A Year on Propranolol

The part I remember best is waking up with my head down on my arms. On my desk. With the voices around me, it only took a moment to figure out where I was. Oh, crap. I decided I must have fallen asleep at work. What could be more embarrassing than that?

Then I remembered.

I know the science on propranolol, emotion and memory is all terribly last week, but I've never promised or even particularly tried to be a current events blogger. Also, I still owe Juniper a blog post, and while this isn't that post, it gets at some of the later stages of how my emotional life changed from child to adult.

I still can't say what switch flipped between my junior and senior years of high school and took me from deeply depressed and anxious to moderately functional. My social circle hadn't changed much, but the individuals I hung out with within the circle did. It might have been the one newish friend who I knew wanted something from me but who didn't reject me when it wasn't something I could give. Come to think of it, I can't imagine how that lack of rejection could have been anything other than critical.

Whatever happened in high school, time and success and independence were all very good for me. So was Ben, although that is, again, another story. Eventually, depression was brief (still despair-deep, but brief) and tended to be set off by triggered memories.

The anxiety never went away, though, as might be expected. (Ed, I promise. I'll keep reading you even if you stop posting about my life.) I still haven't learned to fall asleep properly when anything remotely exciting is happening, much less anything where people are relying on me. For most of my life, the time before sleep has been filled with obsessive deconstruction of the prior day and planning for the next--or fiction. I prefer the fiction.

Waking life was hardly free of anxiety either. As an adult, I've been one of the people whom others look at and ask, "Can you do this?" Usually it's something I haven't done before, so I'm as curious as they are. I rarely say, "No," but this tends to leave me with big unknowns in my life, big opportunities to disappoint. I'm not fond of disappointing people.

I was over 30 before I realized it, but I'd been getting migraines on a very regular basis since at least junior high. I didn't know that's what they were, because in a way, I was one of the lucky ones. Only a few migraines a year actually hurt. For the rest of them, the debility came from strange visual and somatosensory effects, hypersensitivity and confusion.

I love my doctor. When I walked in with a big list of symptoms that could, even in this day and age, get me labeled "hysterical" and said, "I think I get migraines, although mostly they don't really hurt," she pulled out her PDA and started checking off symptoms rather than immediately referring me to a psychologist. We tried a few drugs for treatment of symptoms, including some stunningly bitter pills that dissolved on the tongue. They worked, but they were nothing that insurance was going to cover at the frequency I got migraines, and they did nothing to cut down the frequency.

Then she asked me how I felt about abortion. She already knew I wasn't planning to have kids, but she wanted to be sure I wouldn't feel compelled to carry to term if I accidentally became pregnant while on propranolol. If I would have, she'd have prescribed something else. The idea of congenital defects was obviously quite disturbing to her, pregnant as she was.

With a few more checks of my blood pressure against the lowest recommended pressure for the drug (I was borderline), she sent me off with strict instructions to either come in or check my blood pressure with one of the in-store cuffs every few days for the next few weeks and a six-month prescription. Six more months were to follow if it helped and didn't produce undesirable side effects. After that, with a little luck, I'd be migraine-free.

Believe me, I checked my blood pressure. Getting used to propranolol felt almost as strange as the migraines. I felt so light. It wasn't lightheadedness, except when I stood up too quickly. (I learned how to get out of bed slowly, in stages.) I was just light.

It took me a while to realize I couldn't get really upset if I wanted to. I could still recognize things that were wrong, and I still acted to fix them. I just didn't do it riding on a wave of righteous adrenaline. I could get angry and act angry, but I couldn't feel the same degree of anger I was used to. Flooding my body with adrenaline no longer produced any noticeable results. My reputation for calm in the face of chaos became more than just me putting on a calm face to keep others from freaking out and getting me going. It was now true.

The same thing happened with anxiety, of course. I didn't get any less ambitious in what I attempted, but facing failure no longer raised all the ghosts of failure past. I can't tell you whether I thought about my childhood during that time, thus stripping it of the negative emotions attached to it. I can tell you that the longer I spent without anxiety, the further away those memories got. That anxious kid became less and less someone I knew. I'd already trained myself not to think of my childhood often. The drug removed the emotional triggers that kept me remembering whether I wanted to or not. It let the present run on uninterrupted.

Maybe that could have been a bad thing, an unexamined life and all, except that I'm nothing if not introspective. Not only had I mined my memories for the lessons they could provide, but I had lived in them far longer than they deserved. Distance was a mercy and a pleasure.

The propranolol got rid of the migraines, too. Mostly anyway. I still get them occasionally, just as I haven't completely trained myself not to respond to non-immediate threats with a burst of adrenaline, particularly around election time. And I still haven't learned to sleep well.

Still, a year on propranolol was one of the best things I've ever done for myself, even considering the waking up at work.

I'd been sitting at my desk, having just raised my soda, when someone came around the corner to ask me something. I quickly swallowed--too quickly, setting off one of those pointless but painful esophageal spasms. Pretending I wasn't about to gasp with pain, I turned to listen to my coworker. When I felt the roaring in my ears, I took a couple of deep breaths to hold back the black, but it was too late.

People look at you differently when they're afraid you might drop on them at any time. A bottle of prescription drugs and the explanation, "I swallowed funny," don't quite cut it. They gather around. They want you to lie down and take things easy and reassure them several times a day for the next several weeks that, really, you feel fine. No, really.

Yes, passing out at work because your blood pressure is low and doesn't respond well to pain is ever so much more embarrassing than falling asleep.