It is going to be an interesting time. Perhaps that’s proverbial, or maybe not.
D-bombs: If you’re going to declare war on your brain, why not throw in some overdoses of Vitamin D? One a week for twelve weeks, and no wonder. While the International Unit a completely arbitrary measurement, it still provides some entertainment. Apparently, one can overdose on Vitamin D at about 10,000 IU. Naturally, the pills containing 50,000 IU are available only by prescription. In the war on my brain, this is the equivalent of periodic MOAB air strikes to soften up the enemy.
Varenicline: Better known by its brand name, Chantix, this is the ground invasion as such. I need to quit smoking, and sometimes when you’re depressed, it’s enough to just get a handle on one aspect of your life. Nicotine addiction seems a pretty good candidate.
Sertraline: Zoloft has long been on my list of psych drugs to avoid. It probably has more to do with the fact that they ran cartoons for advertisements than anything else. But sertraline will be the counterinsurgency plan as I re-occupy my own brain and begin to attempt some useful influence. Unlike fluoxetine, I don’t know anyone who has attempted the flying leap into oblivion while taking sertraline. I’ve probably known plenty of people to take this drug, but only a couple who ever acknowledged it, and they were … how to put it … all over the map. We’ll see how this goes.
How strange, to call my brain the enemy. I’ll have to figure something out, because that’s not a notion I really want enduring through this process. I may be looking at popping some sort of candy like this for the rest of my life, and if Marsha Norman’s ‘night Mother comes to mind, it’s only as a rally cry. The point, obviously, is to live through this.
There are some concerns murmuring around the market about Chantix, that some people are deep-ending one way or another. I was told, anecdotally—albeit from a reliable source—of a woman who recently dropped Chantix because, well, when she walked into the living room and decided her husband and children needed to die, she had the good sense to get out of there and call her doctor for help. Good call. Now here’s an ADD drug to take its place.
I’ve tried to quit smoking several times over the years, and in some cases enjoyed certain success. I once cold-turkeyed for eighteen months, but I just don’t have the energy for that right now. And, besides, it was a morbid tale, that often saw me sitting out in my car on a smoke break, watching the rain fall, and cussing out the cigarette in my hands. I can only imagine what passers-by must have thought. I tried bupropion, a.k.a. Wellbutrin, once upon a time, and that just didn’t go well. It worked while I was on it, but ADD drugs and my brain are just a difficult union; I don’t ever want to feel like that again in my life.
To the other, to be fair, I know a guy who took Wellbutrin for his head, and both he and his wife praise it as a miracle drug. I won’t badmouth the drug in general, but it certainly wasn’t the right one for me.
And I have, in fact, used Chantix before. And it worked. I spent nearly a year nicotine-free, and then I spent a day working on a sailboat. After crawling around in the back of a minivan for a couple hours, making a schematic of a desalinization unit and then busting it out of a shipping crate, and then spending the rest of the day on my hands and knees on the fiberglass forms under the floor of a Hunter 41, all I wanted was a beer and a cigarette. So I thought, “Yeah, I can manage this,” and grabbed an IPA and a couple of those cheap single cigarettes in the plastic tube and, well, that was the end of my non-smoking days. No matter how many times people tell you, it just doesn’t click that, no, you can’t manage it, until you’ve put yourself through it a few times.
The only thing that has me remotely nervous about this assault against depression is that the last time I used Chantix, I wasn’t on anything else. I had tried Lexapro for my head, and it worked reasonably well. I dropped it after reaching a certain plateau at which I felt better but was still completely dysfunctional. At least when I’m depressed, I care about the fact that I’m getting absolutely nothing done. Neither the pill nor I could move beyond that, so I dropped the antidepressant and took the opportunity to quit smoking.
So having spent yet another year with my deadly, deadly friend, and finding myself making no progress at all, I’ve accepted that it’s time to try something new.
I have a good doctor. I trust my doctor. Aside from the Wellbutrin episode, he’s never steered me wrong, and there’s no way he could have known it was going to go that badly. (And no, nobody got hurt.) When I first visited his office, I was struck by his gruff bedside manner, but he’s warmed over the years. Still, though, if he doesn’t like one of your answers, he lets you know. These days you can read it on his face, like when I said I needed to quit smoking again. Concern, disgust, puzzlement. I told him I made it a year; he brightened some. At least the Chantix worked, and I’m willing to do it again. And when he asked about the Lexapro, I told him the bit about the plateau, and he understood completely.
But he’s one who fends off pharmaceutical representatives to some degree. I don’t know if he’s openly hostile to them, but before Chantix, Wellbutrin was the only anti-smoking route he would advise of his patients. Other popular methods including patches and gum? He had a drug in his arsenal that worked. Except it didn’t in my case. And he didn’t give me much for flak about it until Chantix came along, and then he didn’t bother asking if I wanted to quit; he just wrote the prescription and said, “Try this. It works.”
So when he said, “How do you feel about sertraline?” I just sort of looked at him blankly. “Zoloft,” he said. My first reaction was, “Damn it, no!” but I didn’t bother saying it. I trust my doctor. He didn’t offer fluoxetine. He started with Lexapro, which, while not the strongest SSRI out there, had an established track record. And sertraline is the next step up in his arsenal.
So, yeah. I trust my doctor. I’ve got no better ideas. He says sertraline, that’s good enough for me. I mean, what’s the worst thing that can happen? This isn’t going to kill me.
To the other, I started on Friday, and, frankly, it is legitimately trippy; I’m prone to peaking sensations in my brain, perhaps because of my history with self-medication. Okay, so there isn’t really any perhaps about it. Unlike other people, I enjoy the feeling. But I expect it to fade, as it did with Lexapro and Chantix. (Although I was amused once upon a time to experience the phenomenon while taking penicillin in advance of some dental work.)
But there are words yet to be said about somatic depression, which brings us round to the moment. As much as I enjoy feeling trippy, it’s not always a functional state. Friday night I crashed into sleep, as if the combination of the D-bomb and opening volley of sertraline … it’s hard to explain. Something like your brain saying, “Fine. If we’re really going to do this, then go lay down and let me work.” The thing is that you feel antidepressants all over your body, which shouldn’t be a surprise. But even when you are aware of the idea of somatic depression, you forget about it. There is a television spot about how “depression hurts”, and it’s true. After a while, though, it is possible to become essentially numb, which leaves you in a curious, not-quite zombified twilight. And when your body starts coming back online, it’s a lot of signal for the brain to deal with. And, naturally, the first place you feel it is in your stomach and digestive tract. It’s not really feeling sick to your stomach, but it’s enough to make you disdain verticality.
Which means that I’ve slept enough that I’ve been wide awake since about twenty to four, and it’s now pushing seven in the morning.
Of course, you can smoke on Chantix; that’s part of the point. So maybe I’ll do that and try to get some more sleep. Of course, as it’s pushing seven, that means I can probably pop my daily sertraline, which will likely demand that I take a couple more hours in dreamtime.
This is the war on my brain.
This is the war in my brain.