Well, I had my appointment on Monday and came away guardedly optimistic. My Pdoc had checked with his colleagues, some who are very experienced with all forms and combinations of anti-depressants. He thought making a change at 6 weeks or even 8 weeks might be premature as he was advised it's not uncommon for the full positive effects to take 12 weeks for some patients. With me being a return user of Zoloft I'm not sure if that makes my acceptance of the drug that much more difficult. We also talked a lot about specific strategies for retirement and finding purpose and meaning. I'm still not doing so hot this week on Zoloft but find my late afternoons and evenings are pretty normal. I'm tempted to ask him to bump up the dosage to 250 mg but he may want to wait a week or 2 longer. As for Wellbutrin, it sounds like it's a good augmentation for Zoloft as it affects the other neurotransmitters. I'm just concerned that it might further disrupt my sleep and cause more anxiety (I know it can be expected during the first few days of taking it). I continue with the mindfulness and cognitive therapy but that's really an up and down experience for me so far. I am more aware of the anxiety (it's pretty constant) and I constantly turn toward it and fully accept that it's uncomfortable and painful but it is what it is and I can fully accept it in the moment. The problem for me with this approach is you have to do this constantly, hundreds of times over and over, similar to practising mindfulness where you bring your mind back to the present moment over and over and experience everyithing that is going on at that moment.
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I don't believe it should, based on my understanding, as the large part of it mode of action is on dopamine, with less effect on serotonin and norepinephrine.
If there happens to be some form of sleep disruption, you would probably notice it in the first or second dose, and it should wear off by morning, in which case you would contact your doctor, who would likely make a change.
Most people tolerate the augmentation of an SSRI with Wellbutrin, but some don't, and that happened to be the case with me when my doctor tried the same thing when I was being treated for depression.
With me, it was sleep disruption, so I just let myself get through the night the best I could, and called the doctor in the morning.
I expect he'll either want me to stick it out at 200 mg of zoloft for another week or 2 or bump me up to 250 mg. I just feel like I've been spinning my wheels with fairly good evenings but lots of anxiety during the day. By the way, I put my notice in to retire on November 15. That's coming up pretty quick. I'm half looking forward to it and half dreading it but I regard it as a life change that I've been avoiding and I need to jump in and figure out what this next stage of life will be.
It might help reduce your anxiety about it if you allow yourself time to acquaint yourself with your new way of life, without any expectations.
Your time is your own, and although you probably don't want to be sitting in front of a TV all day, you may want to simply decompress for a couple of months, use the time to regain your health, and just do a few things that you didn't have the time to do while working.
Some people find pleasure in taking on a part time contract using their professional skills, while others prefer to leave their work and profession behind, spending more time with the important people in their life. perhaps travel, or set up a lifestyle where they might live in a different place for part of the year.
There are lots of options for time management, as long as there is sound financial management after retirement, taking into consideration reduction in certain job related expenses, downsizing of home etc.
Hopefully your anxiety levels might moderate when you have more quiet time at home.
Thanks for the comments Steve. Throughout this struggle I haven't handled leisure time that well due to high level of anxiety I'm feeling. Work was at least a distraction but lately the stress at work has convinced it's time to go. I've accepted that I might experience a sense of loss and might see my anxiety increase for a time. But I'll work through it with my psychiatrist and hopefully get some adjustments to my meds to help with the anxiety.
I believe the key to adapting to your new retired lifestyle is to view your new lifestyle as the beginning of something new with all its new discoveries, surprises and fascination, rather than the loss of the old work lifestyle.
Your psychiatrist / therapist can probably help you here, especially if your identity is tied up with your profession, your work and your job.
Those whom I know who embraced their retirement, saw their new lifestyle as the goal that was enabled by the job / profession, thereby forming a forward looking view to the next phase of their life.
Is there a significant other in your life, OtterB with whom you will share your new lifestyle?
Your psychiatrist / therapist can probably help you here, especially if your identity is tied up with your profession, your work and your job.
Those whom I know who embraced their retirement, saw their new lifestyle as the goal that was enabled by the job / profession, thereby forming a forward looking view to the next phase of their life.
Is there a significant other in your life, OtterB with whom you will share your new lifestyle?
Yes, my wife has been very supportive through all of this and is very eager to start this next chapter of our lives. Our retirement place is on the west coast and she is itching to get out there. I don't blame her. It's beautiful there but I'd like to get a lot better before I make the trip. We do plan to split our time between here and there for the first couple of years and eventually relocate.
Well it's been 2 weeks since my pdoc upped the Zoloft to 250 mg. I've noticed that I can handle the anxiety better but it's still there. I am also more like my old self and am up to doing more and interacting with people at work. He is still holding the option open to add Wellbutrin but I'm a bit leery of the effect it could have on my sleep as I have a hard enough time as it is. My retirement is now a week away and I experienced a jump in my anxiety when this hit me as I drove to work this morning. On the one hand, it's a crappy day here with lots of snow and the thought of not having to venture out in these conditions once I'm retired is some comfort. I'm also lining up some projects to keep me busy but I'll take my time and leave space for reading, prayer, exercise and meditation. I need to keep working with my pdoc on therapy and mindfulness (I'm getting a little better at watching my thoughts and being in the moment). We want to head to the coast after Christmas so I've asked him about therapy by Skype or phone. He seems reluctant to do so, mainly because he isn't a tech savvy guy although he said one of his colleagues does this and he would check into it. I appreciate Steve's comments about taking things slow, step by step. Good advice.
OtterB,
The expectation to become 100% anxiety free may not be realistic. I think each of us experiences some anxiety in life, it's probably what keeps us sharp and alert.
Anxiety that paralyzes us or that impairs our ability to function is what needs treatment, but I don't think you would be the person you are if you were completely anxiety free.
One week away from owning your own time can be a little daunting, until you reset your daily expectation of yourself, and similarly reset your "identity".
Though it's good to have activities to occupy you time in retirement, I would caution against putting pressure on yourself to stock up on activities just for the sake of having stuff to do.
Your wife will likely have a TO-Do list for you, but the important thing, in my view, is that you will be the ruler of your time, and you will choose what you want to do and when you want to do it.
You will also have the luxury of turning down projects or demands on your time...another adjustment many retired people have to make.
You will be able to say "yes" to projects you want to do, as well as say "no" to projects you prefer not to do...what a treat!..
No doubt, everyone lives with some anxiety. My Pdoc told me this my first or second appointment with him. He said having no anxiety was likely only possible for someone in a coma. I suppose my compiling a list of projects is a way to deal with the excessive anxiety I'm feeling so I at least will have some distractions as I adjust to retirement. Most of these are home renovation type jobs - some big, some much smaller but having in common the fact that they have been put off for quite a while. I like the idea of being the "ruler of my own time" but at the same time know that this will be an adjustment for me. Getting some enjoyment from how I spend my time will be important but I may have to push a bit through the anxiety until this starts to happen. It's great to bounce this stuff off of you Steve, especially since you have gone through a similar experience. Thanks again.
Glad to hear you're making progress toward "time independence", OtterB! Retierment life is wonderful, and I would recommend it to anyone who is fortunate to have the financial independence to make it work.
Financial planning is an important component to the lifestyle, and for anyone planning on retirement living, the plan should begin taking shape as early in life as possible.
Will be eager to know how you are making out!
Financial planning is an important component to the lifestyle, and for anyone planning on retirement living, the plan should begin taking shape as early in life as possible.
Will be eager to know how you are making out!
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