The "Black Dog," Part III

By the end of March, we decided to get engaged and work out our differences. (I’d move to Kentucky and he’d be open to not having biological kids.) In early July, I quit Lexapro cold turkey. (This, folks, is a NO-NO.) Two weeks later, I had a relapse and attempted to commit suicide. Bob freaked out and called the cops and I nearly lost my job at a prestigious magazine. It wasn’t Bob’s fault; it was mine for quitting a med cold turkey and it was Dr. X’s for not warning me about the potential for suicide attempts on the drug. Perhaps she didn’t know. After all, she kept doling out Lexapro samples to me via the drug rep. When I told her in August that Lexapro wasn’t working, she became skeptical, assumed that I was still being noncompliant and wrote out a prescription for Zoloft. By that point, I was tired of meds. I’d gained 40-50 lbs between Paxil and Lexapro (after being skinny all my life) and still had a difficult time functioning normally. I never filled my prescription.

I moved to Kentucky in September and started a new job in October. After things became a little hectic and overwhelming at work in December, I became suicidal once again. I never saw Bob during the day (I worked second shift into third shift sometimes) so he was able to be depressed during the night and hide it apart from me since I rarely saw him. Bob, fearful of a failing marriage and I’d make good on my promise to kill myself, made the decision for us to move back to his hometown in Pennsylvania in April 2006.

As of January 2006, I knew I needed to be hospitalized and talked about it frequently. However, I felt like I couldn’t: "My job needs me," I said. "We’re understaffed. My job needs me." Even the anxiety of handing in my resignation at a job I hadn’t been employed at for a year gripped me.

We began our job search in the metro Philly area in April and both landed jobs in May. He in the suburbs; I in Philadelphia. My suicidal attempts and thoughts remained with me, but began to increase in August. My sick days became frequent. After a honeymoon at the end of August, I came back in September to a hostile co-worker and a micromanaging, picky boss. Those factors – in addition to whatever I was already dealing with – contributed to taking a disability leave from my job and admitting myself to a psych hospital. I’d been unwilling to do it because I was so busy, but if not, my husband would have been forced to do it for me.

I stayed in the hospital for 7-8 days. The doctor who initially admitted me asked me what meds I’d been on. I said Lexapro and Paxil. I mentioned I didn’t like them. He suggested that I try Celexa in the meantime and that it wasn’t the same as those two. Before I began this blog, I had no idea that Lexapro (escitalopram) and Celexa (citalopram) are virtually the same thing. I passed on Celexa at med times, knowing that my case doctor would be switching me to something different. My case doctor, Dr. S, recommended Effexor XR after I told him that I’d had trouble with Lexapro and Paxil. He said, "Well, it’s an SNRI and functions differently than an SSRI. Let’s try you on that. We’ll start you off at 37.5 mg and get you up to 150 mg by the time you leave."

On the first day of Effexor, I developed severe somnolence that lasted an hour. Later that day and the next three days, I developed severe dry mouth. I’d never known what dry mouth was until then. So I chugged several Snapple Iced Teas a day since water wasn’t available through their vending machines. (Weird, I know.) When I began at my intensive outpatient treatment afterward, a nurse told me that drinking too much sugar can cause the liver to overproduce sugar – if I remember correctly – which can lead to diabetes. *sigh*

Because of a (somewhat) sexual assault incident at the hospital, my release was hastened and I left at 75 mg of Effexor. My psychiatrist at the outpatient clinic titrated me up to 150 mg, which according to him, "is standard. Some patients do better at 300 mg." (!) By the time my outpatient treatment was over, I was steady at 150 mg of Effexor.

In the meantime, my husband was overtaken by all the events that had been occuring since August. (You’d be freaked out too if you woke up to see your spouse trying to hang him/herself.)

In November, he finally admitted to me that he struggle with depression. He began crying all the time over nearly everything. As a computer programmer for seven years, he felt inadequate and insecure at his new job. He cried over my depression. He cried about worsening my depression with his depression. He became anxious over everything. He couldn’t sleep in the event that he’d wake up to see another suicide attempt. He became wracked with anxiety. After much provoking and nagging, he finally agreed to seek treatment in the evening at the outpatient clinic I’d been to. He found it somewhat helpful but admitted that it was difficult to act on what he’d learned.

November threw another curveball at us when my outpatient psychiatrist diagnosed me with bipolar disorder. That finally explained my hostile, irritable, and angry episodes (which normally occurred at night) in addition to my depression. Now, Bob became anxious over the next manic episode that might occur.

Just as he had involved my mother of my situation, I sat down with his parents and spoke with them about Bob’s. His parents seemed taken aback. The quiet, shy kid had all these problems that they’d never known about? His parents and I thought that Bob was freaking out over me and the recent events. Little did we all know that it was simply a trigger. Since I was around Bob all the time now, he wasn’t able to hide it from me any longer.

Despite weekly counseling that we began in August, he still suffers from extreme anxiety. He still suffers from depression with passing suicidal thoughts. He still cries and gets angry over, well, insignificant things. But he’s been brave to admit that he struggles with depression. He’s taken a leap of faith to talk to his parents, his brother, and me about what he deals with and some of what he’s been thinking. Bob has a long way to go, but he’s finally taken the steps forward to recovery.

8 Comments

  1. Mark said,

    March 7, 2007 at 6:18 pm

    I wish you could see that there is a step between feeling terrible and commiting the action of suicide. They are seperate. I often feel terrible myself, then think of suicide for relief of the pain and agony.I then decide to change what I’m feeling.Everyone can do this to escape suicide.

  2. March 7, 2007 at 9:35 pm

    Mark,
    The thoughts and actions of suicide are different for everybody. There are some people who can stop themselves and have control over their urges. As for me and many other people, I have been to the point of desperation where I could not even think.
    To assume that everyone has control over their actions and thoughts like you do is a mistake. And in some ways, judgmental. I am learning to control my actions. For some people, it comes naturally; for others, it takes time.
    ~ Marissa

  3. Dad & Mom said,

    March 8, 2007 at 11:05 am

    We love, support and encourage Bob and Marissa in every way that we can think of or are asked of. We wish that we had known more of what Bob was going through in his childhood and in his school and college years but he kept it very well hidden. We as parents maybe should have seen through some of what was going on but Bob tells us now that he became a master at keeping it hidden and we are not to blame for not realizing. That doesn’t make it any easier as parents to accept that we were oblivious to our own child’s needs but it is something that we are working on changing and accepting so that we can NOW be there for them, to do all that we can NOW to give them all the backup, encouragement, support and love that we can. There is nothing in this world that we wouldn’t do for our children (including our loving daughter-in-laws). We want the best for them and for their lives, we wish them contentment, stability, happiness, love, an understanding of each other and a willingness to forgive and forget – that they would turn to each other and us but most of all God in times of need. We pray that they will let us “in” and find a need for us as much as we need them. We hope that they can remember to pick their battles – to not sweat the petty stuff, to give and forgive freely and openly to each other and others. Bob and Marrissa mean the world to Dad and I, there is nothing that they can’t tell us, show us, do, think, or act on that would make us turn away from them – we just love them!

  4. Mark said,

    March 10, 2007 at 12:36 am

    The power of the word suicidal as a feeling and behaviour.
    http://www.salon.com/mwt/feature/2007/03/09/suicide/index.html
    The suicide test
    Alarmed by recent reports of student depression and fearing malpractice lawsuits, colleges are struggling with ways to treat suicidal students — including expelling them
    After watching how upset students became around classmates who talked incessantly of death or cut their arms in self-mutilation, Amada concluded that a student’s suicidal behavior unavoidably disturbs others. “Most times if you have highly suicidal students, you’ll find people around them ripped apart,” says Amada.
    Schools, he says, should inform suicidal students that they’re hurting others and warn them that they’ll lose their academic standing or campus housing if they continue their behavior. That message can snap them out of a suicidal mind-set.

  5. Stephany said,

    March 10, 2007 at 11:19 am

    Regarding students, suicidal thinking, and losing campus housing, etc.
    I have a 24 yr. old daughter who became suicidal, acted on it, was taken to an ER twice at the University, and one of the times, campus police got her an ambulance and made sure I knew she was in the E.R. The school not only backed her; they made sure to notify all of her Professors, that she needed leave from work due, etc. due to mental health issues. The Dean of Students worked personally with her, not wanting to lose her as a person, and a student.
    She was accomodated, and allowed to re-take finals that during this time she had failed.(F).
    Now one year later, she is excelling at the University. She was not able to control her suicidal thinking; and as Marissa said, not everyone can control the thoughts, and they indeed DO act on them.
    Through DBT therapy groups that the CAMPUS provides for free, along with Lamictal, she is now able to stop her thoughts from becoming actions. She swears by DBT group for teaching her how to ride above the thoughts. This took effort and time on her part.
    The threat of losing academic status, or housing never would have stopped her.

  6. Marissa said,

    March 12, 2007 at 6:17 pm

    Stephany,
    great, great comment. I’d like to know where I can find DBT in my area. CBT is bigger around here.
    I’m glad that she can get GOOD therapy for free through her school.

  7. Marissa said,

    March 12, 2007 at 6:19 pm

    Mark,
    In response to your post: do I have a story for you! Look for it soon. I was expelled from a college for this exact reason.
    Thanks for the link.

  8. Stephany said,

    March 13, 2007 at 12:38 am

    Marissa,
    I would look towards a ‘teaching’ hospital’. Do some footwork. If you would like; email me, and I will help you look into DBT in your area.–Stephany


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