I saw my psychiatrist earlier this week and talked about my symptoms and how I felt like I have anxiety. They said that it does sound like that, and mentioned that when I first came to see them (September 2012) I scored a 37 on the social anxiety scale and my latest one was a 92. I was somewhat surprised but it also made perfect sense, as I have seen my ability to handle social slowly slip away. It's hard to tell because it's always somewhat stressful - it's a matter of the quantity of the feeling rather than the quality.
We talked about meds and they said that they'd prefer to prescribe sertraline, but that mirtazapine should work and it would be fine to try that, as it's a relatively safe drug. I feel so very grateful to have a doctor who listens to me and doesn't try to push me towards what they think is best. I do my homework about brain-altering meds, and while I am sure that sertraline isn't the exact same as citalopram, they're both SSRIs and I suspect that sertraline would make me feel numb too (which I find very depressing and wish to avoid!).
So my doc prescribed the mirtazapine and gave me instructions to step down my bupropion while stepping up the new med. Now I'm off bupropion and just on mirtazapine, waiting for it to build up in my system because apparently it takes 1-3 weeks for full effect.
I immediately felt an effect on my reaction to stress. Right after I took it the first time, I almost knocked over my toothbrush holder and when I did, I felt a jolt of adrenaline that didn't make me feel awful. Usually anything that sparks adrenaline makes me feel edgy and angry and shaky for a good while after, I think because it's like it's scraping the bottom of the barrel. But this felt so different, almost good. And since then I have noticed that happening again and again, where adrenaline has a whole new feeling in my head and doesn't make me feel sick and like I want to attack things. I also realized how ridiculously often throughout the day I get startled and stressed. Unexpected noises do it, even nice ones. I am constantly on alert. I can tell when the meds start to wear off because I will have a startle response that doesn't come with that almost-pleasant split-second-dizzy feeling. I can't tell you what a relief it is to not have bad adrenaline responses all day long. This would be worth it just for that effect, and the energy I save from not having to avoid and fight off my bad adrenaline responses may be enough, alone, to build back my ability to be social. I am still hoping for more help than this though.
It has a somnolent effect, so it is supposed to be taken before bed. Since I take a stimulant for ADD mid-day, I am taking 1/4th of the pill with that medication and the other 3/4ths at night. So far it seems to be working well that way, but I am going to have to be more careful to get enough sleep because if I miss an hour of sleep after taking this I feel SO SLEEPY. It also has an effect on my metabolism, bringing back my appetite - which is great because my ADD meds suppress it and then I don't eat, which makes my ADD worse and is generally bad for me. I feel like this med will help me to be more healthy just by pushing me to better sleeping and eating habits.