i have actually seen a neurologist!

and not only have i seen him, i have spoken to him! so - a) neurologists exist and b) appointments with them can be a reality. ;)

this one, dr. k., is actually the neurologist i saw in 2007/8 at the crisis intervention centre at vienna general hospital, and he made a very good impression then, because he always took my concerns seriously and tried to answer all my questions regarding medication and every drug's mechanism of action as well as regarding the processes happening in my brain.

it was a good session today - once again, my concerns were not brushed off, and this made me feel more comfortable. i voiced concerns regarding sertralin, which i took last time, and which had not so pleasant side effects (as mentioned before: zero creativity, rapid weight loss, weeks of nausea, anorgasmia over long periods). so we discussed alternatives. he ended up suggesting citalopram, which is also an SSRI, but slightly different from sertralin. the recommended dose is 20 mg.

apart from that, due to renewed difficulties falling asleep / sleeping through the night, dr k. also suggested changing my dose of trittico retard from 75 mg to 100 mg for now, and then eventually to 150 mg.

so here i am again - back on more meds as of tomorrow morning. i was told to expect nausea again, and perhaps some dizziness. but we'll just have to wait and see how it goes. i have another appointment after my holidays, on 15 april.

it's not easy for me to accept that i need to take that stuff again, i am finding it difficult to regard the pills as my friends - although part of me knows, of course, that they are supposed to help me. i know i'd be way less opposed to taking drugs if it were only for a few weeks, like antibiotics or something, but this is mid- to long-term. and i am already dreading withdrawal symptoms.

dr k. also told me it would be very wise to stay off work until my holiday, i.e. all of this and next week. once again, something that i don't find easy to comply with, because of my sense of duty and all that well-trained old stuff. the part of me that is learning to be different knows that he is right, of course. he is only repeating what my therapist and GP advised three weeks ago.

so i guess i'll just try to be good to myself while getting used to the new medication. watch some good films, go for walks - even though the weather hardly seems to cooperate, we are in for eternal winter, it appears, cook nice food (if i don't feel too nauseous), maybe write a little, and try to rest. and on the NOT TO DO list: worry about work, guilty conscience, checking work emails every other hour, stress.

here's a suitable pic, taken yesterday:


dangling shoes


... and this quote

Someone once told me
To hold on to what's me
But I must be too slippery

[listen on youtube]

is from my

song of the day: my two feet by ida gard.

setback

so it has happened. the thing i'd been dreading since i went off the SSRIs. i had a panic attack.

i felt better each day, but yesterday i just wasn't myself at all: felt like crying half the day, and i managed to fight off attacks several times throughout the afternoon, but i was so touchy and moody and tense by the time heinz came home that some silly misunderstanding just sent me over the edge. and that triggered the first panic attack in quite a while. i just couldn't breathe, and the fact that i was crying hysterically didn't exactly help. my hands and arms went numb, and breathing into a paper bag didn't help for ages. so i decided to take a xanax. which, of course, put me to sleep in no time. the sound of the rain outside helped me relax, too. heinz, as usual, was a star.

this episode really scared me. i guess part of me had been anticipating a panic attack, and perhaps that was what actually brought it on. yesterday afternoon i kept wondering whether i could "do it". stay off the SSRIs, that is. whether i'd be "strong enough" - to cope with anything. once the attack began, it was all "see? i knew it! i knew i couldn't do it ... i will never get through this ... it'll always be like this!" and of course that scared me even more, so it spiralled out of control. i just felt like a total loser. when i sit down and calmly think about it all, i know this isn't true, but yesterday evening it was.

my only hope is that this was the one dreaded panic attack and that i just had to get it over with, and that's the end of it.

thanks to my lovely friends who have been concerned about me since i went off the SSRIs - you rock.


song of the day: mama leone by laibach.

withdrawal

i went off my SSRIs (sertralin) on tuesday. so this is day five off the pills - for the first time since late october 2007. i am still taking 25mg of trittico (for sleeping / as a mild anti-depressant), but would like to get off those in a few months' time as well.

i'd reduced the dosage of sertralin twice - from 75mg to 50 and then 25, and both times my stomach was a little upset, and i was a little moody for a couple of days, but that was that. once i'd decided that now was the right time to quit (doctor had given okay months ago, said when i felt ready, i should just go ahead), i did. lately i had nearly forgotten to take the pills on some days, and i didn't really expect this to be a big deal. but it's not as easy as i thought it would be. now that i've decided to quit, all i seem to be thinking about is my little white helpers. not a big surprise, though, is it, when i've just not been myself these past five days?

at first i did not even make the connection - i thought i was so exhausted because of the pollen bothering me, or that i'd caught a cold. i didn't think that the effect would be that immediate. but after two days i did some research, asked around a little, and well ... they do have a name for this: SSRI discontinuation syndrome. doesn't that just sound marvellous? long list of symptoms, some of them sounding very familiar: exhaustion - check. occasional headaches - check. stomach problems - check. occasional dizziness - check. occasional sweating - check. temperature - check. and also what they describe as "brain shivers" - check. i have these minor black-outs, it's like arriving at the end of a very short period - of a second or a few seconds or even a split second - and not quite knowing how i got there. i find that sometimes my feet or hands or my brain won't do what i want them to do, at least not immediately - very disconcerting, that. i find it hard to concentrate. i don't sleep well. during the day i sometimes have the feeling i might just fall asleep standing up. i dream a lot, even more than i usually do. i am moody, feel on the verge of tears much of the time. and all this because my brain is trying to find some sort of balance again. i've tried to sleep as much as i can, i try to relax and let myself be distracted without doing too much, and i have my lovely man who supports me and puts up with my moods. i'll see how the weekend goes, and if things don't change, i'll consult my doctor. i just don't want to go back on the pills anymore. i can do what i want to do without them. enough, i say.

on friday, one student felt a panic attack coming on, and when i said "oh i know about those" in the process of helping her, people were surprised, i think. i've often had that reaction: "depressed? panic disorder? you?" but one thing i have learned is that you really cannot tell who has experienced these nasty things. the most outgoing, fun, confident people might tell you that they are being treated for these things, or have been through them in the past. there's just no telling. turned out that some people in my class - and there were only 9 of them on friday - know from their own experience or second-hand (daughters, friends, colleagues, ...). so for a while i abandoned what we'd been doing, answered questions, listened to others' accounts, and it was the right thing to do. i've always been open about this, and i think it does help to show people that they are not the only ones, and to raise awareness. one student wanted to know what to do if anybody around him had a panic attack - he actually seemed pretty scared that he might not know how to react, and he obviously had not realised how common such things are. so, here i am, blogging about this once again. who knows, it might help somebody out there, as it has done in the past.

apart from going off my SSRIs, the birch pollen have been extremely annoying, and i am very much looking forward to the day when i can breathe normally again. and go for a walk outside in the lovely spring weather.

i've been offered more work for five weeks in may and june, which is very good news. this means that i've allowed myself to go away for a few days in may, most likely croatia, just like last year.


song of the day: across the universe (live) by sean lennon, rufus wainwright & moby.