Natalie Weiss

Medication

Note: This is a topic I desperately want to get right. I am sensitive to differing opinions about, experiences with, and heartaches caused by antidepressants. This is certainly not an entry I want to write for clicks or likes. It is an entry I want to write for transparency. A little over three years ago, I start a series on my previous blog, LAUNCH without fear., about mental health. I tried to focus on my own experience. I still stand by those posts as being mostly honest, though I acknowledge that at the time I left out a big contributor to my depression and anxiety, a.k.a. my sexuality. I feel I have since remedied that particular topic, having devoted my out. series to my journey of accepting my identity as a gay woman. Now, I feel it is prudent to provide an update to my experience with depression and anxiety, and so I attempt to wander gently into the topic of antidepressants.

As with any of my entries on mental health, it is important to note that I am not a licensed mental health professional, and I do not claim to know all the answers, nor can I speak to treatment recommendations. However, if you or someone you know is struggling, there is definitely someone and something out there that can help you. If you need help, please reach out to someone. Visit https://suicidepreventionlifeline.org/ to chat with someone or call 1-800-273-8255 if you are in distress. The organizations The Trevor Project and To Write Love On Her Arms (TWLOHA) are other great resources.

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I lay on my bed, tears streaming down my face. I’m dressed in a blue t-shirt and khaki shorts. I have on a sports bra that will soak up sweat and keep things in place, and my socks are these black, ankle-length running socks that I’ve grown to love. My hair is in a ponytail. A hat lay near my head. My head, which is so cramped with thoughts I can’t shake, thoughts that ninety percent of the time aren’t coherent. They’re just mush. They’re just a heaviness, a fog that won’t relent. They’re painful. In so many ways. The actual thoughts – the ones that string together actual words – are hateful and terrifying and beg me to give up on ever wanting anything again, of wanting to breathe. And all of the thoughts – the ones that are coherently evil and the ones that swirl in mush – create what feels like a weight inside of my mind. Like a headache, but dull, dull, dull. A lead ball wedged within the crevices. Impossible to extract. Impossible to shake loose.

The sun is shining, and it’s a Friday at about 1 p.m. I left work at noon, eager to escape to an early weekend away. This was it: my first solo camping trip. I booked it close to home, just in case. And it’s not like I was backpacking or pitching a tent in a dense forest. The campground would be full. There’d be kids on their first-ever camping trips. There’d be old men and women who have graduated to RVs instead of tents. There’d be beer-slinging and fire-making and cornhole and relaxation. It’s not like it should be an anxiety-inducing sort of trip.

Except it is. Or, maybe, I am just in such bad shape to begin with that the slightest hint of the unknown sends me spiraling. I should be in my car, driving down 31 towards North Liberty, Indiana. But it’s hot. Like HOT. Over ninety degrees. Fires would have to wait until the sun goes down. The plans I had made to run the trails and hike and kayak and lay by the beach quickly deteriorate in my mind. Who wants to camp in ninety-degree weather? I’ll just be miserable. And a thought like that is the first shot in a war.

The back-and-forth begins. I’ll just be miserable. No – you’re just a wuss. What if I get dehydrated? What if you don’t do this thing you said you were going to do? I’ll be so hot. Wow – you’re such a loser, so stupid, so awful, no one will ever want you or love you or…

Spiral.

I lay on my bed, and the thoughts envelope me. I’m too far gone to come back. My first solo camping trip would have to wait. Until this passes. If this passes.

——————–

Fast forward just over ten months from that almost-camping trip. I’m driving east on US-36 towards Denver, Colorado in a silver Nissan Altima. I’d just been in Boulder hiking and exploring and sampling the local coffee and beer. I was on my hike when I realized two things: my phone was dying, and I had neglected to bring a charger with me. Boulder is just over a half-hour drive from downtown Denver, where I was staying, but it wasn’t like I made the drive every day. I had just arrived in Colorado the day before. There were a lot of anxiety-inducing boxes I had to tick off just to get where I was.

• Drive from Indiana to Chicago O’Hare International Airport
• Find parking at O’Hare, get on shuttle, get to airport
• Get through airport security and to my gate
• Endure my first flight in well over a year and overcome my fear of flying
• Navigate Denver International Airport, find the rental cars, get my car
• Drive from the airport to my hotel
• Decide to take a day-trip to Boulder

I did all these things by myself. I was going solo. There were more than enough opportunities for me to crack, more than enough chances for my brain to shut off and scream TOO MUCH! Heck, just ten months prior, I couldn’t even get off my bed and get myself to drive forty minutes to a park I’d visited countless times.

On US-36, I knew my phone would die before I got back to Denver, which meant I’d lose my GPS and the directions back to my hotel. I’d been so accustomed to an irrational, anxious mind, that when the most rational of thoughts started flooding my mind, I almost had to laugh. Aim for the skyline; you’ll be able to find your hotel once you’re in the city. I could stop at that Best Buy over there – but I trust my navigation skills enough not to buy that $10 USB cord. Oh shoot, I wanted that exit. It’s fine, I’ll just take the next one. I got this. I got this. I got this.

Sure enough, I made it back to my hotel. I charged my phone. And then I went back out to explore the city.

——————–

It’s been nearly three weeks since my Colorado trip. I went camping at that park that I was supposed to go to last June about a week and a half after I got home. It was a planned camping trip with friends for my twenty-eighth birthday. And it was a ton of fun, just like that Colorado trip.

A few days ago, my mom texted me a warning about antidepressants. Can give you TD …also dementia . . . I’d be careful with that medicine. “That medicine” being the antidepressant I started taking about nine months ago.

I am not naïve enough to dismiss the fact that medications – antidepressants included – can cause side effects. People close to me have suffered greatly at the hands of so-called medications. I refused to take antidepressants for so long because of this. They can make things worse. They can interact with other drugs. They can cause side effects like flat emotions, weight gain, and low libido.

Before I started taking escitalopram, the generic name for Lexapro, I tried bupropion hydrochloride, more commonly known as Wellbutrin. My first ever antidepressant. In many ways, it felt like I had failed. I had done everything I could think of to avoid “getting on” medication. I figured if I started medication, I’d be chained to it the rest of my life. I was afraid of being dependent on something, afraid of the effects that something could have on my psyche and my well-being, even if that something was meant to help me. For years, the only thing I did to manage my depression and anxiety was attempt to eat mostly healthy and exercise. Then, after walking to the edge of a metaphorical cliff, looking over, and wondering if I should throw myself off, I did therapy for a while, took vitamins more regularly, and attempted to double-down on the eating healthy and exercising approach. It worked for a while. But I found myself at the edge of that cliff again about two and a half years later, and so I started therapy more regularly. I switched therapists. I dated my first girlfriend. I came out to my parents. I moved out of their house and into my apartment. I switched jobs. Covid came. My girlfriend and I broke up. My job felt far from fulfilling. And I felt lost, standing on the edge of yet another cliff, this time looking out at a mountain expanse, knowing I could start climbing, following a path most wouldn’t approve of, or I could chuck myself off the side of the trail, either into a life unfulfilled or anything that would numb the lingering pain of everything I was experiencing. And it was finally here, at this cliff, that medication seemed to be just about the only option left. I knew I had to start climbing that mountain – chasing my own passions and my own dreams – but I was so drained after so many years of fighting my own mind. I had to stop fighting; I had to let go of my preconceptions and my biases.

There were two other important catalysts in my journey to medication: the fact that a close friend started taking anxiety medication just a few months before I considered it and listening to the testimonies of people I admired who had taken medication for their mental health conditions. Two people in particular who have been very open and vulnerable in their discussion of their own mental health are authors John Green and Veronica Roth. It was Roth’s New York Times article What I Learned From Being Off My Anxiety Meds in a Pandemic that really gave me that final push to try medication. It sounds counterintuitive, given how she discussed no longer being on meds, but it gave me hope that I wouldn’t be tied to medication my entire life. I no longer view it as a failure if I am, but I also recognize that maybe this is a season. Maybe it won’t be forever. Roth’s words resonated deeply with me. I honestly could quote the entire article here just to say THIS. This is how I always felt. But I’ll try to keep it a bit more brief. She says, “Mostly, my anxiety was exhausting, a hobby I had never intended to take up but spent all my time doing . . . The anxiety was draining me of the energy required to fight the anxiety. What made me decide to finally take the plunge [into medication] was something very simple. My therapist told me, Veronica, you don’t have to fight so hard all the time. I burst into tears, relieved. She had given me permission to rest.”

Roth tried four medications before finding the one that worked. I have been a bit luckier in my journey, needing only two. Wellbutrin and I didn’t hit it off. My primary care physician had decided to try it first because, according to her, there were many positives including fewer side effects, less time necessary for me to feel its medicinal effects, and – should it not work – no “weening off” period necessary. I could just stop. In the end, I stopped taking it after less than a week. I have no way to know how much my anxiety about taking a drug for my anxiety played into my experience, but given where I am today taking a different medication, I do not doubt that I made the right decision.

In a note I wrote to my therapist three days after starting Wellbutrin, I wrote, “Unfortunately, I have not felt ‘better’ yet, which is disappointing. It’s not listed as a side effect, but I felt extreme fatigue . . . which for me always seems to worsen any depression I’m feeling.” I did not experience, as they (they being the voiceover narrators in all those commercials) say “worsening depression or suicidal thoughts,” or at least nothing I hadn’t dealt with before. But my depression did feel worse – not worse than it had ever been – but bad. And so I stopped taking Wellbutrin, and I almost gave up on the idea of antidepressants altogether. I won’t sugarcoat it: god, it just absolutely sucks to know you are trying. You are making the right steps. And it still isn’t working. There’s still a long journey to go. I felt this way when I realized I had to switch therapists. It feels like starting over, but it’s important to remember that it’s not. When you switch therapists, when you stop one medication to try a different one, it’s not starting over. You’re closer than you’ve ever been to getting it right.

It took me a month from the time I stopped Wellbutrin to give another medication a go. Frankly, I was terrified. I felt awful off medication, but I was terrified I’d feel worse on medication. It took another almost-failure of a camping trip to get me to try again. It’s always a wake up call when you’re unable or nearly unable to do the things you love. And so, given my skepticism of medication, my doctor and I decided to start me on the lowest dose of Lexapro. This time, I tried to adjust my mindset. I was so hopeful that Wellbutrin would make me feel better and quickly, that I was so focused on how I felt all day long. This time, I backed way off. I told myself that I was just taking a pill, like a vitamin, like a placebo. No expectations. I still monitored my mental health state – ensuring that any worsening symptoms would not go unnoticed. But I tried to let go of the hope that things would just *snap* change. After a month, things seemed neither better nor worse, so my dosage was increased. I kept the same mindset – no expectations, just take my pill every morning, ensure nothing felt super off, and keep going.

It’s hard to pinpoint exactly when things started changing. I think that’s due in part to my lack of hypervigilance over every change in my mental state. But, as I remember saying to my therapist, I also felt like I was throwing a ton of darts at the problem, just hoping one would stick. Around the same time I started Lexapro, I adopted my cat. I had dropped to part-time in order to focus more on writing my novel. As covid precautions started lifting, I became more social. It’s hard to tell if any one of these things played a major role in the bettering of my mental health. I relate to what Olympian Alexi Pappas states in her book Bravey: Chasing Dreams, Befriending Pain, and Other Big Ideas: “I can never know for sure what the single most helpful thing was for me, because in the end everything blended into one stew.”

But I do feel better. So much better. Sure, I still have a bad day every now and again. But what I consider a bad day now is so much better than what I considered a bad day a year ago. And I would argue that the bad days are fewer and farer in between, so that when I feel one coming on, I am more likely to rest and take preventative measures. Before medication, I felt like I was always on the defensive, always willing the bad days away. Now, I can finally be on the offensive. I can try to beat the bad days before they even come.

When I started taking antidepressants, I told people who were close to me, people who saw me nearly every day, people who I could confide in. It was a preventative measure, a “just in case” if something went really wrong with the medication. I feel confident in lauding the positive effects my medication has had for me; I wish I would’ve taken it sooner. But I still approach it cautiously and would urge others to do the same. Take the warnings seriously; check in with yourself regularly to try to understand what is happening in your body. Side effects are real. The first medication might not be the right medication. The dosage might not be right either. Trust your instincts.

And finally, it may not be forever. I stay vigilant on other fronts of my mental health – nutrition, exercise, rest, socializing, and therapy all play just as large of roles as my medication, if not larger, in combating depression and anxiety. I also think that adopting a cat is one of the best decisions I have ever made.

When I got that message from my mom about being “careful” with my medication, I immediately felt my defenses shoot up. She doesn’t know how much of my life, of myself, I’ve reclaimed these past several months, I thought. She’d rather me suffer day in and day out from depression and anxiety than chance a distant condition. I admit I probably got a little too angry, a little too defensive, even though I didn’t respond with these grievances. I think the thing I was most angry with was the close-mindedness and distrust I read in the message, whether she meant it to read that way or not. It is true, though, that I must trust a company I know next to nothing about, I must trust a government that may or may not have my best interest at heart, I must trust a system that has proven to have its many faults. But I do so because I trust the testimonies I’ve read, and now I trust my own experience. And of the possibility of a future in which I face a new illness due to years of antidepressant usage? Well, first off, yay for a future! At my worst with depression and anxiety, a future was not guaranteed by a long shot. And, second, we are inundated every day with reminders that tomorrow is not guaranteed. I just want to give myself the greatest chance at living my best today. And so I fight on, now without having as much to fight.