Part 14 - Shifty Shades Of Grey

I felt like such a failure.

After nearly two years living free of the black dog, and twelve months of regular blogging about my experiences, opinions and dodgy dancing techniques, I recently found myself back at my local doctor’s surgery. My mission: to obtain an increase in my daily dosage of Paroxetine.

The Growler I described so colourfully in my last post had more of a fight in her than I’d given her credit for. She started to lose that underlying look of timid friendliness, the colour slowly drained from her, and she continued to wrestle with my unguarded thoughts.

She didn’t even come close to turning into a black dog like the vicious, rabid hounds I’ve fought with in the past. She was, however, a shifty little bitch who turned several different shades of grey – and I’m not, of course, referring to the saucy variety.

As I sat waiting for the doctor to call out my name, I couldn’t help but wonder where I had gone wrong. What had happened to that life more normal, more enjoyable than I had ever dreamed possible, the one I had been living and so proudly professing about to whomever would care to read?

As well as feeling like a failure, I also began to feel like a fraud. How could anyone ever again take my story seriously, or take any comfort from reading it?

I’d done all the right things to bring the bitch back to heel in the previous weeks – getting back into regular exercise, maintaining a healthy diet, getting to bed early, making sure I had some decent downtime every day, and so on.

I’d even resorted to writing down all the things that were causing me to worry, whether at work, at home or at play. But instead of writing down what their worst possible outcomes were, I listed what the desired outcomes were. I also listed all the things I needed to do in each case to realise those desired outcomes.

The mere act of compiling this list lifted my mood significantly. Before I had written it, I felt as though I had a large collection of beach balls that I had to frantically juggle to keep in the air. But now I could see that it was nothing more than a small collection of marbles, one I could more or less hold in my hands. Yet still I could not completely shake off those occasional mildly anxious, irrational thoughts.

As before, they continued to surface in various shades of grey whenever I woke up in the middle of the night. They usually dissipated by the time I had my morning coffee, but now they were starting to appear at occasional random intervals throughout the day. I was becoming concerned about when – or if – I would ever get back to that state of feeling 100% normal again.

For sure, I had taken on more of late, life had been busier and more stressful for a couple of months. But for nearly two years I’d felt bulletproof when it came to maintaining a positive state of mind. Here I was now feeling like I had lost my invincible superpower advantage over my arch nemesis. Now I knew how Superman felt when he was exposed to kryptonite, and then found himself defenceless against the three black-clad criminals with similar superpowers.

Fortunately, my feelings of failure and fraudulence were brought to an abrupt end when the familiar smiling face of my doctor called out my name. I took a seat in his room, explained my situation, and reasoned that I saw this as just another tango in my overall dance-off with the black dog.

My situation, I explained, was not by any means unbearable. But over the previous several weeks, the hairline cracks had started to spread further, and life was not as enjoyable as it had once been.

My predicament was helped a great deal as my doctor nodded in agreement, smiled knowingly, and then out of the blue he added “I’ve read some of your blog by the way. I think it’s a great thing you are doing.”

Uplifted and reassured, I pointed out that as we sat there, we were actually playing out what would become part of a future blog post. “What do you want me to call you in it?” I asked him. “After all, I’ll need to protect your real identity!”

He paused for a moment, before simply replying “Stella”, with a further nod of his head.

And so, Doctor Stella wrote me out a prescription for the next six months, increasing my daily dose of Paroxetine from 20mg to 30mg.

Mission accomplished, I asked Doctor Stella if I was going to experience the same massive mood slump that I had when I first started taking Paroxetine two years earlier. He explained that it was unlikely, but I might experience some mild side effects over the following week or two, including stomach upsets, dizziness or headaches.

The next morning, I calmly downed my cornflakes and artificially-sweetened coffee, followed by one and a half tablets of my other daily sweetener. As it was a Saturday, I then took Jack to his weekly AusKick footy training. It was a Dads ‘n’ Lads Special event, and I was feeling carefree and content as the session kicked off and I chatted to a few of the other fathers.

About halfway through the session, however, I started feeling glum and negative. As the day progressed, I would feel upbeat and positive for half an hour or so, and then glum and negative again the next.

By the time Sunday afternoon came around, I was feeling mildly but emphatically depressed for no reason whatsoever, in a way I had never felt before. I wasn’t actually worrying about anything, and my thoughts weren’t anxiously racing. I was just feeling negative, pessimistic, down in the dumps. I had to reason with myself that this was just my brain trying to find a way to deal with the increase in my medication – but it was a struggle.

I didn’t experience any of the stomach upsets, dizziness or headaches that Doctor Stella had described, but I did experience some temporary mild head throbbing. Plus, if I were to be honest, I also felt quite teary at times.

I did, however, make the mistake of turning to Doctor Google on the Sunday night, search parameters: “increased paroxetine dosage”.

Whatever was I thinking?!

I went on to read about one young woman who had been getting tremendous results for over fifteen years on a lower dosage. She had recently struggled through a particularly stressful event, so had been prescribed a similar increase to mine. She had now been experiencing the same symptoms as me for four weeks, with no sign of her mood leveling off.

I also read about another person who found he just could not tolerate more than 20mg per day, and there was another who found no change whatsoever after an increase dosage. Well, whatever I was thinking now, it wasn’t exactly what had been hoping for.

When it comes to consulting Doctor Google, I usually reach for the nearest and biggest soapbox, and preach profusely against it. However, this particular search did reaffirm my view that each of us are different; each of us has to find the right balance of the right ingredients to beat the black dog, and what works for one will not necessarily work for another.

With all this in mind, and knowing how much better I function after a good night’s sleep, it was sensibly off to bed early for me, praying that I would wake up in a more positive mood. The thought of facing four or more weeks in the same negative frame of mind was not exactly a prospect I relished.

The next morning I woke up early, still feeling fairly low and anxious. Fortunately, I still felt confident that I would be able to cope with the week ahead, as I kept reminding myself that I had managed to work through far worse for far longer in the distant past.

Much to my delight, by the time I got to work, my confidence levels lifted and the feelings of standalone depression completely disappeared. And that was the last I saw of them.

As the week went on, I continued to chip away at the actions on my list of concerns and desired outcomes that I’d written out the week before. I still found myself waking up in the middle of the night to find my unguarded mind being provoked by a dog of some unpleasant anxiety-inducing variety. But with each passing day, the colour slowly returned to her grey coat. I gained more and more confidence that I would feel infinitely better once I was out of bed and fed – even when that was the last thing I felt like doing.

I also continued to remind myself that while those racing what-if worrying thoughts can feel so real, they can also dissipate in an instant, leaving you wondering what the hell you were so worried about. Knowing from experience that I could feel fine again at any moment did give me strength, but it was bloody frustrating at times because I would never quite know when it would happen.

By the time the weekend came around again, I was feeling good – I wasn’t feeling great, but then I wasn’t feeling bad either. I wasn’t quite back to the point of being Mondayitis-free yet. Rather ironically, it was only when I actually woke up in the early hours of Monday morning that I felt the best I’d been in over two months.

I lay awake in the dark at precisely 3.25am, calmly and confidently pondering all the challenges I had to face in the week ahead. Despite my lack of sleep that night, the calmness and confidence followed me into the working day. I was back!

I continue to feel better with each day that passes. As I write this, I’m about 95% of my way back to my best. This is in comparison to the roughly 80% I was feeling just before I paid a visit to Doctor Stella, and a further comparison to the all-time low 2% I slumped to two years ago.

I now realise that I did make myself bulletproof two years ago. But as is the case for every Superman, Ironman or Batman, a nemesis can always come back stronger, shiftier and wiser. The past several weeks have shown me that I too needed to up the ante; I needed to learn more about myself and my own weaknesses. I needed to wise up, to tweak the defences and make myself better-than-bulletproof. And that is exactly what I did.

I’m not saying that simply taking a larger dose of a drug is the only answer. I still strongly believe that taking action is always the answer when tackling the dogs of anxiety and depression, whatever colours or shades of grey they may be – and I did try taking several other actions first.

And while increasing my medication was very much a last resort for me, it was not a resort I was in any way ashamed of or unwilling to take. In recognising the early signs, I simply wanted to nip the bitch in the bud early on, before she stopped growling and started biting.

I’m sure the dog will try to bite back at me again some day. Whether it be in a month, a year or a decade, I’ll be waiting, I’ll be ready, and I’ll get stronger and wiser each and every time she tries.

I’m sure there will also be times in the future when I will again feel like a failure – but I now recognise that does not necessarily mean I will be failing. Failure could only occur should I ever neglect to take the necessary action to keep the black dog at bay, The Growler from turning grey. Failure, therefore, will never be an option.

No matter what it takes.

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Andy responded: 7 years, 12 months ago

Hey mate, Great blog! I was wondering whether you had tried to ease off the meds and try any form of counselling? I've been taking pills for a while but have recently started looking at CBT. It sounds interesting and there is lots of good evidence on its effectiveness. Might be worth exploring? Take care, Andy

claire davidson responded: 7 years, 12 months ago

I have turned to grey as well, not knowing which way to turn....I will seek help and head in the right direction but my anxiety is affecting me. I am trying to exercise too but have done my back in ( two teenage kids dont help much too) . Keep your spirits up, turn to the people you love and it will get better Claire

Andrea responded: 7 years, 11 months ago

Thank you again for sharing this! I hope it won't discourage you to know that sometimes a medication becomes "tolerated" and there becomes a need for a switch. The first time someone told me that, I wanted to back-hand them. I'm thinking "How dare you take away my hope like that??" It was years after I was told that unwanted advice, that I did have to switch. The first time of switching was a time of questioning myself again. I went through all of the "what if" fears about the medication not working, of the black dog devouring me. Recently I went through a medication switch again and that was when I discovered your blog! I posted my delimma to you (not realizing you hadn't been through this yet). I am happy to say this switch has been very successful and better than the first time I had to switch. The transition has been quick, thankfully. I may just have to start a blog myself! LOL! Just as long as you stay aware of your grey dogs growling, you will know when you need to switch, just like you knew when to see your doctor for an increase in medication. And you will be ok then too. It sounds like you have a great doctor! :) Keep blogging! You are a tree to climb for those who are dogged!!

Ana responded: 7 years, 11 months ago

This's the big push i badly needed to go see my Dr. tears now...Thanks...Huge Thanks.

judy responded: 7 years, 11 months ago

Very interesting read, as a phobic agora and others and parent of a phobic I relate to a lot you say.

Irene responded: 7 years, 11 months ago

I'm now up to 40mg citalopram and I go from high happiness to low mood in less time it takes to say black dog barking. Feeling low this morning - mountains of of silly mole hills - perspective shot. This to will pass (quickly I hope).

Gerry C responded: 7 years, 11 months ago

Don't know what ur going through but keep up the good fight. Let me know if I can help in any way. Gerry fae Sandy

Margaret responded: 7 years, 11 months ago

Thanks for sharing this, I have suffered bouts of depression and anxiety for most of my adult life and after my initial embarassment of being told I had depression, accepted that I have to be on my medication. If someone questions my being on medication I just ask them if they would take medication for a heart problem, most people would not think badly of people on heart medication - why feel differently about medication for anxiety and depression - it to keeps a vital organ in working order. We need to stop this shaming of people who have anxiety and depression. You are helping that. Thanks again.

Colin responded: 7 years, 11 months ago

I heard your interview with Adam this morning so i thought I'd have a look. Its gutsy 'coming out' so as to speak and I wish you many full and rewarding years to push your message. I also have wrestled with what I call a black cloud which every so often would creep over me as if to block out the sun. Plenty of metaphors there ie veils blocking out hope. Like you I got some professional help. in my case 12 yrs ago. Its not all perfect but it certainly has evened out the highs and the lows. A lot like radio waves really, the frenetic high frequenciy peaks are more often replaced with rolling low frequency hills. I know which are easier to climb. I'd prefer not to have pills but its far better than the alternative Regards Colin

admin responded: 7 years, 11 months ago

Hi Colin and thank you for the comment, I love your closing point so much that I put it on my DWTBD Facebook page (I didn't mention your name) Many thanks! Mark

Brigitte responded: 7 years, 11 months ago

I have just finished reading your blog, which I first heard about last night on a late night radio programme and I am so glad I did! It's like I am hearing part of my life story through you and I don't feel quite so alone. I have sufferred from phobias, anxiety and depression for most of my life. At the beginning, I thought everyone had similar feelings - I just was not dealing with them effectively. To cut a long story short, I tried counselling, CBT, read numerous self-help books but although I learnt to tackle some of my irrational thoughts and develop a more positive rational outlook, my black dog retreated to the edge of the cave but would not stop growling. Eventually, I had had enough and went on medication. When the effects finally kicked in after a few weeks, I felt like a cloud had lifted and I felt 'normal'. My anxiety decreased to manageable levels and the depression was gone for a while. I felt good for some time then stopped taking the tablets, believing I didn't need them any more and was now cured. Things were fine for a few months and then the black dog started creeping closer again and now he had brought his friends along. The whole cycle then started again and I went back on tablets and things improved for a while - then I came off them again because I was not weak and wasn't going to be beaten. I would learn to deal with this alone without tablets and be rid of the shame of having to take them because that is how I felt. Useless, worthless, ashamed and now scared for the future. I could not go on trying to beat this anymore so I made my mind up to go back to the GP, waving my white flag and get proper help. This was a few weeks ago and I have now increased the dosage and have vowed to take my tablets daily and indefinitely. I am beginning to feel better and hope things will continue to improve. I am convinced that medication is the only thing that will help and I just need to get the right balance. Thanks so much for your blog. It will most certainly give hope to many people and go some way to eradicate the stigma attached to mental health problems. Good work!

des responded: 7 years, 11 months ago

I had been on Prozac for about 8 years - a life-altering experience in the best possible way - when it suddenly just didn't work any more. I was surprised, shocked, without any defenses. I knew that from a logical standpoint I had a perfect life - no money worries, a lovely home, a garden, a loving husband, and interesting work - although not enough of it. After struggling for some months, I decided to quit the anti-depressant altogether, given that it wasn't working. That's when the real hell started. Waves of grief or fear would engulf me, usually on waking in the morning, or at other times when I was totally defenceless. I spent several months in a hell of misery interspersed with sadness or terror. In the end I crawled back to my GP and asked for another SSRI. (In the meantime I had learned that ADs can stop working after a period of time. Now I am Sertraline, which works very well.) At the moment I am drinking too much wine before bedtime, which results in a panicky feeling of nameless fear when I wake up in the morning. I remind myself of my mindfulness training, embracing the feeling instead of fleeing it. And I tell myself, "When you are going through Hell, keep going." This helps, and the bad feeling always passes. The bad feeling always passes! Thanks for your blog. It's so good to know other people have the same struggles. Des

Murfomurf responded: 7 years, 7 months ago

Just came across your dancingblackdogblog! It's good to hear about someone else struggling but not freaking out- I've been struggling with the same vicious hound for most of my adult life (40 years!). I've also had long periods of feeling pretty good and being very functional at work and at home, so life has had bright patches. My experience is a little different in the long term than yours has been so far - eventually the effects of the anti depressants and positive daily actions tend to "wear off" and increasing my dose just isn't productive. I guess you're lucky that your dose of paroxetine wasn't at the maximum, so there was room to increase. The trouble with my black dog is he needs a very high fence topped with razor wire to keep him out- I quickly get to the highest dose allowed to be prescribed by a GP & get shunted to a shrink. If whatever wears off, I usually get switched to another drug- but they have almost run out now. As for side effects, I don't really worry too much plus I NEVER look up the drugs and side effects online. Partly because I worked as a researcher on a psychiatry ward, seeing people have side effects and/or complain about them, I always thought that the side effects were better than the bastard dog! Also I have had friends and acquaintances who were total wimps (in my reckoning) because they complained about little headaches and a bit of fuzziness around the gills. Since my latest shrink (I had a long term shrink years ago who was inspiring) didn't have much in her toolbox in the way of medication (tried one mirtazapine and slept for 48 hours, almost straight!), she decided to LOWER my dose of Venlafaxine from 600mg to 450 and add some nutritional supplements plus exercise and prescribed socialising. I started on 15ml high dose omega fish oils daily for the depression and glucosamine 1500mg for wrist/thumb arthritis pain, 20 minutes + walking daily plus one hour of vigorous aquarobics once/week and started to feel a lot better. Once I'd had a blood test, she discovered I had thyroid deficiency and awful Vitamin D deficiency, so thyroxine, daily sunshine and massive doses of Vitamin D oil were added. Within 2 weeks I was feeling strong enough to finish my postgrad dissertation and start doing some gardening and housework. Plus, miracle of miracles, my brain-zapping & sweats were cured by the fish oils in the first 3 days! Currently, I'm just climbing out of a Christmas MNT triggered by a moralistic friend telling me I am so "selfish" with my depression & not working, but I've licked that with increasing my pills temporarily plus some Vitamin B & not too much wine & carbs over the last 2 weeks. So I'm still battling on with the promise of trying PTSD therapy with a cognitive psychologist during 2013 (referred by my shrink!) to see if I can kill off the childhood hound of the baskervilles that probably started my wobbly journey. I also blog at: