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.