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Answers to the Questions Post 4: Anti-Depressants and the Grief Process

Posted May 11 2010 12:00am

Great timing on the questions post. My question is, will being on mood stabilizers interfere with the grief process?

I’m 4 weeks post break-up. I was put on a mood stabilizer and antianxiety medication 3 weeks ago. I had so much anxiety that started approximately 2 weeks prior to break-up. I constantly have the feeling that I need to move my legs and/or feet and shaking that gets worse throughout the day. I’m starting to see a decrease on the physical aspect of it, but I have only teared up once in the past 3 days. (not that I want to cry all the time, I was really getting tired of that) It just made me wonder if it was like an alcoholic being drunk, but when they sober up the problem is still there.

Again, thanks for your help.

When you say “mood stabilizers” I’m not sure if you’re talking about anti-depressants or true mood stabilizers. The former is for depression while the latter is usually for mood swings associated with bipolar disorder. I’m going to guess that you’re talking about anti-depressants. If not, feel free to let me know you mean actual mood stabilizers.

It is very early in your breakup process. If you were so overwhelmed with constant crying and debilitating anxiety then you absolutely made the right choice by seeking medical intervention. Clinical depression is NOT a joke and being treated for it is NOT a weakness, it is a strength to know when you need help and to seek it out.

Anti-anxiety drugs are helpful in that you can function without the overwhelming anxiety sometimes associated with grief. I talk about anxiety in the book (pp. 63-64; 94-98) and how to combat it without anti-anxiety medication. This is helpful if you’re beyond the point where you have debilitating anxiety where you wake up with a pounding in your chest and feel like gasping for air. I experienced this kind of anxiety and used to say that my anxiety woke up an hour before I did. I was looking for a job at the time and could have probably used anti-anxiety drugs because I was a mess for a few months and did not get a job for almost 4 months past the breakup from the MoAB.

I did have trouble functioning but I when I went to therapy or a 12 step meeting or (non 12 step) support group or a class or hobby group, I felt better. The anxiety actually drove me to do something every single day and that helped me go places and talk to people which I might not have done otherwise. I don’t know if I would have gotten better as fast as I did without being driven to groups and outside help to battle the anxiety. HOWEVER, that is not for everyone when the anxiety is truly debilitating. If I had a choice at the time (which I did not because the only things available at the time were truly addictive) I would have opted for a medical response for a few months while I got my S#!t together.

The exercises and suggestions in the book are there for two reasons: 1) for people whose anxiety is not so debilitating that they have trouble functioning and 2) for people who have used anti-anxiety meds for a few months but are coming off of them. Most doctors will hesitate to keep people on anti-anxiety medication beyond a few months because most of them are highly addictive. So if you use them for a while, please still work on the non-med exercises to battle anxiety (esp the meditation/visualization exercises or find relaxation audios [mp3s/cds]) to try to get used to their calming effect and to get into the habit of using them. I have no idea which meds you are on but reaching for a non-medication solution as described in the book or going to support groups is a good thing to do in the event that you are taken off of them, which you will be in the majority of cases.

With anti-depressants the story is different. You can stay on them for years and years and even if you only use them for a few months, step down gradually to go off them completely. But some people simply can’t step down. They fall apart as they tackle the difficult emotions of grief over and over again. That is why some people are on them for a few months and some several years (or permanently). Anti-depressants should lift you up to the point where you can do your work and keep you from being clinically depressed. You cannot face your grief and go through the process if it is overwhelming you and causing you to fall apart.

The way I talk about it is that anti-depressants can help you rise to the level where you can do your grief work and do your inventories and not be a complete mess from day to day. If you choose to use them and NOT do your work because you don’t think you have to or the pain is not that bad now that they are kicking in, then yes you are just avoiding the problem. But most times I think that if you journal, do your inventories, talk about your pain you will still experience the grief process but the anti-depressants help you avoid the huge black hole of despair that many people experience.

Medication is a personal decision and if you cannot control anxiety and depression without medication and you can’t do your work because you can’t even function, then yes it is necessary. If you do your work and still feel numb you might need an adjustment on the anti-depressants but in my experience they don’t keep people from feeling. They keep them from feeling “TOO MUCH” where they are completely incapacitated.

As for anxiety, I would suggest non-medical exercises while you’re on the medication so that you can wean off them in a few months but can self-soothe whenever the anxiety hits. Again, I don’t know what medication you are on for anxiety but most are meant for the short-term and not the long-term because of their addictive characteristics. So learning to combat the anxiety in a non-medical way is very important.

Again, you are early in your breakup. Meds can help you get to the point where you can do your work. If you’re not doing your work then you are going to really struggle if/when you come off them.

Also talk to your doctor about the effects and chances are that you are having a perfectly normal response to them in that they are controlling the anxiety and depression to the point where you can function but still feel your feelings.

Let me know if this does or does not answer your question.

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