Disclaimer: I am not a doctor or a mental health practitioner, everything I say here is in relation to my personal experiences with SSRIs (not MAOIs). You should always see your doctor about any decisions relating to your mental health.
In light of Mental Health Awareness Day and seeing all the wonderful, brave people who stood up for those with mental illness by sharing their own stories, I felt like I should have written a new piece. I didn’t though, because the creative and inspired part of me struggled to weave all the newer feelings of depression into a legible story, because I’m still struggling with this and sometimes I don’t feel like I have the mental capacity to make sense of what’s going on in my head. It’s always easier to write about this kind of thing retrospectively, as they say “you can’t see the forest for the trees”. Instead I re-read my initial “coming out” article and it took me back into that headspace – back into that liberated mind-set where I wasn’t ashamed or trying to hide my depression like some big heavy secret. At the same time I was transported right back into the cold, grey hopelessness that shrouded me during that time. It got me thinking: what sort of things would have helped me when things were really bad? There were a lot of questions that I needed answers to, and not the textbook GP answers that seemed more geared towards speedier appointments than real empathy.
To medicate or not to medicate was one of those big questions that I wrestled with. During my first ever doctor’s visit- where I complained mostly of physical symptoms- it was suggested that I was probably depressed and I was sent off with a packet of low dosage SSRIs with very little information. I admitted that I was frightened to take them and had relatively strong feelings about it, to which I was mostly greeted with a cold “well do you want to get better or not” attitude. Choosing to carry on with counselling and seeing medication as a bit of a mask for the real problem, I resisted the constant peddling of SSRIs for three years before finally relenting. Little did I know that this was a big part of my depression, not truly wanting to improve.
Medication is always one of those polarizing topics; many are dead set against it and see it as a temporary solution to a lifelong struggle that will eventually leave you worse off. Others believe that a combination of medication and counselling is the real ticket to getting out of the depression and anxiety rut. I sat firmly in the “no meds” camp. I didn’t know what it would do to me, the side effects sounded scary and what if my personality was irreversibly changed? I’d already gone through that once and didn’t fancy it a second time. I had read about having to be weaned off when the time came to live a drug free life and that frightened me even more – the fact that I couldn’t just suddenly stop taking them should I choose to. A big driving force behind all of those fears was the concept of losing myself, losing the few parts I actually liked and ultimately the idea that my creativity and thoughtfulness was propped up by my diminishing mental state.
I can hear you all wondering: what about that really positive piece about counselling? All of that still stands. Talking therapies honestly do work wonders, particularly if your mental illness is circumstantial. My mental illness is a constant, there is a disconnect between what’s going on in my life and how happy that makes me. Things can be going amazingly well and my mind will not let me enjoy it, it will create awful scenarios that will likely never happen when things are going too well and tip me over from depression into anxiety. When things are going badly, my miserable mind is proved right and I get plunged back into utter despair. So, while counselling really helped me to tackle past and present issues – it wasn’t sinking in as well as it should have because the miserable parts of my brain wouldn’t shut up for long enough to allow any of that great advice to be put into practice.
So how did I go from an anti to a pill popper? Desperation for a peaceful mind became more powerful than my decision to remain miserable on the off chance that I might stop being interesting. I had gotten used to feeling shitty all the time, I’d convinced myself that this was it – those around me had other ideas. I was encouraged by my partner, friends, doctor and counsellor to go for it. In fact, my counsellor was the one who really won me round: she asked me what I was afraid of, I told her all of the above reasons and she met every single one with “you can just come off them if you don’t like it”. She highlighted the unnecessarily huge emphasis I was putting on this medication and informed me that actually it would probably be pretty underwhelming how little I actually noticed the effects. After a few sessions of being talked down off my anti-pill ledge, I realised that if these pills helped me even slightly that it was worth conquering my fears and giving it a shot.
Armed with my starter dose of SSRIs (Selective Serotonin Reuptake Inhibitors) along with some awareness and coping mechanisms that my counsellor had taught me, I soon discovered that the initial dose of Sertraline was a placebo dose because I felt no different. After a month the doctors bumped me up to a higher dose which is when the unpleasant nausea, dizziness and fatigue took hold. This lasted for around two weeks and then subsided. My counsellor was pretty much right about being underwhelmed, the effects of anti-depressants don’t make themselves apparent until you notice yourself reacting differently to a situation that would usually send you into a meltdown. Certain things change, your eating and sleeping patterns for example can go one way or the other because you may have been eating less or sleeping less because of your depression – so when the symptoms of depression are diminished you may find that you eat or sleep more as your body goes back to normal. Drinking can be problematic, I often found that alcohol no longer agreed with me and I would only need two drinks before I was quite tipsy.
I didn’t feel like a zombie or anything even at their highest dose – which I eventually reached after 8 months of doctors’ visits. You definitely feel different but not numbed by any means, you still experience negative situations but you experience them through a clear lens without the overwhelming sadness, worry or apathy. Contrary to popular belief, SSRIs do not make you happier or induce false euphoria; they dampen your spikes of negativity and allow you feel things as they really are rather than how your depressive mind perceives them.
I was on medication for around 2 and a half years and I can honestly say that I would probably not have completed university or gotten through stressful periods post-graduation had it not been for the combination of medication and counselling. The best way to look at SSRIs is that they simply supplement a chemical in your brain that you naturally lack, this doesn’t make you weak or a failure and you absolutely can come off them. Sometimes you just need to give yourself a break, give yourself a chance to breathe and get through a tough time without the added stress of battling with yourself as well. Counselling will take you as far as you will let it, but sometimes you’re not chemically balanced enough to truly let it help you and it can end up falling on deaf ears.
I hope this was helpful to anyone hesitant about going on medication, I’ll be sharing a piece I’ve written on coming off medication as well in the coming days.
FeverDream 
That’s some scary artwork with all those pills included.
I came to this more-than-a-year-old post via another post I found on my “feed” of “suggested reading.”
And, as I read, the first thing that grabs me is you revisiting an old piece you wrote and coming up with a bunch of new questions. Part of me thinks that while writing can be cathartic, it can also be like music and other drugs that lure us back into the murky waters of inactive meandering. It’s like going back to bed after you wake up and don’t feel like facing the day. It’s like you shed some skin just to find it on the floor and put it back on your body.
In short, I think we need to stop going back over what we write if we want it to be cathartic. I think we need to write more and either let it lay where it may or burn/delete it soon after.
I used to pester people who deleted heart-felt statements, wondering why they would feel the need to remove what came from their cores. But, now I kinda get it….if they were deleting the writing to get it out of their heads. If they wanted to purge the old feelings and stay in the moment/present, great. Only part of me feels we need to keep the old writings as a reminder or journal of what we did so we can learn from the past. Yet, another part, the part speaking now, thinks we are reconnecting with the darkness we are trying to purge by looking back.
Even in Greek mythology, there are tales of people being warned not to look back lest they get locked into a netherworld. [Ever heard of Persephone? She was lucky she could return to her mother part of the year.]
So, write from your heart. Get it out. In this space, deal with any comments that come your way. Ignore the LIKES which don’t really mean anything other than someone is stalking your thoughts in the shadows for whatever reason, maybe afraid to comment and just wanting a mirror to look through. And then let it go or delete the old files/posts, as long as the old files don’t impact your taxes or any other documentation you need to report to someone.
I’m remotely concerned and aware of my own inclinations to become depressed by going through my journals. I occasionally flip to find something and get stuck on an entry about a sad day. Instead of learning something from that, I feel the urge to drift back into that day and those feelings. I cannot permit that.
As far as treatments go, talking, yes, is a big help. But, what is just as important is with whom we talk. Sadly, during my darkest days, I went through a battery of strangers who were supposedly helpful sources. And, as it seems to be the norm with me for whatever reason (many would say I am just too “resistant” and not compliant), the counseling wasn’t enough. I didn’t see it so clearly then, but what I really wanted was a friend, someone I could talk with and share activities that would take my mind off of what was haunting me and motivate myself to be a better person. Someone to challenge me a little without acting like a drill sergeant. I didn’t need more “what you should do.” I needed more “let me show you how its done and work with you on that.” Therapy became expensive. No one could afford it without being a “welfare case.” I was a minor in a dire position. My trusted aids turned to my parents to know what was eating me and handed me pills to help before handing me over to other strangers who were more drill sergeant than anything helpful, more tough love without the effort to get to know me and my “demons,” expecting me to jump through hoops they set as if that’s all I needed to do to get over what was bothering me. I was processed paperwork and financial matter, not a feeling person.
I lost my faith in that situation. I could have been an atheist like so many I encounter online. But, I had a turnaround, at least as far as faith is concerned.
Counseling/Verbal therapy is great if it’s enough for you to get through the (time). But, seeing someone once every other week, or even once a week, wasn’t enough for me. Not to mention, when I returned to the therapist, I’d go in flushed with revisiting despair, either because I wasn’t better or didn’t feel I had anything good to report. [And, again, the cost factor was a concern.] That’s very reflexive for/of me; no matter if the day is an okay or bad day, I tend not to see any positives worth discussing. I’d rather not think about that and busy myself with something that feeds my soul.
And, as for medication, I went through all the fears/doubts you had. But, once I gave in, I was not so much concerned about losing myself as I was about losing my life! I still had all the dark thoughts and aches but could not fully express my feelings. I could not cry, suffering from dry eyes, one more eye ailment to my life history of such. I had bloody stools. And, worst of all, I was warned by a second opinion that the medication I last took could cause cardiac arrest. I flipped out that day and swore I wasn’t going to rely on any pill for life. [Yet, here I am, taking BP medication for the time being. But, that’s another story.] I wasn’t on any pill as long as you. Which might be another area of concern. I didn’t exactly ask for a quick fix, but my meds were changed quite frequently during a 6 month period. I went through about 7 different ones. None of which made me think any more clearly, but, again, maybe it took being on them for months to take effect, months I did not or could not give them as my feelings tore me toward the depths of death, of being unable to eat, puking my anxiety out and uncontrollably crying. I guess the psychiatrists were grasping at straws just to keep me alive. But, those straws were not helping and even making me more scared.
As far as psych meds go, I even have other family members with struggles who have recently shared with me how their meds took them down dark paths I did not even expect to be real. If they are being honest with me, that only adds to my concern. I have spoken with people who took Paxil and Prozac and had negative physical if not mental results. I get very angry at the thought of this being so financially fixated in our world and at how these highly paid people are given the liberty to dole out and promote this stuff that experiments, gambles with lives. It makes me VERY resistant and more fixated on the deep-seeded need for friendship and love/acceptance.
I think that’s what it all boils down to and reveals the shortcomings of our species. Unlike all the animals you care for and hear about in all the nature shows and such, we are not the most connected or peacefully social species. Our competitions are not limited to butting of heads for sexual domination. We are the dominant species–at least, in our minds–yet are far from deserving of that status. There is a great void of acceptance and social comfort that needs filling. And, for all my “smarts” (as people like to point out), I don’t seem to have enough of a solution to help myself or the world. I need support and teammates.
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