He's an Emotional Man

He's a desperate man in a world so cold
...
Ooh he's emotional
So emotional
He's an emotional man
He's got tears in his eyes
Watch him break down and cry
{Falco, "Emotional"}

    I certainly haven't gotten less curmudgeonly as I'm hurtling through my 50s. For most of the time I've worked at my current job, I've been able to keep an even keel and my emotions under control; however, I've really struggled with it in the last couple of years. I think the toll of the COVID-19 pandemic along with my generalized anxiety disorder morphing into full-blown panic disorder has a lot to do with it. In my past two performance reviews, I've been dinged a point for "not keeping my emotions under control." I, let's say, passionately voiced my frustration with a substantial problem that everyone acknowledges and yet no one in authority will do anything about on a team call that included my new boss. He wasn't upset with me but commented that he was "concerned about my blood pressure." He later printed out a copy of the first part of the Serenity Prayer and gave it to me. He meant it as a joke but the undercurrent of comment on my behavior was there.

    I'm not exactly the poster child for being adaptable and have been dealing with a lot lately, which hasn't improved my emotional volatility, irritability and anger issues. I have ambitious goals to change my current meds and eventually eliminate as many of them as I can. But the mental turbulence this is causing me is fucking me over, including resurgent daily struggles with anxiety symptoms and panic attacks. The day after my last post I decided I couldn't deal with the side effects from Buspar anymore and quit taking it. Even after stopping, I'm still getting episodes of tinnitus, which is disappointing and adding insult to injury. They're not as frequent or severe, so hopefully they'll eventually fade away. I managed to get worked in at my psychiatric provider, and I'm trying yet another medication. Theoretically, it has a lower potential for anorgasmia, but I'll just have to wait and see.

    There is also a serious issue going on with a close family member, and I'm doing my best to be supportive and as helpful as possible. Unfortunately, there is some corollary and (in my humble opinion) entirely unnecessary pedestrian family drama BS going on as well that I am characteristically caught in the middle of. Sometimes I feel – probably unfairly – as if I'm viewed more as a function in the family dynamic than as a whole person, but then no one in my family (by design) really knows what goes on with me. So it's hardly surprising that I don't feel "seen" and not entirely the fault of people left purposely in the dark.

    In addition, work has been uncharacteristically stressful lately. It's the best job I've ever had, and it has rarely been a source of stress in the 7+ years I've been there. But we are in the midst of a period of rapid change and upheaval. The uncertainty – where even the executives in my department don't know how everything is going to shake out – is unnerving to an "individual contributor" like myself when the future of what will happen to my position is unknown. Turbulence in the workforce also means that less people in my department are handling more tasks, and recalibrating the scope of what we're able to offer our internal customers and the need for greater reliance on other departments facing similar issues means navigating the new normal can be taxing on my emotional equilibrium.

    In spite of it all, I've been pushing ahead with daily self-care (frequently a challenge) as well as moving forward with my self-improvement goals. Considering my mental state lately, this is nothing short of astounding. I don't know why I've managed to will myself into motivation while dealing with profound anhedonia and spikes in anxiety. But I'm grateful and have made an effort to practice gratitude, reminding myself of all the many blessings I enjoy to redirect myself from obsessing over the inconsequential inconveniences and annoyances. It can be as small as being grateful for the technology that allows me instant access to music and audiobook entertainment to ease the time as I work on improving my life to as large as reminding myself of how the people in my life show me I am loved instead of just focusing at the disappointments I sometimes feel by the actions of flawed humans with as much going on in their lives as I have in my own.

An Honest Assessment

    I managed to get back to taking my walks this morning, and in the storm of my thoughts, I once again landed on the idea that I would be better off dead. I hate life. I despise everything about it. There is a great quote that I can't seem to find about not being grateful to one's parents for giving you life and how creating life is an act of monument hubris. That's how I feel about it.

    I'm not going to harm myself, but I'm so sick of desperately seeking relief from my mental illness, only to find intolerable side effects. Even after I moved to the bare minimum dosage of 5 mg twice a day, the buspirone has left me with a constant ringing in my ears along with agitation, constipation, headaches, nausea and lightheadedness. The 7.5 mg dosage gave me all that along with extreme irritability and hypersexuality to the point it was interfering with my life. I was only on the 10 mg dose a couple of days, but that made me feel so terrible I felt as if I were dying. I'm going to give the buspirone until the end of January to see if it truly helps and if the side effects lessen. If not, I honestly don't know where I can go from there. I've tried almost every class of psychotropic there is and every other avenue of treatment. They are either not effective and/or have side effects I can't live with.

    I just don't want to be constantly managing depression, anxiety and panic to the point where everything else in my life gets crowded out. But the cure always seems as bad as the symptoms and invariably sets you up for terrible withdrawal when you want to get off things. All while keeping up with the day-to-day demands of holding down a difficult job, all that goes into living independently and dealing with family stressors.

Side Effect Whack-A-Mole

    I'm tapering off one antidepressant and starting another psychotropic. Unfortunately, short-acting SNRIs can be some of the most difficult to quit. Fortunately for me, it hasn't been all that bad. It's called Antidepressant Discontinuation Syndrome, but it's really just a form of withdrawal. Today is day three of halving my dosage of Effexor ER, and – right on schedule – I woke up this morning feeling exhausted and my emotions have been (even more of) a trainwreck. (It doesn't help that everyone else in the world is a complete idiot!) My job is rarely stressful, but it can be demanding. So I'm trying to just take a breath and take care of things one item at a time. Rereading and waiting a few minutes before hitting "Send" is also a critical part of this strategy.

    One major reason I wanted to change medications is that I am tired of being chemically castrated by my antidepressants. In the past decade or longer, I've had maybe three orgasms that weren't caused by my own hand. I've got precious few years left to enjoy my sexuality, and I can't live in constant frustration over everything to do with sex. And I still hold out an anemic hope that I might actually find a partner one day, but sexual intimacy is integral to a romantic relationship for me. Buspar may actually help with antidepressant-induced sexual dysfunction. Of course I can't make an effort to rid myself of one side effect without picking up another: I seem to have developed tinnitus, which I've dealt with before and which can be a side effect of Buspar. So far it's tolerable, thankfully.

    I mainly wanted to switch to Buspar because my anxiety and panic disorder are having the most impact on my life. I've considered in-patient care a number of times over the past year solely because I was not able to deal with my panic attacks. If it can help manage my anxiety, then I'm hoping to be able to stop the medication to lower my heart rate and a tranquilizer that I take daily. (Each with their own side effects, not to mention the counterindication of taking benzodiazepines long term.) One of the longer-term goals I mentioned in the last post is to drastically decrease the number of medications I take – always under the supervision and care of my medical providers, of course – because all medicines have side effects that affect the totality of the person. I even stopped the pill I was taking to preserve my hair for this reason, though I'm already considering topical alternatives. I'm shallow & vain, and I proudly own it.