A year on medication

3-minute read

Content warning: mentions of suicidality; discussion of sex and body weight.

There are many ups and downs in this journey and I'm still far from reaching a conclusion.

I managed to go to a private trans-friendly phychiatrist for free for quite a while thanks to a charity.

We'd begun with sertraline and gabapentin. For the first month there wasn't a lot of progress, but small things like music did start bringing me joy. I started to have pleasant lucid dreams, but only temporarily. In one of such I walked in a museum of contemporary art, enjoying every small detail and every colour as if they were real.

On the third month lithium was added and there were significant positive changes. I started being more assertive rather than resorting to my usual flight or freeze response. I stopped getting irritated by mother and cats. I began doing small social interactions such as recording a voice message and calling with ease. There were quite a few side effects like slight nausea, teary eyes, waking up in a cold sweat, but it didn't bother me. The only effect that did was frustratingly low muscle strength. Because of that I stopped taking lithium.

The doctor figured I switch from sertraline to venlafaxin to help me focus more, but it failed at that, besides it gave me intrusive suicidal thoughts and intense derealization episodes. The only positive thing in comparison to sertraline was slightly restored libido.

I switched back to sertraline, and buspirone was added.At this point I was seeing a psychiatrist for half a year. I virtually stopped getting flashbacks and feeling soul-crushing guilt for my mistakes. I gradually started to work and it was easier to begin drawing something new.

Speaking of sex life, it got really hard to achieve an orgasm. It's like you get somewhere near the peak but you can never reach it. However If I did get orgasms, they were fascinating and long, maybe because I spent more time unintentionally edging myself.

Almost a year in I suddenly lost a lot of progress and I suspect I developed drug resistance. So my psychiatrist drastically changed my plan and prescribed olanzapine and fluoxetine instead of sertraline. As of writing, I'm taking them for four months. Improvements are very slow. For now what is most apparent is side effects. The libido is now non-existant and I don't really care about it as I didn't only lose the ability to reach an orgasm but also the sexual desire in general. I want to sleep all the time, but seems like it's improving a bit over time. I occassionally get hypomanic episodes when I feel very productive and stay awake for 18 hours or more, but those are rare. There's a thing I take a lot of joy in, and it's weight gain. I was always struggling to gain weight. I gained 17 kg since the start of taking meds, and I genuinely like my newly fat folds so much.

I spend my days mostly by sleeping, but it gets better every day, I think. I have less suicidal thoughts. Going to a phychiatist got a bit trickier as I now go to a state-owned clinic (it provides services free of charge in my country although its quality is sometimes much much lower than those of private clinics), but I have the most important thing now — hope. It's the best I got so far.

February 19, 2024 — February 19, 2024