How to Decide When it's Time to Ditch Your SSRI
Mental health is no joke, and for some of us, it's a tumultuous relationship that needs a lot of tender love and care. We have good days and bad days and wonder why things can't be easier. The truth is it can be, but finding the right remedy can be a feat all on its own. For someone who has struggled with anxiety, OCD, and depression for 20 years, there is a lot of baggage to unpack to understand why. Even after unpacking it, it doesn't always get easier. You can make sense of it all, but it doesn't mean the symptoms and behaviors disappear. Human behavior isn't that simple, and some people's brains are just a little different. My mental health battle started when I was young after suffering trauma, and any girl would struggle with the societal pressures during their teenage years. Anxiety runs deep in my family, and I didn't realize that my racing thoughts and constant worry were reasons for concern. I didn't know any different. I showed telltale signs like picking at my face, constant fidgeting, and excessive drinking to minimize the anxiety that radiated off me. Still, it wasn't until the panic attacks started that I paid any attention.
"Mental health is no joke, and for some of us, it's a tumultuous relationship that needs a lot of tender love and care. We have good days and bad days and wonder why things can't be easier."
My panic attacks started when I was about 19 years old. I was also taking diet pills which only fueled my nerves, and I hadn't even gained the freshman 15. The first panic attack I experienced was at the inopportune moment of giving a speech in my public speaking class. I bolted into the bathroom only to hide until everyone left the building. I was mortified, and you'd think I'd connect the dots on the diet pills, but vanity was more important than my mental health. The normalization of mental health hadn't happened yet, so as long as you looked pretty and could fake a smile, that was all that was important. I went on to have a second panic attack, this time behind the wheel of my Mitsubishi Eclipse. I was too fast and too furious, and so began a troubled relationship with me and the open road, which was not ideal at the moment. I was commuting to a new school, and I didn't have an option but to drive. I proceeded to go to my family doctor to talk about what the hell was going on with me.
Maybe it was my mistake to go to a family doctor for mental help. My family nor I knew what else to do. I remember distinctly the doctor didn't ask why I was feeling this way or anything about me, for that matter. As a doctor, her job was to treat my symptoms and get me functioning again; she wasn't trained to deal with the trauma that had brought me there in the first place. She prescribed me some Xanax for emergencies, and an SSNRI called Effexor. I don't remember her explaining the dangers and the side effects or why she chose this medicine. All I knew was at this point; I was desperate. Looking back, I trusted doctors entirely too much, and I didn't do my homework. I was only 19, so I did what I was told; who was I to argue with a doctor? I had no idea what I was dealing with, and for anyone who has experienced panic attacks, it's a miserable experience. You feel like you're having a heart attack and what's worse is the anxiety you then begin to feel, worrying you will get another. I choked down the pills but never bothered to look deeper at why it was all happening.
"You feel like you're going to have a heart attack and die and what's worse is the anxiety you then begin to feel, worrying you will get another. I choked down the pills but never bothered to look deeper at why it was all happening."
Therapy wasn't a thing growing up as a millennial, what's funny is my aunt was my school psychologist, but it never occurred to me to talk to someone about my issues. Therapy had a stigma; it was for seriously mentally ill people or people who had extraordinary circumstances. It wasn't something we talked about, read about, or even thought about. My era was the era of taking a pill to fix all your problems. As I mentioned, it was the dawn of diet pills and any other pill that could fix your problems. Marketing was really the issue, but I ate it up, and I was always looking for a quick fix for my problems, isn't everyone? So taking a pill to stop my panic attacks sounded great to me. I didn't anticipate the slew of side effects that I was too young to handle. A lot of medication like the type I was on is risky for young adults, increasing suicidal thoughts. I don't remember my doctor sharing this crucial tidbit of information. Initially, I was ok on the meds, the panic attacks stopped, but sure enough, I started to change. The worst part about it was I wasn't prepared for it, nor was I even looking for it.
Slowly but surely, I lost interest in just about everything. I started getting flakey, skipping school, missing work, and lying to my parents. I was gaining weight, eating, and drinking without regard for my health; I dyed my hair, opened a credit card, and started shopping excessively. It's like I had zero concern for limits; the only thing that made me feel better was consumption in any form. I got irritable, depressed, and so very tired. I remember this was when I started drinking coffee because I couldn't keep myself awake. I wasn't myself, and my coaches and parents began to notice. My father confronted me about my little shopping habit, and I knew that I couldn't hide it. I was living at home that year, and I was mentally deteriorating before their eyes. It wasn't until I found myself at rock bottom, which was buying donuts by the dozen and napping in a target parking lot (when I should have been at school), that I knew I had gone off the rails. I had to get off of the meds and try to regain my sanity.
"I remember how challenging it was, but once off the meds, I felt like a veil had been lifted. It's like I had been numb, and all the consumption was my attempt at feeling anything."
Weaning off the meds was more complicated than I thought; the brain zaps or what I like to call the wah-wahs were awful. I remember how challenging it was, but I felt like a veil had been lifted once off the meds. It's like I had been numb, and all the consumption was my attempt at feeling anything. Years later, I'll never forget that same aunt, and I realized that we had both tried this medication; she had the same reactions down to the erratic behavior as I did. I swore off meds from that moment on. I didn't trust them, and I didn't ever want to lose myself like that again. The panic attacks dwindled, but I did have them from time to time. Still, I hadn't figured out my anxiety; I was just coping with it. I white-knuckled it for so many years, terrified that what happened to me once would happen again if I needed to take medicine. I spent years trying to handle my mental health on my own until something in society changed. Mental health started to become normalized, and instead of wearing a badge of honor due to exhaustion and overwork, people began talking about self-care.
My self-care journey started slowly; my idea of self-care was sleeping in and letting myself watch TV all day to cope with my busy life. Sometimes that is the self-care you genuinely need, but when it becomes a routine, you have to wonder, is it self-care or is it self-sabotage? I didn't realize I was creating a life around my anxiety symptoms instead of treating them. It wasn't self-care. It was pure avoidance because, at this point, I lived in New York City, and sometimes the city was just too much to handle. Everything was stressful, from mass transit to picking up groceries. City life was hard, and to add to it, we worked hard and played harder than anywhere else. I mean, the city doesn't sleep! New York is the least mentally sane city out there, and for an anxious perfectionist determined to make it, I was a disaster waiting to happen. One of my dear friends, a health nut from LA, started me off on my self-care journey and bought me a journal. That journal would become my therapist until I finally got the courage to see a real one. I made a few attempts at Therapy, but it wasn't until I was at another rock bottom that I eventually forced myself to meet Jennifer, my first actual therapist. This time my anxiety and depression had me in a place I didn't recognize. This time it wasn't doughnuts and naps; this was full fledge mental crisis. I share the full story here, and I couldn't avoid all those issues any longer; they were starting to interfere with my life in such a way that I was worried I wouldn't make it through.
"Sometimes that is the self-care you genuinely need, but when it becomes a routine, you have to wonder, is it self-care or is it self-sabotage?"
At this point, I finally started to crack open the trauma that had built up over 20 years, but I was faced with a difficult decision. Because I was in such a vulnerable place, my therapist AND my doctor recommended I go on medication again. I was hesitant due to my previous experience, but that was over 15 years ago. My mental & physical health had declined so rapidly; I didn't feel like I had a choice. I needed help and fast. We decided on a low dose of Lexapro at 5mg; this time, I knew the risks, but I knew I was in need regardless of the potential side effects. I finally stopped googling and just took the pills. I needed a break from myself and a good night's sleep. Sometimes the benefits outweigh the risks, and only you can decide that for yourself. For me at this moment, anything was better than what I was going through. Lucky for me, Lexapro worked. Within a matter of weeks, I was feeling better. The medicine did what I needed it to do, slowed down my brain so I could catch up. Also, weekly therapy allowed me to finally unload and start to process the pain I held inside. It helped me identify the OCD I struggled with and learn not to let my thoughts dictate my sanity. Finally, I was giving my mental health the time and attention it deserved. However, I knew that the medicine wasn't a cure-all or a lifetime solution for me.
Maybe it was the pandemic and a new relationship, but I recognized some similar behavior start to creep back in. I slowly started gaining weight, consuming to consume, and my sex drive had vanished. These things all concerned me, but the fear of lapsing with my mental health kept me on the medicine, just lowering my dosage. Most doctors want you to stay on your SSRI long enough to retrain your brain a bit; they say 6-9 months at a minimum, and once you're feeling better, that's because the meds are working. I pushed to stay on the meds long enough, so I knew without a doubt I was in a stable place to handle coming off of them. That's also not a choice that works for everyone. For me, I know at this point I could take it. Starting or discontinuing medication can be a tough decision; there are no guarantees on either side of the coin. I believe that medicine is there to help us when we need it; for some people, that's a period of time, and for some people, it's forever. The problem is the stigma surrounding it. I'll never understand why we judge something that helps people, and at the end of the day, you have to do what's best for you. I decided to take medication a second time, knowing that I would probably have side effects, but my mental health was fragile, and I knew that was the best decision for me.
The same goes for deciding to wean off the meds. It's a personal decision that only you can make for yourself. At this point, I decided I was in a healthy place with my mental health, and the benefits were no longer out weighting the side effects. When deciding to change your medication, it's recommended to do so with your doctor's help; going cold turkey can cause a myriad of issues, and even with weaning off, those can come along for the ride. Luckily my dosage was low, so my withdrawal is relatively manageable, but it's time I say goodbye to my SSRI. Who knows if I will need to use one again in the future, and if I do, that's ok. If you have a tumultuous relationship with medication, know that you're not alone. Thirty-seven million Americans are in the same boat. Just do what's best for you.
