It’s been just over a year since I switched from Effexor XR to Cymbalta for my anxiety and depression. To my memory, I had been taking Effexor for nine years at the time of the switch, which went smoothly because both prescription medications are from the same class of drugs, SNRIs. The decision was made primarily to get the additional physical health benefits that Cymbalta could provide that Effexor was not giving me. It was miraculous.

I hadn’t yet been diagnosed with Small Fiber Neuropathy (SFN) – something I have yet to blog about, but really should in the near future. But I’d been treating some of the symptoms for years by taking gabapentin whenever my “skin hurt” too much or I was getting shooting pain down one nerve or another, and I went from taking 300-600 mg of gabapentin daily to needing none of it literally overnight after switching to Cymbalta. I still have gabapentin on hand for breakthrough nerve pain, but I don’t have to take it very often.

The thing I didn’t expect was that I would “wake up” from the haze I’d been in for three years.

I didn’t recognize that I was in a fog and a downward spiral pretty much from the time the ball dropped to welcome in 2014. In January 2014, we still thought that my dad would beat his cancer a second time, instead of losing him to Mantle Cell Lymphoma that June. Consciously, I didn’t know he was dying. But my subconscious mind knew, and it was affecting my mind and my behavior. I was literally not myself from then on.

It’s funny, because my memory of all of the horrible moments from that year was crystal clear for three years. I could remember every word of terrible conversations. I could call up the extreme grief of getting that middle-of-the-night phone call to get to the hospital as soon as I could, only to find out Dad had died before any of us could get there. (I secretly believe he made a deal with the hospice nurses before he lost lucidity, to make sure none of us would have to watch him die. The nurse who stayed by his side when he died had him cleaned up and looking so much more peaceful than he had when we’d said our goodbyes just hours before.)

I could remember screaming at myself from inside my head every time I texted or messaged a friend something that was the exact opposite of what I wanted to say, then doubling down on the dreadfulness of the message instead of apologizing. (I would later realize this was how my situational mutism operates when I’m experiencing extreme emotion.)

But I had perfect recall of every moment of horror in my ruminations at night as I tried in vain to fall asleep. I could relive the memories in waking nightmares, wondering what the hell was wrong with me, wanting to fix things, but only making them worse.

It got worst, I think, when I had my breast cancer scare just four months after my dad died of cancer. The lashing out part, at least. My dissociative episode wouldn’t be for another two years, and that was scary as hell.

For all this time, from January 2014 until July 2017, I had near-perfect episodic memory that reinforced itself through ruminations. My psychiatrist increased my Effexor as high as he was comfortable with doing, and he recommended taking my Valium every night at bedtime (instead of only “as needed” for panic attacks) to help turn down the ruminations. But it just wasn’t enough. All the pain was crystal clear in my memory as if it had just happened the day before.

Until Cymbalta flipped a switch in my brain.

There are no words that can adequately describe how it actually felt that very first morning when I woke up after making the switch. I know that, pharmacologically, it shouldn’t have worked that fast. But it did. And I wasn’t as depressed. I wasn’t as anxious. I wasn’t in as much physical pain. My world was no longer made up of clear recollections of the past but only fuzzy edges around what was happening in the present. I do have a slight problem with not knowing whether some conversations from those three years actually happened, though, or if they were conversations I “rehearsed” multiple times as I ruminated about things I wanted to say to various people.

In an unhealthy corner of my brain, I miss the perfect clarity of certain memories, no matter how painful they are. I don’t remember exactly what I said or did in some situations. (Sadly, I do still have perfect recollection of my dissociative episode and the events leading up to it, and it still bothers me that I don’t know what the hell happened. But…it doesn’t hurt as much anymore. Most of the time.)

But it’s like…I’m myself again. I’m still autistic. I’m still physically disabled. I still struggle with depression and anxiety… but I am more in control of my own thoughts again. And I have been for a whole year now.

And I’m learning so much more about myself. I’m unpacking what it means for me to be autistic. I’m unpacking what my physical limitations mean for me, my relationships, who I am, and what I want to do with my life. I couldn’t do any of this before because I was not in the right mental space for it to happen.

I still ruminate sometimes, but not like I used to. It doesn’t keep me awake every night. My short-term memory is terrible; it always has been, but I think it’s getting worse. Memory is such an odd thing.

Read my Big Fat Medical Update for more details.

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