Abilify


I went to see Dr. McEnroe yesterday. It’s been thirteen months since he put me on antidepressants. Placebo or not, they’ve done wonders. Thirteen months ago I was over 40 pounds heavier than I am now. I showed up at his office hiding myself in baggy black clothes and cried during the entire meeting. I felt like I needed a forklift to get out of bed in the morning. Although always an introvert, I’d become even more reclusive. I didn’t go to a single holiday party. I went months without a pedicure.

No, this isn't really my foot. But without antidepressants, it could have been.

No, this isn’t really my foot. But without antidepressants, it could have been.

I was extremely overdue for a teeth cleaning. I didn’t cook any more. I didn’t have the energy. (Lack of movement and takeout probably were largely responsible for my weight gain.) In fact, I didn’t have the energy to do much of anything. Except turn the channel with the remote. When I was not at the office, I’d be either on the sofa or in bed. I went to bed as early as 8 p.m. because I had no interest in doing anything else. I’d sleep 10 or 12 hours a day. And still I was exhausted.

In the midst of my fog, it occurred to me the black dog was back.

After trying a few different combinations (one that made my hair fall out), we settled on 300 mg Wellbutrin in the morning, along with 15 mg of Deplin. (Deplin is a medical food. A super duper form of folate that has been shown to boost the efficacy of antidepressants.) I was taking 30 mg of Deplin in the morning, but Dr. McEnroe has suggested I take one in the afternoon, so now I’ve spread them out. Along with dinner, I take 40 mg of Viibryd. So that’s it:

Morning: 300 mg Wellbutrin, 15 mg Deplin
Noon: 15 mg Deplin
Dinner: 40 mg Viibryd

Initially, there were side effects. Eventually, they all dissipated. Except muscle twitching (myoclonic jerks) when extremely relaxed. (No, these are not ex-boyfriends. Go here if you’re curious about my jerks.)

I mustn’t forget the weekly (or bi-monthly, depending upon how things were going) visits with Annie, my therapist. Outdoor exercise (Vitamin D) also is part of the equation, along with good nutrition and less wine. And of course cat therapy.

On this regimen, I’ve made it through two deaths in my family within six months (brother and father), the holidays in the wake of those losses, cancer (and recovery) of my remaining brother, followed by an intervention in hopes of helping him to stop killing himself with alcohol. (He’s in rehab now, and doing great. :) ) Oh, and I was thrown together with my sister and her husband (who molested their daughter) due to the deaths of my brother and father, and so had to manage my feelings about all that (a post I’ve been avoiding).

Through it all, I’ve stayed out of the quicksand.image

I asked Dr. McEnroe last week whether I’d be on them indefinitely. After all, it’s been over a year. He said he’d like me to have one good year under my belt before tapering off. A year without crises or uber-stressful life events. A year where I could focus largely on me and taking very good care of myself. My goal is to make 2013 that year. With any luck, no one will die.

So the bottom line is, don’t listen to Newsweek.

Ignore this.

Ignore this.

For some, including me, antidepressants do indeed work.

***Because antidepressant-related searches are at the top of the list for traffic to my blog, I’ll continue to provide updates on my progress. Feel free to email me: unconfirmedbachelorette@austin.rr.com.

Today’s post is about natural antidepressants. Here’s on of my favorites:

Cat Digging My Shoes

I think psychiatrists should hand out kittens, along with the drugs. (While this is not my cat, those are my shoes.)

Next is nature therapy. I took these shots at a park not ten minutes from where I live. When you can walk, trail run, or ride your bike here, who needs a gym? I’m a firm believer that outdoor exercise is way better for mental health than slogging away on a treadmill. You get your vitamin D, a little nature (yesterday I saw a gorgeous deer), and lots of fresh air. The last shot is of my favorite tree in the park.

But don’t take my word for it. Here’s a link to a scientific study showing that outdoor exercise is better for you than indoor exercise. http://www.sciencedaily.com/releases/2011/02/110204130607.htm

Also, these two types of therapy don’t make your hair fall out. No more Abilify for me! (But I am still on the Wellbutrin and Viibryd. For now.)

I saw Dr. McEnroe on Monday and told him I stopped taking the Abilify ten days ago. Since stopping it, I’ve felt a little anxious, but thought maybe it was just a side effect from getting off the drug. Apparently my acceptable level of anxiety and his acceptable level of anxiety differ. So he gave me samples of a brand new drug called Viibryd. Who comes up with these names? This one sounds like a cross between vibrator and vibrant. So of course I accepted the samples. I did, however, think long and hard Monday night about whether to actually take them. By Tuesday night, I figured, what the hell. So now I take 300 mg of Wellbutrin and 15 mg of Deplin in the morning, and 10 mg of Viibryd at night. After a week, I  move up to 20 mg of Viibryd, and then maybe 40.

Before I decided to take the new drug, I scoured the internet. Apparently everyone is having “explosive diarrhea” and nightmares involving Sleestaks. Nevertheless, I plunged on and took the dose. I had pretty bad insomnia the first two nights. That settled down a little the third night. And last night, I slept pretty well. No explosive diarrhea or Sleestaks. Although a Sleestak or two might have been fun.

While I’m feeling virtually no side effects, I’m not really feeling any effects yet, either. This drug is supposed to start working more quickly than other antidepressants, but it is early days. I shall keep an eye on things and report back. Since there’s not much out there on this drug Viibryd, updates on this one might be useful to someone.

I’ve scoured the internet, and there’s a dearth of information on the topic of Abilify withdrawal. Hopefully this will help those searching for information, if only a little.

I started Abilify on February 2, 2012, on top of 300 mg Wellbutrin and 15 mg Deplin. My psychiatrist slowly eased me up to 5 mg after starting with the wee dose of 1 mg. On Friday June 1, I quit cold turkey. (Disclaimer: Do not follow my example and quit your antidepressants cold turkey. Always consult with your physician, who likely will wean you off them slowly.) I figured it would be no big deal since I’m only on 5 mg. For the most part, it has been no big deal.

First, why I quit.

I noticed that when I try to exercise outdoors, even walking, I get overheated, even if it’s only 90 degrees in the sun. While 90 might sound hot, for those of us living in Central Texas, it’s not too bad. It’s when we hit 100 that I might opt for indoor exercise. I hate indoor exercise, so getting overheated so easily is a problem. And then there was the constipation. Having a bowel movement every five days, even with the help of Miralax, is awful. Before the antidepressants I prided myself on being a regular girl (if only when it came to bowel movements). And then there was the hair. I was reading about Abilify’s side effects, and discovered that hair loss is often mentioned. Hair loss? Hell no, will I risk that. And come to think of it, it did seem that more of my hair was finding its way into the sink and the tub. So we’ve got overheating, constipation, and hair loss. Could it be any worse than that? Yes! How about weight gain, or even an impediment to weight loss. Lots of people complain of significant weight gain on Abilify. I don’t weigh; it makes me crazy. But I do know that despite being conscientious with my eating and getting more exercise, my clothes are not getting looser like they were in the early days of taking Wellbutrin only. Even if it’s not the Abilify, like hair loss, this is not something I’m willing to risk.

Once the reasons for quitting the Abilify had piled up, I decided to quit it. I called Dr. McEnroe (not his real name, but he kind of looks like him, and has that whiny little voice) and left a message about quitting. That was on a Friday morning. I didn’t hear back from him until the following Monday. In the meantime, I got antsy, and decided to take matters into my own hands. So Saturday, I didn’t take my daily dose. And I haven’t taken the drug since. Today is Day 8. From what I’ve read, the drug has a half-life of 72 hours, meaning it’s not fully out of your system for 72 hours. 72 hours was Tuesday. So Tuesday my system was Abilify-free. Today, Day 8, it’s been fully out of my system for 4 days. Here’s how it went.

The first couple of days, I had a headache. This makes sense, as I had a headache when I was starting the drug. The next few days I felt somewhat nauseated, especially when doing yoga. I had the same symptom in the early days of the drug: I always felt like I was going to vomit half-way through a yoga routine. Especially one with forward bends. So again, not too surprising. Next, I feel tired. I want to sleep ten hours a day. And there’s been some insomnia. Hopefully this is a temporary withdrawal symptom, and not a slide back into depression. I’m guessing it is temporary, because the insomnia seems to be easing, and other than feeling tired, I feel pretty good mentally.

The last thing I’ve noticed, and this is the freakiest, is what I’ll call time-skipping. It happened yesterday when I was bowling. Yes, bowling. I had to bowl for a client’s charity event. This yearly function is a fun but humiliating little boondoggle. I’m a terrible bowler. But I did break fifty both games. Better than last year. So back to the time-skipping. I’m standing there watching one of my team-members, and he bowls a strike. Woohooo! A few seconds later I look up at the board and it screams in block letters: STRIKE! I then turn to the cute new (single!) lawyer in one of our other offices and say, “Who just bowled that strike?” He knew I’d just been yelling for the bowler as he knocked down ten pins as he was standing next to me and heard me cheer. But I’d forgotten in a matter of a second. My brain had skipped, like a scratch on a record. And then it came back to me: I’d just watched it. I covered with a mumblefuck of something like: “Oh, I thought I was watching the other lane.” Cute new lawyer now thinks I’m a ditzy brunette unworthy of my J.D. Even worse, the whole experience was rather eerie. My brain malfunctioned, and I watched it happen in real time. This had better be an isolated and temporary withdrawal symptom, but I’ll be watching it closely.

Here’s something positive I’ve observed: the constipation is easing already. This morning I had a bowel movement for the second day in a row. I almost called this blog: I POOPED! But thought perhaps my gentle readers would find it too early in the morning for that.

Next up, a walk/run in the heat. I do an up and back. On the way out, I’m fine, but on the way back, I’ve been finding I have to stop under a tree every ten minutes or so and cool off. Hopefully I’ll do better than last weekend and I won’t have to spend as much time pretending to stretch under trees.

And last: some extra-special positive news. My brother with the mouth cancer, the one doing radiation and chemo, who just had has lymph nodes in his neck removed, has now been given the all clear. His lymph nodes were clean. He is cancer free! I just crumbled at my desk when I heard the news, and cried out of sheer relief. It wasn’t until that moment that I realized how upset I’ve been about his illness, and how scared I’ve been that I might be losing another brother, after I just lost one in April, and what that would do to my poor mother, and my brother’s children. But he’s cancer free, for the second time. Come to think of it, my dad has achieved the same feat, twice.

So today I shall take in all the good things that are happening. No cancer, and I pooped!

After a fabulous vacation in Tuscany, I am back to the mundanities of life. I’ve spent the past week and a half digging out at work (and getting behind on my blogging). I traveled to Chicago for meetings this week, and while I love Chicago in the summertime, the last thing I wanted to do was get back on a plane. My reward was accepting my neighbor’s invitation to drink bubbles by the pool last night. (Much to my chagrin, I think I may actually feel the stirrings of a requited crush.) The combo of the bubbles and all the recent travel finally hit me, and this morning I stayed in bed until 11:00 a.m. catching up on sleep and recharging.

Okay, okay. I won’t skip over the requited crush topic. My neighbor has been crushing on me for years. The trouble is, he’s nearly fifteen years younger, and wants babies. (“But not tonight,” he said, the last time he made a pass at me.) Despite the fact that he’s charming, sophisticated, well-traveled, single, stable, and has a job (the opposite of my last foray into romance), not to mention a sexy Latin accent, there’s just no point in going down that road. And then there’s the fact that it’s a terrible idea to have a fling with a neighbor. So I shall keep it as a flirtation, and enjoy that. But still, there is a stirring in my girl loins that I haven’t felt in months.

All in all, I’m feeling pretty good these days. But the anticlimactic feeling that often comes at the end of a great vacation has me looking for something more. The something more that comes to mind is getting back to my running. But I’m having trouble running in the heat on the antidepressants. The Abilify warnings state that it’s easier to become overheated while exercising, and cautions against strenuous exercise. I live in Austin. I exercise outdoors in the heat. I refuse to spend my life on my elliptical (sheer freakin’ drudgery). So I’ve made the decision to see how I do quitting one of the trifecta (Ability, Deplin, and  Wellbutrin). I called Dr. McEnroe yesterday to get his input on my plan to quit the Abilify, but he hasn’t yet returned the call. Nevertheless, I’ve decided to go ahead and stop it, cold turkey. I’m sure there will be those who protest, but I’m going to do it anyway. When I’ve made up my mind to quit something, I don’t do it by halves. Including relationships and cigarettes. And besides, having quit smoking cold turkey some years ago, I can’t imagine this could be any worse. Just rip the band-aid off and get through it. It’s the best way. In quitting drugs, and men.

Hopefully once the Abilify is out of my system, I’ll be able to run without feeling like I’m going to keel over from the heat. And just to get it out there, I really want to be drug-free within the next several months. I’m feeling better. And with proper sleep, exercise, and Vitamin D (and staying away from abusive jackasses), maybe I’ll be successful in managing the depression without the drugs.

I think I’ve got this now.

I’ve been on antidepressants and back in therapy for a little over four months. It’s difficult to remember how tired and apathetic I was. How disinterested. But slowly over the past four months, I’ve begun to emerge from the pit I had dug for myself. Not entirely, though.

You see, the pit has a certain allure. It’s an easy place in which to live. I get to feel numb. Feeling numb is great when you’ve got more shit to deal with than you’d like. Seriously. Who wants to deal with a sister who stayed married to her pedophile husband after he molested their daughter? The whole world seems out of kilter when you’re faced with that shit. Deep dark holes are where it’s at.

But I’m not hunkered down in the hole any more. And the pedophile is still here. He was at my brother’s memorial last weekend. He consoled my mother. I fantasize about choking him. I think I’m making progress, emotionally.

Now that my mother has acknowledged that he’s still wasting space on this earth, he’s exhibiting a sense of entitlement. The man glared at me across the aisle when I turned around to look for my brother, Seth. I kid you not. He glared at me. He glared at me for having the audacity to say out loud what he is. A man who sexually molested his daughter. For years. How dare I tell my mother and brothers what he’d done? You’re supposed to keep that kind of behavior a secret, don’t you know. So he glared at me at my brother’s memorial and made no effort to keep his distance from me. Yes, he’s feeling emboldened. I wanted grab him by the hair and shove his face into the holy water, holding him under until he begged for mercy. And then dunk him again, just to be sure I’d made my point. Yep, the medication and therapy are working.

If he had molested someone elses daughter, he’d be in prison. Not hanging out in churches.

But if I’m shining a light, I may as well shine it on my sister, too. If it wasn’t for her, the man wouldn’t be around any more. What kind of woman stays married to a man who molests their daughter? What kind of mental gymnastics must she perform each day to keep her head from exploding? What does she tell herself? What could she possibly say to justify his behavior, and hers?

My sister is a horrible person. No way around that. And the co-dependent cycle continues with my nieces hiding their father’s secret, as if his shame were theirs. I really don’t get it. I don’t understand how she could stay with him. Does she have her own holy water fantasies? Does she imagine beheading him and putting his head on a spike in the forest for the crows to pluck out his eyeballs? Or does she block it all out with the contents of her plastic travel cup that she carries with her wherever she goes?

I’m guessing she finds her redemption at the bottom of a travel cup.

This post is about depression, sleeping, and peeing. It’s not the kind of thing most people want to read about, but if you’ve got problems with any (or all) of them, you might want to read on.

I used to awaken numerous times in the night, often the result of needing to pee. Once I’d gotten up to pee, I’d go back to bed and lie there for hours. I’d finally fall asleep when it was time to get up and go to work. Even though I’d been in bed for ten hours, I’d wake up exhausted. I walked around in a constant state of sleep deprivation. And I constantly needed to pee. I’ve been on medication for several years for overactive bladder. It’s helped, but not entirely. Until recently, I still had to pee all the time. I’m talking a dozen times throughout the work day. And often the urgency was overpowering. I’d be on a conference call, and the urge would hit. I’d pace my office, try to focus on the call, but end up fantasizing about peeing in the trash can, instead. When the call ended, I’d run down the hall to the restroom. Since this is an anonymous blog, I’ll tell you that I didn’t make it on a couple of occasions. (Good thing I had gym clothes as a backup.) Or I’d go to an appointment, pee before I left, and then need to use the restroom again when I arrived at my destination fifteen minutes later. I’d then have my meeting, which would last thirty minutes or so, and then need to go again on my way out. I’ve had to go in the middle of massages. In the middle of teeth cleaning. In the middle of acupuncture treatments. I’d done a series of acupuncture treatments in an attempt to solve both the sleep and the bladder problems. It did no good. I went to a urologist who put me on medication. As it turns out, what I really needed was a psychiatrist.

But I had no idea why I developed this problem, and my (somewhat cursory) online research suggested doctors don’t really know, either. Some of the medication the urologist put me on was useless for me. I tried two different types before I settled on a third that seemed to help. But not entirely and not all the time. And it was so random. At least seemingly so.

And then I fell into a deep depression, and luckily, I went to a psychiatrist. And a therapist. The psychiatrist put me on antidepressants. Slowly, I began to feel better. I began to sleep through the night. A few nights of good sleep a week turned into good sleep most nights. That’s right: most nights I sleep through the entire night without waking to use the bathroom. Since I’ve been on the antidepressants, my bladder symptoms virtually have disappeared. It’s really quite remarkable. So, of course I googled it and dug a little deeper this time. We all know depression causes insomnia, or in some, hypersomnia. But what I didn’t know is that there’s a link between depression and overactive bladder. Treat the depression, and the bladder problems disappear.

It seems when the brain is misfiring, it can cause all sorts of issues: sleep, bladder, cognitive (including brain fog and memory loss), and emotional issues. Since I’ve been on antidepressants, all those symptoms have improved. Every one of them. What am I taking? Currently I’m on 300 mg Wellbutrin, 15 mg Deplin, and 2 mg Abilify. I started the Wellbutrin and Deplin three days before Christmas, and the doctor gradually increased the Wellbutrin dose until I hit 300 mg. I started the Abilify at the beginning of February, first 1 mg, then 2 mg.

All this leads me to believe that I’d been suffering from depression for years, at times worse than others. But now, I feel better. Much, much better.

If you have symptoms of depression, I urge you to not suffer in silence. You don’t have to. See a psychiatrist and/or a therapist. Take the medication if prescribed. If the first one doesn’t work, try a different one. There is help out there. And there’s nothing to be ashamed of. Brain function is like any other physical aspect of the body. And when it goes haywire, it shouldn’t be viewed any differently than high blood pressure.

The more we speak up about depression, the more we chip away at the stigma.

Post breakup (back in late September) with an abusive assclown, I found myself deep in the pit a/k/a the abyss, the quicksand, the deep-dark-hole-of-nothingness. When Dr. McEnroe suggested antidepressants, I must admit I was quite skeptical. I’ve read all the articles about them being no better than placebo and causing horrific side effects. And I’m generally against medication of any sort on principle.

But I knew I had to do something, so I relented. As the days passed, I began to feel better. I found it less difficult to get out of bed in the morning. I felt a little less hopeless. I stopped hunkering down at home, avoiding social interaction. I started sleeping better. I had more energy. My motivation improved. And most importantly to me, the brain fog began to clear.

Now that I can think clearly, I see just how off I’d been cognitively (in addition to emotionally). I’d been struggling with completing projects. I couldn’t stay focused. I had a hard time following substantive discussions and responding appropriately. I thought I was just distracted and needed to try harder to focus. But now that my mind is sharp once again, I can see it was the depression. These past few weeks, it feels as if I’ve gotten back the fire, completing work projects with gusto. Yes, this girl is back. And maybe even better than before.

Even better than before, you say? Yes. Better. Case in point: I cleaned out my closet. Yes, the dreaded master bedroom, walk-in closet. I filled two of those black trash bags with clothes, and a third with shoes and handbags. I didn’t struggle over what to keep and what to toss. I made the decision, bahm, and moved on to the next item. They’re now in my trunk, ready for drop-off at Good Will. And this weekend, I’m going to weed the garden. I love pulling weeds; the sound and feel of the roots releasing the earth. Good stuff.

This all feels a bit manic to me. For most, I’m guessing it’s normal. It’s nice to feel other people’s normal.

If you’re interested in what I began taking, when, read the paragraph below. If not, you might want to skip on down below to my nod to Davy Jones.

I started on 150 mg of Wellbutrin and 15 mg Deplin on December 22, 2011. Three weeks later, on January 12, 2012, Dr. McEnroe bumped me up to 300 mg Wellbutrin (continuing with the 15 mg of Deplin). Three weeks after that, on Feb. 2, he added 1 mg of Abilify to the mix. Abilify? An anti-psychotic? Am I psychotic? While I may have been temporarily insane for dating Mack for a year, no, I’m not psychotic. Apparently, for some, Abilify helps with depression and anxiety. For the first few days I was sleepy and nauseated. Eventually, both side effects disappeared, and I began feeling more energetic and  motivated. (I’ve also been told I’ve been more pleasant to be around.) Four weeks after that, on March 1 (yesterday), I started on 2 mg Abilify. So the current breakfast cocktail is 300 mg Wellbutrin, 2 mg Abilify, 15 mg Deplin. That second milligram of Abilify seems to be the icing on the cake. I feel pretty darn good today.

So after ten weeks on the antidepressants, like Davy Jones:

I’m a believer.

Davy Jones of the Monkees, gone but not forgotten. Click here for the video of I’m a Believer. http://youtu.be/XfuBREMXxts)

 

While I haven’t quite achieved the nirvana depicted in this photo, I’m getting there. The antidepressants no doubt are doing their job. I wouldn’t say I’ve been transformed, but certainly there’s some reconstruction going on. On the antidepressant front, I’m now on 300 mg Wellbutrin, 15 mg Deplin, and recently Dr. McEnroe added 1 mg Abilify. After the breaking-in period, the side effects have been minimal. Although the Abilify does make me extremely nauseated from time to time, particularly when I do yoga. But when I’m nauseated, I don’t want to eat, so I’ll deal with it.

Since beginning the antidepressants, I’ve noticed a significant difference in my self-confidence. Yesterday I had a 4.5 hour meeting with 15  or 20 of my colleagues consisting of heavy-hitting lawyers and members of the judiciary from across the state. I’ve been on this particular committee for a little over a year, and have felt rather intimidated most of the time. But during the past two meetings that has changed. Yesterday I suggested a somewhat controversial addition to the publication the committee is updating, and I (with some help from my subcommittee) held the naysayers at bay, and gained a majority, pushing the change through. Yeah, I’ve come out of my fog. It’s simply amazing how much more confident I feel now that my brain is working well.

Here’s another difference: I’ve booked a solo trip to Tuscany in May. Okay, not entirely solo; I’m joining up with a group. It’s a gourmet cooking trip, and I’ll be staying at a villa somewhere in the Italian countryside between Pisa and Florence. In addition to the cooking classes, there will be trips to Tuscan vineyards, the coast, local villages, and markets. After my 6-night stay at the villa, I’ve planned three additional nights on my own in Florence. I sure hope I have internet access so I can blog my newly-bursting heart out.

I would say I’m back to my old self. But I’m not. I’m feeling entirely new.

 

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