I recently attempted to decrease my dose of amitriptyline (an antidepressant often prescribed as an off-label daily preventative for people with migraine). I had done this successfully in the past, gradually bringing my nightly dose down from 50mg to 20mg over several years while I focused on other parts of my treatment plan to maintain and improve my quality of life. But this time, I experienced some blatant, intolerable withdrawal symptoms.
What was different? Maybe it came down to the time of year? March in Central Canada is pretty much an unpredictable weather smorgasbord, with a heaping portion of gray days and snow showers; it’s not good for moods or migraine brains. Maybe it’s simply what my pharmacist suggested: that it gets harder to wean off amitriptyline once you edge closer to 0 mg. Or maybe the difficulty was that I’m just pushing myself too hard professionally. But regardless of the reasons for my symptoms, I was not willing to stick it out. With trouble sleeping, a dark could hanging over my head, and increased migraine severity and frequency, I gave up after two weeks.
Which is fine, except, I was trying to wean myself of the class C drug so that someday my partner and I might try and make a baby. So to increase my dosage again means taking a step back from that. I haven’t given up on the idea of conception. I may have a few more childbearing years left, and there are still new non-drug treatments for me to try, but when it comes down to it, I’m not willing to give up my current quality of life for baby making.
Body versus plans
Which is fine. For a variety of reasons, adoption has always been on the table for me, and I’m not particularly encouraged by my friends’ candid birthing stories… So why have I been on the brink of tears all week?
I think it must come down to the fact that once again, my body has put a limitation on my plans. I have a choice between potentially wreaking havoc on my body and experience much more pain and disability, or trying to have a child via pregnancy. Not a great choice. In fact, that decision warrants an article all of its own.
When does the grieving end?
I’ve worked through this before. I left a career and a city because of migraine. I’ve more-or-less rearranged my whole life around migraine so that I can still make a living and have some kind of social life. I’ve grieved my past abilities and career, and I’ve learned that my identity is so much more varied and complex than my job title. Shouldn’t I be over it all by now? Shouldn’t I have accepted my new limitations and learned to live within them without falling to pieces with each new hurdle?
I wish. But it seems that’s not realistic. Barring some miracle (please?), migraine is likely to continue to limit my choices, and no matter how much gratitude I practice, I’m probably never going to fully accept that.
Maybe grieving never ends. Maybe it’s just a part of life that is more frequent and intense for some. Maybe it’s the reason I’m so good at finding silver linings.
The silver lining of this darn difficult awful terrible stupid March is that after moving through migraine-related grief over and over, I can definitely see that I’m getting better at it. Instead of following my first instinct to stay holed up in my bedroom eating chocolate and cheese and disconnect from the world, this time I let some people know what was going on right away. Then I saw my doc and got a referral to have a few counselling sessions. I forced myself to the gym, and damnit, I hated every second of it, but I felt better afterwards.
How do you deal when migraine throws up a new wall between you and your dreams?