Suprise! I'm on anti-depressants
Who woulda thought?
I resisted for so long. About thirty-five years, to be precise.
There were a few spots on my otherwise unmedicated record. My mother slipped me a few valiums without my consent or knowledge when I was a teen. I would wake up late, feeling heavy and confused. In my mother’s defence, I wasn’t feeling anxious anymore. But the experience was enough to make me equate pills with a loss of control. Every other family member, including the dog, was on antidepressants. My abstinence was also a statement of my independence.
Then, in my early twenties, I walked into a metropolitan, anonymous medical centre. I denied feeling suicidal (a lie) but said I was in bad shape. I detail the interaction in my memoir, How to be Happy. It was rotten, but I walked away with two pills.
I took them and fell asleep for more than twelve hours. I felt more depressed and completely adrift. I didn't retake them.
When I took the pills, I was about twenty-two and my life sucked. I had no furniture, I’d broken up with my girlfriend and was standing on street corners begging people to sign up for an environmental charity. I ate like shit and barely exercised.
Now I'm thirty-five and my life doesn't suck. I have two kids, a beautiful wife, and a home we love. But despite black moods and constant irritation, I didn't identify myself as depressed. This felt different to my twenties. I was far from suicidality and had no trouble getting out of bed each morning. I was just white-knuckling each day to get to the end.
I was doing everything right for my mental hygiene, but my mental health was still suffering. I was sleeping well, exercising like a madman, meditating every day and taking cold plunges every morning. But nothing was shifting.
I have been in and out of therapy all my life. I hadn't been back in eighteen months, partly because I'd done so much cognitive behavioural therapy my brain was turning itself inside out.
I knew these mental habits, and I knew the tools to fix them. I implemented the tools as best I could, but I still felt like shit.
Let's be honest. There also must have been some part of my ego that didn't want me to go on anti-depressants. For all my writing on mental health and advocacy, I still clung to an adolescent version of myself that said I wasn't 'that bad'.
I also didn't believe they worked. I was suspicious of their half-life and even more wary that starting a prescription meant it was tough to get off. I'd keep having an escalating amount of meds until I died.
But I felt I didn't have any other option. After discussing things with my wife, I dropped everything one weekday morning and took myself off to a GP.
I'd never met him before, but he was brilliant. He was comprehensive, kind and straightforward.
I left his office with a prescription for Lexapro.
It's estimated 10% of Americans are on an antidepressant. The ABC reckons it's 1 in 7 Australians.
The most common type of medication is an SSRI, or a selective serotonin reuptake inhibitor. It blocks serotonin receptors in the brain, so you have more floating around in your system.
Turns out - and no one knows why - but SSRIs are highly effective in reducing depression and anxiety. They were first developed to treat seizures in epileptic patients. But now, they have medicated a decent chunk of the Western population for several generations.
Lexapro (an American brand name, I take a version of it) is one of the most common. Side effects are many and varied, but it's estimated as many as 70% experience some 'sexual dysfunction'.
I experienced this dysfunction as a slight drop in libido and difficulty reaching orgasm. For me to climax these days, I have to schedule a day off and remember to take hydration breaks. Premature ejaculations have never been an issue for me, but Lexapro is sometimes given to guys who want to slow down. I'm now so slow I’ve developed a repetitive strain injury in my hand.
Still, it's a small price to pay.
Does it work?
Yes, it works.
I felt floaty and weird for a week. My lousy mood vanished instantly. Life was stressful, but I didn't find it burdensome.
We were sitting in McDonald's, and two women started praying beside us. I found the scene so moving that I began to get teary.
'The medication is doing SOMETHING,' my wife observed.
Three months in, and things have stabilised. The blackness that I would feel in my chest has vanished. When I get irritated or stressed, I find it easy to let it go and return to a good mood.
For the first few weeks, I was obsessed with philosophical questions.
Am I still me?
The drugs change my thoughts, which change my behaviour, which changes my personality - so.....where does me finish and the drug start?
This is the confounding tangle of mental illness. Questions of reality and individual personhood get slippery. Frankly, I even feel this with caffeine. Most of the Western world has a personality baseline that is mildly caffeinated. Does that mean we're all not being ourselves?
Things get very spiritual very quickly. Any study of biology or physics means the eventual collapse of individual personhood anyway. There is no 'me', only a combination of systems that are constantly reacting and bouncing off itself. My gut microbiome contains worlds of individual bacteria, just as the city I live in is made of teeming life. All exist within a relationship to each other. Is it too reductionist to say that the introduction of a new drug is equal to me eating a new ingredient or a new highway in my city?
Probably. We like to think the brain is unique, superior to other biological systems. I could think about that rabbit hole for hours and probably make myself very anxious, but my medication encourages me to stop. Or am I just wiser now? Have I learned a new behaviour based on years of experience and gained insight?
I don't know.
And overall, I probably don't give a shit.
This is not an advertisement for the drug. It doesn't work for everyone. And the GP told me to keep my exercise up, keep a healthy diet, and go back to a psychologist. I've done those things.
Something is still wrong with the system when I need to wait six months for a psychologist and pay over a hundred dollars a session. My pills were available immediately and cost me ten dollars a month.
Yeah. There’s that.
I also know I'll try to get off these pills at some stage. I don't know when.
When it makes sense.
I don't know what that means.
I'll update you when that happens, one way or another.
I know I'm a better husband and father now than I was before. I know I'm a better writer. I can now make it through a day and a week without eating myself alive. That difference changes the family ecosystem around me, which allows that ecosystem to affect others too.
So from this little corner of civilisation, I wish you peace and health.
A beautiful and brave post, Dave x