I went to my psychiatrist yesterday. I discussed my cognitive issues with her - as far as I can tell, I don't have any loss of memory or knowledge/intelligence, but I have a righteous lack of executive function. I can't get things done, not because I don't know how to do things, or what to do, but because... I'm not even sure.
It's like this: I go to the grocery store to get stuff for dinner. I walk in with a list, maybe? And then I get the stuff. But I might get a cucumber, and then walk across the store to get beans, and then remember I need a lime, and then get something from the freezer, and then oh dear - lettuce. Then back to get yogurt, and crap, forgot the onions. And it's all on the list.
Or like this: I can't plan routes to places I know. I can't decide whether I should use Route A or Route B, and I feel lost (literally). Even though I know where I am, and where I need to go, and three ways to get there from here. Not sure what I'd be doing without my Google Maps right now.
Or like this: I sit down to work, and after 45 minutes, have accomplished nothing, and I wasn't wasting time surfing the interwebs. I mean, I know how to procrastinate. I am good at it, having honed my skills for years. I am not doing that.
I don't recognize myself. I feel like a stranger. I don't feel like me, sometimes at all. It's like I'm in a parallel universe, watching myself, and being all, "get it together, Natasha." But I don't even know what's broken. I don't know myself. It doesn't matter how much I meditate on it!
So anyhow, my psychiatrist? She says that it is believed to be the practically overnight onset of menopause from ovarian suppression (just like oophorectomy, but possibly reversible if you stop taking the shot in the behind) that leads to most of the cognitive dysfunction she has seen in her breast cancer patient population. Not actually the chemo. People who age into menopause have this thing -- also unpleasant, but apparently beneficial, wtf, seriously -- called perimenopause. It takes a few years to go from functioning ovaries to nonfunctioning ovaries. And then, they still have some estrogen from other sources, but really it's the ovaries. The other estrogen can revive my latent (and hopefully nonexistent) cancer, which is why I take AIs and am not in the Club. But the defunct ovaries = menopause.
She says that brains just don't like rapid changes. And the instantaneous removal of estrogen has a profound effect on the brain. And that's one reason menopause usually takes a few years to happen, because your brain matters.
So now what.
I'm currently on a high dose of Lexapro, an anti-anxiety medication. I am not feeling too anxious about it. Ha. Ha. It is a serotonin medication. Serotonin is one of a few neurotransmitters psychiatrists medicate and regulate. Dopamine is another, norepinephrine is another.
The first thing we're going to do is taper me off the klonopin and maybe that will make my brain function normal again. And if it doesn't seem to, we'll start switching me slowly slowly over from Lexapro to Pristiq. And that regulates both serotonin and norepinephrine. It should help my brain.
But the moral of this post is -- PRISTIQ? Really? You named a medicine PRISTIQ? How much did you pay for that branding company to come up with that name? Seriously. Almost as bad as Abilify. I'm embarrassed. Not because of stigma of mental health issues. We need to talk about these things. But just pure, unadulterated embarrassment of having to take something with such a ridiculous name. Dammit, pharmaceutical companies.
It's like this: I go to the grocery store to get stuff for dinner. I walk in with a list, maybe? And then I get the stuff. But I might get a cucumber, and then walk across the store to get beans, and then remember I need a lime, and then get something from the freezer, and then oh dear - lettuce. Then back to get yogurt, and crap, forgot the onions. And it's all on the list.
Or like this: I can't plan routes to places I know. I can't decide whether I should use Route A or Route B, and I feel lost (literally). Even though I know where I am, and where I need to go, and three ways to get there from here. Not sure what I'd be doing without my Google Maps right now.
Or like this: I sit down to work, and after 45 minutes, have accomplished nothing, and I wasn't wasting time surfing the interwebs. I mean, I know how to procrastinate. I am good at it, having honed my skills for years. I am not doing that.
I don't recognize myself. I feel like a stranger. I don't feel like me, sometimes at all. It's like I'm in a parallel universe, watching myself, and being all, "get it together, Natasha." But I don't even know what's broken. I don't know myself. It doesn't matter how much I meditate on it!
So anyhow, my psychiatrist? She says that it is believed to be the practically overnight onset of menopause from ovarian suppression (just like oophorectomy, but possibly reversible if you stop taking the shot in the behind) that leads to most of the cognitive dysfunction she has seen in her breast cancer patient population. Not actually the chemo. People who age into menopause have this thing -- also unpleasant, but apparently beneficial, wtf, seriously -- called perimenopause. It takes a few years to go from functioning ovaries to nonfunctioning ovaries. And then, they still have some estrogen from other sources, but really it's the ovaries. The other estrogen can revive my latent (and hopefully nonexistent) cancer, which is why I take AIs and am not in the Club. But the defunct ovaries = menopause.
She says that brains just don't like rapid changes. And the instantaneous removal of estrogen has a profound effect on the brain. And that's one reason menopause usually takes a few years to happen, because your brain matters.
So now what.
I'm currently on a high dose of Lexapro, an anti-anxiety medication. I am not feeling too anxious about it. Ha. Ha. It is a serotonin medication. Serotonin is one of a few neurotransmitters psychiatrists medicate and regulate. Dopamine is another, norepinephrine is another.
The first thing we're going to do is taper me off the klonopin and maybe that will make my brain function normal again. And if it doesn't seem to, we'll start switching me slowly slowly over from Lexapro to Pristiq. And that regulates both serotonin and norepinephrine. It should help my brain.
But the moral of this post is -- PRISTIQ? Really? You named a medicine PRISTIQ? How much did you pay for that branding company to come up with that name? Seriously. Almost as bad as Abilify. I'm embarrassed. Not because of stigma of mental health issues. We need to talk about these things. But just pure, unadulterated embarrassment of having to take something with such a ridiculous name. Dammit, pharmaceutical companies.
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