It is still there....

I have been maintaining very well for a months now, on the right dose of the right medication.  I finished up therapy, and have been keeping myself pretty busy.  I have still had my "dips" on a monthly basis.  I have been able to recognize the pattern.  I know I am going to have 3 to 4 bad days a month, and I also know that every few months I am going to have an extra bad  month which will be 6 or 7 bad days.  I can deal with this because I know what to expect.  But it has also left me wondering:  Is the depression still there?  Is what I am experiencing merely hormonal shifts?  How long do I need to stay on the medication?  Since I have only felt well controlled for about 8 months or so, I haven't felt ready to "take the plunge" and go off the medication.

Then life threw me an unexpected twist to let me know where I REALLY stand.  I don't have prescription coverage, but the county that I live in gives a prescription card out to ALL of its' residents.  This has been great for my family, but the catch is that it only covers generic medication.  I have been on Cymbalta for my depression.  Initially we tried Zoloft, but that didn't work as well as I needed and I had some issues with side effects.  The Cymbalta has been wonderful since we found the right dosage for me.  The only side effect that I have had to deal with has been some fatigue.  However, Cymbalta does not have a generic.  My doctor's office has been providing me with samples for about a year.  The office has recently stopped receiving samples.  The cost of the medication is way too high for my family to afford on a monthly basis.  So I was faced with the choice to go off medication all together or switch to another antidepressant.  This was really not a choice that I wanted to make.  I was completely happy with the predictable way things were going and how well my current medication was working. 

I really felt that I wasn't ready to go off medication and I was concerned about stopping cold turkey anyway.  My pharmacist (who is really wonderful) gave me some advice and I called my doctor and made an appointment.  Now, my GP is absolutely fabulous.  I could not ask for a better, more understanding doctor.  She saw me pretty much right away.  She said that they are no longer getting samples of Cymbalta because it is going generic at some point in the future and it is not cost effective for the company to give out samples any more.  However we can't wait for it to go generic, who knows how long that will be.  We had a long talk, discussed my options and the symptoms that I am still experiencing.  We made the decision to switch to Fluoxetine.  My GP felt that because I am still experiencing depressive symptoms on a regular basis that I needed to stay on a stronger medication as close in structure to the Cymbalta as possible.  Sigh...the big concern with this medication is that it is a hard one to come off of.  I guess I will cross that bridge when I come to it. 

So I am one week into the medication switch as of today....I am weaning off the Cymbalta while starting the Fluoxetine.  And it is definitely still there.  I have been feeling my depressive symptoms returning as I am weaning off the Cymbalta.   I know I have to be patient through this change, and I did expect that this would happen.  It will take time for the Fluoxetine to build up in my system enough to start to work, and I may need a higher dose of it.  But you know, I just don't want to deal with this again.  I don't want to have to struggle to get through the day.  I have been there and done that, and I feel like I have put in my time already!  I just have to try to keep myself busy and wait this out, but it isn't easy, and it certainly is not fun.  The next few weeks are not going to be a picnic for sure...

This experience is clearly answering my question as to whether or not I am ready to go off the medication.  The answer to that question is a resounding NO.  Now I am left with another question....is it still PPD or am I starting to head down the road of chronic major depression?  I guess the answer to that question doesn't really matter.  I can't look too far into the future with this.  I just have to fight this as hard as I can on a daily basis.  I won't let it win.  The fight just has me tired.  I think the meds might have something to do with that too.  I wish I didn't have to be on meds and deal with side effects, but the medication is the only thing that allows me to be ME.  That is one thing I have learned.  The depression is not me, it is just something that I have to deal with, and I have to fight it so I can be me.