I recently blogged about my decision to take a break from therapy during the Covid-19 pandemic. (I love how I felt the need to specify which pandemic I meant.) Long story short, my intuition told me to take a break from therapy, so I did. At the time I wrote that post, I had no idea how long the break would last.
Quick update: the break lasted six weeks.
I also blogged about how I have been taking 7.5 milligrams of Mirtazipane to help me sleep at night and how I was not going to try to wean off that small dose in the middle of a pandemic.
Slight update there: I have had to quadruple my dose to 30 milligrams in order to sleep.
Pre-pandemic, I was taking 7.5 milligrams of Mirtazipane to sleep at night, but my psychiatrist had actually prescribed 15 milligrams. Sometimes, when I was stressed or had PMS, I needed the extra boost to sleep. So I always had a little extra supply in reserve for those lovely PMS nights.
About a month ago, I started sleeping like crap. I’d fall asleep fine, wake up in the middle of the night to pee, and then never fall back to sleep. I took 15 milligrams of Mirtizipane for a couple of nights, and still, I did not sleep. I called my psychiatrist and we decided I should take 30 milligrams. At the end of our call, my psychiatrist warned me, “Don’t try to wean back down to 7.5 milligram too quickly!”
Yeah yeah, cool cool, right man.
Of course I tried to wean back to 7.5 milligrams too quickly.
I took 30 milligrams for a few nights, slept beautifully, and decided I was ready to wean back to 7.5. I took 22.5 milligrams for two nights and still slept great. I took 15 for another two and slept well enough. Then I forced myself back to 7.5 milligrams. I reasoned that I should only take 30 milligrams of Mirtazipane for as long as I had extra pills to supplement my dose. I did not want to call my psychiatrist for a new prescription. I had some internal resistance to increasing my dose.
Back on my regular dose, I slept okay for a few nights, but then the insomnia returned. But rather than think, Hey, maybe I have some extra anxiety and need the higher doze of Mirtazipane, I started looking for scapegoats. First, I was a little congested, so I blamed my allergies. I took Nyquil at bedtime and that worked for a couple of nights. But then the insomnia prevailed even over the extra strength Nyquil.
I tried blaming PMS, even though I was no where near the PMS zone.
I blamed refined sugar, even though I have not actually been eating much refined sugar.
Finally, after several consecutive nights of only sleeping for four hours, I woke up on Monday, June 22, 2020, and realized I had a problem. The insomnia was not a blip. It was my body’s cry for some help and tender loving care in the mental health department. I took a deep breath and called my psychiatrist and told her that I was struggling. Then I emailed my therapist and said I was ready to get back to therapy.
My therapist had an appointment available the next morning that worked perfectly with my schedule. We talked about my sleep issues, and my resistance to increasing my medication; and I realized I still have some work to do in regards to my insomnia, anxiety and the medication I take to sleep.
I am still trying to figure out why I did not want to increase my bedtime anti-anxiety medication for more than a few days. WE ARE IN THE MIDDLE OF A PANDEMIC. But I had subconsciously decided I should not need more medicine to sleep. Since being diagnosed with postpartum depression in 2013, I have done so much work to dismantle my anxiety. Surely my mindset could handle the extra stress of 2020. Needing to increase my medication felt like a sort of defeat or failure.
Right now, I am taking 30 milligrams of Mirtazipane to sleep at night. It is working. I am sleeping beautifully, and I also feel more like myself. Now that I am feeling better, I can see that the pandemic had activated my anxiety. But my anxiety is a sneaky beast, and instead of jumping from a 1 to a 10 all at once, it crept up slowly, bit by bit. I could not see what was happening until I was in insomnia hell.
I have another therapy session scheduled for next week. I am excited to keep digging into my anxiety and resistance to taking medication for my mental health.
I do not have a neat, tidy ending to this story, because this is my work in progress.
But here is one thing I have learned since my first adventures with postpartum depression: sharing my stories, especially my ups and downs with mental health, is something I have to do. When I do not share these stories, they start to feel like dark secrets that fester and make me feel ashamed of myself. I have to share these stories so I can banish my shame to distant lands.
p.s. My psychiatrist suggested I take 30 mg of Mirtazipane for the next four months before we even consider weaning me to a lower dose. I am fully on board with that plan!