Be warned: this is a long one, folks, so settle in to a comfortable seated position. Or skip it altogether if it ain’t your thing:
I have struggled for years with anxiety disorders. I have four, formally diagnosed disorders, but it just really feels like one big mess of nerves. It’s not like I wake up in the morning and say, “oh hey, here’s my generalized anxiety to start the day,” then later at work think, “why, hello there, social anxiety,” and then, that night, “Oh good, my panic disorder has arrived, right on schedule.” Lastly, anytime I have a family gathering, as I take my Klonopin I’m not consciously thinking, “ah, and this is my PTSD, just in time for Thanksgiving.”
But nonetheless, I wake up with a level of nervousness in my system that most people would find highly uncomfortable; I spend my day trying to avoid situations that would turn my heightened anxiety into a full blown panic attack, and while most nights I can fall asleep with relatively no trouble, I never sleep the whole night through undisturbed. Any little sound wakes me up, and then the underlying anxiety keeps me up. This has all worsened recently, and I think some of it is to do with the testosterone.
I’ve been told that testosterone can give one higher levels of energy: great, right? Who couldn’t use some extra energy in our busy contemporary lives full of technological distractions and cliched examples of the current American day-to-day? But with me, my body is reading all this extra energy I’ve been feeling as of late as anxiety, because, well, most of the energy I have I use to worry about whatever comes to mind, and so extra energy means, guess what…extra anxiety!
I have used Klonopin (generic Clonazepam) for about 13 years now. It is a drug primarily used to control seizures, but also prescribed for panic disorders. Yup, I have panic attacks and anxiety attacks; the difference between the two is real, and (if you wish) something you can learn more about here. To make a very long story short, and as many of you already know, I grew up in a house with three alcoholics and an unmedicated paranoid schizophrenic. I’m traumatized. ‘Nuff said.
I go to talk therapy, which has helped me immensely. I believe talking about my problems, searching for the root of those problems, and working everyday to unlearn the bad behaviors and patterns I have developed over the years is the only lasting way to “cure” myself of all these anxiety issues. But that is the work of a lifetime. It took a couple decades to screw me up good, and it happened during formative childhood years. Some of these patterns I may never be rid of, no matter how hard I try. But I am going to try anyway–what else do I have to do?
So, in addition to therapy (I’ve also tried EMDR and biofeedback, and they have been mildly effective) I take Klonopin, because I would like some relief now from the deep seated problems that negatively affect my daily life. And Klonopin has worked well: I take half of the lowest does prescribed, as needed, which means sometimes my prescriptions expire before I even use all the refills. Lately, what should last me a month lasts me about two, so I’m taking the Klonopin more frequently, but not nearly as frequently as some people have to take it. The problem with Klonopin is that it is meant to be used to control a panic attack as it is happening, the last and most severe line of defense in the fight against anxiety. But lately I have been using it preventatively–I take a half a pill at night just (hopefully) to be able to fall back asleep when I inevitably wake up, for no reason other than my body has too much energy, at 5 a.m. Also, Klonopin is habit forming, and although I have had it under control for 13 years, I think now, with my heightened testosterone levels of anxiety, might be a good time to switch to something else to control the anxiety–something that is not habit forming. Something that I can take once a day to keep me even, and not something like Klonopin that I have to be constantly aware of the dosage and times of day I am taking it.
So I went to Dr. Josh at Howard Brown and had an appointment to talk SSRI options. I have tried them all in the past: Zoloft, Effexor, Paxil, Lexapro, et.al. and although they had relatively good results (Zoloft being the one I felt the best on) they all had the dreaded and much talked about sexual side effect: While taking any one of them I couldn’t “get over the falls” as it were.
So Klonopin, carefully, it has been for over a decade. Josh tells me because I’m on testosterone the sexual side effects likely won’t affect me this time. So I give Zoloft a whirl. And this time it is different: In the first five days it has increased my anxiety, it is making me lightheaded, and the sexual side effect is obviously there. I feel worse on it, not better. And this time, not only can I not “get over the falls,” but also it is tanking my libido altogether. So I call Josh. He wants me to stick with it, cut the pills in half, and see if it gets better. I want to be fair and give it a shot. But the overwhelming number of people on Zoloft say the sexual side effect, the one I am not willing to live with, will not go away. Some people respond to Zoloft that way, many people in fact: SSRIs are sort of known for destroying your sex life. So I’m torn between giving it a shot in the spirit of compromise and humility (I have noticed lately that, contrary to previous long held beliefs, I don’t know everything), and quitting right now in order to try something else. I found this article on ol’ Cheaty McSteroid’s* website about anti-anxiety meds without sexual side effects. So I am split: do I tough it out and see if I am the golden child whose sexual side effects go away and I can live happily ever after on Zoloft, or do I cut my losses now and tell Josh I want to try something different?
Gah, I just don’t know.
I want to reward you, dear reader, for hanging on to the bitter end of this post, with an anecdote from work yesterday:
Bossman: Eli, will you need any help finishing frozen tonight?
Eli: No, I think I’m good.
Bossman: Are you sure?
Eli: Yeah, totally. I had some help earlier and it put me in a good spot for the end of the night.
(Bossman exits aisle)
Will: (my friend working in the same aisle as me, and in a playful, chiding tone) You know Eli, it doesn’t make you any less of a man to accept help when it is offered.
Eli: (smiling) Thanks Will, I’ll remember that.
Will: (revising his previous statement) But it does make you less of a man to ask for help.
Priceless advice. 🙂
Be nice to yourselves,
Your Pal Eli
*While I am very disappointed in Lance Armstrong’s professional cycling decisions, his website proves inspirational and is full of valuable information. For livestrong.com, and Armstrong’s determination to beat cancer and be a good example in that way, I applaud him.