Psychotropic medications and I possess a tumultuous relationship dating back to when I was seventeen years old. When my anxiety and depression hit an all-time high, I reluctantly tried Effexor for about two weeks followed up by Lexapro for about another three weeks. My psychiatrist put me on low doses of both, but I abruptly stopped taking both of them. That was a huge mistake on my part because I experienced a serious spike in suicidal thoughts coming off of the second one.
Thankfully, I did nothing stupid, and I am still here. Although I was never really a fan of them, those early experiences validated my dislike for psych meds. I did everything in my power to avoid them and stuck primarily to therapy. My therapists throughout college suggested medication in addition to therapy. I adamantly refused at first. However, as time went on, I was just not making enough progress with therapy alone. I opened up to the idea, but without health insurance and the finances to pay for meds, I was shit outta luck at the time.
Eventually, I obtained a job that provided both health insurance and the funds to afford any potential co-pays. I got myself linked up with a primary care doctor too. Luckily, my doctor was willing to prescribe me a low dose antidepressant. Not every primary care doctor feels comfortable doing so and often will refer you out to a psychiatrist. I do not blame them one bit since those medications are beyond their area of expertise.
I explained my hesitance to her. I worried about putting a foreign substance into my body that might not even work. I dreaded the idea of becoming a guinea pig trying out a different antidepressant every month. Not to mention the side effects like drowsiness, weight gain, and cotton mouth that come with many antidepressants. It scared me.
My doctor started me on the five milligrams of Lexapro once a day. At the time, five milligram tablets were not even being circulated by the pharmaceutical companies. My doctor prescribed ten milligrams that I cut in half every night. That night I took the first tablet. I prayed to god that this was the first step towards improvement.
The next morning, I woke up feeling hungover. My head was like a ten-pound bowling ball on my shoulders. My eyelids felt heavy. That itty bitty five milligrams fucked me up big time. I pushed through it and took it again the next night and the next. Over two weeks, the drowsiness and heavy feeling wore off. My body was finally adjusting to the med. However, I saw little improvement in my mood.
The next time I went back to my doctor she heard me out and suggested upping the dose. Immediately, I went on the defensive. I already took a step by putting this shit into my system. Why in hell would I put more of it into my body? She gently went onto the next question.
The next several visits mirrored this pattern. I give my doctor credit for dealing with my stubborn ass because I eventually caved. She upped my dosage to ten milligrams every night.
Again, my shoulders carried around a cinder block between them the next morning. This time around I knew what I was getting myself into however. I woke up a little earlier each morning to give myself time to not feel rushed. I took my time and the feeling gradually went away each morning. It was only temporary. The downside was that there was only mild improvement in my symptoms all while taking Lexapro and seeing a therapist. You already know where this is going.
My doctor upped my Lexapro to a “therapeutic dose” (her words) of twenty milligrams every night. I contended with side effects for about a week and then the time came to see if it had any impact. Over the next few weeks (which it usually takes an antidepressant to kick in), I felt….better. My mood and anxiety symptoms greatly decreased. Holy shit. I felt good. I hit the emotional jackpot.
Of course, there were still times where my mood fluctuated in response to environmental stressors. This was normal. I will say the medications made those situations easier to handle though. I could only imagine what I would have been like without my Lexapro. It kept me from going off the deep end many times.
I stayed on Lexapro for about another three years. It seemed to help manage my depression and anxiety. During this time frame though, I was also diagnosed with fibromyalgia, which is a bitch to deal with in itself. That was another extravaganza in trying to find out which medications would best address my pain and fatigue. Multiple times my doctors switched out meds and dosages to develop a cocktail that would my fibromyalgia symptoms manageable. The one medication that remained consistent throughout this debacle was my Lexapro. I knew a good amount of fibromyalgia prior to my diagnosis since an ex-girlfriend was diagnosed during our relationship. I understood the strong connection between mental health and the fibromyalgia symptoms. I knew that if my depression kicked back in full force that it could truly spell disaster and exacerbate my fibromyalgia well beyond what I could tolerate.
Over those three years though, I constantly toyed with the idea of switching out my Lexapro. I heard time and time again that there were antidepressants that could address both my mood symptoms and my fibromyalgia pain. It was a win-win no brainer. God, I wish it was that easy. I waited until both symptoms stabilized themselves for at least six months before considering because I knew there was a chance that the medications might not work.
With help from both my rheumatologist and primary care physician, I decided to try out Cymbalta. Here came round two. I weened off of the Lexapro and started out of the low dose of thirty milligrams of Cymbalta. Just like with starting Lexapro, grogginess bit me in the ass with Cymbalta. Similar to Lexapro, the side effects went away after about a week.
I gave Cymbalta a chance. As the months went by though, my fibromyalgia came back strong. I missed days of work each week. Pain radiated down my limbs into my digits. I changed my Facebook status to “in a relationship with my bed.” It was bad.
I upped the dose twice over the next six months- once to sixty milligrams and then again to ninety. I just felt shittier and shittier though. Of all my symptoms, the one that messed me up the most was insomnia. I always had issues with sleep. I stayed up throughout high school and college. I usually ran off of a few hours, but that changed when I got older. I needed around six hours to be able to function the next day. For the six months on Cymbalta, I slept no more than three or four hours at a time. I gave the med a chance. I ruled everything else out first. I saw all four of my specialists. I tried new meds like Elavil in conjunction with what I was already on. I even went to an overnight sleep study. Nothing improved. Finally, my pulmonologist pointed out that my sleep patterns changed right around the time I started the Cymbalta.
The following day I saw my primary care physician who agreed that Cymbalta could be the culprit. Once more, the titration process began. Over the next two weeks, I cut my dose in half and in half again. I went back to the concoction that worked before. With open arms, I welcomed Lexapro back into my life.
During this recent switch, I knew there was a possibility I would feel a little off. It was inevitable. My equilibrium was about to be thrown out of whack. Shit, I was right. Little things annoyed the crap out of me. Situations I normally blew off with ease got under my skin. I woke up in pain most mornings and with a pounding headache. I prepared myself for it though. I purposely gave myself more time each morning to get ready. I eased myself into the day. I balanced out self-care and workload.
Presently, I am adjusting to ten milligrams of Lexapro every night with the intention of going back up to twenty milligrams. I totally get why people do not take meds or like switching them around. It is NEVER a fun experience. I battled with it myself. I replayed the scenario in my head a million times. After truly examining the cost-benefits analysis each time though, it was worth a try. When my methods did not work, I needed that little something extra and swallowed my pride. Once you find a cocktail that works, it feels like you won the lottery. Even if the symptoms do not totally go away, the meds help get you to a point where you can function. You can live your life again.
-The Caring Counselor