Sunday, July 15, 2018

So Much TMI

First, if you're a perfectly healthy, happy human being whose life is working out exactly as you planned, this post is not for you. Feel free to skip it, and we'll see you next month when I return to my normal babble about books and dogs.

Let's talk about brain chemicals. And thyroid hormones. And poor sleep. And being a little embarrassed.

My brain chemicals are a little off. Just a little, but apparently for a long time. Thyroid problems are easy to diagnose with a blood test, but not so easy to treat. And restless leg syndrome (RLS), when it's mild, can fly under the radar enough that it interferes with your sleep but so subtly that you can't really pinpoint it and don't understand why you're so. fucking. tired. all. the. time. (Which is also a symptom of thyroid issues, just to make it a little more confusing.)

A crisis point in late March/early April finally landed me in the doctor's office. Don't worry, not a dangerous crisis, just an I've-had-enough-of-this-bullshit-something-has-to-change-come-to-jesus moment. My matter-of-fact PCP handed me a tissue and put me on a selective serotonin reuptake inhibitor called escitalopram (the generic version of Lexapro). I found a nice therapist to talk to, too.

Apparently my serotonin reuptake really did need to be selectively inhibited because, after some dosage adjustment to deal with side effects, the escitalopram started to work. My mood improved. Actually, "mood" sounds too flip. I haven't been in a bad mood for fifteen years. My brain chemicals were wonky. So I guess the right thing to say is that my brain chemicals began to properly regulate. I started feeling . . . hopeful? I wasn't sure.

But I was still really tired all the time, and it sucked feeling hopeful but not being able to do anything about it, so I went back to the doc. This time I didn't cry. I was mad. I was diagnosed with hypothyroidism in 2010 and here it is 8 years later, and I still feel like shit? (In retrospect, knowing the symptoms, I think it's likely that I developed it sometime around 2005 or 2006, so it's actually been at least 12 years.) She checked my levels again, and they're normal, so the last-ditch effort was to switch from the generic thyroid meds to the name-brand Synthroid. Apparently there can be up to a 30% difference in effectiveness between generics and the name-brand versions. Turns out that 30% is important. Y'all, I haven't had brain fog in a month. I can find words when I'm talking to people. I can get up and fix breakfast and it doesn't wipe me out to the point that I have to go back to bed. I almost feel like one of those people who likes to spend their weekends going out into the world!

I said almost. Let's not get crazy.

The last thing to work on was the RLS. Lexapro can exacerbate RLS, and my suspicion that I had it was suddenly a certainty. I was flopping like a fish every time I tried to lie down to sleep. I think sometimes I literally fell asleep while I was still moving. After a particularly rough night, I called the doc again and she added another medication, pramipexole. That one worked the very first night and it was glorious. I slept. (There were some crazy visual side effects and the dosage had to be adjusted, but it works so well I'm willing to live with a little crazy.)

I've had all three of these meds working together for two weeks now (with the Lexapro and Synthroid already built up to therapeutic levels) and I feel . . . normal? It's hard to tell. The maladjusted coping habits of 15 or 20 years are still there. My first response to stress is still to want to take a nap. But my mental and physical energy are improving. I can make long-term plans and visualize how to follow through. I even started a new writing project, Little Yellow House, that will take a pretty serious level of commitment. This is not something I would've even considered 6 months ago. I wouldn't have had the time, what with my strenuous napping schedule.

Why am I telling you all this? Mental problems are supposed to be private, right? I guess because it would never have occurred to me that there was a solution if I hadn't heard other people talking about it. It was celebrities like Jenny Lawson (the Bloggess) and the hosts of My Favorite Murder and all their fans talking openly about their mental health that first got me thinking that maybe I didn't have to feel so run-down and discouraged all the time. And after I quietly mentioned to some close friends that I had started medication and almost all of them said, "Oh, yes, that worked for me," I realized how common this is but how embarrassed we are to talk about it unless someone else mentions it first.

So I'm mentioning it. I may be an introvert, but I'm not shy and being embarrassed makes me mad. So screw it. If you need a friend to nudge you into the doctor's office or the therapist's office or wherever you need to be, let me be that friend, even if you're not really sure what it is you need. The doc will help you figure it out. I finally realized that I don't have to be suicidal or a threat to others to need help. There is no "sick enough" to deserve help. I didn't feel well. I deserved to get help. And I feel so much better that I want the rest of the world to feel better with me. I don't mean to imply that two weeks of feeling good have made me a mental health expert. I'm at the very beginning of figuring out how and to what extent my life can or will change. But when I think about how long ago I could've started this process, if I had only known, and how my life might be different now. . . . If you're in a similar situation, I want you to know.

[In fact, as I was proofreading this, I just remembered a doctor's appointment about four years ago, when I was telling the doc how tired I was all the time and she asked me if I thought I might be depressed. I was surprised and poo-pooed it immediately. "I'm not suicidal," I told her, "I'm just tired." If I'd realized four years ago that you don't have to be suicidal to need help. If I'd let her write the escitalopram Rx four years ago. Hell. I guess there's my next topic for therapy.]

I don't have a good ending for this one, maybe because there is no ending to this story. So here are some zinnias and sunflowers. They're about the only thing July heat is good for anyway.



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