Two weeks into the initial course of the Lexapro, things are generally going well. I haven’t noticed any side effects so far, and I feel a bit better. The last time I did this, with Celexa five years ago, it worked well, but I experienced weight gain as a side effect. Given the lack of side effects this time and the fact that I still don’t feel quite as well as I’d like to (though I’m pretty uncomfortable trying to decide how well I should feel–it certainly seems unnatural), my psychopharmacologist and I have decided to increase the dosage to the minimum average dose, which is twice what I had been taking. I’m feeling pretty optimistic about this, which I would guess is a good sign in itself.
The most profound effect I’ve noticed so far has been on my dreams. Not on the dreams themselves, but on my relationship to them. It started with me remembering more and more of my dreams; seeming hours worth of clear, calm, vivid narrative, evolving over the course of a night from image to image and situation to situation. And as clear as they were, they were strangely impersonal, as though I were watching a movie. I wasn’t confused or disoriented, and it wasn’t as though I was trying to solve a puzzle or fulfill any particular responsibility. I was just watching events–events that I was in the midst of but that didn’t involve me, or with which there was no me to be involved–unfold with a sense of gentle curiosity and a vague awareness that it was just a dream. As this experience has become less exotic, the boundary between my dreams and my waking thoughts has become less clear. I’ve been lying in bed following a particular train of thought, with my eyes closed picturing all of the associations and implications of those thoughts, and been awakened by a noise or a movement, only to realize that I had fallen asleep and the train of thought I had started while still awake simply continued uninterrupted as a dream. And if I wake more gently, I find that the dream can also continue uninterrupted as a waking train of thought.
As I said, I don’t think this is a change in the dreams themselves. I think it’s just a change in my relationship to them. Having gone back and forth in an unmediated way between dreams and waking thought, I’m struck more by their similarities than their differences. Waking thought is more driven by associative leaps and the tangled, non-linear connections and dreams are more bound by logical connections and recent experience than we usually realize. The only real difference between my waking thoughts and my dreams seems to be that when I’m awake, external events or my own conscious intentions shape and focus my train of thought. Asleep, the dreams wander based on their own internal logic. Having experienced those deeper similarities, I can, for the few minutes I’m waking up each morning, hold a different relationship to my thoughts about the day to come. As I’ve gone on at great length about elsewhere, this relationship to our waking life, this sense that we’re dreaming it as it happens, is one way to analogize enlightenment. We’re dreaming, and in becoming enlightened, we wake up but maintain that relationship to our experience, which continues uninterrupted as the train of our waking life. It’s not that dreams aren’t real and waking life is real; it’s just that we relate to the experiences differently, even though they’re both just the manifestation of mind.