The Ted Talk They’re Never Going To Ask Me To Give
It’s titled “It Sucks To Be Crazy.”
Ninety days ago I had a really productive appointment with my psychiatrist. I was drowning in darkness. I was on a max dose of my antidepressant, Wellbutrin, and it was becoming less effective. The Strattera that I’d been taking for my ADHD for three months, wasn’t ever effective. It was the middle of winter and I was struggling to find any light in the world.
The Psychiatrist, really a licensed practical nurse that works under the direction of a psychiatrist, suggested that we switch from Wellbutrin to a new form of it called Auvelity, and that I wouldn’t even need to wean off of the one onto the other. He suggested stopping the Strattera and he prescribed a new, non-stimulant medication for my ADHD called Qelbree. I asked questions, and we discussed them and it was very much a mutual decision that I’d switch my meds up the next day, and I was optimistic and looking forward to finding some help and relief.
I picked up my new medications, and started them, and went on getting through the winter’s devil dances as best I could. Finding light remained challenging. The parts of my mental health that hold the most threats of fatality got louder and more persistent, and after about six weeks I had a real “what the fucking bloody hell is going on here” moment.
For well over a decade now, I have this time honored ritual of changing medications once or twice every year or two, and I spend two days searching the internet for potential side effects. I look up what the medication does inside the brain, which transmitters that it’s supposed to alter, and search and search to make sure it doesn’t react to my other meds or make my other mental health diagnoses worse. For example, many mental health medications that are prescribed to treat depression or ADHD, can also have underlying effects for people that are bipolar and have mood instability issues.
Well, fuck, I didn’t sit down and research anything about Qelbree. A friend I know takes it and said it helped a ton, but you weren’t supposed to drink caffeine with it. They all say that shit and I drink two pots of coffee every day anyway. So I took it and I took it, and it didn’t help my ADHD at all, and when I finally sat down and looked at its side effects, surprise! These possible “more rare and serious” effects are on WebMD:
New or increased thoughts of suicide or death
Suicide attempt
New or increased feelings of anxiety, depression, or other unusual changes in mood or behavior
When you visit the official Qelbree site for physicians, this warning is at the bottom of the screen
WARNING: SUICIDAL THOUGHTS AND BEHAVIORS
In clinical studies, higher rates of suicidal thoughts and behaviors were reported in patients with ADHD treated with Qelbree than in patients treated with placebo. Closely monitor all Qelbree-treated patients for clinical worsening and for emergence of suicidal thoughts and behaviors.
My bad. Never in a decade would I have agreed to try this during the winter, but it happened, and I stopped taking it and I just so happened to have a Neurologist appointment to discuss a new medical test report that shows I have some mild brain damage, cognitive impairment and ADHD, combined type (only around three percent of Americans my age have combined type.) The neurologist changed my ADHD medication to Vyvanse, a stimulant medication that’s a controlled substance. He and I agreed to start on a low dose, and go from there, and we agreed on that because for years I was prescribed Adderall, but I had to stop because of blood pressure problems. Now my blood pressure is better, not perfect, but much better, so I’m optimistic this might help in the long term.
Meanwhile, it’s weeks later and I still find myself playing Texas Hold ‘em with Satan. Maybe it’s only 60% as often, but you go all in with your life on the line a few times a week and come back and tell me how anxious you are to shuffle the cards again. I’d like to step away from the table for a bit, too.
And wouldn’t you know it? Right in the middle of all of this ugly black blob of bullshit, all of a sudden I stopped being able to have orgasms. I’m going to try to not offend common sensibilities here, but please know that I am also diagnosed as hypersexual, and orgasms are one of the biggest and most favorite highlights of my daily life. I’m 47 years old and I was nearly giving myself an aneurysm or stroke trying to achieve the impossible. Even worse, I began to sometimes lose the ability to maintain an erection the last few weeks. If this side effect lasts long enough it will contribute to my already stubborn suicidal ideation, just so we are all uncomfortably aware.
I had a near mud puddle meltdown. I raced to the internet to see what was really going on with this new antidepressant, Auvelity, and fuck, shit, right up there listed in the most common side effects on WebMD:
Sexual problems such as decreased sex drive, delayed orgasm or unable to have an orgasm, or problems getting or keeping an erection.
Fuck shit motherfucker. I emailed my Psychiatrist a nice letter. I said my Neurologist changed my ADHD meds to Vyvanse, I explained why, and I attached the new medical test reports so that he would have them, too. And I told him that the Auvelity was fucking up my sex life, and that I looked forward to seeing him soon at our regular visit.
This is where I made the biggest mistake in the whole situation: I stopped taking my antidepressant. I said to myself out loud, “it’s not going to make me withdraw like alcohol or heroin, so fuck it. I’ll see the Pysch next week. I’m having a fucking orgasm, or two.”
Anyone that is still reading this, and that has struggled with their own mental health is now saying, “oh no. OH no. OH NO.” in their heads, and rightfully so. I want to be clear about this, if you take antidepressants, mental health medications, or any prescribed medication at all, you should NEVER stop taking it, or them without talking to your prescribing doctor, unless it’s an emergency. Increased suicidal thoughts IS an emergency for me. A lack of orgasms feels like it is, but it IS NOT.
Even more, for over a decade now, I have tried to hold a commitment with myself, and with my therapists, that I would not stop taking my meds without talking to them and my Psychiatrist first, and I hadn’t broken that commitment in at least a few years, a huge accomplishment for a bipolar human. But the last two years have been the most difficult years of my life (not the hardest) and my brain doesn’t work like it used to, and all of my mental health has been more challenging to manage because of it, and I have stopped taking them the wrong way, briefly, a few times in this new phase of my life.
I’m bipolar and I’m human. And I did it, and after a couple of days, I quickly realized my massive fuck up. I’d been on that max dose of Wellbutrin for a year or more, and then to the Auvelity, and had I talked to my Psychiatrist, or my therapist, they would have reminded me that I needed to wean off of these powerful antidepressants. That my brain had been throttled for a long time, and that stomping on the gas pedal like I was trying to pass a slow car on a two lane highway might rattle a few old bolts and screws loose.
I noticed I was a little emotionally sensitive, like weepy, but not crying. I had a pounding headache. My emotions were up and down, and I was feeling things far more deeply than I normally do, which is already a heavy and deep empathic. I felt this way for a few hours and lucky for me, I have been trying to get better, and to learn to manage and stabilize my mental health for a long time, and even before then, I was court ordered and coerced into therapy for many years. After only a little while of feeling like that, and analyzing and self-reflecting why, something I have to do all of the time when I feel things too strongly, I realized it was the immediate stopping of the medication, and I took my pill.
I’ve stopped taking my meds 50 times in life probably. I’ve been down this road so many times that it’s easy to get stuck in the ruts if you don’t watch your next few steps. I know that my agitation and anxiety and emotional stability will settle today or tomorrow, and I know I see my Psychiatrist tomorrow, too. It will take a week or so for my brain chemicals to even back out to where they’re going to. I’m ok, and I’m not even that mad at myself about it. Who do I think I am? Buddha?
I’m bipolar, and I have anxiety, CPTSD, and ADHD, combined type. People like me stop taking our meds. We’re not supposed to, and we know we shouldn’t, but our brains are not like other brains, and we so very often make decisions that are against our best interests because we just want to feel good, too. We want to feel connected, and in control, normal and happy, and all of those things are harder for us, and it isn’t our faults. We are doing the best we can just like almost everyone else in life.
The lessons in this for me have been re-learned the hard way, but not as hard as it could have been.
Lesson 1: I have to remember to spend two days researching as best I can, every single new medication that I agree to take, so that I am aware of what I’m getting myself into, because I have a lifetime history of being overly sensitive to some side effects, and if me and the medical professionals get it wrong enough, it can become life or death for me. This is my responsibility just as much as it is the responsibility of a heart attack survivor to learn a new and healthier diet.
Lesson 2: I have to have another conversation with my Psychiatrist about how sensitive I am to medications that have these two side effects, so that he can note and remember, too, and better be able to help me.
Lesson 3: That my hard work in therapy is really paying off. I owe myself a lot of credit. I am getting better. I was able to identify my mistake of stopping my medication after only three days, a new record for me. I did a lot of things right that helped minimize the side effects. I talked to my Neurologist, a medical professional, and researched Vyvanse for two days, and talked to my partners about it. I emailed my Psychiatrist. I “told on myself” right away. I didn’t beat myself up for it.
Lesson 4: That I am bipolar and I have anxiety, CPTSD, and ADHD, combined type, and I have brain damage, brain fog, cognitive impairments and memory issues. If you are still reading and you have struggled with your own mental health, it’s ok to laugh and cry here. I know. We remember these things almost everyday, fifteen times a day, even on good days, eh?
Lesson 5: I am a mentally ill human, and despite overachieving in life against all odds, like surviving and becoming a productive asset to most of my communities, like getting and staying sober for 19 years and counting, like being able to hold a stable job for years and becoming a UAW chief union steward, and like becoming a published writer with six books out and a seventh on the way. Despite all of those unlikely achievements, I am still very mentally ill, and those illnesses are like every other chronic illness: I will occasionally have bad flare-ups, and I will occasionally do things that mentally ill people do, no matter how hard I work in therapy, and that is ok. I know, and the people that love me the most know, that I’m doing the best I can do, and me and them both love me no matter what.
Lesson 6: Loving myself is still hard, but I’m gettin better at it every year, and mostly, the orgasms have nothing to do with that.
Thanks for listening to the Ted talk that they’re never going to ask me to give.
Dan Denton is a lifetime factory worker and a longtime union man, a LGBTQIA+ ally and an advocate for the homeless, the addicted and the mentally ill. As a writer he has been nominated for the Pushcart Prize and Best of the Net, voted as the best writer in Toledo, and has authored six books including The Dead and the Desperate, a novel from Roadside Press. He believes in socialism, peace, spaying and neutering your pets, the St. Louis Cardinals, castling within the first 10 moves of a chess match, free love, daily dancing and radical consent.
