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August 18, 2003

How Paxil Made My Life Odd in Hindsight

It was very difficult to come up for a title for this rant. After all, my life is pretty good. As it is good I could not possibly use the title "How Paxil Wrecked My Life" as I had initially intended. In fact, Paxil essentially made it possible to have the life that I now enjoy and there are things about that life (my wife, for example) that I am eternally grateful for.

But enough about titles. Why was I on Paxil and why did it make my life Odd in hindsight?

Ever since, let’s say, my parent’s divorce (just to cause speculation as to cause) I have been tormented by what my mom called a "nervous tummy". I would get severe cramps if there was even the suggestion that I would have a hard time at school. A presentation, my homework undone or even a bully who had yet to fulfill his latest threat would leave me doubled over in pain for hours each morning.

I never fully grew out of my nervous tummy but it would generally settle down after mom forced me to go to school. After all, nothing so terrible ever happened which required the sort of pain my body was using to avoid things. I, of course, did nothing to help myself. For example, out of 164 school days in grade 7, I had detention 151 afternoons with Mr. MacKinnon. These were primarily for failing to do my homework. I would have held the record if my pal, "Sneaky Douglas", had not been there the few afternoons when I was allowed to leave with everyone else.

I had a good life. Sure, my parents had split up but there were a mere seven minutes apart on foot and I saw them both often. They were both professionals and made certain that we were exposed to a lot of culture and what not. They didn’t spoil us but we had everything we needed. In school I made good grades without effort, had a girlfriend, was getting laid early in life and regularly, and was active in amateur theatre. In fact, life was easy and the nervous tummy relaxed for the most part as I grew older.

By University the only time my tummy would get upset was upon planning a visit home. At school it was fine. Granted, I was quite medicated during my undergrad, got a LOT of sleep and didn’t attend class too often. I had good friends and good outlets for my creative talents in the school paper and independent theatre. In short, since I really didn’t care much about my marks, there were few things to stress me out.

My stint in a Masters program was similar. No pressure. I had no idea why I was taking the Masters other than the fact that I also had no idea what else to do. Therefore, there was nothing to work toward. Therefore, no pressure. I enjoyed the work and the class time was minimal. It was a good relaxing life spent drinking coffee and rye and coke (depending on the hour) and paying for everything with student loans borrowed against my uncontemplated future.

Then my dad got sick. Really sick. I switched to law school to be closer to home and, I suppose, to make him happy. He had always wanted to see at least one of his three creative children attend either law or medical school. He got to see one of them do just that but he passed away at the end of first year just before exams. Determined to be non-affected I wrote one. Then deferred the rest. I was, I finally had to admit, a mess.

As law school continued, things got worse. I started being unable to go out for dinner or sit in a movie theatre. I would panic. My stomach would tighten like a ball and all I could think of was escape. That thought led me to thinking I would look foolish rushing from wherever I was seated. This then trapped me in my chair feeling miserable, crowded and ready to blow something out of at least one end of my body. The fear was consuming and, worst of all, it didn’t seem to be about anything so there was nothing I could do to fix it.

I started staying home a lot.

I even went to the doctor to get help.

Now I have a philosophy degree with a minor in experimental psychology so the whole mind/brain question has always held an interest for me. Where does one stop and the other start? Who am "I" really? Am I just an observer inside my head like I feel that I must be or am I a complex set of chemical interactions with no real consciousness at all? Stuff like that fascinated me.

Also, it was stuff like that which made me dead set against mood altering drugs for the treatment of anxiety or depression (for recreation, well, whole different story). Sure I would probably feel better on drugs but would it be me that was feeling better or just some flesh and blood robot that the doctor and I had set up to get through life as me? I was terrified of losing my self even though I was not certain what my self was.

So the doctor and I tried Beta Blockers. Lots of public officials and other persons with high stress jobs, I was told by the doctor, use beta blockers because they have a calming effect but do not disturb brain function (at least not directly).

If I understand correctly, the theory behind these magic pills is that by controlling the secondary "symptoms" of panic such as a racing heart, increased breathing and sweat, the panic itself will not be able to take hold. Imagine the chemical equivalent of breathing exercises. You find yourself in an anxiety filled situation so you consciously choose to breath normally and your body figures that you can not be anxious because, after all, if you were anxious, you’d be breathing fast. The Beta blockers worked a bit but eventually I got to the point where I could not leave the house for any kind of social event whether I took them or not.

Obviously I could not go on like that so I bit the bullet and signed onto the Paxil program. That was during the summer of 1999.

Things improved immediately with the Paxil. I was more relaxed. Dinner with other people hardly bothered me. I could see movies and go to bars again. I felt good most of the time. Not great, but good. Of course, my sex drive went down the toilet, I was tired a lot of the time and I put on twenty pounds that I could not afford, but I was getting by and coping in the world "out there". I was moving forward in my career and making things happen. I got a job. I got married. We bought a house. Things were good. In fact, things were good for about three years. Again, I want to make the distinction between good and great because that, in hindsight, was a distinction I did not notice at the time. My lows were gone but my highs were gone as well. However, since it was "me" (or robot me) that was doing the feeling (or non-feeling) everything seemed fine.

Then I started getting panicky again. Along with the side-effects of the Paxil (which were no fun even if I didn’t particularly care), things were becoming unbearable again and I wanted them fixed before they got worse because now, unlike during law school, I could not just hide at home for a few weeks and let things pass. I had a job and responsibilities to otheres.

So, after a consult with a shrink, I came off the Paxil.

It was like coming out of a dream. For three years I had been coping with everything because I could not dwell on things. I mean, I could not have dwelled on things if I had wanted to. While I was on Paxil I didn’t really notice a change but, in hindsight, three years of my life was spent being someone else. I went along with things I would not have. I made choices I would have avoided. Very little, in fact, caused me any concern at all. The lows were gone mind you. No more feeling as if I was going to throw up four days out of seven but the highs were gone too. I never noticed. I kind of just "was". For all intents and purposes I was a well-coping automotron. It was not me. I lost my creativity. I stopped sketching, stopped writing and stopped wondering about theatre. I stopped worrying and dwelling on things. Granted, I could fall sleep at night, which was a new treat, but it was a sleep caused by the fact that I had turned my tendancy to dwell on things off with chemicals. My thought processes were slower but I didn’t notice. Probably very few people noticed. I mean, I was mostly still me. I walked like me, talked like me and interacted with people like me. You would have had to be very close to me to see that anything had changed. But it had. It had changed deep down (or up) where it is important.

Now I am awake again. I am nervous again. I have attacks of panic again where my whole body goes into fight or flight mode and all I want to do is go somewhere and hide. I am terrified of public appearances and have difficulty going to dinner and a movie. It is an effort just to get to work in the morning. But I am so much more alive!

I am still on drugs (now Zoloft) and it obviously isn’t working that well. In some ways I thank god because I am thinking more clearly. In other ways I wonder how I would be if I were completely without medication. Would that be me? The guy who is unable to leave his bed? The adult who can not get a job or hold one down? It could be the real me (whatever that is) but right now I can not afford to find out.

I do want to warn people about these drugs because there is a deep dark secret beneath their harmless looking little shells. The secret is that you will still feel like you - only you won’t be. What you will be is closer to "normal".

I think that shrinks do honestly want to help us to get better but I also think that they have made the mistake of thinking somehow that better is normal and normal is average. They want us to be happy but have made the mistake of thinking that happy found in not being unhappy. They want us to get along but have made the mistake of thinking that getting along is to be found by being complacent.

They don’t know what they are doing! Oh sure, they know that they are chemically neutering those parts of our brains that control panic and depression but they have no idea what other parts of our personalities are effected. They know that they are changing the chemical balance of the brain but have no idea what they are doing to the mind. They may even believe that they are fixing a chemical imbalance in the brain. However, to believe that necessitates believing that a chemical imbalance can be defined as any brain functioning in such a way as to make normal life difficult or impossible for the person whose brain it is. See the problem? It’s right there: "... make normal life..."! What is normal? Who defines normal? Does normal mean "like most people"? If it does then it means average and I do not think that we are all aspiring to be average. The logic of the treatment is based on unproven (and perhaps unprovable) premises. Since I am having trouble being me in the world I find myself, the treatment is to change me so that I am no longer having the trouble. How do we do that? We make me function more like those who are, or appear to be, having less trouble. We make me the same as them. Then "normal" becomes larger to the tune of one and those who are not "normal" are even less so. The goal, I suppose, would be to have everyone coping fine and acting normal. To have us all as close to being the same as possible.

But what if they are wrong. What if these are not imbalances but real brain solutions to the stressful problems we face every day. What if, by mistakenly assuming the situations "out there" to be normal, they are essentially keeping us all going strong in situation that is, in fact, not normal. Keeping us all productive in a situation that we are supposed to avoid and are not supposed to handle well. [NOTE: I am not a Marxist but in a later rant I may get into how the connection to "production" is related to the thinking of the psychological community. For now, suffice it to say that, being a prodctive member of society is the goal here, it always has been].

So many people are on so many drugs for so many things these days. Professionals are especially venerable to the alchemist’s charms because we deal all day with stressful situations. Situations that we probably should either be avoiding or, at least, dealing with less. Maybe it is not that high level executives should be able to handle 60 to 80 hour weekdays filled with power sessions. Maybe they should each be doing 20 hours and there should be more of them. Maybe it is the odd suit that can handle that level of stress and the rest of us shouldn’t be getting that involved. Maybe our bodies, through fight and flight mechanisms are trying to tell us something about the society we live in.

Maybe, just maybe, it is a problem with society and not a problem with our brains at all. Maybe we have lost our familial support groups and our tribes and our social identities and are actually losing our minds (and bodies) because we are going about things in a way that is counter-productive to our health.

If we define success as a measurement taken "out there" and then need drugs to achieve that sucess then maybe that is not how success is supposed to be defined.

But I am just letting off some steam because I feel like I have been lost for years and now that I have been found I am even more lost as I can not fathom how I managed to get here.

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