More travails on the road to mental health
What a fuckin’ month, huh? I haven’t written since the end of October, before I spiralled into two weeks of election anxiety. We got through it.
Our lockdown here is finally, really over. I left Melbourne for the weekend for the first time since February, and we don’t even have to wear masks outside. There are zero active cases in the entire state of Victoria. It’s incredible.
A few months ago, I wrote about starting a new anti-depressant, and my struggles with finding the right medication. In the spirit of openness, I thought I’d do a bit of an update.
Pristiq didn’t work out for me. I went up to 100 mg after a few weeks, and still it didn’t feel much different than before I started my medication odyssey. I’ve been feeling pretty anxious, and back to the low hum of anhedonia that I was experiencing before I decided to try meds again. Thus the lack of newsletters. Nothing feels very interesting or inspiring right now. It also fucked up my sleep and gave me crazy dreams.
I started reading about Pristiq withdrawal and it really freaked me out. Like the notorious drug Effexor, it has a short half life, which can make getting off it brutal. Given that the longer you’re on it, the worse the withdrawals can get, I wanted to get off it ASAP. I cut down to 50 mg over a few weeks (with my doctor’s approval), and it wasn’t hell, but it wasn’t great either. I was exhausted, passing out after work every night, and on a few occasions felt a kind of derealization bordering on a panic attack.
Given how bad I felt, I decided to hold off dropping off the drug entirely until I could talk to an actual psychiatrist. In Australia, most people seem to be prescribed mental health meds through their GP, who aren’t necessarily experts on mental health treatment. Given I’d tried three drugs, I wanted to see what someone who actually knew this stuff thought. I just had to wait two months for an appointment that cost $200 with a Medicare rebate (love that public-private healthcare system).
I’ve also been in therapy for the past few months, paying $100 an hour to cry in front of a man I’ve never met on Zoom. He does something called Acceptance and Commitment Therapy, a kind of mindfulness-infused CBT that seems to involve feeling your emotions fully as a way to get to the root of your anxiety or depression. I like it so far, but I don’t know if it’s enough on its own.
A week ago, I thought I’d messed up the time and accidentally missed the long-awaited appointment with the psychiatrist. I sat on the floor and cried until Tom checked the paper and saw it wasn’t until this week. On Monday I drove down to Prahan, got stuck in traffic, and frantically ran from building to building at the Victoria Clinic before finding the correct office.
A late middle aged woman in a skirt suit listened to me for an hour and prescribed Valdoxan, which is what I would have recommended for myself. It’s an atypical antidepressant that works on the melatonin receptors, and I have always had a hard time with insomnia. I start it tonight.