Sunday, December 30, 2012

One of the best decisions I made in 2012: antidepressants

I wish that eating well, running, and staying busy were enough to keep depression and anxiety at bay for me, but they aren't. Those are all things I've been doing for years, and still - for years - I had this constant, nagging feeling of Something is wrong with me. I planned my own funeral for fun. I wrote depressing entries in my diary. I made friends and lost them, over and over again. Something is wrong with me. I got angry and threw things. I cried while lying on the floor of the bathroom, light off, door locked. I quit things, changed jobs, viewed moving once every year or two as a perfectly logical approach to dealing with social discomfort. Something is wrong with me.

And yet throughout that time, I looked totally functional to most people. I went to school or work. I excelled in classes and in my jobs. I smiled, bantered, was personable. I maintained my relationship with my husband. I had a kid.

Few people outside my immediate family knew how much I was struggling. I didn't know how much I was struggling. Periodic bouts of exhaustion, near-constant irritability, and daily anxiety attacks were, from my perspective, just part of the fabric of my personality. And to a certain degree, one gets used to feeling bad when one has felt that way since her early teens. I had enough coping strategies in place (like working really hard, eating well, running, sleeping, zoning out, distancing myself from others if I might go all Jekyll-and-Hyde on them, etc.) that I got by, for the most part. As the years went on I also became adept at hiding what was really going on.

That's a common theme in mental health: hiding. Which is partly why so many of us who struggle with difficult mental experiences feel so isolated and alone. We don't want to embarrass ourselves, so we compensate by striving to look normal (or better yet, GREAT!); when we do furtively glance over the wall to see if there's anyone else out there, the place looks empty. In reality the mental health landscape is full of people struggling with similar things, all hiding from one another, afraid (often understandably so) to stand up and put it all out there. I think that's slowly changing. Finally.

I started therapy long before I started taking an antidepressant, a strategy that now seems somewhat backwards. Don't get me wrong: therapy has been invaluable in that it's offered a place where I can dig through my life and identify where, how, and why ineffective habits developed. It's given me tools: I've learned how to set boundaries, be nice to myself, combat negative thoughts, handle conflict, and be more assertive. I needed the therapy; it was one of the best decisions I have ever made. The problem was, implementing these strategies while dealing with full-on depression and anxiety was like trying to build a life raft while in the active process of drowning. 

Only after I got in touch with a psychiatrist, received a diagnosis (major depression and PTSD), and started on Zoloft (a relatively reliable, long-studied antidepressant used specifically to treat PTSD, among other conditions) did I realize just how long I'd been on the verge of being pulled under permanently. I'd gotten so used to treading water that I didn't know life's not supposed to be a constant day-to-day, year-to-year struggle. I did recognize that the bad times were growing progressively worse. By last January I was having the conversation with my therapist of, "I won't end my life. But I think about it. But I won't do it. But sometimes I want to just not exist," and him saying, "What you're holding onto is an emergency exit option. As long as that door is open, even just a little, you are in danger."

It's hard to describe how different my life is now that I am taking that little white pill every morning. Maybe it looks the same from the outside. I'm still doing what I've always done: working hard, running, putting time and effort into my relationships, challenging myself. But from the inside, it's like Extreme Makeover: Headspace Edition. My anxiety is still there, but I'm mostly able to manage it. I still get depressed, but I recognize the warning signs and know to take action before things get really bad. And all the techniques from therapy? Now I can actually put them into practice on a consistent basis. (Turns out, positive self-talk really works, if you can make yourself do it!)

Sometimes it's hard to remember what it used to be like. I do find myself wondering why I couldn't pull it together, why I made things so hard for myself. But then I'll read an old journal entry or think back to one of my earlier sessions in therapy, and I'll remember that I didn't do this to myself, that I was working as hard as I possibly could to fix my brain. I couldn't save myself no matter how much CBT, EMDR, or western meditation I did. A person with two broken arms might know everything about what it takes to construct a house; she might have all the tools, all the blueprints. But unless her broken arms are set and have a chance to heal, there's no way she's going to be able to actively use her arms to build it.

That's what medicine has done for me: it's put me in a place where my brain can rest long enough to (hopefully) get better. Sometimes I do wonder whether I will ever be able to stop taking Zoloft. Part of me believes it's just a temporary support beam, and that if I can just use this time to reconstruct and galvanize my way of thinking, I'll eventually be able to remove that support. Another part of me worries that if I ever stop, the whole thing will collapse. At any rate, I'm not ready to quit medication just yet. It's working for me; if it's working, why stop? The statistics also give me pause. Depression is one of those things where if you experience it a couple of times, you're likely to experience it again in the future, and it might be worse the next time.

Of course, every person's experiences are unique, and that's certainly true when it comes to antidepressants. I've read that for some people, they don't work; some people have side effects that negate the positive outcomes; other people do well on them for awhile, and then the medication loses its effectiveness. For all I know, Zoloft might lose its oomph for me, too. But for now, I'm just grateful that it's working. It's one of the best - perhaps the best - decision I made this year.


  1. This is a great post. We have lots of mental illness in our family (half of my family has been institutionalized at some point), so I'm constantly on guard for myself. One of the big things for me is sleep, which, of course, I am horrible at getting enough of. But I can feel myself slipping when I'm not sleeping enough. I'm going to bookmark this post to share with friends/family who are trying to decide if they should take medication. Thanks!

    1. Thanks! I resisted medication for years, I think because I worried it would change my personality. What it actually did was make me feel more like myself than I had in a long, long time.

      Yeah, I can't do without sleep, either. Or food. When I'm hungry, I could win the award for Hangry Person of the Year.