Pro- and Antidepressants

What I'm really thinking about is the pros and cons of taking antidepressants; it was just more fun to phrase my title that way. Because of my panic disorder, I have taken a variety of antidepressants on and off for about the past five years. (Some types of antidepressants are also effective in treating panic disorder.) I'm sure I've talked about this condition before, but just to recap briefly I will say that, while it's completely "normal" to be anxious or panic-stricken in the wake of a scary or devastating situation, my "normal" involves having that feeling in response to nothing. In other words, I'll be going about my day as usual when suddenly I feel that oppressive sense of terror, completely out of control of my body and my mind. I can't even begin to explain how miserable it is. I know we all have our crosses to bear, and that just happens to be one of mine. Fortunately, it's controllable (for the most part).

When I saw my doctor a few weeks ago because I was having more time in panic than out, he suggested that I go off the medication I was on (Zoloft) and try something that has been shown to "help with mood swings in menopausal women." You don't want to see the look I gave him when he said that, but it turns out he was actually agreeing with what I was saying about my condition being physiological rather than psychological. (That shouldn't matter; if I have a problem, I should feel okay about whatever it takes to treat it.) The new medication is Prozac. Right now I'm in the having-tapered-off-the-first-and-not-having-started-the-second phase.

My crazy-great mood yesterday may have been just spring fever, or it may have been a consequence (and I mean that in the best way) of not taking the medication. I haven't been having problems with panic and have been feeling really good since getting off this medication. Of course I'm not a doctor, but I understand enough about how antidepressants work to know that they tend to "flatline" you. You don't get the highs and lows. That's probably a good thing, but sometimes highs and lows are nice. Or at least the highs are nice. (This, I think, is why many people who take medication for mental illness stop taking it.) I was thinking I wouldn't start my new medication. And then this morning, with no provocation, I burst into tears. I just cried and cried and didn't know why. If you know me, you know that isn't typical. Maybe I shouldn't have been offended by the "mood swings" comment.

I'm still on the fence about starting the new medicine. My body may have some residual Zoloft floating around, and maybe my moods will even out after that goes away. I'm finally seeing the cardiologist this week -- it only took nearly three weeks to get my referral! -- so I'll talk with him about how this medication may be affecting my heart condition. I'm supposed to follow up with my primary care doctor in two weeks, and if I haven't already started the new medication I can discuss it with him too. I don't want to have wild mood swings or major panic episodes, but I also don't want to take medicine I don't need. At the moment, I'm feeling mostly even -- not exuberant, not sad, not panic-stricken -- and that's fine. I'll wait and see what the coming days bring.