Pills 1 Neuroplasticity.

Basically, your brain can–and will–remodel itself in response to stress, injury, your environment, a whole host of pressures. Humans are marvelously adaptive critters, but (as always) there’s a catch.

The pressures you encounter when you’re young and defenseless run deep, and they wire you for certain things. You can (and to some extent will, just by dint of getting older) change that wiring. (Yes, I know I’m reducing incredibly complex neurological and physical processes to a laughable simplicity. I ain’t no brain surgeon, and I’m not giving advice.) However, the longer you’ve spent doing something, the more deeply it’s burned into your wee neurons, and the more effort it takes to redirect.

Calm Therapist, I think, put it best when she explained that I most likely had a genetic predisposition to anxiety that environmental pressures triggered and reinforced. If I’d had a different upbringing, I might have avoided the triggering, or had different resources and means of coping when the slings and arrows of just-plain-living descended. My coping mechanisms worked when they were initially wired in–I survived, after all–but they weren’t quite doing me any favours later in life.

I had some success rewiring myself with cognitive therapy, visualization, EMDR–those were just the things that worked, because Calm Therapist and I tried a million other things as well. But then came the plateau. Again, completely normal.

So when we last visited Lili Long Ago, Calm Therapist had broached the subject of medication again. I said I’d think about it.

And I did.

My objections were many. I wanted to fix myself, dammit, and not just take a pill. I’ve seen people use medication as an excuse for bad behaviour, or habitually go off their meds and lash out, again blaming it somehow on the pills–people I do not want to be like. Plus, the idea of pills triggered the stigma of mental illness. If I depended on medication, would I finally have to admit I was weak? Broken? Less? Stupid? All those things various nasty abusers had said to me might well be true. Maybe I was a crybaby, looking for a pill to fix things.

Balanced against this was the fact that so far, Calm Therapist had been right about pretty much everything. And frankly, if something short of medication would have worked, that would have been great, but the anxiety was still with me, along with its friends the panic attacks and insomnia. If there was something that meant I could sleep again–or drive without one eye always looking for places to pull over if an attack threatened–well, that was something to sit down and think about. I wanted to give my body and brain a rest and the best possible chance to get itself rewired to a state more conducive to, let’s say, not freaking out like a prey animal every time I heard a noise. It would make me a better writer, a better mother, a better all-around human being.

Still…pills. Pills, for God’s sake.

All of which ended up with me nervously sitting in an office, explaining to a very nice lady my therapist had recommended why I didn’t want to take the damn pills, I just really didn’t, but if I had to, what was the lowest possible dose of ANYTHING she would recommend?

I’m sure that initial consultation was either hilarious or terrifying for poor Frau Doktor, as I’ll call her. (She’s tall, blonde, and very Brynhildr.) I was all but vibrating with tension and doing the nervous-talking thing. I am pretty funny when I get like that (as anyone who’s seen me speaking publicly can attest) but it can’t be comfortable to watch.

The bad news was that antianxiety medications are usually habit-forming. I squirmed on the leather couch and said, “I’ll live with the panic attacks, then. I can’t be dependent to that degree on–”

“There’s good news.” Frau Doktor interjected, gently. “You have family members that do well on antidepressants without major side effects, and low doses of those have antianxiety effects.”

I blinked. “Oh. Okay. Can you send me the research on that?”

I think it was at that moment Frau Doktor really started liking me. I do know that it was the moment I found out why Calm Therapist had recommended her, because she didn’t bat an eyelash. “Certainly. These things are only tools to help you, it makes sense for you to do your research and select the right one. I can tell you what I’d recommend, though.”

And so it was that I left clutching a prescription and some copies of medical studies with notes written all over them, and by the time I got home I found more research in my email inbox. She’d taken me at my word.

So I took her at hers, got the scrip filled, got a pill cutter (because the dose was so low they didn’t have pills in that size) and nervously (ha ha) waited for whatever would happen next.

Next: Side Effects

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  • martian moon crab

    I like your Frau Doktar, it sounds like she gets where you are coming from.

  • Mel

    This is why I get so angry when people say idiotic things about taking medication for a mental illness. I can name precisely zero people who have been helped by that crap, and dozens who have been hurt.

    Anyway, I think it’s awesome that you’re talking about anxiety and treatments for it. I have the sheer dumb luck not to deal with that myself, but I have friends who suffer from various anxiety disorders.

  • Kristina

    Wow. It’s like I could have written this post.

    I weaned off of my prescription antidepressants – glad they got me thru PPD, but I have lots of negative side effects so… Last winter I started having major anxiety issues. In addition to the obsessive thoughts, heart & breathing issues, I also get hives. I’m having good luck with Visterol which is non-habit forming.

    I hope you find your medication that works. {hug}

  • Meds absolutely saved my bacon once upon a time, and the bacon of several family members. (I also had a very good experience with anti-anxiety meds, but it was basically an emergency hello-mental-breakdown! and I was only on them for about two weeks, plus they caused nausea so they had to be paired with an anti-nausea drug. Still, for those two weeks, everybody in my head just shut the hell up and I didn’t have to keep rehashing old arguments ad nauseum. It was incredible. Who knew that was a chemical thing?)

    The thing about taking meds, of course–and talking about it publicly!–is that suddenly everybody and their pet weasel has Opinions About Your Psyche And Medical History. I got hella weird e-mails during that stretch…but these days, I also get the occasional “because you talked about this on your blog, I recognized/admitted/figured out what was happening with me, and I got help, thank you,” and “because you talked about this, I knew what to expect in a way I understood, and it helped because I was really freaked out.”

    So good for you for talking about it–I think it’ll wind up helping more people than you know.

  • Stever

    Thanx for sharing your experience, strength & hope. I have done both Cognitive and Rational Emotive therapies, and have used low dosages of meds with some success. Hope you find what you need. Peace, etc…

  • Jess

    Thank you.

  • I have a slightly different take, perhaps.
    Without societal stigma, how is taking an anti depressant or anti-anxiety med different than having to take thyroid supplements the rest of my life?
    I can compare the heavy hitting drugs taken when in crisis mode to having a cast put on a broken leg, for example, but people who take insulin every day for their diabetes are no different than people who depend upon a medical solution to a chemical imbalance, IMO.
    Conversely, it seems foolish for me to hobble around on my broken leg when I can just get that cast put on. And it would be foolish of me to struggle with no energy when just taking my thyroid pill helps.
    And when I’m talking emotional situations caused by a chemical imbalance, taking the meds that may help improves not only my life, but the life of those who live with me.
    I know it is more complex than I am stating here, and there are many times that non-chemical assistance can work. (The brain can be affected by things like meditation etc) but when you try all the methods you find acceptable, and they fail, it only makes sense to go to the ones you found less acceptable IF they end up helping.

  • Thanks for sharing your experience. I have so many friends who deal with depression and anxiety and feeling alone inside of all of that makes it so much harder to seek help. When someone such as yourself speaks out the ripple effect can be so powerful and positive in so many lives. xoxo

  • George Olive, MD

    I agree with Dianna Troldahl. Interesting fact: centuries ago hypothyroidism was considered one of the Seven Deadly Sins, Sloth. Taking medicine for that would have been considered shocking and irreverent, an attempt to defy God. One was expected to cure this by faith and prayer. Now people generally accept that taking a thyroid pill simply puts the body back into balance.

    I view pills as a tool. As a proud member of a tool-using species, I realize that tools (and medication) can be both harmful and helpful. You are wise to be cautious but I think that after reading and researching you will find that some of the anti-depressants can be quite helpful in restoring balance.

    I have to confess to being a professional pill pusher, btw.

    George Olive, MD

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