Treat the Migraines? Or Quit My Job?

Hi, C. I know you’re not a doctor, but I’m not sure my doctors are helping, so here’s the deal. I began going to our family doctor because of migraines from the loud noises at work. The high pitched squeals of the air compressors, engines and pressure washers drive me nuts, especially the air chisel. Light is also a trigger — I’ve gotten migraines from light bouncing off glass or metal. I’ve also been having tingling sensations on my skin, like ants, and bouts of dizziness. My doctor sent me for an MRI and blood work. The tests all looked normal, so I was referred to a neurologist. She interviewed me, checked my reflexes and memory, then prescribed 2 drugs: Sumatriptan (for when I get a migraine) and Nortriptyline (taken before bed to prevent migraines).

After three days I stopped having migraines. It’s been about two months since then. While taking the night pill, the shop noise hasn’t bothered me as much and I don’t have to wear earplugs as often. I tried not taking either pill for a week. After a few days the noise at work became increasingly more bothersome. By the way — this job is not exactly on my career path. I’m a musician, but it’s impossible to make a living at that right now because I write my own music.

The stress and migraines are really getting to me. My boss has been psychotic lately and I’m having panic attacks. I’m calling out sick tomorrow. What do you think?
Charlie

Dear Charlie;
Good move. That’s the best idea I’ve heard yet.

Basically, here’s what’s going on. You work in hell. The nice doctor gave you some pills so that you could continue to work in hell. After all, your tests didn’t show any signs of heavy metal poisoning yet, you can still remember your name, and lord knows we all gotta work. So, let’s talk about what the nice doctor gave you to make that possible.

Nortriptyline is a tricyclic antidepressant. It makes those sounds more tolerable by inducing a sense of emotional removal. It can also, paradoxically, cause anxiety and panic attacks, and carries a black box warning due to the possible risk of suicidal thoughts.

Sumatriptan is supposed to ease migraine symptoms. It claims to provide “ prompt treatment to help you return to your normal routine.” Paradoxically, overuse can sometimes lead to worsening of headaches or cause rebound headaches. It should not be used for long periods of time.

So, Charlie … how long ya expecting to stay in hell? And seriously, why would you want to? From your letter, I suspect that you already know what you should do. You just want some encouragement. No problem. Go to the edge of the cliff and wait for me. I will give you a good swift kick in the butt.

The use of antidepressants in this country has nearly doubled since 1999. They are the third most commonly prescribed drug in the US. At least half of the people taking these drugs, including you, did not obtain them from a psychiatric professional. A neurologist prescribed yours, but in fact, primary care doctors are responsible for handing out the majority of prescriptions. When standard tests don’t give them a clear medical problem to whack at, it’s sort of like saying, “Jeez, we don’t know WHAT the hell is going on, but at least this will make you stop complaining.”

There are too many doctors out there who are treating what is essentially “I Am Grossly Unsuited To The Life I Am Stuck In” syndrome with pills that make people comfortable enough that they could drift along for years in places they don’t want to be. If the pills are stopped, patients experience a sense of panic that is so unbearable they run right back. If the pills begin having dangerous side effects, their nice doctors find something else that will make them numb without killing them … or at least something that corrodes them at a slower pace.

I am saying this to the entire freakin’ country: If you hate your life, do something to change it. People who hate their lives don’t make anyone happy. People who hate their jobs don’t do a good job. If they do, it is because they are either drugged into submission, or putting on an act that is sure to cause them to take out their real feelings inappropriately on innocent bystanders at some point. And god help the next person who actually deserves their anger. It’s a fabulous excuse to KILL them.

Get out while you are young, Charlie. Change gets harder the longer you wait. Trust me on that one. There are so many things in this world to be. There are people who would actually love your job. Let them have it.
C