Prozac Nation: a return to the land of the SSRI

Well, I saw my doctor today, and talked to him about the OCD thoughts. He said it did sound like OCD type symptoms because they are thoughts I don't want to be having and I can't get rid of them. I have pretty much known this for years, but I just never really addressed it recently with a doctor. I mentioned how Prozac seemed to help with these thoughts in the past. He said that he couldn't ethically prescribe me any more medication (like I said before I also don't want any more medications myself), so the only way to put me on any Prozac is to go off something else. So I agreed to reduce my Wellbutrin a lot, down to 150 mgs, and try 20 mgs of Prozac. I'm pretty sure I was on at least 40 mgs of Prozac when I took it before, but we'll see if this does anything. I have to say I am pretty nervous about this. I definitely know that Wellbutrin helps me with depression, and I've been on it most of the time (whenever I had medical care) for the past 13 years or so. I am afraid to go off of it. I don't want to get horribly depressed and unable to function. Also, I just read one of my old blog posts stating how depressed I was while on Prozac. So I am unsure now that this is the right thing to do. But I guess I can try it and see what happens. Even though this seems like a very cliche thing to be doing.



The other thing we discussed was this research study they're doing at my community mental health center. The purpose of the study is to see whether two antipsychotic medications are helpful to people or whether it is better to only use one, and two have too many side effects to be beneficial for most people. My psychiatrist mentioned the last time I saw him that I could go into this study and there would be a 50 percent chance I'd be put into the group of people who goes onto only one antipsychotic, meaning I could stop taking Risperdal, and there would be a 50 percent chance I would be in the other group which means I would stay on both medications. Basically he doesn't want to take me off Risperdal, so this was being offered as an option. He told me today I have the choice of doing this or of staying on Risperdal for a while longer to wait and see how I'm doing before he will reduce the dosage. (Of course, I also have the option of refusing to get these shots or finding myself a different doctor who will not prescribe me Risperdal, but I didn't mention that.) So I said I would talk to this woman there on teh phone about possibly going into this study.







After talking to this woman, who I really couldn't understand because we had a terrible connection, and hearing basically no reasons why I should want to enter this study other than that it would be helpful to her if I did, I thought, well, I don't think so. I can't really see the point in it. I do not want to be on these damn injections of this fat-inducing substance that I have been on for years anymore. I want to be off of them. I do not want to leave it up to chance as to whether I will go off them or not. I just want to stop the damn medication.


I can see the benefit of them doing this research, and I can see that it is a good idea for it to be done. But becoming a guinea pig for the purpose of some study isn't really all that enticing. As my former therapist said when I first told her about this at my last appointment, "How would this benefit you?" I don't see how it would. Not that I'm a totally selfish person, but I'm not that worried about making the $200 over the course of a year that you can get from being in this study and going to appointments and evaluations for this.


But, being afraid to say no to someone right away, I told the woman I'd come in to talk to her about it. I think I'm going to cancel that because I don't really feel that this is worth my time and energy. Plus, she wanted me to come in at 8:30 on a Monday morning to meet with her. I don't have to be at work until 2:00 PM on Mondays, and I am not a pro at waking up early and making it to early appointments. It is hard enough dragging my leaden body out of bed to get somewhere in the morning. I see no point in doing something I don't really have to do when I could be getting some sleep. Especially considering on many nights I don't fall asleep until 4 AM with the usage of copious pharmaceuticals I've written before.



Chelle left a comment about the antibiotics causing nausea, and I know many of them do so for me, but unfortunately this problem with gagging and nausea started before I started taking the antibiotics. My rheumatologist had some obscure reason for putting me on antibiotics, and I honestly don't understand what it was. Normally, I don't take things without knowing the reason, but she seemed to think it would do something to the inflammation and joint pain I was experiencing if I took these antibiotics for two months. I will have to go back to see her again to find out what the heck the reasoning to this was, but honestly this doctor's office makes you wait up to three hours before you see the doctor after you enter the waiting room, and I don't have the desire or the time to do that again right now. It takes so long to see her, I've seen people walk out after waiting for a while and say that they didn't want the appointment anymore because the wait was so long. The last time I was there, these elderly people in the waiting room all clapped when my name got called by the nurse, because I had been waiting the longest and we were all complaining to each other about the ridiculous nature of sitting in a doctor's office waiting room two hours after your appointment time. If she wasn't a good rheumatologist, I would never go back to her. But I have known her for years now, and I don't really want to start over with another one.


Enough of my complaints! Everything is not bad. I will see what happens with this Prozac. I wish I had a better memory for the ways that every med I've taken has ever affected me, but I was never interested in keeping records of that kind of thing, so I don't. This is going to be like the fourth or fifth time I've started on Prozac in my life, so who knows if it will even be effective. But I guess it's worth a shot.







As always, thanks for listening to me gripe.

Acid reflux mixed with obsessive thoughts equals the problem

I was thinking about my nausea and vomiting and gagging that is such a problem these days, (which I mentioned in my last post) and came to the conclusion after some reading online that it is likely GERD - acid reflux disorder. I have been told by doctors before that I might develop this because of Sjogren's Syndrome, and it seems that I now have all the symptoms of it.

So, the thoughts are still a problem. The thoughts are there and often there when I'm nauseated or vomiting. But I don't think the thoughts are the entire problem, I mean as far as the physical issue goes. I used to take a medication for acid reflux and stopped taking it a long time ago because I am on so many medications that it scares me to take things if I don't know that I definitely need them, but perhaps I should try going back on that medication. It's called Omeprazole. In fact I just took it tonight because I thought I would give this a shot before I resort to asking for another psychiatric drug.

But I did think about Mary's suggestion of asking for a different drug rather than a new drug. It is just that it has taken a while to get to this regimen I'm on now which, aside from the obsessive thoughts, is pretty effective.

I know that the obsessive thoughts must be addressed regardless of whether or not they are making me physically sick, because they cause me a lot of ridiculous mental stress. The thoughts are about all sorts of gross things, and generally the same things repeatedly, and the problem is that I don't have an effective method for ridding myself of them. I do know that when I took Prozac I thought it helped with my obsessive thoughts. But do I want to go on another drug? Not really.

This is what I'm taking right now:
Latuda
Risperdal Consta (injections) (highest dose it comes in)
Clonazepam (low dose)
Vistaril (for sleep)
Ambien
Wellbutrin *450 mgs (high dose)

Then I also take two thyroid medications for hypothyroidism, a medication for lack of saliva and dry eyes caused by Sjogren's Syndrome, a medication that's a muscle relaxer for my Fibromyalgia, and sometimes Naproxen for joint and muscle pain, and right now (temporarily) an antibiotic (I honestly do not understand why  I am on this), and an antifungal drug which is necessary because of the antibiotic, and 50,000 mgs once a week of Vitamin D because my blood levels of that were so low (this is like an entire bottle of the over the counter Vitamin D). And I take a large dose of Melatonin every night because it's the only way I can sleep.

And now, perhaps, I'll be back on Omeprazole.

I think that's enough drugs for one fatty, overwhelmed liver to handle.

My goal is actually to get off Risperdal, and I am still hoping that will be possible, because I attribute most of my weight gain to Risperdal and Seroquel. I finally got off the Seroquel last year, which is why I never have a decent night of sleep anymore to this day, and I still didn't manage to lose any weight after that honestly. I didn't gain weight, but I didn't lose it either. (I need to put a lot more effort into this I'm sure). And I'm pre-diabetic. So I cannot afford to be overweight. All my doctors have told me that losing weight would be helpful and I just can't stand the thought of being on these Risperdal shots anymore when I gained literally 100 pounds on them. That is a lot of weight. And I don't know how to even describe to you how difficult that's been to deal with, mentally. So my psychiatrist seems to think I'm on too many medications, and I agree. And the first one I think should go is Risperdal.

I don't know what can be done about the obsessive thoughts because I don't want to change the other things I'm on right now since I don't want to lose the stability I have with those meds. I've been thinking that perhaps therapy could help me with the obsessive thoughts if I found someone who really understands them and knows how to address them and accepts my government insurance. Not sure I really believe this would work though.

OCD 123

So I have written about it only a little bit before, but I have some OCD type problems. I don't believe I have full-blown OCD, but my therapist would point out to me over the years that these thoughts I have were "OCD thoughts". I also had Anorexia for many years when I was younger, so I have a history with the cousin of OCD.

It's not important what the thoughts are about. But my therapist would say it is important and that if I never talk about it or think about it on purpose, the thoughts will have more power than if I say them out loud.

So....okay, I have these disgusting thoughts about bodily functions. I'm slightly paranoid about such functions. I have the thoughts when I eat, and when I go to brush my teeth, or take medication, and the thoughts are so horrible, they make me gag. Recently, for some reason, it's been worse and the thoughts actually make me vomit sometimes. I try to control the thoughts by thinking about something else, but I have this terrible gag reflex that kicks in, and it makes me ill. I do not know why this has been happening the past few months more than it did before the past few months, but whatever the reason, it is kind of a problem. Particularly since, I don't have a therapist anymore.

I don't know exactly why I would have these thoughts, but I've had other OCD type thoughts before about different things. It never made me sick though. It just made me anxious. This actually makes me sick. It makes it difficult to even eat sometimes. It makes it difficult to swallow pills or brush my teeth. This gag reflex and the thoughts come in at the same time. I thought at first that actually I was gagging because of my medication, but my psychiatrist thought that was not a side effect of Latuda. Then I realized that every time I gagged, I was also having the gross thoughts. So I have been, at times, confused as to what was actually causing the gagging and if the gagging was really caused by the thoughts. But I had thoughts a long time before the gagging started, so I am pretty sure they are the cause.

I am trying to remember how long this is been going on for and I'm not really sure. I know it has been since around this past spring or so that I have noticed myself gagging, and then it increased, to the point that it now happens several times a day, every single day. The thoughts are there so much it is almost impossible to avoid them. I have a hard time dealing with even going into a public bathroom or changing my cats' litter box because I get nauseated by it and the thoughts are horrible. Sometimes I go to brush my teeth, and start vomiting. This is not a pleasant experience.

It is kind of a joke in my family that I am like this. My younger siblings will make jokes about gross things just to gross me out because I will freak out and scream at them to stop it before they make me throw up. I suppose I have been that way for years. But it is a real problem now, which it wasn't really years ago. And nobody  really knows about it except my former therapist.

She told me to think about it on purpose so the thoughts would lose their power, but I can't make myself do that because it is too disgusting. I can't force myself to think about disgusting things that I am trying to stop thinking about. But I should probably try that approach just to see if it works at all.

It's embarrassing, and the worst part is even talking about it would make me sick, and humiliate me too, so I can't tell anybody about this. But I am tired of gagging all the time. Many things have made me nauseated throughout my life, but I don't remember it ever being this much of a constant problem as it is now before. I am wondering if Latuda can worsen OCD type symptoms, but that seems unlikely. There is not as much research on Latuda as there is on older drugs though, so it is possible that this could be an unknown side effect.

I think I will bring it up to my doctor when I see him next week, because I have never discussed this problem with him before, and it has become increasingly bothersome.

The other types of OCD symptoms I've had before are not really problematic. For example, I have a habit of counting which I've had all my life. Like, before I get out of bed I must count to fifty (this is just a random example) forwards and backwards or 100, or something. I would do that when I was nine years old and I still do it sometimes now. But that doesn't make me physically sick. That's just a weird quirk. The gross thoughts are more of a problem, and I want to be rid of them. The only thing that I know for sure which has helped me with obsessive thoughts is Prozac. I only know that it helped me because I've read the posts where I wrote that very thing on this blog. But the last thing I want right now is to go on yet another medication, and I refuse to ask for one. I don't think my doctor would put me on another pill at this point anyway, but I definitely do NOT want any more pills. Taking as many as I already take is bad enough for my liver which has been breaking down pills for 21 years. So I don't know what can be done about these thoughts. If you have any suggestions I am open to hearing them.

Inspirational Poems

This is a poem I like that comes from Alanon. I first read it when I was a teenager and went to Alateen meetings. I was involved with that around age 14-16, going to meetings at a church and at my high school. My mom got me involved in it. In retrospect, it probably would have been a good idea to stay involved in it.

Anyway, I don't believe in the typical idea of God or anything, but I do like this poem and find it useful for anyone with any type of problem, particularly mental illness or substance abuse or family dysfunction, etc, because even though with a chemical imbalance causing a mental illness you can't really "choose" to be happy, there is still something to be said for the benefits of the cognitive behavioral and dialectical behavioral therapy approaches and trying to find happiness despite having an illness too:

"Just for Today"


Just for today
I will try to live through this day only,
and not tackle all my problems at once.
I can do something for twelve hours that would
appall me if I felt I had to keep it up for a lifetime.


Just for today
I will be happy.
This assumes to be true what Abraham Lincoln said,
that "Most folks are as happy as they make up their minds to be."



Just for today
I will adjust myself to what is,
and not try to adjust everything to my own desires.
I will take my "luck" as it comes, and fit myself to it.

Just for today
I will try to strengthen my mind.
I will study. I will learn something useful.
I will not be a mental loafer. I will read something
that requires effort, thought and concentration.

Just for today
I will exercise my soul in three ways.
I will do somebody a good turn, and not get found out;
if anybody knows of it, it will not count.
I will do at least two things I don't want to - just for exercise.
I will not show anyone that my feelings are hurt;
they may be hurt, but today I will not show it.


Just for today
I will be agreeable.
I will look as well as I can, dress becomingly,
keep my voice low, be courteous, criticize not one bit.
I won't find fault with anything,
nor try to improve or regulate anybody but myself.


Just for today
I will have a program.
I may not follow it exactly, but I will have it.
I will save myself from two pests: hurry and indecision.


Just for today
I will have a quiet half hour all by
myself and relax. During this half hour, sometime,
I will try to get a better perspective of my life.


Just for today
I will be unafraid.
Especially I will not be afraid to enjoy
what is beautiful and to believe that as I give to the world,
so the world will give to me.


And this is a poem by May Sarton, who dealt with depression and wrote about it in some of her books. She has published many books of poetry and I highly recommend them. She is a very talented writer.
"Now I Become Myself"
by May Sarton


Now I become myself. It's taken



Time, many years and places;



I have been dissolved and shaken,



Worn other people's faces,



Run madly, as if Time were there,



Terribly old, crying a warning,



"Hurry, you will be dead before--"



(What? Before you reach the morning?



Or the end of the poem is clear?



Or love safe in the walled city?)



Now to stand still, to be here,



Feel my own weight and density!



The black shadow on the paper



Is my hand; the shadow of a word



As thought shapes the shaper



Falls heavy on the page, is heard.



All fuses now, falls into place



From wish to action, word to silence,



My work, my love, my time, my face



Gathered into one intense



Gesture of growing like a plant.



As slowly as the ripening fruit



Fertile, detached, and always spent,



Falls but does not exhaust the root,



So all the poem is, can give,



Grows in me to become the song,



Made so and rooted by love.



Now there is time and Time is young.



O, in this single hour I live



All of myself and do not move.



I, the pursued, who madly ran,



Stand still, stand still, and stop the sun!