My GP faxed over referral to participate in a group Cognitive Behavior Therapy program. He said not to get my hopes as the weight times are long, but CAMH has centralized its intake process so I received a call same day.

I will have to wait a little for an evaluation appointment but this is moving a lot quicker than I’d imagined.

My doctor has concluded after just under three weeks that Wellbutron is not the right medication. It was actually making me worse – my anxiety was through the roof and I was still experiencing insomnia. By now I should been seeing some benefits and fewer side effects.

So what’s the solution? For now, we’re giving Cymbalta a shot. It’s not like Wellbutrin and it’s not exactly an SSRI. It’s a selective serotonin and norepinephrine reuptake inhibitor (SSNRI). As always, my doctor is concerned about weight gain and is hoping Cymbalta will be weight neutral.  Of course, there are a bunch of side effects including nausea and fatigue which I may encounter, particularly in the adjustment phase. I also have some Atavan to manage the anxiety in the short term.

I am not ashamed to take medication for an ongoing problem that is actually a chemical imbalance. It’s all about quality of life. But if the side effects are worse than the cure, it defeats the purpose.

I am crossing my fingers that Cymbalta is the right if only because I don’t want to keep throwing darts until I find the right drug.

This is an older article from Slate that provides a good primer on how different medications treat anxiety and depression:

Prozac vs. Wellbutrin: How do newer antidepressants work?

I hate being medicated. I hate that I have to rely on a drug to function and I hate the side effects that comes with them.

Rationally, however, I know that I need something to balance out my wacky brain  chemistry and keep me from vicious self-fulfilling prophecies.

For years I was on Celexa, 40mg, and it did wonders. It also had a plethora of side effects. Celexa is supposed to be the most advanced SSRI on the market and the drug companies will tell you that SSRI side effects only affect a small number of users. For me, the side effects started to outweigh the benefits: I felt lethargic, I had weird sensations throughout my body and after a while, I became very depressed.

My GP at the time suggested perhaps switching from an SSRI to an alternative, Wellbutrion. While SSRIs such as Celexa focus on serotonin levels, Wellbutrin is more about dopamine levels. Most importantly to me, it doesn’t usually cause weight gain and sometimes it even leads to weight loss.

When I first started Wellbutrion, I transitioned from Celexa. The adjustment was fine. But this time, I am going onto Wellbutrin with nothing in my system, and the side effects in the adjustment phase are very noticeable – insomnia, anxiety and tremors, to name a few.

The adjustment phase takes about three or four weeks I’m told. I am just starting week three and desperately hoping things get better soon. When I tried it a few months ago, I gave up on Wellbutrin after a week because I found the adjustment cycle too difficult, too overwhelming.

My new GP doesn’t want me on SSRIs anymore, especially because of the weight gain (my weight is a source of depression and anxiety), so that leaves very few alternatives aside from the Wellbutrin. If it doesn’t start to have more positive benefits than side effects, I’m not sure where to go from here.

Denial is often the initial reaction of someone diagnosed with a serious, perhaps even terminal illness. We don’t want to believe that something so awful such as cancer is working its way through our system and that we may not win the battle. We want to believe it’s something other people get, not us.

Mental illness is no different. No one wants to accept that we are not quite right in the head, that somehow something inside our brain is off, that we’re not like everyone else.  We deny our mental ailment because we think it means we are somehow defective, weak or damaged goods.  We fear rejection from family, friends and colleagues.

One in five Canadians will experience a mental health problem at some point in their lives, potentially causing them and those around them significant distress. Mental health problems have a huge impact at the personal, community, and societal level, wrote York University researcher Madalyn Marcus recently in The Mark: “Of those experiencing a mental health problem in Canada, only 50 per cent will actually receive professional care. The largest barriers to getting help are not waiting lists (although these are too long) or financial costs (although these can be too high). Rather, it is our negative attitude towards mental health problems and lack of effective support systems. If you worry about how others will view you, you may be less inclined to reach out and ask for help. Awareness is vital, but it is our actions to improve these attitudes and support systems that will lead to change.”

I have been actively grappling with anxiety and depression for seven years now. I’ve gone through phases where I accept it and make use of medication and other times where I convince myself there is nothing wrong with me, that I just need to think positive, exercise more and I will be normal again because I hate the side effects of the medication and the idea that I can’t solve my problems with sheer willpower alone.

Going between these two states has left me feeling much like Sisyphus. Sometimes I feel that I’ve hit a point where I’ve made it to the top of the hill, only to backslide again. But being at the top of the hill often means I’m feeling well but completely disengaged from life. Meanwhile, being drug free means intense highs and lows but most of all feeling lost and alone in a dark place.

Coupled with some physical health scares and other challenges the past few months, I barely managed to put a brave face on everyday and I know sometimes I have failed. It’s affected the people around me, both personally and professionally. There have been moments where I thought I was having a nervous breakdown. (Someone who’s had one assured me I wasn’t there yet).

Today I actually have moments where I can see the top of the hill and believe I can get there and stay there. But regardless of what direction I am going on any given day, I am not going to do it quietly because there should be no shame in being mentally ill. I should not have to hide it.

This blog started because I wanted to make a major shift in my life and my mental health is a crucial part of that journey. I am no longer in denial, and if I have to struggle with this the rest of my life, something good should come of it because no one should have to feel this lost and alone.

I am tired.

Tired of being fat.

Tired of being depressed.

Tired of being alone.

Tired of rolling the sane rock up the same hill.

So I am going to London on vacation and hoping to return re-energized with new ways of looking at my problems.

I worry. A lot. In the past, I’ve been told it’s anxiety, but plenty of things that are supposed to freak out anxious people don’t bug me – public speaking for example. I’m great in front of a room of strangers.

And since I started treating my sleep apnea, I’m certain I never had any true anxiety disorder, just a tendency to worry a lot. I think I’ve been conditioned to worry through my upbringing and experiences.

Certainly, cognitive therapy is something I should explore. I’ve done meds and I don’t believe they are a long-term solution. In the meantime, Psychology Today suggests you make an appointment with your worries:

“What if you decided that you would put off the worry until later? Set aside a time of the day-say, 4 pm-when you will sit down and methodically review your worries.

If a worry shows up before or after your WORRY TIME, you jot it down, put it in your pocket and get around to it later.”

A wise Klingon once said, “Worrying just wastes energy and creates its own enemy.”

I have a lot of worries these days, but I’m going to give this a shot.

Make An Appointment with Your Worries

Anyone who’s read this blog on a regular basis knows I suffer from sleep apnea and treating it with a CPAP has made a big difference for my well-being.

Now there’s speculation that eating breakfast has an impact on how well you sleep too. Eating breakfast first thing in the morning calms and reassures the part of your brain that still thinks you’re a cave person, according to Dr. Nerina Ramlakhan. The author of Tired But Wired tells the UK newspaper The Independent that having that first meal promptly in the morning reminds you that you are no longer living day to day on slow-running game and avoiding predators.

Ramlakhan calls it a “metabolic window”, a timeframe in which you can give your body the message that there is an adequate supply of food, it can relax, and that it can fall into sleep mode when it needs to. This is even more critical than what you eat or when you eat before bed, she says.

Not eating breakfast as soon as I get up is a bad habit of mine. I often am up for an hour before I grab breakfast to go on the way to work or even later.

Read more at Don’t sleep longer – sleep smarter.

This is both fascinating and disturbing at the same time:  Someone decided it would be interesting to put a McDonald’s Happy Meal up in a cupboard and leave it for a year.

It aged rather well. This is both amazing and disturbing.

According to today’s Globe and Mail, the debate over what’s better for you, margarine or butter, continues.

In short, margarine has improved so it doesn’t look like radioactive sludge that glows in the dark. And it’s full of Omega-3s, but not the ones from fish.

Butter is full of saturated fat, but maybe saturated fat is not as bad as we once thought it was. The article doesn’t really come up with a verdict, but I think if I have a choice between something that is made naturally and something is made from a process, I’m going with the natural option.

A little bit of butter is not going to kill you.