The Decision

Today, I finally made an important choice in my treatment. This is a monumental moment for me for two reasons: I came to a conclusion in an important situation, and I am confident in my choice. This has been something that I’ve been debating for months. It’s a difficult choice. It’s life-altering, it’s divisive, and it’s potentially dangerous. Today, let’s talk about medication.

I had considered taking antidepressants since prior to my first counseling session. However, I knew that I wanted to try therapy on it’s own first, as I typically don’t take medication unnecessarily. As I began to make progress and experienced fewer panic attacks, I noticed that I was still having trouble regulating and expressing my emotions appropriately. I was still irritable and sometimes wasn’t able to accurately show what I was feeling.

I relayed my concerns to my counselor, and he referred me to a psychiatric nurse practitioner. It took them over a month to call me for an appointment, but that’s another story. Anyway, I’ll summarize my visit, for anyone who’s wondering what this may entail. First, my vital signs were taken. You know, heart rate, oxygen saturation (the little thing they put on your finger), blood pressure, and height and weight. Then I met with the nurse. Since she had all of my information from the referral, the following evaluation was very brief. She reviewed my symptoms with me, asked me about my progress in therapy, and asked a few more questions about things like family history, childhood events (abuse, trauma, etc.), and allergies. She then began explaining the options that were available to me.

There are a few different classes of medication used to treat chronic anxiety. Benzodiazepines like Xanax are not effective in the long-term management of anxiety disorders, and are rarely prescribed. More common are SSRIs, which block some of the neurochemical receptors in your brain. These are relatively low risk options and include Paxil, Prozac, and Zoloft. However, there are some potential side effects (including some sexual side effects that just turned me off), although they are typically mild and rare. MAOIs are stronger, and are often reserved for those who haven’t responded to SSRIs. Beta blockers (blood pressure medications) can be used in some circumstances, but my blood pressure is already on the low side, and I don’t need to spend half of my day unconscious. SNRIs and Tricyclics are other types, and there are a few medications that don’t fit into a category. Two of the uncategorized medications discussed with me are Wellbutrin and Buspar. These are both low risk, and after some debate I selected the Buspar.

The NP wrote the prescription, and gave me one important piece of advice. She told me not to begin taking the meds if I was not 100% sure that I wanted to. I then picked up my prescription and immediately began arguing with myself. This has been going on for 2 weeks. Do I take it? Do I not? If the suspense has not yet killed you, I opted not to take it. I may still change my mind. However, at this point, it’s not for me. My symptoms are mostly under control with counseling alone, and I still learn new skills at each session. I don’t think this is truly necessary for me.

In today’s culture, I know that many people are put off by medicine. I also know that the term antidepressants carries a crazy strong stigma. But, for some people they really are needed. The good news is, these medications are fairly affordable and readily available. There are many options in case one doesn’t work for you. Many are taken short-term. It may be only a few months, and then you’re done. If you’re reading this and are curious about depression/anxiety medication, I encourage you to talk to someone about your options. Even though mine is sitting in a drawer, I am comfortable knowing that I have it available to me. Go see your doctor.

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