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."
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.