I was sick of waking up in a panic. Except now, it wasn’t just in the mornings or at night —it was all. damn. day.
48 hours after my doctor increased my daily dose of an anti-depressant, Wellbutrin, it seemed that this overwhelming sense of impending doom consumed me.
In a previous post —Insomnia and Full Blown Insanity: My Experience with Wellbutrin, I discuss, my experience with some pretty scary anti-depressant side effects.
I thought, isn’t this shit supposed to make me feel better?
And that’s just it —it was making me worse. So I did what any millennial in this type of situation would do —I researched those effects. Per my Google search, I better call the psychiatrist prescribing me these meds. He was nice, supportive and sorry I had such a bad encounter. After the conversation, I learned the side effects were, in fact, outweighing any positive leeway Wellbutrin could do for my depression. I was a little bummed. TBH, I still am.
Because I thought the increase was really going to help. But no. No way, Jose. So I went back to my original dose and, “We’ll go from there,” he said. A part of me felt like I was taking a few steps in the wrong direction. But I’m trying to remember that sometimes, going back is exactly what we need to move forward. So I did just that. But then, other weird things started to happen. I think my body was extra sensitive to the medication. I suppose the increased dose was still in my system.
So it was kind of freaking out. I was too.
So I call the doc again. At this point, he agreed, the side effects I was now experiencing were not your standard dry mouth. He wanted to see how I’d feel if I stopped the meds completely. Because what I haven’t mentioned are two new symptoms —a few somethings my doctor said were indications of a bigger issue. Because now, I was having difficulty swallowing and breathing, which was scary AF. I mean, this shit was serious enough to warrant a discontinuation. So that’s exactly what I did. And here’s why.
Here’s what happened next.
Difficulty swallowing —referred to as dysphagia, usually means there’s an issue with your throat or esophagus —the muscular tube that moves food and liquids from the back of your mouth to your stomach. Difficulty swallowing can have causes that aren’t due to an underlying illness. Shit like taking large bites of food, inadequate chewing, dry mouth, prescription pills, or food that’s too hot. When this happens, swallowing may also be difficult when talking, laughing, or lying down. Yup. All true.
Like after I’d eat something, it felt like something was stuck in my throat. It felt like I was permanently choking —even when I could breathe, swallow and gargle. I read if something like this happens, you want to drink a glass of water, down some type of carbonated beverage and/or eat a piece of bread. They say that because a few sips of water can wash down the stuck food by moistening (hate that word) your throat. Whatever is blocking your esophagus can typically pass through…
And bam, you’re OK.
So after you let one out, that odd feeling should pass.
It’s interesting because doctors don’t know exactly how it works. According to Healthline, an online physical and mental health platform, the carbon dioxide gas in soda helps disintegrate food. It’s thought that particles from soda travel into the stomach, which then releases gas. The pressure of the gas should then dislodge the piece of stuck food. And then, there’s bread (I love that too). Eating bread will absorb whatever is impaled —bringing it down your throat to your stomach —where it should have gone in the first place.
You can try dipping a piece of it in some water or milk. Eating a banana —a naturally soft food, works too. Anyway, that shit isn’t fun. Because then, it started happening more frequently. It started happening when I wasn’t even eating. That’s when I did more research. Per my quest about Wellbutrin side effects, if you’re taking an anti-depressant and start having trouble swallowing (and/or breathing), call a medical professional right away —as it may be time to stop taking that particular medication.
And damn, I think it was.
Because it said the specific side effects I was experiencing are a little more severe than restlessness or insomnia. That’s when I gave my doc that ring. All this shit was definitely making my anxiety worse. But I’ve learned to tackle the bad stuff head-on. Because it’s real —whether I choose to deal with it or not. So I call and explain how awful I’ve been feeling. He asks for a play-by-play. After describing everything in between, he tells me to, “Stop taking it immediately.”
He was concerned. TBH, I was too. He said it’s nothing to freak out about but that he was glad I called. We talked some more. By the end of the conversation, I felt a little better but I was still bitter. I mean, feeling sick from something that’s supposed to make me better is so fucking annoying. No time for regrets though. Because then he brings up anti-depressant withdrawal (more on that below), which (of course) is a thing.
For those who don’t know, most antidepressant drugs are apart of a class of medications called selective serotonin reuptake inhibitors (SSRI’s). They work by boosting the levels of serotonin in your brain. Serotonin is a type of neurotransmitter —a chemical messenger that carries, boosts, and balances signals between neurons (nerve cells) to other cells in the body. Serotonin (the chemical that neurotransmitters send out) contributes to feelings of well-being and happiness.
It also modulates cognition, reward, learning, memory, and numerous physiological processes. Shit we need to be happy; to feel healthy and normal. People with depression (like myself), however, tend to have lower levels; therefore making them (me) less happy than the next guy with a routine set. So in theory, if you take a drug promoting higher levels, it should make you happier. That’s why mental health specialists prescribe this shit in the first place.
Because when it works, it works.
That’s also why they are the first line of defense for people with depression. The thing is, there are so many types and classes of anti-depressants. Each will vary in their effects on who’s taking it, why they’re being taken, and how they’ll interact with other medications. There is no evidence that one is more effective than another. However, patients may respond to or tolerate one more than another. In my case, I’m on Wellbutrin, which is an anti-depressant —but it’s not an SSRI.
Wellbutrin (or the generic equivalent, Bupropion) is a norepinephrine-dopamine reuptake inhibitor (NDRI), which boosts levels of the neurotransmitter norepinephrine (yeah I can’t pronounce that either) —also known as dopamine. Dopamine is a chemical in your brain that affects your emotions, movements and your sensations of pleasure and pain. It also helps with motivation. So in theory, by increasing levels of dopamine, you can increase all of the above while lowering your perception of sadness and pain.
What’s interesting is that, besides working as an antidepressant, this particular drug blocks the receptors that nicotine normally binds too —making it useful in smoking cessation. Specific to me, because I’m using it for depression, Wellbutrin works by increasing the activity of natural chemicals in your brain. That’s the easiest way to put it. Basically, once those chemicals (neurotransmitters like dopamine) are activated, your nerves use them to send messages to one another.
Messages that then travel back to your brain that essentially erase feelings of depression.
Unlike most anti-depressants, Wellbutrin does not cause drowsiness. For reference, I also take 50 milligrams of Zoloft (an SSRI), which makes me really tired. That’s why they say to take Zoloft at night and Wellbutrin in the morning. There are other reasons for that too. Reasons such as insomnia, cardiovascular shit like heart palpitations, dizziness, muscle spasms, and joint aches. You may also experience an overwhelming sense of impending doom.
A.k.a. severe anxiety, nervousness, and restlessness, along with dry mouth, nausea, and vomiting. My point is, SSRI anti-depressants cause severe withdrawal when you suddenly stop. The NDRI (Wellbutrin) class, however, does not. I was relieved to hear that. Finally a win. Because I’ve gone through withdrawal before —opioid withdrawal that is. And let me tell you, it was the hardest thing I’ve ever had to overcome. I will say, anti-depressant withdrawal is a little different.
Here’s how it works.
When you take something for an extended period of time, it changes the matrix of your brain —in this case, how your body reacts to serotonin receptors. When this happens, your brain will “down-regulate” the number of receptors in response to the increased volume of serotonin. It’s a physiological balancing act meant to prevent the overstimulation of brain cells. But when treatment is ultimately stopped, there will be fewer receptors than before —and a short-term deficiency of serotonin activity.
Hence why doctors recommend to gradually take less and less.
That way, your body has time to respond to the diminished amount of medication. Tapering over a longer period of time will also reduce the potential for serious withdrawal symptoms. But like I said earlier, Wellbutrin is different. Stopping anti-depressants like Wellbutrin —that do not affect serotonin systems (because they are dopamine and norepinephrine reuptake inhibitors), are less troublesome overall. Meaning, withdrawal symptoms are fairly minor. Halle-freaking-lujah.
Besides some irritability, your body adjusts rather quickly. The withdrawal timeline will differ from person to person. Symptoms typically last from a few days to a few weeks. 99 percent of Wellbutrin is eliminated after roughly four and a half days. For me, when I stopped (a few months ago), I felt basically nothing, which is a good thing —a very good thing. And TBH, I feel better than I did when I was on the medication. My anti-depressant side effects are nearly gone. Besides that swallowing shit, which has gotten better, I’m back to my normal self.
Isn’t it crazy?
Because the pills were supposed to make me feel better —when, in fact, I feel better without them. Now, I’m not saying these medications don’t work. That’s just not true. Because I’m also on 50 milligrams of Zoloft (an SSRI). I can say without a doubt, this shit helps me and my OCD tremendously. I remember how I felt before I started taking it. I was working, working out, plucking my eyebrows, and cleaning the house all at the same time. I was driving myself crazy because my OCD was left untreated.
That said, everyone is different. What works for me may not work for you and vice versa. I think the issue, in my case, was the increased Wellbutrin dose. I went from 150 to 500 milligrams and my body just didn’t know how to handle it. So any standard side effects were intensified and it took some time for it to normalize. Because today, I’m back. The cardiovascular shit like heart palpitations —dizziness, muscle spasms, and joint aches don’t affect me anymore.
Same with insomnia (well, most nights), that overwhelming sense of impending doom —anxiety, nervousness, restlessness —dry mouth, nausea, and vomiting are gone too. It’s pretty fucking remarkable. I can’t even tell you. It’s a beautiful thing. The best part is, my new treatment regimen is all done at home. I don’t have to travel to the doctor anymore. I don’t have to wait in that darn waiting room for hours on end. I don’t have to go CVS to pick up my prescriptions either.
Looking on the Brightside.
I don’t have to do that shit anymore because of a little something called Brightside —the fucking future of medicine. It’s an online service —a one-stop-shop for all things depression. I saw an ad online (I know right) a few months back. It prompted me to take this depression assessment to see if their services could help me. I was intrigued. Because I was sick of driving two hours to this mental health clinic. It was driving (pun intended) me crazy riding to and from every other week.
So when I read I could be matched with a mental-health physician, receive ongoing support and medication delivered straight to my door —heck yes, I looked into it. So I took that test and after about the company, I actually signed up. And damn. This shit works. Because today, I receive digital therapy through this face-time like app every couple weeks. I have 24.7 access to my awesome doctor. I also get self-care tips on how to make the most out of everything in between.
Because as you know I have severe depression and anxiety.
Which can make it extremely difficult to seek treatment. Not anymore though. These days, I feel hopeful, supported and head. Partly because my doctor checks up on me regularly —to make sure my medication is working —and that I’m not having any more side effects. And as you know, when I experienced the shit I described above, he helped me get through it. I mean, my depression score went from severe to mild. My anxiety ish too. There’s a reason for that. There’s a reason I feel healthy, and happy and normal.
And damn. He nailed it. Because that shit helps too. My point here —when something is too hard, there’s always another way. There’s always another option. If “plan a” doesn’t work, remember, the alphabet has 25 more letters. So if something doesn’t feel right, change it. Take a step back. Breathe. Hop in the shower —wash the day off. Drink a glass of water. Make your room dark —lie down and close your eyes. Notice the silence. Notice your heart —still beating, still fighting. You made it. You made it another day. And you can make it one more.
Just look at me.