It seems that life is made up of a lot of different “firsts.” The first time you leave home, the first time you have sex, the first full-time job you accept, your first apartment, etc. etc. I’ve experienced many different “firsts” and had thought that there were not many big ones left for me (other than my first marriage, which hopefully will be the only one). This was not a correct assumption on my part. This morning I had a big life “first” — my first appointment with a psychiatrist.

I’ve always been somewhat of an anxious, worried person. Not to stereotypically blame my issues on my less than sparkling childhood, but I think it started when I was four. My parents got divorced and my father remarried a few years later. I remember my dad being fine with me when I was as a small child, but when he got married for the second time, everything went downhill. The woman he married did not like me. She and her daughter made that extremely clear. In retrospect, my stepmother’s dislike had little to do with me as a person, it was who I represented. I represented my mother. My presence reminded her that my father had once been married to someone else. I believe that my very existence made my stepmother feel threatened, so she froze me out.

My father either didn’t notice what was going on or didn’t care and he let this happen. Visits to my father’s house were fraught with extreme worry because I was a child walking into a hostile environment where I was not wanted. I was too young to understand that I could stick up for myself or just stop going to his house, so this anxiety plagued me for my childhood and teenage years.

As a kid, when I wasn’t trying to disappear into the wallpaper at my father’s house, I was at my mother’s house. This was much better, but held a different kind of anxiety. My mother loved to date. She went through boyfriend after boyfriend and there was always a strange man around our house. Because my mother was occupied with men most of the time, I fended for myself from an early age.

Living in an unstable, nervous environment was something I dealt with from ages four to 17. It’s not an easy thing to shake and has set me up for a lifetime of worry and anxiety. What’s strange is that anxiety has been such a permanent state of mind for me that I didn’t realize it until recently. Living with this mindset has been with me for so long, that to me, it’s simply a way of life. I worry constantly and even a happy moment can become fearful because I believe that the happiness can be ripped away from me at any time. I rarely experience a moment of peace or contentment.

For the past seven months, I have seen a therapist every week. A recurring subject my therapist comes back to is how my worrying influences my sleeping habits. I have never slept well for extended periods of time. Times of particularly high anxiety equate to poor sleep. My sleep has always gone in waves – I’ll sleep well for a few months, then have months of terrible insomnia.

For the past year or so, my sleep has been especially poor. It’s been a tumultuous time; I got laid off twice and went through a terrible breakup. Because of these events and the worry surrounding them, my sleep has suffered. I have had a prescription for sleeping pills for a number of years, but over the last year, I’ve started to take a lot of them. My Ambien prescription and I have become well acquainted.

While I would love to sleep soundly and normally, it doesn’t bother me much that I have been taking so much Ambien. My therapist disagrees – it bothers him. He does not think that Ambien is a good, long-term solution to my sleep problems. The therapist believes that if I could reduce my general anxiety, I would sleep better. He believes that an anxiety-reducing antidepressant would accomplish this.

Going on an antidepressant has always sounded like a big deal to me. I was not sure if it was something I wanted to do. I decided to discuss the idea with my primary care physician.

My primary care doctor told me that going on an antidepressant is not a big deal or a small deal. She described it as more of a “medium sort of deal.” The doctor decided to write me a prescription and I could fill it if I wanted. She prescribed 10 milligrams of Prozac, to be taken once a day.

I held onto the prescription and kicked the idea around for a few weeks. I decided to get the medication and see what happened. If I didn’t like it, there was no harm done and I could simply stop taking it.

I filled the prescription and took the Prozac for two weeks. Those were a terrible two weeks. I felt sick to my stomach and dizzy most of the time. In addition to my physical symptoms, I felt a generalized, strange sort of feeling that would come and go. I didn’t know if this was normal or not, so I looked into different Internet discussion groups on the drug. It seems that everyone has a different experience with Prozac, so comments were all over the map. Some people loved it, some people hated it.

It was when I was reduced to tears about how sick and weird I felt that I decided to stop taking the Prozac. Within a few days, I felt normal again. At that time, I thought I was done with antidepressants.

A few months went by without my seeking any sort of medication. It wasn’t until I realized that living my life in a state of anxiety wasn’t completely normal that I started to reconsider medication. I guess it’s obvious that not everyone lives with the same amount of worry I do, but that was not apparent to me until recently. I decided to re-explore my medication options, this time with a doctor who specialized in these sorts of issues.

At my first appointment today with the psychiatrist, a lot of ground was covered. We talked about my history with anxiety and the patterns it follows. We talked a lot about my brief experience with Prozac and my views on antidepressants. I explained that I was open to trying a different medication, but was highly concerned about the side effects. I refuse to walk around feeling sick and strange all the time. I would rather keep worrying.

After discussing all my options at length, the psychiatrist decided to give me Remeron. She explained it as an antidepressant that would reduce anxiety and also make me sleepy. The only common side effect is an increase in appetite. I can deal with this. I would much rather feel hungry than nauseated and dizzy.

While I am still nervous about taking an antidepressant, I am going to fill the prescription. Once again, if I don’t like it, I can stop taking it. The idea that life can be lived without extreme anxiety is a new one for me, but something I would like to strive for. I’ve already scheduled my second appointment with the psychiatrist to discuss how I feel after I’ve been taking the Remeron for a month. My first trip to the psychiatrist must have been okay if I’m going to a second.