Thursday, February 20, 2014

Washout Introspection

Regular readers may have noticed that I've been writing more frequently and posting fewer YouTube music videos. The reason for this is because I'm about to change antidepressants. The one I've been taking for around two years was once very effective, but its efficacy has decreased substantially over time. It's not uncommon for psychiatric medications to take this course, but it is no less frustrating when it does.

In a couple of weeks, I'll need to go through a period of what is known as wash out. By this I mean that I'll slowly taper down off of my current medication until there is none of it left in my system. One cannot have two antidepressants in the bloodstream at the same time, as that would produce what is known as serotonin syndrome, which can be dangerous. I've been through this process multiple times. The first couple of weeks are only mildly uncomfortable, deceptively so, but the final stages are very painful.

Wash out usually limits my productivity. I'm stuck in bed or on the couch for a couple weeks during the worst stage of the process. Cognizant of what is to follow, posting may be scarce for a little while. If I'm able to put together something passable, I will. If I can't, I won't. In the meantime, I'll try to compensate for what might be an extended absence.

Once my current antidepressant is entirely out of my system, then it will be time to introduce a new one. The drug I'm on, Zoloft, is one of the older selective serotonin reuptake inhibitors out there. Fortunately, there have been new medications in the same class developed in the past five or six years I have yet to try. It is in many ways unfortunate that the brain is as complicated and poorly understood as it is. To put it a different way, current medical understanding of the brain is like a map of the New World drawn up in the 1600's, full of inaccuracies, guesses, and uncharted regions.

When we say mental illness, what we really mean is a disease of the brain. It's more medically accurate to label manic depression as a disorder, but doing so makes it less understandable for the average person. I have a brain disease that is chronic, meaning it will never go away. I will need to take medication for the rest of my life. I may even have to go through wash out again, even multiple times. At last count, I've been through this five times before.

Some medications I take, like Lithium, will stay static, a part of my treatment forever. Antidepressants and augmenting agents are a different story. As research and development of new psych drugs progress, I may periodically need to come completely off of an older, less effective medication, and on to a newer one. In any case, none of this can be avoided. Though I do not expect it in my lifetime, I pray daily for a cure.  

I go into detail here, as I always do, to remove the secrecy and shame of chronic illness. Maybe a reader struggling with his or her own psychiatric problems will read this and seek treatment himself or herself. At times, I can almost forget how regimented my life is around the taking of pills, modification of my diet, all the while always scrutinizing myself for any evidence of imbalance or abnormality. It's work being disabled, but I've been at it this long and rarely feel the need to lick my wounds.

I've had medical problems since childhood, so I have no recollection of a time where they did not exist. That helps somewhat. In some ways, my current state is similar to people who are much older than myself, only now experiencing the onset of problems that are a result of the collective wear and tear of the aging process. We are biological machines that wear out eventually. One lifetime is all we receive. My body is wearing out much sooner. It does make me introspective, to wonder why we're completely wrapped up in a life that will conclude in the blink of an eye.  

1 comment:

Daniel Francis said...

Hope everything goes well for you in the next few weeks, Kevin.
Thanks for taking your readers into consideration in this way and thanks for educating us.