Chasing the white rabbit

About two months ago I started seeing a therapist. I found her through the in-network directory of my insurance company, and there frankly weren’t a lot of choices. While I didn’t exactly dislike her, it seemed that often our sessions were more like sitting around and shooting the breeze like you do with an acquaintance. I wasn’t feeling that she was helping me move through the funk into which I had fallen.

So, just before the Labor Day holiday I showed up at our scheduled session ready to “fire” her, but also wanting her help to move on, too. In thinking about how I wanted to end the therapeutic relationship with her, I had decided to say “This isn’t working and I need to do something else.” Then I thought the conversation would be productive and business-like as we worked out how to close things, while also getting some recommendations on who I could see to get some medication.

It didn’t exactly go that way. Instead she stepped up and helped me more than I expected.

I delivered my planned line right away, but when she asked what I thought I needed I just dissolved into weeping. When I was able to talk again I told her that I thought I needed some medication at this point. I felt I had gone past my limits of resilience with everything I’ve had to deal with in the past 2 1/2 years:

  • moving across the country and setting up a new life;
  • being transferred to a new team at work, with a new boss and leadership, and an entirely different work culture;
  • multiple bouts of diverticulitis;
  • getting diagnosed with an incurable eye disease;
  • a cancer scare and subsequent hysterectomy and oophorectomy;
  • surgical menopause;
  • another bout of diverticulitis;
  • a lower anterior bowel resection surgery;
  • long periods of exercise restrictions and gaining over 40 pounds;
  • an eye surgery that cost me nearly $6,000 out-of-pocket and failed to treat my condition;
  • and, finally, another eye surgery scheduled for the end of the month.

Of these major life changes, the only one I had chosen to make was the first one. Yet all of these things rank pretty high on the stress scale. I was done in. I recognized that I was pretty much at bottom and had been having trouble with daily obligations: personal care-taking, and being productive and reasonably successful at work.

I shared with her my aversion to antidepressants. I had used two different kinds in the past — Paxil for treating panic attacks 20 years ago, and Lexapro for depression about 11 years ago — and the side effects I had experienced were a big concern for me. She offered some hope by mentioning other antidepressants that may help instead of those. Then we talked about how I could get a prescription.

The therapist is a LCSW and couldn’t write prescriptions herself. She first recommended I go to my primary care physician for a script and offered to call him, if needed. But I really wanted to see a psychiatrist. In my experience, they’re the experts when it comes to understanding which medications to use for mental health issues. Luckily, she knew one (the only one in town, apparently) and made a call as soon as I left her office. Within two hours I had an appointment with the psychiatrist the next evening.

The psychiatrist listened to me relate my medical history — including a run down all of the above issues — as well as my experiences with antidepressants and anti-anxiety meds. (Xanax and Klonopin are old, dear friends.) She made me feel comfortable with my discomfort, if that makes sense. She reassured me that I have been strong and brave, and that it is OK that I feel I have had enough at this point. But she surprised me by recommending that rather than an antidepressant, I should try an anti-anxiety medication: Buspar.

I started the Buspar just before Labor Day weekend. It was fortunate that I had the extended holiday, as it allowed me to work through the kinks of starting a new medication. My first week back at work was challenged first by extreme sleepiness, then by insomnia, but I feel that the Buspar is helping. I feel more focused; more on an even keel, and able to deal with the minor slings and arrows of a normal work day without getting distressed.

I had a follow-up visit with the psychiatrist this week and reported the side effects I’ve had and how I’ve been trying to cope with them. I had been resorting to taking Benadryl at night to sleep, which she said wasn’t good to do for very long. We both wanted me to be able to continue on the Buspar for now, so she gave me a prescription for Trazodone to use at night before bedtime.

I’ve been using the Trazodone for three nights now. The morning after I first used it I found it challenging to get up the next morning because I still felt sleepy, but it was also an extra early morning for me. When I took the first dose of Buspar that morning I also felt sort of dizzy, but that passed after about an hour and it hasn’t returned since. I’m still working out the best time to take the afternoon Buspar and how early I should take the Trazadone before going to bed so I can feel less dopey in the morning.

While I usually try not to rely on pharmaceuticals in my life, I feel like doing so now is the right choice for me. There are other ways I can address the anxiety and issues that I’ve been facing, and I intend to use them. But I was finding myself nearly non-functional. I was mentally dithering most of the time which wasn’t allowing me to do any personal work, much less professional work. Now I’m more focused and less reactionary to minor upsets. I’m starting to find the positives in my daily life and thinking about goals I can set for myself to increase my motivation. My sleep is still choppy and I’m restless through the night, but when I rouse I can go back to sleep quickly, at least.

I’ll still keep seeing the talk therapist and hopefully have more success now that I feel like I can focus and set goals. I can’t help this song playing through my head, though.

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