The Joys of Tegretol Withdrawal

This is NOT my typical style of blog—which is to say, it’s NOT really written to “entertain.” In fact, I’m not entirely certain why I’m even writing it, but one possibility stands out: that maybe I should just share a little recently gained insight. Maybe it will help other people understand a subject that most people probably don’t—depression.

I was diagnosed with depression years ago. This came as a surprise to no one—it seems to run in my old man’s side of the family. HE certainly had it, anyway—he even underwent electroshock therapy in his forties, a time of life that I myself have recently entered into, and at one point he even got rid of all of his guns just in case the depression simply became too strong to fight—and I strongly suspect that many of the other members of his family had it too, such as his little brother (whom I barely knew and he never got along with) who died from a heroin overdose when I was 20 or so. Today (as for many years now obviously) my dad is on Prozac (which he has said to me before, and again a couple of days ago, was maybe the best thing to ever happen to him) and some other drug that I can’t remember right at this minute. I myself was on Prozac for a few years, but of course when I lost my job, and thus my insurance, I lost that too—and I REALLY don’t remember it making much of a difference to my mood anyway, either when I STARTED taking it or when I STOPPED taking it. But of course, I was drinking like a fish—an ALCOHOLIC fucking fish at that—and indulging in various other “party favors” at the time, so maybe that helped to hide the changes.

I took my last Tegretol last Tuesday (the 20th). In the space of two months I went from 800 mg a day, which some (like the doctor in the emergency room) would consider a large dose although I HAVE heard of even larger ones, to zero by dropping one 200 mg tablet a day every two weeks—in other words, I started at one pill in the morning, one pill at noon, and two pills at night but dropped it to one pill at morning, noon and night, down to one at morning and one at night, down to one in the morning until...well, you get the picture. My only concern at the time was that I may have some seizures and have to go back on the shit—however, so far so good on the seizure front. HOWEVER, Tegretol has another benefit to it that was unbeknownst to me—in addition to stopping seizures it is also occasionally used as a mood stabilizer and depression aid. And my CURRENT doctor didn’t know about my depression—it was another doctor in another clinic, back when I had insurance, that made the diagnosis and prescribed the Prozac. I just kind of assumed that he (my current doctor) had all my medical records and was aware of it. So as of that moment, for the first time since I started partying at 15, I was completely free of not only any mood stabilizer-type meds but also of any alcohol or pot or speed or anything else that affects mood or releases endorphins, the chemicals that make people feel pleasure or happiness.

After I had gotten down to taking 1 pill a day for a few days I began to feel pretty lousy: I had no energy nor desire to do anything but lay around, plus my stomach was always hurting, or at least I ASSUMED it was my stomach—it also felt reminiscent of when I would get hepatitis during my drinking days, just a deep, throbbing, unending pain in the center-right side of my abdominal area (which is where the liver, as well as the gall bladder, is located). However, I didn’t really think it was liver-related, since the doctor has run zillions of liver panels on me (to check the Tegretol level and a couple of other things) in the years since I quit drinking and they never showed any problems. Also, I would get hungry and eating would make my stomach feel somewhat better, although I had no appetite—even though I KNEW I was hungry and COULD force myself to eat I had no desire to. Nothing seemed to taste right, including the shit I generally loved to eat or even drink like iced tea and Sierra Mist, and anything I put into my mouth I just wanted to spit right back out. However, like I said I could still make myself eat—when I had the hepatitis I couldn’t really even FORCE myself to eat, other than a few small Ritz crackers here and there throughout the day; I would simply have to wait a few days for my liver to stop throbbing and the swelling to go down before I could really eat normally again. I almost saw the doctor at that point, but I began to feel a little bit better and already had an appointment to see him on this coming Monday (Aug. 2) so I figured maybe I was being a little premature about things.

However, by last Friday or so things had gotten MUCH worse. The pain was not only getting worse again, but I was completely depressed in ways that I had NEVER really known. Some people are better than others at moving on, I suppose—better at realizing that they’ve fucked up in the past, may have thrown away YEARS of their lives or blown chances that may NEVER come again but also at realizing that each new day brings new chances and new opportunities, if you know where to look or who to ask for help and are willing to put in the work because you also have to realize that almost NOTHING GOOD EVER COMES EASY. I myself have never been one of those people, particularly. I have always wondered why I couldn’t have buckled down in school, at least enough to have graduated at 18 rather than 32. I have always wondered why I can’t seem to figure out my “place” in the world, why SOME people at 18 have a laser-like focus on getting a business degree or becoming a doctor or architect or engineer or something as though they KNOW that is what they were born to be while I flounder about just trying to figure out WHAT will make me NOT miserable while providing at least enough of a salary to not have to worry about rent and eating and having a proper and reliable car that doesn’t break down at every other fucking stop sign and all those other things that so many people take for granted. These are thoughts that occur to me almost EVERY DAY at some point—basically, both my past AND my future haunt me. However, I was always able to balance it out somewhat by simply realizing that, no matter HOW bad things may seem to be in my life, there ARE people in this world who have been through far worse and survived, and some of them have even gone on to flourish. There are people who are FAR, FAR bigger idiots and assholes than I am who have pulled it off—maybe I can too. And there are people in this world—family, friends, instructors at COS—who care about me, who never miss the opportunity to tell me how smart I am and that I WILL, one day, figure all this shit out if I keep trying.

Suicide has always held a kind of cold fascination to me. I have known people who’ve killed themselves. I have known others that, while they didn’t directly kill themselves, I do believe they more or less intentionally took the slower way, just like Ozzy’s song “Suicide Solution” says—“Wine is fine but whiskey’s quicker/Suicide is slow with liquor.” I sometimes wonder if it didn’t play a role in my uncle’s OD all those years ago. Mainly I have wondered what made people like Kurt Cobain—a guy with money, a secure legacy as a musical icon/genius, a wife and young daughter and millions of fans—feel so badly that he could blast his skull to dust with a shotgun (assuming it wasn’t murder like the conspiracy theorist-types allege). Or a guy like Owen Wilson—maybe not the best-looking guy but who doesn’t love Owen Wilson? With his money and personality who cares if he’s got a nose that’s slightly fucked up, he could still get any woman he wanted in all likelihood, you feel like he’d be a really great buddy and all-around fun guy to hang out with, he doesn’t have to worry about his future…what makes a guy like that even dream of attempting suicide?

But I don’t know if I can say I’d ever TRULY considered it before. In a detached, feel-sorry-for-yourself kind of way, maybe—I suspect that MOST people have. But considered it to the point where it just scares the living fuck out of you, I’m not so sure. There ARE considerations that have always, to ME at least, made suicide far too radical an act to actually commit…such as God. Assuming he exists, the Christian belief obviously is that God doesn’t accept suicides—that if you “reject his gift of life” you’re denied entry into the “Kingdom of Heaven” and instead spend eternity BBQ’ing your nuts in Hades. And how does one do that to their loved ones? If you cared about them AT ALL how could you possibly put your spouse/children/parents/best friends or whatever through the sheer life-shattering horror of walking into a room to discover brains and blood blown all over the walls and your lifeless corpse lying on the bed or swinging from a curtain rod, or make them have to go down to the morgue to identify the splattered remains you left behind when you leapt out of a tenth-story window? That seems rather selfish, doesn’t it? Does ANYONE deserve that? These thoughts, in my normal state, make suicide absolutely unthinkable to me, no matter HOW badly I may think my life sucks from time to time.

By last weekend, however, none of those things helped. I hated seeing the morning come, assuming I was even lucky enough to have gotten to sleep at all, because it meant I was going to be hounded by those thoughts all day long. I didn’t enjoy listening to music, playing video games, running around town…nothing. Quite basically, I was becoming suicidal myself. The thought was simply omnipresent in the back of my mind, and nothing could chase it away for long. My debts, my inability to figure out just who I am in this life or what I should pursue for a living, the thought that NOBODY can find work these days on top of the thought that nobody would want to take a chance hiring my ass anyway because of the decade-plus gap since my LAST job, and all the other failures of my life to date…all those things were just swarming through my mind constantly. And all those things I mentioned a couple of paragraphs ago that I used to think about, to re-assure myself that I was just being a big drama queen who just needed to stop feeling sorry for himself, no longer chased those black thoughts away, at least not for more than a few seconds, before they were back at full force. I simply felt sheer, black-as-night terror and dread all day long. NOTHING scared me more than being alone, I needed to be around people at all times because…well, who knew? The sheer, cold, logical answer to everything seemed more and more like—just get it over with. While I can’t say that I “heard voices” I could understand how SOME people in a similar situation could interpret it that way, because the idea just HOUNDS YOU—“Come on, you KNOW nothing’s ever gonna get any better, do you REALLY want to feel like this anymore? There’s an easy way out, y’know…and it doesn’t even have to HURT.” By Monday night I had simply had it; I asked my mom to drive me to the emergency room to find out if there was anything wrong with my stomach or liver or any of my other internals, and also told them about the depression. I simply felt like I had to try SOMETHING, because without a doubt I felt like I was truly losing it and that if I DIDN’T try something I wasn’t going to make it much longer.

So I spent the next 7 hours sitting in the hospital. They pumped me full of Dilaudid and Ativan, a painkiller and a tranquilizer, while they ran a shitload of tests and called a social worker (something they have to do when someone suicidal comes in). Fortunately, I can say that I’m in perfect physical health aside from the 4 or 5 spare tires I wear around my waist: my liver is completely normal (after 8 alcohol-free fucking years you’d certainly hope so), no gall bladder problems or gall stones, EKG was normal, etc. They (the doctors and the social worker) told me that, in all likelihood, my physical pain was simply linked to the depression and that both were almost 100% due to coming off the Tegretol. They also told me to come into the Department of Mental Health the next morning and get signed up for benefits. At 1:30 Tuesday morning (we got there at 6:30 pm) they finally released me.

So I signed up at 8 am Tuesday morning just like they told me: I see a doctor at 10 am next Thursday. However, I also moved up my other appointment with my regular doctor—I saw him Wednesday morning. He was rather upset that he had never known about my depression, and also apologetic. He instantly wrote a prescription for Prozac, as well as a week’s worth of alprazolam (which everyone knows as Xanax) to help out until the Prozac kicks in. He started me out with a very low dose—20 mg a day (I believe I was taking 50 back when I was originally on it)—but I understand that they ALWAYS start you out that way. I’m happy to say that, physically speaking, I’m basically back to normal, or at least 99%. I’m not ENTIRELY back to my old self yet psychologically speaking—after all, like I said I’ve only been taking a very low dose of Prozac for 4 days now (plus .5 mg of Xanax twice a day, which will run out Tuesday) and those 3 or 4 days before I went into the hospital were incredibly unsettling. However, I will make sure the doctor increases my dosage. The guy I see Thursday will probably (hopefully) do it. And I AM probably 50-75% back to my old self. I think that, as much as anything, I’m rather frightened and a bit haunted by how low I NOW KNOW I can sink without any antidepressants in my system. And it’s VERY unsettling to realize that all it takes is one bean-counter asshole, or maybe even just a paperwork mistake, at some insurance company or government agency to cut me off and put me right back into the hell, the utter despair and hopelessness, that I felt last weekend.

But like I said, for now things are lookin’ up.

And to be clear, I DON’T want anybody to be worried about me or anything else. This is NOT a “sympathy blog.” However, if you know anybody who suffers from depression—be it a family member, a friend, a cashier at the local SaveMart that you’re friendly with or someone else you care about—then be there for those people if you think they’re struggling, because I can assure you—NOBODY deserves to feel that kind of torment.

And now I have to go and think up something light-hearted and filthy and funny to write about, to put everybody’s minds back at ease…see ya!