daisyblog

A little bit of background might help give some context.

In 2023, I've been on Wellbutrin for about 8 or 9 years, at various doses and formulations. I was first medicated for depression at about age 12, with sertraline (Zoloft), after first becoming suicidal at around age 10 or 11. It stopped being very effective within a year or two, and I began a common journey of being a young person on an endless revolving door of different medications and cocktails; Prozac, Lacmictal, Lithium, Effexxor XR, Geodon, Abilify, Zyprexa, Ativan, and probably some things I don't remember, all before age 18. I experienced a range of side effects and contraindications: Zyprexa caused me to quickly gain 40 pounds and made my cholesterol very high when I was about 15, and it probably only didn't give me diabetes because I was already quite underweight at that time (Zyprexa would later be in legal trouble for off-label and other unapproved uses which caused severe weight gain, diabetes, high cholesterol, and heart problems in patients, especially those under 18...oops!); Geodon contraindicates very badly with something I was taking at the time (Zyprexa or Abilify), which my prescribing doctor did not inform me of when he added it to my cocktail, and I spent several days throwing up and unable to eat or take medications - I was about 16 (i think this was probably when my disordered eating started getting serious, and I quickly lost the weight I gained on Zyprexa - but that's a post for another time); Effexxor XR caused all manner of issues, particularly making orgasms difficult or impossible, stomach problems, and its extremely short half-life caused brain-zaps if I took it even an hour late; occasionally I would have spasms/seizure-like symptoms on Effexxor, especially if I had had any amount of alcohol and sometimes with cannabis. I was about 18 or maybe 19 when I eventually got off all my medications, probably without adequate supervision but by this point I was very interested in psychology and psychiatry so I likely reduced my medications somewhat responsibly (that is, not quitting anything cold turkey, as with most psychiatric drugs this can cause problems, sometimes severe or life-threatening ones). I was still suicidally depressed and debilitatingly anxious, but at least now I was able to cum and I could more safely smoke weed and drink my sorrows away without having a seizure, like my peers. *cough*

I spent a number of years in my late teens and early 20s without any medication, opting instead for a lifestyle of good old fashioned silly debauchery, including aggressive alcohol abuse and occasionally other drugs like ecstasy and cocaine. It was a bit "sex, drugs, and rock n' roll" for several years. Alcohol was the drug of choice as it was cheap, easy to get as I had older friends, and was sufficiently numbing of my anxiety and inhibitions and helped me dissociate. The ecstasy and coke were occasional treats which I enjoyed liberally when I did use them, but were never really problem drugs for me oddly enough. I did however realize that my drinking was kind of off the rails, affecting my general health and my work as well. I got sober from alcohol before my 21st birthday.

Fast forward a few years to about 2015, I was 24, trying to live on my own in an apartment with my then-partner, and cripplingly depressed; living in a different city, job transfer fell through, i wasn't eating much, wasn't moving much, not socializing, not working. I was honestly disabled. I had a few breakdowns and went back to therapy and started seeing a psychiatrist, partly to attempt to save my relationship, and got back on medication: Wellbutrin to start, as I was very averse to taking any medication again. It was like night and day, I had energy and was able to get out of bed and do some things. My entire body was extremely sore for a few weeks, because I had been sedentary for so long and the Wellbutrin gave me more than a trickle of energy. I was able to get a job (though I was never able to work a full-time schedule, maybe a post for another time). I still had persistent symptoms however, so eventually I got on Zoloft (again, more than 10 years later). The Zoloft affected me very strangely, and overnight. They say it usually takes about a week or two to really see improvements, but I just really went to sleep one night and woke up kind of a different person. Again, I was never fully functional and my depression never REALLY went away, but with Zoloft I was calmer, more at-ease, and had absolutely no sex drive, which didn't do wonders for my already strained relationship. I was also intensely dealing with a lot of unhandled early-life and ongoing trauma at this point in a therapeutic setting, and the medication made this actually possible to do effectively. After maybe a year or so I got off the Zoloft because I wanted to have a libido and I was tired of having no meaningful feelings. That was about 5 years ago. I stayed on the Wellbutrin, specifically buproprion XL, at either 300 or 150mg. I had also been taking Ativan (lorazapam) as needed for sleep and anxiety for over a year. My doctor had told me that it was "non-habit-forming," and I have no idea why he said that because it is a benzodiazapine which are known to be extremely habit-forming in fact. I only considered there might be an issue when I went several days without taking any at all and noticed that I felt strangely similar to when I was quitting alcohol. (Interestingly, I learned that the benzo addiction and alcohol addiction and their respective withdrawals are apparently similar in terms of of their chemistry.) I began taking hydroxyzine, which is like... a different kind of benedryl: a hypnotic anxiolytic and sleep-aid, antihistamine, and anticholinergic, and unlike benzos they actually are non-habit-forming.

So now, years later, at 32, I'm thinking once again about the possiblity of going off my medications. 8 years is a long time for any medication. I have still had mental health issues during this time, but their features have changed quite a lot over the years. I mean, I've done a huge amount of heavy-lifting in terms of trauma therapy for one thing. I'm just a bit older for another. Much of what I deal with now seems to be the ongoing anxiety, nightmares, sleep issues, anger/irritability, and stomach problems, in addition to various aches, pains, fatigue/lethargy, gender dysphoria, and disordered eating. I've gained about 50 pounds over the last 2 years (floating between 145-155, up from about 105) dealing with the disordered eating, again maybe a post for another time because that is a whole-ass thing.

It's kind of silly but a lot of things seem to change as you get into your 30s, and it's hard to explain, but the experience of having been alive for 30-something years is different even than being alive for 29 years (which is of course different than being alive for 25 years, and so on). Life just goes on and people are changing the whole way through. The world is changing the whole way through. I suppose it could be possible that this medication simply affects me differently now than it did even 2 years ago, or rather that my body just handles it differently now. Even without the weight gain and the addition of food into my life, simply getting older can apparently really affect how you respond to medications of all kinds. Or maybe it always affected me in these ways, but now that the symptoms that I've been treating have shifted somewhat, the less pleasant side effects are more obvious and less tolerable.

Lately, I've been forgetting doses somewhat frequently, or waking up late and realizing that I'll once again be up all night if I take Wellbutrin XL at 11am and so choosing not to take it. This is an irresponsible approach to medication, and with other medications can be dangerous. In the past it has even affected my mood, causing me to get extremely depressed and unstable. I have also had a recent period of taking it religiously which lasted several months, and still regularly get grumpy and depressed. However this latest stretch has me noticing a few things. Firstly, on the days I don't take it, I sleep better. I get sleepy earlier, I fall asleep faster, I have fewer nightmares, I toss and turn less, and I wake up less anxious. I'm calmer, less anxious overall, less racing thoughts and outsized worrying. I've noticed that on the days I think of self-harm, it's on days I HAVE taken the Wellbutrin, and days that I DO have racing thoughts and anxiety rather than when I'm feeling "sad" or "suicidal."

Some time ago my previous psychiatry clinic informed me that once again the provider I'd been seeing (remotely) was leaving and I would need to make an appointment with a new provider. I took the opportunity to look for a new provider closer to my area instead because, well, I fuckin hated that clinic and wanted to leave for a few years anyway (lol). So... I made the new appointment, and I started being more generous with the days I skipped. A past psychiatrist had informed me that Wellbutrin is generally alright to take every other day, especially when someone is trying to taper off or a minimum dose is still too high. So I thought, why not take 300mg every other day until I see the new psychiatrist in a few days?  So that's my new project because to be honest, I feel exhausted taking this medication. For being as relatively benign as it is, I'm starting to feel how hard it is on my body. Maybe a stimulant anti-depressant isn't what's needed anymore. Maybe rather than depression being the primary problem, maybe it's the anxiety, the panic, the fears and obsessions. Maybe I need some fuckin rest and a bit of detox, and to not have a dry mouth and skin, and to have a better appetite so I'm not fighting a battle just to eat a subnormal amount of food. Perhaps I need to be more honest about what's bothering me, and that those things can't be medicated away: that the world is fucking horse shit, that I will always be anxious and depressed as long as I live in an oppressive nightmare-hell of surveillance, hate crime, violence, inequality, endless wars, and relentless exploitation by a monied ruling class. Medication won't cure me of being probably autistic: of being overstimulated and overwhelmed or confused at times where others are not, of seeing patterns and connections others aren't seeing, of social dynamics being painfully uncomfortable and weird, of having intense special interests and passions, of my sensory and autoimmune experiences that are just not quite typical, and a strong sensitivity to injustice, unfairness, having a moral compass I can't generally ignore or compromise even if it would benefit me to do so. But maybe it would be good for me if I wasn't exhausted from being artificially energized and agitated all the time.

It's an ongoing line of inquiry. As I said, I will be seeing someone about it again very soon, as even I know it's unwise to make drastic decisions about medication without supervision. Just the idea gives me some excitement and optimism, feelings that haven't always come to me very easily.

**Updates**

(01/06/2024)

Happy new year!

So, I started writing this about 2 months ago. Just a few days after, I started taking a prescription of 150mg of Wellbutrin everyday for about a month, at which point I had another appointment where we agreed I would take 150mg every other day for another month. (She also told me to cut my extended release Wellbutrin in half, which you EXPLICITLY CANNOT DO because the pill is physically designed to EXTEND the RELEASE of the drug, and if you cut through it, it will IMMEDIATE RELEASE which is BAD. I told her this and she frickin Google'd it and agreed with me. So uh... luckily I'm an "over-informed patient," I guess.) I followed through on that for about one week, and then I started missing doses on accident. Rather than deal with the consequences of inconsistent dosing, I just said "Fuck it" and stopped entirely. 

So... i've been medication free for almost one month now. And, well.... I feel fine? Most of the time I feel good, even. I've continued being overall less angry and anxious, I'm less overwhelmed by things, and food is less repulsive (though I still struggle with my appetite sometimes). I'm a bit sleepier, but the holidays just ended and that always leaves me very exhausted, as does my period, so honestly I haven't noticed any major drawbacks so far. This has been a really good move overall, and it's one less thing I need to worry about, plan for, or recover from when i fuck it up every now and then. It should take another month to be "fully" rid of the drugs and we'll see how it goes, but the outlook seems pretty good. Being on meds didn't solve all my problems, and neither will quitting meds.

I'm still traumatized and autistic and I probably will continue as such for a long time, and that's not a bad thing. Very recently, I have noticed that I haven't been feeling "great," I've been quite grumpy, lonely, tired, and well, a bit sad. I had one night where I just cried a lot, about all manner of things. I have a lot of grief about a lot of things in my life, and honestly, I'm stressed and mad about all the things I'm usually stressed and mad about, just a bit more intensely: climate change and pollution, poor air quality, white supremacy, patriarchy, ableism, anti-queerness, misinformation, capitalism, policing, surveillance, and healthcare and insurance, and that's good actually. I think there is something wrong with YOU if you're not stressed about those things, and you should perhaps seek professional help and possibly medication to help you have more empathy, compassion, and a sense of urgency to see these problems solved. And that's about all I have to say about that.