Today’s inane image of the day:
I recently posted a reel on my instagram about how I experience seasonal affective disorder (SAD) annually in the winter and how I try to manage it. One thing that I mentioned on the reel is that I will take fluoxetine (Prozac) for a short course to help me through the season.
Let’s back it up to almost 5 years ago when I was going through a major breakup. Like… we lived together. We survived most of residency together. We sort of endured the COVID pandemic together [I think that the pandemic ultimately was what accelerated the realization that we were not a good fit for each other]. And I was facing the most challenging exam of my career: anesthesia oral boards.
There was a day that I was scheduled for an afternoon operating room shift and I spent the entire morning crying. I could not stop the tears from flowing. I could not stop my mind from feeling horribly sad and despondent. You’d think that eventually your body would run out of the salty water that pours out of your eyes. But apparently my body saw no end to it and I somehow had to go to work and study for this high-stakes exam?!
That was the day I realized I needed to do something. I had to overcome the voice inside that represented my upbringing and its resistance to psychiatric ailments and the medications used to treat them. There was no way that I was going to be able to focus on studying and figure out how to live post-breakup without a little help.
So I made a virtual urgent care appointment with an internist and explained to her that I had an acute life stressor and I needed an antidepressant to help me through this period. I also made it very clear that I needed an antidepressant that would not make me gain weight or lose my libido because… well, I was single now. And I wanted to look hot for dates. And I want the ability to get aroused by potential future partners.
The internist recommended Prozac and I said, “sign me up”!
I’ve always been extremely sensitive to any medication I’ve taken. The dose she started me on was the “lowest” dose but it was still incredibly stimulating. I’m so sensitive to medications that literally the day I picked up the medication and took my first dose, I could feel a difference. I felt like a person again that wasn’t weighed down by heartache and the reality that I was going into my 30s as a single woman [if you don’t know me… I’ve wanted that whole nuclear family thing for my whole life; I want kids and I thought I’d have them by this point in my life].
I got through oral boards. I started dating. And eventually I recognized that the medication was starting to have more side effects than benefits. Or maybe through time, and therapy, and journaling, I was finally able to get over the acute stressor of the breakup.
For me, the side effects included: lack of appetite [which… I actually enjoyed since it was a great way to lose weight and feel confident in my single hood], GI distress, diminished libido, and a total lack of ability to cry.
It’s like we came full circle! I started Prozac because I couldn’t stop crying and now suddenly I’m complaining because the tears won’t come?! Make up your mind!
One thing that I have always been proud of is my ability to be empathetic and caring. My ability to feel emotion. Strongly. I’ve always equated crying with catharsis. I think that I am a better intensivist because I feel the emotions surrounding tough medical situations so strongly.
In my life I’ve been prone to depression/sadness. I fought through waves of very dark times. But as I’ve grown older, I’ve started to realize that the feeling happiness and joy seem exist because of the contrast to the sadness and despair I’ve felt before. I think I needed to experience the struggle into order to appreciate the sweetness of when life delivers good things.
So when taking Prozac meant I was numb to feeling and emotion… I decided this was too much. I weaned off of it [I believe it was during the spring/summer] and could feel like me again. Life was steady. Life was good.
But each winter would roll around and I would start to descend into a darker place again. Or I’d find that my anxiety would act up. One thing that I was amazed about while I was on my first course of Prozac was how well it quieted my anxiety.
A few years ago, I decided, why not go on a short course of Prozac for my winter seasonal affective disorder? Turns out, this is a relatively effective approach for me and has gotten me through a number of very dark winters in New England.
I was inspired to write this today because I wondered if this season would be different. I wondered if I would be able to get through winter without the Prozac. I’ve made it pretty far into the season and haven’t felt like I am incapable of living life. It’s almost halfway through January and I cannot say that I’ve needed to curl up into a ball and cry my eyes out. Life feels steady. Work feels manageable. Dating feels mostly fun [sort of… more on that in the future].
But it hit me that the last few days I’ve noticed time passing in a weird way. It’s both moving too fast but also too slow. I’ve sat down and felt like I needed a fast forward option. I needed a 2x for this part of life. And I didn’t like that. Life is so short. It’s precious. Every moment is meant to be savored as best as it can. And I hated that I didn’t have the ability to do that.
So… this year will be a new experiment. Prozac PRN [as needed]. I pulled the trigger today because my monkey mind was raging. This time, it was crippling anxiety and the inability to just take action that led me to restarting.
More to come!
[P.S. This is not medical advice. None of this blog is ever meant to be medical advice.]