I went on my first antidepressant at 37. I’d always considered myself to be a sunny, stable person, if a bit high strung and anxious. My family tree is filled with worriers, though I would not go so far as to call them nuts. We can function well enough, we just tend to suffer quietly in the way that emotionally repressed sensitive types do.
Just like I never thought I would be an alcoholic, I never thought I’d need an antidepressant. I’d seen friends go on them and slowly turn up happier but also bloated. No thanks. The law of averages suggests that each of us will suffer the death of a loved one or unprecedented heartbreak or job loss or woes of the legal or financial variety or perhaps a crippling combination. We all know this, but we can’t possibly know how we will react until it happens.
My depression was situational in origin, but at some point it went from leaving a toothbrush in the medicine cabinet to moving its favorite leather chair with matching ottoman into the family room. It had no intention of leaving. Maybe my brain had developed new pathways in response to the horrible feelings I was feeling for what amounted to years. The drinking to help cope sure didn’t help. It shames me to admit how long I struggled, not because I waited that long to ask for help but because I still wasn’t able to get over it on my own.
Once I asked for help, the relief was almost immediate. I picked a therapist from a web site based on a one-paragraph profile and accompanying photo. Mainly I chose her because her background was in addictions counseling and this felt a safe first step. The stars had started to align.
She didn’t prescribe me an antidepressant, obviously, though she did gently suggest that I seemed depressed. Maybe it was all the crying I did in front of her. I distinctly remember sitting on her couch and folding damp tissues in my lap like the saddest origami ever. I agreed to see an in-house psychiatrist and left with a low-dose script for Effexor, an SSRI. I suspect he chose Effexor because it has a low occurrence of weight gain and sexual side effects compared to the other SSRIs.
I felt Effexor rushing through my head within the first couple of days. I felt terribly wired and restless and my jaw clenched involuntarily. I knew there were going to be side effects, so I hung in there. I also hung in once I discovered I had lost the ability to orgasm, though that was most terrifying of all. I speak openly about this because I believe orgasms are as important to our state of well being as adequate food and rest.
The crazy-wired feeling and inability to orgasm did pass after a couple of weeks, though I suffered from difficulty reaching orgasm the entire time I was on it. After two months, I started feeling really good. The cloud lifted, just like they say, and I felt comfortably numb and no longer sweated the small stuff or even the big stuff. This was a wonderful drug to be on in early recovery.
After about 4 months, I started getting insatiable carbohydrate cravings. I would wake up at 3am and pad downstairs and raid the refrigerator like Dagwood, only instead of clever sandwiches it was an all-out binge on ice cream and cookies. Not surprisingly, I started to get fat. I gained 12 pounds within two months, and that was tipping point where the therapeutic benefits no longer outweighed the side effects.
I weaned off the SSRI and switched to Wellbutrin under the supervision of my regular doctor. (I stopped seeing the psychiatrist when I called and was told by his handler that I’d have to wait a month to see him and would also need to pay a $25 convenience charge to have a refill called in. My experience with psychiatrists was short lived and unpleasant.)
Effexor was sheer hell to get off of. It has a ridiculously short half-life, which accounts for the severity of the symptoms, but I still don’t like how the brain comes to rely on a drug to process serotonin. What I don’t know about psychotropic medications could fill space, but I do know I felt way crazier while coming off Effexor than I ever did before. It turns out all the reasons I was afraid to go on an antidepressant were well founded! Unfortunately, I needed something else to keep from crashing and burning and very likely relapsing.
Instead of serotonin, Wellbutrin works on dopamine receptors. Before I took a single pill, I felt in my heart it would not work the same for me. And it hasn’t. Actually, it hasn’t worked at all because I’ve only been on a therapeutic dose for about two weeks. So far the only thing I’ve noticed is that I sure do cry a lot in my car. But instead of turning my tears into tissue origami, I feel like I’m releasing pent-up emotions I haven’t dealt with in years. It’s hard to explain, but it feels important and, more importantly, temporary in its intensity.
I don’t expect Wellbutrin to provide the comforting numbness of an SSRI. This makes me sad because I loved feeling calm and mellow, but I also know it doesn’t cause weight gain. And the sexual side effects are gone, so double yay! It also helped me quit smoking, so triple yay!
My doctor told me she hopes to be able to stop the Wellbutrin in about six months. This is what I wanted to hear. If I have another recurrence, I’ll be open to treatment, but I am very wary of relying on psychotropic cocktails to get happy. I’ve followed enough message boards to see the patterns emerge. It would appear that mental illness can be just as progressive as alcoholism and I can’t help but wonder if that’s at least partly caused by the chemicals prescribed to treat it.
The end goal is always balance. When I think of balance, I think of moderation. I have a little bit of elation and hope on one side of the scale. I wish I had more, but life gives me as much as I need if I am in the right state to receive them. The other side is weighted with fear and pain. When this side tips too far, I have to use my resources to get back as close to even as I can. Drugs help with this, but they are not a quick fix and often cause a whole new set of problems for me. The answer feels as if it is just in front of me if I give it time and stay away from things that I know bring pain. Just having hope again is major.