But My Problems Aren’t Bad Enough for Prozac: Busting a Myth
I started taking Prozac on January 20, 2017. The date was not entirely incidental. I made an appointment with my gynecologist for that day because I knew I’d be working from home to avoid having to commute into the district during inauguration. I decided I may as well do something useful for myself on such a dark day in American history.
Planning to receive health care for this female-sexed-at-birth body and reproductive system on that exact day was my way of saying “fuck you” to an administration so openly hostile to the concept. Once I came out of my post-election shock, I scheduled multiple routine health check up appointments. If republicans were going to repeal ACA, I was going to take advantage of the free preventative care while I had it and rack up some pre-existing conditions along the way.
The inauguration didn’t come up during my appointment, for which I was grateful. It was a small reprieve from the heaviness of the day. What did come up was the horrendous PMS I had been having for the past 18 months or so. It seemed to be exacerbated by the increased level of constant stress I was experiencing trying to juggle working a full time job, an internship at a domestic violence shelter, school work, being a decent spouse, routine adult responsibilities, and trying to keep friendships in tact, all at the same time. Throw into the mix the anxiety I had always had, but had only realized and been diagnosed with 9 months prior. The anxiety can be kept sort of in check with mindfulness and meditation, but not entirely. It’s exacerbated by stress. So, every month, just before my period, I was prone to having MELTDOWNS. I was irritable and thoroughly disinterested in doing anything I didn’t want to do. I teared up at every commercial and BAWLED at movies. It was all very “ugh, bitches and their PMS, AMIRIGHT?!”
My evaluation from my first semester of my internship happened to fall during one of these periods. The review didn’t go as well as I had expected it would. I care more about this internship than I do most things in my life and am the kind of person who can’t stand not excelling at something I care about that much. It had been a very long week at the shelter- I had been there past my bedtime multiple days that week and thought I had made some significant breakthroughs in my comfort level and practice skills. Because of the timing though, these things were not really reflected in my evaluation. Just before I left one of those late nights, my supervisor warned me that some of her ratings might be different than my self ratings. She emailed me the completed evaluation after she finished it around 1am that night. I made the mistake of reading it on my phone as soon as I woke up the next morning. I was devastated.
I spent the morning angry-sobbing around my apartment while I got ready for the day. How could she rate me this way!? I AM BETTER THAN THIS. THIS IS NOT FAIR! OMG I’M GOING TO FAIL THIS INTERNSHIP AND RUIN MY CAREER! I CARE SO MUCH ABOUT THIS JOB!
I had a call scheduled with her to go over the review later in the day. Just before the call, I had a shake-off cry in my office, got some validation from a trusted co-worker at my full time job, and got on the phone. I managed to stay somewhat composed in my discussion with her, but it was not without barely holding back tears and a shaky voice.
My gynecologist explained to me that PMS gets worse with age. Something about it lowers the level of serotonin in your brain. This sounded exactly like my problem! She explained that she could write a prescription for Sarafem for me. This is the way they label Prozac/ fluoxetine to treat PMS. You take it for two weeks every month- from ovulation through the first day of your period. Being a mental health professional in training, I knew that going onto and coming off of antidepressants like that was frowned upon, so I was dubious. But I was ready to try it. I had been resistant to drugs for treating my anxiety for a while, but her telling me that PMS would only get worse was enough. This was impacting my life every month and I was ready to do something about it.
I talked to my therapist about this approach and she, too, was dubious about the intermittent use. I tried to monitor the impact it had going on and off of it, but I got a terrible cold during my first 14 days off of it and couldn’t tell if feeling shitty was because I was dropping off of the drug or my illness.
The second month I was on it, I had a bit of a breakthrough while out of town visiting with my in-laws. I realized that I could sit still and focus on enjoying time with family. I also realized that I was content.That trip often makes me antsy. It’s a change in my routine and there’s often a feeling of “ok, what activity are we doing next because I can’t just sit here and watch reruns of this show all day!!”
My realization moment came while sitting outside on the porch in the sun. I realized that I felt relaxed. That I was thoroughly enjoying watching the next door neighbor kids play basketball and doing nothing else. My mind wasn’t spinning. My wife came out of the house and asked if I was ok, because it’s abnormal for me to sit alone quietly without being engaged in some sort of activity. I told her that I was fine, in fact, I was just sitting here reflecting on my contentedness. I told her that I never thought I was an unhappy person, but I was definitely happier now. She, too, had noticed the decreased frenzied energy and increased level of calm.
I asked her to take a photo of me. I felt like a model, posing the way I was sitting on the step in the sun, gazing out at the world. It was a full body photo. After she took it, I asked her if it was good. Her comment was “well, you’re not going to like it.” In the past 5 years or so, I had lost and then regained about 40 pounds. Full body pictures of myself have not been my favorite since I put the weight back on. In fact, I’ve sort of always hated my body (there are lots of reason for that, story for another time). Except this time, I liked the picture. It wasn’t especially flattering. It was just me as I am. For once, I was totally ok with that.
It was this day that I decided rather than keep trying to figure out if only taking the pills 14 days per month would work for me, I decided that this change was too good to mess with. I wanted to take it every day. I emailed my gynecologist, told her that it was working for my PMS and making me feel better overall, including helping with my anxiety. She expressed that she was very pleased with this and prescribed it for all the time use.
Despite fully understanding the utility of medication and being totally open to its use for other people treating their mental illness- I resisted it for myself. Hell, even one of our cats is on Prozac! But I didn’t think my issues were bad enough for them. I wasn’t having panic attacks all the time. I wasn’t unable to get out of bed. I was functioning at a relatively high level. Except for that few days per month. And you know, whenever stress would increased and my brain would spin and not stop. But I was fine. I was holding on tight to that stigma about the severity of mental illness that required medication.
It hasn’t fixed everything. I still get anxious. And sometimes I still tear up at commercials. Especially when I’m feeling overwhelmed with responsibility and stress. But I’ve found a happiness and energy that I didn’t think I was actually capable of obtaining- and it’s improving my life drastically.