Mirtazipane Weaning: The Pandemic Edition

I have been taking an antidepressant called Mirtazipane since July 2013 when I was diagnosed with postpartum depression. My doctor yanked me off Mirtazipane when I got pregnant with Julian, but for the most part, I have been taking some Mirtazipane at bedtime since 2013.

I have tried to wean myself off Mirtazipane so many times, I have lost track. I have to check this blog to remind myself! I have also lost track of the number of times I have blogged about Mirtazipane weaning, but the most recent post is here. I wrote that post on November 3, 2019, when I was starting to wean off Mirtazipane, aka Remeron (that’s the generic, and that’s what I actually take) for the fourth time.

So here’s the update: Mirtazipane Weaing, Take 4, didn’t work.

I kept whittling my dose down to smaller and smaller amounts and then in mid-January, I had several nights of insomnia. (Confession: I cannot remember if I was every fully off Mirtazipane this go around or if I was just taking a very tiny dose. #MamaBrain.) When the insomnia hit in January, I called my psychiatrist and got my ass back on 7.5. mg of Mirtazipane at bedtime.

During this latest insomnia bout, my psychiatrist gently reminded me about the MTHFR gene mutation. My psychiatrist first suggested I be tested for the mutation, oh, a year ago. She explained that the MTHFR gene mutation makes it difficult for the brain to process Vitamin B, and for some people, this causes mood disorders like depression and anxiety (hello!), insomnia (hi again!) and weight gain (it’s like my psychiatrist was reading my diary!) My psychiatrist explained that given my mental health history, and all the work I have done in therapy, and my struggles to get off Mirtazipane, I might just have the mutation. She urged me to talk about it with my general practitioner and get a blood test to find out. This seemed like an excellent idea.

But I procrastinated.

When I was first hospitalized for postpartum depression, my psychiatrist tested my thyroid. Sometimes thyroid issues mimic postpartum depression. Oh, that sent my hopes skyrocketing! I didn’t want to have PPD. I wanted to have a thyroid issue, because back in 2013, I was still very sensitive to the stigma surrounding mental health. (And now? I give zero fucks. I know I’m a good person, end of discussion. But 2013 was a completely different time.) I was so disappointed when my thyroid results came back as normal. Damnit. I had a mental illness.

Getting tested for the MTHFR gene mutation felt like I was back in the hospital, clinging to the hope that I had a thyroid issue. I just needed to accept the fact that I need to take a little antidepressant in order to sleep well at night and stop trying to pin the blame on some other health issue. Besides, there is no blame in this! It’s just the way my brain works.

But I finally realized I was being idiot. I am going to take an antidepressant if that’s what I need to sleep, but if there’s some other health issue, that should be addressed as well. Knowledge is power.

So I got the blood test in January.

I waited.

I had an appointment with my naturopath in early February.

She handed me the results from my blood test.

I have the MTHFR gene mutation.

I’m actually tearing up while I write this. When I gave birth to Pippa in 2013, my hormones went batshit bonkers. I had a lot of preexisting anxiety, and my hormones just pushed my anxious mindset into Mental Health Crisis Land. But my poor brain was also starved for Vitamin B. Zoloft and Mirtazipane pulled me out of my PPD crisis, but damnit, I still needed Vitamin B.

Now I am at long last getting the Vitamin B my brain needs. I take a supplement after breakfast, lunch and dinner. (Ok, always after breakfast and dinner. Lunch is 50/50 whether I’m going to remember.) The supplements gives me 125,000% of the recommended daily dose of Vitamin B. Translation: Holy shit! My brain needs a lot of Vitamin B!

For the first few days after I started my new Vitamin B supplements, I did not notice any changes. But then I slept seven hours straight one night, got up to pee at 5 a.m., and fell right back to sleep. WHAT THE HOLY FUCK? I have not done that since I was, I don’t know, eleven years old? Ten years old?

I still tend to wake up during the night to pee, but only once, and then 98% of the time, I fall right back to sleep. I feel better rested than I can ever remember feeling. I am sleeping more deeply for much longer stretches of time. I have even been sleeping beautifully during the present shit storm.

I also have more energy and zip during the day. Was I slightly depressed before I got my Vitamin B needs met? I don’t know. I have to reflect upon that idea some more. I thought I was as mentally healthy as anyone could be, but now that I am getting my Vitamin B, holy shit, maybe I have been slightly depressed for all of my adult life.

I feel like with all this fantastic Vitamin B, I might actually be ready to wean off Mirtazipane.

Except for this whole pandemic thing.

Yeah… I don’t have a lot of experience in this arena, but it seems to me that when one is sheltering at home during a pandemic, that might not be the best time to wean off an antidepressant.

So I am just going to continue taking 7.5 mg of Mirtazipane at bedtime for the foreseeable future. But damn, I love the way I feel with my mega Vitamin B supplements! I’ll just have to add Mirtazipane Weaning, Take 5 to my post-pandemic bucket list.

A Very Sweaty Namaste

I started doing hot yoga! I love it! During class, I can feel myself literally sweating out the crazy.

My first hot yoga, aka Bikram yoga, was about fifteen years ago. I went to a studio in Hollywood with my sister Katherine. I knew next to nothing about hot yoga, but my sister wanted to go, so why not?

Well, I thought I was going to die. I had to leave the room to dry heave a bit in the women’s restroom. At the end of class, the teacher came over and said all these flattering things to my sister about how she was a natural and so flexible and gosh, she should come again. Then she looked at me sideways, sighed, and walked away.

Needless to say, I did not go back.

But, I could not get the idea of hot yoga out of my head. Every now and then, a friend or aunt would talk about how much she enjoyed hot yoga, and the things I heard made me think that despite my first experience, it might be a good practice for me.

My friend Laura convinced me to try again last December. She gave me lots of helpful advice beforehand, like Be hydrated and Bring water and Eat an hour beforehand so you have energy but don’t need to puke. Her most important advice though was to arrive early so my body could acclimate to the 105 degree temperature in the studio.

Armed with this good advice, my second hot yoga class was so much better than my first. I felt like I was getting my ass kicked, but in a way that made me feel radiant. The poses combined stretching and strengthening and midway through the class, my heart was pounding as if I had been running. When I left class, I felt very calm and relaxed. My worries had receded. I had found my dream workout!

Except the schedule did not work for my life.

I could have attended the 9 a.m. class, but I would have been about ten minutes late. (Pippa’s elementary school starts late.) I knew that would make me anxious and affect the quality of my workout. The 11 a.m. classes were all too late, because at the time, Julian got out of preschool at 11:30. Blah blah blah, talking about my mom schedule is tedious and dull, but long story short, I kept walking and wearing my Fitbit, while promising myself that when the time was right, I would return to hot yoga.

That time has arrived!

Julian is older and his preschool days are longer. I dove into my hot yoga practice last month. I’d like to go twice a week, but so far, I’ve only been five times. (I ran a preschool book fair for a week. Pippa had a cavity. We went to Disneyland. Such is life.) But I can feel my body getting stronger. I am getting stronger, body, mind, heart and soul.

I am just at the beginning of this hot yoga practice, but I am excited to see where it takes me. A few years ago, if I had written a post about doing hot yoga, I would have used a lot of swear words and then said demeaning things about how my postures compare to the other students. But now I am forty, and I do not feel the need to ridicule something that is giving me such joy. I just want to embrace this practice, sweat and all.

p.s. There is so much sweat! It’s ridiculous.