Tag: Medication

Sabre toothed tigers and hypocrisy

The Mental Health Awareness Week blog

Feature image “Sabre Tooth Tigers eating Daffodils” by andrew_j_w  CC BY-SA 2.0

Whenever I write about my experiences with mental health people tell me how brave I am for doing it.

I’ll let you all in on a secret though, whenever I talk about a rough patch it is always after I have gotten through it and am out the other side. When I am in the middle of scrapping with my brain I won’t admit I am struggling to a soul.

I tell the world that there is no shame in having mental health issues, but when I’m having my own I clam right up and pretend everything is fine. In short, I’m a giant hypocrite.

I told this to my therapist once and she heartily agreed, in a kind way. She’s one of those people who tell you what you need to know, not what you want to hear. She once gleefully quoted passages of my own book back at me – yet somehow I don’t know what I’d do without her.

The unfriendly ghost

When I’m not well I go into misguided superhero mode. I don’t tell my friends things are hard because they have their own issues to deal with. I don’t answer their messages because I don’t know what to say. Instead of keeping them safe from worry about me though, what I’m really doing is ghosting them, which is actually a pretty shitty way to treat a friend. A message saying “hey, I’m struggling a bit and not feeling particularly social but I’m fine. It’s nothing to do with you” isn’t actually that hard and it helps so much.

So instead of not writing about Mental Health Awareness Week this year because I’m not feeling super mentally healthy, this is my public version of that email.

This is the year I am going to quit being a giant hypocrite. Hi, I’m Anna Kirtlan and this Mental Health Awareness Week I am struggling with my mental health.

We all have mental health

One of the things I really like about this year’s Mental Health Awareness Week material is that it opens with the phrase ‘we all have mental health’. It says that mental health is something everyone has, a taonga that we should look after.

It’s so refreshing in a world where people still talk about “mental health” and “mental health issues” in unspoken air quotes and low whispers. Instead it says mental health is a thing we all have. Sometimes it’s good and sometimes it’s not so good.

People don’t talk about “physical health issues” like they are something unpleasant you wouldn’t want granny overhearing, so why should we do the same with our hearts and minds? It’s health, pure and simple, and we need to look after our health – all of it.

My mental health comes around to bite me on the butt when I’m not looking after it sometimes. I also hold down a full time job, have a great friends and family and am growing my writing career. It’s not always easy for me or the people around me, and I don’t always get it right, but I’m doing it. It’s a learning curve the whole time and right now what I am learning is not to be ashamed when things are tough, especially when I make a point of telling others not to be!

Dealing with sabre toothed tigers

This time round for me, and for a lot of New Zealand to be fair, the particular head weasel (a term I picked up from some awesome writer friends) is anxiety.

It isn’t always easy to spot when someone is anxious or having an anxiety attack. It’s not necessarily hyperventilating and shaking and clammy hands and darting eyes – though sometimes it definitely is. Instead it can be more subtle.

I’m sure by now many of you will have heard of the fight or flight response. Where our brains throw back to the days when it actually wasn’t that unusual to find ourselves being chased by sabre toothed tigers.

The choices you had were pretty much turn around and beat the tiger up or get the hell out of Dodge. Unfortunately, for quite a few of us, our brains didn’t get the memo that there aren’t so many sharp-toothed beasties roaming the streets and eyeing us up for lunch anymore. And sometimes the DANGER DANGER synapses fire up for what appears to be no good reason.

When this happens to me I tend to default to ‘fight’. My heart rate goes through the ceiling, I start talking loudly and aggressively at a million miles a minute and my nerves are fire. If someone sits too close to me when I’m in that state it takes every ounce of my self-control not to physically shove them away from me. So far I haven’t swatted anyone, but it’s not easy to be around that, I know.

The third F

What I wasn’t aware of until this year was that there is a third F in our throwback brain wiring – fight, flight or freeze. Going back to our sabre toothed friend, the freeze reaction would be when we don’t move a muscle and hope Bitey McBiteface doesn’t notice us.

Without the actual tiger this feels more like numbness. When you are finally so overwhelmed you feel nothing at all. It was peak Rona stress, when it seemed like bad things were happening to good people everywhere, all the time, that I learned I was experiencing this one. I rushed off to my therapist convinced I was either sliding into depression or becoming a monster. Whenever something horrible or stressful happened, when people around me were clearly struggling, I felt nothing. Where there should have been sympathy or empathy and concern and the desire to help fix the problem, there was numbness, paralysis – zilch. Surprise! That turned out to be anxiety too.

Instead of the usual million miles a minute, punch the tiger in the nose trick my brain usually did, my prefrontal cortex just noped right out of the whole equation. I wasn’t depressed, I wasn’t a monster, I did care. I was just overwhelmed. I was standing behind a tree, frozen in fear and hoping the monster didn’t notice me. Learning that was a massive relief.

Do what works for you

I am most certainly not a mental health expert so please take everything I say with a grain of salt and don’t use it in the place of professional advice. Different things work for different people, so all I can share is what works and what doesn’t for me.

Medication and therapy work for me. Inspirational quotes and positive affirmations don’t. It may be the exact opposite for others. Exercise works for a lot of people. It does for me, but I have to get my brain space fixed first before I have the energy to do it.

So these top tips are based entirely on me. You do what works for you.

  • Don’t be ashamed if you need to take medication and don’t suddenly stop taking it because you are feeling better. I have done both of these things. Neither ended well. You wouldn’t be ashamed about taking medication because your blood pressure was up or down and you certainly wouldn’t stop taking it (I hope) without talking to your doctor because your blood pressure was back to normal. This doesn’t work any differently when you are dealing with serotonin.
  • Therapy isn’t for everyone, but if you think it might work for you, don’t give up if you get a bung one first time round. Trust me, I’ve had some howlers over the years. I had one tell me all I needed to do was look in the mirror daily and tell myself I was “a beautiful person” and another say I wasn’t going to get better if I didn’t stop using humour as a defense mechanism. Yet another told me Covering Things Up with Humour is Bad counsellor was full of it and that my humour defense had kept me going so far. It was a perfectly legitimate coping strategy – but perhaps I should work on some others. I now have an amazing therapist who challenges me and supports me and doesn’t take any crap from me. She keeps me on the level and I never would have come across her if I had given up after the first time someone waved a crystal at me. I do realise I am saying this from an enormous position of privilege in that I can afford to pay to see someone however. I know access isn’t easy for everyone and going into why this is so unbelievably wrong would take a whole new blog. For the avoidance of doubt though, I believe everyone in New Zealand should have affordable, accessible mental health support and we need to do more in this country to make this a reality, especially now.
  • Remember you are not alone in going through this. For some of us 2020 has been an ‘oh no, here we go again’. For others it has been the first time their mental health has kicked their butt and it is new and scary. Either way you’re not doing this alone. There are weeks like this to remind us that we all have mental health and there is help and resources available all year round (see below).

You can find Mental Health Awareness Week resources at www.mhaw.nz/

Need to talk?

  • Free call or text 1737 any time for support from a trained counsellor.
  • Lifeline 0800 543 354 (0800 LIFELINE).
  • Youthline 0800 376 633, free text 234 or email talk@youthline.co.nz or online chat.
  • Samaritans 0800 726 666.
  • Suicide Crisis Helpline – 0508 828 865 (0508 TAUTOKO)
  • Depression and Anxiety Helpline – 0800 111 757 or free text 4202

    

   

Happy pills – the changing of the guard

Disclaimer: I know there will be people reading this who don’t think medication for mental health is a good idea. That is your prerogative. I have tried living both with and without it and have come to an informed decision that I would rather be a functioning human being on cray cray pills than the wretched creature I am without. Please don’t send me articles about side effects and studies saying they will turn me into an evil alien cyborg. Trust me, I have read them. This is not a blueprint for everybody. It’s what works for me. Please respect my decision.

Right, now that that’s out of the way;

I have been on my little blue (sometimes green, sometimes purple and blue) happy pills off and on for 20 years.  I found something that made me able to function and achieve in the world and eventually I stuck with it.

Last year my old faithfuls stopped working.

It didn’t happen suddenly. In fact it took me quite a while to actually work out what was going on.

I’d have little ‘episodes’ completely out of the blue. I would be happily going about my day, then have a screaming anxiety attack. My jaw would start aching, then I would realise I had been clenching my teeth for an entire day. I would feel really low and lethargic for no apparent reason or I would be overcome by unaccountable rage.

It wasn’t until I started experiencing OCD symptoms again that I realised something was really up. It was just the preliminary stuff – having to stop myself from repeatedly checking whether the door was locked or the iron was on, counting, having to repeat certain phrases a certain amount of times or something bad would happen – but i knew if I didn’t do something about it things were only going to get worse.

Even then, it wasn’t until I talked with a friend who had been through something similar, that I worked out what might be going on.

Like everything, there are differing opinions about this, but for some people – my friend included – once you reach a certain age (in my case *cough* mid-30s) the meds can stop working as well. The colloquial term is ‘Prozac poop out’

It certainly doesn’t happen to everyone, but I was pretty sure it was happening to me. I was put on fluoxetine when I was 15 years old and there are many different drugs out there now, so I figured it might be time to give something new a try.

My GP wasn’t keen to change my prescription without an expert opinion, so off I went to an incredibly good (and incredibly expensive) head doctor. It’s crazy (‘scuse pun) that you have to spend so much to access decent mental health care in this country and so wrong for people on lower incomes – but that’s another rant for another day.

Brain doc said fluox shouldn’t conk out but agreed that something wasn’t working in my case and thought something different might be better for me in a lot of ways.

Enter sertraline (more commonly known as Zoloft) my new kid on the block.

I won’t lie to you, I was pretty scared. Changing something that has kept you sane for decades is bloody frightening. I remembered what it was like in the black days when I was really bad and I was so afraid of going back there. But what I was doing wasn’t working anymore.

I did the switch over the holidays so it wouldn’t affect my work in any way and I’m glad I did because the first couple of weeks were pretty awful.

I stopped the fluox completely and started with small but increasing doses of sertraline until I got up to what we thought would be a therapeutic level. There was a period of time, when one drug was leaving my system and the other just entering it, that i was definitely undermedicated. I was twitchy as all hell and would start hyperventilating and crying while making dinner for no apparent reason.  I was determined to stick with it though, and eventually it passed.

After the first couple of weeks I did begin to notice a rather surprising side effect. I had energy again.  I guess because I had been on the fluox for so long I hadn’t really noticed that my normal was pretty much a permanent state of drowsiness. It had become worse over the past couple of years but it had always been there.

I was on quite a high dose of fluoxetine for my OCD and one of it’s known side effects is that it comes with extra added sleepy. Considering how permanently wired I was when I started taking it this was a welcome side-effect. It meant I could sleep and make it through life without bouncing off the walls. Some people don’t like taking it because it makes them vacant and foggy in their mind, but I never had that. I was still myself and I could function without screaming.

What it did mean though was that, in the later years of taking it, I didn’t realise that fantasising about going home and going to sleep at 3pm every day was not normal. That sneaking off for a nap at any possible moment at any time of the day wasn’t something that everybody did. If I got home from work before Paddy did I would crawl into bed and try to sneak  some z’s before he got home. He told me later there were a lot of times where he thought ‘where’s Anna? Oh, she’s asleep.’

Over the past few weeks I have felt more awake and alive than I have in a long time. I’ve achieved so many things over the past few weeks that I have been putting off all year and I’m getting back into writing again. It feels amazing.

One of my friends asked if I felt ripped off that I hadn’t done this earlier, but I don’t really. I needed to calm my mind and body down when I was really sick. After years of terrible insomnia it was a blessing. It’s only really been the past few years that it has been a problem, and even then I didn’t realise that it was. I achieved some pretty awesome things during that time. I sailed and scuba dived, I wrote a book. I don’t feel ripped off, but I do feel better than I have in a long time now.

The only other side-effect I have noticed is insomnia, but that is definitely easing up now. And the funny thing is, I didn’t get anxious about not sleeping. Previously not being able to sleep would wind me up like a corkscrew until I had to knock myself out with drugs. I don’t feel like that now. I just read a book  until I eventually conk out, and when I do I stay asleep, which is a new and exciting thing for me.

It’s still early days, but so far I have been having very few anxiety symptoms and I’m not getting the breakout OCD stuff anymore.

I feel awake and alive and happy – so roll on 2017!

PS – shameless product placement.

50% of proceeds for Which Way is Starboard Again? now go to the New Zealand Mental Health Foundation. Just click here or drop me a line at whichwayisstarboardagain@gmail.com  

Which Way is Starboard Again? the book