Pharmacological Brain Chemistry and Depression Relapse

It started about a week ago, perhaps even two. I can’t really tell from my journal entries.

At first, I wrote the feelings off to grief and loneliness. But the “blue” feeling – the sadness – intensified. Then some hopelessness started. “This is too hard to fight,” I heard myself tell myself. “Just give in to the familiarity of it.”

These are the lies that depression whispers in my ear. And because they feel like my own thoughts, they are really hard to recognize and fight off. In fact, I’ve never seen them for myself – it’s always been someone else who has observed and pointed out my symptoms to me. But this time, I told a friend. And I told my therapist. Not at our appointment – no, that was too hard. But when I laid it all out in an email – my feelings and thoughts – she said I’d better come back in. I did, and I was honest this time. And she’s going to help me in this journey, no matter where it might go.

I already know my triggers for a potential depressive episode – have been watching for them closely, and even though I knew I had several active ones, I thought I had them managed.

Enter new trigger: my husband had to travel, first for personal reasons, then work.  Contiguous trips, so gone for 7 days. Please don’t misunderstand, it’s not his fault that I’m sitting on the precipice of another depressive episode. His absence may have intensified my feelings of aloneness, but they are not the cause. They might have been a trigger, and since I was already trying to juggle the others, I assumed that my walk towards depression’s cliff was affected by his absence.

Way back background:  Several years ago, my previous psych doc, family doc, therapist and I discovered that my brain chemistry is very sensitive. A small change in medication can have a huge impact on my emotional well-being, and the wrong med can be downright dangerous, as evidenced by a hospital stay in the psych ward. All due to a bad reaction to the wrong meds. I call it my pharmacological meltdown.

More recent background:  I saw a new family doc three weeks ago. While at that introductory visit, I told him that I had experienced a few minutes of vertigo the week prior. I’d never had it before, so figured it was worth mentioning. After answering some questions and the basic check-up tests (ears, heart, lungs), he prescribed a nasal med to clear up fluid in my middle ear – said it was probably allergies, and since I’m new to the area and not sure what I’m allergic to, I should take this every day until I get through all the seasons – by then we should know when allergies are at their worst for me. He had my chart, I’d told him all about my meds, including antidepressants. But I’m a brand new patient; he doesn’t know me.

When I filled the prescription, I asked the pharmacist about the medication, especially in regards to what I was already taking. His description of potential side effects seemed almost flippant to me. But I’m new here; he doesn’t know me.

The week after my first appointment with my new regular doctor, I had my second appointment with my new psychiatrist. Because of my sensitivities to medication, I have a psych doc manage them, not a G.P.  I mentioned to him that I had been put on this nasal spray; he said there shouldn’t be any concerns, it shouldn’t affect my meds. But I’m a new patient; he doesn’t know me.

And then, last week, I had this sudden descent toward darkness. Why? I’ve been doing well for the three months since we moved; what would make the fourth month any different?

Well, lots of things could cause this mood change. So many upheavals:  the emotional roller coaster of the past year and a half, the change and loss and grief of moving across the country – leaving behind my kids, my good friends and my emotional support team. But what if there was something more?

I wondered if this nasal med could be affecting my mood. I emailed my  previous psych doc, and his first response was that there shouldn’t be a problem. But then he emailed again – the hospital pharmacist had done some more digging, and found studies that showed a very small percentage of folks on this med had an increase in depressive symptoms. Could that be true for me? Maybe, says the doc.

So I immediately stopped the nasal spray. I have no idea how long it will take to know if that solves the problem. Or perhaps I’m already on the slippery slope toward the dark chasm of another depressive episode. I have no idea.

But I do know these things. Take them as advice if they apply to you:

  1. I told a friend what I was thinking and feeling. She helped me see that I needed help.
  2. I was (eventually) honest with my therapist.
  3. Though I find it very hard to ask for help, I sent an email to praying friends and asked them to pray for me.
  4. I must be my own health care advocate, especially when it come to my mental health. I told all those medical personnel that I have very strong reactions to brain meds, but maybe I need to say it louder.
  5. I was watching for my triggers – those things that can lead into depression for me. I knew I was vulnerable, given all the recent changes in my life, so I was attentive.
  6. Maybe most importantly, I remember that I’ve been here before. God has seen me through many depressive episodes, many hiccups and bumps in the road, many setbacks, many times I was afraid depression was returning and I was relapsing. He was faithful through it all. He is faithful – it’s part of who He is – and He will help me now.

13 thoughts on “Pharmacological Brain Chemistry and Depression Relapse

  1. Julie July 16, 2015 / 1:11 pm

    I’m so glad for #6 and I pray that God will keep you at a very safe distance from the edge of that dark chasm.

    #4 hits such a nerve with me. When we are sick – mentally, physically or emotionally – we shouldn’t have to put so much energy into being our own advocate. We are paying the docs to be our advocates, to listen to us and look out for our well being.

    That flippancy, that, “It shouldn’t be a problem,” makes me furious. Most docs only know what the drug reps tell them and most drug reps are not going to go into detail about the negative side effects – most likely no detail at all.

    Thank God for your previous psych doc and God bless him for digging deeper. He should be the rule but, sadly these days, he is the exception.

    I miss Marcus Welby, M.D. I miss doctors who care about their patients and go the extra mile for them.

    Liked by 1 person

    • peggyricewi July 16, 2015 / 2:12 pm

      Alas, the med was most likely the trigger, but I am experiencing a depressive episode now. With God’s help, we hope the chasm will not be as deep or dark as others have been. I am extremely thankful to my previous psych doc – I thank God regularly for him, and he knows it!
      I sure watched a lot of Marcus Welby, M.D.! Though rare, in my previous hometown, that was the kind of care I received – this time not so much!


  2. rlseaton July 14, 2015 / 8:19 pm

    Thank you, Peggy, for sharing. I praise God for how He has cared for you so far. I will be praying for you. God bless dear one.

    Liked by 1 person

  3. dawnlizjones July 11, 2015 / 4:05 pm

    Peg, was praying Psalm 143:8-12 over you this morning. You came to mind during my QT. 🙂

    Liked by 1 person

  4. dawnlizjones July 5, 2015 / 4:46 pm

    Peggy! Thank you again for another amazingly thoughtful and courageous post! I had never thought of depression as having “triggers”, just like asthma. I am awed by how complex we are, how are brain states and mental states intersect, and yes, how God is faithful through it all. I have learning about myself (finally, in the last 10 years or so), and this is even more healthy food for me to chew on. In my prayers also!

    Liked by 1 person

  5. andih94 July 4, 2015 / 4:35 pm

    I congratulate you on your honesty and your bravery. There is no hint of self-pity in your account, just a balanced assessment of what you needed to do based on past experience. That shows a great deal of strength. You kept repeating ‘I’m new here, he doesn’t know me.’ But you’re not new to God and He knows you. He’s walked with you through everything and he’s not going to leave you now. There’s an old Mary Mary song called ‘I just can’t give up now’ which has a great final line in the chorus which says ‘nobody told me the road would be easy and I don’t believe He’s brought me this far to leave me.’

    Liked by 2 people

    • peggyricewi July 4, 2015 / 7:13 pm

      You are so right, Andi. God does know me. I can trust in His faithfulness. I love Heb 13:5, especially in the Amplified version:
      “for He [God] Himself has said, I will not in any way fail you nor give you up nor leave you without support. [I will] not, [I will] not, [I will] not in any degree leave you helpless nor forsake nor let [you] down (relax My hold on you)! [Assuredly not!]”
      Now to just remember that in my darker moments!

      Liked by 1 person

      • andih94 July 4, 2015 / 11:07 pm

        Don’t you LOVE the Amplified Bible!

        Liked by 1 person

  6. Carol July 4, 2015 / 4:32 pm

    Thank you for sharing this with others, Peg!

    Liked by 1 person

  7. kbailey374 July 4, 2015 / 3:47 pm

    The biggie for me is letting others in on what’s going on. Good for you; I’m proud of you. Hopefully stopping this nasal med will be all it takes, but as you said, these other factors don’t help. I know! There is this new blog I saw called Red White and Bleuberries, follow her advice (though it doesn’t HAVE to be cake, exactly…)

    Liked by 1 person

      • peggyricewi July 16, 2015 / 2:15 pm

        Can you send me the link? I haven’t been able to find this blog. Thanks.


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