Oh, Wellbutrin: A Torrid Love Affair

In my teens, I had a series of brief yet unsatisfying flings with Zolotft and Serzone. In my twenties, I embraced Wellbutrin, and we had a long, beautiful relationship. That is, until I almost fell down the stairs one night as it fiercely threatened me with dizziness. I broke up with Wellbutrin the next morning; I knew it was no longer a healthy relationship. Even though I knew rationally it was the right thing to do, I mourned the loss of my beloved Wellbutrin. I craved it. I quickly went into a rebound relationship with Lexapro, but was disappointed by its constant companion, Fatigue. Plus, it could never compare to the dazzling molecular beauty of Wellbutrin.

After a year or so of not dating any antidepressants, my desire for Wellbutrin overcame my good sense. I attempted a more generic relationship with Wellbutrin. It ended badly. I required a more expensive Wellbutrin to satisfy my high maintenance needs. It was beyond my financial grasp at the time, so I did my best to move on with life. I did quite well until recently, as fears of the unknown began to overwhelm me. (This was primarily caused by the terror of knowing I would soon stop my lifetime, comfortable job of being a student and move into the entirely new and unfamiliar ballpark of an OCCUPATIONAL THERAPY CAREER.)

For these anxiety-provoking reasons, I decided a few months ago it was time to suggest a fresh start with the new and improved Wellbutrin XL. Surely we would get along better this time, as I was in a different place in my life. I desperately needed it to help calm the anxiety I was almost constantly feeling, as well as the worry cycles and obessions that swept through my brain.

So we met again. And it was beautiful. So, so beautiful. My anxiety and obsessions were replaced with a more flippant attitude. Others commented on how good my relationship with Wellbutrin was. Instead of worrying, I was easy-going. My most common refrain became “Whatever. I don’t care.” It made my friends marvel at the new me and effusively thank Wellbutrin aloud for its calming effects on my psyche. (Last night. Me: Where’s my phone? Oh whatever, I don’t care. Friend: Thank you, Wellbutrin.)

And because love is blind, I chose to ignore its clunky baggage:difficulty falling asleep and increased vulnerability to dizziness and orthostatic hypotension. I remain confident that the good parts of our relationship more than outweigh the bad parts.

For example, tonight I went to a friend’s house for a wonderful dinner. I was full when done. My friends offered me Oreos for dessert. Pre-Wellbutrin, I would have eaten several, regardless of how full I was, just because I love them so much. The rational part of my brain shuts down and my id takes over when presented with sugar. Now, dating Wellbutrin, I was able to calmly watch as one of them ate an Oreo – not really caring at all. It’s helped me lose weight and be a lot less stressed/anxious this semester. Every one in my class has noticed a huge difference in my attitude (enough flippancy to make me a lot more easy-going, but not affect the quality of my schoolwork), and they definitely approve. But when it’s 2:20 am in the morning and I’m still too wired to sleep, my brain frozen awake by an unrelenting Wellbutrin playing with my dopamine, I wish that my brain biochemistry would allow me refuge in an unmedicated body. Especially since I’m supposed to be up in four hours, be on the go all day, and then work until midnight.

These thoughts are especially poignant as I contemplate how much cognitive-behavioral therapy helped me deal with generalized anxiety disorder (GAD) in my teens. Working on a cognitive-behavioral frame of reference presentation has revived my old memories of treatment. I wish longingly that a refresher course could suffice to quench my terror of initiating a professional career. I know there have been many papers showing that cognitive behavioral treatment can be just as effective as medication in treating GAD. But technically, it’s a lot easier and convenient to pay money for a monthly prescription than it is to deal with the time. energy, and money needed for continuous treatments with a therapist. I also have a hard time, at least right this second, in thinking that my brain biochemistry can be altered to a healthy level, just by making changes in cognition.

It makes me wonder about treatment of patients in OT, using cognitive-behavioral techniques. I can definitely see the possibilities of pointing out distorted thinking, increasing self-awareness, improving logic, and using rewards/reinforcing behavior. But when do you throw in the towel and say, hey, I think I’m reached my limits as an OT, you need medication to accompany this treatment or I won’t be able to help you much more”?

I wonder. At times like now, I have a love/hate relationship with Wellbutrin. I hope one day I can permanently tear myself away from its siren call. Unfortunately, if history is any predictor, I think my neurotransmitter destiny will always be one of co-dependency.

*I tried to go to bed after I swore I would, in an earlier post written
around midnight. But then I decided I should read in bed to unwind. I ended up grabbing the book that the movie Dangerous Minds was based on, and then read the entire thing. Since then, I’ve tossed and turned. I’m not worrying about anything specific, my brain just won’t let me rest, even though I’m so tired I can barely see straight, after multiple days of being on the go all day long, running on very little sleep. It’s 2:51am now and I felt I had to get all these thoughts off my chest. I debated whether it belonged on my OT student blog, but I think it does. OTs and OT students do not work/study in a vacuum. My personal experiences affect my schoooling and my schooling affects my personal experience. Right now I’m pondering the choreography of tomorrow, hoping all the elements fall into place so I can complete everything I need to get done. And I’m wondering how I’m going to break this cycle of being too exhausted to sleep, any time soon! Now that I’ve gotten this all off my chest, I guess I’m going to try to go back to bed.*

Newest update: I couldn’t send this at 3am because my Internet was down (hi Comcast, what do I pay you for?). I fell asleep a little bit after 4am and just got up at 7:20. I’m running on adrenaline (again) for the day. Wish me luck.

Aug 03, 2007 | Category: Occupational Therapy | Comments: 2