“You shouldn’t take antidepressants.”
I heard that only once from an acquaintance, but I remember it nearly two decades later. “You don’t need to rely on them to be OK.”
More often, I hear sentiments like these: “I’m going to manage my depression with vitamins and supplements.” Or, “I feel like I should just be able to pull myself up by my bootstraps.”
I let the words slide off me. I used to think that way about depression, too: That if I concocted the right magic potion of herbs, exercise and therapy, I could feel better all on my own. I wouldn’t need to take a pill.
I was 20 the first time I took an antidepressant. I had failed at my first attempt to leave home, moving from my small Alaskan town to Seattle. I’d looked forward to independence since high school and imagined all the things I wanted — success, love, a group of great friends — were just waiting there for me.
But I couldn’t find a job. Or friends. A few stilted attempts at romance were unsuccessful. My small, brick-walled apartment was soon strewn with books, CDs and scraps of paper with dark poetry scrawled on them. Within a few months, I could barely get off my futon, where I soothed myself with TV, food and pot. I felt like the blinds had been lowered over the life I’d hoped for and everything was gray.
Finally, I folded. My parents flew down to help me pack up my place, which looked like it’d been ransacked. Back home in Alaska, our family doctor prescribed me Paxil. Though my mood lifted as I licked my Seattle wounds, I was plagued by nightmares and the sexual side-effects common to the drug. After a few months, I decided to stop taking it and, within a day or two, felt like I was being zinged in the brain by small electric shocks. With the help of an acupuncturist, the shocks tapered off after a few weeks.
But throughout my 20s, depression and anxiety trailed me, and difficult situations seemed to push me over the edge. One of my best friends died in an accident just as I was graduating from college and I again found myself immobilized. The degree I’d chased for years didn’t answer the question of what I truly wanted to do with my life, and my grief for my friend become all-consuming. I found a therapist and she put me on a low dose of Celexa. After a few weeks of rocky sleep and low-grade nausea, I started feeling better. Well enough to pick myself up and begin to face life again.
I continued on Celexa for several years. I subsequently moved to Maine, fell in love, bought a house, turned 30, completed grad school, got married and held down a job. I was smack in the middle of the life I’d hoped for in Seattle. Still, my goal was to finally manage my depression on my own — through diet, exercise, acupuncture, therapy and any other tools I came across. Part of me believed that I had a biological tendency toward depression, but another part of me felt like if I just toughed it out, I could free myself from the chalky tether of the meds.
When my husband and I decided to start a family, with support from my physician, I slowly weaned myself off Celexa, since it was a Class C drug and no studies had proved it a safe choice during pregnancy. As I split the pills in half, and then quarters, I became ultra-sensitive and cried frequently. I didn’t feel depressed, but rather like all my emotional nerve endings were raw. I again turned to acupuncture to help ease the pain.
But when my already stressful job became more difficult, it was too much. I felt panicky all the time, and cried easily and often. It felt like someone had stuck a needle into a vein and syphoned out all the hope, love and happiness from my life. I said to my husband, “I’m not suicidal, but I understand how people can get to that point.” He looked scared.
My doctor suggested I try an antidepressant that was considered safer for women during pregnancy and breast-feeding, but it was a bad fit for me. My anxiety shot through the roof and I had frequent heart palpitations. I felt like my blood was humming just beneath my skin. It became clear to me, and my doctor, that going back on Celexa made the most sense.
When I became pregnant for the first time, I lowered my dose to a non-therapeutic level — just enough that I didn’t go into withdrawal. I obsessed about harming my son by taking antidepressants during pregnancy. The midwives I went to assured me that while there was a slight risk of the medication affecting him, the risks of untreated depression were well documented and much higher.
About four days after my son’s birth, postpartum depression and anxiety hit hard. Even when my son was sleeping — which wasn’t much — I couldn’t. The bright morning light sweeping across our living room floor made my heart sink as it signified the hours and hours until my husband got home from work. My doctor increased my Celexa, and with the help of a postpartum support group, soon I was able to function again.
Sometime after my second child was born, and I survived a second bout of postpartum depression, I stopped thinking about decreasing or stopping my meds.
One of the gifts of aging is perspective. I can now see that my adult emotional baseline runs a close parallel with depression and anxiety. Those ailments are also sprinkled throughout my family, which is why I no longer think about weaning off my medication. I have plenty of goals, but being med-free is no longer one of them. I take good care of myself — I eat well, run, practice yoga and go to therapy, and I recently added meditation to my regimen. The small white pill I take each night is just one of the many ways to keep myself healthy. And even with all those safeguards, there are still times when my mood sinks.
Many people liken taking medication for depression to taking insulin for diabetes — it’s just what you do to stay well. I take antidepressants for the same reason I put my contacts in my eyes every morning — because it helps me see clearly.