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