Medication
Mianserin didn’t cure my depression, but it turned the volume down on the overwhelming noise inside of my head.
It at the very least gave me enough space to breathe, and importantly, get out of bed.
Like a drowning man in a room filled with water…I’d been given an inch of air, into which I could raise my gasping face, and take a breath.
It was in no uncertain terms, a lifeline.
It had been the first medication to have such a profound effect, and the first to not come with some horrendous side effects.
Some had made me literally shit myself with nausea,
“How is this supposed to help with my anxiety?” I’d asked my psych “If I am forever one surprise sneeze away from horrifically shitting myself?”
Others had completely turned out the lights, rendering me some kind of living corpse, an empty zombie like creature incapable of even the most rudimentary tasks.
The Mianserin however had just….turned down the noise a bit, the deafening, unwavering screaming in my head which at every waking moment caused unspeakable pain, and propelled me to end my life.
Considering the plethora of medications I’d trialed and the myriad of side effects I’d experienced….just this minor reduction in volume was as I’ve described…nothing short of life changing.
Having found even a modicum of relief via the new medication, I quickly met with my psychiatrist, and we began increasing the dose, hoping to increase it’s effectiveness.
We increased to about 80mg, however found that whilst it was indeed effective, we started seeing side effects, being increased lethargy and intense fatigue.
I found myself having about 4 hours of time in which to function, before I would fall asleep wherever I was sitting.
So we levelled out at about 60mg, which was at the higher end of dosages.
(Mianserin max dose is a recommended 90mg and a definitive, absolutely no more than 120mg dose)
When things become difficult, I will extend to 80mg, however for no more than 2 days in a row lest the side effects begin to negate any benefit.
As a result of PTSD, I’d also struggled a great deal with sleep, and seeing as we’d discontinued the olanzapine, we introduced a 5mg dose of melatonin.
The combination of the sedative effects of the Mianserin and the melatonin caused something I’d never really experienced before.
I began being able to sleep at night.
Previously I’d never been able to sleep at night, only once the sun began to rise did I feel able to sleep.
But the combination of these medications allowed me to wake up before noon.
Something I hadn’t experienced since I was a young boy.
It was at first…bewildering.
I found myself entranced by the morning sun, I’d never really seen the sun at this angle before.
It was, to me, like a whole new world.
Furthermore, I now had a whole day to fill.
Where before I would have hidden inside, curtains drawn, staring into my phone and scrolling endlessly, trying to find the next 30 second video to distract me from my suffering.
I lived 30 second video to 30 second video, desperately trying to fill the silence in my home, and quieten the agonizing screaming in my head.
Yet now I had a whole day to fill, a new world called ‘morning’ to explore, and the ability to leave my bed.
It was new, it was frightening, it was bewildering….but it was good.
It was a start.
And I’d need to learn how to function in this new reality before anything else.
With the medication keeping the volume at a still loud, but at least somewhat tolerable level, I had the breathing room I needed to do the work, and make the progress I needed.
As stated, it certainly wasn’t a silver bullet, I was still actively miserable, but I could at least get out of bed.
I found that I had to have podcasts playing on my phone and with me at all times, so that I could focus on their voices and not the endless screaming torment in my head….but I could get out of bed.
However small…This was progress.