​Roses Are Red, My Psychiatrist Upped My Meds

It seems like all the cool mentally ill people are on Wellbutrin. OK, maybe not cool, but like, my mentally ill friends.

My friend Chris said Wellbutrin is good for people like us, because instead of thinking about death for 14 hours a day he now only thinks about it for three. It doesn't stop death, but it stops death thoughts.

My friend Lauren, a therapist who gets panic attacks while seeing patients, is on it. One time, Lauren had a panic attack so bad while seeing a patient that when the patient revealed she hadn't eaten all day, Lauren used it as an excuse for them to go outside and get a sandwich. She cloaked this exodus in teaching the patient a lesson in self-care. "You have to eat," she said. But in her head Lauren was like, Thank you, Jesus. If they didn't leave the room she thought she was going to die.

Wellbutrin isn't the panacea. Nothing can take away your humanity, your peculiar fears and twists. But it seems like a better drug than what I'm on, which is Effexor XR: the fucking dinosaur of SSRIs and SNRIs.

I've been on Effexor for about 11 years. I started taking it a year before I got sober. At first I was so fucked up that I would forget to take it half the time, or when I did take it I would get even drunker. The Effexor, coupled with the benzodiazepines I was prescribed and the opiates I was not prescribed, had me blacking out all over town.

Since I've been sober, I have chosen not to take benzos for my generalized anxiety and panic disorders. But I don't rule it out should the day come when I have to choose between being prescribed a benzo by a doctor who monitors my usage vs. self-medicating with unprescribed shit (and/or suicide). Like, I wouldn't consider it a relapse. For today though, I choose not to take them.

But Effexor has definitely been a key component of my sobriety. Psychiatrists have lowered my dosage to almost nothing when I was in periods of chemical balance and they have increased my dosage when I entered cycles of panic attacks and depression.

Two years ago my psychiatrist raised the dosage when I was finding metaphoric bats living in my chest. The increase prior to that occurred when I witnessed the death of a relative, firsthand, and you might say it "fucked me up" a little to discover, viscerally, that death is real. Both increases worked. They left me feeling more functional, less alone, less like the only people who understood me were Albert Camus and Jean-Paul Sartre (and them just barely).

I know that meds can stop working over time. Recently, my panic attacks have been so bad that I wondered if Effexor hadn't just stopped working altogether. I asked my psychiatrist about switching to a newer, sexier med. But she said we should try increasing the Effexor first. Stay with the dinosaur. Take more of it. More than I've ever taken.

Do I trust my psychiatrist? She's better than other ones I've seen. Like, at least she talks to me. I once saw a bro who was so terrified of social interactions that he would just sort of thrust prescriptions at me in horror. I called him the Turtle. The Turtle's body language was like "I'll do anything you say if you get out of my office." This was convenient, because I was still drinking and using then. I got really fun drugs from the Turtle.

At the same time, I appreciate that my current psychiatrist doesn't try to be my friend, or like, have teatime. I once saw a woman who wanted to talk about everything except anxiety and depression: poetry, feminist superheroes, New York Times articles about fetal alcohol syndrome. I was like, "Gurl, the Times is basic and I'm sober so I don't give a shit about fetal alcohol syndrome." I didn't say that. Instead we talked about sestinas and Wonder Woman for four years.

I trust my current psychiatrist more than the other ones: at least enough to up my meds this high. But I feel disappointed. Like, it's kind of been a point of pride for me that I've never gotten close to the maximum FDA-approved dose. Like, there was always room for me to get crazier. Now I'm inching closer to the limit. Am I getting worse?

Effexor is notoriously hard to get off of. If you Google people's experiences you get the horror stories of withdrawal: nausea, diarrhea, hallucination, electric shocks to the brain, sadness, extreme anxiety. Now that I'm on a higher dose will the electric shocks be double? Don't I take this shit for anxiety?

Also, if I ever want kids my psychiatrist says that I will have to transition to another drug like Prozac. To be sure, I don't think having children is for me. Like, you can probably see why I might not be cut out to be a mother, but still, just in case, can't we just transition to Prozac now? If I have to transition while pregnant I will definitely have my head in the oven. I feel like I'm moving in the wrong direction or something.

Then there are the Effexor nightsweats, which I've pretended to ignore for about 11 years. I value my mental health over my sheets, and I guess, my allure to others who might share my bed. But on the higher dose, my bed has gone from a nightly swamp to a lagoon. I already slept naked. I can't get more naked.

A secure person might voice these concerns to her doctor. But it's hard for me to push back against my psychiatrist. I have trouble advocating for myself in situations psychiatric and therapeutic because, well, I never want anyone to think I'm crazy. This is, in itself, crazy. If you're gonna be nuts, your psychiatrist or therapist's office is the place to let that freak flag fly. But I guess I want to be the least needy patient. Like, if I have less needs it means I'm less fucked up. What I want is to have no needs. What I want is not to be there.

Mental health professionals aren't always the most stable people themselves. There's a reason why certain people go into the mental health field. They often have a very personal, vested interest in it. They aren't always the best with boundaries. Have you ever tried breaking up with a therapist?

I saw a "therapist and creativity specialist" who was so crazy that when she left a message for me, people would be like, "Some weirdo called you. Who the fuck was that?" She was in her 70s and was always giving me bad, tangible advice about problems rather than, like, insight. Of my eating disorder, she said: "You should eat an egg." Of my obsession with chin zits: "You should try calamine lotion." She wasn't a dermatologist. It wasn't about the zits. It was about me freaking out over the zits. She didn't get that. It took me seven years to break up with her.

Even when it's not about breaking up, they manage to make everything about them. Like when you're late for a session. It's never just that you were late. The lateness must be analyzed in a Jungian schema. It must be held up to the light and dissected for subconscious passive aggression. I've definitely been late for sessions because I was avoiding talking to them. But usually it's because I'm going deep on Twitter and shitty with time.

Even my current therapist, who is probably the best I've ever had, takes everything personally. I recently told her that I might want to try a cognitive behavioral therapist, because our work doesn't seem to be cutting the mustard when it comes to my panic disorder. As much as I enjoy doing the grand tour of my childhood, infinitely, I think I might need someone to retrain my mind. She was like "Why don't you just try a cognitive behavioral therapy app?" Therapists fear abandonment.

I'm kind of relieved that my therapist won't let me break up with her. I don't really want to have to go to yet another person and retell my childhood. And I am sort of scared to change meds, when Effexor has worked in the past. But it's tiring advocating for myself—especially when the trouble is in my own brain. It's like, you're the professional. Just fucking fix me.

If you're struggling or just need someone to talk to, the Samaritans offer 24-hour support.

So Sad Today is a never-ending existential crisis played out in 140 characters or less. Its anonymous author has struggled with consciousness since long before the creation of the Twitter feed in 2012, and has finally decided the time has come to project her anxieties on a larger screen, in the form of a biweekly column on this website.