Thursday, November 26, 2009

Has Effexor Finally Crapped Out on Me, or Am I Getting Crazier?

Four or five years ago, my doctor prescribed me Effexor. At the time, I had a serious social anxiety problem (Social Anxiety Disorder), which was so severe, I was continually being traumatized in social settings and suffering PTSD symptoms: intrusive thoughts and flashbacks (re-living every possible social blunder over and over as if it were happening again, including the bodily responses that go along with the emotional and mental experience). I'd always suffered from social fear, but at it's worst I had returned to school to finish my degree and had a lot of difficulty in class. I was 30 years old, overweight, suffering from chronic, constant pain (fibromyalgia, myofascial pain syndrome), and often seemed to have very 'unusual' approaches to the subject matters. More or less because I had lived several more years than 99% of the students, and read a lot on my own about subjects I was interested in, I already had some knowledge and opinions. I was also a very curious student - I was there to learn, not because going to University is what comes after highschool. So already I felt like a total odd-ball, totally 'uncool', and to my socially anxious mind, an object of embarrassment and probable ridicule in the minds of the other students.

There were a couple professors I had for several different courses, whom I felt comfortable with, and thus often asked questions or made comments without thinking first. Immediately afterwards I would feel completely humiliated as I thought of all the ways the other students could be thinking about me and what I'd said. I would flush furiously and become totally self-conscious, and have trouble focussing on the rest of the lecture. Later I would replay and relive the scene over and over again, becoming just as embarrassed or even more so than when it actually happened. I'd berate myself for sounding like a fool, analyse every little thing I'd said and figure out all the ways that it could have been misinterpreted or negatively judged. Every day I had a class I spoke up in, I added more incidents to my traumatizing 'vault' as I called it. I did extremely well in my courses despite all the energy and time I spent humiliated. I often wonder how much better I would have done if I'd been able to focus my attention entirely on the material rather than on myself.

When I started taking Effexor, I experienced a dramatic change in my social phobia. Eventually, the time I spent wondering what others thought of me and being self-conscious was reduced to almost never. I just stopped, for whatever reason. I was okay letting people think whatever they wanted, and able to concentrate on what I wanted to think about. Rarely did I replay an incidents in my head, so I stopped traumatizing myself. I became able to laugh at myself whenever I goofed up, able to shrug it off and move on immediately. I cannot credit anything but the Effexor with this change. It literally seemed to cure me of my social anxiety.

Unfortunately by this time I had already graduated university, so I wasn't able to reap the benefits of the change scholastically. But it helped in so many other ways in my life. I was able to make phone calls without fretting so much, feel more comfortable on the public bus, and just generally enjoy my life without worrying what other people thought. It has been really amazing.

Over the past few weeks, however, I've started noticing little niggling thoughts, such as doubting if someone likes me or not. I've made a few foolish remarks (on Twitter) recently about feeling ignored or wanting someone's attention. I've started to lose the confidence I have built up over the last six months or so. But it has not been often, so I kind of just shrug it off and think it's just a glitch. Two major things have happened this week, however, to make me wonder if I'm headed for trouble.

Monday night I was supposed to go out for dinner with several old friends, all but one of whom I haven't seen in probably ten years or more. The last time they'd seen me I'd been physically healthy and weighed a normal amount. I found myself feeling so anxious about this reunion that I really did not want to go. I couldn't bear the thought of answering their questions about my illness. I could only imagine their real question would be: "What happened?" I felt so ashamed of my weight and appearance. I didn't want any attention or to talk about myself at all, but I knew the whole point of the reunion was to catch up with each other. Only my friend C knows much about what has gone on with me over the past ten years, and I couldn't imagine discussing it without feeling like a total downer, and wanting to cry. They've all got real lives, and I've turned into the fat sick lady. I had the beginnings of a migraine Monday afternoon, so I cancelled. I was totally relieved to have had an excuse not to go.

But it was strange for me to have so much anxiety about anything. C posted a picture on Facebook after the dinner, and tagged me in it, saying "you were missed". They all looked so happy and nice, and I wondered why I was so afraid of them. They are good people, not judgmental people. They used to be good friends. They weren't coming to look down on me or even feel sorry for me. I felt quite bad about missing it, but on the other hand, my migraine had gotten very bad so it would have been awful from that perspective anyway.

Then today I was supposed to go to Toronto to see my therapist. I usually take the Greyhound, which is about an hour and a half bus ride. I got on the bus, which was packed, and sat down beside a young Asian guy with a laptop. I took out my book and started reading, but I got motion sick almost as soon as the bus started moving. By the time we got to the stop at Sportsworld - about ten minutes away - I was having an anxiety attack and had to get off the bus. I walked to the public transit stop and took the city bus home.

Obviously, I was (and am), extremely upset about this. I have never had to get off the Greyhound before, and it's been years and years since the last time I had to get off an insanely crowded city bus because of anxiety. But I was feeling so clausterphobic, and I knew if I stayed on the bus to Toronto it would be the worst ride of my life. I was sweating like crazy, even after I'd taken my jacket off and sat in my t-shirt (while everyone else managed to be comfortable with their coats on). I couldn't read because of the motion sickness, and the thought of being in my head for an hour and a half during that bus ride was unbearable. I felt like I had no room to even move my elbows.

So what is going on with me? Has the Effexor stopped working? Has my social anxiety been buried by it, but getting stronger? Is this illness having some other weird effect on me?

To add insult to injury, I'm having some extremely serious problems with body temperature control. As I said, I got on the bus and started sweating like crazy, in part because I'd been nervous getting ready to go on my trip. Even after I took my coat off, though, I could feel the sweat dripping off my forehead. Disgusting. Then, after I got off the Greyhound to take the city bus home, I was so cold waiting at the bus stop, I put on another layer, wrapped a pashmina around my neck and another one over my shoulders. When I got on the city bus I had to hurry and take the pashminas off again because I got so hot. I feel like a total freak.

Even at home I'm either hot or cold. Right now I am sitting in my t-shirt and my arms are cold. But as soon as I put a sweater on over-top, I know I'm going to start boiling again. It has been really bad like this for at least the last week. It's like none of the clothes I own have exactly the right level of warmth, they are too thick, but when I take it off my arms get cold. This morning while I had my coffee I actually had to sit with NO shirt on because I was so hot. The temperature in my apartment does not fluctuate - I have the thermostat set permanently at 22. At that very same temperature I can go from so cold I need to put on gloves, to so hot I have to strip off all of my clothes.

This problem can be severly humiliating in public. Once I get hot I start sweating buckets and cannot stop no matter what I do, since there's only so many layers I can take off. People stare at me when I'm the only one in the room drenched with sweat. It's embarrassing to be putting on or taking off a sweater every five minutes. If I go into a store after being outside for a few minutes, I immediately start sweating, and by the time I get back outside, I'm soaked. Back outside where it's cold, I'm freezing because now I'm wet. So this does not help with the social anxiety.

I wanted to write more about how this is making me feel, but I seem to have shut down. Partly from the gravol I took to help with the motion sickness before I knew I was going to get off the bus, and partly because emotional upset makes me really exhausted. I think I took so much time to write out what's been going on, I've become numb to how it makes me feel. All I know is that I almost started crying on the local transit on my way home. And now I can barely keep my eyes open. So I guess I'll go take a nap and try to reconnect with my feelings later.


I sometimes write things that I don't really mean or believe. These are not to be taken literally, nor as definitive statements about me or my beliefs. Thoughts and emotions are transient, and I reserve the right to change my mind, generalize, exaggerate, give strong opinions, or write other possibly offensive statements. I don't lie, but I may say something that's not true to check whether I believe it or not, or to make a point. Call it creative license. This is my blog, and do have the right to say what I want. I'm using it in creatively therapeutic ways. Whatever the reader may think of me and my words, please believe that my core intentions are always good and I never willingly hurt anyone.