Every time I type "Zoloft" my iPhone changes it to "Spliff"

As I was driving to my Monday therapy appointment, I did a little math in my head and ended up with a rather startling conclusion, a conclusion that every mental health provider I've seen has asked me about and for which I'd never had an answer until Monday.

From the night that I freaked out on Joel to the day that I freaked out on him during therapy, guess how much time elapsed?

Precisely 28 days.

Since I haven't had a real period since before I got pregnant with Genoa (over six years), I'm not all that aware of my cycle. I have this magic Mirena IUD that brings me lovely ovulation hormones and zero period. I love it because I get to be all horny when I ovulate, but then I never have to deal with PMS or tampons.

But apparently I DO have to deal with PMS because it looks like I'm not so much bipolar as I am COMPLETELY INSANE the week before I would get my period were I a woman who actually menstruated.

The technical term for this condition is Pre-Menstrual Dysphoric Disorder or PMDD and the symptoms hit disturbingly close to home. Here's the list from the wikipedia article. I've put in BOLD the symptoms I've experienced:

• feelings of deep sadness or despair, and suicide ideation
• feelings of intense tension or anxiety
• increased intense sensitivity to rejection or criticism
• panic attacks
• rapid and severe mood swings, bouts of uncontrollable crying
• lasting irritability or anger, increased interpersonal conflicts; typically sufferers are unaware of the impact they have on those close to them
• apathy or disinterest in daily activities and relationships
• difficulty concentrating
• chronic fatigue
• food cravings or binge eating
• insomnia or hypersomnia; sleeping more than usual, or (in a smaller group of sufferers) being unable to sleep
• feeling overwhelmed or feelings of being out of control
• increase or decrease in sex drive
• increased need for emotional closeness

Apparently, "five or more of these symptoms may indicate PMDD."

So, yeah.

There's that.

I finally got a doctor's appointment yesterday to talk about PMDD and the near-crippling anxiety I've been having lately. The doctor asked me to describe what happens when I get anxious.

I told her, "I can't take a full breath. The more I think about not being able to breathe, the worse it gets. Sometimes I feel like I'm suffocating."

"That's a panic attack."

"I know! Which is why I'd like you to prescribe me some Xanax, pretty please. Did I mention how much I love your shoes?! And Xanax. I'd really love some Xanax."

"How often do you have these panic attacks?"

"Um, like, I dunno, three times a day?"

"If I give you that much Xanax, you'll be comatose."

So after much discussion, she gave me this instead.

I had some huge concerns about taking an anti-depressant. 

1) I'm doing all this therapy work and it's really important that I continue to be able to feel my feelings. I'm anxious FOR A REASON and I don't want to slap a band-aid over that just to make myself feel better. I don't want to be numb.

2) Since there IS a reason for my anxiety, I don't think I'll need to be medicated FOREVER. That's why I'm doing all this work: to get better. Any drug I take will hopefully just help me get through it with minimal damage to those around me. I wanted a drug that would be easier to wean myself from in the future.

3) I'm not depressed!

4) I'm terrified of losing my sex drive and/or my ability to orgasm. 25% of people who take SSRI's experience negative sexual side effects, which would be a deal-breaker for me. Sex might be the only thing keeping me sane right now.

The doctor and I talked a lot about all the different pharmaceutical options. Wellbutrin is great for your sex drive, but can actually INCREASE anxiety. Effexor and Paxil are better for anxiety and tend to have fewer sexual side effects, but it can be extremely painful to wean yourself off of them. Zoloft ended up being the one that made the most sense. It's also what they usually prescribe for Pre-Menstrual Dysphoric Disorder, so anxiety or not, I'd be taking it anyway. If I have sexual side effects or begin to feel like I'm getting numb to my feelings, we'll simply adjust the medication or switch me to something else. It's a work in progress.

I never thought I'd be here, but here I am. Ironically enough, one of the first tag-lines I had for this blog was: Cheaper Than Prozac. Apparently I needed both all along.

Comments

[Jesse]

I take both Sertraline and Welbutrin (and took Effexor in the past), and I can say with complete honesty that they *never* make me emotionally numb or unable to feel. What they do do, is help to cut through all the bullshit feelings that swirl and swarm around, making it *more* difficult to assess what I am really feeling.

I had the same worries before starting to take SSRIs almost a decade ago, but aside from some sexual side effects (which I manage with adjustments in meds, and some lifestyle tweaks), I have nothing but complete gratitude for what they have enabled me to do with my life.

I have severe, long-term depression, so I probably will never be able to go off these drugs, but it sounds like you may need them only temporarily. Either way, don't be afraid of losing touch with your 'self' - if that happens, talk to your MD right away! You might have to fiddle with Rx and dosage until you get it right, but I promise that when they work, these medications will only help you get closer to your 'real' self, not block you from it.

All the best.

[Therese]

I have PMDD! My OB figured it out a few years ago and prescribed Serafem. I'm obviously not good at the drug details because I only found out about 6 months ago that it is Prozac. I usually take it about 7 to 10 days before I get my period. It makes a huge difference. Trust me I still FEEL lots of stuff, but I can usually keep my shit together and not become a raving bitch.

[yasmara]

I haven't commented much before, but your first post about anger actually made me wonder if it had anything to do with PMDD. It's such a douche-y question to ask someone, though...do you think it's your lady hormones? Ha!

It was just striking to me because I recently realized I have exactly the same problem - huge blowout fight with husband, kids getting on my last nerve, inexplicable crying...3 days before I get my period. 28 days later, exactly the same again.

It's not to say that I, like you, don't have work to do myself, but it helps me to know there's something real going on on top of everything else. Reading your story & thinking about it all (not to mention approaching that Red Zone on the calendar) inspired me to contact my dr today & talk with her about options...is there any way to block these crazy-making hormones completely? I wish...

Honestly, the best I ever felt was when I was pregnant (after I stopped throwing up) and my hormones were on an even keel for 9 months instead of this crazy monthly rollercoaster. My husband even remarked on it at the time - how happy I was all the time...now it's taken me FIVE YEARS to figure out that there's probably a good reason for that.

I have been diagnosed with PCOS (polycystic ovarian syndrome) and I wonder if that contributes to it - higher levels of hormones?

I wish you the best of luck as you try to figure this out - I'm right there with you!

[Bananarama]

I have PMDD too! I've tried lots of different things from the Pill to Prozac and the one thing I found helped more than anything was upping my intake of Vitamin B6. I'm talking 50mg a day (you get about 2mg in normal Multivitamin/Sanatogen for Women type tablets. I live in the UK and get them over the counter at my pharmacy. You can take them alongside your Prozac. You should never take more than 100mg a day though as they have been studies that indicate this can cause nerve damage (it's not a 100% but best be on the safe side).

Now you know what it is, it will be SO. MUCH. EASIER. There is lots of help out there, even for Joel to help understand your PMDD.

[liana]

I do absolutely did NOT want to deal with an anti-depressant. I had a "situation" with my divorce, but it wasn't anything that was long term or that I couldn't get over. But oh...man. The divorce only opened up a huge can of worms that I had supressed for a long long time. My therapist and doctor put me on Zoloft and let me just say - it took a week or two, bu then suddenly - AWESOME! I could turn my brain off to all the stupid overanalyzing and overthinking and stupid thoughts that would not leave me alone, and now I can think clearly and effectively and RATIONALLY. It doesn't numb me at all, and my sex drive is STILL just fine. ;)

[lcg]

when initially starting the SSRIs, there can be an short term increase in the anxiety. It's usually a "good sign"--meaning that a person is likely to have a good long term response to the drug. Just an FYI for you and a reminder to call the MD if this happens. Klonopin can be prescribed for a short while until the anxiety from the zoloft eases.

[Andrea Burgardt]

Unfortunately, Zoloft has never made me numb to my emotions. I'd LOVE that. It just makes life manageable. And me manageable. I'm a rage monster without it. I'm all like "kill, kill, kill!"

[Nancy]

Trying an antidepressant is not a sign of failure! As a blog reader and total non-expert who's never met you, I would have said you've been clinically depressed since the days you were parked on the couch with your kindle, trying to hide from the life you were hating but wouldn't admit you hated.

Try it for a few months and see how you feel. In my experience, a short stint on Celexa helped lighten things up enough that I could deal with things and make decisions that allowed me to restart my life. Hope you have even better results!

[Melissa]

The antidepressants are good, but you should get off hormonal birth control. I used to get insane the Saturday before my period came. It was like clockwork. I have the Paragard IUD and I am so happy to be off hormones. You do get very, very heavy periods for a while, but it's totally worth it not to go nuts every month.

[Elissa]

I went completely, totally, stark raving, ape shit IN-fuckin-SANE with the Mirena. The hormones they "say" don't have any side effects damned near made me kill myself (and others)... took that bitch out and within a few months I felt completely normal again. Not implying this is your problem, just thought I'd toss it out there. Also, I've not taken Prozac but Paxil made it 100% impossible for me to O and that was WAY worse than any crazy I was taking the Paxil for... Good luck with your meds! And if the one you start with doesn't work well (or causes an unbearable side effect) PLEASE don't hesitate to switch to something else until you find what works!

[Heather in AL]

I have a fair bit of anxiety, trouble focusing when stressed/depressed, as well as weeks/months of daily crying. And lots of bottled up anger/tension. My marriage is not in a good place at this point - my husband is a very irresponsible drunk -- and I am working fulltime, finishing my doctorate, and raising two kiddos. Which brought me to my OB's a few months ago where I subsequently bewildered the nurse and used her whole box of Kleenex. Am now on lowest dose of Paxil, no problem with orgasm, no problems of any sort. Felt a little jittery as I adjusted the first week but after that, amazing. Can still cry at normal times, like when I went to see War Horse last week, just not crying at each meal. Have also lost 15 pounds (bonus!). In the past, I took Sarafem/Prozac for PMDD and liked the ability to take as needed but felt...numb. And gained 30 lbs. Could probably have gotten fired a year later when I switched to Wellbutrin because I did not give a rip about anything. It increased my anxiety (racing heart/panic attacks at first) and removed my filter. Paxil has been the mildest so far and I plan to stick with it until the doctorate is granted or the divorce is final, or both. Good luck to you!

[Leigh]

My PMS mood swings have gotten worse as I've gotten older. I used to just get a little cranky, but now I either get horribly depressed or completely filled with rage--or both--and it sucks. I feel so out of control and hopeless on Those Days.

I make it a point to mark my calendar each month when I'm due to turn into The Hulk; somehow it makes it a little easier to bear when I expect it, instead of crying all day and wondering why (WHY, GOD, WHY???!!!).

Conversely, it is not at all helpful when my HUSBAND points out that PMS might be the reason for my rage. Funny how that works.

[outraged]

I have tried a few anti-depressants. Prozac and Lexapro worked the best for me. Lexapro controls anxiety as well. Zoloft gave me amazing migrane type headaches and had to get off it. Never gained or lost weight due to any of them. I had a low dose maybe that's why.

Mirena... add me to the list of people who also had raging PMDD on it. When I first had it in and it started working and the periods disappeared, I thought, "wow this is great". No pill to swallow, no periods to deal with, it worked a like a charm. About 6 months into it, I started developing PMDD rages. Then I had even a worse side effect. I started having intense labor-like pains. Saw a GI doctor, had a million tests, they could not find much. Then I thought, "what if my body just wants to expel this Mirena and that's why it feels like labor?". Had it taken out and no PMDD, no more labor like pains. Conclusive evidence about Mirena side effects? Maybe not, but hormonal birth control can really do a trick on you. So one more thing to consider.

[heidi]

I have never been able to take hormonal birth control because it turns me into a LUNATIC. One month on it and the (now) husband told me to go off it or our relationship was over. In fact, I was v. similar to what you described happens to you. Second, I do have clinical depression. I wasn't diagnosed until after having all my kids and was first on Lexapro. It was awful. No sex drive, no orgasms, muting of emotion. Although, it saved my life so I'm glad I went on it. Now I'm on Zoloft. It takes the edge off the anxiety and depression it also helps with the obsessing over things. I love it so so much. Never want to go off it. Sex drive? Fab. Orgasms? Lots. Emotions? Got them. We all do what we need to do.

[cindy w]

I can't speak to the PMDD thing because that's not my issue, but I got on Lexapro for anxiety last year when I was pregnant and my husband said he wanted to leave me. (Kind of understandable, no?) It's basically saved my life. I don't know about sexual side-effects, because HAHAHAHA! Sooooo not applicable to my current situation.

Anyway, point being: drugs are good. And I hope it helps. Hang in there, lady. XOXO

[Valerie Willman]

I'm proud of you.

[tayler]

Personally, I think it's kind of bad to throw one's parents under the bus as child abusers and then to chock it up to a bad case of PMS, but that's just me.
I also read an article the other day that really reminded me of you about the most 'annoying social media habits'. It talked about like going on Twitter and Facebook and saying things like 'i'm going to the hospital!', then not elaborating. in my opinion, this is what you do all the time that i just don't understand. for exmple you put on twitter recently that your crazy cyberstalker Jules served you with a lawsuit. then you don't elaborate or say anything further at all! i have to wonder why even say anything at all if you aren't going to talk about it? is it either to just keep the blog drama going or maybe it isn't even true? Lots of us readers have asked about it and when you give no answer we don't know what to think anymore. maybe cyberstalker jules can elaborate and tell us why she's suing you?

[jules]

Hey Tayler-get your info straight. I'm not a cyberstalker nor did I serve Amanda with a lawsuit. Amanda can choose for herself which details of her life she shares with people she doesn't even know. If you don't like it-read another blog. And if you don't know by now that Amanda is more than a bit dramatic . . .well, then, you're more than a little slow.

[Faraway Reader]

Where did it say Jules was suing you ??? Is that true???

I have PMS and it sucks. Depending on my diet and exercise some months are worse than others.

I laughed at Leigh's comment. The day I am "Why God? Why?" and then my period comes the next day, I am always like "Oh so that's why I felt so insane". When I read other womens description of PMS it is usually exactly how I feel. Luckily mine is only super intense for about 24 hrs. right before. I warn my husband and I try and keep it to myself, lol. I eat whatever I want and try and ride it out.

Hope you are starting to feel better and things improve this month.

[Meredith]

Oh, honey. It sounds like you've found some good therapists. And, stay far away from the bad ones (I went to one feeling completely overwhelmed with my life and she suggested I get a hobby or some volunteer work.). And, above all, take care of you. Like you would take care of a child who was ill. Give yourself space and time to grieve and heal. I'm fairly certain that Joel is a smart, take-care-of-himself, able to separate the bull from the real, guy and will not head for the hills anytime soon. And, one day, you will believe that you ARE worthy. Of love, and support, and emotions, and even anger.

[Jenna]

I have that too. And bi-polar. Woo. Try the pills, what the hell. I love being on pills. I tried Wellbutrin but after 12 months finally figured out that it was the reason I was suddenly having petit mal epileptic seizures (huh!). I would freeze up like a statue in second year Latin class. Effexor made me manic, but it was GREAT! I was gardening at 2 am! Its a good one if you dont have bi-polar mania problems. Zoloft was the worst sex drive killer of all, and made me foggy for 11 years. But its very well tolerated otherwise. Its also relatively safe during pregnancy, just throwin' that out there! Ha!
Good luck! xo jk

(Also, about the above comment about the shrink who suggested volunteer work, I don't know the circumstances and she might have been a lousy doc, but volunteer work has saved me during several post-hospitalization recoveries. It really is excellent advice! It gets you out of yourself when you see how shitty other people's lives are. But again, I don't know anything about you and your situation :)

[J]

Wellbutrin "no sexual side effects" my ass! Lol when I took Wellbutrin I couldn't have an orgasm if my life depended on it. Off of it I have a hair trigger and can get off in a commercial break. So I decided it was better to be a bit crazy than frigid. Lol I think my husband could tolerate the craziness more than the frigidity.

[fabulouslyinboston]

I wrote a HIGHLARIOUS blogpost back in the day when people were still reading my blog.

So, I was put on something called Lexapro and my doc said to me: "Side effects: Difficulty to reach orgasm and loss of libido."

I looked at her and said "Oh well, those go hand in hand then. No problem."

3 weeks later check in with doctor.

She: "How are you feeling?"
Me: : "Much better, except...."
she: "What?"
Me: "SAME LIBIDO BUT DIFFICULTY TO REACH ORGASM"
She: "You are in a relationship?"
Me: "No. "
She:"Then it's no problem."
Me: "Oh yes it is. I am in a relationship with MYSELF. How the HELL am I supposed to get to sleep at night without taking care of my business."

Yes.
Funny story. Got better.

[Morgan {The818}]

This is the first time I've stumbled across your blog, but MAN if that's not the best title for a blog post I've ever seen.

So frustrating trying to figure out what's gone awry in your mind. I too can attest that neither Zoloft nor Effexor made me feel numb. I can also attest that I WISH my doctor had had the forethought of yours to NOT put me on enough Xanax to leave an Elephant comatose. I lost a lot of time that way. <3