TW: Suicide Ideation.
I’m the type of person who is happy to consume any and all medication. If I have a headache, I’ll achingly head to the acetaminophen. In my world, aches and pains means ibuprofen. So when it came to managing my anxiety, it didn’t take long before I asked my therapist for someone who could just “make it all go away.”
Therapy was helping, but each session’s effects didn’t last long. I needed something longer term that could stabilize and balance me out—make me less jittery. I’d seen all the noise for Hims littered across Facebook, and thanks in part to their ads my expectations were that I’d throw some Lexapro (escitalopram) down my gullet and voila, anxiety cured! Maybe it’s that way for some, but it certainly wasn’t for me.
The psych started me on Pristiq (desvenlafaxine succinate), and goddamn if that didn’t give me cottonmouth. It was actually kind of reassuring, because that way I knew it was at least doing something. Unfortunately, that was about all it did, as my anxiety stuck around despite adjusting the dosage. After that, we played around with Lexapro (escitalopram) and Topamax (topiramate), spending many weeks and months tweaking dosage and time of day to try and figure it out.
The 100mg topiramate did a couple of things:
- Made my hands incredibly tingly. This effect went away after about a week or two, but my god it was bonkers how ever-present and intense the tinglies were.
- Made me incessantly sleepy. I’m still not sure if this is the topiramate or a side effect of my first bout of COVID-19, because I kinda started them both at the same time. We played around with the timing to help mitigate this.
- Prevented my anxiety from rearing its head the second I woke up.
Meanwhile, the 40mg of Lexapro took care of the anxiety I felt throughout the day.
At some point during our experimentation I tried a couple of samples of some other drugs, but I can’t remember what they were called. What I do remember is that they didn’t do anything for me.
My anxiety was better now. Not cured, but better. Like it had ramped down by about 60% or so. At least, I think, because it’s hard to tell, isn’t it?! I wasn’t experienced at this, and I didn’t have a good yardstick. Was it better? Was it helping? Was my brain playing tricks on me? I’d tried so many drugs and dosages by this point that I was worried the psych was going to think I was making shit up. It’s like at the optician when they’re all “which is better, 1, or 2?” and it’s “they’re identical, you snake!”
But I was feeling less anxious, even if I wasn’t anxiety free like I had hoped. Naive of me really, but I was expected to feel more… energized, I guess. After a couple of melancholic weeks really struggling with relentless impatience (particularly with my kids) and being quick to anger, I discussed it with my psych. He suggested something I had been considering myself too: with the anxiety no longer all-consuming, my previously ignored and undiagnosed depression was taking its turn in the spotlight.
Not unusual for the twin demons of anxiety and depression to come together, I suppose. It’s hard to convey how exhausted I was from not feeling like myself. How upset I was about my impatience and short temper. How disappointed I was in my parenting. How sad I was about my lack of fun-ness and goofiness. I’d have done literally anything to make it stop.
So the psych gave me a trial of Aplenzin (bupropion hydrobromide extended-release) in two different doses. I started off on the lower dose, and then upped to the higher dose after four days. I noticed two improvements right off the bat, and two downsides:
Downsides:
- I am one stinky motherfucker now. I sweat more, AND that sweat is significantly smellier than it used to be. Pretty fucking grim.
- I clench my jaw all the damn time. I’m clenching it now. My jaw aches from clenching it. And, all the clenching means I bite my tongue and cheeks way more frequently. So that sucks.
The pros though, are pretty good:
- I am SO MUCH more patient with my kids. The youngest has her… let’s call them “moments,” and I find them so much easier to handle without losing my shit. I am calm and rational and loving. That’s awesome and I love it. I’m super proud of myself—even if it took some meds to get me there.
- I spend significantly less time thinking about hanging myself.
That last one’s a bit out of nowhere, so let me back up a bit.
I spend a fair amount of time alone in the car, and recently I found myself riding along with my thoughts rather than Spotify. With nothing but my drifting thoughts occupying the space between the ears, I found myself… not exactly fantasizing about hanging myself, but planning it. Now let me be clear here: at no point did I have any desire to follow through on these plans and actually harm myself. It felt like that urge you get when you’re walking across a bridge and you consider throwing yourself off.
But my suicidal ideation was far more detailed than idle ponderings. Intricately so. I’d plan where I’d do it (in the attic), what time of day I’d do it (late morning after the kids were at school). If I’d write a note beforehand (yes, and record a video). What I’d write in the note. Where I’d leave the note. Whether I’d leave the attic steps pulled down or pulled up. And on and on and on.
All this planning was strangely comforting, and I ultimately did it every single time I got into the car. It didn’t bother me at all. I didn’t “snap” out of it when I arrived at my destination, wondering what the hell was going on. It was like an escape for me. It brought me peace. Nor did I think it that weird, I guess. It just sort of felt like an extension of that “jumping off the bridge” syndrome.
Once I started the Aplenzin, my suicide fantasies immediately stopped. Completely. I imagine that’s a good thing. It can’t be healthy thinking about how you’d end it all 4-6 times a day for 15-20 minutes at a time. Anyway, with the trial of Aplenzin over, my psych switched me onto Wellbutrin XL and I’ve been taking that for about three weeks now.
Next up for me is to get back in with my psych because my anxiety is getting worse again, and while the Wellbutrin XL certainly gave me more patience and stopped the suicidal thoughts, my motivation is still rock bottom.
So that’s me: I’m just a teeth-grinding, sweaty, stinky middle-aged man, but I no longer fantasize about killing myself and that’s gotta count for something.
If you need help or are considering suicide, please know there are resources and people who can help. If you’re in the US, call 988 or visit www.988lifeline.org. For international (and US) you can use Find a Helpline.