A Bottle of Pills

The other night, half way to work, I realized that when I switched bags I didn’t move over my little pill case. I was headed in for a 13 hour shift without my chemical security blanket. I had a flash of nervousness, what if something happened and I felt myself beginning to freak out? I squelched the thought as quickly as I was able to. I don’t/can’t rely upon medication while at work. But still, not having them was disconcerting. It is like they are my “hail mary” intervention – if everything went to hell, I’d have one last ditch resort to “save” myself.

I don’t recall when I got my first prescription for a sedative to combat anxiety. I think it was back in my 20’s. I’ve never really taken valium, xanax or klonopin regularly (I’ve been scripted all three at one point or another) but I’ve always kept a “rescue medication” with me just in case. I’ve described it to my doctor as being my “chemical woobie”. It’s a comfort to know it’s there, just in case. Gratefully, I’ve never had a problem with over-use or abuse of prescription medication. I’m sure I could have gotten myself in trouble along the way, but I never did.

In fact, there was only one point when I took these medications regularly and it was because of a miscommunication with my doctor. This was in my late 30s when I had one of the worst periods of anxiety ever, and certainly the worst time up to that point. The anxiety was snowballing on itself. Over the course of a couple months I was panicking almost daily. I found myself calling out of work, which scared me in a core way. That’s when I called my doctor and told her I needed help. I explained how I was spiraling and knew if it didn’t stop I would find my world restricted to those places and things that didn’t make me anxious (yet). She really listened and she understood the importance of what I was telling her. I had never been medicated for anxiety, except for rescue drugs, and she suggested that it was time for me to consider daily medication. She made me promise to take it for at least a  year, because research showed that if medications are stopped too quickly, a rebound effect could occur. I agreed. Honestly, I would have agreed to anything, but what she said rang true to me. Something was seriously out of balance and I needed help correcting it.

The bad part is most of the medications (SSRIs and SSNRIs) can take 4-6 weeks or longer to reach therapeutic levels. Knowing this, she started me on Lexapro, but she gave me xanax to help in the interim. She told me to not worry about taking it, if I needed it. She saw that I was on the verge of retreating into my home life to protect myself from panic attacks and knew if I did that, recovery would be much harder. She told me I could use the xanax to help me get past the fear so I could continue with my life, while waiting for Lexapro to help.

I remember she told me I could take it as frequently as every 6 or 8 hours. I was in such bad shape that I took those words to heart and started taking it on a scheduled basis. It was awful. I alternated between hypervigilant and so sedated I felt I could fall asleep at any moment. I pushed through and continued working (at this time I was working in a Spa) as best as I could. I remember having a cancellation one day and curling up on the floor of one of the rooms wanting so badly to sleep but startling awake every minute or two, in a panic worried someone would find me there. When I finished the bottle, I called my doctor for a refill and she was horrified. She had not intended for me to take it regularly. Honestly, I was relieved. Oscillating between panic and a zombie like state was awful. I began taking it in response to panic cues and at a fraction of the dose. It carried me through until the Lexapro began to work for me.

Since that time, I’ve only used it to break a full panic attack. Even then, I would second guess using it. I didn’t like how tired it made me and I didn’t like relying on it as a crutch. A script of 20 pills can last me over a year because when I used it, I would use a tiny portion of a single pill, literally nibbling off a tiny corner to swallow. Since I began working through The Panic Trick workbook, I haven’t taken it once. I began to learn how to recognize what was happening and process it. Being mindful and in the moment actually has enabled me to defuse the anxiety before a panic level is reached. And yet… not having my chemical woobie was concerning.

It turns out work went fine.

I did, however, move my little case to the new bag after I got home. Old habits die hard, I guess.

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