Tag Archives: psychiatrist

Migraines vs. depression

So, during the psych evaluation, an interesting idea was floated by my doctor:  that the birth control pill I was on might be wrecking havoc with my hormones and that might, in turn, be exacerbating my depression.

Okay – I can hear the chorus – “but Laura, why are you on birth control if you’re all gay and such?”  Certainly it isn’t due to all the rampant boy sex I’m having (frankly, it’s not due to ANY sex that I’m having these days…).  No, I started using birth control pills a few years back to control hormonal migraines (not nearly so entertaining, I know).

I had been on birth control pills for a bit back in the old days when pregnancy was a possibility (being gay in my head didn’t count as long as I was still dating boys), but had stopped taking them when I stopped pretending to be straight.  Even though I tolerated them well, and had loved how they made my cycle so regular, I wasn’t all that keen on taking hormones.

For a few years, I went the natural route.  I never had much issue with my period (other than the normal annoyance of it), but when I look back, I can see the pattern of headaches when it started shortly thereafter.  It didn’t get bad, though, for probably another year or two — at that point, the pattern became quite clear:  every month I would lose about 1.5 weeks to headaches.  And of those 10 days, I would suffer through about 2-4 days of debilitating migraines.

When I discussed the issue with my gynecologist, she put me back on birth control pills.  And they helped a little bit, though I was still having issues every month — just shortened the time because my period was shorter.  So, then we moved to a period-every-three-months birth control pill, and that was better — it limited my symptoms to only 4 times a year.  So, this past time around, we went full hog and I’m on a birth control pill where I never get a period.  And this? Wonderful!  I feel like I’m no longer a slave to my cycle.  I never have to worry about time of the month (or 3 months) and over the past 6 months I’ve not had even one hormonal migraine.  Victory!

I did try controlling the migraines with migraine medication, but that worked only some of the time.  I’d get a migraine, take pills for it, it would help some of the time, but then the next day I’d get a rebound headache so bad that it almost wasn’t worth it to have treated the first migraine.  Went through a series of a couple of different migraine medications (though I’m sure there are more out there to try), and never hit on anything that entirely fixed the problem.

So, now my psychiatrist is recommending that I talk to my gynecologist and go to a “less progesterone-y” birth control pill (her words, not mine)… meaning, one where I’ll still have periods.  She thinks that we might be fighting a losing battle with the anti-depressants if I’m still on the same birth control pill.

I’m torn.

It’s a quality of life issue:  not having migraines has been life-changing. I wouldn’t wish migraines on my worst enemy — and I know that I don’t even get them as bad as some people do (mine generally only last 5-8 hours).  Let me put it this way:  when I get one, if I had the choice I’d choose to be put out of my misery than have to suffer through one more minute of it.

But – of course – the depression is also quality of life.  And it’s sneakier because depression doesn’t manifest itself as an ice pick being stabbed into my brain over and  over and over again.  Which makes it seem like depression is easier to deal with.

But is it?

I’m not sure.  I’m loathe to give up my period and headache-free existence. But if that’s one of the reasons that I’m miserable and lonely and utterly disinclined to enjoy life? That’s something I need to consider.

I look back, and it’s possible that there’s a connection between my depression getting worse and when I started on this particular birth control pill.  Was I depressed before that? I think so. Did the birth control pills cause me to spiral further down?  I’m not sure, but, maybe.  I will say this, though:  I believe now that I’ve been dealing with depression on some level or another for a good chunk of my life.  This isn’t new, it’s just worse.

So, I’m still thinking on it.  Trying to gather some information, see what I can find. I can go back to one of my previous birth control pills, see if that helps with the mood.  Maybe it won’t make a difference and I can go back on what I’m on now?  That’s a possibility, of course.  I just hate the idea of migraines. Absolutely hate it.  But I also hate the way I feel now.  What to do, what to do…

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Better living through chemistry

Surprise, surprise… a real, honest-to-goodness psychiatrist thinks I’ve got issues.

The appointment itself was anti-climatic, as my the few remaining logical brain cells in my head knew it would be.  It was a typical review of all my symptoms, a little bit of crying on my part, a little bit of “there, there… it’s okay to cry” on her part.  A little back and forth, a few probing questions so she could form an opinion, and I walked out of there with a prescription for an anti-depressant. Voila! As easy as that.

The doctor told me that it would be about 2 months before I started getting anything positive from the drugs, and first I would probably have 2-3 weeks of side effects to slog through.  Nausea, headaches, diarrhea … standard fare for this type of medication.  She told me to be patient, to bide my time… basically, hang in there until the effects of the medication kicked in, and to not lose faith that there was hope out there.

I’m ramping up on the medication — half dosages for a week to ease some of the side effects — and then it’s just a waiting game.  My first 3 days have been tolerable:  vague nausea and a slight headache that comes and goes.

All I know is that I have the meds, but it’s sort of just been business as usual — it hasn’t really sunk in yet, despite the potential ramifications, both good and bad. It’s another pill to take in the morning, but without any immediate effects, it’s like nothing has changed.  I don’t feel a victory for having done what I did, nor do I feel troubled because I “gave in” and stopped trying to fix myself. Honestly, it’s almost more of an “eh, who cares?” reaction on my part.  Perhaps depression does has some upsides?

Perhaps I need to view this as simply the next step in me stepping back in and taking charge of my life.  Certainly, I am making headway:  I’ve spent the past 5 weeks eating healthier, dropping some excess weight and going through spurts of training.  And now I can tack on the fact that I made — and went to! — a psychiatrist appointment and started on some medication that has a shot at bettering my quality of life.

Little steps, small changes … but moving … somewhere … nonetheless.

Leap of faith

I have to admit:  I’m scared.

Coming up on Friday, I have that appointment with a psychiatrist to discuss getting a prescription for some sort of anti-depressant. This was my therapist’s idea and I initially was resistant to it (“I don’t need no stinkin’ help!”), but as time has passed I’ve been swayed by her arguments.  Basically, I’ve gotten to a breaking point where I know that something has to change and this seems like one of the few flotation devices left in this ocean in which I’m drowning.

So, what am I scared of, exactly?

(note:  if the doctor is any sort of professional, I understand that my fears are unfounded, but, frankly, logic has very little bearing on how afraid I am)

  • I’m scared that I’ll go into this appointment and the doctor will think that I’m either lying or it’s all in my head. This plays on a couple of fears of mine — first, the fear of asking for help, making myself vulnerable and basically being rebuffed and laughed at for my attempt.  Second, the fear that I should be able to fix this myself by “looking on the bright side” and simply “deciding to be happy” (because it’s just that easy, didn’t you know?)
  • I’m scared of being utterly intimidated and overwhelmed at the appointment. Let’s face it:  this whole situation makes me want to curl up into a ball and pretend like it doesn’t exist (see how well that’s worked so far?).  In the face of a doctor that might not have the best bedside manner, I worry that I’ll clam up and not ask the questions I need to ask for fear of sounding dumb or weak or unintelligent.
  • I’m scared about all the potential side effects — everything from dizziness to weight gain to decreased sexual desire (though, with the current state of my dating affairs, this might be a bonus) to tiredness to hair loss to extra limbs growing out of my chest (who really reads all the fine print?).  What if all I’m doing is trading in one problem for another?
  • But probably the thing that I’m scared most about is this: the appointment will go fine, the doctor will listen and sympathize, tell me that things will get better…and then I’ll be prescribed medication and it won’t work.  That I’ll still feel sad. And like there’s no light at the end of the tunnel. No way out. That this pervading loneliness is my destiny.  That I’m too broken to fix.

Yea, that last one, that’s the one that keeps me up at night.  Classic fear of failure, but with stakes that take my breath away.  What if I’m just too broken.

But having run out of ways to make this better on my own, I know I need to make this leap to try and save myself.  So, I will go to the doctor’s office on Friday (after having shrugged on my bravery coat of armor) and hope for the best.  Hope that my random choice of doctor from my insurance list is someone who will listen and understand and be kind.  Hope that there’s…. hope, I suppose.

That’s all I really want.

Back with a vengeance

Over at The Bloggess, she says something incredibly wise:  depression is a lying bastard and life will be brighter again.

(an aside – if you’ve never heard of The Bloggess, go there right now and read! She’s awesome and it’s much better than being here.  Plus, I’ll wait for you to come back.)

I’m struggling to keep this in mind — that this monster that keeps climbing on my back is doing nothing but whispering lies in my ear.  Nothing good or positive or healthy comes from this voice.  You’re boring.  And ugly.  And will always be alone.  And never have sex ever again.  No one in the world wants you.  That’s what it tells me.  Among other things.  (I mean, if it could toss in something helpful, that’d be nice, though.  Perhaps a reminder to change the filter on the furnace or something like that?)

When I’m at my most logical, I can see the fallacy behind these words.  No, I haven’t found someone to be with, but does that mean it’ll never happen?  Of course not.  And I’m quite sure that my stable of friends would argue with me if I told them I was ugly or boring.  If I were as awful a person as the monster tells me, I’d be utterly alone in this world.  And that is far from the truth.

And yet, I’ve been really challenged to work my head past these feelings and move forward. It’s hard to battle something that doesn’t play fair, ya know?

I had made an early August appointment with a psychiatrist to talk about going on some meds, but in the end, I cancelled that appointment.  See, for a few weeks at the end of July, life was good.  Really good.  I had met a girl.  Someone I liked! I thought she was cute and good company and everything she said to me indicated that she felt the same.  The only downside?  She lived about 2.5 hours from me.

It ended up being the relationship that never was.  After the initial date, we made — and she cancelled — 5 more, all with good, plausible reasons.  But fool me once, shame on you.  Fool me 5 times, who’s the idiot?  Whether the excuses were real or not, it was clear that I was a very low priority and if it’s that way in the beginning?  It’s never going to get better.  You can’t make someone love you. Or even meet up for a drink with you, as it turns out.

After that I went all to hell — much worse than before.  But I had already cancelled the psych appointment.  And when I finally called back, she wasn’t taking new appointments anymore.

For weeks I wallowed and dwelled and hated my life.  It was crying binges during the day and spending entire weekends where the only conversation I had (talking to the dog doesn’t count!) was with the checkout person at Trader Joe’s.  I ate with abandon and my only exercise consisted of using the remote control and doing 12oz bicep curls with my drinks. It wasn’t much of an existence, that’s for sure.

But very recently, part of me woke up and decided that if nothing else, I could control my eating and health.  I decided that even if I didn’t have the motivation to work out, I could eat healthy and watch calories.  I think things got so out of control that I picked the one thing that I *could* control.  If even just a little bit.

And so, I joined myfitnesspal.com and started tracking food.  Joined in with the community.  Even managed to get myself a dozen or so friends that check in on me.  And that’s been good.

In the spirit of trying to take care of myself, I also went through my insurance and found another random psychiatrist who was accepting new patients and made an appointment (I have another 3 weeks to wait)… one of those things that sounds easy as pie but is impossibly difficult for me to do (that’s a blog for another time).

So, we’ll see what happens.  This mood/depression/whatever has been hanging around most of the year, and it’s definitely been bearing down on me lately. Despite the fact that a potential girlfriend made me feel better, I don’t believe getting rid of the depression is that simple.  I think the uplift would have been temporary and would have gone away eventually, with or without someone in my life.  In the end, I need to fix myself, not distract myself.

So, while the depression has been back with a vengeance, perhaps I might be crawling back up as well.  At least I feel like I’m making some healthy decisions in spite of myself.  With every good choice I make, it makes a little easier to make the next one.  I’ve started doing a bare amount of exercise.  And I even promise not to cancel the psych appointment, no matter what’s going on by then. Because I need to remember how depression can lie … life will get better. Sometimes you just need to take the first steps.