Then gradually, through some combination of will and natural healing, I began to emerge to something vaguely like normal[1], or at least, something resembling my old self, or maybe my new self.
From May, when my grief crisis over Emily was in ascendency, sleep was troubling. Or maybe worsening, as I had been having sleep problems throughout the years of Marlene’s illness. As all my doctors said, poor/lack of sleep drives so many other mental health problems. Many of the psychotropic drugs we take are not so much to control daytime mood but to regulate proper sleep. In the beginning of my crisis, my long time doctor prescribed 50 mg Trazadone for sleep, one before bedtime as needed.
The crisis deepened in June and the sleep pattern worsened – anxious sleep interspersed with bouts of mania. Evidently I needed something more, or different, as the trazadone wasn’t working. My new doctor put me on zopiclone but the zopi made me feel hung over the next day; perhaps the warning on the pamphlet was right: do not drink alcohol while taking this medication. He also prescribed Diazepam for managing anxiety and panic, and could be taken as a sleep aide also. I’m not sure if the diazepam was efficacious as I misread the label and was taking half the prescribed dosage, but I certainly felt better when I took one. Is this placebo effect?
By August the Paxil was well established in my bloodstream and I had switched back to trazadone for sleep. These drugs might have worked as advertised if the rollercoaster ride with Emily had stopped.
My supply of diazepam was a godsend during the crisis in August, and then that desperately bad week in October; however, as soon as each crisis had passed I stopped taking them. I was determined to avoid dependency, but I was grateful they were always available as needed. Maybe the contingency effect was all the support I needed against panic attacks.
Paxil eventually did its job of steadying me (or was this too just placebo effect?) Or maybe my synapses were repairing themselves. I was no longer experiencing panic attacks and I was sleeping better (not well, but better).
All along I was aware that I did not want to become dependent on these drugs. I was determined that, when the time seemed right, I would wean myself off the psychotropics.
I decided in November to cut back on my Paxil regime. I thought they had done their job, and since I considered my mental state was an episodic condition not chronic, I didn’t want to be permanently attached to them. You can have serious side effects when weaning Paxil and coming off them needs to be done gradually. I went to half a pill (20mg/2) of Paxil for 30 days in December, then to ¼ dose for the next 30 days. And then I stopped altogether by the end of January.
I continued my nightly dose of Trazadone for sleep but as Trazadone is also indicated for generalized anxiety disorder this may have made for a smoother transition from Paxil. I continued with Trazadone for some months afterwards – I had no side effects and sleep was fairly well regulated now, except of course for the 3:00 a.m. trips to the bathroom, the inevitable sign of body deterioration due to aging. (In fact, sleep interruption from bladder issues may be a significant factor in mental health: we wake up to pee, but then our anxious mind has been reawakened and sleep doesn’t return, serotonin cycle is interrupted and we face another day of tiredness and anxiety. Maybe we’re treating the wrong end in old-age anxiety disorder!) Trazadone may also have the added bonus of improved erectile function, and that couldn’t hurt, assuming the opportunity came my way.
So I am grateful for medical intervention in quieting my emotional state, not just from the psychotropics, but also the gentle encouragement of my doctor. But what brought on the stability? Time, obviously, and the gradual rewiring of my brain was at least part of the answer. The acute loss I had experienced, and the resulting disruption to my synaptic patterns, had brought on the emotions of distress; and my continual recycling of the problem with no solution (Insanity[2]?) perpetuated the condition. But why did my depression/anxiety gradually stop? Was it the drugs rewiring my brain? Was it some form of cognitive behaviour therapy from the ruminating[3]? Was it the natural condition of the brain revising its predictive engine[4]to the new reality? Emily wasn’t coming back. Get used to it!
But it was also something else. Other things were happening to me in November. Whether I knew it or not, whether I was conscious of my decisions and actions or not, something was changing in my life. I began to acknowledge the positives in my life: I had developed a great new friendship with Francine; and other old friends were filling my lonely days; I still slept with the on light on in my bedroom but I wasn’t afraid to go to bed; I felt the energy of anger, not the nihilism; I saw living with my hair on fire as excitement and adventure, not desperation; and was wanting to embrace eros; I thought I should start using my boxing gym in the basement – I didn’t act on the thought right away but idea was no longer unappealing. North American white women were proving problematic; even that black Canadian had proven a little too challenging; I had been testing the waters of life again, yet I began to realize that each time I tested, and failed, the recoil was less painful. I decided to stop my subscription to match.com following that fateful football date with Stephanie. I hadn’t found what I was looking for there: and none of them were Emily. Maybe what I wanted was a wholly new experience. I signed up with Asianbeauties.com!
And then I met Carmen. She claims, still, she is the cause of my recovery. She may well be right.
[1]Well, what is ‘normal’? What is normal behaviour for you may be seen as very eccentric, or even crazy behaviour by others. Is ‘normal’ that which is socially acceptable to general society? But who says conformity is normal behavior.
[2]Einstein’s definition of insanity: repeating the same behavior over and over expecting a different result.
[3]Ruminating usually reinforces the original stressor and perpetuates the anxiety, but in my case I also tried to dispute my feelings for the failed relationship with Emily.
[4]See: How Emotions Are Made: The Secret Life of the Brain, by Lisa Feldman Barrett and my review.
