It started a few months ago; but I was not conscious of the fact. In the absence of heat, with the passing of seasons something sinister was occurring; slowly but surely. It may have been imperceptible at first, but as time passed it became more pronounced and identifiable — my mask was melting. Though I am not one to don one physically or metaphorically, this chemically produced mask hid something very personal from the general public — my depression. But as the last days of summer faded and the weather became cooler things began to change; my Wellbutrin XL (Bupropion XL) was no longer working.
We don’t often talk about it. We often try to hide it. But depression is so very real — for millions of people. Sometimes we are shamed into silence. Sometimes the lethargy and sadness makes us just not give a fuck — on so many levels! Depression has been around me my entire life. It reared it’s ugly head while I was living in Alfred, NY in the early 90s. I didn’t know it then, but as it became more prominent and invasive after moving to Seattle — the suicide capital of the Pacific Northwest — in 1995, it was undeniably going to be a problem. I realized that it had started in Alfred from reading pages from diary entries I made during that time. They spoke of the lethargy, the gray weather, and the not wanting to get out of bed — almost every day. The entries started the same way — every morning. And once in Seattle, within months, I had hit an all-time low and sought help.
During this time I was trying to hold down a full time job as a Mac computer consultant at a small Seattle company called Westwind Computing. I was fortunate to have health insurance that also had mental health benefits. Long story short — I was put on Paxil, a then “new” serotonin reuptake inhibitor (SRI). It made me worse! It made me more suicidal. I had to stop. Over the course of the next few months I was put on Zoloft, and a few other “older” SRIs. Each having the exact opposite effect they should have had — not making me better, but making me worse! Even natural remedies like St John’s Wort didn’t work for me — I’d do it and felt like I’d snorted a bag of meth each time! Yippee! It took me a while to figure out the only thing that EVER worked for me was exercise. Going to the gym was my Zoloft! And it worked — consistently!
Fast forward to 2012, Asbury Park, NJ. Having reached a weight of 275 lb, and an ungodly high blood glucose level of 425, the universe put me on a path of weight loss and exercise. I’d been here before, but not with this determination nor support system. As I dropped 100 lb over the next 7 months, my spirit soared — as did my serotonin levels! But about two years in something started to happen. I started losing energy. Lethargy was creeping in despite being at the gym 6 days a week, working my ass off! I started seeing specialists trying to figure out what was causing the energy drain. Saw a endocrinologist thinking it might be thyroid related — NO! The same endocrinologist discovered I had some rare genetic defect where I didn’t produce sufficient DHEA — a hormone in the testosterone chain — that might also cause lethargy. Supplemented with DHEA for a month and that was not the answer. Found a Sarcoid specialist at Rutgers Medical in Newark, who helped coordinate a host of other specialists, including a neurologist and an ENT. The ENT found that Sarcoid was active in my sinuses, but that alone would not cause the lethargy. Went to the neurologist and she could find nothing wrong, including an MRI of my brain, which was also normal. But it was she who posited, “Joe, it sounds to me like just under-treated depression. Your brain chemistry has changed to the point where exercise alone in not enough. NOT WORDS I WAS READY TO HEAR!
It took a few weeks for me to wrap my brain around the concept — exercise alone was no longer going to be my magic bullet. It was at that moment I decided to investigate newer drugs. I knew the name Wellbutrin, and knew a friend had been using it with excelent result. So I did further investigation and read some pretty miraculous stories about its “rejuvenating powers”, and that sometimes it worked on the first day for some lucky people. I talked to my then therapist and he set me up with a psychologist in the practice that could prescribe. Within a week I was able to meet with the psychologist and she prescribed 150 mg of Bupropion XL the generic of Wellbutrin.
Almost two years had past from the my first symptoms started. Around December of 2014 the lethargy, memory loss, and “fuzzy brain” got so bad I could no longer go to the gym. This lasted until I took my first Bupropion — Friday, January 29, 2016. I was so excited, and quite nervoius to take the first pill. What happened if it acted like all the antidepressants I tried previously? I knew I had to try, so I downed my first pill around 9:00 AM after first waking up. I went to my computer, and did some work. Within an hour I walked into the kitchen, put on some music, and was washing dishes, singing and dancing around the kitchen — something was afoot! The cats looked at me like — who the hell is this guy!?!? I didn’t hit me until I started making breakfast and continued my song and dance routine — THE DRUG WAS WORKING! OMFG!!! I actually went to the gm that day too, for the first time since I stopped over a year ago. Miraculous indeed! And I kept going ever day after. I was back to six days a week before long! And Bupropion XL continued to work for the next month, until my body became use to the dose and I had to be moved up to 500 mg. But with that — I was back on course, full speed ahead! I don’t ever remember feeling this good and having this much energy my entire life!
Fast forward to about 5 months ago. The enegy started to slowly — almost imperceptibly — decrease. I had also injured my left shoulder and slowed me down in the gym. I worked around it — until the lethargy became so bad again — I could no longer work out. I could barely get out of bed. The only thing that had changed during that time was RiteAid had changed the manufacturer of my Bupropion. Luckily I all I had to do was wait another week for a previously scheduled appointment wit my psychologist. I waited patiently, and sadly for that day. I knew things were drastically wrong. Jesus! I was crying at the drop of a hat. I cried watching the Karate Kid for Christ sake! Aaaaaaaaaaaaah! Something was seriously wrong!
At my appointment the psychologist wrote two prescriptions; one for Bupropion XL 500 mg and one for the brand name Wellbutrin XL 500 mg at my request. I went home that day & called RiteAid. I got the manufacturer names for both the original prescription and the manufacturer they substituted. I had read in previous research that different manufacturers may create different formulations of the same drug, using different binding agents and fillers etc. This is why I was determined to find another place that carried the original manufacturer — Pro Pharma. I finally found the local CVS on Rt 35 sold Pro Pharma Bupropion XL. So I rushed to CVS. Sadly because the way insurance works — I was not allowed a refill for Bupropion for another 3 days. So I waited. On Saturday morning at 9:00 AM I was at CVS to pick up my new prescription. I drove home and downed the Pro Pharma Bupropion — hoping for the same “first day miracle”. I was waiting to be transformed back into my old energetic, chemically altered self. But as the hours past, I felt the same lethargy and sadness as before. And even a week later, not much better. Well maybe a little better today. So I wait patiently to see if the new version of the drug brings me back to the “sweet spot”, or if I’ll have to be weaned off it and try another in a host of newer antidepressants. My only fear are the side effects. Bupropion had very few if any. But some of these others … I’m not sure if its even worth it. So I wait. I had read that it takes 9 days for Wellbutrin to leave your system. So I’m hoping that as the old drug fades away the newer version replace the old, I will be brought back to my happy place — or not.
I never write looking for sympathy or empathy. I write to document. This is me taking a verbal photograph, capturing moments in time, creating the outline of a history — a pathology. This blog started as a way for me to cope with and document the diagnosis process and ongoing treatment and ongoing story of my auto immune disease Sarcoid — another long time “friend”. Doing these post helps me solidify, codify and process what is going on in my life and the effects — god or bad — ugly or not — they help me understand and tame my demons. And I know the stories also help others. They also have helped me see how much stronger each of these “maladies” has helped make me. Because I have always looked at, researched and fought each of them in their own way — on my own terms! This new twist in the journey is not much different than all the others.
So now I wait. I have another appointment with the psychologist in three weeks. In the meantime all I can do is take the Pro Pharma Bupropion and see if it is all I’ll need, or if a ‘cocktail’ of drugs” will be my next daunting task. I know depression intimately. I know being alone. I know the overwhelming sadness. They have all been my friends for far too long. This may be the first time I’ve written exclusively about the journey from the beginning to present moment. And now I wait for the mask to solidify or to continue to melt along with my energy and my sanity. But whatever the outcome — I will persevere — and never give up — no surrender!
If you’ve read this far … you’re a mensch! Thanks! If you care to share … leave a comment. Take care and be well … Joe.