Dr. Charlie Seltzer

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May is Mental Health Awareness Month: Charlie's Story

May is mental health awareness month, so I thought it was a good time to write about where I am with my mental health issues. For me, getting my thoughts on paper is helpful in solidifying a plan to move forward. Hopefully, this may spur anyone struggling with similar issues to take action.

I have been dealing with depression and anxiety since college and been on medication consistently since then. I started Prozac in my 2nd year of medical school-thank you, Dr. Winn. I didn’t realize how bad things had become until I after I was on the medication and felt “normal again.”

Though I still battled depressive episodes and severe anxiety spells over the years, they were certainly less extreme than had I not been on medication.

Fast forward to last year. Suddenly my fatigue became so bad I would take naps between patients and couldn’t wait to sleep at night. I got extensive lab testing which failed to show any medical reason for this change in my behavior.

I figured there was a shot my psych issues were causing this, so I reached out to my mental health practitioner. She told me that my long-time dose of Prozac wasn’t working the way it should anymore (depressing in itself) and added a drug called Abilify, which for a period helped me feel better than I had in a while. However, the effect lessened, the fatigue returned, and my mood and motivation decreased tremendously. I had no desire to do much of anything, including #lifting, from which I normally derive great joy. In retrospect, I wish we had increased the Abilify, but hindsight is always 20/20. Instead, my practitioner and I decided to try a different drug, called Vibryd.

I had a very poor response; constant sweats and nausea. The only way I could deal with the side effects was by eating. Over 4 weeks, I gained about 8 pounds. We then stopped the drug and started another “new” antidepressant called Trintellix. I am working up to the goal dose of 20 mg, and thus far I have not had any side effects. Still, I feel a nagging sense of defeat, because I haven’t wanted to lift either, which is my go-to stress reliever. I have to remind myself that it’s not that I lack the strength of character to put in the work at the gym, it’s that the chemicals in my brain that regulate serotonin so I feel better that isn’t working.

People often ask me, “What do you have to be depressed about?” Many of you reading this have more than likely been asked the same question.

On paper, the answer is nothing, and that’s what’s so messed up about mental illness. I have a job I love. I adore my wife, my kids, and dog. I have great friends and family. Yet, I feel down. Why? Because the chemical transmitters which relay messages between my brain cells don’t operate the same as in the brain of a person without depression.

Imagine, you’ve broken your leg and you’re asked to climb a huge set of stairs every day without any help. Sure, you probably could do it, but I’ll bet you wouldn’t be too happy by the time you hit the top. More than likely you’d be tired, cranky, frustrated and in pain. Climbing the stairs might aggravate your already broken leg, or your back, or your hands, thus setting you up for a spiral of other health issues that ultimately would make it even more difficult if not impossible for you to climb those stairs again.

Now imagine your brain is that broken leg and you are expected to go to work, act appropriately, make decisions, take care of your family, be effective, etc. when even getting out of bed can be a monumental task. We wouldn’t expect the person with a broken leg to function without assistance, so why would we expect someone with a mental illness to operate “normally” without some form of support?

In order to tackle mental health issues, you first need to accept that they are there. Ruling out other causes (like low thyroid function or B12 deficiencies) is a necessary first step. Once that has been taken care of, I urge anyone who is struggling with mental health issues to reach out for further help. Even if it’s simply saying the words “I’m not feeling right mentally” out loud your PCP, a friend, or even your personal trainer it’s a step in the right direction. As always, reach out to me or my staff if you have questions or simply need someone to talk to. We are here to help.

-Charlie

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