Experiments in Neurochemistry

Since the last time I wrote about my premenstrual dysphoric disorder, I've had a couple particularly bad episodes of it, and I finally took all my friends' advice and went to a psychiatrist. Then, for the past month, I've been pondering what took me so many years. Part of it, I'm sure, was a general distrust of doctors and pharmaceuticals - anyone who stands to earn money by convincing me that my brain is "wrong" and that they can "fix" me. But some of my resistance has also been existential. As horrifically unpleasant as PMDD feels, it remains an intense passion. If my strongest feelings can be erased by taking pills, then what am I anyway? What does that mean for the rest of my emotions and for my personality? Is my entire consciousness mere hormone levels and neurochemistry?

Luckily, my psychiatrist earned my trust after asking if I've ever experienced panic attacks. I answered that I think I've had a couple in my life, but they're not a regular problem; I think the last one was a couple weeks before my wedding. She laughed and said, "That's normal; that's just part of being a bride." She didn't pretend that she could make me rational and happy all the time, or even that I should be rational and happy all the time. So I like her.

So for the last week, I've been exploring the sensation of being on a selective serotonin reuptake inhibitor. And it's been a pretty good week: All the little things that traumatize me on PMDD, or annoy me normally, have been mildly funny. On the first full day, I also had an intense dizzy spell that lasted almost two hours. But even then, I appreciated that I could explain to my co-workers, "I feel dizzy"; dizziness at the office doesn't have the stigma that crying does.

I've since lowered the dose, so the dizziness has been mild, but I'm still not entirely "myself." The SSRI-taking version of me is noticeably slower and more forgetful; my mind occasionally goes blank, even mid-sentence as I'm talking. But then, I also got through an entire month without dysphoria. The night that I would usually spend in the fetal position sobbing, instead I had dinner and great conversation with friends.

If "feeling like myself" means feeling like the 3/4 of time that I'm not premenstrual, then the SSRI is still much closer to "feeling like myself" than PMDD. I've always identified a bit with the absent-minded professor stereotype. So if I miss bits of conversation around me, is that the SSRI, or is that my natural daydreaming? I'll never know for sure.

Without the SSRI, if clients yell at me, how much of my distress is rational and how much is the PMDD? I'll never know for sure.

I'll be experimenting with a different SSRI next month to see if another version makes me less light-headed, but I'm entirely sold. Even if I still can't answer the questions of what the drugs mean for my "true" self. My "true" self is even more centered in my physical body than I thought.