I just dropped off a prescription for Zoloft. My first psychiatric medication.
I didn’t go to the psychiatrist with the intent of starting a medication. I didn’t even go thinking I wanted immediate help with anything. It was more of a preventative visit. In case later, some vague time in the future, I felt I was ready, felt I needed, medication.
I never leave a doctor’s office feeling confident I’ve made the right decision. Was it even me who made the decision? Or was I just swayed by the doctor’s powers of persuasion, their particular take on a particular strain of research in their specialty? Is it their poise, the number of degrees framed on their wall, the fact that they have the title Dr. in front of their name?
I don’t have a good track record with this. I am a pendulum, swinging between utter trust in Western medicine to a complete mistrust in chemicals and a reliance on acupuncture, more natural things like herbs, or a stubborn refusal to pursue treatment of whatever condition. “I’m taking a break from doctors right now,” I’ve said before.
Until I go to the next one, and try whatever medication they’re suggesting, even as I say, “I don’t like taking medication.”
“Oh, you’ll be a great candidate for molecular therapy, when that is fully developed,” one doctor said to me as he wrote me four prescriptions, one for a narcotic, to knock my chronic cough to its knees.
I got a little excited when he said that. The evolution of medicine is fascinating to me. What we know now that we didn’t used to know, and all that we still don’t know. Molecular therapy. I can only imagine what this doctor meant. I picture, in the sci-fi-sounding style of its name, the fictional journey the healer Madrone made in The Fifth Sacred Thing as she went, in a trance, down to the molecular level to fight a synthetic virus.
And at the same time, part of me rejects fully this tinkering with our bodies in this way, however un-physical we may actually be on a molecular level. This is who I am, all my thoughts and emotions, hormones and neurotransmitters. Do I really want to mess around with who I am?
“Tell me about that,” the psychiatrist says when I say my first son was stillborn 9 months ago and I am 12 weeks pregnant now.
Every day I relive Joseph’s death.
Every day I think this baby is going to die, too.
As I say it, I wonder if I sound crazy. In spite of a firm scientific belief in mental illness, and a family history of clinical depression, I still carry this societal stigma of crazy.
I am sitting in the psychiatrist’s office crying. She comes around her table and hands me a box of tissues. Of course today I am feeling emotional. Of course today I cry at everything. See? Crazy. It was a day like this that my OB referred me to see the psychiatrist. A routine fertility visit to check my ovaries for cysts and everything the OB said, I cried.
I have this habit, anyway, of crying when someone asks me, genuinely, how I’m doing.
We talk a little more, about my emotional history, my family history, my medical history. Do I feel depressed? Well, no, not really, less and less as time goes on since Joseph’s death. But this fear and anxiety? It’s there every day, more and more as this pregnancy goes on. I’m horribly afraid, too, of postpartum depression if this longed-for baby is born alive.
I know all this is normal. I know that what I’ve been feeling, all these emotions that come along with grief, all this fear and anxiety about the future, and specifically about this pregnancy, it’s all normal. There’s nothing wrong with it. The psychiatrist doesn’t give me the impression that she thinks I’m crazy.
But as we talk, I start to see that maybe it doesn’t have to be this way. Maybe each day doesn’t have to be finding one distraction after another to keep the anxiety at bay. Maybe I don’t have to worry every single day that this baby is going to die, that this baby has already died and I just don’t know it yet. Maybe I don’t have to wish for a sedative, a cave to hibernate in until this baby can be born.
Generalized Anxiety Disorder is the diagnosis, the psychiatrist tells me. We talk about medications. How what I would prefer—to pop something like a Xanax every time it gets really bad (and I would decide, of course, when it was “really bad”)—is just a band-aid, and won’t help these pervasive feelings. Plus, taking it too often is not good for the baby.
She presents Zoloft like something to try. Start small, increase the dose gradually, check back in to see if I think it’s helping. It takes a while, 4-6 weeks, so it’s not the kind of thing you can wait and take when the anxiety is worse. She warns me that as my blood volume increases with pregnancy, I might find the dose isn’t enough and we’ll have to adjust. She speaks knowledgeably about the drug—she is a medical doctor, after all—and says we a lot. And if it’s not helping, or if there’s some effect that doesn’t feel good, I can stop taking it.
This is the permission I need. To ride the pendulum. To try it for a while—how long depends on the length of the arc of my swing—and ultimately reject it.
It might help with sleep, she says, and I perk up. I have been lucky to be a sound sleeper in my life, and I struggle to accept the realities of pregnancy insomnia. It might help with muscle tension, and headaches, she says. I feel a little spark of hope, too, that it might help me relax at school, and maybe not dread going in to work every day anymore. Maybe it could help me be nicer to my students.
I feel both hopeful and resentful. It’s a familiar mix of emotions, one I always face when starting a new medication.
At issue here is trust.
I don’t trust myself enough. I worry I’ve just let myself be talked into something unnecessary. I worry I’m giving in to some strange hypochondriac side of myself that seems to continuously create a need for doctors and appointments.
Don’t get my wrong, the medical issues I’ve dealt with are real—asthma, allergies, migraines, the kinds of diagnoses that require ongoing care, second and third opinions, alternative treatments, new medications.
But my grief counselor said to me, towards the end of our sessions together, that I fully inhabit whatever I’m feeling in that moment and forget that I won’t always feel that way. Emotionally, I am very successful at living in the moment. Including the moments I am sure this baby, like Joseph, will die. I forget that, as a friend put it recently, feelings are temporary.
I hate, too, that I have to trust someone else, albeit a professional, to give me a diagnosis. And one so bland in its name. I could diagnose my whole family, including my in-laws, with generalized anxiety disorder. We are all worriers. It’s what we do. What’s so special about my anxiety?
I have to trust that this psychiatrist is able to take my few words and compare them to everything else she’s seen and say, definitively, yes, this patient could benefit from medication. I have to trust that she might really be able to help me. That Zoloft might actually help.
© Burning Eye