What follows is an entry I posted to my Livejournal about my fears regarding SSRIs and my experiences with them in the past. I still feel strange and somehow wrong, a bit of a failure as a human being, for taking anti-depressants. But to be honest, I’d rather treat this condition and feel better than let it go untreated and suffer, and have my family suffer with me. There is no glory in suffering with an untreated mental illness, just as there is no glory in suffering through an untreated physical ailment.

—–

Yesterday I was talking to my OB about my bad experiences with SSRIs as a teenager. I was prescribed Zoloft and then Paxil around age 12 or 13 for depression, back in the days when they assumed 12 was old enough for an adult dose and no further testing was needed to determine the effect on children and teens. The Paxil made me extremely hyperactive, and I had uncontrollable twitches and hallucinations. When I told the psychiatrist, she told me not to worry about it.

“Are you depressed? No? Then what’s the problem?” Then the dosages would get increased because clearly I was having problems that needed more medication to resolve.

Looking up those drugs now, out of curiosity, I found that there’s something called “Serotonin Syndrome/Toxicity,” and it appears that the signs are things like hallucinations, hyperactivity, and uncontrollable movements. The drug fact sheet on WedMD for both of those drugs says to get medical help immediately if you incur any of those symptoms.

“Serotonin is a chemical produced by the body that enables brain cells and other nervous system cells to communicate with one another. Too little serotonin in the brain is thought to play a role in depression. Too much, however, can lead to excessive nerve cell activity, causing a potentially deadly collection of symptoms known as serotonin syndrome or serotonin reuptake syndrome.” [Source]

It occurs to me that, had I not begged my mom to stop taking those drugs, I could have died. The side effects of SSRIs are magnified in teens and young adults — namely, anyone under the age of 25 — and upping my dose in response to such serious side effects was grossly negligent on the part of my psychiatrist. However, I was given those drugs in response to my complaints that I was having a horrible time in school (kids spit on me, called me names, threw food at me) and was severely depressed, on top of my natural inclination for heightened anxiety. In essence, it was the “shut your face and get back in line” prescription, much like Adderall and Ritalin are used for hyperactive kids.

We now know more about the effects these drugs have on kids and teens, more than we did when I took them, and yet we still don’t know their full impact. What’s the long-term impact of prescribing harsh psychiatric drugs to kids who aren’t necessarily mentally ill, but just have social problems (namely, they’re not social and the social world is going to remind them repeatedly how little they fit in with the rest of the world)? Do these kids grow up to have worse psychiatric problems as adults from the impact of those chemicals on their brains? Or is there no noticeable effect? I’ve long known that my brain chemistry was somewhat impaired, and judging from what both of my parents have told me about my family history, it seems there may be a genetic component to that. However, I frequently ask myself if perhaps things would have been different if, instead of treating social issues with psychiatric drugs, I’d instead been just sent to therapy. If perhaps my brain chemistry impairments were worsened by the drugs I took.

I’m not sure if I’ll ever know, but these are the things I ponder every time someone suggests I go back onto an anti-depressant.

Addendum: My OB prescribed me Zoloft and mentioned I could take half-doses to wean myself onto the drug. This is exactly how I’m feeling right now:

I’ve been dealing with depression an anxiety since I was young. It’s been almost 20 years since I was on medication for it, back when I was a teenager and the effects of psychiatric medication on teens and young adults was largely unknown. I was prescribed Paxil and then Zoloft, and incurred serious side effects from both. Paxil made me extremely hyperactive and I had uncontrollable muscle twitches and limb movements (clenching and unclenching fists, kicking legs, and the like), as well as hallucinations. Zoloft made me paranoid and worsened my anxiety, to the point where I hid in a closet because I was sure that someone was hiding around every corner to kill me.

In my early 20s, I had frequent panic attacks and serious depressive episodes, along with suicidal ideations. I also started cutting myself to alleviate the intense and uncontrolled emotions I felt, but this didn’t last long as I eventually sank into an emotionless depression where I just felt blank and empty. In my late 20s, I was largely able to control the depression and anxiety with exercise, but I was still suffering from occasional panic attacks. Now that I’m in my 30s, and I work a high-stress job at a CPA firm, I find myself wavering. Sometimes I’m able to control the anxiety and depression, and sometimes it controls me. I had a baby about 8 weeks ago, and since delivery I’ve been suffering from severe Post-Partum Depression. In part, it’s because I had a less-than-favorable delivery. My daughter’s umbilical cord was caught around her shoulder, so 8 hours into an induced labor, after 6 weeks of false labor, we had an emergency c-section. The next day, I had a severe reaction to the medications in my epidural and suffered from severe, uncontrollable muscle spasms. The night we came home, I sobbed for hours because I had such horrible anxiety but I wasn’t sure what about and ended up sobbing hysterically and incomprehensibly about work and losing my job. Since then, I’ve been on an emotional rollercoaster that ended in several panic attacks alternating with a feeling of deadness inside. At my last OB visit, my doctor finally told me that enough was enough and I needed to do something. So I was prescribed Zoloft again, but a much lower dose than I’d been on as a teenager.

I started taking the Zoloft on Thursday, and I posted the following to my Facebook page on Friday. I’m re-posting it here because I feel the need to confront this issue head-on, after years of hiding from it and hoping it would go away because I didn’t want people to think I was crazy or broken and incompetent. A prior entry I posted to my LJ will be posted after this as part 2.

—–

I feel okay. I don’t know if I feel better, but I don’t feel worse, and where yesterday and the days before I felt like I was all edges, I feel like the edges have come off somewhat.

I really didn’t want to take medication for my depression and anxiety — I never have, because taking meds means it’s serious business (i.e. taking meds = being insane). It’s like an actual problem or illness, and not just a passing feeling of the (baby) blues. The problem with having an actual mental disorder is that it’s an actual mental disorder, and people treat you differently. Suddenly you go from just being someone with “issues” to being the insane person in the social group.

For a long time, I had my depression and anxiety mostly under control without meds, and I was able to effectively control it with meditation and yoga, and regular running. When I didn’t have time for that because of work, I struggled to control it, but for the most part I was okay. Now, though, it’s not under control, and honestly it’s not normal or okay to fill out a PPD questionnaire with answers like, “I hardly ever think about self harm anymore!” and “I’m not happy at all, but I’m not sad either.” When you decide not to get treatment because only crazy people take meds, or because you’re afraid that getting treatment will make people look down on you, you’re only making it worse for yourself.

I still feel as though admitting that I have a problem that needs treatment is letting people down. I don’t think, as a society, that we see mental health issues the same way we would alcoholism, for example, where the disorder has very real physical effects, in addition to the effect on relationships, job performance, etc. Even though mental health problems have the same impact, alcoholism seems more external; you’re out of control, not because of what’s in your head and completely unseen, but because of the effects of alcohol on your brain and body. In reality, mental health issues are more like physical ailments — they originate in the body, but their impact is primarily in the brain. If my nervous system stops functioning properly, I see a doctor and get treatment. But if my mind stops functioning properly, and I see a doctor and get treatment, it feels different or wrong even though my conscious mind is directly (and severely) impacted by the chemical balances in my brain. If the mind isn’t working properly, then the body doesn’t function properly. So why would I avoid getting treatment for problems of the mind?

In large part, because we still see problems of the mind as undesirable, scary, or wrong. It still seems as though we expect people with mental health problems to go crazy and become psycho-killers. It’s a direct path from being depressed and taking medication, to murdering your kids, or an elementary school full of kids, or sending bombs to random strangers. I grew up with that mentality very strong around me in the community, in churches, at school. It’s incredibly hard to shake that feeling that if I get treatment, I’m giving in and letting the depression win, letting the anxiety rule my life. Then I ask myself, would I say the same thing to someone who has cancer? Would I look down on them for getting chemo or radiation because treating the cancer was letting it win? Of course not, but somehow I still think it’s perfectly acceptable to run around having frequent panic attacks and being so depressed that I can’t function normally.

I’m not quite at the point where I’m ready to smile and say, “Maybe everything isn’t hopeless bullshit!” But at least right now I’m not so depressed that I want to stop existing. (Not necessarily suicidal, just perhaps I could wink out of existence suddenly.) It’s also weird being on medication again. I can feel very clearly when it kicks in (even at a 12.5mg dose), and it’s a bit unsettling to be aware that I’m changing the chemistry of my brain by taking an anti-depressant, but I can’t keep trying to go on as though there’s some sort of higher glory in carrying the burden of untreated mental illness. It doesn’t make you a better person to want to feel things, instead of walking around like a dried-up hollow husk of a person incapable of feeling things (or “her who is dry cork and never cries,” as John Donne put it).

So we’ll see how it goes. At the very least, I don’t feel as though I’m on the edge anymore. The medication is taking some getting used to, but feeling weird is a far cry from feeling nothing.

Welcome to the world of public accounting! Population: me and a bunch of other poor sods.

Since last January (that would be January 2010), I’ve done all of the following (plus a bunch of stuff I don’t remember):

  • Started dating a guy
  • Moved out of the parents’ house and in with friends
  • Got a job at a software firm designing training programs and writing tech manuals
  • Graduated with an MS in Accounting from UST
  • Lost my cat Tetsuo to old age
  • Got a job at a local accounting firm and entered the world of public accounting
  • Started the CPA exam
  • Moved to a crappy apartment a mile from my office, and learned first-hand the joys of being an adult
  • Went through my first busy season
  • Had a near-death experience in my car on the freeway
  • Decided to adopt a kitten, against my better judgment
  • Attempted to finish the CPA exam all in one month (August ’11)

Time to blog? How about time to shower? Life has changed for me immensely in the past year, and I’m just barely keeping up with everything. When will I start blogging again? Well, I’ll call you when I finish the CPA exam.

See you on the flipside!

Yet grace, if thou repent, thou canst not lack;
But who shall give thee that grace to begin?

One of the reasons why I loved John Donne so much, and one of the reasons why I chose to write a master’s thesis on his religious poetry, was the subtle jabs he took at religion under the guise of faithful ruminations. Those two lines are largely forgotten amongst the rest of the sonnet (Holy Sonnet IV), but they have a way of worming into your brain and standing out.

The bulk of his Holy Sonnets have both Catholic and Protestant undertones, and those lines stood out amongst the rest of the poem precisely because they come right before Donne states,

O, make thyself with holy mourning black,
And red with blushing, as thou art with sin ;
Or wash thee in Christ’s blood, which hath this might,
That being red, it dyes red souls to white.

The sonnet itself is strongly pro-Protestant and clearly advocates the idea that one has only to turn to Christ–and not a religious leader, some Pope or Bishop–to clear the soul of sin. And yet, those two lines are very strongly anti-predestination. They carry with them the connotation that Grace is slightly absurd–once you have grace, once you repent, you have it forever. Once saved, always saved–and yet, who bestows that grace?

But taken in the larger context of the sonnet, it can be passed off as mere rhetoricism–who gives grace? Why, Christ does, of course. Christ’s blood will cleanse your soul and bestow grace upon thee. And yet, it’s that underlying question, the tinge of absurdity, that makes the reader wonder.

I apologize for the leave of absence (again). Grad school has been eating my brain, but the end is nigh! This is my very last semester of graduate school (until I finish the CPA exam), and I’m really freaking excited to not have to write another term paper ever again!! (Unless I want to. And actually, I like research papers.)

In lieu of an actual post, here are my answers to mental_floss’s friday questionnaire.

1. I can’t remember ever walking out of a movie theater before the closing credits. Maybe I’ve blocked those bad movies out of my mind. Maybe I’m just cheap. What movies have you marched out of?

I went to see The Saint with my uncle and my two younger cousins when I was a kid. We walked out after the first 15-20 minutes because it was so awful. Maybe we just have bad taste, or maybe it really was a terrible movie.

2. My dog’s name is Bailey. Growing up, our dog was Jake and our cat was Rosie. What I’m trying to tell you is I’m not a very adventurous pet-namer. (Though I should add that Rosie was a dude, information we didn’t have during the naming process.) Have you ever had a pet with an interesting name, or a good story behind the moniker?

Weird pet names must run in my family. My mom and her sisters have all had really interesting names for their pets. Growing up, my mom had a pomeranian named Jobby (pronounced joe-bee), and her oldest sister had a cat named Nappy, who went to sleep one day and never woke up. (IRONY!) My mom’s other older sister is notorious for weird pet names–she had a dog named Bookstore when I was a kid, and now she has a dog named Rock Sand (pronounced the same as roxanne).

Right now, I own a cat named Tetsuo, who narrowly averted being called Totoro, since he has Totoro-esque markings on his belly. We named him Tetsuo as a kitten, after the character in Akira, and he ended up growing to be a monstrously-huge cat. He never evolved into proto-goo-baby, though he did suffer from eye problems recently and is now completely blind.

3. You might have read about one of the questions Miami Dolphins General Manager Jeff Ireland asked wide receiver Dez Bryant in an interview before the NFL Draft. It was something to the effect of, “Hey, was your mom a prostitute?” It’s hard to argue that any answer to that question would help determine how Bryant would fit in the Wildcat offense, and Ireland has since apologized. We’ve discussed bizarre interviews before, so I’ll ask a different question—what’s the most inappropriate question you’ve ever been asked in a work setting? But if you missed the earlier discussion, feel free to weigh in about your best (worst) interview story.

My HPB interview involved a running series of quotes from The Simpsons. It was kind of like being hazed to see if I would fit in to the store, but luckily I grew up with the show so I’m pretty well versed in Simpson lore. As a bonus, I threw in some Futurama quotes. The most awkward, and probably inappropriate, questions I was asked during an interview were my questions for the shift leader position at that same store. I was asked how I “should have responded” to situations that I had been involved in. It was like a mock performance evaluation (which I failed, by the way, because my answers were rather namby-pamby), and a test to see if I was in line with management. I chose poorly, apparently, because I didn’t get the position. I did get a position more suited to my abilities, though, and they made me Master of the Evil Back-Room Warehouse Dungeon Store Inventory Merchandiser.

4. Our own Ethan Trex runs a great site called Straight Cash Homey, the world’s only website devoted to random sports jerseys. I had my share of obscure player jerseys and t-shirts growing up: Yankee sluggers Kevin Maas, Jack Clark and Mike Pagliarulo come to mind. Did any of you own anything worse?

Nay. I never really collected sports memorabilia, except for that brief time in elementary school/junior high that I was into baseball cards because I’d seen The Sandlot eleventy-billion times (LOL FOR-EV-ER).

Now that I have a phone with sufficient. Capabilities, I can update from a mobile device. Let’s see if I actually manage to find time to update in my last weeks of grad school.

I SCARCE believe my love to be so pure
As I had thought it was,
Because it doth endure
Vicissitude, and season, as the grass ;
Methinks I lied all winter, when I swore
My love was infinite, if spring make it more.

But if this medicine, love, which cures all sorrow
With more, not only be no quintessence,
But mix’d of all stuffs, vexing soul, or sense,
And of the sun his active vigour borrow,
Love’s not so pure, and abstract as they use
To say, which have no mistress but their Muse ;
But as all else, being elemented too,
Love sometimes would contemplate, sometimes do.

And yet no greater, but more eminent,
Love by the spring is grown ;
As in the firmament
Stars by the sun are not enlarged, but shown,
Gentle love deeds, as blossoms on a bough,
From love’s awakened root do bud out now.

If, as in water stirr’d more circles be
Produced by one, love such additions take,
Those like so many spheres but one heaven make,
For they are all concentric unto thee ;
And though each spring do add to love new heat,
As princes do in times of action get
New taxes, and remit them not in peace,
No winter shall abate this spring’s increase.

Love’s Growth

I needed a nicer desk, because the one I had was nice but looked pretty horrific. It was a problem that not even fresh drawer knobs could fix. Unfortunately, I don’t start my new job for another two weeks (it’s part-time work to tide me over until I graduate in May and hopefully score a real job at a CPA firm) and funds have been tight since I cleared out my savings on my cat’s medical care. So rather than go out and buy a new desk and ship this one back to Goodwill, I’ve spent the past two weeks refinishing my desk. It’s a project I’d wanted to undertake since I got the desk about 5 or 6 years ago, but I haven’t had the time until recently.

My desk is a solid wood antique that I got from my neighbor before she defected to her home state of Michigan. It was a truly beautiful desk that someone had ruined with paint–and not just any paint, but several dozen layers of white exterior gloss paint, with a few layers of primer underneath. Imagine my surprise (or not) when I started stripping the paint off and found that it had been layered so thick I could measure it with a ruler. It took approximately 3.5 days of stripping and scraping and scrubbing with denatured alcohol and steel wool, plus several days of sanding, then waiting for the freeze to pass, then several more days of staining, before I’d finally finished turning it into something that looks like a real wood desk. To put that in perspective, it normally takes me a day or less to strip old varnish or paint off of a piece of furniture this size.

When I finally stripped all of the old paint off, I discovered that not only was the desk solid wood with solid wood bottoms and held together with old-fashioned tongue-in-groove or dove-tail joints and wood glue, I discovered that the drawer fronts had a solid wood veneer. Then I discovered that evidently the previous owners (before my neighbor) had decided they didn’t like the original drawer pulls, so they filled in the old holes (poorly) and drilled new ones. The drawer fronts are a little over an inch thick, though, so two of the drawers also had a larger inset routed out to accommodate the short drawer knob screws. I had to fill those insets with wood filler with the screw in place to refit the holes for the proper screw (#8-32 1-1/4″ cabinet knob screw).

I used Citrustrip, which is an all-natural citrus-based stripper, and it was very effective at removing the old layers of paint without ruining the wood. However, with all the paint, it did take several passes–trying regular BIX chemical ultra-enviro-killing paint stripper was pretty disappointing, and smelly, and it was pretty well ineffective at removing half an inch of old shitty paint. When I finally got the paint removed, I used water-based Minwax stain, and to achieve the dark mahogany color I layered Rosewood and American Walnut (using separate layers, and not by mixing the stains), and I had to use more stain to get an even color on the desk–first layer Rosewood, two layers American Walnut, then a layer of Rosewood and a final layer of American Walnut. The paint had soaked into the wood grain in some parts, and I was unable to sufficiently strip, scrape, or sand it off, so there are a few noticeable lighter areas on the back and side of the desk, but they’re on parts that aren’t readily visible. Rather than using polyurethane or some other heavy clear top-coat, I opted to use Tung Oil, which is a natural varnish. I’ve used it in other refinishing projects, and it gives a much nicer, more subtle finish to the wood. And, to top it off, I finished off the project with some new drawer knobs, which I’m going to burnish (later) with a gold/brass color to make them stand out against the desk.

Overall, I’m pleased with the results, and I’m glad I finally refinished my desk. In future projects, I don’t think I’ll use water-based stain because it’s too heavy for my tastes–it’s got a paint-like consistency and is more opaque than traditional wood stains. Because I had to add so many layers to blend the colors and mask the areas with paint remnants, the color came out much heavier, though it didn’t obscure the wood grain. It’s just not as subtle as I’d have liked it to be. Unfortunately, I forgot to take photos through the paint stripping process, though I did remember to take photos after I’d finished sanding. I was more concerned with trying to strip the paint off without going into a rage (seriously, who covers wood furniture in exterior house paint? why do people insist on ruining perfectly good furniture with ugly paint jobs?) I also couldn’t find a decent shot of my desk beforehand, but I did find a photo of my desk piled with school shit last year.

Anyway, here’s the complete photo set on flickr. Below are the before and after shots.

HIDEOUS BEFORE PHOTO OF DOOM:
DSC00177

AWESOME AFTER PHOTO OF AWESOMENESS:
DSC02369

Also, as an update to my previous post about my cat’s eye problems, I managed to get a photo of him trying to find some wildlife to eat after the freeze. Naturally, he was not amused at my intrusion (though I’m pleased that he’s doing much better). Now, though, he only goes out when I’m around to make sure he doesn’t get hurt. He does okay by himself, but he’s old and he’s only got one eye and poor depth perception–which hasn’t stopped him from fiercely attacking any living thing he finds in our back yard. I love my angry pirate cat.
DSC02357
(The freeze chased off all the wildlife, so he was greatly aggrieved that there were no small mammals for him to eat terrify “play with”.)

Well, it’s a new year, and Rebel Yell is shifting gears. Evil Dwight managed to convince me to go to work for my old arch-nemesis (just kidding) The Houston Chronicle, and I’m now blogging on politics as a moderate, independent–just where you’d hope an accountant would be, right? From here on out, all of my well-thought, carefully crafted political posts will go to Political Accountability, my new Chron blog.

With my last semester of grad school coming up, and my job search getting more attention, I’m going to finally–finally–start reworking my website, and hopefully start posting more in Rebel Yell. I say that every year, but this year it’s more important, and it’s actually going to get done.

DSC02238

This is Tetsuo. I’ve had this cat for nearly 13 years–he was a surprise find in a local (now closed) pet shop, a mellow, laid-back kitten who grew into a 19 lb. miniature jungle cat. He’s a pretty special cat, and we’ve been through a lot together since we first brought him home, a few weeks after my brother came home from the hospital after his accident. On Christmas Day, Tetsuo lost his eye to an infection.

In mid-October, I noticed that his left eye was cloudy and leaking a large amount of greenish-tinted clear discharge. I rinsed it with eye wash, but since it was the middle of a hectic semester I left it for a few days while I finished up mid-terms. Finally, I took him to the vet about three days after I first noticed it, only to find out that he had a corneal puncture that had ulcerated. To save his eye, we went through an aggressive conjunctival flap treatment.

The conjunctival flap is a process by which the cat’s third eyelid is pulled down and sutured into place. Since a cat’s cornea is essentially a clear film that is cleaned and supported by the cat’s tears, and it has no real blood vessel structure to it, any corneal woulds can quickly become infected without any means of healing in the way skin heals. If the puncture is caught quickly enough, a round of antibiotics can be given to prevent infection and ulceration. If it’s not caught quickly, the conjunctival flap procedure can be performed. The procedure brings the flap of flesh down over the puncture, which allows blood flow to reach the cornea and promote healing. It’s a very aggressive (and expensive–close to $1200 dollars for the surgeries and medications) treatment, and usually it works. Unfortunately for Tetsuo, it didn’t, but that wasn’t something we’d find out until this past week.

Just about two weeks ago, after about six weeks of having the flap in place, the vet peeled back the flap to expose the eye and allow the flesh to recede from the cornea. At first, Tetsuo’s eye looked to be healing, and it was progressing pretty well–there was a crescent of eye starting to peek out above the fleshy part, and he was obviously getting light through. However, a few days later his appetite started decreasing, and by Dec. 24 he had stopped eating altogether. I checked his eye to find that he had a large crust over flesh, and when I flushed the eye it began to ooze. By the end of the day it had turned to a blood-flecked ooze, and by Christmas morning he was lethargic and the eye had crusted over again. I took him to the emergency vet and after cleaning the eye they found that the ulcer that had previously been covered by the flap had ruptured again and become infected, which caused the interior of the eye to ooze out. Unfortunately, Tetsuo had to lose the eye, and after a final emergency surgery, he started to get better.

All told, I’ve spent close to $3000–pretty much my entire savings–on my cat. It’s a small price to pay to keep my best friend healthy, and some people may have opted to put an old cat down. But Tetsuo has been my friend for nearly 13 years now, and he’s an otherwise healthy cat with several years ahead of him. He carried me through some tough emotional times, and he’s been a faithful companion, so this was a worthy expense. I’m dreadfully broke now, but for me this is something far more priceless than any other luxury on which I might have spent my money.