|Coming Out of the Depression Closet|
Mark Gorkin, LICSW, "The Stress Doc"
In his closing segment, the Stress Doc steps outside and locks the door on his depression closet. From sharing his Prozac trial with a family member to stabilizing on a low dosage, the Doc documents why this has been, and continues to be, a life-changing, affirming and ongoing experiment.
In the last installment of this depression series, I shared a revelation experience: after three months, I realized the Prozac was having a dramatic impact on my depression and, even, my deep-seated sensitivity. I also likened the medication's effects to a runner being freed of shackles or a car finally getting its full complement of oil and power steering fluid after being chronically low. My concrete example: while touched emotionally, on Prozac, tears did not automatically flow during a poignant movie scene.
Feeling better, I decided that Prozac had passed its three month probation period. Of course, I didn't expect to take the stuff that long. My psychiatrist had suggested a six to nine month trial before doing a thumb up or down on continuation. Ha! This Type A New Yorker wanted proof of results in four to six weeks. Lasting three months on meds was not just a clinical victory, but a triumph over cultural neurosis as well.
Confronting the Intimate FOE: Fear of Exposure
Flush with new found confidence and conviction in the experiment, I approached my younger brother (by five years, and only sibling). The family's tradition of secretiveness and shame around mental illness and my brother Larry's aversion to psychotherapy, despite being trained as a clinical psychologist, evoked some anticipation anxiety. But Larry was cool and basically understanding. A sometimes cutting or cover-up humor, especially when feeling uncomfortable, only poked through one time: he wanted reassurance that I wasn't going to be one of those, "Jews for Prozac." As much as it pains to admit it, that was a funny line. I did a counterpunchline, though. I reassured him that I would not proselytize Prozac over caffeine (his drug of choice).
Most important, being open with Larry helped reaffirm my identity as an individual who has struggled long and hard with chronic, if not major, depression. That despite my extensive training, personal therapy, my own practice, etc., even I had closed my mind to many of the subtly powerful and pervasive dynamics of depression. And now, finally, I had evolved a readiness to explore technological advances for treatment and recovery, to complement years of traditional psychotherapy.
A Piece of the Prozac Puzzle
While progress was clear, a frustrating side effect remained: emerging from a hazy, drowsy state was a daily morning chore. This was especially unnerving as pre-Prozac, two minutes after awakening, I would hit the desk writing...without coffee! When still having trouble awakening during a relaxing vacation, and exhaustion wasn't the issue, the culprit became transparent -- overmedication. And so did the pass in the impasse. My psychiatrist gave me the green light to halve the Prozac dosage. And within a couple of weeks, again, the difference was noticeable. I still was not jumping out of bed and becoming superwriter in response to anxious inner voices. However, now there was a dialogue about rising instead of a stuporously mellow state.
Lately, I've instituted a little game to ease the transition from bed to writing desk. I allow myself to read morning email for thirty minutes. Concentrating, first thing, on an early easy task has become my rising sun. It burns away early haze or fog.
And nine months later I reduced the prozac dosage to 3 mgs/twice a day, taken at breakfast and dinner. And with each decrease of dosage, getting up was easier, and not just in the morning. My libido was also getting stronger!
At this point, the obvious question: why haven't I tried going off the Prozac? Here are some of my thoughts:
So I'm on medication for the long haul. Actually, I have come up with another rationalizing reframe. With a 3 mgs/twice a day regimen, I'm not so much taking antidepressant medication as a "Serotonin Supplement." (Isn't a mind a terrible thing to waste?)
- I feel like my healthiest, strongest self these days, and like the feeling.
- Have heard too many stories of people eventually relapsing after stopping their antidepressant meds. (Though some are making a successful transition from the newer generation of antidepressants - Prozac, Zoloft, etc. - to St. Johns Wort, the natural herb which also impacts serotonin efficacy. I still would talk to a doctor, preferably a psychiatrist, about such a switch.)
- Don't feel ashamed or less of a person taking my medications. Prozac is not a crutch. If anything, it allows me to throw away the compulsive crutches that I'd been using to compensate for depression - such as compulsive exercising and codependent romantasizing. I'm finally breaking out of the biochemical and behavioral shackles with which I've struggled for so many years.
- There's a better balance between energy and focus (without the pronounced or prolonged swings of moodiness and agitation) while having access to my current emotions and past pain. I can still be a bit manic as an extroverted performer and obsessed as a introverted writer. But now, the recovery time from my psychophysiological peaks and valleys is much more manageable. There's a greater likelihood I will live and return to tell the tale.
- And finally, and most important, an artist friend who knew me in my early days as a "Shrink Rapper" observed that my, "rap singing (okay, I concede, it's an oxymoron) on the Prozac has never been better!"
So this has been my story out of the depression closet. Some talk about the trinity of mind-body-spirit. For me, I'll flesh out my m-b-s revelation: the Prozac-Psychotherapy-Passion Connection. And as always...Practice Safe Stress!
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Feedback Segment: How about sharing your thoughts on how you, friends or colleagues use humor in dealing with stress, conflict or moods, yours or others, in your personal life, at home or at work? HFTE will run the best stories and, of course, credit you. E-mail me at StressDoc@aol.com.