It’s been years since I’ve felt like this, and I hate it. I desperately want to feel "normal" again. Unless you’ve experienced it first hand, you can’t know how utterly debilitating it is to have a genetic chemical imbalance running amok in your brain.
You walk around feeling like you are holding onto sanity by a thread, impatient and snappish, but at the same time barely able to keep from crying. Any little thing will set you off – an innocent comment from a friend or loved one, a TV commercial, a newspaper story. You mentally hold on with all your might to keep from screaming out in anger or dissolving into a weeping pile of mush – either one of which seems to your mixed up brain an appropriate response.
You go through the motions of living while fighting a constant desperate longing to crawl into a safe, warm bed and pull the covers over your head. Your sense of self worth plummets, you start to dread each new day, and you are exhausted from the continual mental struggle to "maintain."
Then there are the nights. It’s hard to get to sleep with your thoughts racing around like jet-propelled bumper cars. At last you doze off, but in the wee hours, you’re roused from sleep by a racing heart and an overwhelming feeling of impending doom. There’s nothing to be afraid of, but you are afraid – terrified to the core of your soul – over what? Something? Nothing?
You throw off the covers, drenched in sweat. You want a drink of water, but you just know the exertion of walking to the bathroom with cause your rushing heart to explode out of your chest. So you stay put, and force your rapid, shallow, breathing into a normal pattern by sheer force of will, then mentally begin the relaxation techniques you’ve been taught. They won’t work, but they offer a distraction from the cascading terror in your brain, and palpable sensations of hot, liquid electricity rushing through your limbs. After ten minutes or so, the episode begins to subside, and after twenty, you’re back to "normal." You go back to sleep, knowing it may or may not happen again that same night.
It’s hard to explain the mechanics without sounding like a medical journal. The culprits are three brain chemicals, norepinephrine, adrenaline, and serotonin, that have decided to not play nice.
Norepinephrine, (aka noradrenaline) is both a hormone and a neurotransmitter (a chemical that relays, amplifies, and changes signals between neurons). Along with adrenaline (aka epinephrine), it triggers the famous "fight or flight" response that has helped generations of our ancestors avoid getting eaten or killed or crushed by something big and/or dangerous. In a stressful situation, adrenaline gets your body ready to take action by speeding up your heart, sending energy (in the form of glucose) to your brain and muscles, and sending more blood to your muscles while simultaneously reducing blood flow to your skin and digestive system. While helping adrenaline take care of the physical stuff, norepinephrine also messes with your mind, helping to provide the appropriate accompanying emotional response. Serotonin is a neurotransmitter that has a lot to so with regulating your moods, as well as things like appetite, sleep, libido, and metabolism. If it doesn’t translate the messages between neurons correctly, it can make you either excessively or inadequately angry, fearful, irritable, sad, optimistic, etc.
When your serotonin, norepinephrine, and epinephrine levels get out of whack, you are a mess. Stuff like I’ve described above happens.
Luckily, there is a class of drugs called SNRIs (short for serotonin and norepinephrine reuptake inhibitors) that can fix you up just fine and dandy. You know them by their common names – Effexor, Cymbalta, Norpramine, Serzone, and Pristiq. (note: Prozac is similar, but it’s an SSRI, not an SNRI). They are widely available, work great, and have minimal side effects. That’s the good news.
The bad news is that they are expensive - as much as $4-$5 a pill. Depending on the pharmacy (CVS, Costco, Walmart) the price for a month’s worth of Effexor XR (my medication) ranges from $120 - $147. With good medical insurance, you can get them (90 at a time, mail order) for about $40 a month. With private, bare-bones medical insurance, which we (both now unemployed), pay $360 a month for, the drug costs $118 (at Walmart) for 30 pills.
I stopped taking my medication in November. We just don’t have the money to pay for it.
Since I couldn’t afford the cost of an office visit (not covered by our private insurance) to get the "step-down" dosage, I had to wean myself off. I did this by buying $4 worth of generic Benadryl (the only thing I could find over-the-counter in a capsule), breaking the seal on 2 weeks worth of capsules, emptying them out, and then dividing the contents of each of my Effexor capsules into two portions – leaving half in the "real" capsule and putting half in the empty Benadryl capsule. It was not easy to do.
Despite my controlled escape plan, I had severe withdrawal symptoms after discontinuing the drug that lasted for about a week. But that all went away and I'm back to my native drug-free self.
The upside is, I have reduced our monthly outgo by more than $100. The downside is now I feel like crap (see above) and will for the foreseeable future – maybe the rest of my life, if I never get another job with medical benefits.
But despite my self-absorbed whining, I consider myself myself very lucky. I can live without my medication. It is not insulin or a blood thinner, or some other drug without which I would likely die. There are many people out there whose life depends on daily medication. Increasingly, they are like me, unemployed due to the recent economic downturn. They, like me, have had to severely cut back their spending. I chose to give up my pills so we would have more money for food and utilities, but they cannot make that choice without endangering their lives. When the subject of universal health care comes up, I get pretty adamant.
We need it. We need it now.