Xanax

In 1996, my general practitioner of one year, prescribed me .25 milligrams of Alprazolam, generic for Xanax. I had no clue what a Benzodiazepine was or even why I needed it, really. My doctor said, take one a day along with the Prozac I had been taking. I did as I was told. I was eighteen, I was a nervous wreck, what’s it going to hurt?

Let me tell you what hurts: depression. I did not know about sadness and depression until I was 21 years old. I can not medically or scientifically prove this; but, I am 90% sure Xanax introduced depression to my mind and brain chemicals. All drugs are different for all people, this goes without saying, however in my experience and now speaking with a better pharmacological understanding of the drug; Xanax is extremely effective in managing panic and anxiety but with a slight come down after its half-life (length a drug stays in the body) which can be from 11 to even 40 hours. While in your body, only a few hours are devoted to blocking the dopamine that is causing anxiety, so the rest of that time in the body and brain it is slowing everything down. And slowing so gradually, that you do not immediately feel the ‘come down’ for lack of a better word.

At 22, I began drinking alcohol pretty frequently, as most college kids do, only I can no longer remember a lot of those years. I have the highlights, but zero details. The depression was cyclical then, and the anxiety was constant so the Xanax had to stay, I felt. And, my doctor continued to prescribe-explaining the proneness to black outs when mixed with alcohol. I was warned, but given no alternative or any discussion of addiction. Zero. Also through those years I was switched to multiple different SSRI/anti-depressant drugs (the Prozacs, the Paxils, the Zolofts, the Cymbaltas, the Celexas, the Lexapros, the Luvoxes) which meant basic emotional and physical hell for every pill I had to ween off and every pill I had to ween on, wash, rinse, repeat. For years! If you’ve ever been on the Tilt-A-Whirl or the Grav-A-Tron at a fair or theme park; just imagine that feeling right when the ride starts and right when it stops repeating over and over, with no reprieve, and, you’re not on a ride. You’re in your every day life, with the very stressors that have you on the medicine. It’s the cruelest Catch 22 ever put into play.

By my 30th birthday, I was no stranger to depression and still suffered with severe anxiety and less, but still present, panic attacks. Add a dash of PTSD, due to the Hurricane and I was on a lot of medications. My Xanax dosage was up to 1 milligram as needed, because of course, your body gets used to the drug and then you need more. And, the doctor gives them to you and sends you on your way. I’d had therapy on and off, its importance not as harped upon as the drugs and for a few years uncovered by insurance. But, I was getting all the help I could and I was still suffering. My marriage was suffering because I could not work due to deafening negative thoughts, only curbed by sleeping. The breaking point was going to the Intensive Outpatient Therapy my clinic and my insurance offered, and my psychiatrist pretty much insisted.

Intensive Outpatient is a three week group therapy, individual therapy, homework, 9am-4pm, job working on yourself. We had a nurse on-hand, and two psychiatrists oversaw our progress and prescribed and altered medications more directly. It seemed like a really important place for me to be. I benefited greatly from the therapy and the group (see entry COMPASSION for more) and the program really helped me figure out some healthy coping skills. I had gotten so bad, that when I was in that dark, sad place I had to feel something else. Until then, I never understood self-harm, but I dug my fingernails into my forearms until they bled–so I could feel different pain than I felt, even if just for minutes. It is embarrassing to admit, but I have to say it, to say that the alternative I learned in that program has saved me from the shameful act of inflicting pain of a different kind on yourself to gain some semblance of control. Ice cubes. Put an ice cube in your hand and squeeze. Sometimes I use both hands. It hurts and your mind is seared with a very different kind of pain, and, when you are ready to drop them, you are ok.

I made it about two months after the Intensive Outpatient ended. I had my ice cubes. The doctor had upped my Xanax to 2 milligrams twice a day, yes that’s 2 milligrams. Yet, I still felt the urge to run as far away as possible. I would hold my breath, defying my body’s innate defense to smothering oneself. I cried. I worried. I took all the medicine as directed and I still cried and worried, felt sick, exhausted, doomed, worthless. My husband came home to me sitting at the coffee table with all my medicine bottles on the table and a bottle of Fiji water. Just staring at it all. Needless to say, I was in the Intensive Inpatient Treatment the next morning, for more help.

By day six of my second round of group therapy, the doctor had me up to 3 milligrams of Xanax…wait for it…twice a day. They’d added another SSRI/anti-depressant, I have blocked out the name of it. It was horrendous. I felt completely done with everything that was happening to me. Pulled out of group therapy because of my obvious tremors, I went to the doctor, with just an insane amount of fear inside me. I could tell these professionals did not seem to know what to do next. Scared doesn’t even cover how I felt when he looked at me and said, ‘it’s time.’ Dazed, yet shaking like a leaf with panic and nerves, I ask, ‘for what?. I can not remember any movie I watched from the age of 29 to 31, thanks to doctor- prescribed Xanax, but I will never forget the words that came out of this doctor’s mouth.“You have to go to rehab, we have you on too much Xanax, and in order to take you off, we must monitor your vitals 24/7 and withdrawal can be very hard for some.”

 

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Diagnoses

In my family, you go to the ‘lady doc’ when you hit eighteen or when you start having sex. Both happened for me at the same time, so I had to make the dreaded appointment. A doctor was going to be poking around my hoo-hah and getting some type of smear. Smear is just the worst of words. Ew. I did not want to be smeared.

This is well before cell phones, so no pleasant distractions in the waiting room besides eavesdropping on others and in the hoo-hah doc, it’s all whispering so you have to hone your ears and sit close to your target. I try to take my mind off the fact that a doctor is going to probe me, but to no avail, and the anxiety hits. Mack truck slamming into your clueless, stationary body making it a shaking, sweaty mess of anxiety.So, within minutes I had to poop. You know what is more fun than having a poop-inducing anxiety attack in a public place that you can not leave? Having a poop-inducing anxiety attack in a public place that you can not leave and doesn’t have a bathroom.

I got to the bathroom and anxiety pours out of me as I remember someone is about to be in that very area, up close. Inspecting it. Post poop! I wanted to die a thousand deaths. I wanted to run out of the bathroom and not stop until I reached my bedroom. I wanted to never be inspected! But, just as the jelly legs subside and I am physically able to move again, the nurse knocks on the door saying ‘we’re ready’. Yeah, y’all are not about to be spread eagle for inspection, of course you’re ready. I was no where near ready, but at that point I knew I never would be and knew I couldn’t stay in their restroom for the rest of my life, as much as I wanted.

Easiest part of the visit…being spread eagle and inspected. My doctor was fast and worked with ease and a sense of wisdom. Almost no discomfort. Hardest part of the visit…my first diagnosis. The first of many, many similar conversations happened while I was being probed. She was making small talk to take my mind off of the probing and of course small talk with me led to an hour of me explaining my thoughts and feelings, openly and honestly. And then, as she was labeling the smear tubes, she tells me, ‘you have Generalized Anxiety Disorder and seem to be borderline Agoraphobic.’. I did not know what agoraphobic was, but I knew what phobic meant and that I felt phobic about a lot of things. And, now I learned one more new thing, I learned that being naked and probed and smeared is easy compared to a diagnosis like that.

During the clothed part of the visit, she explained the anxiety disorder and told me that my fear of leaving home, my stomach aches at restaurants with lots of people and my general fear of the public was an actual chemical imbalance in my brain chemistry that would last forever, but could be altered with medication and make me feel more ‘normal’. Well, I thought I was normal. Until that moment, I assumed every human got a stomach ache before school and felt sick or uncomfortable a lot of the time. I had no idea people were walking around not obsessing about where there might be a bathroom, or how many people might end up in the store they’re in, checking for exits and always thinking of a way to excuse themselves quickly and successfully.

In the 21 years since, I have been diagnosed with the following additional mental illnesses: Post Traumatic Stress Disorder, Severe Depressive Disorder, Acute Anxiety with Panic, Major Depressive Disorder, Borderline Personality Disorder. But, what I feel like my diagnoses should’ve been was guinea pig. I have been put on and taken off more medications than I can count. Doctors have tried to balance my brain chemicals without ever looking at my actual brain for my entire adult life. Now, I say, diagnose away–I still have to live this life in this brain. Diagnoses change nothing.