I know everyone’s brains work differently, but do any of you have a voice that isn’t your own in your head? I call her the mean girl in my head, and let me tell you, she is not very nice. It’s mostly the intrusive thoughts that she inserts, the
“Are you sure you locked the door?”
“Do you smell smoke?”
“That one person probably still hates me for that thing I said 20 years ago… You remember that?”
“Wow, that food looks like cat food. You’re really going to eat that?”
“How do you know that food is cooked thoroughly? What if I give myself food poisoning and have to vomit?”
And while I know it’s still my voice, that doesn’t mean that I agree with it or should give it the time of day. Learning to shove that voice down, to drown out the what ifs, to get to shore when I’m lost in the sea that is my mind. That is where I struggle, but I want to share my most recent journey with how I found my way back to shore after a particularly bad dive into the deep.
In August of 2024, I vomited for the first time in 14 years. Yes. 14 years. That may not sound like a big deal to you; after all, it is just vomit. But it is so much more for me. To me, it represents a complete loss of control. Vomiting is my biggest fear, and it turns out to this day still my biggest trigger. I have what is called Emetophobia, which is the fear of throwing up. I thought as I had gotten older, I’d gotten better about it, even that I possibly had my fear under control. That was just a false sense of security I’d lured myself into for those 14 years, because all it took was once to send me into a full-blown panic. I thought I’d mastered it, I thought it wouldn’t be a big deal, but I was wrong. It took 3 months of testing for me to be fine eating again. It took me until now for me to be able to look at food the same way. But that wasn’t all that changed.
When I couldn’t find any reason for why I threw up, my life stopped. I was driving to the barn, and out of nowhere, it hit me. I barely had time to pull over. Thinking back, it took me months to drive after that because I was paralyzed with fear that it was going to happen again. Any car ride became an issue for me, and I normally love to drive. Driving has always been my escape; it was awful. Because the one thing I’d always used to clear my head became overrun with the intrusive thoughts of vomiting and the fear that I might do it again. But that wasn’t the only problem. The voice in my head convinced me that it was because of my meds. So, that started me on a whole journey of being scared to take my meds.
I’ve gone off my meds before, multiple times. I feel like it’s a rite of passage with mental illnesses. At some point, I think I’m doing better and try to come off my meds. The last time I went off my meds, it was by choice; this time… It wasn’t. It became impossible for me to take my meds without gagging because I was so scared they were what made me vomit. I faced crippling, constant fear and intrusive thoughts about what would happen if I took my meds.
This time, it nearly broke me. Because I knew I needed them, but this overwhelming fear of vomiting kept coming up. Why is it such a trigger for me, you may ask? I mean, no one enjoys vomiting, but I have full-blown panic attacks and shut down for months. When I was four, I had the hemlock maneuver done on me by my father. I was choking on a hot dog of all things. I remember it happening, I remember feeling like I was going to die, and then I remember watching the hot dog fly across the room. But I don’t remember anything else. Ever since then, I’d always have a breakdown when I would have to vomit. Until this past year, I’d only vomited 5 times in my life. I remember them all vividly, but I won’t share the rest with you.
So for a few months after the throwing up in the car episode, I finally started driving again, and I finally started trusting my body a little bit more. But then came the medication part. Because I wasn’t on my meds, I was falling back into old habits, and the intrusive thoughts got out of control. They became suicidal ideations, and then it just kept going downhill. The doctor who prescribes my medicine is a saint, because he tried to help me through it and went with me on the idea of changing the meds up that I’d been on for years, because (I was convinced) these were making me sick. So we tried me on lithium, because we were trying to figure out something and deal with the suicidal ideations fast. That started a whole new cycle. (Please, keep in mind that meds work differently for everyone. While Lithium was terrible for me, I personally know people who it has helped tremendously!) Six days into taking lithium, my heart “paused” while I was on the toilet. Meaning I full-on fainted, and woke up face down on the floor with my pants around my ankles, butt in the air, and my head throbbing.
I will add an aside here, I also have heart problems that all started about ten years ago, “due to a rare medication interaction”. I’ll do a deep dive into my heart history later, but it is important to know that I’ve had three ablations for SVT, and at the last one, I had a loop recorder implanted. It is a small device that sits just under my skin near my heart. It constantly records an EKG of it and sends it via a device I have next to my bed, if it flags anything, or I manually record symptoms. This is then sent to the people at the doctors to read it. So I thought, okay! We finally caught something on the monitor, at least. Come to find out, the battery had died in February, and this was in April. I was so busy with wedding stuff in February that I missed the notification. Long story short, this wasn’t a new thing for me. They think that when it started back up after pausing the first time, it traveled through the extra electrical pathways I had from the hole in my heart I had as a baby that closed on its own. So they went in and did an ablation, basically burning the electrical pathways to try to return it to its normal beating. It took 3 ablations, and they still hadn’t fully figured it out. I had also recently moved back to my home state, so I hadn’t developed a relationship with a cardiologist and electrophysiologist here. So that became a whole separate journey that I will cover another time soon.
Anyways, after I fainted this time, I ended up going to the ER the next morning, this wasn’t my first fainting episode and I wasn’t sure if it was related to the recent start of the lithium, so I wanted to get my levels tested (I tried getting my doctor to call in to a lab, but he was out for the day, and Urgent Care sent me to the ER.) so to the ER I went. My lithium levels were low, which, seeing as I had just been on it for a week, they were where they should have been. My lab work came back a little abnormal, but the head and neck CT I had (I’ve also had 4 concussions related to horseback riding, and tile is not a forgiving flooring) had no new findings, so that was good. But here’s where it gets weird. They did the EKG, and no one said anything to me. They released me but hadn’t shown me the EKG results or talked about them, so I assumed they were fine. I found them later on my portal, and it said I’d had a heart attack.
I’m sorry, WHAT? Yeah, I panicked a bit. Went to see my primary care doctor the next day and repeated the EKG; it was my normal, so they think the leads just got crossed or it was the placement of them. I continued to have heart symptoms for a while, and eventually came off the lithium, and they mostly cleared up. But, I got so sick on it that I ate nothing but chicken noodle soup for 3 weeks straight because the mean girl in my brain had convinced me that anything besides that would make me vomit. I finally started eating again, but the fear is still there every time I pick up a fork to eat.
So there she was again, the mean girl in my head, convincing me that if I took meds so my mind would feel better, my body wouldn’t cooperate. I came off the lithium, tried something else, which didn’t help at all, so we went back to my old faithful of Zoloft. And there it was, the clarity that I was missing. The quiet in my mind that I’d come to hold so dear for the last 10 years. And while it didn’t fix all the problems, it made the mean girl quiet down a lot. She became laughable and a little easier to ignore. I’m about two months into starting back on Zoloft, and while I still have a lot of recovering to go, I’m finally starting to feel like what is normal for me.
But this journey, this being so lost in my intrusive OCD thoughts that I was paralyzed and afraid of the one thing that could bring me relief. I know some people manage without medication, and I’m so happy for them. But for me, living unmedicated is not an option, and I was reminded of that again. My home life fell apart, I got agoraphobic, I stopped leaving the house, and I couldn’t even make it to the barn. The intrusive thoughts I would get stuck in made it almost impossible for me to take my meds. I wouldn’t say they went away, but I knew that if I didn’t take those pills, I wouldn’t survive because I couldn’t live with the other symptoms that came with being off my meds. And it’s still a battle every time I take my meds, but it’s getting better. I just have to remember who I am without my meds, and remember that though they sometimes suck, if I want to be a functional human being… I have to take them. I remember who I am without them, and I choose who I am with them. This isn’t surrender; it’s how I stay.
Publication note Originally on Medium ([October 2025]). This is the canonical version.