The Egg or The Chicken

Had a long talk with my shrink today.  At our last meeting he suggested that I go on meds to "even out your mood swings."

I told him about my abysmal record with anti-depressants.  The only one I've done well on is Prozac and that was over 20 years ago.  I've tried many of the new ones.  I had side effects to most other SSRI class drugs and that was BEFORE CFS.  I had a severe reaction to SNRI class drugs that were proscribed in low dose for pain use after I contracted CFS so those are totally out of the question.

Of course I was told by Dr. Komaroff that anything that acts on the central nervous system wreaks havoc with CFS patients so I'm loath to even try the Prozac.  I would have to start out on the lowest dose they make and maybe even mix it into juice and only drink half.  I would also have to be monitored closely for side effects of any sort.

Aside from the drugs themselves, we also talked about why I would be taking them.  I told him that it made me feel like my sadness, my grief wasn't legitimate.  That it wasn't right to feel this way.  That it needed to be wiped out by the drugs.  He gave me an excellent list of things to consider:

Is the sadness overwhelming?
Does it interfere with everyday life?
Is it persistent?
Can I tolerate the sadness?

My sadness comes and goes.  It isn't persistent.  I cry more often in his office than outside so his perception is a bit skewed.  I generally have triggers for the sadness such as watching the Olympics (people doing things I used to do such as swimming or running)  or digging my ice skates out of the closet.  I cry.  I get most of it out of my system.  I go on with life.  I get annoyed that I'm still sick.  I get angry at not being able to do stuff.  I grieve for the life I've lost.  But most of my days I'm okay.  Most days I can function within the boundaries of CFS.

I also realized that I can't really untangle the CFS from the sadness. I don't know if I wake up feeling crappy because of the CFS or because I'm sad at being sick.  The proverbial chicken and egg problem.

I know what would absolutely improve my mood: BEING ABLE TO DO STUFF!!  If i could get a drug that cured CFS I wouldn't have to take any prozac!