I wake up feeling nauseous. I try to have some food, but my stomach complains. My heart beats faster. My thoughts race through my mind as I try to get calm enough to have some breakfast into my body. Something. Some food in. I need to make phone calls. Get budgets, schedule fitting appointments, call the florist. I'm getting married in 4 months and I still don't have a date set. My fiance is thousands of miles away, while I'm back home in my country of origin, at my parents', trying to plan the biggest party I've ever planned in my life. On the day before, I had an argument with my future husband. About lunch menus. I also got a prank call that made me believe, for a couple minutes, that my parents had got into a car accident. As lunch time approaches, the nausea hasn't gotten any better. I try having an apple. Lunch is at the table. We all sit in to eat, but I can't manage to touch the food. It's happening. Please God, no. Not again. Never again, please, never again.
The days that followed what seemed to be an uneventful January 4 or so were the worst days of my life as far as I can remember. I felt constantly nauseous. My anxiety levels escalated to the point I couldn't function. Nothing stopped in my stomach; I felt like crawling up the walls, but had no physical energy to do so. I lost 10 pounds in the first 2 days of what I call 'my worst nightmare', the second anxiety attack I had and the third depression episode. I had been off meds for exactly 2 months. JUST 2 months. Why? Why was this happening again? And I had to go pick flowers and try on wedding dresses. Set a wedding date; book a place for the ceremony and the reception; talk to musicians, to the sound system guy, to the wedding invitation printing place, to the restaurant that would do the catering... While I was throwing up everything I ate and could barely stand on my feet, let alone make decisions, or use my brain at all.
When it happened the first time, in 2005, I swore I never ever wanted to go through that again. An anxiety attack like that is the worst thing that has ever happened to me. Worse than wanting to die, worse than physical pain, worse than anything I've ever experienced. It was pure anguish.
I was immediately put back on antidepressants, but whoever's had them before knows they do not start really working before 4 to 6 weeks of treatment. My doctor put me on Xanax, as well as on a drug that slowed down my digestive system, so that food could actually stay in my stomach before the extreme levels of anxiety I was feeling made me throw up. I remember before this second attack, 0.5mg of Xanax (or Alprazolam) was more than enough to keep my anxiety down. Not this time. 1mg wasn't enough. 2mg weren't enough. 3mg held me together for a while, until Effexor XR started kicking in. I got better as the weeks passed. I saw my doctor twice a week. I thought that nightmare was over.
It wasn't. Four days before I was supposed to get on the plane to come see my fiance, get legally married in the U.S., and apply for the spouse visa, I start throwing up again. It happened when my mother and I were leaving the house to go pick up my wedding invitations that had just been printed. I needed to take them with me to mail them to our American and Canadian guests. More so, I needed to mail all of our guests as soon as possible. As I talked to my doctor on the phone, hearing him say he did not think I could actually catch a plane being in that state, tears rolled down my eyes. We were at the beach house and had no internet connection at home. I went to an internet cafe nearby to talk to my fiance, who did not receive my news very warmly. Not getting on that plane on February 7, 2007, meant I would lose my plain ticket, would have to wait until April in my country, would not get legally married in America, nor be able to get legally married in my country without my fiance being present one month before the wedding just to schedule the ceremony (Brazilian bureaucracy). I felt defeated. My emotions had taken over my mind and screwed up my body, and I felt powerless to do anything about it.
As I contemplated the sun set down over the hills, in a little tiny beach town in Southern Brazil, my mother looked at me from the hammock where she was sitting, and said the words that gave me the courage to take back control of my body and my mind. "Go", she said. "Get on that plane, go and be happy. It is what you want, so you can do it. Shake this illness off you, tell it to go away, tell your body to stop hurting and go. Go. Be brave, be strong. Go". So I did, and my then fiance and I got legally married on the morning of February 15, 2007, at the beautiful San Francisco City Hall, on a glorious sunny day, like most days in California.
I did not throw up on the plane, or in CA, even though I arrived there pretty sick of my stomach. I had to go to new doctors, different than the ones I had in my own country, but doctors nevertheless. I was put on 220mg of Effexor XR and taken off Xanax. I started having trouble sleeping and needed Trazodone to be able to fall asleep. I went to numerous therapy sessions, including cognitive-behavioral therapy, psychotherapy, psychoanalysis... I was told I probably had strong genetic influence (given my family history) and would probably need medication forever. At that point, I did not care anymore. I simply did not want to go through that ever again. EVER again.
It's been 4 years now, and things have changed. After 4 full years in treatment, I'm down to 100mg, scheduled to stop my 'chemical crutches' completely by the end of March. Hopefully conceiving by April or May. Giving birth around this time of the year in 2012. Those are plans, all plans. Hypothetical, ideal situations. And as I enjoy my husbands' care and attention this Valentine's Day, amidst flower bouquets, chocolate-covered strawberries, and Thai food, I think to myself, 'never again'. I don't want another nightmare following a release from medication. I don't want to be hungry and not able to eat because my body is rejecting food. I don't want to stare at the floor with a lump in my throat and pressure on my chest, wondering why it won't go away, why won't it just go away. I feel confident it will be different this time, but the truth is I am afraid. Afraid of my own body's reactions. Afraid of not being in command of my emotions, my glands, my mind, my heart, my digestive system! I am terrified of going through something like that again. I want to be optimistic and believe I can beat this. The truth is 'this' has beaten me twice before, so the record isn't on my side; Statistics and research aren't on my side; all I have is my will of succeeding and my desire of being a mother - without the aid of antidepressants.