If you need to feel it to heal it then don't meds stifle the process?
December 7, 2019 5:40 PM   Subscribe

After I quit nicotine several months ago (and in conjunction with menopause) I found myself starting to cry at everything. I nearly quit my job. I left a relationship. I felt that I was having years of suppressed anger and sadness come welling up within me. There was no suppressing it.

I wrote pages and pages in my journal. I took long walks and sobbed in the woods. I felt deep grief for the ways that I had betrayed myself in life and anger at wounds that I'd never acknowledged. I feel like I was doing some good work. But wondered if I was moving through things to get to the other side or was stuck.

So I ended up asking for some antidepressants.A low dose. I can still cry and still feel things, but not as deeply now. Earlier tonight I was reading about toxic shame which I'm convinced is my problem. And a quote came up about how it's so easy to intellectualize pain but one has to "feel it to heal it". And now I'm wondering if I should get back off the medications. I know you're not my doc. I'd like to hear thoughts and experiences.
posted by Jandoe to Human Relations (23 answers total) 3 users marked this as a favorite
My old boss quit smoking and then couldn’t stop crying, even at work. It was a long time ago so I don’t remember how it got better.
posted by gryphonlover at 5:43 PM on December 7, 2019 [1 favorite]

I think the key is that moods and feelings are two different things. You can be in a totally shitty mood and still be excited to see someone, or be in a good mood and still be jealous or annoyed or disappointed about something.

Depression is a mood disorder. When I'm depressed, I spend a lot of time in a shitty, fragile, emotionally exhausted mood for no reason at all. Getting on the right meds meant I spent less time in that mood — but I still have feelings about things that happen.
posted by nebulawindphone at 5:59 PM on December 7, 2019 [32 favorites]

Nicotine is a powerful brain alterer. It will take time, even with antidepressants, to feel normal again. From Wikipedia: "Nicotine withdrawal symptoms include depressed mood, stress, anxiety, irritability, difficulty concentrating, and sleep disturbances.... On quitting, withdrawal symptoms worsen sharply, then gradually improve to a normal state." Sorry to write it, but you're experiencing normal withdrawal. The only way for it to be relieved, is to wait it out. Tough s**t. (I'm sympathetic but the truth is, alas, the truth.) You'll be better and healthier if you can tough it out. Go for it!
posted by tmdonahue at 6:00 PM on December 7, 2019 [4 favorites]

It so much depends on the medications. For example, I felt some SSRIs I took in the past blocked me from some feelings. On Lamictal, I still have a full range of feelings, but in not such an intense and lasting way. It is important to feel things in order to process and heal, but if one gets so disregulated that they’re in constant pain or despair, that gets in the way of the work or healing, too. I can’t tell you to stay or go off your meds (please do this with your doctor if you do), but I’d personally question what you’re feeling is at an appropriate level and go from there. These are hard things to parse, and I wish you well on the journey.
posted by kyliej at 6:01 PM on December 7, 2019 [3 favorites]

If you were having unusual mood swings because of the absolute ass-kicking that quitting nicotine is to your brain, and then you take something that brings you roughly back to center, that's not some kind of cheating or avoidance, that's modulation.

Also, lots of people use antidepressants as a Stage One of getting a handle on hard shit. Start on whatever work you want to do, and then down the road if you feel like you've got better tools you can wean off.
posted by Lyn Never at 6:14 PM on December 7, 2019 [17 favorites]

When I quit smoking, once the smoke cleared, what was left to me was the reality of the way I had used cigarettes for 13 years to control and manage a chronic anxiety disorder. It took me a while to figure out that's what it was, and treat it, thruogh lifestyle change, a couple years on an antidepressant, and, yes, to make longer-term changes, therapy.

Once you're clear of withdrawal, you may notice some underlying stuff that was wound up in the addiction. It's not a bad idea to go get evaluated and explore some things that might help - therapy, antidepressants, exercise.
posted by Miko at 6:25 PM on December 7, 2019 [4 favorites]

I liken this to throwing out a disc in your back. It's immediately painful, and will drag on for weeks if you don't do anything about it.

In the olden days you could go to a doctor and get muscle relaxers and a fistfull of vicodin. After a day or two of that medication you invariably "forget" you are hurt and in pain, bend over to grab something (a move you could not have even imagined a day before) and POP, the things that needed to go back in place, go back in place. You are miraculously healed, by your own unawareness brought on by medications.

This can happen the same way with other things. Use the medications to get you through the hard part and then POP, you don't need it anymore and your view of everything has changed. You don't need to feel all the pain all the way through to get to the end. That's what the medication is for.
posted by sanka at 6:48 PM on December 7, 2019 [3 favorites]

Antidepressants don’t (or shouldn’t) prevent you from doing deep emotional work. In fact, they are often an important tool to decrease symptoms to the point that you can truly benefit from therapy and other healing modalities. It’s difficult to do that when your judgment is heavily clouded by depression or anxiety.

Also, menopause comes with intense mood and anxiety symptoms for many women, though that’s not as discussed in the medical/psychiatric realm as it should be. That in conjunction with quitting nicotine is a huge change for the brain and body.
posted by namemeansgazelle at 6:54 PM on December 7, 2019 [11 favorites]

Having a patient lay around with half a femur sticking out of their leg doesn’t promote healing. In fact the stress diverts their body from it and the screaming upsets the other patients.

Similarly, living constantly in an emotional crisis isn’t going to let you heal. Dialing things back a little makes a lot of sense.
posted by Tell Me No Lies at 6:57 PM on December 7, 2019 [20 favorites]

a state of constant agitation isn't engaging more deeply with the world. It's just neurons firing off in a way that makes it impossible to be happy or calm.

Your symptoms very much like what I've heard several people describe as their experience with menopause. I assume nicotine withdrawal is similarly physically hard on the brain. You may have toxic shame, but you've also got a chemically tricky situation in your nervous system. If the antidepressants help you not cry all the time, then keep taking them and be glad they're helping.
posted by fingersandtoes at 8:41 PM on December 7, 2019 [8 favorites]

You are not required to suffer in order to recover form what ails you. Healing and suffering are not hand in hand. Infact, having meds that clear out the terrible, relentless sadness can actually be conducive to healing.

Let the antidepressants do their job. Enjoy this opportunity to feel more "normal" again. Then, get a therapist if you don't already have one and let yourself continue to heal.
posted by Amy93 at 8:50 PM on December 7, 2019 [9 favorites]

Coming at this from a trauma therapy angle: somatic-ish approaches argue that crying is an emotional release/ catharsis that only provides short-term relief. It's a physical response - indicating you're too distressed to actually process what you're feeling. So not feeling as deeply actually promotes processing and healing. Not feeling something because you're afraid to acknowledge it is the problem imo.
posted by ahundredjarsofsky at 11:47 PM on December 7, 2019 [4 favorites]

Menopause can really wreak havoc on your moods. Many women are prescribed antidepressants to help with the symptoms. Some women choose to go on hormone replacement therapy, and since you've given up nicotine, it may be an option for you (depending on your family history). There's no shame in taking meds to help you function every day.

There are a lot of websites out there about menopause and mood swings. Unfortunately, a lot of them are pushing some sort of herbal product, or just have basic lists of things.

This website has some pretty decent information. This page has interviews with several women about their experiences, ranging from "sailed through it" to a "dark night of the soul" -- that is, every woman's experience is different.

I don't know about toxic shame, but I do know that menopause can cause severe mood swings, including the crying a lot, and make you feel crazy at times. You've also experienced the loss of a relationship.

I'd recommend talking to your doctor, or an ob/gyn who has experience with menopause, and maybe a therapist, if you feel you need it. It could be physical hormonal changes that are the underlying cause of your moods.

Really also recommend a full physical work up, if you haven't had one already. I went through a few years of low thyroid symptoms, before I got diagnosed and put on medication for it. That's also common in older women (and it's also hormonal, yay!). Some people see an endocrinologist, who could also address your menopause issues, and check your hormone levels.
posted by Marie Mon Dieu at 4:35 AM on December 8, 2019 [3 favorites]

Anecdata - Welbutrin is an anti-depressant that is prescribed off label for smoking cessation.
posted by rudd135 at 5:48 AM on December 8, 2019 [1 favorite]

Hi - you mention quitting nicotine but not specifically smoking - so this may or may not be relevant.

I, too, cried and cried during the first year or so after I quit smoking. But prior to quitting I had read something in a book on acupressure - “Grief is held in the lungs”. So I assumed this was a good thing, that my lungs were releasing their grief and it was all part of healing.

I would think this healing would take place with or without the use of medication to ease the extreme range of emotion experienced. I found this web page that discusses the lungs > grief > sadness connection in case you find this concept useful as you heal.
posted by hilaryjade at 6:33 AM on December 8, 2019 [1 favorite]

I wonder if part of that toxic shame is that you sometimes think you don’t deserve to feel good. You have to feel it to heal it doesn’t mean you have to be sobbing miserably. It means you should be in touch with your emotions, which you are.
posted by bluedaisy at 8:12 AM on December 8, 2019 [2 favorites]

Menopause and quitting smoking? At the same time? You deserve a medal.

I would wait a minimum of six months to fade off the anti-depressants even a little. I have been through both of those things...it was really hard. Doing them at the same time...OMG.

The feelings you feel and things you are wrestling with are real but hormonal explosions and the rewiring of the brain that comes after quitting smoking....those things are very, very hard, so you might want to consider that not all of this is 100% on you...some of this is biology having its way with you. Maybe put some limits on how much time you spend examining these deeper things you working through....for example, no more than an hour a day. Or three pages of writing a week. Something to put up some boundaries between all of the things your mind and body are going through.
posted by A Terrible Llama at 11:48 AM on December 8, 2019 [1 favorite]

I know people who feel like, if you're sad you need to just fully give into it and live it and be it for an extended period of time or you haven't really gone through that emotion and you'll never "get rid of" it.

Maybe. When it comes to extended periods of depression, though, definitely what happens if you just roll with it and feel like "I just have to go through this for months and months and years and years" is, instead of getting better you just get stuck there. It becomes the new normal.

Apparently, extended periods of deep depression actually change the brain substantially, and make it far more difficult to get out of the deep depression and back to more normal functioning.

So if you're talking about, "I have to fully feel my sadness and my other negative emotions or they're not 'real'": For an hour or two or a day or two, sure.

But the more it drags into week and week and month and month and then year after year of sadness, depression, and other negative emotions, the more it starts to look like clinical depression and that is something that you want to work to get your way out of as quickly as possible, not roll all the way down to the bottom and then spend all the time you need to there to "work your way through it". Hint: If that's your approach, you'll never do it.

So feel emotions, experience emotions, don't deny emotions, work through your emotions, sure.

But spend week after week and month after month in continual (or even mostly) negative-emotion states: No. It's only bad for you, and the opposite of healing. Work to get out of that cycle as quickly as you can. Use any aids or support you can, including medication, to help deal with it and end the cycle.
posted by flug at 2:25 PM on December 8, 2019 [4 favorites]

Also, after feeling that intensely sad, angry, etc, when you get feeling a little more normal again, you'll probably feel guilty. "Why am I not feeling as sad/angry/emotional as I was before? There must be something wrong with me!"

So that is a feeling, an emotion, a valid one, and one that is worth thinking/feeling through and understanding and processing. But it does not mean you need to go back and feel stronger versions of the emotions again. It does not mean there is actually something wrong with you now if you are feeling more normal and on an even keel.

It just means you are moving more towards the next stage, towards more ordinary or sustainable stage of emotional regulation, and that's fine.

Another version of this is not guilt per se, but a feeling that the stronger emotions are valid and now, feeling far less-strong versions of those same emotions, the less-strong emotions are somehow not valid. They're too weak and pale by comparision. So you feel a longing to go back to the time when you "really felt something" vs now when you "feel a bit numb".

But it is worth remembering that emotions like grief, betrayal, and deep anger are super-strong emotions that can't possibly be very long lasting. Imagine feeling that way for years or decades on end. No one could sustain it.

It's OK to have felt the stronger emotions back then and it's OK to feel them far less intensely now. That's all part of a healing process, from nicotine addiction and perhaps some other things, too.
posted by flug at 2:35 PM on December 8, 2019

I think the advice given already is good, but I have a contrary view.

Anti-depressants can be very, very, very hard to withdraw from. If you are concerned that they are dulling you in some way that seems worse than the problem they are treating, perhaps try weaning off - assuming you feel totally safe in doing so, and have good monitoring support etc. If you quickly start going back to feeling unmanageable despair, then you can go back on the anti-depressants in the knowledge that it's worth it.

I wish someone had told me when I started taking anti-depressants that there is little research on long-term use & withdrawal. I am now 9 years in, have tried to stop taking them multiple times. But I always end up in a despair much, much worse than I had ever felt before taking medication. So I go back on it again. It's impossible to know if this despair is withdrawal, or if my baseline mood become somehow worse *while* I'm taking anti-depressants. Anti-depressants have side effects for a lot of women, such as inhibiting your ability to cry or orgasm, that are often dismissed. But these things matter. I am one of those people who find it worrying that so many adult women are on anti-depressants. Is the problem really us?

Of course, it all depends what is "safe" for you in terms of your mood and your ability to manage yourself. Listen to yourself, but be open to advice from others around you too, because it is possible that anti-depressants, with all their inhibiting side effects, are better for you than the alternative. I just think it's good to keep an open mind; everyone is different.
posted by 8k at 4:46 PM on December 8, 2019 [2 favorites]

*heavy* tobacco user, 14 - 40 y.o. daily. When I quit and was a mess of anxiety, my shrink reminded me: "you spent 26 years - including adolescence - preventing your brain from growing any neurons for handling anxiety - or really any strong feelings. You *need* some meds to start growing and healing."

So I say meds +1. Best wishes ~>
posted by j_curiouser at 5:25 PM on December 8, 2019 [1 favorite]

There's a difference between escaping your feelings with distraction or drugs or sleep or whatever, and getting some help with your feelings with antidepressants. Antidepressants can make it a lot smoother to deal with your issues. You shouldn't feel bad for using what is another coping tool, any more so than you'd feel bad for using a walking boot if you broke your foot. It's just a help, it's not an escape.
posted by fiercecupcake at 10:03 AM on December 9, 2019

20 years ago, I quit smoking cold turkey after smoking a pack a day for many years. I started smoking when I was 14, so all of my coping mechanisms were wrapped up in smoking. It was very difficult, perhaps the hardest thing I've ever done, and I was a HOT MESS for about six months. Maybe even a year. Looking back, I so much wish I had taken anti-depressants during that time because it was a very dark time for me.

It sounds like you are still feeling things. Please don't stop taking the anti-depressants yet. Keep on keeping on, and be incredibly proud of yourself for quitting!!
posted by lyssabee at 6:31 AM on December 10, 2019 [1 favorite]

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