On the subject of losing one's mind...

Disclaimer & Trigger Warning... A frank discussion of the events experienced as a result of a 6 month negative cognitive reaction to the medication Zoloft. Whether I may or may not succeed, my aim in this post is to try to dissect the signs and symptoms and my reactions (or lack thereof). Trying to make something good come out of the bad. 

"Darmok and Jalad at Tanagra... 

   Shaka, when the walls fell." 

Here I am, one day shy of four weeks since my Dr switched me back to Cipralex from the Zoloft which was the source of  95-97% of my cognitive decay (with the remaining 3-5% proving to be menopause related: nausea, power surges so strong that I can raise the temperature in a room by ten degrees just by sitting still, night sweats, low grade headaches and very mild difficulty focusing). My thoughts have cleared enough now that I'm hoping to be able to discuss the experience, mostly as a means of self-analysis to ensure that, if ever this should happen to me or to anyone else around me I should have not only a means of recognizing but also a chance to intervene before it gets as severe as this did.  

I used the term 'cognitive decay' to describe what I've gone through, it's the best concise descriptor I have been able to come up with so far. I figure I'm still at around 70% of normal cognitive function but it's still improving daily so there's a good chance I'll stabilize somewhere close to my pre-Zoloft IQ.

So, I got confirmation of this cognitive decay as a seldom seen negative drug reaction from one of Kara's psychology professors . I know this professor because I had him for Psych 102 back before raising the grandkids became the priority (Funny story about him, I'll tell you later). He's spent time in research and, where it comes to the mind altering properties of psychiatric medications, he is better versed than most. Having asked my permission beforehand, Kara made time to talk to him about what happened to me and he confirmed that dementia-like side effects can occur... I did not previously know this but it definitely explained a heck of a lot. 

The last six months have been terrifying, the decline was masked by symptoms of other illness (iron anemia, menopause, fibromyalgia, anxiety, phobia, take your pick) I was navigating at the time so, by the time the extend of the problem started to be recognizable, I had already lost the capacity to communicate in a precise manner. As thinking became increasingly difficult, my distress and anxiety increased in what felt like exponential increments and my ability to retain a train of thought evaporated. Though I could remember how I used to be -- higher level communication skills which I had taken for granted and a facility with language that allowed me to discuss topics of self-awareness, identity, building a mental health toolbox, managing ideation to minimize harm, etc with a depth of understanding that has amazed mental health counselors, psychologists, and psychiatrists -- but I could no longer remember  HOW TO be that person. 

Looking back, strictly from my perspective as it's the only one I have to offer, I can identify my first stumbling efforts to try to communicate the problem as being the point where I started telling the people around me that I couldn't regulate my tone of voice... I could hear myself becoming increasingly snappish and over reactive. It got to the point where, no matter how I tried to moderate my tone, Walter level cranky grouch was all I could manage. My sense of humor disappeared, as did my personality and I literally turned into an angry dullard drudge. Why angry? Because I was fighting so hard to appear normal and I tried using meditative techniques to manage the anger but, as many will have heard me say before, the brain uses anger as a fight or flight response. I've experienced it numerous times when a careless human has slathered themself in stink (perfume) and then has come into proximity to me and my COPD lungs (hovering at the border between severe asthma and mild emphysema) and trigger an attack that can leave me needing a trip to emergency. Anger is the emotion that powers the fight reflex so it's a common response to a strong allergic reaction. I was fighting with myself for my mind and, all the while, 

Because my intellect was evaporating and my short term memory along with it, and with my experiences with dementia with my mum and Kara's mom, the possibility entered my consciousness that I could be having an early onset dementia or Alzheimer's. And that, in and of itself is a soul chilling prospect... terrifying... but, not knowing what I do now, what other possibility fit the bill? Almost as much "fun" as the cancer scare back in 2005 to navigate emotionally... And I mean that with the thickest slice of sarcasm I can dish. 

By the time November had rolled around, my inability to communicate both the nature and degree of my distress combined with my symptoms reduced me to the point where I was in a panic state all the time... my train of thought reduced to a handful of minutes with up to two out of  three sentences I started plummeting off my mental rails to the memory dump. Now, not only could I not communicate my distress but neither could I make decisions any more. I got to the point where the people around me (Kara, the grandkids) had to tell me what to do (do the laundry, make dinner, sweep the floor, etc - simple tasks that I could perform without requiring much cognitive effort. 

I'm starting to be clear headed enough to begin calculating what watching me deteriorate has put Kara and the grandkids through. Gods, it breaks my heart that Kara confided in me today that she was starting to worry about dementia also, due to the cognitive changes, she was worried it was Creutzfeldt-Jakob disease. A fast paced progressive deterioration accompanied by personality degradation with less than a 10 year lifespan. Yeah, it has to have been horrible watching a normally able and alert person devolve into a useless near stranger who was frequently given to angry overreaction to any stimulus she could neither control nor block out. Yeah, I owe them all a great debt of gratitude for tolerating me at my increasing worst and an equally great apology for being the source of their distress. 

It was around this point when I first saw the animated movie Finding Dory and, unable to verbalize why coherently, I identified so strongly with the anxiety, hopelessness and emotional distress of the titular character with her " I suffer from short term remembery loss " that I started using " I feel like Dory" in an attempt to communicate the depth of my distress at what was going wrong. The problem was, though I could never generate enough coherence to explain, what I needed the listener to do was take that image of  Dory, lost and alone in the dark, from the movie and place themself emotionally in the character's role of the memory challenged fish and then draw the parallel to what I was going through. Unable to marshal my intellect, I was resorting to an instinctual use of metaphor. 

Which garnered me the same kind of response the Tamarians had in ST:Next Generation when trying to communicate with the Enterprise crew (quote posted at top)... confusion and failure. Getting desperate, I started throwing out the Dory references at anyone who spoke to me, hoping someone would clue. Considering I couldn't figure out what the hell was happening, it'd be pretty unreasonable of me to be upset with anyone else for missing it. I tried again and again with  Kara and other family members, the  contractor who did our reno, strangers who tried to talk to me. Everyone had the same reactions : 1. Had not seen the movie so had no clue what I was referencing, and 2. Had seen the movie and had an amused reaction to my comment, completely misunderstanding what I was talking to convey. 

Early December is when I stood in my bedroom and said to Kara, "it's getting bad in here" while tapping my right temple. She heard and responded but completely misunderstood the significance of growing danger in the words. I was getting more despondent and my Depression growing stronger as I gradually had no choice but to abandon the attempt to engage in conversation and still the deterioration continued. I tried a little harder in the truck with Chris Danton the day he ran rescue for me in the snowstorm. Quick to catch the implication when I responded to his chuckle with a sour "yeah, everyone always laughs, but that level of distress..."  He got  past the initial amusement with the Dory reference and was able to make the jump to ask himself "what would it feel like to be Dory?" but I was so far gone into the dullard state by that time, I just couldn't steer the conversation where it needed to go and it got missed again. 

It was pretty much the last time I made the attempt. I was starting to accept that this was my lot in life and, since I've made a lifetime practice of maintaining a tight control of my outward responses, my rapidly dwindling resources all became focused on just getting through each day until I could fall into bed and escape into unconsciousness. Then the sensory processing issues became severe enough to necessitate the chopping off of my hair to derail activities of self-harm and the instances of suicidal ideation began to climb, frequent enough to be recognizable now (looking back with a much clearer head) as the signal that I was entering the last stages. I slept more and more, withdrew from social media (not because I was trying to avoid anyone  even though I was avoiding everyone, but because I just didn't have the resources to shield myself from the numerous toxic elements inherent in Facebook so I avoided them.. I gave up on communication and started grieving the loss of me. I entered the threshold and  began a sort of emotional free fall into the grey.  

I want to mention at this juncture that I had been trying to be heard by my Dr. during this whole time. I had Kara make me several appointments so I could talk to him about the memory loss, inability to communicate more than basic wants and needs... He missed it. My deterioration made me unable to press my point (it's hard to even have a point when your memory lasts less than three minutes) and so it made for some very awkward appointments where I would babble at him ineffectually in poorly contained state of Anxiety and he would reiterate his standing opinion that my plate has been over full for several years now, between my own health (mental and physical), the grandkids, Kara's health and schooling, M'Lady dying. Not grasping the severity of the situation, he felt that my troubles were pretty reasonable versus my functional stress level + the loss of my #1 pillar of strength, my blessing on four paws. I knew ahead of time that losing her would be devastating, and it was. Duck is coming along nicely but he was nowhere near ready for the level of support I needed as I lost my equilibrium... Almost ready now, tho.

There's something good to take away from any situation, if you just look for it... even if that good is simply to learn what you won't permit yourself to go through again. I can't go through that again, the cognitive deterioration, not for real. I will not allow myself to should either dementia or Alzheimer's turn up in my future. I could not possibly be more thankful that Denese was able to catch me before I hit bottom. I may be suicidal but I don't actually want to die... I would hurt too many people who depend on me. Lucky for me, my rational self has no wish to inflict trauma on my loved ones. So long as I have a working antidepressant, I'll resist that whisper. 

And I bless whatever spark managed to kindle in my brain to make me question the Zoloft. 

I'm mentally wrung now, out of words for the moment. 

I'll be back, possibly tonight, to puzzle out some more.