I start grad school in four months, and I’m worried about my apathy and extreme fatigue that are possibly a result of my marijuana dependency and/or my SSRIs. What are some steps I can take to get these issues sorted out in light of my anxieties about changing meds and my reluctance to give up marijuana?
posted by anonymous to Health & Fitness (20 answers total) 6 users marked this as a favorite
I’ve organized my question into paragraphs outlining the main issues. I put a TL/DR at the end of each paragraph.
I’m a healthy female in my late twenties, about to complete my second undergrad degree and start a prestigious doctoral program in September. I’m really excited about grad school, but I’m worried about my long-standing problems with fatigue and depression, and my recent problem of a marijuana dependency. I really want to get a handle on these issues before I start grad school, and feel like I have four months of relatively low stress to maybe try adjusting my meds and working on the pot thing. I just don’t quite know where to begin!
TL/DR: Late twenties woman wants to cure fatigue and drug issues within the next four months.
Girl loves to sleep. For pretty much as long as I can remember I have cherished sleep and engaged in wayyyy too much of it. Especially in times of stress, my time in bed can go up to 16-20 hours a day. Much of this time is spent in a strange sleep state where I have disturbing dreams or nightmares, and some waking time is spent scrolling on my iphone or watching internet tv. Lately it’s felt really bad, where I want to get out of bed but just…can’t. I have even called my mom near-tears, asking if she was coming home soon so that she could try to pull me out of bed. I lie there with just absolutely no motivation or…ability…to get up. Obviously my muscles still work and I could if I forced myself, but even if I somehow propel myself heavily into the kitchen to try to make a sandwich, I quickly retreat back to bed before even getting the bread out of the bag. At school I spent hours napping on one of the lounge couches when I should be doing homework. My sleep schedule has been messed up lately – where I stay up until 5am and sleep until 6 or 7pm, but I can’t seem to break it. In the day all I want to do is sleep, but sometimes at night I feel almost afraid of going to sleep….I have to watch tv until I drift off. On my long days in bed I will often not eat well, and if I do eat it has to be something warm and mushy that doesn’t take more than 5 minutes to prepare (microwavable kraft dinner). I am so tired of this fatigue – I never get anything done, I miss out on social opportunities, and I feel almost paralyzed by my lack of ability to get out of bed.
TL/DR: I can spend up to 16-20 hours a day in bed sleeping, and even getting up to get a glass of water feels like too much effort/energy. I can’t get a handle on my extreme fatigue.
It is highly probably that my marijuana use contributes in some way to my sleeping problems, but on a day to day basis it is the only thing that seems to help. When I’m lying in bed comatose, I know that the one thing that can get me going is to have a little puff. Often I will lie in bed for hours just trying to get the energy to get up and put a pinch in my pipe. The effect of smoking marijuana is almost instant: suddenly I am up, fixing myself healthy food, cleaning things, wanting to socialize or exercise, and getting excited/motivated to do my homework. I don’t know why it has such a stimulating effect on me – I mean, I know it’s a stimulant, but it makes many people instantly lazy and munched-out. It makes me want to hike a local mountain trail eating fresh oranges and baked fish. It really just seems to perk me up completely, and so I’ve started using it a lot more often lately. I don’t smoke a large quantity, but I do smoke very often. I usually only take two puffs each time I smoke, and smoke between 1-4 times a day, so I probably end up smoking about a joint a day. A gram lasts me about a week. My pot-smoking friends often laugh at the teeny amounts I smoke – but I feel like it’s part of the secret to using marijuana effectively –too much makes me lazy, just a little makes me efficient.
I feel shame and worry about my pot dependency though. Recently I tried to quit for a week to show myself that I could, and I only lasted five days. I’ve been an occasional user for a long time, but I don’t really like the fact that I smoke by myself, or feel like I have to smoke to get through a day. I don’t like that I recently got pretty anxious when I was down to my last puff and couldn’t find any more anywhere. During the five days I did quit, thought, I did end up doing some things that I previously used to get high for (swimming, work) and was kind of surprised to see that I still enjoyed them without smoking it. The reason I gave in was because I had work to do and just couldn’t get myself to do it, and a lil puff did the trick.
TL/DR: I smoke modest quantities of marijuana a couple times a day, and it really helps with my energy/motivation/productivity, but I don’t like feeling dependent on it and it seems that’s where I’m at/headed.
I have tried stimulants to deal with this problem. I was once prescribed a low dose of Ritalin by a psychiatrist ( a few years ago) – but I didn’t like taking it and I can’t remember why (I have a really bad long term memory). Recently a friend gave me a handful of Adderall (20mgXR) – and I really liked it but didn’t like the side effects. The part I liked was feeling awake – for the whole day I would just go about my business like a normal person! I was awake and doing things! I would set an alarm for 7 am, wake up and take it, and get out of bed at 9 am with ease and anticipation for getting started with my day. On a normal day the only thing that can drag me out of bed is an unshakable commitment to be somewhere (and that doesn’t even always work). The part I didn’t like about Adderall was the personality and come down. I found my personality way too obnoxious/in your face (relative to my usual, easygoing, kinda quiet personality). I felt like I was annoying people with my happiness and excitement and inability to stop pacing/talking. So it brought me up to be a bit too energetic. I also get really bad cramping in my lower back and butt muscles in the evenings on days I’ve taken it. I’ve looked this up online and some people have this symptom but don’t know why. It’s REALLY uncomfortable and hurts a lot. (I don’t know if it has anything to do with the fact that I also get weird butt cramping during my period, which extends down the front of my thighs, and really hurts. Or with the fact that my whole childhood I had insane restless leg syndrome but didn’t know what to call it. My mom says I would just kick and kick my legs and say they were dizzy. Restless leg syndrome sounds flaky but I still sometimes get bouts of extremely uncomfortable antsy-legs). I try to stay hydrated while I’m on it, and maybe sit at a computer for a while more than normal, but this seems like an extreme reaction.
TL/DR: I’ve tried Ritalin and Adderall, and while they did help with my energy levels, I didn’t like Ritalin and Adderall gave me strange and painful cramping in my back and butt along with mild annoying hypomania.
SSRIs and Depression
I’m currently on 20mg on Lexapro to treat atypical (characterized by fatigue and increased appetite) depression. I’ve been on it for 3 years now, and although I had a lot of hesitations/resistance to feeling dependent on medication (just like on pot), I’ve accepted that it helps me immensely and that I want to stay on it. I’ve tried decreasing my dose a couple times (always gradually, usually with doc approval), and have had horrible experiences each time. The side effects I get from Lexapro are annoying, but the withdrawal is almost unbearable. I get brain shivers almost immediately after missing a dose (like, if I’m supposed to take it in the morning, by the evening I’ll know I forgot because I start getting brain zaps). This really freaks me out, especially because I can’t find a comprehensive scientific explanation as to what is happening in my brain during brain zaps. Is my serotonin being re-uptook, when the presynaptic neuron is not used to getting it or something? Are my synapses accustomed to having a certain amount of serotonin, and the gaps are the synapse reacting to a decrease? I just want to know because to be able to feel my brain giving off an electrical charge worries me.
Aside from the brain zaps, I get really emotional and depressed when I taper down my Lexapro, so I’ve always ended up going back to 20mg. For this reason I’m scared to tamper with my dose again or try another antidepressant. I also heard that tampering with good doses can screw them up, and I don’t want to lose a good thing by messing with it. That said, I don’t know if the Lex is working as well anymore, or if it is playing a role in my apathy/laziness, since that is a known side effect. My body just feels depressed, even if my mind mostly feels okay.
I tried Wellbutrin 100mg once for a couple months, but didn’t really notice a difference aside from some heart palpitations. It would be something I’d be willing to try again, but the anxieties about messing with my meds is making me hesitate. If I am going to tamper with this stuff, I want to do it in the next four months before I start grad school, because I know from experience that med-messing times are full of mini-mental breakdowns.
TL/DR: So Lexapro has worked for me, but may be contributing to my fatigue, and I don’t like the brain zaps. I’d be willing to change meds, but want to be stabilized on something by the time I start grad school in September.
The other stuff I know you’ll ask:
I don’t get nearly enough exercise, but plan to change that once I move to a town next month that offers dance lessons.
I see a therapist when I need to, but don’t feel that I need to right now.
I don’t eat that well, because I hate cooking, but I don’t eat awful, either.
I do really well in school, so somehow I manage to maintain an appearance of functionality despite my internal feelings that I am unable to get almost anything done.
I hardly drink alcohol, and don’t smoke cigarettes.
I have not had bloodwork done in a while, as I can’t get it together to get the bureaucratic stuff together enough to go see a doctor.
I don’t know if I have thyroid problems, but I am slim and have a low blood pressure.