I increased the dosage from 50mg to 100mg last night. I suspect it will be a couple days before I notice any appreciable changes.
I noticed some changes after I increased the dosage from 25mg to 50mg, but that took about a week. Coincidentally, that is about the time I started to spiral down for 5 days before slowly recovering. I was functional at the lowest point, but just barely. My brain started to suggest destructive behavior and it took every ounce of self control to resist those suggestions. I was a bit relieved to find I still had some control. I called these suggestions "mean" because they were mean things to do to myself and indirectly to others. As a recovering alcoholic, there is always a risk of returning to that destructive behavior. That seed was planted decades ago and my brain seems to prey on that addiction.
My brain suggests going back to drinking and weekend long benders as a way to forget about my struggles. I know in my gut that this is the wrong path. Instinctively, I know where that would lead. Unfortunately, my brain knows and doesn't care. It sees relief and there is a part of me that wants that. There is a part of me that wants to drown out what my brain is telling me. A part of me that despises my brain for being such an asshole.
I shared these mean thoughts with Ming and she was understandably upset. She apologized for crying and expressing her emotions. I assured her there was no reason to apologize. She should never feel guilty about expressing herself, but I understand she is coming from a relationship that didn't permit such behavior. Her response upset me in that I hated the fact she had to hide how she felt in the past. That is something we are working on as partners. I am very open and she isn't used to that from her partner, which is shameful. Being more open is one of the many things I learned from my marriage. I restrained myself because I didn't think my ex-wife could handle the raw truth of my upbringing and my thought process. I didn't think she could handle the instability of who I am. I'll never know if that is true or not, which is one of the many failures on my part.
I still felt low at 50mg. In fact, I had a depressive episode that lasted about five days. At the peak, I was terrified of the potential interaction with people. Days like that are difficult to navigate. I have to go to work, but that's where the commitments end. After that, I owe nothing to anyone. I was hopeful that 100mg would help bring some relief because I was running out of options in my head. Of course, my brain being the asshole that it is, had solutions for me. It doesn't care about the long term damage those solutions could lead to. Maybe I am expecting some sort of panacea at 100mg. Maybe I am expecting too much from myself and the medication. Every day feels like a multiple choice test. Will I or won't I sink into depression? That is my only concern now. The highs are long gone, which is somewhat unfortunate.
I started 100mg last Tuesday. I didn't notice much difference for a couple days, but I can feel the difference now after four days. Despite not sleeping well for a couple days, I am still mellow, calm, and measured. I am not animated. I am not agitated. I wouldn't say I am necessarily happy, but I am not unhappy. I am not anxious. I am not on edge. I am less unpredictable. My response to people is more in the realm of social acceptability. One notable exception to that is my willingness to walk away from people mid-sentence or mid-conversation without warning. I walk away as soon as I lose interest. This is a bit socially awkward for people, but I guess it's the new normal for me. It will hurt some people, but I guess they should be more interesting and I wouldn't walk away.
I met with my doctor yesterday and he wants me to stay at 100mg for now. He can't say for sure if we have found the right amount, that depends mostly on me. There isn't some sort of test we can run to figure out if I am in the middle of the curve or more to one side of that curve. I don't like the prospect of having to be medicated forever, but I also don't like the idea that the next low could be the last low. We frequently think we are in control until we're not. That is my fear. I am worried that I think I am okay until I'm not. I worry that the line won't be as blurry as I think it is. That I won't teeter on some imaginary boundary between life or death. I worry that the line will be clearly defined and finite. That my brain will be more decisive and seek finality.
My brain has become a weapon of sorts. It is armed with too much information and time. It is nefarious and cruel. It is also kind and gentle. It is intelligent and affectionate, if only just a little. It is capable of many great things and destructive things at the same time. I want to think that it only wants to help me, but I know better by now. It has its own plans and thoughts that I know nothing about. It often does its own thing even when it knows better. My brain has become more like a second person to me. A person that needs to be properly supervised and guided. I find it unsettling that part of me is unpredictable. I am optimistic that this will change as my brain chemistry changes. I hope that the two finally merge into one cohesive person.
No comments:
Post a Comment