So I’ve been struggling a bit this month. Which is ironic almost, because Year Twenty Eight has been the movie-like coming of age year for me in so many ways, and I expected nothing but spring to end my year. But we all know how that goes.
I’ve been working nights this month, almost the last time I would likely have to do that in my life – there aren’t many emergencies typically in Infectious Diseases, my chosen fellowship field starting this summer. Despite the havoc on one’s circadian rhythm, I have almost enjoyed every one of my night rotations previously. You’re on your own, taking care of everyone else’s patients in the hospital while they are gone for the night, and admitting any new ones that come in. You attend to any Rapid Response Team calls or Code Blues that arise. There is a lot of autonomy involved for a resident, and the kind of exhilarating scary that promises a feeling of ‘who da bad-ass who survived that mofos’ at the end of one’s shift. But this one has been unexpectedly hard for me.
I’ve been stressed out, snappy, easy to anger. And that is uncharacteristic of me. At least the grown up me. My teenage years were in fact spent as an angry young woman staring down men abusing power and parenting women who were being bitchy. I cringe. It was not my place.
And those edges had been painstakingly smoothed out over the last three years. I remember one particular evaluation from an intern that said “S is super kind and understanding when mistakes are made”. That was one I was particularly proud of. But it feels like I haven’t been deserving of that for the past three weeks. I could say I wonder why. But fact is I definitely know why.
So I have mentioned the depression before. I have mentioned my triumph over it. While I credit writing, working out and volunteering to my recovery, I cannot deny the role the right antidepressant has played. The one that has become second nature now – that single pill I pop right before I dash out the door every morning without a second thought. Well, we all can agree I haven’t needed it for a long time now. It was like a reasurrance for the powers that be that things were under control, a security blanket of sorts. Needless to say my Psychiatrist and I agreed that it was time I left the blanket behind. Side effects are an inevitable reality for every medication, but they are justified only as long as the benefits outweigh the risks. Long story short, it was time.
The weaning process has been careful, methodical. From taking 300 mg daily I was to reduce the dose to 220 mg for 10 days, then 150 mg for 10 days, then 75 mg daily for 10 days before stopping. But what has been erratic has been the irritability, the snappiness and the pangs of anxiety that made an unwelcome comeback after two years of supreme confidence. It was like I was a teenager again, insecure, unsure of my worth, with a bitch of an imposter syndrome causing a nagging feeling that something, somehow was going to go wrong any minute now. I pondered going back on the meds, every day. Was the freedom and the ability to feel like myself and the avoidance of further side effects worth the risk of my work suffering? WAS my work suffering? Is this something I should just take all my life? Is the ‘angry young woman’ an illness, or just my personality? If it was, did I want to be that person?
S always said I was a bad judge of people. And by default, that makes me consider myself a bad judge of me. Am I acting like a crazy person? Would someone tell me if I were? My dear friend M insisted that I seemed completely fine, amazing in fact. “You are your incredibly kind and good self, as always”, she said. But she hasn’t seen me at work, which is where all my anxieties manifest. I decided to take my night co-resident into confidence. She was someone I thought was trustworthy and a decent human. It was not a pleasant conversation to have, but a necessary one. I explained my ‘Past Medical History’ to her, so to speak, and requested her help. Would she tell me if I were acting, say, not like a normal person? ‘Of course’, she said. Besides, she’s always thought I have been so much calmer than her during stressful situations on nights at work this month. I heaved a sigh of relief, and thanked her.
I read more about the process of weaning. It was not supposed to be easy. “Discontinuation Syndrome” was common. The key was to replace the drug-induced Serotonin in your brain in more natural ways. I started making sure my workouts were consistent. I started doing yoga almost every day. Bought myself more flowers than usual. Organized my closet and my finances. Went for long walks. Did my first run outside, that I was training a long time for since being impaired by shin splints. Slowly but surely, I found my footing.
Sure, it’s all not perfect. I’m still snappy sometimes, but I have not been beating myself up about it. I just decide it was a mistake and resolve to do better next time. And now, on day 6/10 of 75 mg, I feel like I can see the light at the end of the tunnel. I feel like I can do this. I hope I can. I sure am scared. But I have to try. I have to do this for my teenage self – I feel for her so much. She had all the talent and intelligence in the world, but was crippled by her anxiety and insecurities. And taken advantage of, for them, with the loss of many an opportunity which otherwise would have been a piece of cake for her. I have to do this for my sweetheart of a Dad – he has all the talent and intelligence in the world , but is crippled by his anxiety and insecurities. I see how good kind people like him are taken advantage of by the bad guys in life all the time for their insecurities. And I want it to stop. The question is do I achieve that with the aid of drugs that I take for the rest of my life, or do I utilize the infinite power of the human mind to change my detrimental defaults?
I could take the easy, safe, former route and just go back on the pills. But if I succeed with the latter, this will be among my top personal achievements.
I have to try.