This morning, for the first time in almost a year, I did not take a pill when I got out of bed. The reason I took these pills, and the reason I stopped, has to do with a word I learned recently: Iatrogenic, which means 'caused by the doctors.'
I'll start at the beginning.
For six years, I "balanced" a demanding job, a commute, and raising young children. All things considered, I thought I was managing really well until just before my last child turned one year old. Then, the stress and exhaustion I'd been holding at bay engulfed me. I could barely get out of bed, or eat, or think. I couldn't work, so I took a leave of absence.
We're making women crazy, then acting like there's something wrong with them for being crazy.
I made an appointment with a psychiatrist who, naturally enough, prescribed anti-depressants. Makes sense, right? Because by the time I dragged myself into her office, I was really, really depressed.
I was also really, really anxious. I was having horrible, crippling panic attacks almost daily, and I was waking up in the middle of the night, shaking, heart pounding, unable to go back to sleep.
The anti-depressants were supposed to help with this also. Unfortunately, they made me jittery. Now, on top of the anxiety I was already grappling with, I couldn't sit in a chair without jiggling my knee up and down. They gave me other weird side effects: night sweats, headaches, cotton mouth. I started having a lot of trouble sleeping, but it was hard to tell whether it was a side effect of the anti-depressants, since I'd been having trouble sleeping when I was working, too.
So my psychiatrist wrote me a prescription for pills to help me sleep.
Things slowly started to get better for me. Summer came and went. I stopped feeling depressed. I quit my job for good. I started eating like a normal person. But still, I couldn't get a decent night of sleep without taking a sleeping pill.
I quit coffee and chocolate and started doing a lot of yoga and meditation. Still, I couldn't sleep without pills. If I didn't take them, I would wake up between 1 and 3 am, heart pounding, and stare at the ceiling for a good two hours before I could sleep again. After several months of this, I developed an eye twitch.
My psychiatrist, who was intelligent, thorough, and sincere, suggested I do a sleep study. I packed up my pillow, kissed my husband and the kids good night, and drove to a sleep lab in Berkeley. There, a young women with pale skin and dyed black hair skillfully strapped me to various machines designed to monitor breathing, leg movements, brain waves, and God knows what else.
Naturally, I had another terrible night's sleep. Which was sort of good news...
When the results came back a few weeks later, there were pages and pages of detailed findings. There was a problem with my breathing, with my "index of sleep arousals" and with something called RERAs, an intriguing acronym that was never spelled out. In short, I had a "moderate" version of sleep apnea.
My doctor called as soon as she got the results.
"This could be what's causing your depression!" she said. "We need to get you an apnea machine so you can breathe at night. Katrina, if this works, then all your problems may vanish!" She was triumphant. I was hopeful.
Back I went to my HMO. A respiratory nurse named Joan patiently outfitted me in the latest artificial breathing technology, a CPAP (pronounced SEE-pap) machine.
"Our newest model," said Joan.
The machine itself was slightly larger than a lunchbox, a dark designer gray, with a corrugated hose that looped over my head and three slim black straps that held rubber nose plugs snug to my face.
"I gave you a medium," Joan said, looking critically at the nose plugs, which were now plugged into my nose. "If that doesn't work, you can try the large."
The large? I thought. I am not a large person. Is my nose really so out of proportion to my body?
But it was not the time to be vain.
Joan snapped on the machine. Oxygen flowed up the vacuum-cleaner hose on top of my head and through the nose plugs. When I opened my mouth, air came whooshing out, like I was some kind of human leaf blower.
"Don't open your mouth," Joan said.
I closed my mouth and nodded.
That afternoon, I took the machine home for a two-week trial. I hated the Darth Vader breathing sounds, the itchy nose plugs, sleeping with a hose on my head...but I used it diligently. If it worked, I was going to have to buy one -- about $1,000. My insurance wasn't going to pay for it, so I had to be sure it was right for me.
After ten days, I caught one of the worst head colds I've ever had. I couldn't breathe through my nose at all, so I gave up on the machine. I was still sick when I brought it back to Joan.
"I don't think it helped," I said. I could see she was disappointed. We stared sadly at each other for a moment. I sneezed. She wrote me a referral to see a pulmonary doctor that afternoon.
The first question the pulmonary doctor asked was, "Are you sleepy during the day?"
"Tired? Yes. Sleepy...not really."
"Do you take naps?"
"I find it hard to nap," I sniffled. "I mean, I find it hard to sleep. Period."
"If you're not sleepy during the day, then you don't have sleep apnea."
"What about the sleep test?"
"There are different ways to interpret the results," she said. "But the breathing issue that came up, that could be from the sleeping pills you're taking. They depress the central nervous system. They could definitely cause shallow breathing. Especially if you've been taking them for a while."
"I've been taking them for ten months."
"That could do it."
"But it I don't take them, I can't sleep!"
"Yes, the antidepressants you're on can cause insomnia in some individuals."
We smiled at each other. Because the whole thing was so stupid.
"And on top of it all, I got this horrible cold," I said, because suddenly I was feeling really sorry for myself.
"Oh, yeah, I see that all the time," she said. "The CPAP can dry out your nasal passages and make you more likely to catch a virus."
Let's recap here:
1. Trying to work full time and raise young kids put my body under unendurable strain.
2. My body broke down.
3. The doctors decided that something was wrong with me, so they prescribed pills.
4. Those pills made it impossible to sleep, so they prescribed more pills.
5. The second pills depressed my breathing and made it look like I had sleep apnea.
6. The doctors gave me a machine to treat the sleep apnea, which dried out my (medium-to-large) nose and made me sick.
!
I called my doc and told her the whole story.
"In conclusion," I said, after pausing for a breath. "I don't think there's anything wrong with me. I just needed to quit my job, which I did. Now the only thing making me sick is the meds."
"There's a word for this," she said thoughtfully. "Iatrogenic. It means 'caused by the doctors.'"
Here's my diagnosis: It is crazy to put working parents in impossible situations where they are bound to go crazy, and then act like there's something wrong with them for going crazy.
Why am I telling you this story? Because there is a public health crisis afoot. We are suffering from a chronic state of busyness, particularly families with young children and two working parents.
We are also suffering from our adherence to a childish ideal of rugged individualism, which keeps us from supporting each other and from asking for help when we need it. This is not an individual pathology that can be solved with a pill (the effectiveness of which is now debatable), but a massive cultural pathology that dictates everything from our individual relationships to laws and workplace policies that fail to support working families.
Make no mistake--at every step of this bizarre journey, I was in the hands of a competent and caring health care professional. They used every ingenious tool at their disposal to help me. The problem was, they didn't have the right tools. Where I needed work that challenged me without sucking the life out of me, they had anti-depressants. Where I needed someone besides my overworked husband to watch the kids for a Saturday, they had sleeping pills. Where I needed the support and encouragement of my peers, they had breathing machines.
So I'll leave you with this question: If our doctors can't help us, then who can?
Cross-posted from workingmomsbreak.com and momsrising.org.
A Peaceful Revolution is a blog about innovative ideas to strengthen America's families through public policies, business practices, and cultural change. Done in collaboration with MomsRising.org, read a new post here each week.
Follow Katrina Alcorn on Twitter: www.twitter.com/@kalcorn
I hope the author was on a less addictive med. If she is on Effexor, Cymbalta or Pristiq she will likely suffer what big pharma marketing has spin-named "discontinuation syndrome" which is just withdrawal from addictive meds.
The author was fortunate that she experienced mild side effects. Some typical side effects sometiems experienced are: weight gain, intolerance, anxiety, anger, frustration, impulsiveness, weight gain,. loss of memory, loss of cognitive abilities, frigidity (yes, women on these meds go a years without sex and don't miss it) . So fat, angry and sexually rejecting your mate, how does this help? There are many patient accounts and scientific studies of side effects on the web.
Antidepressant advertising is targeted at manipulating, healthy women to be medicated. Women must stand up to big pharma’s bullying them to over-medicate. We are targeted for antidepressants by big Pharma in the same way that tobacco companies targeted us. Drug companies are so effective at selling unhappiness to women that we take more than twice as many antidepressants as men.
http://sadnessaddiction.blogspot.com/
Never in human history have people made such a fetish out of individualism; a century ago, the author likely would have had an exhausting full time job building and maintaining a home, i.e., cooking, cleaning, etc; Likely had 4-5 children to care for;
Yet she also likely would have lived in a house with a mother/ grandmother, sisters, maybe an aunt or two; she would have a support network of other wives and mothers to assist with the effort of life.
A quilting bee wasn't just a quaint custom- it was an example of working mothers banding together to provide support and encouragement, and community bonding.
The notion that every family should live in splendid isolation, consisting of a single woman carrying the load of family rearing and housework on her back as a sole enterprise never existed before the 20th Century; yet it is regarded as the historical norm, and any other configuration is seen as dangerous and radical.
Great Article, Thanks!
I no longer trust doctors apart from basics such as getting tests. I do my own research and lots of it before I make any decision now. Common sense has sadly gone out of the window these days. As they say on paxil progress "You are enough. You are your solution".
"our adherence to a childish ideal of rugged individualism" - don't get me started on that!!! It's getting worse what with the twitter and facebook age.
,Congrats on getting out of your job.
try 5HTP ( both a natural sleep aid and anti depressant ) at bedtime , its a precursor for serotonin.
For those midnite panic attacks /awakenings try Ignatia Amara - a homeopathic remedy for everyday stress.
Its amazing how helpful it is . You put these tiny pills under the tongue and let them melt , while you do too
And you know what?
They have fewer of the problems That Katrina describes. They are happier and live longer. Their health is better by every measure.
Like the author, I'll leave you with a question: Are there lessons to be learned there?
Those sound nice, and maybe they really are, but all of those health care systems take advantage of the fact that the US is by far the number one developer of new drugs and procedures in health care. Innovation is expensive, we pay the bills, they reap the benefits. Of course they refuse to pay our costs for new medicines, they did not develop them, and don;t have to pay to develop the next one. But somebody does.
Lastly, Europe is less litigous than we are. If someone is injured during a medical procedure in the US, we beleive it is our right to demand heads to roll and pockets to be filled with money. "Across the Pond" (like England) there are set "reimbursements" for actual injury suffered as a result of a medical procedure, and they are not going to make anyone rich. There are no punitive damages, and there is no additional money for pain and suffering. Lost a leg? Here's your $100K, see you next week for your check up.
Everyone is busy, that's true, but...is this just a complaint about the world? I'm just not sure what the author is suggesting here.
Of course, *my* question is, what do people (men and women) who don't have the luxury of just quitting their jobs, as Katrina evidently does, do?