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Musings and reflections on—you guessed it!—life, filtered through the neurodivergent brain of a former business strategist turned essayist and fiction writer.

Side Effects

An update + 5 things.

Sara Eatherton-Goff

Nov 12, 2023

Content Warning: Mention of medication-induced suicidal thoughts, and of past self-harm.

If you’d prefer to skip the short essay part necessitating the content warning, scroll to the graphic “things I liked this week” for recommendations.

A photo I snapped while waiting for coffee at Caffe Vita in the KEXP radio station in Uptown, Seattle this week. The fall colors in the courtyard behind it were just too stunning to resist capturing. And the colors reflecting in the buffed concrete floor of the space just made it even more beautiful to me.

Yet again, I pushed myself too hard and crashed. Only this time it was primarily a medication behind both the pushing and the crashing.

Although I’m seeing a new prescriber after my previous psychiatric nurse practitioner (PNP) retired, still, I knew that I’m one of the oversensitive-to-pharmaceuticals Autistics,1 even with poor absorption issues from late-diagnosed Celiac Disease.234

I got up to the recommended starting dose for an adult of this anti-anxiety medication from the two-times lower pediatric dosage I actually started at. Then an onslaught of side effects occurred/became glaringly noticeable, including my first-ever experience with suicidal thoughts.

Prior to the increase, I didn’t notice the heightened anxiety, nervousness, depression, confusion, dizziness, (persistent) skin rashes, and occasional headaches were a part of the medication’s side effects until I began tapering off it. Brian noticed and noted some of it, but it still didn’t register with me until late. (Another way Autism affects me.)56

Most of those symptoms come and go for me anyhow—even skin rashes due to the mast cell disorder (MCAS7). But when they’re persistent, it can be easier to isolate them as caused by something I’m ingesting every day versus getting triggered by something I’m randomly exposed to or ingesting.

Roughly once a quarter, I have an identity crisis of some kind—a common occurrence among Autistic women,89 but also for a subset of Autists, regardless of assigned gender at birth. (Often this happens when I’ve consecutively over-scheduled myself, or over-extended myself emotionally or socially. I lose sight of who I am and what matters to me versus what others need from me, creating a disconnection between my brain and much-wiser body.10)

I knew things were weighing on me more with the stress of the living-half-my-life-without-my-mother realization, and with potentially moving in a couple of months (among many other things). But as I readied for bed one night last week, I experienced within-the-norm identity crisis thoughts of, Is this just how life will be forever? Will I always take one step forward and four steps back?

But those normal, generic thoughts spawned into, You’re a bad example for your kids. You’re never getting anywhere. Everyone knows who and what you are, and you’re never going to be accepted by neurotypical people. Why do you keep trying? Why do even you care, anyway? Aren’t you supposed to be UNmasking? You’re pathetic.

Then, Is life worth this? You don’t have to put up with it, you know. You should just—

“NO.” The word popped out of my mouth, firm, as I stared at myself in the mirror. “This isn’t you,” I said aloud to my reflection.

I hurried out to Brian and told him what happened. I asked him to look up the side effects of the medication for me—I was too shaky and didn’t want to re-stimulate my brain by engaging with my phone when I needed to sleep soon. Then, I went back to the bathroom and brushed my teeth. My brain remained quiet for the first time in what feels like an eternity. (Maybe giving myself a unsettled stare-down in the mirror helped.)

I fell asleep quickly, confident that my recognition of the invasive, unwelcome thought and words were put to rest without the risk of reoccurrence.

Brian sent me the drug facts information, and in the morning, I read everything on it.

Although suicidal thoughts or ideation weren’t directly listed for the suspected medication, I was also prescribed cannabis as a sleep aid by my previous prescriber, and had a grapefruit cocktail earlier after writing the preceding post in public, celebrating my ability to hold in emotions. (Not the healthiest thing to celebrate, I know. And maybe not the healthiest choice to celebrate with.)

All three—cannabis, alcohol, and, surprisingly, grapefruit—can interact negatively with the medication.

But, I deduced that the grapefruit in the cocktail was what caused it, as I’d consumed a non-grapefruit alcoholic beverage while on a 5-milligram-lower dosage of the medication once without issue.

Although the mental self-battering and beginnings of a suicidal thought were caught and halted immediately, it was certainly a scary experience.

Even when I’ve felt invisible, and like I didn’t actually exist in the world due to chronic dissociation,11 I’ve never actually wanted to disappear or not be alive.

And I was never so cruel before, either.

It was easy to catch because of how unlike me the experience was. But I completely missed the exacerbated symptoms being actively experienced. Even after Brian pointed out that I was acting erratically during an apartment tour, I took it as a criticism instead of what it was: An observation of abnormal behavior. Something that should have triggered mental alarm bells, but didn’t.

So, as I’m focused on self-regulation and re-stabilizing this week, in lieu of a longer essay, here are some:

One.

After suggesting the practice to one of my kids, I’ve rekindled daily Morning Pages.

I feel much more emotionally “together” since restarting.

Artist and author Julia Cameron came up with the concept of hand-writing three A4 (8.5” x 11”) stream-of-consciousness pages every morning before beginning the day. It’s a way to clear distracting thoughts and capture important ideas you might have missed if you hadn’t taken just 15–30 minutes (depending on how long it takes you to write three pages) to empty your mind before starting the day.

My too-glarey-in-photos Supernote example of Morning Pages beside the Focus Keeper app on my lotion-smudged phone. I’m leaving it—it’s real, dammit.

It’s starting the day with a clean slate.

I’ll share more about tasks and activities I do to lift myself back up after and during recurring identity crises next week, plus my updated end-of-the-year action steps to prep for the new year in a few weeks.

Two.

Brian and I finished the show Catastrophe. I loved it.

While on a business trip in London, an American man meets a cheeky and self-assured Irish transplant, where they spend his free time in town hooking up. After his return to the States, she discovers and informs him that she’s pregnant. And there begins four seasons of two whip-smart (and often razor-tongued) strangers figuring things out together. I’d rather not give anything else away, but it definitely broadened my scope of relationship dynamics, that’s for sure. 😅

If you check out the show, be sure to note the name on the American’s phone when his Irish counterpart calls him. The consistency in those minute details, and the nods to attentive viewers (and readers!) give stories an added flare I just can’t get enough of.

Three.

When I’m not reading other writers' Substack posts and articles, I’m devouring Mary Laura Philpott’s collection of interwoven essays, Bomb Shelter*. I’m also re-reading Keep Going* by Austin Kleon.

Bomb Shelter is such an easy yet beautiful read. I’ve found the easiest things to read are often the most difficult to write, but Mary is a master wordsmith and storyteller. I just can’t get enough.

Keep Going gives me strength when I feel mine waning. I’m grateful to both authors for creating uplifting works, but also to myself for selecting them from my home library at just the right time in my life. 😉

Four.

While reading Emma Gannon’s post last week on building a successful Substack, it dawned on me that my Substack design wasn’t “me.” Don’t get me wrong, I’m all about plants (haha), but my little leaf paragraph break was awfully poised for the mess that is my life, life’s experience, and musings which capture that truth.

The words I write didn’t match the aesthetic design I offered. So, I created some “splatter graphics” to better represent me—inside and out.

I’m a mess. I accept that. But with the balance of a serif typeface (representing my more “controlled” side), with stylized and hand-written lettering mixed with splattered ink, now the design fits me just right.

It was a fun task, for sure. And one I could do while in an emotional and complicated state.

Five.

“The creative adult is the child who survived.” —Ursula Le Guin

(A little punchy quote to wrap with, from dearly missed Ursula.)

See you next week with a basic breakdown of my key activities for lifting myself back up after I’ve been down.

My best,

Sara