6 weeks of fluoxetine

the plebeians prozac

olá people,

sometimes, i think life is a numbers game.

10 years ago i was diagnosed with ocd, by which time i'd been living with it for 4 years. which means that i've now lived with ocd for 14 years.

2 years ago i realized that my normally pessimistic low-energy personality had veered into something more like depression. and, as the title of this piece indicates, i began taking an SSRI, fluoxetine, 6 weeks ago.

i don't know many people who talk about their experience medicating. that could be because i'm old and anti-social, but just in case it isn't something people talk about, here are some notes on my experience.

embroidery work in progress. black, blue and purple thread on raw cotton fabric. fluoxetine at 6 weeks.

first of all, this isn't meant to be like a what i eat in a day vlog. there is NO way that i think my experience or trajectory should serve as a reference for anyone else. period.

i'm taking a med for my brain. i have no clue if you should take a med for your brain. but if you do, you aren't the only one who is popping a pill in the hopes that your brain will work differently. and if you don't need or want meds, i get it. just don't judge those of us who do. being unmedicated doesn't make you superior. it makes you lucky. period. ;)

i probably could have benefited from meds a whileeeee ago but it took middle age kicking my ass to make me really consider doing it.

the decision

it was actually quite difficult for me to decide to start taking medication.

fluoxetine was approved by the fda in 1987. it is the oldest SSRI available in the u.s. and i'm older than it.

there was NO social support or encouragement for treating mental health with pharmaceuticals when i was growing up. no one spoke of it. not in high school. not in college. not at work.

philosophically, i have no objections to treating mental health. whether it be with pharmaceuticals or with therapy or exercise and diet or whatever works for you. i am ALL about treatment.

in theory.

in practice, it freaked me the fuck out.

take a pill, every day, that will give me unknown side effects and change the way my brain functions?

i'd already been living so long with ocd and dysthymia, why fix what is broken but i'm familiar with?

maybe it wasn't a brain thing, i wondered…it could be something else…my very low ferritin? or perimenopause? or pollution?

what if i was looking for a crutch or an excuse?

i use the public health care system. it's great to have and very flawed (because of corrupt fascist politicians, but that's a story for another day). i go to therapy 1x a month. for 30 minutes (numbers game). and as i went on about my fears she said, at least talk to the psychiatrist. see what she has to say.

it took me three months to see the psychiatrist (remember, great to have but very flawed public health care). when i did, it was a resident. i put him through the paces. i had 20 questions for him.

and he wrote them down and answered them. and ultimately i realized it was a decision of what if.

what if life can be a little bit easier? what if minimum daily functioning doesn't have to feel like a monumental task every day? what if i don't have to use all my energy to do the bare minimum? what if my total exhaustion isn’t about diet or exercise or environmental factors? what if i'll never know if i just don't take the meds?

so, with HUGE support from my hubby, brother, and m.d. bestie, i took the pill.

so far

i've been on fluoxetine for 46 days. i waited to write about until the 6 week point because many sources indicate that it takes at least this amount of time to have a sense of how the drug will work in your system. (but there is no exact number for this).

the first 5 days were probably the happiest of my life. i felt warm and tingly, kind of like i'd taken lsd, but without the hallucinations (thankfully, because those can actually be a possible side effect of fluoxetine). i woke up and wasn't tired. i had energy to interact with people and do activities until the end of the day. i felt like i'd put down a 50lb bag of rocks and that life was…easy.

i don't remember ever feeling like that.

i wondered if i was having a manic reaction (another possible side effect). i was so light. i had no exhaustion. when someone on the street cursed me out for not giving them change, i just smiled. when a car almost ran me over in the crosswalk i was like “don't do that bud". i was yawning all the time, had insomnia, and dry mouth (other side effects) but life felt…easy. it was incredible.

on day 6 that feeling stopped. and i went back to exactly how i felt prior to day 1.

this was devastating.

i wish i'd never felt so easy breezy happy and free. because then i wouldn't even know that was possible.

but by day 10 i knew it was possible and i was fucking bummed out.

exhaustion was back. zero motivation to do anything. i was more irritated. headaches appeared.

sigh.

by day 21 i had accepted that the first five days were long gone. my mouth was like the sahara desert (prior to the freakish torrential rains this year) and my libido was tanking and i couldn't have an orgasm. i'd never had that problem in my life.

day 29 i had diarrhea, dry mouth, insomnia, exhaustion, couldn't have an orgasm and i had zero desire to do anything.

day 35 i made a mistake at work and it didn't bother me so much. that never would have happened prior to taking fluoxetine. but i had some ocd thoughts and was bitter the pill didn't magically erase all of those and i still felt so exhausted and life felt so hard.

at the 60 day mark i have a follow up appointment to evaluate how it has gone. my dosage will probably increase because that's how treatment works (initial and maintenance dosage is 20 mg and treatment is more than that). or maybe there will be a different drug. who knows.

all i know is that today, day 46, the minimal benefits don't outweigh the mild disadvantages.

in conclusion

i'm a slug. because of my dysthymia. because of environment. because i was born that way. and for a brief moment, i saw a glimmer of something else. but no, i'm just a slug. a slow leisurely not productive slug. i can pay my bills and wash my kid's clothes (but no iron them). and that's about it.

my dreams for having my own lit mag and opening a used book store and writing a novel and creating art every day are just that, dreams. i'll never have the energy to do all that. and you know what, okay.

maybe i had to take a med to accept me the way i am. we'll see.

i don't regret trying, mostly because the side effects aren't horrible. if they had been, then i'd be pissed.

i committed to one year of treatment. i'll see if the recommendation is to continue on fluoxetine or make a change. and i'll keep y’all updated. because if one other person can feel less alone in popping pills or if one other person can feel less judgy about the poppers, then that's awesome.

and good luck to all of us, with brains that need rewiring or not, because life is easy for so few of us. we've all got our challenges and i really hope yours are a little lighter today.

cheers,

m