Foo Fighters in Toronto

Stadium rock show! And no mention of antidepressant withdrawal beyond this introductory paragraph! Progress!

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Grohl!

Set:

  • All My Life
  • Learn to Fly
  • The Pretender
  • The Sky is a Neighbourhood
  • Rope
    • Drum Solo (which was spectacular)
      • Sunday Rain
  • My Hero
  • These Days
  • Walk
  • Under My Wheels [Alice Cooper] (Chris Shiflett on vocals)
    • Another One Bites the Dust [Queen]
      • Imagine [John Lennon]/Jump [Van Halen] mash-up (“Imagine” music, “Jump” lyrics; it worked oddly well)
        • Blitzkrieg Bop [The Ramones]
  • Under Pressure [Queen] (Taylor Hawkins and Luke Spiller from the Struts on vocals, Dave Grohl on drums – which, though I’ve seen it a few times already, will never get old)
  • Monkey Wrench
  • Run
  • Breakout
  • Dirty Water
  • This is a Call
  • Best of You

Encore:

  • Big Me
  • Times Like These (alas, not the acoustic version)
  • Everlong
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25th Annual International OCD Foundation Conference

I’ll get to non-OCD blogging shortly, but I don’t think I’ve mentioned this and it’s important and I want to brag: in a couple weeks I’m speaking at the 25th annual International OCD Foundation Conference in Washington DC. I made submitting a proposal to talk at the IOCDF conference a 37 for 37 item, but didn’t give much thought to the proposal being accepted…until it was. I’m co-presenting with Doc Awesome and a fellow sufferer (and therapist-in-training) from New Jersey. Our topic is as follows:

It takes approximately 14 to 17 years for people to obtain appropriate treatment for OCD. Exposure and Response Prevention (ERP) is an effective, yet demanding treatment for OCD. This panel consists of an OCD specialist therapist and two OCD sufferers who struggled and are now successfully living with OCD. First, the clinician will present the clinical applications of ERP and how to use it effectively, and then attendees will hear the personal reflections of ERP treatment from the two clients, including the unique perspective of an OCD sufferer who is studying to be a therapist. Their personal stories of ERP treatment as they journeyed from severe OCD to life beyond will be shared followed by Q and A.

This feels like a big deal. It is a big deal, isn’t it? I can’t think of a better way of getting one over OCD (short of living my best life right in OCD’s fat, ugly face) than speaking at a conference attended by some of the world’s leading OCD experts. Sam and I are tacking the conference onto the end of our trip to New Mexico and Arizona, for which we depart this Saturday. I can’t wait, either for the road trip component (we’re driving Route 66 from Santa Fe to the Grand Canyon) or for the talk. Muy updates to follow.

A Bit More Math

Let’s do a bit more basic math, along with some even more basic doctoring.

Today is Tuesday, June 26th. I stopped taking Trintellix, my antidepressant, on Tuesday, June 12. Trintellix has a half-life of anywhere between 57 and 66 hours depending on (among other things) a person’s age, metabolism and overall health. It takes five times as long for the drug to fully exit a person’s system. 5 x 57 = 285, 5 x 66 = 330; 285/24 = 11.875, 330/24 = 13.75. In other words, 11-4/5 and 13-3/4 days.

Which means at some point between the early hours of Sunday and Tuesday mornings my body secreted the last lingering vestiges of Trintellix.

I am officially antidepressant-free.

And I think it’s gonna stick. I feel good. The withdrawal symptoms that were the bane of my existence from February till May were practically non-existent during Phase Four of the Trintellix Taper (which I’m comfortable referring to in the past tense). The lingering tiredness, dizziness and intrusive thoughts disappeared last week, never to resurface. I’ve learned, through brutal experience, that I don’t need antidepressants as mood enhancers and should focus instead on healthier lifestyle choices. And earlier this morning I went to Rexall and disposed of the last remaining pills:

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Let’s see what tomorrow brings. Thanks to each and every one of you for you support.

Now can we please talk about something else?

Withdrawal

Today, Sunday, is my fifth day antidepressant-free, and so far withdrawal’s been relatively smooth. Sure, I’ve been tired and lightheaded and irritable and had a mild surge of intrusive thoughts, but these are all perfectly normal withdrawal symptoms. Besides, the last time I did this I had a much different experience:

Day one was fine. Day two was okay. Day three was bad; day four was hellish. Day four was when the withdrawal symptoms really kicked in. Strangely enough I hadn’t really anticipated the possibility of negative side effects, yet they were myriad and surprisingly aggressive. I figured insomnia would be one of them, since one of my antidepressants was a sleeping aid, and it was. But what I didn’t reckon for was the nausea, dizziness, obsessive thoughts, or general sense of dread (not to mention some of the weirder side effects, like the inability to eat dairy or an itchy scalp).

Almost none of that’s happened this time, the dizziness and the obsessive thoughts aside – and even then the obsessions, while sometimes persistent and usually unpleasant, are mostly white noise (I could never have said that the last time, when obsessions still had the capacity to paralyze me). I suppose I should qualify that by mentioning I was going off both an antidepressant and an off-label antipsychotic the last time – but still, so far the difference between the two experiences has been night and day.

Ultimately, withdrawal symptoms are nothing more than the miserable, short-term consequences of tapering. Unfortunately, given that they oftentimes mirror the initial disorder, they’re easily confused with a return to symptoms; this is one of the many reasons it’s crucial to taper under supervision. The term “antidepressant” is a misnomer, by the way, because they’re used to treat any number of different things. Having OCD doesn’t mean having depression, too, even though there’s significant comorbidity (or overlap) between the two disorders. In the case of OCD, antidepressants don’t eliminate obsessions or compulsions but rather lower a sufferer’s anxiety so that they’re better able to do Exposure and Response Prevention, or ERP, which is the lone evidence-based treatment for OCD. Once I’d mastered ERP I stopped needing antidepressants – hence the decision to stop taking them.

So we’re off to a good start, but we’re also well-positioned for long-term success. I redid the basic withdrawal math and determined that the Trintellix will be completely out of my body June 24 or 25. In the meantime, I’ve made a withdrawal to-do and to-don’t list. Check it out! (These symptoms could linger beyond the end of June.)

DO:

  • Sleep 7-½ or 9 hours a night.
  • Drink more water than usual. Keep starting every day with a glass of water – and then drink nine more, for a total of 2-½ litres a day.
  • Continue to develop your brain healthy diet.
  • Exercise regularly.
  • Write about your recovery.
  • Start making medium- and long-term goals. Goals help with recovery.

DO NOT:

  • Give your withdrawal symptoms (or your OCD, for that matter) more attention than necessary. The rest of these items flow from this overarching point.
  • Read about withdrawal symptoms. You already know everything you need to know.
  • Read your own blog entries about withdrawal.
  • Rate yourself on the Yale-Brown Obsessive Compulsive Scale. Every time you do you will donate $20 to the provincial Progressive Conservatives.
  • Seek reassurance. Perspective is fine; reassurance is not.
  • Overcommit.
  • Become obsessive about withdrawal.

ONE MORE DO:

  • CELEBRATE THIS MASSIVE ACCOMPLISHMENT.

The Final Phase

At eight this morning Ze Good Doctor approved my full withdrawal from antidepressants.

Thus, the taper that started four-and-a-half months ago enters its final phase. We’re not quite finished. The drug’s still in my system. Trintellix has up to a 66-hour half-life, which means there’ll still be traces left in me till next weekend. But I’m done taking it: my last dose was yesterday at 7:09 in the morning, which means this is the first day in three years where I deliberately haven’t taken an antidepressant. I wasn’t sure whether complete withdrawal was even feasible when I started tapering back in February. At the time I wrote: “I still don’t know the end goal of this latest experiment. I don’t know if it’s complete withdrawal – but I’m allowing myself to entertain that possibility. I’m in a much better place than the last time I tried it; in fact, this might be the perfect opportunity to give it another go. Or, it might not be! I accepted the possibility that I’ll be on antidepressants for the rest of my life a long time ago.” Turns out it was the perfect opportunity.

So now we wait. Joseph Glenmullen, author of The Antidepressant Solution: A Step-by-Step Guide to Safely Overcoming Antidepressant Withdrawal, Dependence, and “Addiction,” says people sometimes experience worse withdrawal symptoms when the drug’s being fully flushed from their bodies. On the other hand, my family doctor thinks the worst of them will have occurred when I went from 10mg down to 5 – from a therapeutic to a non-therapeutic dose. Ze Good Doctor equivocated as Ze Good Doctor tends to do, saying I might have worse symptoms, similar symptoms or no symptoms whatsoever. I’ve been on antidepressants since the second Bush Administration; I’d be surprised if I didn’t experience at least some discomfort, whether it’s real or a placebo effect or whatever. Ultimately, I couldn’t care less if I do: any withdrawal symptoms will be gone within a few weeks and I’ll be done with them forever.

(Or, well, “forever.” The standard disclaimer applies: I may have to take antidepressants again somewhere down the road. I’ll cross that bridge if and when I get to it.)

Taking that last pill felt big, like I was done scaling a peak on my way to an even higher summit. It’s as though all the work I’ve been doing – with sleep, exercise, a more conscientious diet that emphasizes brain healthy foods – is coming together. I feel alive – more alive than I’ve felt in ages. I don’t think I’m at risk of becoming complacent: I want to keep this momentum going. Like Bono, I’m ready for what’s next. But first I’m going to savour this major personal victory.

Ativan

It’s Ride to Conquer Cancer weekend, and because I remember these sorts of things that means it’s exactly a year to the day since I last took Ativan. I’d been using it regularly following Chris Cornell’s death. Once we got to Hamilton on Saturday I was so exhausted from the biking, the heat and Ambassador Gordo’s godmother pumping us full of lasagna and roast beef and charcuterie that I passed out before taking my dose – and then realizing I had an opportunity to kick it completely, fought through a bit of discomfort on Sunday while the the last lingering vestiges exited my body.

I haven’t touched Ativan since. But I still had a bottle of it lying around, and in March (after disposing of the pills at Rexall) Sam and I went for a walk so I could get rid of it.

Here’s how I did it. It only took two tries! (The container had a narrow opening, hence the sidearm.)

T-minus four days to go. This time next week the last of the Trintellix will be outta my system.

Math

Let’s do some basic math! (I can only do basic math.)

Today is Thursday. On Tuesday, five days from now, I’ll be taking my last dose of Trintellix. Trintellix has a half-life of 66 hours, which means it takes 66 hours to fully leave your body…and so assuming I take that final dose at around 7am on Tuesday I’ll be antidepressant-free at about 1am on Friday, June 15 it takes five times that length of time to fully leave your system…and so assuming I take that final dose on Tuesday my body will be antidepressant-free on or around Sunday, June 24.

That’s about 180 hours from now I suck at math.

Speaking of 180s, I still feel a sense of bewilderment when I think back to the summer of 2015 and then look at where I am now. I feel like a different person; heck, I sort of am a different person. And yet I wouldn’t trade that experience for anything, because it helped make me the man I am now. And I sorta like that guy. A lot.

I can’t wait for next week.