Medications are working, therapy not crucial

I saw my therapist on Saturday and we had a routine session. Lynn (yes, some of you may notice a change but it is the same therapist) began with the usual question, “How are things going?” and after I said, “Pretty well, actually,” Lynn talked about how I had cancelled therapy last week.

She said, “I assumed you were doing okay if you didn’t need to come and see me.”

Part of me thought, Oh, shit, when I cancelled I didn’t explain how I was doing at all and now she’s calling me out on my lack of explanation beyond “I don’t want to get up and out so early on a Saturday.”

I explained that the 8 am time is tough for a Saturday and I looked directly at her and asked pensively, “Maybe you would prefer to not start that early, also.”

She shook her head and said, “That’s when my day regularly begins.” In thought only, I considered the type of person who would work all week and then begin her private practice on Saturdays at 8. My answer: An ambitious, go-getting personality who doesn’t need rest and an escape from the “real world.” A person unlike myself who needs time off to refuel on the weekends.

Learning she regularly has an 8am appointment, I followed with an apology and said, “I hope you had time to fill my slot.” Although I know she did, since I cancelled our Saturday appointment on Tuesday, I still felt guilty. Lynn replied, “You gave me plenty of advance notice.” Now it seemed to be all about pleasantries and I wanted to end this small-talk.

We moved on to the important business of the medications she prescribes for my depression and her thoughts were:

Since Celexa is working for me we could cut the pill in half and try 5mg. I asked her “Do you know how small that pill is?” She told me the Klonopin is small and I educated her that the Celexa is half the size of the klonopin. I described it as about the size of a tick. (Yes, I have a dog). We decided to leave the dose as is, which is the lowest dose of Celexa at 10 mg.

I told Lynn about the early morning awakenings and she appeared surprised that I wake every morning at 3 or 4 am. I admitted that my routine of taking 2 Tylenol always put me back to sleep. Lynn suggested I try taking the Celexa at night but I told her I was worried I would be up all night since I’m not tried during the day when I take it in the morning.

The difficulty, Lynn says, is I’m also taking 100mg of Wellbutrin in the morning so we don’t know which is causing the poor sleep. I’m thinking, Perhaps the Wellbutrin is the culprit for my alertness since the higher dose made me angry and irritable. And Wellbutrin is an SR so it’s releasing for 24 hours. Lynn didn’t suggest we change or drop that drug so I will continue taking both in the morning.

Lynn asked about the Klonopin and I explained that since I began the Celexa I take it every night at bedtime. One night when I tried to go without it, I was wired and could not sleep until I took it.

Lynn reminded me that the reason she prescribed it was for early afternoon anxiety. “I don’t have that anymore,” I replied. “My evenings are calm and I’m relaxed. I no longer have anxiety and most nights I sit and have a cup of tea.” How much more relaxed could I be? She told me to take the Klonopin right before bed if that is working for me.

I admitted to Lynn that I took a Klonopin for my anxiety before a dentist appointment. I said, “I wasn’t even sure it worked and if it did, it may have been a placebo effect because it wasn’t really noticeable.” When she heard I took it ten minutes before the procedure, she said the medication takes 45 minutes to be absorbed. Next time, she suggested, I should take it earlier. I replied, “I feel like I should have taken 2, although I have not done that yet.” Lynn shook her head and came back with, “don’t do that because we may need the wiggle room in the future.”

Ah, this therapist always has a “plan B” if the current pharmaceutical cocktail isn’t effective. I like that about her. I feel comforted to know she sees my depression and is treating it now and looking toward the future.

Now to the lovely (NOT!) side effects.

I mentioned to Lynn that I have been constipated. I recall when I was on Effexor or Lexapro (not sure which) that I had difficulty urinating and would sit on the toilet, feeling the need to pee for a few minutes and not being able to. That is not happening with Wellbutrin or Celexa (thank God) but this constipation is no fun either. Lynn said it was most likely the Klonopin. Perhaps she’s right. However, I believe when you are on 3 meds it is hard to know which the culprit is.

I also mentioned a slight headache in the morning and evenings. It’s not such a problem that I can’t bear it but it’s noticeable. Lynn reminded me, “You already have issues with migraines so it would be hard to blame the antidepressants.” I firmly replied, “This headache is not a migraine and it’s not bad enough to take Imitrex.”

Lynn wrapped up this conversation by summarizing, “Your mood is better, you’re not drinking and you’re not as hungry. Every medication has side effects and we must weigh the benefits against the negatives.” True enough and I agreed.

What I didn’t tell her is that since I began Celexa I have not been able to have an orgasm. I continue to get pleasure from stimulation but I cannot bring it to a conclusion. Truthfully, I could masturbate for ½ an hour with my vibrator on high and still not get off. This is unlike me. Usually after 5 minutes I come. Hey, I’m writing about this because I am more than just a physical and emotional person — I am also a sexual being. I’ve always felt my ability to release pent-up stress by having an orgasm was one of the better things I can do in terms of my mental and physical health. The meds have me so relaxed that I can’t get myself tightened to the point of being able to have a fully released orgasm. Currently, it’s not necessarily frustrating but it is significant and noteworthy.

Okay, so I can’t orgasm. But, my mood is 100% better and I’m not anxious or depressed. Which would I choose? For now, it is to not be depressed. I’ll forgo the orgasm.

I’ve been here and done that. Eventually, I will miss having an orgasm enough that I’ll complain. Once I get cocky enough on my positive frame of mind; but for now, I’m going to enjoy this good mood. And I’m thinking of investing in a higher-powered massager. Maybe that will solve the aforementioned problem…

Oh, my, did I digress. Back to the point of this post, which is my recent therapy session.

After Lynn wrote me a new RX for Klonopin, she asked when I would like to see her again. She’s not available next week; I’m busy the following weekend so that puts us 3 weeks out. She offered me an 8 am on that day. I’m feeling so good I declined that appointment so I will see her again in 1 month at 9am on Saturday. I laughed and joked, “Just a few weeks ago I was complaining every other week was not enough.” As any good therapist would respond, she said, “It is good I spoke up about how I was feeling.”

Before the therapy session ended, Lynn said, “I’m here to talk about any issues you have so feel free to bring anything up in therapy.”

I’m feeling so calm and in such good spirits that I asked, “What were you thinking I need to talk about?”

Her response, “I don’t make the agenda. What did you talk about with your other therapists?”

My reply, “I had stress and issues around my childhood.” I continued, “When I’m depressed all of my childhood traumas move to the forefront and I have a lot to deal with all over again.”

Lynn affirmed, “When a person has been in therapy and done the hard work around healing from past traumas they don’t need to reinvent the wheel.” I think she meant the medications settle my thoughts.

I felt vulnerable that we were bluntly talking about me when I’m depressed and when I’m properly being treated.

Seriously, how many people know all facets of me and I have a dialogue with them about my depression? NO ONE. Not one person on this Earth right now is as capable and willing to help me heal as this therapist. I have begun to trust her completely.

Shit, this is real growth — I’ve done the hard inner-soul searching work, found a therapist who is treating my depression and for the time being, the past is firmly behind me.

One last thought – Can I freeze this moment in time?

7 responses to “Medications are working, therapy not crucial

  1. Your orgasm will come back, no pun intended. When I started Celexa I was so sexually frustrated. But, after 3-4 weeks I was able to orgasm, and my orgasms were actually longer! -Best

  2. You’ll come again!! ha ha
    no seriously.
    i love the way you write.
    I read every word you post, even when I’m not actively blogging.
    thanks for being so honest and decreasing the amount of bullshit in my world.

    • I’m glad you get my sense of humor because even though when I write about orgasms it seems all serious but it’s not at all. Yeah, I know I’ll come again too. There are worse things for me to be trying to correct! HA HA

  3. Wow, sounds like you are in a really good place and have a great relationship with your therapist. Good for you!

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