Should you up your meds?

Seems like everyone in my life, especially since the pandemic started has been asking themselves this question to varying degrees. Spoiler alert, I don’t have the answer. I am not a psychiatrist, but I can tell you this is something I think about, like a lot.

What are the benchmarks of what ssri’s can do? And when do you know when you have reached a threshold where you need some help? In my perceived reality, I feel like people really need help right now. No one I know would claim, “I am happy the amount of time that I feel like is enough.” Or, “I am getting a proper balance of emotions that is inclusive of joy from time to time. I have hope for the future.” I feel like these two statements are pretty basic in terms of assessing what a life well lived is.

Everyone I meet says something like, “I need to make a change. But I just don’t know what…” Could it be as simple as just upping your meds? Do you feel like you need a change right now?

Zoloft has been really helpful for me. And I just crossed over the threshold to up my meds last week.

This is not a sales pitch. My intention with this is to talk about this weird nebulous thing that more and more (when I was 16 no one was on meds. Now like most of my friends are on them) people are doing which is seeking chemical help for mood “disorders.”

One could argue, that sad people are actually just more in touch with the world; that feeling the immense pain and suffering going on is basically closer to reality. That hope and joy are just human coping skills that we use to make it through the day. But do I want to live that life that is consumed with emotions limited to the constellation of sadness? When I was young, I would have said, “YES. I value the real, whatever that is…” now that I am older, things have changed.

I still value reality. Reality as being our collective understanding of existence. Pain as a human construct shows us the road map away from this our change in energy states. Moving towards joy is in some ways manifesting a desire to live life. Or continue in the current energy state. We move away from pain in an effort to keep going. In the format (our bodies and culture) that provides less pain and suffering.

The perceived “Real” is a valuable but not effective strategy to make the world better (assuming you are debilitated by sadness and despair), but now I value a life well lived and doing good, and to do that it is more effective for me to be on meds.

Both young and old me really want to be a good person. To make the world a better place. We just have different ways of getting there. The young me felt compelled to be really aware of the pain - and to use that awareness to motivate to make change. There is a logic there. The only problem is that this logic, it doesn’t also account for the harsh reality of depression. That most of the time, you cant get out of bed. That worry about doing the “right” thing (when there is no easy right thing most of the time) enables you to do anything out of fear. So you just stay in bed. Dreaming sometimes about the life you could have had, but mostly lamenting on the things you didn’t do, and hatred forms the existence you have.

For me, the depression and anxiety dug deep. So deep that I could only think about killing myself at all times. That the effort for “hanging in there” was just too much. Not worth it. My mom and therapist talked 16-year-old me into going on an ssri, Paxil. I remember thinking that maybe this would help? Mostly, I wanted it to help me be more social. To be able to not be terrified to talk to people and pit out sweaters in subzero temperatures.

And I think it helped. So much so that I am still on one. I am on the max dose. But I have gone up now, this will be the third time. And it is scary. I don’t want to be the type of person who needs meds to be myself - but I do. I am that person.

The 39-year-old me thinks that there is a balance to feeling the pain of the world. I understand at this point in my life that to be most effective in making the life I want, the world better, being kind and generous, assuming the best intentions in people, all are much easier when I want to get out of bed. This might be a delusion, but it is a useful one.

So how do you know when it is time to go up? For me, going up offers some relief. Relief from the constant existential crisis of being alive. It offers up the enjoyment of other humans without the worry of being misunderstood or boring. It offers up the energy to offer compassion and empathy to all living beings.

It was last week. I felt it coming. I keep saying things like, “I just want to prepare for the future, but no one knows what you will need in that future?” And it’s true. The weight of that is massive. Some people argue that there was a time when there was a formula to live - just do these 5 things and you will be safe (this was a comforting lie). But that is not true, and I don’t think it was ever true. Life is not fair. I don’t know even what fairness looks like despite the fact that I know I value it.

I do know, that I will need the will, the energy to keep going. I have data points in the past I could recognize the recession in my mood on the horizon and the idea of some sort of relief lifted me up. I did it for myself. But also for my daughter. I want her to feel like she can use the tools that she has to feel how she wants to feel.

Was it the right decision? Who knows? What if the path to the future is long and hard and your humanness just wants a break and for things to be easy? To have some certainty while knowing that certainty is a false notion made up to help us cope with reality. People say you should change your diet first. Or make sure you are exercising. But both of those things, I think are great, but I need a kickstart to make me do them. To care about doing them.

Again, just to be clear, whatever decision you make for yourself is yours. This is what helped for me. And I just wanted to share in case it was helpful for you, in whatever you decide.

This week, I am super excited to talk to Liz Fosslien about her new book with Mollie West Duffy called Big Feelings.

We all experience unwieldy feelings. But between our emotion-phobic society and the debilitating uncertainty of modern times, we usually don’t know how to talk about what we’re going through, much less handle it. Over the past year, Liz Fosslien and Mollie West Duffy’s online community has laughed and cried about productivity guilt, pandemic anxiety, and Zoom fatigue. Now, Big Feelings addresses anyone intimidated by oversized feelings they can’t predict or control, offering the tools to understand what’s really going on, find comfort, and face the future with a sense of newfound agency.
 
Weaving surprising science with personal stories and original illustrations, each chapter examines one uncomfortable feeling—like envy, burnout, and anxiety—and lays out strategies for turning big emotions into manageable ones. You’ll learn:
 
  •  How to end the cycle of intrusive thoughts brought on by regret, and instead use this feeling as a compass for making decisions
  •  How to identify what’s behind your anger and communicate it productively, without putting people on the defensive
  •  Why we might be suffering from perfectionism even if we feel far from perfect, and how to detach your self-worth from what you do
 
Big Feelings helps us understand that difficult emotions are not abnormal and that we can emerge from them with a deeper sense of meaning. We can’t stop emotions from bubbling up, but we can learn how to make peace with them.

We ALSO have 4 Copies to giveaway! We will randomly choose 4 folks from the people who comment (say anything this just lets me know you are interested) on this post and/or the video post - on Friday. If you can’t and need to get it now, click here.

Above image from the book…

Thanks again everyone for being here with me. I really look forward to writing each week.

Wherever you are at, with whatever you are processing, I know there are moments of joy to be found. I have faith that things can change.

With the softness of a cool summer breeze when you are feeling overwhelmed, Carissa