I am not sure what to do. When I am feeling relatively well, which is when I am productive, when I feel connected with people, when there's female energy in my life or the potential for it, etc., I am enthusiastic, joyful, humorous, and motivated. Feeling connected and feeling loved is so powerful. As powerful or more powerful than medicines. I have been able to cope fairly well during the pandemic. In fact, in April and May I felt joy and pleasure at times. But the past few weeks have been shaky. Last month I shut off a certain female energy that I have been using to feel well for the past several years. We had an epic argument over the phone unlike any other. She is not a healthy person for me. She is self-centered and doesn't express feelings well except for anger.

The loneliness of working from home every day is starting to wear on me. Socially, there are fewer opportunities for social interaction and fewer opportunities to meet new people. And some weekends I feel so terribly lonely that it feels like there is no hope for the future. When I am feeling well, I think "wow, why would I want to try microdosing with psychedelics." When I feel lonely and trapped -- yes, trapped, as if I am in a prison in my mind yet I can move about the world freely -- I long deeply for the one thing that I think can save me: love and connection. I know it would make me feel well, but I can't snap my fingers and make it happen. I fear for the future, having to continue to have moods like this. Years and years of therapy. Years of medication. Yes, it has all helped and I am grateful for these treatments and to have the means to be able to be selective and go out-of-network. When I read people's experiences microdosing with psychedelics, I wonder what that would be like for me. Will it finally help me absorb this lonely and trapped feeling and help me to feel more free? Will it help me reconnect with the feeling of freedom and joy that I had as a child? I can make it happen, but I worry that my microdosing with my current medication regime could be problematic.

Is it time to break up?

Nardil has given me stability for many years to be able to live "normally." I need to remember this. Because recently I've been wondering whether it is time to break up with my smelly, old, bright orange friend. I experienced my first depression in a long time last month. I was not myself. I was quiet, unhumorous, moody, and nothing gave me any morsel of enjoyment. After 8 days, somehow it disappeared, only to reappear again a week later. I thought I would be in for several months of needing to be patient while transitioning medications and for this I need to find a gray-haired doctor who can confidently advise in this matter. I got prepared to tell work. But then, after my latest refill a few days ago, the depression disappeared again. Every time I've had a significant re-emergence of anxiety or depression it is because of a change in the manufacturer of a medication. However, in this case the manufacturer had been the same as always, so was it a faulty bottle of phenelzine? I don't understand. Right now I am not depressed, but I am miserable nonetheless, trying to transition back into feeling OK while all the issues that plague me in my life seem to have strengthened and pinned me up against the wall. I feel like I've lost my confidence. I'm limping through these past few days trying to find my balance. I'm hating the Nardil and I want to get off of it. This is why I say I need to remember what Nardil did for me in the first place.

8 Years and A Switch

Eight years have passed since I started taking Nardil. What happens in the brain when a person is on a medication for so long? I desperately wish I could reduce my medication because I worry sometimes about potential long-term consequences. I have thoughts about being 60 years old and ugly and alone. Will I still be on Nardil then? I quickly stop such lines of negative thinking! The last time I reduced the dose of Nardil, I felt the depression sneak up on me. I just want to reduce it; I don't want to go off of it completely just yet. I want to believe that the process of maturing as an adult can make me feel more safe, secure, and joyful inside, and, therefore, less dependent on medication. But, deep down inside, I still feel like I have more maturing to do.

A few weeks ago I noticed the refill for Nardil was taking unusually long to process. I called the pharmacy and was told that the brand name Nardil is on back order at the manufacturer. It can take several weeks for the medicine to be ready. I could have called other pharmacies, but I decided to just take the risk and ask for the generic version. I received the phenelzine manufactured by Lupin (formerly Gavis). I was relieved that it was not the Greenstone version, which I had tried several years ago and which felt different. I have been on the Lupin version for three weeks and I don't think I feel any difference mentally. I do feel a difference in my wallet because the generic has a much lower copayment than the brand name.

I remember

I remember a time, perhaps in 2011 or so, when nothing was giving me any pleasure. I remember telling someone this and shedding a tear. Then, maybe 6 months later I noticed that, without any change in medications or any new treatments, I felt better. I was enjoying things more and feeling some pleasure. How did that happen? Here I am, feeling sort of the same unwellness as I had experienced before. Only a few months ago, having felt well and strong, I had tinkered with the dose of Nardil, reducing it very gradually down by 3.25 mg, and then by 7.5 mg just to see what would happen. I noticed more distressing thoughts started to appear in my mind. As I was just about to leave on a vacation, I resumed taking 60 mg. The thoughts eventually went away. But since this little experiment on my part, I have not been able to regain that feeling of wellness and stability that I had been feeling. I feel more off-center. I feel more overwhelmed. I don't feel as chirpy and in the mood to socialize. I feel sad at times. Two days ago I increased the dose of the Nardil to 67.5 mg, but I feel like I'm repeating the same thing only to have the same result: no improvement and more side effects. I'm going to go back down to 60 mg. For the last five weeks I have been feeling this way. Will this just pass in due time? I haven't mentioned the other things happening in my life right now. Good things, yet there is a flip side to said good things. I am deliberately ignoring these things. And, in doing so, I'm only telling half the story.

It's time

It's time to evolve beyond the former tagline ("one person's experience, as it happens, of taking an MAOI") and shorten it to be more holistic. Because we are more then the medicines we take and there is more going on than just the medicine.

Whoops

I went on a short trip and forgot to bring the medicine with me. This is the first time I've done this, and it isn't the right time to skip Nardil since the last 10 days or so my mood has not been so good; I've been struggling a bit and have not been my gregarious, positive, hopeful self.

In May, I tapered off the Lithium and have felt fine. I even lost a few pounds and felt better about my body. I felt no other physical or emotional changes, as if the Lithium wasn't doing anything in the first place. I had a fantastic two-week summer vacation.

I dislike chain stores generally, but for pharmaceutical matters national chain stores can be convenient. I was able to get a few days worth of pills while in another state after a short phone call to the local Walgreens. Here's the rub: they only had the generic available. Last time I switched a long-term med to the generic version, I relapsed and the depression/anxiety/panic mix returned. I had no choice, so for the next three days I took the generic version of the medication. Whether this is psychosomatic, I'm not sure, but the generic version (made by Greenstone, so it's "supposed" to be the same as the Pfizer version -- well, damn, it's the Greenstone Zoloft that failed me many years ago after years of stability) felt different in my body. I had more GI symptoms, let's just say, and felt a slightly unpleasant taste in my saliva/sinus. Upon returning home I switched back to the brand name version.

But that's not the main point here. Today was one of those days where I felt like something just isn't right with my mood. And it is so deceptively subtle that I think a low-grade depression, or dysthymia as some might call it, is actually just as dangerous as a "severe" depression. I caught myself thinking, "well this is just the way it is." But it's not. I'm fully-functioning, but I feel a slight undercurrent of gloom and numbness. Something just doesn't feel right. Well, yes, I'm not very happy with one part of my life and this has caused me utterly incessant stress day in and day out. I just returned from wedding, so it's fresh on my mind what I'm unhappy about in my life. Will I be, or rather feel, alone forever? This is the gremlin that exists. I don't nurture it. But it is there. I want to obliterate it, but I can't. Yes, I know what else it is about and I have recurring dreams that remind me of what lies bubbling under the surface of my conscious mind. So what's the next step?

I want to believe that I could be well without any medication, but perhaps that's the danger. Can I find a balance between being OK with taking medication while doing everything in my power to get well on the psychological side of the equation? I read a posting somewhere that said well something that I need to keep in mind. It goes something like this: "medication is an aid to recovery, but not necessarily a cure. They are something you take to alleviate symptoms of an illness. They help you feel better, but the lasting cure is how well you feed yourself with good food, exercise, rest and support from friends and family." Taking medicine bothers me, and at times I want to believe that I can feel well without them, or just on one. I don't want to believe that I have an "illness" or "condition." But I do, right? So let's see how the next week goes. Should I make a phone call and see about resuming the adjunctive medication that I stopped taking several months ago? Feeling like I did today is not a long-term option. It's bearable, sort of, because I know that even when I feel "well" I get into certain depressive moods that usually wear off after a few days. I know this as a fact.

Interactions

It's a rainy summer night, after an oppressively humid day. One of those days in which I sweat just standing still; I should wear a wristband. I've had a glass or two of refreshingly white wine with a woman I know. Nothing happened (with her, not with the wine/Nardil combination, which has never been an issue). I've returned home a bit sad.

I've been exposed to the work of Carl Jung and his adherents recently. The concept of individuation strikes at the core of my soul. The word itself represents both what I lost as a teenager (and perhaps before that) and what I stand to gain. As part of this process of individuating, one of Jung's adherents writes that we must fully engage in life.

"Quit seeing life as something we want to avoid. By this I mean accept that taking risks, loneliness, conflict, defeat and suffering are not only vital parts of life, they are necessary to transformation, wholeness and the experience of joy."

I really try to fully engage in life; I take risks, yet they haven't yielded any gain it seems. So I still feel incomplete and untested because I haven't experienced a profound part of life experience. Sometimes it baffles me that it is this way; other times it makes complete sense. What's certain is that underneath any confidence there is a great amount of fear; the fear of the unknown and the unfamiliar. On the flip side of my dreams and fantasies is fear. The fear of inadequacy.

I haven't been praying as much recently and I haven't felt as connected to Jesus/God/Holy Spirit. I'll just let it be for now. If the Kingdom of God is within us, then the work of individuation perhaps is an inherently spiritual practice.

Uncanny?

It's uncanny, if that is the right word, that so many people do well on Nardil and for so many years. 10, 15, 30 years. Just read the message boards on Nardil. I wonder what "well" means. Perhaps it's relative. I'm on my fourth year on Nardil, my "senior year," I guess, and I believe that the medication I am taking has kept me steady and stable. This is after two years of mental anguish and multitudes of treatments and medications. While my "chemistry" might be in balance, this does not mean that I feel happiness and joy through my days. Looking back at my journal entries I see how I often felt days of moodiness and gloom despite being "stable." I sought treatments and supplements that might make it go away. To no avail. Yet, somehow, despite the failure of these additional trials, these days I do feel moments of happiness and joy, confidence and liberty. What did I do to cause this? I started going to church. I started praying. I continued going to therapy. I continued looking underneath the moods to find what's behind them, and there's always something behind them. I challenged myself and took an international vacation by myself. I had an amazing time. And I continue praying.

Nardil goes generic

Nardil, quietly and with little fanfare, has gone generic. Gavis Pharmaceuticals is now producing a generic version of phenelzine. I hope that Parke-Davis continues to produce Nardil because I am not changing to the generic version any time soon. The last time I switched from a stable brand name medication to the generic, relapse. It was awful. I suppose I can understand how people felt when they had to switch from the original pre-2003 Nardil to the new formulation.

So here I am, stable but still feeling empty and flat at times. What's the next step? These days I haven't been looking at medication for the solution. I've found something that gives me stability, but can increasing the dose or adding something else fill the hole in my spirit? I could try increasing the Nardil to 75mg. Looking back at my journal entries, however, this did not have much of an impact. I have, however, at times felt well and happy in fact. But what makes me feel well and happy is outside of me and out of my control largely. I wish I could nurture that feeling from within. I can nurture that feeling from within.

Records

It's been so many months since I've posted to this blog that I forgot about it. I had been doing a Google search about Nardil and my own site came up. Looking back at previous postings, this blog serves as an excellent record of my experience with Nardil. Recently my mood has been quite low and I wondered if I should increase my dose of Nardil. Looking back at previous postings, it seems that increasing Nardil beyond 60 mg had been only marginally helpful. But what comes next? If I can't increase my dose, there aren't many other medications that can be combined with Nardil. Should I go in for the rTMS?

Nardil, one year later

Thank you Nardil for keeping me semi-stable for the past year, along with accomplice Lithium. Nardil was the medication I started taking just after my last unhelpful ECT treatment. I remember those first few months of a roller coaster of side effects, especially the euphoria. These days, though, I wish I felt some sense of euphoria. The soft downs and rebounds of depression continue, with the average of my mood being a few points lower than I remember. I remember having more spunk, more excitement, more hope more than several months ago. Something broke and I've come down a few steps to a more apathetic state. When I say "spunk" and "excitement," mind you, it is all relative within my moods. It is so difficult to pursue and be in relationships while in this state. But I'll keep plugging away.

The latest

I've been taking 60mg of Nardil for a while. However, I still feel sadness and depression during the day. My doctors had told me to increase the dose to 75mg, but I resisted for a while. Finally, however, I decided to go up. I've noticed that the depression is gone, which is good, but I feel quite sleepy during the whole day at work, no matter how much caffeine I drink. And my vision is blurry. The fatigue/sleepiness is holding me back a bit, but I am able to still get my work done effectively. It's just that I feel low energy throughout the day. I want to feel vital!

Back Up

So my mood has been "blech" for the past week. Yes, there are things that have happened in my life to contribute to it, but I still feel that a medication adjustment is necessary. I'm so blah at work that it's hard to engage and be interested in work. I have numerous interviews coming up for new projects and I can feel that there is no sparkle. My muscles are tense, I feel irritable. I'm going to increase the Nardil to 67.5mg. I wonder if any side effects will return since my body is now well-adjusted to the medication.

Up, then back down

Several weeks ago I increased the Nardil to 75mg because I still was not feeling relief from the underlying sadness, the dysthymia. I started at the end of August at around 67.5 mg, and in mid-September went all the way up to 75mg. I did notice some more aggravation of the existing side effects: lots of gas and release of gas, lower sex drive and more orgasm difficulty. These are problematic at my age and life situation. I'm single and dating. Can you imagine? These two side effects are embarrassing! However, even more detrimental, I started noticing that I didn't feel many emotions. My friend even mentioned this to me. I don't want to feel like a drone! I took 75mg for 11 days. I didn't notice any improvement in the dysthymia. In fact, I had a horrible week while on 75mg, in part due to the end of the summer, a season that I love so much. So I went down to 60mg. It's been 5 days on 60mg and I feel the side effects ameliorating a bit, my emotions returning, and no worsening of the dysthymia.

My very first hypertensive crisis

At about 1:00am this morning, after I returned from picking someone up, I lay down in bed to go to sleep. I noticed my heart was pumping very strong and fast. I was short of breath. Ok. So it will pass. Is this an MAOI hypertensive crisis coming on? I started getting scared. Was my anxiety only aggravating it, or was I simply just anxious and panicky about my heartbeat? It wasn't until the severe headache emanating from the back of my neck that I knew something was very wrong. It was my very first MAOI hypertensive crisis. What had I eaten? The only thing I can think of was that at 12:00am I had eaten some Monterey Jack cheese. I've eaten this cheese before with no problem, so what gives? This time it was not melted; I ate it straight from the bag in the fridge. So I know what caused it. I took a Nifedipine tablet, bit into it, and drank the tasty insides. I figured this is pretty serious so I took a cab a few blocks to Pennsylvania Hospitals ER. The nurse took my blood pressure and it was high. Really high. 193/101. Whoa. So I waited for the doctor, which took like 1.5 hours. And during that time my blood pressure went down to a relatively healthy 137/83. I asked them to send me home. They did. I am home now. I need to go to sleep!

7 pounds and excess water

I was at my uncle's house today. He has a scale. I haven't stepped foot on a scale in months. Today I weighed in, without jeans on, at 160. I gained about 7 pounds since being on Nardil. Imagine carrying around a 7 pound dumbell. That's a lot of extra weight in 2 months on Nardil. For me it is mostly carried in my abdomen, and I really don't like how that feels and looks! And, today, my Dad noticed that me feet looked swollen. Lo and behold another side effect of Nardil: pedal edema. Fortunately my intestinal system is now "regular" let us say. And since splitting the Nardil 30mg at midday and 30mg in the evening, I've felt my physiology returning more to normal. When I exercise my heart feels like it is beating properly -- strong and fast. Maybe this might help bring down the weight. That and stopping my crazy consumption of frozen yogurt everyday!

Now I know what side effects are

I've been blessed to have taken many different medications over the past 10 years with few side effects. Effexor did raise my blood pressure a bit, Prozac made me get motion sickness, Lithium gave me tremors at high doses, and Abilify made me restless. Granted some of these side effects were not tolerable, so the dose was reduced or the medication stopped completely.

But nothing compares to Nardil in terms of the strange stages/packages of side effects that I've felt over the past 1.5 months. Now I see what the doctors are talking about. It all started with the extreme thirst, the dizziness, the balance problems, the feeling of being high, the euphoria. This was all on 45mg of Nardil. These sides effects passed. Then, after increasing the dose to 60mg, it moved on to afternoon sleepiness to the point of not being able to function much at work during these episodes. Then came the slight weight gain (I am very fit, except my abdomen is noticeably bigger), the constipation, and the anorgasmia. Pain the the ass. And now the fatigue in terms of when I exercise. I get tired very, very quickly. I can't run two blocks without having to stop. I feel like Nardil has slowed down my physiology to the point that my heart rate is lower than it should be, even when exercising.

Well, I haven't been on this medication for too long, so I look forward to what most people say about these side effects: they will pass.

Super trough

For the past 10 days or so I've been in and out of a horrid state of atypical depression. I say atypical because, again, you would probably not realize that I was depressed unless you spent a lot of time observing me. It did make working difficult, and my motivation and cognitive capabilities were definitely a lot lower. For two of the days I did something different. Rather than ride my bike I came home and sat on the couch and watched TV. It was actually a pleasant change. I watched Friends for the first time in years. I forgot how funny Joey Tribiani is. But having suicidal feelings wasn't a very pleasant change. A few days ago I saw my psychiatrists who increased the Nardil to 60mg. I pray that this helps alleviate this atypical depression. So far the side effects have pummeled me. From about 1pm to 5pm at work I am a ZOMBIE. I am falling asleep. I can barely think. I walk like I'm drunk. I drink coffee and tea all day, to no avail. I may need to get an IV to feed me caffeine directly. Maybe that might help. This is an expected side effect of the Nardil that I pray passes soon. I have never felt this level of sedation. Granted, it's quite possibly the combination of depression and medication that is making me feel this way.

The joy (or pain) of hypomania

I do believe that my recent euphoric episode was sort of a Nardil-induced hypomania (Or was it? Read on). I am not bipolar, and no doctor has ever suspected so. I talked to a friend yesterday who said she had a two-week hypomania episode. For her it manifests itself as becoming super productive, but forgetting about the rest of the world. My "hypomania," or whatever you want to call it, left me feeling exhuberant and giddy. I was super funny, super productive, super confident, and super friendly. So what's so wrong with all of this? As "good" as it felt, there was no peace inside all of this good feeling. Something was driving me, and it wasn't me.

...Or was it really medication-induced? I also had a lot of reason to be giddy. One of my core longings is love. There is a long story behind this, but it's not right for this blog. So just before my "hypomania" I had three potential dates. One came through and it was a fun time. Imagine someone walking around in the desert for a decade thirsty and finally he finds water. Well that's an exaggerated way to compare how I felt. I was so happy to finally feel like I'm getting somewhere in this area of my life which has been largely non-existent. That's sure to make me happy, right? How about hypomanic? If my theory were correct, then I guess I would have been hypomanic during the dating period. Well, turns out I was depressed the week I went out on the date. Even the day of the date I was depressed, but I managed to pull myself up and have a decent time. Perhaps along with the wonderful feelings of dating there are also real feelings of fear and distress that come along with it. Thus the fluctuation between depressed and giddy. Who knows.

The trough

I have hit my first trough since being on Nardil. The last two days I have been a damn zombie. My face feels heavy, I have very little motivation, I just want to be by myself, I don't laugh at anyone's jokes. I guess even the most "powerful" of medications can't necessarily remove these troughs. They might tame them a little bit. I mean, life is full of troughs. But when I talk about troughs here, I mean real serious depression troughs.

Since I didn't have the oomph to continue with the previous blog I saved it as a draft. I'm revisiting this post now (July 19) after several days. I have come out of the euphoria and the subsequent trough. Now I'm just feeling dysphoric and that something is just not right. Fortunately, other people have had similar experiences when initiating Nardil. I've learned this by reading messages from this forum. I'm realizing, too, that I'm probably not at a therapeutic dose of Nardil yet. I'm taking 45mg, and for my weight (150 lbs) I need to be taking at least 60mg. The rule-of-thumb is 1mg/kg, which is 1mg of Nardil per every 2.2 lbs of body weight. So, for me, that would be 68 mg of Nardil. So I'm on 45 right now. And that could be why I go through horrible depressive spells at points throughout the day.