Thursday, September 26, 2013

Another Medication Update

I went back on the buspirone a week ago after talking with my therapist and my case manager.

I don't think it's going well.

I mentioned previously that when the wedding was over, I felt my anxiety level might go down. Instead, it's gone way up. I said before that I was somehow more nervous, even though I had less stress. Actually, what I said was: "I'm tired, sometimes uncoordinated, sometimes lightheaded, a little irritable and I'm having those long, drawn-out, meticulous, exhausting stress dreams every night."

I stopped taking buspirone to see how it affected these symptoms, and only a few them went away. The extreme fatigue eventually cleared up, but the sense of being irritable only got worse. In fact, not only have I become much more impatient, but I'm somehow quicker to anger than I was before. I'm more aggressively angry than I've been since before I started therapy (during my withdrawal period). That just got worse, even after stopping buspirone to see if it would go away.

I admit, I'm suspicious of being on drugs like that because of my bad experiences with Lexapro and Prozac. I'm sure that there's some hypervigilance on my part, and the fact is, because of my high blood pressure, I can be very, very sensitive to medications. Everything goes through my body more quickly than it should, and so I do have a tendency to feel side effects very quickly.

My therapist and case worker both wondered, independently of one another, if what had happened to me was that my nervous energy now has nothing to focus on. I was so worried about the wedding, so focused on getting everything right and surviving what turned out to be my biggest period of outside activity since I was teaching, that now all of that anxiety didn't have a drive behind it and I was reacting to not having anywhere to put it. I thought that sounded reasonable and agreed to go back on the buspirone to see if it helped me deal with this new burst of nervous irritation.

But it hasn't, and I feel like I'm just getting worse.

The thing I'm most ashamed of and worried about is my anger. I've had serious anger issues in my life, and I've worked hard to try and get them under control for a decade now. My first instinct--and this is partly blood pressure-related, because the adrenaline and anger go through me so fast (my fear does, too, which is why I panic so easily)--is to yell and scream and throw and break and hurt, and I've worked so hard to not only get to a point where I can try and swallow that and not lash out, but to make strides to process my anger more reasonably so that I'm not just trying not to lash out, but trying not to even have the reaction where I want to lash out. I've been somewhat successful, and I was proud of that.

But sometimes I slip, and I've been able in recent years to just sort of punch out at the air instead of hitting myself or putting holes in walls or smashing something on the ground, all things I've done in the past.

I don't know if she's going to see this, but this is behavior I internalized at an early age from both my mother and my grandmother. My mother was the same way I am: she got angry very easily, and the frustration from her anger would often prompt her to just hit me. So I learned that response: get frustrated, hit something. I'm not blaming her for the way I am, because the anger issue is its own thing. But it's a response to the anger and frustration that I was inadvertently taught.

Another thing I don't like to talk about is that I've hit Becca once before. A long time ago, before we even moved here. It happened because we were fighting about something and I got really frustrated and smacked her on the butt really hard. So hard she fell down. I hate that I did that, and I was immediately guilty and fretted for a long time that doing it once would just make it easier to do again. It's why I never got into boxing as an outlet for my nervous energy, because I was worried it would internalize in me the idea that the reaction to that energy was to hit something. But, I realized later, I already had that idea in me.

I vowed never to hit anybody again after that, and I never have.

But sometimes, I'll admit, I feel that instinct. Not Becca specifically. But that instinct that the thing that's annoying me and making me angry needs to be smashed. And it scares me, and that's why I've worked so god damn hard to not let that emotional response overcome me.

And it's been fading away this week. All I want to do is take out my anger by throwing things, breaking things, hitting things. Becca touched me at one point yesterday and I lashed out and almost hit her, and I will be horrifyingly honest, the only reason I didn't hit her is because I missed. I tried to slap her hand away--very hard--and missed her. Thank Christ.

But I did yell at her last night. And that hurts, too. It's wrong of me, and I'm terrified that I'm getting to a point where I'm not going to be able to control the outbursts anymore and I'll just yell at her all the time. I've already been very quick to snap at her sarcastically. The yelling means it's escalating. And I can't do that. I won't do that. She doesn't deserve it. No one deserves to have to tiptoe around a monster who could explode at any moment. I will not be like that again.

If a drug meant to control my anxiety is giving me this much aggression, I can't be on it. It's too dangerous.

I've been reading around the web a bit about the side effects of buspirone, and I can see cases where it does make people more angry and more aggressive. Not everyone who takes it, of course, but there are a few incident. It seems like a pretty small number, but I appear to be in that number.

Also: the incoherence. I had a bit of it before, and now that's coming back, as you can probably see from my blog. (I've been noticing more rambling than usual, more spelling errors than usual, more grammatical errors than usual.) I've had trouble concentrating in conversation again. I've lost track of time a lot lately, too.

Oh, and the long, drawn-out, exhausting stress dreams? They went away. But only because I've got insomnia instead. (Another possible side effect of buspirone, according to everything I've read about it.)

And I'm experiencing another problem. Remember how I said that the high blood pressure pushes everything through my body too quickly? Well, sometimes--not always, and not even incredibly often with the blood pressure medication I'm on--it can cause my heart to beat too fast. I can actually feel it when it happens. I'm really sensitive to what's happening inside me, and I can feel when my blood pressure is high or my heartbeat is too fast because I get dizzy and/or fatigued and/or nauseous.

See, last night I went to bed and slept for about two hours. I couldn't sleep because my extremities were tingling so hard that I couldn't be comfortable. My feet, my hands and my arms were tingling. They still are, actually, though it's not as bad as it was overnight. (Though I've had a lot of coffee this morning--ever since I overdosed on the stuff back in 2003, caffeine has had the opposite effect on me that it's supposed to have, and coffee makes me really calm.) And I could feel my heart rate was up. I stopped laying there and trying desperately to sleep, came out here into the living room at 3:30 in the morning, tried to meditate to calm down, couldn't, and then exercised for an hour. After that, I watched TV for a bit and then tried to go back to bed about 5:30, but I never did get to sleep. I was more comfortable laying down after having worked out (got a lot of that energy cleared out and gave it a purpose), but my fast heart rate and the tingling in my arms made it impossible for me to relax. I'm still not relaxed now. I'm exhausted, but not relaxed, and if I can't relax, I can't sleep. I stopped trying at 7 and just gave up on the idea of getting sleep today. I'll take a Xanax probably and see if that calms me down for a while, because it usually does.

But I felt really suicidal all night. It was the return of the feeling I had on Prozac, the impending doom that says "You know, maybe killing yourself is the only way to make this all just stop." I was mentally composing my suicide note there for a while. It's pretty sobering when you're laying there in bed next to the sleeping figure of the person you love most in the world, the person who makes you happiest, the person who makes life worth living, and you're just ignoring all of that because you really believe that the best thing you can do for anyone--especially you--is to erase your own existence

So that's dangerous, too.

I didn't take buspirone today and I'm not going to do it again. I just can't live like this. I can't be that person again who snaps and yells and lashes out in anger. I can't sleep. I can't relax. I want to kill myself just to make it all go away so I don't have to feel like this anymore.

I can do better than this.

I have to do better than this.

UPDATE 9/27: My therapist agreed with me that stopping the buspirone was a good idea. She said to expect the side effects to continue for at least the next four or five days, but she agreed with me that the best thing to do would be to stop trying to put me on a regular medication and go back to what I was doing before, which is relaxation techniques/breathing techniques/etc. combined with an occasional Xanax as needed when the anxiety goes too much into panic territory.

When I was in with her, I was a shaking, twitchy mess, but she made me close my eyes and do a relaxation technique with her that calmed me down a lot. We went over to med services together and they took my blood pressure (higher than my normal high, 160/104), my weight (444) and my pulse (62, better than I thought it would be, but I calmed down so much in session--not only that, but I'd gotten hugely emotional as we talked, and cried so much that I wore myself out).

I'm doing everything I can to help flush this out of my system as quickly as possible. Drinking lots of water, cutting back on my caffeine intake (no coffee today), and staying active (walking, exercising, whatever I suddenly decide today's cleaning project is--something else that keeps me focused... probably the kitchen floor today).

Last night before bed I took a Xanax and finally slept through the whole night. I was so exhausted for days, but I feel rested now. That tingling sensation is still in my arms, but it's gradually receding; mostly it's my hands and forearms now.

I know I have serious problems. I have four diagnosed mental health disorders. And I want to learn more about them and more about myself, because that's what's been helping me to manage them. I was making a lot of progress with the many relaxation methods I've learned and with exercising and with eating better and doing more things that make me feel like I've accomplished something. I want to keep getting over all of that internalized trauma that has repeatedly told me how worthless I am and made me so damaged.

It's just that every time they try to put me on a daily medication, my body goes haywire. So I can't do it. I have to do it for myself, which means I have to work harder. But if that's how I still get to be able to sleep, then I'll do it. My life with my wife is worth that.

For fuck's sake, I owe it to myself, too.


Dan said...

I don't read your blog very much anymore - although sometimes I 'check in' to see how you are doing with the various issues you have described. Many of which I've experienced. I've been on both lexapro (for me, a godsend) and buspirone (meh). My concern is that you seem to not have a very effective way of coming off the meds. You take them, you go off them if you don't like it. Do you consult with your doctor regarding a discontinuation plan? After a decade, I'm coming off of lexapro, and I came off to fast. A nightmarish month. Be careful about going off and on the drugs please. Have a plan. Sometimes you need to give the drugs longer periods to work, and sometimes you need to find an alternative (Lexapro worked for me, but other similar SSRI's were useless). careful.

SamuraiFrog said...

I made that mistake with Lexapro; I had to stop it after three years because I couldn't afford it anymore, and I didn't even think about the nightmare withdrawal that would follow. Lexapro numbed me and I just sat around and gained weight and didn't do anything, so my head wasn't clear when it came to taking that into consideration.

The problem with buspirone and Prozac is that they've both exacerbated my high blood pressure and made me darkly suicidal. I was doing much better learning relaxation and calming techniques and taking the occasional Xanax as needed, and my therapist and I agreed today that seemed best for now. (Just getting home from therapy now.)

I can take a few more days knowing that the side effects are only temporary. We did some relaxation techniques in session today that have me feeling relaxed for the first time in a couple of days. I have an appointment with me psychiatrist next week to talk about it, too. If it gets too crazy I can do a walk-in.

This center is the first time I've honestly felt medically supported. The problem with the Lexapro is that the general practice doctor who put me on it just kept prescribing it without a diagnosis, so no one was looking for the numbness. I wasn't even aware of it until after withdrawal and suddenly three years of my life were just sort of lost.

Kelly Sedinger said...

Continued support and best wishes. I wish I had more wisdom to offer than this.

New York Erratic said...

I'm going to be honest: I'm actively engaged with divorcing my husband due to issues like these.

However, you're getting help, which he never even tried to do, so huge kudos to you.

Avoid inebriating substances - even pot. Nobody likes to hear it, but pot makes you paranoid (and really screws with psyche meds.)

I'll pray for you. It's a sign of your inner strength that you're actively seeking help. It really isn't forever.

Hugs - NYE

Roger Owen Green said...

Talk to your people - case worker, therapist - whether this is a good idea, but it seems SOMETHING to punch, i.e., a punching bag, would be an option. You have anger, and it's got to go somewhere. It'd be therapeutic and exercise that might help your BP, release endorphins, perhaps give you a more restful sleep. Anyway, that's my theory.

Truth: in my 20s, when I was angrier, I had a large teddy bear that I would pummel when I got frustrated. I'll yell at it, curse at it, which, I suppose was yelling at myself, something you are doing in this post.

Autumn said...

I wish I had more to offer you then support, I don't have any wisdom on this kind of thing. But it seems to me you honesty and willingness to get help are both signs of you being on the road to getting this problem to a point where you can manage it. I really look forward to a post someday from you talking about how much better things are and how these issues are in the past. Good luck and I hope writing it here helps!