
Long-time readers of this blog will know that SSRI anti-depressants transformed my life, beginning in 1997 (so, for 15 years now). Prior to that point, despite eight years of intensive pyschotherapy, I suffered from clinical major depression and lived much of my life wanting to kill myself.
Yes, it was that bad. There was plenty of circumstantial reason for it between the ages of 3 and 35, but major depression also runs as a biochemical streak throughout generations of both my mother's and my father's sides of the family. Double, triple, and quadruple whammies.
Successive pharmaceutical intervention made all the difference. It leveled the psychological playing field for me so that I had a chance to apply the tools I had learned in therapy and to transform my life. It then allowed me to maintain that transformation and to move on to living a productive and reasonably successful life.
Thankyouthankyouthankyou. I should live my life constantly on my knees in a state of perpetual gratitude, and most of the time I have the sense to know it.
So I'm a lifer on antidepressants. They require tweaking from time to time as my body becomes overly used to one and it stops being effective, but so far that's been manageable. Without these medications, I'm convinced that I would be long dead. They're as necessary to me as oxygen. Case closed.
My two other life-long ailments, in addition to major depression, have been insomnia and anxiety. All three are somewhat related, of course -- at some times more than others -- and I do understand that. You can't have had as much therapy as I or researched meds as much as I without knowing these things. At the same time that I was initially treated with pharmaceutical intervention for depression, I was also prescribed successive medications for anxiety, mostly on an as-needed basis. And a few years ago I began taking occasional, as-needed prescription meds for insomnia.
And yes, in case you're wondering, I also understand that exercise and meditation help improve insomnia and anxiety (they don't do shit for my experience of untreated major depression, but off meds for that, I am very, very ill and can barely move out of bed ... so that's a separate issue) . Activity and meditation absolutely do help mitigate some of my sleeplessness and stress. I am very consciously trying to incorporate more activity and meditation into my days, even in little ways, and that helps. But right now? They're not enough. Just saying,
At the same time, however, I'm not convinced that I want to take the sleep and anxiety meds anymore.
In fact, I've been taking the two medications I've been prescribed for them less and less frequently -- although I still suffer from insomnia (more than ever -- thank you, perimenopause) and anxiety (mostly what I experience now is a lot of day-to-day stress, which is a little different from outright anxiety and certainly from panic attacks, the vast majority of which have almost totally disappeared from my life).
Why don't I want to take them any longer? Because frankly, they feel like overkill -- even when I decrease the recommended dose. They just feel like too much, particularly the next morning. Each one feels like too much as a remedy for whichever problem it's intended -- i.e., insomnia or anxiety.
Now, an alcoholic beverage helps with the stress at the end of the day -- but I come from a long line of alcoholics on both sides of the family as well, and medicating with alcohol is most definitely Not a Good Idea for me. I have had a stressful year on the job, I have been drinking more as a result, and it just doesn't feel wise. What might be perfectly okay for another person is not okay for me -- not where alcohol is concerned. So ... no.
All of which brings me around to medical marijuana (I live in California where, if you qualify for it, it's legal) and the reason why I decided to discuss the matter with my prescribing psychiatric nurse. Wouldn't you know it, she's opposed to it. In rather knee-jerk fashion, I might add. On the grounds that pot can be laced with all manner of other substances, blah, blah, blah.
"Well, I'm talking about the idea of getting it from a regulated dispensary," I said. "Not off the street -- and of using it instead of the two meds you're prescribing now, not in addition to them, and only on an as-needed basis, not for recreational use."
Her answer: "Well, I don't prescribe it."
Sigh. "I'm not asking you to; I simply want to have an informed conversation about the issue." But that obviously just wasn't going to happen with her. (She's not my regular prescribing meds person; unfortunately, he's on temporary leave.)
Flash forward a week or so: I met with her antithesis -- a female doctor at a marijuana-friendly clinic --discussed my records and meds with her, and within about half an hour, I received a one-year card certifying me for medical use of pot. And then I located an upscale dispensary, near my former therapist's office, and, uh, availed myself of its services. ("Do you have a mix that's particularly good for anxiety? What about insomnia? I mean, really targeted stuff?")
To be honest, the pot doctor was as knee-jerk positive toward marijuana as my meds nurse had been opposed to it, so as with all health matters, it seems to me that one absolutely must do one's research and due diligence and make an informed decision. I have an appointment with my regular internist tomorrow and am giving her a list of my meds, including the pot, to review them with her. She and I have a 12-year relationship and work well together, and I want her to know what I'm doing. She may or may not like it, but her input will be valuable, and she oversees all my medical care.
And, after reading and talking with people, what I think I've decided -- for me, for now -- is that I'd prefer to ditch the prescription sleep med except for completely sleepless nights, reserve the anxiety med for panic attacks only (which I almost never have any longer), decrease the alcohol, up my activity level, and make very light use of pot (a hit or two but not to the point of being stoned because that feels yucky to me) every now and then when stress or insomnia strike hard.
I'm not about combining different substances, by the way: a little alcohol, a little pot, a few prescriptions meds??? Recipe for death. It's important to keep them separate.
Pot is shorter-acting than the prescription meds, it doesn't leave me feeling hung over as the meds can, it's legal in California, I'm now I.D.'d as a medical patient for it, and I can afford to get it through legitimate, regulated means.
Er, the one flaw in this plan? I don't much like marijuana. Seriously. I don't care for the smell. And I hate the experience of smoking. Ahem. I know, right?
We'll see. There are various ways to ingest the substance that mitigate the smoke or don't require smoking at all. I do know that one or two hits do/does work for me, and the help-you-sleep varietal really did its job well the other night without leaving me with a medicated feeling the next morning. So ... I'm willing to explore this option for now.
Carefully, I might add. I realize I'm protected by my medical card in this state, but still. I don't exactly want to walk into a local head shop or dispensary and be greeted with "Hi, Professor HD!" Any shopping will have to be done in another town!