New Old Medications Thoughts

If I’m honest, I’m still not sure what I’m doing – how I feel about my writing – but there’s been a lot in my head this week so I thought I’d just try and get it all down. Maybe it’ll help.

I’m not sure if I’ve mentioned it already but after two and a half years of trying medications, I’m back on Phenelzine for my depression. I’m back on the drug I was trying to get away from. Back in 2017, it was starting to fail but I was also starting to fight it. The lifts to my mood felt artificial and suffocating. I felt depressed but there was this thick layer of calm suppressing it and it was causing me great, great distress. I felt like I was scratching at the walls of my mind with my fingernails, desperate to get out and just feel how I was feeling. Of course, feeling deeply depressed is a miserable, paralysing experience but at least it felt real. It was the truth and the truth is one of the most important things to me.

But despite all of that, I’m taking it again and I can’t help feeling like we’re starting to run out of options. We must be if we’re going back to a drug that I struggled with, that stopped working – although it’s true that it did work for a significant period of time. But we started looking elsewhere for a reason. Multiple reasons. I voiced that in the session with my psychiatrist and he said that there are still options but I can’t help worrying. Because if I’m running out of options at the age of twenty four, that’s a lot of life left without much to work with. Will we reach a point where I just have to live with it? Live with crushing depression and paralysing anxiety?

And let’s talk about anxiety. Last time I was taking the Phenelzine, I also took Quetiapine, primarily for the insomnia that the Phenelzine caused but it also helped with my anxiety. Because it’s a sleep aid, it has a sedating effect, which helped me to manage that constant anxiety. But I can’t go back to it. The sedative effect almost seemed to increase over time and it got harder and harder to wake up in the mornings. It was like I was so deep underwater that I couldn’t find the surface; I could hear people talking to me but I couldn’t open my eyes or move or speak. By the time we were abandoning the Phenelzine, it was so bad that I was losing half the day just trying to wake up. I can’t go through that again. It was awful.

So that limits the options, if I can’t take that or any of the similar drugs. The drug we’ve decided on is Diazepam. I’ve been taking it on and off over the last year and it works; it stabilises my emotions when they get out of my control. But it has addictive potential and I’m not supposed to take it every day. So, every day, I have to look at my anxiety and feel my anxiety and assess whether it’s bad enough to take the medication. And that’s exhausting. I never get an escape from it. To me, that’s not living. That’s managing.

But this is it for the moment. This is life. We’ll reassess in a month.

The New Plan

The last few months have been tough, medication wise. I had a wonderful, un-depressed Christmas (which I’m massively grateful for) but since then, I’ve been struggling. My mood just kept dropping and my anxiety just kept getting worse and we tried to alter the medication to compensate, to find that perfect balance, but it’s gotten to the point where we just need to try something new. So I’m taking stock of everything and trying to figure out how I feel about all of it.

The Clomipramine (a Tricyclic anti-depressant) worked for a while. As I said, I had a really good Christmas where I felt joyful and energetic and actually happy for the first time in a really, really long time. But then it seemed to lose its effectiveness and my mood dropped, whether that was because I was taking a magnesium supplement (I talk about that here) or because it just had a short shelf life. I don’t know. But it stopped working and my depression returned. Since then, my depression has been stifling and I’ve really struggled with suicidal thoughts, at an intensity I’ve never experienced before.

My anxiety also skyrocketed so, in addition to the Pregabalin (also known as Lyrica) I was already taking, I started taking Flupentixol to help manage it. At first I felt no different but after adjusting the dose, my anxiety decreased dramatically and I started to feel a bit more functional. But in the months since then, it seems there have been a number of difficult side effects: my energy levels dropped dramatically, to the point where even a shower is a real struggle. Standing for any length of time is impossible and I ended up being wheeled around multiple airports in a wheelchair during my Nashville trip. The worst part though was that my hands felt thick and clumsy, like my fine motor skills had just evaporated into thin air. Playing guitar was practically impossible.

At first I didn’t realise that these things were connected to the Flupentixol but thanks to my Mum and her incredible attention to detail, we realised that the dates all seem to match up and since we reduced said medication, these problems have disappeared. I’m ridiculously grateful to have my hands back, even if my anxiety has flooded back in.

We’ve reached a point where I can remain where I am or start over. So I’m starting over. I don’t want to live like this. So, after a lot of thinking and talking to my psychiatrist, I’m coming off both the Clomipramine and the Flupentixol. I’m not a massive fan of the Pregablin either to be honest but even changing two things at once is ambitious. So that one can wait. I’ve already started reducing the meds and I’m bracing myself for a barrage of mood swings, depressive episodes, and more. It’s not going to be fun. But it will be worth it. Hopefully.

The current plan is to come off the two drugs, go the ‘wash out’ period (two weeks of no drugs – apart from the Pregablin – so that there aren’t any negative interactions between the medications), and then start Phenelzine again. Yes, Phenelzine – the drug I stopped taking two years ago because it had stopped working, because the joyfulness it gave me felt fake and suffocating. BUT it’s the only drug that’s allowed me to be functional – creatively and otherwise – so we’re giving it another try. It did work for a long time and if it doesn’t, we’ll try another MAOI (monoamine oxidase inhibitor) anti-depressant.

I’m not sure how I feel about it, to be honest. Part of me is frustrated and disappointed. I’ve spent two years trying to find something better only to end up where I started. But on the other hand, that’s two years of knowledge, experience, and confidence that I didn’t have before. I’m a different person and chances are, my reactions will be different: our bodies change and our chemical makeup is constantly shifting. These medications all but cause a hurricane inside us. So I’m trying to be optimistic. I’m trying to be hopeful.

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Nashville Looks Good On You

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This trip to Nashville wasn’t exactly what I’d expected. I’d had this vision of going out there and writing a load of songs and going to show after show after show and seeing all the friends I’ve made out there. I managed to do some of those things – and I’m really proud of what I achieved – but my mental health really dominated the trip, much more than I’d hoped it would.

We got off to a pretty rocky start when I forgot to take my medication the night before we flew out. We had to leave at two o’clock in the morning so I never really went to bed and therefore my nightly routine was disrupted. Plus I was excited and nervous and just generally all over the place. We got to the airport and I couldn’t even walk the distance to security, I was so completely out of energy. I thought it was the lack of sleep and stress of travelling but I physically couldn’t do it. We ended up asking the airport staff for assistance and they were absolutely amazing, at every airport we travelled through over the trip: they got me a wheelchair and took me wherever I needed to be, getting me early access to the planes, and so on. It was so helpful and honestly made the whole thing possible. I don’t know what I would’ve done without their help. It took a few days to recover and it was only then that we realised what had caused it.

The reason we go at this time of year is because the Nashville Songwriters Association International hold the Tin Pan South songwriters festival, where hundreds of songwriters perform songs that they’ve written. They have a great mix of famous and up and coming so you get a lot of different, beautifully written songs. All of the shows that I went to were good and some of them were fantastic. My favourites include Lori McKenna, Alyssa Micaela, Emily Shackelton, Hannah Ellis, Natalie Hemby, and Travis Meadows. They were truly incredible.

There were a couple of other musical highlights too. By some wonderful coincidence, Kelly Clarkson was playing the Bridgestone Arena while we were in Nashville. I’ve always wanted to see her and I’ve always wanted to go to a show at Bridgestone. And to make it even sweeter, Kelsea Ballerini – who I LOVE – was opening. So it was perfect. The show was amazing and I had a blast. Totally a bucket list moment.

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The other musical highlight was getting to see my friend, Caylan Hays, perform. We’ve written together several times and on my last trip, she came to see me play a gig and by another beautiful coincidence, she was playing on the last night of our stay. She was fantastic. She’s such a talented writer and I love her voice. Throw in some gorgeous electric guitar and I was in love. You can check out her music here.

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And of course, I got to go to two Song Suffragettes rounds. I love this organisation with my whole heart and so it meant so much to me to see both shows while I was there. They – the people who run it and the girls who play – are so inspiring and I hope I can play with them again someday.

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I had several writing sessions while we were there and for the most part, they were a struggle. I love the people I was writing with dearly but my brain still isn’t right: a casualty of my depression and the medications I’m taking. We’re still trying to find the balance where I’m emotionally stable and not creativity stifled. Still, I’m trying and I so appreciate these writers for having patience with me while I work through this. I also got to spend some time with friends, old and new, and they really inspired me in this dark patch of my life.

But throughout the trip, I really, really struggled. My anxiety was so high that I actually had trouble breathing and my depression was so overwhelming that I found myself falling apart (even in public places, which I’m usually able to avoid doing) multiple times. There were lots of tears and lots of Diazepam; it was very hard. I struggled desperately with wanting to go home and I was battling suicidal thoughts (helpfully described by Claudia Boleyn as, “my brain trying to kill me”) for most of the trip. In truth, it was a bit of a nightmare but there were some really great moments that helped me manage it and of course, I had my wonderful people (my Mum and my writing partner, Richard Sanderson) there to support me. The trip wouldn’t have been possible without them.

Also, shout out to Pancake Pantry for teaching me what it’s like to get excited about food.