Month: September 2014

Hello Sun, You Vicious Bastard

I’m writing this at 5am on Monday morning. That’s not a good thing. That’s not a good thing at all. That means I haven’t slept – in tonight’s case – at all. Grr. It’s really annoying. I’ve become used to sleeping – for y’know seven or eight hours at a time, without waking up. Without waking up in the middle I mean, obviously I wake up eventually, usually when prompted by my ancient radio alarm clock that can only play a blend of static and glimpses of awful radio music. This is an excellent state of affairs, being quite alien to me from the age of 14 through to 30 something (save for the loving sleepy embrace of alcohol and other cheery brain-numbing drugs). To have reversed this awesome new state of normal is deplorable. Surely I’ve done nothing wrong…

So what the fuck? I mean, what the fuck?

Weeeeeell. I’ve been taking amitriptyline (or “tripty” as I like to call it) for going on two years now (more or less). Generally it’s been ace – I have literally never slept like that before. It’s a boon for the anxiety that blooms in me during the evening and gently puts my worries to sleep. In May I had a bit of a spaz out and got prescribed daytime tripty as well. Seemed to be alright but then I found anxiety actually increasing during the day. In fairness it’s accompanied a hideous phase of work, so that’s perhaps not surprising.

But along with that it became clearer that I was finding it much harder to do creative things in the evening (and sometimes really struggle to do much first thing in the morning), in particular to be able to take me tripty and still be able to improvise, or write, or socialise. If I took the dose I needed to later get to sleep I’d be dulled into dullness and be unable to properly participate. That’s damned inconvenient, especially when performance is linked so closely to self-esteem, satisfaction and all that important jazz. So I’d not take the stuff till later. That might mean it takes longer to kick in, pushing the evening back later without hope of reclaiming those hours in the morning, which shunts ya into an even more awkward bumbling around while under the influence and not really waking up and feeling more removed from the situation etc. etc… But it’s taken me a while to notice, or become concerned enough about the impact I felt it was having.

Change Is As Good As A Good Night’s Sleep

So a fortnight ago I went off to my lovely doctors (with whom I have an excellent and frank relationship), explained what I thought was going wrong and asked to switch drugs. I spent the last week and a bit tapering off tripty while taking my new drug Trazodone. The idea with this stuff is that it kicks in faster, so I can take it later in the evening after doing some stuff and maybe get that balance back. Of course you never stop dead with a brain drug so I gradually reduced the tripty dose and munched the taserdome.

Out cold the first couple of nights of course since that’s more or less just a double-dose. After that it got a bit weird, with some really heightened anxiety and awful bleak valley moments. I was waking up early and struggling to get back to sleep. It felt hideous, a shock, but not especially surprising – transition between anything and especially stopping something familiar is bound to have some consequences. So that’s horrid, but manageable and fine. Well, y’know. I am blessed with a loving and supportive partner, a wonderful cat and pretty damn supportive and reasonable boss.

This is the second night without any tripty at all. The first night it took an age to get to sleep (at least relative to my new normal) and I woke up from vivid dreams about killing an endless swarm of monsters with a lightsaber. One of the nicest things about tripty is to remember dreams so rarely… Last night, well. I’d been fairly anxious all day but a combination of regular hugs, Lego, the new Doctor Who and the magnificently odd Murder By Death (1976) made it all look like bedtime was going to be fine.

Lies, all lies! I thought I was prepped for sleep – the doziness and bumbling that I’m beginning to associate with Trazodone (my god – the number of things I blunder into dizzily!) feels a bit like being sleepy. And yet no. I realised at about one o’clock that this wasn’t going anywhere. I know better than to lie in bed being frustrated so I pinball downstairs, trying to be quiet and dropping everything and smashing into the edge of the kitchen table. Sigh. Initiate self-pity matrix… now. It didn’t get any better. I went back to bed for half an hour. It was nice and warm and there were cuddlable things. But no sleep.

So What To Do Next?

On the plus side I’ve written this post, and the ‘This Week’ post that I’ve failed to write for the last fortnight. And, fuck it – I’m still going swimming in a minute as planned.

So let’s attempt reason: I’m barely into a new cycle of drug use, so really I have no idea what effect it’s going to have. A crap night doesn’t actually tell me anything about Trazodone. I’ve got a prescription for a month’s use, then review. That makes sense. It doesn’t stop me wanting to run back to amitriptyline crying “all is forgiven”. It does make me wonder if I’d correctly assessed the factors in how I was feeling that lead to me choosing to switch drugs. But – I should give it a chance, surely. Or should I?

All Change Please And Go Back The Way You Came

I’ve stopped taking the new stuff. Trazodone, which sounds satisfyingly like ‘taser-dome’ and conjures joyous imaginings of Mad Max III gladiators duking it out while doped up with SSRIs and Tina Turner in bondage gear just ain’t for me.

It all seemed pretty bad on Monday morning after not sleeping and enduring awesome waves of anxiety, but I was up for giving it a whirl. You never know quite how any batch of chemicals is going to slap up your noggin so you can’t make snap judgements. But it was pretty bad. It’s difficult to reflect properly on the effects a drug might be having, partly because it’s tricky to step back but also because the drug is actively having an impact on how I think and feel. Also, not sleeping is one of the most mentally debilitating things a person can experience. It has a more immediate effect than alcohol annihilating attention span, coordination, memory formation, common sense and emotional control. I needed assistance.

Review, Reflect, Reject

So in the evening I was talking it through with my other half (god bless her [should I believe in such a concept… I suppose I really mean to bestow, or have her self-bestow some form of benediction in an entirely secular way in recognition of my endless gratitude in a deeper way than “ta” implies]) and she suggested the wholly alien notion of reviewing the notes that came with the Trazodone. I’d skimmed ’em when I got them and did some light internet reading because I feel you should always know something about what you’re taking; really hard to do with illegal drugs so may as well take advantage of the regulated industry when you can. But I have to confess to taking the document less seriously because it was just photocopied by the pharmacist to jam into the funny little half-packet box she gave me. Presentation has an effect.

Turns out that I’d already nailed about a third of the ‘other side effects’ and 2 of the 7 ‘talk to your doctor now’ effects. Score! The dizziness (and clumsiness that results), sweating, high temperatures and nausea may not have been the mild cold I thought I had (could be plague I suppose). The weird skin sensations of shivering fingertips running up my arms might not be ghosts and the nightmares not a karmic punishment for laughing about Innerspace. The massive ramp up in anxiety was probably the lack of Amitriptyline, but is also a possible side-effect (like everything) of most anti-depressant / sedative type drugs. So that’s a whole bunch of waving flags right there. I got back in touch with the doc and canned the new stuff. I’m back on my old pal tripty and already feel much better and am sleeping fine, although I’ll have to get used to the morning fuzziness again.

Setting Fire To Clouds

Despite the side-effects I think it’s been a useful experience (and I am not a silver lining person, I tend to feel that the silver lining merely masks the awful darkness within). Having taken tripty for about two years now I’ve actually forgotten what the sensation of anxiety is like. Sure, I’ve had bad moments and days since then, but that’s had to be exceptional to punch through my tripty mask. Fuck me though, it’s awful. I’d lost the memory of what it’s like having anxiety crawling up the very marrow of my bones, spiralling and gnawing in an endless seething wave of ants. It’s paralysing, frightening and very hard to ignore – its lack of a cause (that’s stress when there’s a clear cause) makes it all harder to deal with. I’d forgotten, and for that I’m grateful, but it’s good to have been reminded. Why hadn’t I felt like that for two years? Well, that’d be the tripty. Duh.

It’s definitely worth trying something different, because who knows – it might be better. But for now, for me, the old fashioned broad-spectrum of side-effects Amitriptyline is the right choice. But, starting Trazodone helped me feel like things were different and I could change some of my habits – returning to swimming after sixteen years for example. That’ll do. Plus I’ve got a box of sedatives should I ever need to be sedated: bonus.