Update: From Effexor XR to Zoloft

For those of you playing along at home, it’s been a little over two weeks since I began the switch from 225mg/daily Effexor XR to 50mg/daily Zoloft. While it’s too early to claim a victory, the early results since beginning Zoloft have been very promising.

I will reiterate here that this post is not here to discredit or discourage the use of Effexor XR. Nor is it here to promote Zoloft as ‘better’ or ‘more effective’. How you respond to medication will rely entirely on your body’s ability to produce and use chemicals that affect brain function.

I came to Zoloft after a year and a half on Lovan (which worked for around eighteen months, and stopped) and three years on Effexor XR (which had very little or no noticeable effect on my depression). My research told me that others who responded in the same way to Lovan and Effexor XR had good results with Zoloft–which is hardly good medical science but it’s a better start than picking the next one off a list and seeing how that works. Finding the right medication at the right dose is trial and error at best.

Stepping off Effexor XR (especially from that dose) was one of the most uncomfortable, unpleasant, and downright frustrating experiences I’ve had. I knew it wasn’t going to be good, I’d been avoiding making a switch for that exact reason. At the time where I had tapered down to zero, I could barely function without wanting to scream, cry, or  vomit. I watched a lot of Netflix and crawled from lounge to bathroom to avoid the dizziness of being vertical.

And I had meltdowns, but if we’re  being perfectly honest–the withdrawal meltdowns were no different to the meltdowns I was having on a full dose. This was just further proof to me that the Effexor XR had not been assisting me in the way it should have.

I went straight onto Zoloft at 50mg. I was expecting more negative mental side effects, I was expecting more mood swings and unpredictability–but that never happened. The pharmacist warned that it could cause dizziness (he was very right about that!) and along with some nasty headaches from my body screaming for Effexor XR, I was in a pretty rough physical state for a week. The dizziness still comes and goes, I’m still adjusting (it’s very early days yet) but I feel I am presently more stable than I have been in perhaps the last three years.

Take, for example, my day trip to the city on Saturday. I went down to sit a test, and because the train services from town are ridiculous on weekends, I would have to arrive at 9.30am and leave at 6.30pm. The test was at 12.30 and only went for an hour. It’s a lot of time to fill when you’ve got very little money to spend.

I went anyway, and I went at the last minute. I’d originally decided I wouldn’t, and would try to secure some work. I was unsuccessful with that. I was tempted still to cancel the appointment and mope at home, conserve money. Or I could go to the city on strict rules to not overspend and attend the test anyway. So I did that.

I told myself I could go to a couple of cheap shops for homewares that I needed (jugs for the fridge, so I can make myself iced tea) that I suspected I would be able to get at a better price than shops here. So I spent the morning at Daiso, and purchased two solid watertight jugs at $2.80 each. Considering the ones here at home were $9+, I was pretty happy with that. I was only allowed to purchase a food item if it was for immediate consumption, substantial, and less than $3. I ate a lot of good sushi rolls.

On the train, the most bizarre (for me) thing happened. When I boarded, I selected a seat across from a girl who had curled up over three seats and was trying to sleep. I planned on doing the exact same thing. A few moments after I sat down, she asked if I could wake her when other people wanted the seats.

This is normally where I would do a small nod, and hope to goodness for no more talking. Instead, I laughed and told her I intended to sleep as well but if I was awake I would have her back. She laughed and we both dozed off on the train. Halfway to the city, where the train fills up very fast, it was her who woke me up so an elderly couple could take the seats beside me. By the time we got to the city, she was asleep. Again, normally I would scoot out of there as fast as I can and avoid further interaction.

Instead, I tapped her on the knee and woke her up so she could exit the train before the conductors had to do it. She woke, and told me about how she was going to adopt a cat while in the city, and we chatted until the train was stopped.

I’ve been feeling extra social and relaxed like that. When I go into town, I don’t hope the people I know don’t see me, I actively walk up to them and start a conversation.

In fact, I’ve been relaxed about a lot of things. Simple things, like not waiting until every visible car is out of sight before I cross the road, and just walking to the shops when it’s starting to get dark rather than obsessing over whether I should or shouldn’t.

I’ve been more energetic, too. Outside of the physical exhaustion, I’m finding the drive to do things I would normally leave for another time. I’ve been cooking. I love cooking when I don’t have to do dishes, so I’m making the most of the dishwasher I have here. Cooking up some chicken tenders no longer feels like too many steps to get food. I just… do it.

I don’t need quite as much time to prepare for a task, either. That may not make sense most, but when I look at a rack of clothing that needs to be put away, I very rarely have the ability to just do it then. If I try, I feel extremely unsettled about it. The other day I went into the laundry and saw the towels on the rack were dry.

So I put what I was doing on hold (this is also crazy hard most of the time) and got the towels down, folded them and put them all away.

That is an unbelievable level of domestic function for me. This generally only occurs in those intense bursts where I DO ALL THE THINGS at once. Those are useful, but entirely unreliable. I’ve been operating at this level for about a whole week now. A whole week straight.

The best part is that I’ve noticed an increased ability to drop a train of thought if I don’t like it. Where a negative thought would once spawn two more negative thoughts, and I would spiral down to a horrible place–I have literally been able to tell myself ‘Yeah, how about we drop that?’ and move on to the next thought. Without having to forcibly distract myself.

That is unheard of for me. Today I got rejected for a job that I do desperately want–something that two weeks ago would have left me in an inconsolable ball of misery and low self-worth. It still stings and I still feel pretty shitty over it, but it is not the sole thought in my mind. It’s just one of many and I’m able to focus on the better ones. I’m hurt, but not imploding.

I’m beginning to feel a freedom from the detrimental obsessive thinking patterns, and it’s wonderful.

There have been less shiny side-effects, yes. My actions aren’t as heavily regulated as they were–which is good, but I’m more likely to do things without preparation so I don’t get as much of a chance to analyse whether it is a good idea or a bad idea.

Like deciding on Saturday afternoon that I might as well just head out to my football team’s fan day, because it was on. That whim was rewarded with free icecream, a drink bottle, pancakes, and the chance to hold the AFL Premiership Cup! Best day! But not something I would have previously decided to attend just because.

So far it’s all worked out good, but I’m aware that I need to be careful I don’t go to the extreme of blind impulsiveness.

I’m also eating a lot. Food tastes better, I think. I want more and more tastes. I want to cook because cooking is fun, and then I get to eat. I’m slowly switching over from soft drink to iced tea, because it’s cheaper and probably marginally healthier. I’m not picking at things obsessively, the benefits (so far) are worth the journey.

It won’t be this shiny and wonderful forever. I’m looking forward to that too, where basic functions aren’t something to marvel over. I’m looking forward to a new normal built around mundane stability.

I really feel that right now, I’m on the right track to get there. And that’s a pretty good feeling.

Debunking the dangerous ‘lack of empathy’ stereotype.

On most desktop computers, there are separate switches for the tower (the actual computer, the bit that ‘thinks’) and the monitor where output is displayed. If you turn on your computer, but not the monitor, the computer can do all the work it likes–but nothing will be displayed.

I often compare computers to the autistic brain; I find there are a lot of similarities. This is one. It’s a gross over-simplification but it goes a long way to explain how autistic people are so often accused of being void of empathy. So much so that the cold and unfeeling autistic person has become something of a stereotype.

Autistic people are very capable of empathy. Our ability to display that feeling is impaired. Our computers are functioning, but often times the monitor is switched ‘off’… or on another channel completely (and trust me to switch to a television comparison now just to confuse the issue).

For me, it’s a case of the monitor being off most times. I have to remember to change the position of my face to reflect the appropriate feeling for the moment. It doesn’t come naturally. It’s a logic-based process that says, ‘You’re feeling happy now, you should be smiling!’ and so I turn the corners of my mouth upward.

Manual smiling can get painful, by the way.

There are times where my feelings are so strong and I’m so caught up in them that the expressions form themselves–but that’s rare.

I’m also chronic for the pseudo-condition ‘resting bitch face’, which is the tendency to look worried/tired/angry. This is just the way my face falls when I’m not giving it direction, and it doesn’t mean I feel the way it looks. Usually I’m so deep in thought that I’ve relinquished all active control of my facial expression. I could be having a hilarious daydream, but to the outside world it looks like someone’s upset my apple cart and I’m about to tear strips off the next person who bothers me.

For others, it’s less a case of the monitor being off and more a case of it being on the wrong channel. They may exhibit expressions and behaviour that make little to no sense in context with the situation around them. This could be misinterpretation of the situation, not knowing how to react in a situation (and giving it a best guess), or it could be as simple as the mind reaching a different emotional reaction to that which is normally expected.

I watch a lot of true crime specials, and the way people read each other after a homicide is troubling to me. So much that I hope I’m never directly involved in such a situation because (aside from the obvious) I worry that my lack of reaction, or incorrect reactions, would be misinterpreted as possible guilt.

If you think that’s paranoid and crazy, check out the Amanda Knox special on Netflix.

She’s not alone in being suspected because of her reactions. Lindy Chamberlain is another high profile case that utilised her behaviour after the death of Azaria and throughout the trial process as a sign of guilt.

I don’t pretend to know what happened to Azaria Chamberlain, nor am I convinced of Lindy Chamberlain’s guilt or innocence. I’m certainly not claiming that Chamberlain and Knox are autistic, either, only that their lives have both been upturned in part because they did not react the way they were expected to.

And there lies a very dangerous expectation, for everyone, and especially for  those on the autism spectrum. The expectation that every person will react to a situation in a similar way, and that deviations from that expected behaviour are wrong.

Greater understanding that there are infinite ways to respond to a situation, and that each person will respond in their own individual way, will set free so many from fear of their own personality. Clinging to ‘sameness’ is a human desire that continues to fuel fear and hate, between races, religions, nations, anyone of difference.

We are so much more diverse than social expectations allow.

In regard to empathy, we all feel it. We all respond to it differently, we all show it differently. Some are able to disregard it. Others are slave to it.

The notion that autistic people are not capable of empathy is a myth. It’s far more common that the autistic person is less capable of displaying it.

In some cases, myself included, the feelings of others are present in the air. Like a solid, electrifying force that grows with the intensity of feeling. I know the feelings are there, I know there is an emotion being communicated, and I feel it so keenly that it burns.

But I don’t understand it. I don’t have the ability to take that force, break it down into its parts and know that what you are sending me is happiness, or anger, or fear. It’s another language, one  I can’t interpret, and the force of it leaves me paralysed and unable to act.

My own feelings, I have so many of. I feel deep sorrow, and boundless joy. I don’t always know what to call them, nor do I always know how to deal with them. They lie behind a face that moves as I tell it to, but they are still there.

I repeat. They are still there.

And what to do about it? I don’t know. I like to know when my behaviour isn’t what’s expected, and perhaps this comes from a place of wanting to fit in, to be seen as ‘normal’ among others. But isn’t that just as damaging?

After all, if I put on a successful mask, learn to behave as others do–if we all conform to this expectation–how will any of us learn to embrace and understand the true diversity of the human mind?

Some things, I will change. Some things I won’t. My reactions, expressions and the way I approach the world is my own. Even if that is to have no visible reaction, that’s simply how I am. I cannot be judged from the outside. Knowing me requires conversation, patience, and a mind open to the idea that not all body language speaks truth.

I have feelings as much as any other person, autistic or not. It just takes some digging to see them.