Drugs and other difficult things

And I’m on to antidepressant number 4! Yes, four.

I’m probably a little too good at hiding my symptoms. Years of being made to feel like my feelings are irrational and overdramatic, or that I am way too sensitive have taught me to internalize everything.

Talking about it while I’m in the midst of is super uncomfortable. I don’t mind talking about it afterward the fact, because it’s in the past, but when I’m in it, I don’t know if I’ll get out, and that’s stressful on its own.

I know they say it gets better, but when you’re depression is chronic, rather than episodic, it’s a lot harder to believe.

It hasn’t been quite as bad as this time last year, but last year I had an emotionally traumatic event as a trigger. This time, everything is going excellent, which makes it far more difficult to deal with because there’s no logical reason for feeling like a worthless piece of shit.

This time last year, I was so overwhelmed with emotions and pain that I didn’t know how to deal. Now, it’s not like this:

  • lack of emotion, most of the time.
  • Inability to sleep, but not because I’m worrying about everything and it’s keeping me awake, more that I’m not drowsy when I should be, even though I’m physically exhausted and all o want to do is be curled up in bed.
  • Absolutely zero motivation to do anything, except to make sure no one notices, to I continue on as if everything is fine, waiting for it to go away.
  • Almost constant suicidal thoughts or wishing I was dead.

I feel lost in life. Like in just going through the motions. Simply existing, rather than actually living. I’ve felt like this before without a trigger, but that was before I understood what depression was, before I was diagnosed.

I talked to my doctor today because I’ve been on the same dosage of medication since January, and the fact I’m feeling this way indicates that it’s not helping as much as it should.

Because one of the meds I’m on had been making me tired, he decided it’s probably time to try something else.

Since I haven’t posted about my meds in a while, so here’s a recap.

In late November 2014, my old doctor put me on 50mg of Pristiq, an SNRI. It felt like it was helping for a bit, but I think most of it was the fact I finally had a named to put on the way is been feeling and that made me feel better. That’s why I wish I hadn’t started medication right away. I didn’t know anything about antidepressants at the time, so I thought it would be a quick fix. I was wrong.

About a month later that feeling went away. He increased my dose to 100mg.

End of February 2015, I moved. Saw my new doctor for the first time in late March or early April. I told him I wasn’t sure if the Pristiq was working or not. After some discussion, we decided instead of going up to 150mg, we’d try sertraline, an SSRI, which is the generic form of Zoloft.

We phased out the Pristiq while introducing the sertraline to my system. Started at 50mg, then increased to 100mg a month or so later. A few weeks later, I didn’t really feel any different, so we increased to 150mg.

I went on medical leave a little while later. The crap that happened after that made things worse. My doctor was hesitant to increase the sertraline to 200mg because he didn’t think it would be much different. 200 is the maximum the usually prescribe.

He said his next step would be to try an add-on antidepressant, Welbutrin, an “atypical” antidepressant, but he wanted me to get the opinion of the psychiatrist at his office first.

The psychiatrist, at the beginning of August 2015, diagnosed me with social anxiety. But he also said that I was “definitely not depressed,” which was a load of crap, because he’d only spent 20 minutes with me and didn’t know a lot about my past and what we discussed really didn’t show my depression at all. Just my anxiety. He put me on 250mg of sertraline. No, that’s not a typo. 50mg above the normal max.

I started to feel a little better after a few weeks. I was tired all the time but I just assumed it has to do with the fact I wasn’t working and spent all my time on the couch.

Once I started my new job, at the end of November 2015, I realized that was not the case. I wasn’t feeling better and I was sleepy all the time, but did not feel rested when I woke up in the morning.

Back to my doctor’s original plan. Added 150mg of Welbutrin (technically the generic, bupropion, but I don’t know how to pronounce it and he always refers to it as Welbutrin). He said that he’d had patients who felt it gave them a boost of energy, so he thought it might help with how tired I was.

It took a lot longer to kick in than the Pristiq and sertraline had, but once it did, I felt a lot better, mood-wise, but I was sleepy all the time still.

He had me try clonazopam, Sublinox, and zopiclone for sleep. Since my problem at the time wasn’t really falling asleep, but rather feeling rested the next morning, none of them really helped.

After several weeks of rarely making it through a day without dozing off at my desk at least once, my doctor decreased the sertraline in increments of 50mg over a few weeks until I was down to 100mg. (I wish I’d read this beforehand because the withdrawal kicked in about two weeks later and really kicked my ass.)

I stayed on 150mg of Welbutrin and 100mg of sertraline every day for about 6 months, until today.

For the next two weeks I’m taking 100mg of sertraline every other day (because they’re capsules so you can’t split them to 50mg and I have quite a lot left, so it’s not worth paying for 7 days with of 50s) and I’m starting on 5mg of Trintellix every day. Trintellix is another atypical antidepressant. They say it most closely resembles an SSRI, but they aren’t really sure what exactly makes it work. Continuing the Welbutrin at 150mg a day.

After two weeks, I will stop the sertraline and increase the Trintellix to 10mg. If all goes well, I will see my doctor 8 weeks from now to restock on samples (he knows I don’t have benefits, and it’s a fairly new drug, so there’s no generic, and he didn’t want me to pay a bunch for new medication while I’m trying it out.

So, we’ll see how it goes.

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