Tuesday, October 19, 2010


When I decided to keep a semi-regular, semi-public journal that would (hopefully) force me to stay on top of my goals and stop being such a damn quitter, I had a certain type of quitting in mind - quitting exercise, music, ballet...all things I do, and should be doing, but which occasionally fall prey to my laziness.

This time I'm writing about something else entirely. For reasons I'll discuss in a future entry, I recently was forced - FORCED, I say! - to quit something. Some of you will instantly know the horror, and others will be blissfully unaware of the sheer wattage of suck, involved in what I'm about to describe: I had to quit taking Paxil.

Before we get into some details of the truly delightful process of paroxetine withdrawal, I'll back up...all the way to the mid-1970s. Functioning as a child with OCD was not an easy task. I was a very good kid - I have no problem acknowledging this, or stating it aloud. I don't think of that as any kind of personal achievement, or badge of awesomeness - it's a simple statement of fact. I was a good kid; I was kind and affectionate to everyone around me. But I was hiding something very dark, and it wasn't until I was about 11 years old, sitting in my grandparents' dining room and reading a magazine, that I was able to put a name to it. I was living with crippling obsessive-compulsive disorder, the kind you read about in textbooks.

There's a certain degree of humor to the OCD stories I've stockpiled from my youth, only because it's such a bizarre affliction that so often plays out in silly and ridiculous behaviors. I did all the weird shit you read about - counting things, checking them, retracing steps, touching and tapping things, clearing my throat a certain number of times - all in order to avoid persistent horrible thoughts. God only knows who decided this would be a fun disease to dole out to random embryos, but I was a lucky recipient, and boy was I in its clutches but good.

Without indulging in endless detail about my weird thoughts (the obsessions) and the batshit crazy maneuvers I'd engage in to combat them (the compulsions), I'll just say that this was something that plagued me mercilessly throughout my childhood, and well into my college years. And hiding it from the world was never easy. There's no way to re-enter a room 600 times while trying to have "only good thoughts" without someone noticing you're acting really fucking weird. But as anyone with OCD can tell you, you HAVE to do it...or very bad things will happen, and YOU will have caused them to happen.

When I was about 11 years old, I remember leafing through one of my grandmother's "women's" magazines, and one article in particular stopped me in my tracks and made my blood run cold. It was an article about obsessive-compulsive disorder, and it was simultaneously the most horrifying thing I'd ever read, and the source of the greatest relief I'd ever experienced. The good news was, there was a name for this insanity I'd been living with; the bad news was, I was fucking crazy.

I don't know why I didn't wave this article in the faces of every one of my family members and beg to be taken to a doctor immediately so that I could stop doing what I was doing to myself. Truly, I don't know (or remember) what stopped me from bringing this to anyone's attention and thereby, presumably, lifting the most gigantic burden I've ever carried from my shoulders. Maybe because it was so embarrassing, or maybe because I was afraid to acknowledge there could be something THAT wrong with me...? But I'm pretty certain I said nothing, and just filed away the knowledge that I wasn't completely alone in this, and that maybe there would eventually be a light at the end of the proverbial tunnel.

Most of my childhood and adolescence was SO happy - but I'm not sure I ever FULLY enjoyed a minute of it, because there was this horror bubbling under the surface at every moment. My weird, intrusive thoughts - almost always about bad things happening to people I loved - were ceaseless, and that wasn't even the bad part. The bad part was I was CERTAIN I was a horrible, evil person, and that those thoughts were my brain saying, "you WANT these things to happen - you should let your family know how evil you are so that they'll stop showering you with all this love." So my mostly-terrific growing up years were always clouded by this feeling of dread and awfulness that made it impossible for me to fully enjoy just EXISTING in the world. There was always something horrible that might happen - and if it did, it was most certainly my doing.

Disclaimer: I know we're getting a little personal here, and I'm okay with that, because I have about 13 followers on this blog. This stuff needs to get out of my system, and if you guys can take it, I can take it.

So although I was now armed with the realization that my weirdness had a name - and that there were PLENTY of other weirdos like me out there - the relief faded quickly, and I kept up my OCD ways until they morphed into other, more manageable forms of self-torture, eating disorders topping that list. Those years were nasty, but anorexia and bulimia seemed sane to me. I knew I wasn't healthy, but it never even occurred to me that all I had done was give the OCD a new face. 

Soon after that subsided, I thought I was totally fine...until the intrusive thoughts started to return with a vengeance. This time there was no ridiculous counting or tapping or "undoing" steps - but the self-destruction was just as palpable, and it all culminated in a doctor finally saying, "maybe we should try a low dose of something that will tweak the brain chemistry into place."

It took a few rounds with a few different prescriptions, and a few different doses, but once the Paxil kicked in, I'm almost certain a choir of angels chimed in. I resisted the idea of taking any kind of DRUG because come on - drugs are for crazy people. But the thing is, no they're not. Look around you on any given day, and you'll find any number of perfectly normal, functioning human beings who are taking some form of anti-anxiety or anti-depressant medication - sometimes for disorders much more severe than mine, and sometimes just for that little brain tweak, like the one I needed.

I think the shame was minimized for me by the fact that these awful symptoms and behaviors were something I'd been dealing with literally since about age 5. I knew I hadn't done something to force myself into a life of weirdness - there was brain chemistry involved here, something that was completely out of my control, and very easy to remedy. What a relief to realize there was a little quirk going on in my brain that was making this stuff happen, much like any other ailment that simply requires the right remedy.

For the following decade, up until a few weeks ago, I'd been taking a popular SSRI class drug called Paxil, which "corrects" the flow of serotonin in the brain and causes a person with OCD to, in layman's terms, cut the shit. It's always advised to continue therapy, or at least continue talking to someone when you're on any kind of medication - but at some point in the past several years, it became unnecessary. I was fine.

What the almighty "they" don't tell you about in much detail is what happens when you need to STOP taking this stuff. And I can see why. Anyone with a passing familiarity with Paxil - now the most notorious of the SSRI class drugs, particularly in terms of withdrawal - knows you need to taper off of it slowly. You DON'T just stop taking it. But there are instances in which tapering off slowly isn't really an option.

I naively thought the 2 days of blinding headaches and weird rushes of blood were going to be the bulk of it, and that once I endured that, I'd be in the clear. I have never been more wrong about anything in my life. A few weeks into the cold turkey detox, and I'm experiencing just about every symptom that ever lead to me taking this shit to begin with. Plus a host of physical side effects that would be enough all on their own. 

Some people say the symptoms of paroxetine withdrawal can mimic those of heroin withdrawal. AWESOME. That's exactly what I wanted to hear. I should clarify that I'd called my doctor's office the moment I realized I needed to get off the Paxil. However, they couldn't see me for several weeks. With conflicting doctors' advice, and based upon my own instinct, I felt I really had no choice but to do the ill-advised abrupt quit.

After the headaches, things were okay for a couple weeks...until the barrage of megasymptoms flooded in. Mercifully, my appointment was approaching. When it finally arrived, the NP asked me to remind her what dose I'd been taking when I suddenly quit taking the Paxil. Her facial expression and "phewwww" sound simply underscored the knowledge that I'd made things very, very difficult for myself, and that this was going to be an extremely long month or two.

She said something about a car going from 0 to 60 instantaneously, but I've formulated what I feel is a more accurate analogy. The instant switch from 60 mg of paroxetine to 0 seems more like the act of driving 60 mph in your car and hitting the brakes on a dime, with no warning, in the middle of a busy street. There's an almost 0% chance of avoiding serious and violent aftershocks if you try this. But here's where the analogy fails: if you pull this 60-to-zero shit in your car, you're going to get hit very hard, probably more than once, and so are the cars around you. Many other people are likely to get hurt. The brutality of the aftershocks will be severe...but they'll come quickly, and the mess will be available for viewing within a minute. Not so if you're doing this with a drug. You're going to feel violent ripples for what seems like an unbearable amount of time (even if it's not, really) and you will be the one to absorb all the shocks. Not other cars, not highway dividers. All you.

It's become necessary to remind myself that this is going to pass, as the doctor and every one of my friends has advised me. I have what I will wager are the greatest friends and family in the known universe, and there's never been a moment at which I've been any kind of "danger" to myself or anyone else. So I have all the necessary tools to ride this out. But it is not a ride I'd ever recommend to anyone. And it underscores the need for a little more research into SSRI medications and other drugs that, when used correctly, can be a genuine blessing. Over the past few years, Paxil has raised some questions, more so than its probably-safer counterparts. Perhaps this is something that warrants a little more attention than, say, the 759th boner pill on the market. 

I'll leave you with this: there's a silver lining to this long-winded story, and a method to my madness in deciding to discontinue this drug in the worst way possible - and I'll get to that part soon. If you're still reading by that time, then cheers - I thank you for sticking with me :)


  1. I really cannot even fathom what you ate going through, but it sounds absolutely awful. Hang in there. It's worth it. And by the way that was seriously one of the most eloquently written descriptions of OCD I have ever read...

  2. Thank you, Beb. While I don't know if I can agree about the eloquence factor, I'm going to force myself to simply accept a compliment. It means that much more coming from someone who *kinda* knows what she's talking about and, y'know, as a PhD and stuff...

  3. Great post. People tend to use the term OCD lightly--I think sometimes I do, even though I know full well what a debilitating life it can feel like. I'm not going to anymore.

    Thanks for sharing this story, and know you have my support. Hang in there, lady. You can do it :)

  4. I use the term lightly, too - I don't get offended at all when people do that. For me, there would be no way to deal with any of this without a healthy sense of humor.

    I'm just thankful I know what it all IS. The worst was simply wondering what in god's name I was doing all those years. I ended up getting a psych degree in school and I'll admit, I approached the OCD chapters/segments of college psych classes with seriously mixed feelings. ha.