I find myself thinking about the biochemistry of depression a lot lately. The neurochemicals that are out of balance, and how they become out of balance. Medication side effects, or genetics, or environment.
I find myself apathetic. Detached from concerns and cares. Recently I have been bothered by the sorts of intrusive self-harm thoughts that haven’t appealed to me since the first time I took Topomax at 19. I was shocked when I woke up from a dream, holding my wrist, my thumb rubbing over decade-old long healed scars.
I just want to feel something again.
I went to call my doctor two weeks ago and schedule an appointment to go off this medicine, but his office is closed on Fridays and half of Mondays, and I forgot to call back. Its hard to muster up the energy to remember, or care.
I’m drifting through the days instead. In a detached way, I know this is not good. But in a more immediate way, I’m just sort interested in making it to the next minute, and the next, and the next. I’m proud of myself if I leave the house. Look at me! I am adulting. I adulted today. I got dressed and did a thing and interacted with a people.
Hallucinogens are supposed to help with depression. Like LSD and shrooms and molly and whatnot. But I am not in high school or college anymore, and I have no idea where to obtain such drugs.
Marijuana is legal in my state, but marijuana is a depressant. Additionally, I smoked some extremely strong marijuana at my 30th birthday, and have had panic attacks every time I smoke it since. I do not think marijuana is the solution here.
There are, of course, traditional pharmaceutical antidepressants. That requires going to the doctor, getting a prescription, and then finding a therapist to discuss my ongoing moods and make sure I’m stabilized. Since this current situation has occurred as a direct result of taking Topomax for my migraines, the most rational course of action seems to be to go off Topomax instead.
I could, of course, de-escalate my medication dosage on my own. I am hesitant after my last experience going off psychotropic medications without complete medical oversight. I came too close to killing myself. These drugs are nothing to mess with, and my state of mind is already precarious. I need to call my doctor.
I read that people at risk for suicide may exhibit suicidal behavior due to a lack of adequate serotonin — which, incidentally, is also produced by gut bacteria. One of the side effects of Topomax is “medical anorexia,” which was my old psychiatrists was of explaining that Topomax limited your physical appetite without inducing the body dysmorphia common to the psychological anorexia.
I wonder if taking Topomax has reduced my serotonin levels, and that is why I am depressed.