing symptoms and providing the correct medication. (That is who I go to for my meds; he truly listens to what I have to say and then we discuss what meds need to change.)
Do you think your anxiety and depression might be because you are trying to do too much (just a thought)? You are just one person, with a very active two year old. And a new house. And a creative streak. I suspect a perfectionist streak is there too! Give yourself a break, take good care of yourself first.
mimi

Anonymous said...

ditto everything mimi said, and a small plug here for trying Prozac if you haven't ever done so. it made a huge difference in my life and still does, after more than 15 years on it. i tried xanax first, which didn't make much difference that i could see, AND it's one of those wean-on-wean-off kinds that you can only be on for six months or so. not much help! my then-new doctor said she had never had any trouble with Prozac for her patients, and i find it perfect for me, tho of course, it might not be for everyone. life is far too short to be miserable, mentally or physically, so do look into another doctor who might be more attuned to your perceptions -- after all, it's your body, who knows it better than you do?! hang in there! (mrsdillydally)

cs white said...

sorry you're dealing with all of this, but do you mind if I use the "brain herpes" line? you nailed it with that one!

Anonymous said...

I am sorry that you hurt. I was fortunate that my deep bout with depression had a single cause. My depression was the "anger turned inward" type of depression that responded well after finishing graduate school. I am sorry that your brain herpes does not have such a simple solution.


NOW, I fear that I'm going to irritate you. If you want to avoid being irritated, then stop reading now!


I am going into problem solving mode. It drives my wife batty, especially when her behavior is hormonally modified. But, I'm an engineer and I just can't help myself.

Here are my thoughts on some of the specific points that you mention:
1) We reduced the severity of my wife's hormonally modified behavior by getting off of the pill. We have found an IUD to be a wonderful invention and wonderfully effective. We, too, saw big differences in the psychotic effects of the pill before and after the first kid.

2) You mentioned headaches. My wife had debilitating headaches. She was getting more powerful drugs to minimize the headaches but they were also minimizing her participation in life. We were able to eliminate(!) them through the help of physical therapist. The problem appears to have been the muscle-thingies that connect the head to the nech. When my wife learned how to stretch them properly, then the headaches permanently disappeared.

I do not know your headaches, but digging your thumbs into the muscle-thingies at the head-nech interface helps, then there may be a stretching solution.

3) You also mentioned stress. I have been taking yoga classes and find them wonderful. My local rec center offers parent and child yoga classes. They also offer babysitting during classes. I find the stretch, centering, and silence of yoga to be useful.

4) Remember that we love you.
- MLF

Anonymous said...

A couple of other thoughts from the files of Mr. Fix-It.

5) The first paragraph of this blog really sounds like the symptoms of bipolar. Then again, the reading on PMDD sound a lot like the symptoms of bipolar. I guess it is another thing to worry about (sorry).

6) Pay attention if you find yourself taking "high risk" behaviors. When in my depression, I found myself wondering what would happen if I accidentally got hit by that car while crossing the street. I didn't want to get hit, but found that I wouldn't really be upset if I did get hit. At the time, I did not recognize the warning signs of this high-risk thought process; hopefully you will.