Now I’m not a doctor, in fact, I don’t even play one on TV, but I wanted to share a little about me and how I’m handling getting off of, or at least reducing, Pristiq.
I’ve been talking the antidepressant Pristiq (desvenlafaxine) for months and it doesn’t seem to be doing much, but honestly, the withdrawal from Pristiq is so bad I didn’t want to attempt getting off of it. As you might know, Pristiq is a metabolite of Effexor and Effexor, another antidepressant, is also a nightmare to get off of. If I would miss a Pristiq dose by even a few hours I would become suicidally depressed. Really. No joke.
No Taper Strategy for Pristiq
So getting off of Pristiq wasn’t on my short list of fun things to do. There is no taper strategy for Pristiq as it only comes in 50 mg and 100 mg tablets and you cannot cut them.
How I’m Getting Off Pristiq
But I seem to be successfully reducing the dose of Pristiq with minimal impact and withdrawal.
Today I feel that my mentally ill, depressed, bipolar life is inexorably unfair.
Today I hate everyone.
I Hate Everyone Who Isn’t Suicidal
Yes, I know, I’m supposed to be better than that. Yes, I know, I’m supposed to rise above that. Yes, I know that isn’t fair or particularly true. But I feel it anyway. You try being this depressed. You try being this suicidal. See how many people you hate.
Does Pristiq Just Serve to Extend the Effexor Patent?
If you live in the US, you’ve probably seen all the commercials for the new and pastel-pink-coloured antidepressant Pristiq. (Yes, prescribed for depression.) Pristiq is new and has a huge marketing push behind it and is a selective serotonin norepinephrine reuptake inhibitor (SNRI) antidepressant. In other words, it’s an antidepressant that works on both serotonin and norepinephrine neurotransmitters. It is not the only antidepressant to do this, but SNRIs are a smaller class of drugs than those that just effect serotonin alone (like Prozac). (Although admittedly, there seems to be a suspicious number of SNRI antidepressants in development.)
Bipolar disorder is defined as the cycling of moods between a depression and a mania, or hypomania. It is not characterized by being cut off in traffic and then being depressed about it.
Last night I watched Crazy for Love a very bad movie wherein a man, Max, is put into a mental hospital for attempting suicide for the tenth time. When he’s there, he glimpses a very ill, schizophrenic, Grace, whereupon he instantaneously falls in love with her. She too is determined to kill herself. His life’s mission then is to “make her better”. To “make her happy”. Having found his new mission in life, he no longer wants to kill himself.
I am crazy. I tell this to people in my personal life. It’s not a secret. I figure there’s no point in trying to cover it up; it’ll come out eventually. I’m crazy. The approximately 20 scars on my forearms rather give away that something is amiss.
But people really don’t like the word “crazy”. In fact, most often, what people say to me is, “no, you’re not!”. Well, actually, I am. I have a mental illness, I’m bipolar and I’m crazy.
Here is today’s interview with me, Natasha Tracy, complete with call-in questions. I think it went well. We discussed some of the negative impact bipolar has had on my life. I talked about bipolar disorder, depression, suicide, coping and how my writings at HealthyPlace have been controversial.
Stabbing is bad. It just is. If you have to pick self-harm options between cutting, hitting, and stabbing, don’t pick stabbing.
Unless you’re trying to kill someone, in which case I think stabbing would be pretty good. And satisfying. I’m surprised more murderers don’t pick stabbing.
Anxiety, Impulse Control Self-Harm and Stabbing
I’m having anxiety issues. And impulse control issues. And stabbing issues. Well, that last one is really a function of the other two, but it’s an issue nonetheless.
I’ve always been attracted to stabbing. I think that’s because when you start wielding a blade with force, you can’t change your mind. And it’s so easy to did deep. And draw a lot of blood.
This silence feels familiar. I despise the deafening, familiar sounds of silence. They terrify me. I suppose the silence strangles me. Strangled, alone, screaming.
I Hate Being Ignored
People who know me, know this about me. They know how much I hate being ignored. They know that when they don’t return my calls or my emails my mind riles in negative and catastrophic scenarios. People who actually like me don’t want to do that to me.
It would be nice to know ahead of time, if a treatment would work. Unfortunately, no one cal tell the future: not for cancer treatment and not for mental illness treatment like electroconvulsive therapy (ECT) either.
Will Electroconvulsive Therapy Work for Me?
But very smart people try to figure out what might predict the outcome of treatments. Especially treatments like ECT, a hotly debated, and much maligned treatment. That’s the good news. And the bad news.
In a retrospective chart review of depressive and bipolar patients in a Netherlands hospital, of those who received ECT, 65.8% met the standards for remission. The only predictor of response found was duration of index series.
There are frequent reports that of the people who survive suicide attempts, they realized sometime after the pills, or the gun, or the jump, they didn’t want to die. This is obvious. No one wants to die. People who attempt suicide don’t want to die. They want to be out of pain.
People Who Attempt Suicide Don’t Want to Die, They Want to Be Free of Pain
It is obvious that every human wants to live. No matter what their personal circumstance each human claws against death until they either don’t see it coming, or they feel there is no alternative for them.
Many people actually have no problem with that – we call it doctor-assisted suicide. The reason it’s “OK” to kill yourself near the end of your life is because it is medically certain you will be in agony for the short remainder of your existence. In this instance doctors just turn their head while a little extra morphine is administered. Happens all the time.
Bipolar (Mental Illness in General) Isn’t Considered a Terminal Illness
No one, however, recognizes mental illness as a terminal illness. It can never be determined to a medical certainty that the rest of your life will be lived in agony. Even though it might be. Tomorrow might be different. Magic might happen. A unicorn might walk through my front door. But probably not. Tomorrow is probably going to be exactly like today. Only it’ll be Saturday. Yay.
Depression Deprives People of Pleasure, Causes Pain
The problem with a disorder like depression is that pleasure is simply absent. Pleasure in all ways is gone. Desire is gone. Depressed people don’t like anything. Depressed people don’t want to do anything. And even if something extraordinary were to happen, like a unicorn in your living room, it wouldn’t matter. Because the ability to feel pleasure is gone.
And if anhedonia weren’t enough to make life absolutely pointless, there’s the adding of pain on top of it. Pain on top of pain on top of the unbearable, unarguable knowledge of more pain. And still, the fact is, I don’t want to die. I just really don’t want to live. Like this.
It’s understandable that people who love those of us with a mental illness tend to feel powerless. But here are some ways you can help make the world better for the mentally ill.
Bipolar is one of the most commonly diagnosed psychiatric conditions among teens and twenty-somethings, but there has been little written about it from a younger person’s perspective and few people know how to approach the topic. In her new book, Welcome to the Jungle: Everything You Ever Wanted to Know About Bipolar but Were Too Freaked Out to Ask (Conari Press, May 2010), Hilary Smith fills in the gap with an upfront and empowering approach to the challenges of being diagnosed with bipolar. Here she shares with us six tips for making the world a better place for people with mental illnesses.
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