Opening Up About Antidepressants

I have always been a crier. It’s how I cope when I’m upset. Some people are shouters. Others storm off in a huff. Shutting down and not dealing at all is another option. A good cry helps me let go of pent up emotions and move on. I have always found it to be a release. I feel better and stronger after I’ve cried my eyes out. I’ve cried in private, on the phone, with friends, while driving, at oncology, and in a public place or two. It doesn’t take much to open the flood gates.

Antidepressants have controlled the flood gates more effectively.

Antidepressants balance neurotransmitters in our brain that affect our emotions and mood. We cry less. They can improve our sleep, increase appetite, and promote better concentration. These are all improvements over being depressed. I’ve learned they also can be used to treat anxiety and panic disorders, obsessive compulsive disorder, as well as physical pain like fibromyalgia.

I am all for less depression. Honestly though, I never thought crying was bad. I still don’t. I’m friends with my tears because I know how they work for me. I never have been in favor of stunting my emotions. I want to feel my feelings, happy or sad. After I cry, I feel better. Crying helps me work through feelings and gets me to where I need to be.

My first experience with antidepressants was seven or eight years ago. My initial treatment for metastatic breast cancer was finished. I was back teaching. My mother had died from MBC. There was other family stress. I was an emotional mess inside. Everything was just too much for me. My oncologist thought I had crossed the line from between okay and not. I had asked and I agreed. I don’t remember what the drug he prescribed was called because I only stayed on it two days. I remember sitting on my couch the entire weekend staring blankly into space. I didn’t move. All my thoughts were in slow motion. I’d tell myself I needed to get up to do such and such and it would take hours for me to move. I didn’t want the rest of my life to be like that weekend. I needed to enthusiastically teach and respond to twenty-something second graders the following Monday. Off the drug I went. It wasn’t for me. Reflecting back, I needed to give it more time or adjust the dose, but I wasn’t willing to try. I’d rather cry and feel what I needed to feel, thank you very much.

Timed passed. I learned how to manage. I knew where I could get support. I knew which friends I could lean on a bit more when feeling upset or out of control. Life felt normalish. I would cry because that’s what I did. If I cried every day, that was normal for me. It passed and I felt better. I thought it was normal to cry so much because that’s what I did.

It was suggested I return to Taxol when I needed to change treatments for metastatic breast cancer in December. I developed moderate neuropathy when on it back in 2012 for my initial treatment of Adriamycin Cytoxan+ Taxol. I regained some of the feeling in my feet over time, but that feeling of tiredness and numbness never left completely. I learned to ignore it and worked on my movement and balance. I wore comfortable shoes that pampered my feet. I loved foot massages to stimulate feeling. I had gotten to a good place with my feet when returning to Taxol was suggested. Neuropathy was of course one of the potential side effects I felt was almost certain I’d see as it had already happened once. I did not want that to happen again and didn’t know if I could endure it again. It would be worse than the chemo itself. I’d experience more loss as pain free movement would be greatly diminished.

Apparently, I have an oncological pharmacist at UW Carbone that I never knew I had. She is fantastic from all my conversations with her on the phone and through MyChart. She suggested Duloxetine, an antidepressant commonly known as Cymbalta. It has been found useful in preventing neuropathy. I was in. I didn’t want to do an antidepressant because of my previous experience with one, but avoiding neuropathy was a deal maker. I’d been looking for an answer to this permanent side effect for years.

I started in December with a low dose 30 mg for a week and then progressed to the regular dose of 60 mg. A Saturday came around that marked about two weeks of being on Duloxetine. I remember realizing I felt relaxed mid-morning or early afternoon. I was having a pleasant day. It took me most of the day even to settle that this foreign feeling was indeed relaxation. I could feel it especially in my shoulders. They weren’t tight or tense. It felt like I had taken a Lorazepam and I hadn’t. I decided it was me and I must be doing something right, be it sleep, exercise, nutrition, or a combination thereof. Good job, Me!

The next morning it hit me that it was the antidepressant when I went to take it along with all my other medications and supplements in my personal pharmacy. I felt disappointed that it was the drug causing the change and not my own doing after all. Sunday continued to be just as relaxed as Saturday. Relaxation and happiness was a foreign feeling. I checked the calendar and yes, I had been on Dulox for about two to three weeks. It had kicked in and its effects were obvious.

I didn’t expect I’d feel happier on Dulox. I did. I laughed more and did not get rattled at appointments. I didn’t feel doomed. It’s been an unexpected benefit.

It’s having the desired effect I wanted – neuropathy has been kept at bay. It’s the three-month mark and my feet feel pretty much the same if not slightly better. I will stay on this drug as long as I keep getting this desired result. I am very happy for my feet. Hand-foot syndrome had tortured them over summer. Not having moderate to severe neuropathy means just about everything to me. I need to move.

Dry mouth has been a less enjoyable side effect. Some days are worse than others. It has not helped my sleep. I also wonder if it’s removed a filter. I blurt out opinions too freely that I once only said in my head. Most aren’t awful or particularly hurtful. They are bluntly honest. It’s probably more due to freely offering reactionary opinions to the TV too much during a pandemic when I’ve gone without conversation.

A stigma of silence comes with taking an antidepressant. I had told only two people I was taking one before sharing it here. There’s an unspoken message that you must not be tough enough to manage life’s challenges without help, you have a mental problem, that you are somehow more fragile than you were a moment ago before this news was shared. I’m still pretty quiet about it, as I am with the other medications and supplements I take. It’s private information. I also feel embarrassed. I don’t feel embarrassed when I take Ondansetron if I feel nausea, or Metformin to regulate glucose levels. The difference is those are meds for physical needs. There is nothing for anyone to feel embarrassed about if they take medications for their mental health. Forget that I’m on it for neuropathy. I don’t think people will associate it with that need. It doesn’t matter. I know what I need. We all do. If we need an antidepressant for whatever reason, we need it.

It’s interesting though how many others I’ve learned take antidepressants. The teaching field has more teachers than I would have guessed who have a prescription for some type of support. Is that normal? How does it compare to other professions? I don’t know. What is harder about life today than when our grandparents lived? Is use more prevalent today simply because these drugs are available? The answer to that last question is undoubtedly yes.

What has happened to my tears? The first time I cried after starting Dulox was on January 26th. It was a good month after starting the drug. I was missing my mom. My cry didn’t last long and amounted to a few crocodile tears rolling down my face. It sounds strange but crying made me feel happy because I was still able to be sad. I had worried I’d never cry again or be able to experience normal emotions. I have cried a few times since then, but it isn’t the same. Now I worry there is something wrong with me because I worry about not crying enough. Feeling emotionally flat is another side effect many experience. I mentioned crying helped me work through feelings and took me to where I need to be. If I cry less, I still need to work through feelings and wind up at the right place emotionally.

I have a few issues and that’s okay.

Neuropathy isn’t one of them at the moment. I’m going to take that as a win.