On 75mg of Venlafaxine, taken once a day, in the morning.

The supposed benefit of a serotonin-norepinephrine reuptake inhibitor (SNRI) over the more commonly used selective serotonin reuptake inhibitors (SSRIs) is that SNRIs improve the overall supply of serotonin and norepinephrine available to the brain. Norepinephrine can impact your levels of excitement, leading to a more general feeling of alertness that is often missing from those experiencing depression.

My experience with Venlafaxine has been mostly good. Before the election, I was rating my depression as a 1 or 2 out of a scale of 10 and felt, generally, like I had more energy throughout the day. When I first started it I felt like my body and mind were racing, like I couldn’t collect myself or I was inching closer and closer to mania. That ultimately went away or dwindled, though I still feel a generally higher sense of alertness.

I.

In therapy, I talk about what it means to continue going to therapy when your depression feels different or minimized. We continue EMDR and I recall, painfully an image of me dropping off my first ex at his dorm for the last time before he left Spain. Years before, I made the internal decision that I had never loved this man, even though I spent a summer anxiously tracing grooves into the contact lens he left melted on my bathroom counter. Years later I awake in the middle of the night, anxious and panicked over forgetting his last name.

The connections can feel tenuous and pointless at first. What point is there to diving back into the past, retracing the past threads of my love and lust? Does it even relate to who I am now? I am trying to understand the origins of a core feeling: a sensation of being unlovable, a deep sense of unworthiness that’s not stymied by love, friendship, sex, and romance. We trace the branches of this feeling, and how they part from the original inciting incident and into the future.

It is a bit metaphorical and melodramatic, but sometimes that’s what I need.

II.

The worst side effect of starting a new medicine was vivid dreams, though those have mostly stopped by now. At night I’d fall asleep and have complex multi-part dreams. In them I was with my partner, at my last job, at my current job, sailing on a cruise ship, reuniting and fighting with past exes.

Freud believed (wrongly) that our dreams were our subconscious desires and conflicts unspooling at night. A simplified theory is that our brains hide more of our internal conflict than we let on. Most people don’t believe that anymore. The running theory is that dreams are our brain’s best attempt at cataloging the day in relationship to our past experiences.

I’m not sure if I buy it. Maybe a part of me wants my dreams to connect so some form of hidden desire, some secret truth to my nature. Then again (in most dreams I remember) midway through I realize it’s a dream and connect it to what it means in my waking life. So I guess I don’t need it anyway.

III.

My biggest worry with going to therapy and taking antidepressants is an inability to write. I’ve used my depression as a quick crutch to writing, easily throwing myself into a depressive state by cycling through sad songs or thinking about the past before attempting to write anything.

The irony of living with depression or anxiety is that you want it gone but you’ve lived with it so long, you’ve come to rely on its familiarity. The habits you’ve learned while anxious or depressed don’t magically disappear with antidepressants, which is why a combination of medicine and therapy is generally recommended. The positive thing is the brain remains malleable throughout our life—though it is harder to form new connections the older we get. Harder, but not impossible.

IV.

There are things I don’t talk about in therapy or things that I work up to talking about in therapy. There are days when I jump around, distracted or angsty about the world around me.

A non-exhaustive list of things we’ve talked about:

• My childhood

• Suicidal ideation

• What I love about my current partner

• Whether the white dude from Shogun is hot or not

• If I’ve seen the substance yet

• What values are important to me

• The strong, concrete, and consistent examples of male relationships I have in my life

• My writing

• Feeling burned by my past jobs

V.

I’m not taking a full dose (yet). Traditionally, around 115 - 150 mg is a standard dose to treat depression in adults. Right now I don’t think I need a higher dose.

We’ll see what the next summer brings though.