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  •  Lexapro is a selective serotonin reuptake inhibi- (2+ / 0-)
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    yoduuuh do or do not, splashy

    -for.  It blocks the reuptake of serotonin from the space between neurons -- the synapse -- by the presynaptic neuron, thus increasing the concentration of serotonin in the synapse & thus presumably in the serotonin receptors in the post-synaptic neuron.  Low serotonin levels are associated with depression, sleep disturbance, irritability, and even suicidal and violent behavior.  Its biochemical precursor is tryptophan, the chemical in turkey meat that produces sleepiness in a lot of people if they eat enough of it.

    SSRI's are prescribed not only for depression & PTSD but for anxiety disorders & for post-concussive syndrome and stroke,  the symptoms of which usually include irritability.  The post-surgery syndrome described in the OP obviously has some things in common with concussions & strokes -- it's a form of acute brain injury.

    The cognitive side-effects of Lexapro described in the OP are not usual but not uncommon.  Sometimes they can be eliminated by switching to a different SSRI, assuming the therapeutic effects can be maintained.  Although each SSRI has a general profile of therapeutic & side effects, individuals' responses to each SSRI are often very idiosyncratic.  Lexapro is usually the default initial prescription because it's general profile has the lowest rates of the most bothersome side-effects; but that doesn't mean it's the optimal SSRI for everyone.  

    •  If your symptoms are not severe, some people have (0+ / 0-)

      found relief from moderate to mild anxiety and sleep disruption using a supplement called GABA.

      If you have severe symptoms frequently, I am unsure how much this will help, but for someone who has only occasional episodes or issues staying asleep, this can be an alternative.

      I would also highly recommend journaling, ESP when you have episodes of irratibility.

      How do you feel physically and emotionally?

      Some people who have had some form of TBI + PTSD report feeling physical pain inside the brain when they have strong emotional responses.

      Also this will help you gain some perspective, and identify the situations or stimuli in your life that are triggering some of your episodes.

      Meds and Supplements might help with symptoms, however, it is very important that you begin, as soon as you are able, to take steps to empower yourself.

      Being Irritable is a normal response. And sometimes the feelings of abnormality and fear of stigmatization exacerbate bouts of irritability. Once you learn to accept what is going on, you can take active steps to mitigate your responses, and therefor your condition.

      PTSD is a frustrating mix of emotional and physical responses, that don't necessarily make sense to people outside of your own skin, and not even to you at first. Taking steps to get a handle on what is going on inside of you is a tremendously big deal.

      •  I failed to get to my own point (0+ / 0-)
        Being Irritable is a normal response. And sometimes the feelings of abnormality and fear of stigmatization exacerbate bouts of irritability. Once you learn to accept what is going on, you can take active steps to mitigate your responses, and therefor your condition.
        You have to identify your new normal. The good news is, that this may not be a new permanent normal. That you may find treatment options that help mitigate many of your symptoms.

        But identifying what your new normal response is, emotionally and physically, to everyday stimuli helps to lower anxiety levels significantly, so that when you have an episode, it's to an association inside your brain and body, and not in addition to feelings to helplessness and bewilderment, because you don't understand what set you off to begin with.

        If you know that some encounter whether it be with a movie, a place, a smell or a sound is going to set you off, piss you off, scare you, cause low level anxiety, then you can take steps to avoid that encounter, or at least know what to expect when you have it.

        It makes all the difference in the world.

        I will give you an example: I cannot have alarm clocks going off to wake me up. Instant Adrenaline Rush, and instant--Piss Off.

        I got my spouse a clock that starts at a barely audible tone that gently increases in volume, and hey, no one has to be stuffed in the closet.

        Things that startle me out of sleep are triggers. They aren't the worst ones, but they lead to irritability and consistent low levels of anxiety.

        So I solved that problem.

        Some are not so easy to solve. But being able to remove some of these triggers helps make room for me to cope with bigger ones.

      •  current state (1+ / 0-)
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        Physically I am fitter than I have been in years. Daily exercise, weights, walking, treadmill. Mentally it's a paradox. Fulfilled, grateful, but more stressed ( in the sense of being apprehensive about another bout) than I want to be. That's what I want to work on. I'll start with more deep breathing exercises. Don't smoke (duh) or drink (sigh), I'm 99.9% vegan. I do need to eliminate caffeine. I know that. I keep telling myself that. But then the only addiction left to me will be verbosity on dailykos.

        •  Maybe the verbosity on the Kos is really a good (0+ / 0-)


          With that kind of stress, it helps to work on changing your perspective where you can, with a more positive outlook. I don't mean going into denial about real issues or problems, just being mindful of negative emotional habits, that until this health problem, might have gone unnoticed or perhaps were of no real consequence.

          Right now though, it sounds as if you are very raw right now and more sensitive than usual and that this is putting a strain on you, in addition to normal stressors.

          It sounds like you are really going in a great direction with the other new habits you have built. You should pat yourself on the back. Not everyone is able to do that, even with the threat of ill health hanging over their head.

          You know you could also start with letting your immediate family knowing how you feel, when you feel it. It's a lot easier to avoid annoying a person who is pissed off, or irritable, if they know that you are already having a bad day or feeling poorly.  

          This accomplishes several things. It trains you to be more mindful about your own inner mental state, and it keeps the line of communication and trust open with your closest loved ones, like your wife. It is a positive sign that you are trying to get better, and to be better.

          •  Thanks (0+ / 0-)

            Just send me your bill. You've got to be a family therapist in the real world. Amen to everything you've just stated. I'm thinking of a follow up diary to this one on r.d. laing, in particular his work knots. You are a very compassionate person, and I'm now going to figure out what to click or where so I can follow you. One therapist I had years ago, whom I asked if I was the oldest client she'd ever had, laughed at me and said it's never too late to work on family issues. I'm not so sure, seeing as I'm turning 64 in January.

            A good teacher shows you HOW to look, not what you will find.

            by bisleybum on Mon Nov 19, 2012 at 07:52:03 AM PST

            [ Parent ]

            •  Not even close, just a person who has lived (0+ / 0-)

              with this for a very very long time. Anything I put down that helps, great. If it seems not to apply to you, ignore it. This is the interwebz after all. :)

            •  BTW, did I mention my spouse is a saint? (0+ / 0-)

              There are days, when I know for a fact, he wants to say to someone out there that occasionally sets me off--"Thanks, you know I have to go home with her, nice work."

              I learned most of my stuff the hard way, unfortunately, he also learned a lot of my lessons the hard way.

              •  ditto on the spouse (1+ / 0-)
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                but mine plays tough love and makes me figure things out for myself, even though she knows long before I do what's really bothering me.

                Tell me a story of deep delight. - Robert Penn Warren

                by bisleybum on Tue Nov 20, 2012 at 04:37:11 PM PST

                [ Parent ]

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