I went off of my depression medication recently. It was a disaster. (Spoiler alert: This story has a happy ending.)
The reason I did so is that, like many — if not most — people with a mental health condition, I have, at times, bridled at my diagnosis. I’ve had moments of doubt that there was a biochemical basis for my "feeling down," and told myself that perhaps it was based, instead, in maladaptive coping patterns learned in early childhood, negative social and political forces or even plain old loneliness. I wanted to believe, like we're all told, that being sad and agitated all the time was, in fact, something I could just get over.
And then, after years of therapy for both my depression and my complex post-traumatic stress disorder, I was cruising along on 10 milligrams of Lexapro daily, and feeling better than I ever had. Perhaps, I thought to myself, all the therapy had finally healed me and the meds were now just overkill.
Because I was so healthy, I knew that, even if you don't "need" them, it is terribly dangerous to quit psych meds cold turkey and without professional supervision. So under the watchful eye of my therapist (with my primary care physician on alert, just in case) I opted to try to go off of them gradually and safely, and see how I felt. I was so sure that, finally, I'd just be normal.
I started to taper my daily 10 mg as part of a plan to wind down over the course of 90 days — or longer, if the side-effects were too much. I’d take it slow, see how it goes. When I cut down to 5 mg daily, I still felt OK — a little dizzy at times, which is a common side-effect of cutting back on or discontinuing SSRIs, but otherwise it felt like smooth sailing.
Feeling good at 5mg a day, I had visions of being one of those people who write the “I quit my meds” essays that I inevitably end up devouring whenever they get published, just as eagerly as I read horror stories about being overmedicated, improperly medicated and irresponsibly medicated.
I'm sure these pieces are all necessary in a broader conversation about mental health — as are well-researched inquiries into the non-biological causes of depression — but that's not why I read them. I read them (and, I admit, I wanted to be in a place where I could write my own version of them) because I wanted to believe there was a version of me reflected in the words, a version without these problems, who didn't need these medications and who would look back at my years taking them as a temporary, but necessary, course. An alternate route back to the "real" me.
Well, after those three months of tapering off, and five days without a single milligram of Lexapro, I found the "real" me, and she was edgy, anxious, overwhelmed by even the tiniest source of frustration, mad at the world and at myself for being mad. I felt like I was juddering along in my life with no way to stop, barely in control and likely to crash. In other words, I felt exactly like my old, unmedicated self.
Even though I these days I am buoyed by trauma-specific therapy, eye movement desensitization and reprocessing therapy, somatic-focused therapy, clean diet, exercise, yoga, meditation and prayer, it turns out the bottom line is that my body just does not produce adequate amounts of serotonin without my medication.
So I started taking it again, and felt better almost immediately. (There’s no amount of argument in the world that could convince me that this was the placebo effect at work.)
And having started again, I realize that my attempt to quit was motivated in no small part by the insidious ways that stigma around chronic illness — especially mental illness — play out in society and in our own heads. Taken together, the myriad “I went off my meds” pieces with happy, prescription-free endings play into the existing stigma, and may exacerbate the internalized idea that there is something “wrong” with any of us for having a chronic disease at all.
The supposedly new-and-newsworthy angle in so many of these articles — that, by golly, we’re overmedicated as a nation and we really should be going off all these silly drugs we probably didn’t really need in the first place — is actually a well-worn trope, and a potentially dangerous one. As much as there are many Americans who continue to take medication for anxiety and depression when they are no longer the optimum treatments, there are millions more who would benefit from these medications and either can’t access the medical care required to obtain them or won’t take them because they're ashamed to seek that care.
I realize that I am at liberty to tell this story because I am self-employed, partnered with someone who fully acknowledged and accepts my depression, and otherwise parked in a little cul-de-sac of security that affords me the privilege of being able to speak about my depression — and my insecurities about it — without worry or inhibition. I don’t need to fear losing my job or my social network by being forthcoming. That, I’m sad to say, is probably a rarefied state of being.
We need more discussion about every dimension of depression and other forms of mental illness. The outpouring of remembrances for pioneering "Prozac Nation" author Elizabeth Wurtzel (who, at age 52, passed away last week from metastasized breast cancer), underscores how grateful people are for candid testimony about living with the boot heel of depression on one's neck.
So, to be candid: I thought, like maybe you're thinking, that I might be able to live my best life without the assistance of antidepressants. I found out, swiftly and safely, that I was wrong. I need my medication; I appreciate my medication. I will continue taking my medication for as long as I need it — even if that means for the rest of my days. And, at last, I am 100 percent OK with that.