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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Yes, We Need Psychiatric Labels

Recently I stumbled upon a Huffington Post article by one Dr. Peter Breggin, who lists himself on HuffPo as a “reformed psychiatrist.”

This should’ve told me everything I needed to know, but I read on.

The article is titled “Our Psychiatric Civilization” and tries to make the tired point that in this day and age, we are defining ourselves by our psychiatric diagnoses and not by anything else. It’s difficult to fully dissemble this argument because Breggin unceremoniously shoves so many unrelated arguments into the same sad little article, but his main points seem to be:

  • Psychotropic medication is overprescribed.
  • Psychiatric diagnoses (i.e. major depression, bipolar disorder, ADHD, etc.) oversimplify the human condition.
  • Back in the good ol’ days, people apparently did a lot of spiritual soul-searching rather than resorting to all those damn pills.
  • The way people connect in our culture is through their psychiatric diagnoses.

I honestly don’t know which planet Breggin is living on, but it’s certainly not mine. I’ve addressed the overprescription crap elsewhere so I won’t talk about that now.

As for the second point, this is, to a certain extent, true. Psychiatric diagnoses DO oversimplify one’s psychological state, but that’s because you have to have a starting point. If you’re diagnosed with ADHD, you know that, some way–whether it’s through medication, therapy, or some combination of the two–you need to learn how to focus your attention better. If you’re diagnosed with major depression, you know that you need to somehow learn how to fix your cognitive distortions and become more active. If you’re diagnosed with seasonal affective disorder, you know that you need to do things that counteract the shortening of the days–use a full-spectrum lamp, take vitamin D supplements, etc.

Just as knowing that I have, say, asthma or the flu doesn’t describe the full state of my entire body, a psychiatric diagnosis isn’t meant to describe my entire psychological condition. Breggin seems to think that we live in a world where all we know about each other is what pills we’re popping, and nothing else. This is ludicrous. In fact, that’s something we don’t often know, given the stigma that still exists regarding mental illness.

Breggin goes on to claim in a condescending way that there’s no reason for people to connect with each other based on psychiatric diagnoses at all:

Patients ask me, “Should I join a bipolar support group?” If I were flippant, which I never am with patients, I could respond, “Only if you want support in believing you’re bipolar and need to take psychiatric drugs.”

My first thought upon reading this drivel was, Thank G-d he doesn’t say this to patients. My second was more like, What the fuck?

The idea that seeking support from others who face similar issues as you is somehow disempowering and promotes seeing oneself as a victim is quite possibly the most batshit stupid thing I’ve ever heard from someone whose profession is helping the mentally disordered. Shockingly enough, people like to feel like they’re not the only ones with problems. Perhaps this has truly never occurred to Dr. Breggin.

Quite the contrary, I have benefited immensely from connecting to other people who have depression and other mental disorders. Many of my friends have one, and together we’ve formed a sort of support network. All of us can always count on having someone to talk to, and those of us who aren’t as far along in the process of recovery as others can ask friends for advice. I don’t know where I’d be right now without that.

(Maybe in a perfect world, we could just have support groups called “Fucked-up People Support Group,” but somehow this seems counterintuitive.)

Anyway, psychiatric diagnoses can also be immensely helpful in explaining to healthy friends and family what the deal is. While Breggin seems to think that “depressed” is some sort of insulting, disempowering label I ought to reject, let me tell you some of the labels that my close friends and family described me with before they knew I had depression:

  • overdramatic
  • overemotional
  • bitchy
  • attention whore
  • immature
  • insensitive
  • selfish
  • crazy
  • weird
  • fucked up

Yeah um, I’d take “depressed” over that any day.

Not surprisingly, you don’t make a particularly strong case for yourself when you try to insist to people that, no, it’s not that you’re really overdramatic, it’s just that you have this problem with, well, being overdramatic, and you’re trying to work on it, you promise!

Trust me, that doesn’t work. What does work is saying, “I have a disorder called depression that distorts my thinking and sometimes makes me act in a way that seems overdramatic. With therapy and medication, it’ll improve.”

Apparently, though, Dr. Breggin is much too intent on destroying his own profession to allow those with mental illnesses even that small comfort. After all, he makes it pretty obvious that the reason he hates psychiatric labels so much is because they make it possible to prescribe medication, and that, of course, is a big no-no.

If I got a dollar every time some well-meaning fool tried to inform me that the medication that saved my life is unnecessary, I would have enough money to actually afford a therapist.