Tuesday, April 16, 2013

My Year on Zoloft

Back when I was deciding to go on Zoloft, I searched the web for information. I was scared to go on medication. Scared to become addicted, scared to feel like a failure because I couldn't deal with my psychological issues on my own, scared of side effects. Scarred of just about everything but hey, I was suffering from anxiety issues so that makes sense. When I searched the web I found a lot of helpful specific anecdotal information regarding benefits and side effects. What I really wanted was at least one full story, some structure that I could use as a type of baseline to hang all of the anecdotal stories on. I didn't find one though there must be such stories on the web. To help out is my intention with writing this post. This will be one more story out there on the internet that others may find if they are looking for it.

That being said, I am not a doctor. My story is only my story. Anyone else reading this could have vastly different experiences and needs. But, if you would like to hear one type of story to use as a reference point, mine is available to you here. So, here is my story.

Background

In 2009 I suffered what I believe was a first panic attack while being dehydrated. I was treated for dehydration in an ambulance and at a hospital and then released. Over the next several weeks I suffered many physical discomforts and fears. I went to the emergency room with several symptoms, I went to doctors appointments and had so many tests including three EKGs, blood tests, x-rays, and more, many tests. It was very scary. I was uncomfortable all of the time, loosing weight fast, and eating was horribly uncomfortable. I remember breaking down and crying in the doctors office on one visit when I was told I simply had to keep eating. I couldn't bear the thought of continuing to eat. What was wrong with me? And all the time, not sure if what was hurting me was killing me, my wife was pregnant with our first child. I was going to die and abandon my child and family, I feared. This went on for a very long couple of months. I had never felt so horrible while being told test after test that I was healthy.

I was exhausted and scared all of the time. I asked my wife to be in the bathroom while I showered. I couldn't drive easily and sometimes couldn't drive at all for fear the symptoms would be so great that I would pass out and crash. It was miserable. As the tests continued to rule out possible issues I would find myself hoping for a definitive test result but fearing the life that would be mine from having to deal with the particular diagnosis the next test would prove I had or did not have.

Somewhere towards the end of this period of testing, in the process of reading online about peoples experiences and about each test I was next to take and the various conditions that may be the problem, running out of tests to take, I got the notion form what I was reading on the internet that perhaps I had irritable bowel syndrome or some sort of psychological condition. I asked my doctor about these two possibilities.  She said she could certainly refer me to the psychology department for testing to see what would come of it. But, irritable bowel syndrome was just what they diagnosed when they didn't know what the problem was so she could diagnose that at any time with me and it wouldn't change anything. In the mean time, there were more tests prescribed. By this point in the process I was still uncomfortable, still scared, but feeling a little more cavalier as I knew for a fact, at least, that my heart was healthy despite the crazy things it had been doing lately and that I knew I had no tumors in my whole torso after the X-ray scan. No cancer and no heart conditions meant half my worries were unjustified even if I felt that I would stop breathing several times each and every single day. These test results went along way in helping me later when I was in therapy. I was able to assure myself that my heart was good and I was in good health by a whole lot of tested measures.

Then I got the call. It was a couple of months into this stressful adventure when I got the prescreening call from the psychiatrist office to see if I should come in to speak with a therapist. I remember I was in Santa Cruz when I got the call. It was October. Before we got off of the phone the doctor told me that he technically could not diagnose me over the phone, but yes I should definitely come in very soon, it would be ok because they were very good at helping people in my situation, and that while he couldn't officially diagnose it, I was suffering from extreme anxiety issues and panic attacks. It was like a 150 million pound weight was lifted off of me. I had something! It had a title! There were words for it. And, it wouldn't kill me. The Doctor spent a few extra minutes giving me some encouraging words and a couple of strategies to make it through the time until I got in to the office. And there was suddenly hope and a refreshing air that let me know that no matter how difficult this was, I wasn't going to die and abandon my family. In truth, just knowing I was dealing with anxiety issues had a great effect on me and was extremely helpful on my road to recovery.

Over the next two years I had a lot of success with therapy and reading books about my condition. At first I was diagnosed with panic disorder. I was building up some bad habits that were in the direction of agoraphobia but with the books and therapy I stopped having panic attacks and instead had a lot of close calls that I was able to stop from becoming panic attacks with the help of what I was learning. There was still a lot of anxiety, another thing I was diagnosed as having. Then I heard the surprise, I was diagnosed as having OCD, too. What? At that point I was seeing a psychologist monthly and a psychiatrist from the same office once in a while. The psychiatrist proposed his suspicion that OCD was my root issue and that dealing with and compensating for it had created the years of anxiety which ultimately became over whelming when I began having panic attacks. Panic attacks often happen at major points in a persons life such as weddings and life changes and……. having a child.

During the whole of these two years and the therapy process I had been told on a few occasions that my conditions, what I was dealing with in my mind, were pretty severe. Despite what I assumed as normal and tolerable from years of my own experience, the levels of anxiety and obsessive thoughts that I dealt with were well beyond normal levels and that patients at this level would be on medication as would be recommended for me. The doc always respected my feeling that I may be willing to go on meds someday but that I was not comfortable with the idea, so not now. I continued to make progress in therapy. That went on for two years. As I mentioned regarding my resistance to medication, I was afraid to be addicted, afraid to be on a drug for the rest of my life, afraid to feel like a failure who couldn't solve my own issues without the help of medicine. But anxiety was hard to work through at times. And then, after much improvement, it got harder. So much so that I called in desperation and said that I was willing to try anything, even medication, but I needed help badly. And that's when I got onto Zoloft in the end of 2011.

On Zoloft

The first day on 10mg and I had a panic attack. I had not had but a couple of panic attacks in two years since I started therapy. Why now that I was on a medication to help me was I having one? Because some of the initial short term side effects that don't last more than two weeks when going onto Zoloft are exactly like symptoms of a panic attack. I knew that. I had read that. I still wasn't prepared. I was out alone in a town when the sweaty palms hit, rapid heart rate, narrowed vision, a feeling of disassociation from my body, and fear set in. My mind whet down that track, it felt like a panic attack, so it became one. I called my wife and she talked me down. I had two years of new skills to deal with this and my wife on the phone and so I was able to work through it and then drive myself home. The next day the stomach upset feelings and cramping started. That went on for a few days. I was then prepared to think of all side effects as merely that, temporary side effects. But there is no way I would have stayed on the drug if those first couple of days had been indicative of the experience of the drug. Luckily that was not the case. The upset stomach was replaced by an odd but unobtrusive stomach sensation for several more days before fading away. The drug dosage went up incrementally as was the plan to let the body get use to the drug and to minimize initial short term side effects. At one point I remember noticing that while I couldn't tell if the drug was working for certain or if I was having a good week, I sure wasn't having many anxiety episodes lately and none of significant degree.

At 50mg I felt awesome! I remember thinking that one of the possible side effects of Zoloft was a loss of libido but my libido had seemed to quadruple and I felt great all around. I still had some OCD  issues and occasional anxiety but at all other moments in the day I was felling much better. Great. At 100mg, the first stopping point in my gradual dosage increases, I found some pros and cons. My libido was depleted slightly and that didn't feel exactly good. I also felt a little unnatural. But the OCD thoughts had finally begun to reduce a bit and my anxiety was significantly reduced. The same drug treats depression in low dosages, anxiety in greater dosages, and OCD in high dosages. The doc told me that rarely do OCD symptoms go away completely from meds but the goal is to get them down around 90% so that the compulsive thoughts may still occur but they are no more than a minor inconvenience that one notes and does not really suffer from. He also said that the negative side effects I was then feeling mildly may subside but that a good idea would be to stay at that level for a while and see how I responded as I was seeing such great success in the decrease of negative issues. It would also give me time to really work on therapy without having to simultaneously deal with so many anxiety and OCD symptoms. This is the dosage I stayed on for the better part of the year while reading and seeing a psychologist.

After many months I started wanting off the medication because I felt a little off and that I was kind of ready to try going without. I was completely over any concerns I had about being on medication. I could see that my quality of life was vastly improved and that I had gained a lot from the relief of constant extreme anxiety that being on Zoloft had provided. I realized it was silly for me to care if I needed help; it was ok to need and receive help. I realized it would be ok to be on medication for life if I needed to. But I wondered if I wasn't ready to try being off. Unfortunately, I was also beginning to feel some anxiety issues creeping in and I was still dealing with some OCD thoughts semi-regularly. I mentioned my desire to try being off the meds. The psychiatrist said he was actually thinking I should up the dose to see if we could now get the OCD symptoms down even lower but he would be willing to work with me either way. We decided to stay at 100mg a little longer. Then, I hit a rough spot again. I went through some extreme anxiety again as a result of some life factors. In desperation, several weeks after I had said no to a dosage increase, I called and said I would try anything and that I was having some major issues and I needed more help with current issues in my life. The doc took me up to 200mg and gave me a few fast acting pills, Ativan, to prevent a panic attack if I felt one coming on. At 200mg of Zoloft, my libido definitely dropped. It was an odd thing and it didn't feel comfortable. But, I survived the extreme anxiety episodes and I only used three of the Ativan pills in a two week especially stressful time period. I was at 200mg of Zoloft for about a month. I felt odd, not exactly myself, and ill at ease, but not full of the traditional anxiety and OCD thoughts I had been dealing with and it helped me through a rough spot.

I had been on medication for almost exactly a year at that point. I continued to go to therapy and to be thoughtful about my mentality. I worked through a lot that I needed to work through and felt much success with my regular counseling sessions.


Going off Zoloft

Then I got sick, I caught a cold. I was in bed for a couple of days and forgot to take my Zoloft pill. I had a horrible sore throat next and didn't want to swallow the pill. And in the back of my mind, I wanted the break to see if I could handle being off Zoloft for a while. After a week of being sick and no Zoloft, I though it was the cold giving me weird symptoms but I soon realized and confirmed on the internet that I was going through withdrawals from Zoloft. You are not supposed to just stop, you are supposed to taper off with doctor supervision. But I was that far so I kept on going. Over the next couple of weeks I coughed and dealt with the last of the cold symptoms while I simultaneously experienced the withdrawals. The most common weird feeling was as though, in an instant, my whole body was shifted over about an inch, a half of a second was allowed to pass, and then my body was shifted back almost but not quite where it had been a second before. And I was left to make sense of that feeling and decide how to move in space and time again. It was odd. That occurred randomly until about three weeks after I stopped Zoloft. There was also the pounding heart flutters each night and randomly in the day over about a two week period. And bad sleep in that same time. But then it was all over. I should have tapered off with medical supervision. I recommend that to anyone who wants to try going off Zoloft. I do not recommend simply quitting.

After Zoloft


I have been off of Zoloft for about 5 months now. I have not had a panic attack. I do not have daily anxiety episodes. I do not suffer daily extreme compulsive thoughts. I had suffered nearly two and a half years of extreme anxiety before Zoloft, taken Zoloft for about one year, and am now, 5 months later, feeling good like I did in the years before my first panic attack. I am feeling better than I dd back then, actually. As far as anxiety and OCD go, I feel great now. I feel mentally healthy, balanced, and "normal."

How can this make sense? I can't say for sure, but here is how I make sense of it. Here is how I explain it to myself.

I had learned to live with anxiety and OCD for years without knowing it and without thinking of my issues as such. I lived a good life and dealt with it. A major experience, having children, pushed me to the edge as a result of my fear of being a bad or absent father. The stress became too much and I had a break down that expressed itself as panic attacks, anxiety and OCD symptoms beyond what I could "handle" and that turned into many physical representations of aches and discomforts.

And then, I got a one year break from it all with Zoloft. I got one year without the extreme anxiety and OCD symptoms allowing me to put it all back into perspective, to see that it was all ok, to reset my self, to work through therapy, and to find a balance. And then, when the training wheels were removed, I was fortunate enough to find that I had regained my essential balance and coping ability equipped as I was with many new coping skills. Perhaps if I was super rich and without responsibility when my panic attacks started my doctor could have prescribed me a year of travels and low stress to take my mind off of my worries and gain balance. Perhaps if I needed the break in a different time and place, I would have been committed to an asylum for several months and my family told I had suffered a nervous break down. But I am part of these days and times, I had a family to be a part of, an income to generate, a job to do, and still the issues to overcome. And so I was given a year of Zoloft which gave me space to be a father, income earner, responsible professional, and still get a partial mental vacation from my stresses allowing me the room to work clearly on dealing with my issues through therapy in counseling.

In short, Zoloft worked for me and now I do not need it. I may need it again some day. I may need it for the rest of my life. I am ok with that now. I see the value in quality of life. There are no awards for toughing it out. I still have issues I work with. I still see my psychologist. I still practice skills to deal with compulsive thoughts and anxiety. In my case, I feel I am in a place where I have been reset to as I was several years ago but slightly better equipped to deal with my particular issues. I'm in a good place. Zoloft worked for me. It was a tricky ride, not perfectly smooth, but the trade offs were worth it and the result has been successful for me in a way that fit in with the requirements of my life. So here I am now, feeling more "normal" than I had in years, accepting of where and who I am, ok with receiving help as needed, willing to accept help in the future as I need it,  and better equipped to handle stress in life

I hope this helps somebody. It was good for me to write it out. Of course, my interpretation may be incorrectly clouded. Everything may change for me some day. Other people will have very different circumstances and experiences. This is one story from one person to use as a comparison and a reference point. I hope all who need it find the help they need in what ever form that is.

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