Goodbye Lexapro

[TMI Warning]

Today marks the end of an era of my life.

Today I took my last dose of antidepressants, and tomorrow, for the first time in a year and a half, I will get up in the morning and (purposefully) not take that pill again.

I went on Lexapro as a last resort in July 2010. I won’t go into all those details here since I’ve written about it before, but I’ll say that, at the time, I had no other choice. When a body has been critically injured, it enters a coma. I was in the mental version of that.

Lexapro did a lot of things to me, some expected, some not so much. I stopped crying every day and wanting to kill myself, at least for a while. I also became, according to my friends, more lively, more social, and visibly happier.

But then, there was the other stuff. Lexapro broke up the one meaningful romantic relationship I’ve had in my life. (Was it destined to break up anyway? Now I’ll never know.) It altered my values and beliefs for some time and turned me into the sort of person I would’ve hated a few months before. Now I’m back to my normal self, thankfully.

It was also a cruel helper at times. If I missed just a day of it, I’d be a wreck by nightfall. If I missed two days, the withdrawal symptoms kicked in, and they were horrible. I’d be dizzy, nauseous, barely able to walk, completely unable to explain to people why I was suddenly sick when I’d been fine just that morning. (“Sorry, I’m going through drug withdrawal” isn’t really an effective explanation for most people.) The worst symptom of antidepressant withdrawal has no official name, but depressives refer to it as “brain zaps.” They’re momentary sensations of being shocked or stunned in the head and they happen every few minutes or so, or even more often.

Theoretically, of course, there’s no need to ever miss a day of a prescribed medication, but when you factor in insurance issues, CVS’s constant fuckups, weird sleeping schedules, and other crap, it happens pretty often. I remember one awful time when I forgot to bring my medication back to school from break with me and I had to get my parents to ship it. Those were an unpleasant few days. Another time, my psychiatrist refused to renew my prescription unless I came in to see her, but I’d already be back at school by the time she had her first available appointment slot, and there was no way I could skip classes to drive six hours home to Ohio. She wouldn’t budge.

I’m not going to go into a whole condemnation of psychiatry or the pharmaceutical industry because they gave me back my life. However, I will say this: there is so, so much work to be done.

My psychiatrist prescribed me Lexapro after a nurse practitioner talked to me for ten minutes, and she for about five. She said that “academic stress” was causing my depression and that antidepressants would help me deal with it. She must’ve missed the part where I said that my depression started when I was 12 years old. She also apparently missed the glaring cognitive distortions and emotional issues I was having, and had been having for years and years. She oversimplified my problems and thus prescribed a simple remedy.

It took a while to even begin to sort out what the problem really was, and I’m still not there yet.

Some other things my psychiatrist didn’t tell me: the personality changes. The withdrawal symptoms. The fact that I was more likely than not to have a relapse (which I did). And, of course, the fact that you don’t really recover from depression. You only learn how to avoid it for bursts of time.

That was stuff I shouldn’t have had to learn through experience.

Now I look at that almost-empty bottle and I just can’t look at it with a sense of gratitude. I will never be an enthusiastic advocate of psychiatry, though I will continue fighting for the rights of patients to obtain complete information about medication and to make their own decisions.

I look forward to the end of that daily reminder of what I’ve lost. For the past year and a half, I have started every day by taking Lexapro and remembering that I’m not okay. Now I won’t have that anymore. Now I’ll be able to go half the day, maybe even an entire day, without thinking about that part of myself.

I’m not nearly naive enough to think that this is the end. For all I know, I’ll be back on the medication in a month. I’m almost certain that I’ll be back on it within the next few years.

But for now, at least, I’m done with it.

For now, the only things I’ll be taking in the morning are a multivitamin and a shower.

Normal, just like everybody else.

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My Facial Expression is None of Your Business

[Snark Warning]

I am not a cheerful person. I don’t wear my happiness on my face, and I do not consider it my moral duty to brighten the day for perfect strangers.

I am an introvert despite the fact that I’m usually pretty friendly and sociable when spoken to. Most of the time, I inhabit a world that nobody really knows. When you see me sitting still with a facial expression that is technically neutral but that many would characterize as “glum”, I’m actually anything but. Usually I’m making up music, writing my next blog post, planning out my love life or my career, or analyzing people I know, all silently in my mind.

But most people don’t bother to ask what I’m doing that’s taking up so much of my attention that I haven’t bothered to plaster a smile onto my face for others’ benefit. Instead, they assume.

And so it begins. “What are you looking so miserable about?” “What’s wrong with you?” Or, simply, “Smile!”

Some of these responses are passive-aggressive attempts to chastise me for not doing my womanly duty to keep everyone around me happy at all times. Others are genuine attempts to understand me, or genuine concern that I might be in a bad mood.

What they all have in common, though, is the shared assumption that underlies them–that there is something “wrong” with my facial expression and that this fact is anybody’s business but mine.

It’s not only people that I choose to associate with who claim the right to dictate what should be on my face. What woman hasn’t walked down a city street, perhaps on the way to work or to run errands, and encountered a random man yelling at her to “Smile!” or “Put a smile on that beautiful face!”?

Such remarks, which feminists call “street harassment” and most non-feminists call “a compliment,” represent the most glaring and offensive of non-physical intrusions into a person’s private self. My facial expression is even less the business of a total stranger on the street than it is of a person who does know me.

(Speaking of feminism, my inner feminist compels me to ask: how often are men publicly berated for the arrangement of their facial features? Quite the contrary, moody, brooding men are often considered very sexually appealing in that mysterious way. A moody, brooding woman, on the other hand, is usually called “difficult” euphemistically, or just “a bitch” if we’re really being honest.)

This issue is intimately related to something I wrote about just recently, on the concept of Debbie Downers and how sad or negative people are constantly accused of “bringing people down.” In contrast, this situation is even more absurd because the facial expressions in question usually aren’t even negative; they’re just neutral. They’re just missing that socially mandated smile. But if you read my argument for why people shouldn’t allow themselves to be “brought down” by “Debbie Downers,” you’ll see that it applies just as well for those of us who, for whatever personal reason, choose not to go about grinning like maniacs.

Furthermore, lest anyone attempt to feed me platitudes about how people who concern themselves with my facial expression are just worried about my mental wellbeing, let me ask you this: when you’re concerned about someone, do you ask them privately if everything’s okay, or do you draw attention to them in a group setting and demand to know why their face looks the way it does?

(For the sake of your friends, I hope you choose the former.)

What strikes me as most ironic about all of this is that, for all the constant blather I hear about how the unappealing configuration of my face means I’m “selfish” and “don’t care” that I’m “upsetting” people and whatnot, I’ve chosen a life that’s infinitely more helpful to those around me than many other possibilities. I’m going to be a therapist, which means that, yes, it’ll be my actual job to help people feel happy. If that’s not more important than my transient facial expression, I honestly don’t know what is.

Moral of the story (or tl;dr, for my fellow internet nerds): If you don’t like what my face looks like, don’t fucking look at it.

An example of my neutral facial expression. No, it is not a personal insult to you.

Some Thoughts on Depression

[TMI Warning]

About five months ago, I wrote a post on Facebook (and on this blog) about my experience with depression and how I came to receive treatment for it. I remember feeling very triumphant as I wrote it, because I felt like my difficulties were finally over.

This turned out to not exactly be the case.

In January, perhaps precipitated by some unfortunate personal circumstances, I relapsed and have been trying, mostly unsuccessfully, to recover ever since. The months since then have been filled with a lot of self-loathing, many random bouts of crying (daily at times), and much speculation on my part as to whether or not I really belong in this world.

This is when I realized that my problems, whatever they may be, don’t simply go away when I’m not depressed. I don’t “invent” the issues that I’m unhappy about. But being healthy makes it easier to ignore the pain in the back of my mind–all the wasted opportunities, lost friends, and scarring memories that have built up over the years like dust on a windowpane. When I’m healthy, I simply don’t think about it, and consequently I’m happier. But the mockery that I’ve made of my life isn’t a figment of my imagination; it’s quite real.

~~~

I also started to realize, perhaps even more than I did when I wrote that post, how little the healthy world knows about depression. Mental illness is truly the last taboo; many people refuse to even consider dating someone who has it. Kinda makes me reconsider being so open about my experience…

Even people who would otherwise be supportive just don’t know enough. For instance, if you know your friend is a diabetic, would you offer her a piece of cake? Probably not. But would you casually make fun of your depressed friend? Unfortunately, many people would, even though teasing and jokes are things that many depressives have a lot of trouble with. (This is because depression often causes a cognitive deficit that makes people take everything–a snappy tone of voice, an odd glance, a sarcastic remark–very personally. Here’s a great guide to cognitive distortions.) I am always analyzing and picking apart things that people say to me to try to figure out if they were just teasing or not. I am terrified of the threat of rejection that these casual utterances may carry, so I am always alert, always on my best behavior.

~~~

Another thing I’m never sure of is which parts of me are depression and which are simply me. I’m a skeptic, a cynic, and generally not too big a fan of things that most people seem to really like (Exhibit A: this). I don’t fit in with my surroundings in many ways. I’m more complex, polite, caring, respectful, quiet, conscientious, serious, passionate, emotional, and sensitive than most. I’m less assertive, flaky, impulsive, cheerful, “chill,” and casual than most. This makes for a great number of personality differences between myself and most people I know. When I’m not feeling depressed, these differences fade into the back of my mind. But when I am, they come right to the front, putting up a wall between me and the rest of the world, making me feel like I’ll be an outcast for life.

~~~

One more realization–Northwestern might be the worst place in the world to be depressed. (Not that there’s really a good place for that, except perhaps the psychiatric ward of a hospital.) It’s isolating, stressful, and miserably cold from October till May. Your peers churn industriously around you like a hive of North Face-clad bumblebees while you vegetate listlessly in your shitty shoebox room and email professors, friends, student group leaders one by one and tell them that you’ve been ill and cannot come to whatever crap you’re supposed to be at that day. You eat Nutella from the jar and wonder why none of your friends care. You wonder why you expect them to care. You sleep, a lot.

Northwestern also happens to have entirely inadequate mental health services, but that’s a topic for another post. My friends and I are working to change that. But for now, this is a really, really unfortunate place to be depressed.

~~~

And that’s it, really. I’m not entirely sure where I’m going now, but hopefully it’s somewhere good.