This week is a series of posts about depression, anxiety, family issues, and other brainweasels, for the people who have come on over from CaptainAwkward.com's various open threads. Hello, welcome, and feel free to comment here.

I do have other, unofficial drugs, besides the Xanax. Caffeine, for one. I started taking the stuff regularly when I was a teenager. My high school started classes at 7:20am, and my brain does not boot up until half past ten at the earliest; if I intended to show up, ever, I was going to need some chemical help. I still had a pretty appalling attendance record, to the point where I'm pretty sure they were supposed to flunk me for it, but someone evidently noticed that I turned in stellar performances when I did turn up and had the sense to lose the paperwork.

I take in 100-200mg a day, most if not all in the morning. I quit once for a solid six months, on the suggestion of a doctor who thought it might help the anxiety disorder. Exactly the opposite happened. I fell apart even worse, because suddenly I couldn't finish anything. I assume I'm self-medicating for some sort of mild ADHD-lite executive dysfunction thing, but since it's cheap and it works, I cannot really bring myself to care. The main symptom is that without it, I cannot make things organize themselves. I know they tell ADHD sufferers to break tasks down into lists of smaller steps, but that is exactly the opposite of helpful for me -- trying to juggle the list of baby steps is like trying to carry laundry down to the utility room without a basket. I can kind of get most of it, but it's all jumbled up and leaking socks and shirt parts in all directions, and I'm continually scooping stuff up in an effort not to drop it. Inevitably I manage to leave something important on the stairs.

The threshold at which caffeine inhibits the GABA response is ~500mg in the drug-naïve, and since my intake is both far below that and chronic, I get to skip that, and also the insomniac and diuretic responses that are so maligned in the popular press. I used to drink a lot of cola -- I just don't like the taste of coffee, in much the same way as I just don't like the taste of tequila -- but these days I have just given up on denial and treat it like a maintenance prescription, which I fill for myself in the form of generic CVS caffeine tablets.

I'm dependent on it in the sense that my brain doesn't really work right without it, but I don't think I quite rise to the status of addict. My intake has stayed at the same level for years now, and I'm quite capable of running out of the stuff and deciding that it's (too hot, too cold, too wet, too late at night) and going out to get more before my next scheduled shopping trip is way more effort than I'm willing to expend. I do get the traditional withdrawal headaches, the same as I do with anything that drops my blood pressure suddenly, but that's what Aleve is for. I try not to let it go on more than a few days, primarily because I'm incapable of finishing any tasks like that, up to and including simple things like dishes. Eventually I haul my butt to the store and buy more on the next grocery run.

I have, a few times, taken what I believe is technically referred to as "a whole shitload" of caffeine, mainly to see what happens. I know other people say that caffeine precipitates their panic attacks, but I've never found it to be so. Caffeine intoxication and my panic attacks share a couple of generic symptoms, mainly a raised heart rate and excess muscle tension in my back and shoulders, but otherwise are not at all the same experience. Many people depersonalize and/or derealize during panic attacks; I don't, but I do get a touch of both after several hundred milligrams of caffeine, both of which make it difficult to be alarmed rather than merely alert. Kind of interesting, in an academic sense, but not intellectually helpful, or entertaining, so I don't go about doing it on purpose.

I also get what I can only describe as the smell of burnt neuron hanging around the back of my nose, but I'm heavily synaesthetic, so God only knows how other people experience that. It's sort of rubber-cementy and dries out my sinuses.

Diphenhydramine is another thing I try to always have around, although on a more episodic basis. My sinuses are goddamn defective -- I think probably everyone's sinuses are goddamn defective, mine are just more enthusiastic than most. I have hay fever-type allergies and upper respiratory infections are not only miserable, but prone to turn into ear infections if I don't keep my head cleared out. (I distinctly remember not doing this once in college. It ended with me stumbling down to the Student Health Center with a hand on the nearest building, because one ear was so jammed up I couldn't walk straight.) One of these days, I will find out who designed the interior of the human head and file a class action suit against them -- naming R. norvegicus as co-plaintiffs, as rats tend to be sneezy at pretty much the same times, for pretty much the same reasons.

I mainly use antihistamines to treat the snot and inflammation because all the efficacious decongestants are stimulants, and I've always found anything more GABA-stifling than caffeine to be intensely unpleasant. Sudafed does invoke what feels like a panic attack, although that kind reliably goes away when the pseudoephedrine wears off. They make me unfortunately stupid, so they fall under my blanket policy of "don't take this unless being a space case is more useful than being a distracted puddle of misery". Hydroxyzine, which requires a prescription, works better with fewer brain-eating side effects, but it didn't work enough better to be worth the trouble of rummaging through all of the low-cost doctors in Arizona to find one who would give me more of it. I may or may not have a weird histamine thing going on as well, depending on how rare something needs to be before it's considered strange; I'm of Celtic decent, and like a lot of my fellows, I do react to histamines in wine and such by turning a brilliant red across my nose and cheeks, a phenomenon a friend of mine used to refer to as an "Irish tan". Benadryl does what it's supposed to and wears off quickly, so I feel it's an acceptable trade off.

I am okay with using things like alprazolam and caffeine and diphenhydramine to keep myself functional. The main source of stress in needing something to make my brain work correctly comes from the threat of not being able to get it. My use of all three seems to rise to a certain level and then go no further, and I don't see the fun in using any of them in amounts exceeding what it takes to treat the thing I'm trying to treat. The level that works is low, all of them are cheap, and with a prescription all of them are legal. I'm not in any danger of losing access to any of them, which is a huge improvement over the way my life used to run, believe me. The more 'bootstraps' a place is, I've found, the harder it is to get a goddamn doctor to listen to anything you say that isn't verifiable by a blood test.

To be perfectly honest, it doesn't actually matter if I'm okay with all this. Not liking it and not taking them would make me not work at all; not liking it and taking them anyway sounds like a great way to waste a lot of energy on resentment. I might as well just be pragmatic, shut the fuck up, and keep buying NoDoz.

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