After a somewhat taxing Holiday season, I have to admit that it's time to up my depression meds. I've been resisting it. I've been rather pleased and relieved that I have been getting by on a very low dose of Celexa: only 20mg at night for the past 7 or so years.
But this last bout of PMS has convinced me that I need to finally up it a bit. I had accidentally taken two pills last Tuesday. I wasn't sure if I'd taken my pill, so I took it (again.) It would have been worse to skip it all together, than to double up. The worst that would happen if I doubled up is I would clench my jaw. Without it, I'd clench anyway, AND be even more out-of-it.
Wednesday was the only day last week I felt good.
Before I'd even started on my meds years ago, (which I had resisted beginning until I had made sure that I was done having kids and that everyone else's health needs, especially MLB's, were attended to,) I knew my moods were quite attenuated to my menstrual cycle. I was started on the 20mg dose, and after an about 5-week adjustment period, found that I had more energy and less needless stress and better sleep. I was thrilled that I only needed a tweak; I'd known of too many others' long searches for the right dosing. I had the usual initial side-effects of thirst, somnolence and fogginess, all of which passed. The one side effect that never truly passed, and has always been an odd one, is that I involuntarily clench my jaw when my med/serotonin level changes.
After all of this time, I've noticed that my week of PMS has been getting "draggier." I tried having my meds "cycle" with my cycle: 20mg for a week, 10mg for a week during ovulation (I'm euthymic then,) 20mg again for a week, and then up to 30mg for PMS week. But with all of that constant changing, my jaw stayed tight. Also, my cycles aren't precise weeks. It wasn't worth the effort.
I've been having more "rumination" before I sleep. (Night-owl, night-thinker-- runs in the family.) My psychiatrist, last year, suggested upping my meds. I declined, because I believe science is still trying to determine how an SSRI might permanently change the brain. While the results of coming off an SSRI are not officially categorized as "withdrawal" as if one was coming off some other meds, it has still been noted that discontinuing must be done slowly and that many people do not fully adjust to life without an SSRI, or at least not quickly. Since I plan to be on this the rest of life (unless menopause gives me a radical overhaul,) I have been concerned about "maxing out." I am at a point that I have adequate experience and family support to ride-out those outlier emotional collapses, and to not get in a tizzy about day-to-day stuff. I've done well.
But, I have to admit, it's been time to up it. So I've been on 30mg for the past few days. Again, sleepy and clenching my jaw, but both will pass soon. I'm feeling a bit more together. We'll see if I need to stay here or bump it up again.
Life is too short to not have one's head in the game.
