Category: antidepressant

The North Wind

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A month and a half ago I halved the intake of Fluoxetin, otherwise known as Prozac. From 20mg to 10mg every morning. So far so good. A couple of changes occurred, but I cannot tell if its psychological suggestion or chemical adjustment in my body. I want to understand this better, and discern between self induced effects, placebo effects and real medical effects. No matter what happens in my body, I am still happy and satisfied about what I am doing. Work is going well, very well indeed, I have closed a major deal for the company, and in a new field, aviation, which I like much more than automotive. I am very proud of how I handled this deal and the negotiations since January. It all went pretty smoothly and quickly. 6 months of talks for a very good outcome. I gave myself a good pack on my back. And so did my CEO and the whole company. We popped two bottles of good champagne at work, and F. made a speech announcing I had made the biggest deal in the company’s history. What a good satisfaction. And if I think that only 7 months ago I wanted to quit.

One thing I am learning about this anti-depression process: to cultivate patience, and to fight my perfectionism. More things I am learning, which I will write as I go.

Patience is a big deal for me. And acceptance of a certain routine. I realised that over the last 14 of my relationship with W., and even before, basically since I left Italy to go and live in Germany in 1998, I have not been in one place or one job for more than 2-3 years. Events in life, jobs made redundant, W. entering my life (he is still the love of my life, although we are no longer together), new passions being born, the quest for film making, the eagerness of seeing the world, the choice we had to change our lives when we saw fit and how we pleased, made me wonder around the globe, traveling across oceans to beautiful places, living in the turquoise beaches of the Caribbean, moving to South Africa to pursue a film career, going to Canada to work at the Olympics, going back to Italy for a short while (3 years) setting up a company I didnt want to create, getting angry at life in Rome, leaving again, etc etc. I realised I have not been in one place for more than 2-3 years in the last 20 years. Whereas my childhood and my youth have been very regular, filled with routine. And my youth was very happy. I realise now that Alain de Botton is right when he says that in love we seek to reproduce the familiarity of what we are used to in our childhood. I recommend one of his speeches at Zeitgeist. Where I am getting at is that, also in life, not only in love, we seek balance based on what is familiar to us since the beginning. Now, I still need to understand why I was so attracted to a life without rules, and I still am, but why this has over 20 years damaged my self esteem, my happiness, and my relationship to the greatest man for me. Everytime I didn’t like what I was doing, I (I should say, we) would pack up and leave. I am like Juliette Binoche in Chocolat: I leave from village to village at the blow of the north wind.

Once I returned to Switzerland, helas without W., it was 20 years after I left my home in Rome, the home of routine, familiar habits, and the love of my family. I wondered in this world for 20 years, 14 of which with the love of my life, and now that I am back in CH, my life has been shaken from the core. I had to stop, in a very harsh and hard way, and depression has been the climax of this journey. There’s more to say, but I need to get up and go to my next meeting. Life is full of surprises, definitely worth living every bit of it, even the suffering parts. I am growing through this process. I am learning to be patient. I will find my answer, but not yet today.

Control your emotions

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I have not written in over 15 days. I have been thinking a lot about the diary, and I made notes in my calendar of what I was going to write next. Work has been overwhelming, as we started going out again, visit customers, and going abroad. But despite the more hectic schedule, I have managed to always meditate in the morning. I do it as I wake up. Mornings are when I have most thoughts coming through my head, and I process what happened the day (or days) before and I do my list for the day. This list promptly shows itself while I am breathing through my mantra, and I try to not put attention to this list, but rather to let go my thoughts, as meditation teaches. Not easy, Especially these days, when I find myself being very excited about work – amazing if you think that in December I was ready to quit.

I am presently charged with positive emotions, sometime I am so excited and happy that I want to burst. If I think back only 6 months ago, my emotions were loaded with negative guns, firing up through my stomach, head brain and Agata brain suffering (see Agata here). Negative then, positive now; I’d rather burst of joy than of sadness, that is 100% sure. But I think of ways to protect myself from falling down into the abyss of depression, and for this reason I want to control my emotions, even when they are extra positive. Meditation helps me in the morning. And breathing consciously during the day.

I often think of my boss these days, He is a charismatic, young and ambitious man who has managed to create a great innovative company from scratch over a decade ago. I am working more and more on international projects and often happens that I sit with him, and the creative juices start pouring from both our heads. He is very inspiting and smart, and I feel excited and stimulated by his intelligence, and feel that we are on the same wavelength. This shoots in my vains the equivalent of 20mg of Fluoxetin per day, making my day and week better. I feel the seratonin going crazily well, and I want this to never end. But, I have to be very careful, to not make a yoyo out of this. Too happy today, too sad tomorrow. No way. Plus I need to remember that I have halved the dose of Fluoxetin, it’s been almost a month now, and so far so damn good. I don’t want to mess up my good work. That is why I want to control my positive emotions, so that I know how to control my negative ones one day. It is super important.

By reducing the level of excitement for things happening today, such as a good deal made with a client, a beautiful sunny day out with my family, a hike in the mountains etc, I know that I will preserve my newly found self, and will be ready for the gloomier days in life. Cause those are part of our life, it’s not always happy moment, it’s difficult ones, and the only difference it makes in me is how I deal with them. Half full or half empty glass. I choose the full.

10mg

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I am back in Rome for a week. My mom had an urgent surgery due to a hernia that was pushing against the root of the nerve (L4 level), and caused her tremendous pain plus was preventing electric impulse from flowing in her left leg. Bref, as we say in French, I had to rush down to Italy from Lausanne, which was not easy, since COvid measures are still not totally relaxed between countries, and I had to start a sort of pilgrimage to the holy city, which entailed taking the train from Zurich to Chiasso, walk to the Italian border with a big luggage, the laptop bag and a plant for my mom, catch a bus to Como station, and jump on a train hoping it would lead me to Milano Centrale. Almost, it took me to Porta Garibaldi, a few metro stations from my destination. I slept in Milan at an Airbnb, and at 6am the next morning I took the Frecciarossa train to Rome. It took me almost 24h to get there.

A few days earlier I had asked my psychiatrist to reduce Fluoxetin. As I said in another post, the self isolation time has helped me work on myself, and do mental exercises that have helped me get stronger, and feel that my core happiness that I am regaining is due more and more to me and not to the medicament. He agreed to reduce from 20mg to 10mg. Big step for me. I was worried about the consequences, and the effects or side effects it would have on me. I am still very careful, and am being vigilant to the mood shifts I may have. I started 10mg on 5 June, and today is 15 June. Already ten days.

I can’t tell what exactly is the effect of the reduction, but I can certainly tell that my stomach is adjusting to the new intake. I was taking another brand of Fluoxetin, which was in gel capsules (with powder inside), and I had to change it to another brand (solid tablets) because I need to cut the tablet in two (there is no 10mg pill, at least in CH). I can tell that my stomach has been burning during the day, and I am sure it is because of this change. So, that is clear.

What is less clear is whether the reduction is making me more angry, or whether it is my hormonal state. It so happens that I started the reduction just as I was about to have my period. I take Estrogens and Progesterone regularly because in the past years I had started having less and less menstruation (at about 42), as if I were in pre-menopause. I know now that this pre or peri-menopause is due to the stress my mind and soul found themselves in, a slow process towards depression that has blocked my body functions. Just like a high level sportswoman who has no more menstruation because of the strain the training has on her body.

In the past 4-5 days I have found myself angrier, and more “delicate”. I love this word, delicate, Roy from “The IT Crowd” very cutely says it at the episode called “Aunt Irma”. You have to watch this : Series 1 Episode 6 . Hilarious. So, yes, I think I am sensitive because of my period, but my period started and didn’t continue at this round, so that’s another story. I am guessing that I have been hormonally challenged, and on top of that work has been exciting yet stressful, a lot to think about and to follow up on; couple that with the long journey to Rome and the worry that the surgeon might injure my mom even more, I was ready to kill somebody 3 days ago! I didn’t literally kill, but I was very vocal with my words, and found myself being angry at every little thing that was happening to me, all the more when the little thing was against my self. Example: a colleague who didn’t want to help me at work, or the train manager who didn’t want me to get on the train; the lady at the Airbnb who was not talkative and was rather dry (she did her job though, handed me the keys to the room and showed me the kitchen), but I wanted her to be more lovely, just like I am with my guests at home.

Bref…. (long story short), here I am in Rome, I finally made it. My mom had her surgery, she is fine and now I will work from Rome remotely, nursing my mother and giving my father a break. They are getting old. I still don’t know whether my mood swing towards anger had to do with the 10mg, or with my period. Maybe a bit of both? I will monitor the situation and will revert asap.

More soon.

Recipe for Happiness

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Happiness to me is the conditio sine qua non in life. It’s not very clear what happiness is, and how we measure it. I have been trying during my life to understand what makes me happy and what makes me sad, and I have associated often a place to a happy moment, or maybe a happy moment to a place.

I often wondered if my gauge for happiness was the same as in other people, or to all people. The same goes for pain. Let me explain. When I have had moments of full bliss, happiness, plenitude, abundance, or whatever we want to label it, it felt amazing, and nothing more could make me feel better – I wouldn’t want to be anywhere else. If I think of such moment in the past, my memory brings me back to when I was in New Zealand with W. (the love of my life, haven’t talked much about him yet); it was July 1 2005, and I labeled that day as the best day of my life. I have had other best days before and after, but this one in particular stands out. We had ventured into a farmland the day before, we had parked our rental Britz van near a sheep farm, had made a lovely breakfast in the morning, with lots of things from a local store called …. Mmm can’t remember (Hackleberry’s maybe?); we did our first sheep shearing of our lives, took some lanolin straight from the sheep’s cut wool, and ventured off into this wild NZ land full of magnificent colours, rivers, etc. When I told W. that it was my best day, we were staring together at the vast spaces of New Zealand and we were closely wrapping in each other’s arms amazed with the beauty of that land. That was a happy moment that I will always remember. A moment that lasted many days actually, and months, and years, as W. and I were traveling around the world.

Now, when I think of the happiness of another person, I wonder if he or she would feel the same level of happiness, and if so, in which conditions. I mean, was my feeling of happiness on July 1st the highest a person can feel? Does a woman somewhere else in this planet, at this moment, feel the same level of happiness doing what she does love most? Could I be more “happy”? If so, how? The point is actually not whether I can be happier, but how I measure my happiness compared to others, and if my state of bliss staring at the sheep farm is the same bliss another person, with another character and history, feels when driving his/her favourite car. Is it the same happiness a grandmother feels when she spends one day with her nephew? Is it the same bliss Elon Musk feels when he sees his first shuttle take off? Or Armstrong and Aldrin when their foot first touched the moon? So, is happiness relative or absolute? Do I need my neighbor’s Ferrari to feel the same amount of happiness he feels when riding it? And is my joy higher than his, when I am hiking a mountain, or I am kitesurfing in a turquoise waters? Do I need to envy other people’s happiness? Cause that’s the feeling I get when I watch TV.

Same for pain : was my surgical pain last year the highest a man or woman can endure ?

I am still looking for a way to gauge happiness levels. Because if it were measurable, we could possibly help each other being happier. No? It’s a difficult task. I am open to suggestions.

Back to happiness, why am I saying this today? Because I am preparing for the month of June, when I am going to reduce the intake of Fluoxetin (Prozac). I have a meeting with my psychiatrist (the jolly Congolese guy) on 4 June and I will ask him if he is ok with me reducing the antidepressant. I want to do it during summertime, when it’s nice out, the days are long and sunny, the air is warm and everything is alive. I don’t want to do it in autumn, which per se is depressant to me. I know, many people love autumn, I don’t like it, despite the beautiful colours (Quebec has some of the best landscapes in the fall, check it out, I have been there, wow). It’s been 6 months since I started taking antidepressants, and I feel good, very good. I think I can start move away from them. I am scared, I admit, because I can’t tell how much my good state of mind is due to medicine at this very moment, and how much is due to my self-training (meditation, routine, enjoying work, doing sport, yoga, buying new plants…).

So I want to pack in as much as info as possible on myself, and in what conditions, when and how much I am happy. During my preparation to less Fluoxetin, I am appreciating some down moments, like the little “fight” I had with my friend M., which brought me back to negative moments. It was good to be reminded what bad moments feel like. I managed to revert those bad feelings into positive, by thinking of something I like, by not letting her bad mood affect me, and by being more “egoistic” towards my own feelings (translation: I value my own state of being more that hers, what’s important right now is that I feel good). I stay away from negativity. It helps.

Take action before it’s late

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Dr. G., my psychologist, said one thing that struck me, and that I will forever remember. He said it in such a natural and unassuming way that it resonated clearly in me. He said “you have a certain fascination for dissatisfaction”. And I realised, it’s true. Why? Because when I was at the beginning of the practice, I used to tell him my story, stories, thoughts, fears, anxieties, long story short, I was a mess and he was my punching ball. The thoughts I was sharing with him were initially, say, 99% negative, sad, hopeless; as the medicine was starting to have effect, I started to relax more, the problems in my mind were taking more distance from me, and I tried to see more positive; he was telling me that I had to shift the way I see my reality, and make it work for me. Not easy, as I initially interpreted this recommendation as a way to say “be contented with what you got, that’s all there is, resign yourself to the reality”. Which, in other terms, meant for me “you are a failure, pal, you have messed up, lost the love of your life, never got to finish one thing, are back in a country where you feel trapped, just accept it and find happiness in what you can get”. That’s what I was thinking, and that feeling of dissatisfaction and forced resignation fueled my depressive state. I had such a clog in my stomach every time I was thinking what I was missing in the world, while others were living the life of their dreams, why not me, and yet I am a smart person. Etcetera, etcetera.

Oh, if I recall these thoughts my mood becomes more grey. So I won’t linger too much today, and I will say why I am mentioning this now, months after it happened. First because I want to remember how bad depression felt, and remember to always compare those moments with my moments today; that sadness with today’s serenity, and I’d dare to say, even happiness. I am happy with myself right now. It has only taken me a few months to feel this way. And that’s the other reason why I am mentioning my sad memories. It took me 4 months more or less to feel good again, like I have not felt in years. This is, and I am sure of it, thanks to the medical help I received. I was too low to get back up on my own. BUT! It doesn’t have to be this way. and I am here to warn whoever is reading these notes, whether it is today, 9 May 2020, or in 5 years, or in 20 years. If I had listened to the signs sooner, I would have been able to heal on my own. There is no need for medical chemicals, and I am pretty sure of it. My mother had warned me several times prior to my deepest depression in November. She told me years before, that I should go see someone. Initially she meant a psychologist, and when things got really bad, she advised I go to a psychiatrist. She meant good for me, but I always thought that the mind is something we can control, unlike a broken arm, a heart attack or a kidney infection. We go to the doctor whenever one of our organs hurts; we visit clinics and hospitals way too much even, but whenever the head is concerned, it becomes a taboo, at least in my culture and family environment. So I always felt that going to see a “shrink” meant a defeat, cause I wasn’t able to take care of my own thoughts. Today, 5 months after my biggest (and last!) depression phase, I am glad I listened to my mother – and I know she is glad too.

Each of us goes through his or her own life the way we deem right. We all want to be happy, right? We all want to feel those great sensations that we associate to words such as satisfaction, victory, love, happiness, serenity; I don’t feel good when I hurt somebody, or am hurt, or when I see people murdered on TV, or when a client doesn’t close my deal. There’s some strong feelings in our stomach, in our guts (and I know that Agata has a brain – who the heck is Agata ?). Well, I haven’t listened enough, and am only starting now, because I am in survival mode and will do anything to beat the beast, which is my depression. But it doesn’t have to wait until this late, so if you are reading this and feel depressed, but think you can make it on your own, start taking measures. I took up meditation . It’s soooo good. Can’t believe I didn’t do it until my forties. For you it might be something else. Take action before it’s late. Trust yourself.

Speak soon.

Side effects of Fluoxetin

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The first few weeks, after the effect of Fluoxetin started to stabilise, I noticed that I remembered my dreams after every single night. I remember dreaming all along my previous years, sometimes I recollect very clearly what happened in the dream, sometimes not. Dreams have always been part of my life. But this is a very vivid experience. For about 3-4 weeks, when I was into my 5-6th weeks of taking the pills, I could notice clearly that whatever I had thought during the day, I would dream it at night. Did I think of my parents on day x? I would dream of them on night x. Did I picture a particular memory of my ex boyfriend on day y? I would dream it on night y. The dream was a distorted version of reality, but still very very vivid. That, for me, is the only side effect I can report of Fluoxetin. I don’t know how these medicaments work, but I figure all antidepressants must give a similar reaction. I would love to know if you have had a similar experience.

One particular thing about this dreaming pattern: I had come to a point, up until a month ago, that I could determine during the day what I was going to dream at night. That was powerful, and awesome! I remember talking to a young friend of mine, whom I am very fond of (as a friend purely) and whom I find very handsome (sweet, good body, young); we chatted on the phone talking about our lives, and catching up (he left Switzerland for a couple of years); I have no particular feelings for this young man, except for some physical attraction maybe; at night I ended up dreaming of him and me in an intimate situation; it felt really good, real and vivid. Haha! I had fund that night. When I woke up, I had a good memory of the dream, and till today (about 45 days later) I think of it smiling. I don’t think I’ll tell JC about the dream. I don’t want our friendship to be jeopardized. I prefer to keep him as a friend for a very very long time. Physical attraction, in my experience, ruins friendships. But that’s tropic for another day.

Going back to dreams and side-effects of antidepressants, I haven’t been able to sustain this dreaming habit for long. I think it lasted a month or a bit longer. Interesting. What happens now is that dreams still occur, and I still remember more than in the past, and day previous hours before the sleep still affect greatly the content of my dreams, but I don’t seem to have a grip on it. Dream just comes. This morning while meditating, I was thinking about the dream I had last night. I dreamt of going to W.’s wedding to his present girlfriend (who is W? Long story), he invited me. I went with my best friend M., we went with a VW, where I had put a change of clothes to get dressed, cause I was still in my PJ while driving to the venue. W. didn’t look like him, he rather looked like another guy I fancied in the past; his fiancée was not his actual fiancée, but my ex work colleague from the previous firm. When finishing up the meditation (as I was trying not to think…) I reviewed the dream in my mind, and realised that all elements of the dream had been in my mind in the previous 12h hours: W. looked like I guy I had just happened to think about a few hours back; my neighbor friend, whom I see every day for half hout in the public garden during isolation time, told me about our common ex-work colleague and her gift to her little daughter; the clothes were to change my PJ, which is what I have been wearing for the past 5 weeks in isolation (for Zoom or Whatsapp work calls all I need is to look decent from the waist up :-)). And voilà le cake is ready. Many ingredients (WV: not sure why it was in the dream). All make sense. Wow, it’s really great to follow this process as the studying subject and object of this phenomenon called healing from depression.

As for any other side effects of Fluoxetin, the only other thing I can remember is feeling stomach pains the first few weeks; the medicine was hard on my stomach, even if I was taking it after breakfast. And the heart beat growing faster a few hours after taking it. These effects have passed after 2-3-4 weeks. Sometimes I feel so good actually, that I need to calm down, to not explode of happiness. I want to preserve my emotions and be ready for when I stop the medicines. No intention of stopping as of yet. I am thinking another few months. I’ll for sure wait that Covid isolation is over.

Fluoxetin

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This is what is looks like, Fluoxetin:

Very unsexy name, I got it prescribed last week for the first time. My mood was too low and I couldn’t see any joy in anything I was doing. I have fought so many times to avoid getting to this stage, and here I am, taking antidepressants. Another unsexy word – antidepressants. We could have come up with a more compassionate word, one that includes the hope of healing. In Africa they use so many refreshing words (like Ubuntu – brotherhood, sounds so nice), we could have gone to an African tribe and asked “what healing name would you give to an epidemic disease that’s spreading in the first world?”. They would probably look at us in disbelief. Depression: what’s that? We haven’t got that far up into Maslow’s pyramid!

True, ‘cause depression is a disease of people like you and me whose basic needs have been already fulfilled. We are not fighting to drink, eat or find shelter. All of that is already taken care of. We are among the few lucky in this world. I have time to think of how to fulfill myself in this lifetime; I have money to take a holiday, buy furniture and new clothes; I never felt really hungry in my life; my grandmother used to describe to me what hunger was, during World War One and Two – I could try to imagine, but that was it.

I got sidetracked, but there is a reason for it: the very first psychiatrist I ever visited, who gave me the Fluoxetin you see in the picture, is a Congolese doctor. Man, he must be thinking “what a first world problem to have” …. I am not sure I trust him yet (I don’t trust doctors in general) but his jolly, bubbly, slightly over-weighted self is comforting.

It takes two to three weeks for the medicament to have an effect; I am down to week 1. First two days I cried, was anxious and panicking, I wanted to scream at the doctor that he should have warned me. Be warned: the first effect of an antidepressant can make you more depressed. Great! Had I known, I could have been prepared. Next few days have been better. I took three days off work, which helped.

It’s been now one week, and since a couple of days my afternoons are feeling normal, serene, like I haven’t been feeling in a long time. Since July 2019 (five months ago) I have been falling into a sad sad mood, not one day of joy and nothing to look forward to. So, this white and green pill I am taking is making me feel better, and hallelujah for modern medicine! Bring it on, inject chemicals in me that have been missing: serotonin, dopamine, endorphins, whatever works. It feels good.

Side effects: stomach burns (you need to eat well before taking it), one or two morning spasms when waking up (you know the feeling of when you wake up before you fall?), not a big deal, I guess, and anxiety in the morning – which diminished the last 2-3 days because I took 3 days off work.

A good friend (who has been through this) told me I should take time for myself, get a sick leave, and spend one or two weeks resting. I took 3 days only (I feel too responsible towards the company). Tomorrow I have to go to Lugano for work. I will be testing my moods, it should be ok. I have to work to earn money, but I may have to tell my Director to slow down on my tasks. Maybe work 80% (In Switzerland this is possible).

Another good day. I posted this note. Tomorrow is work day, we’ll see how anxiety goes. Thank you for reading. Eventually.

Podcast progress: maybe some today, after this post is up.