Dr. Fox was recommended to me countless times over the last ten years. She had a reputation for being the very best at finding the “right cocktail” to alleviate depression, anxiety, ADHD or any combination of these. I finally tired of feeling like a woman who lived in a parallel universe alongside millions of happy, well-adjusted, luckier people, and went to see her.
My general practitioner, who fully disclosed that she herself was not an expert at diagnosing or treating psychological problems, had given it the old college-try anyway by prescribing me Celexa (it worked by blocking my ability to feel sadness and happiness with an impressive lack of discrimination); Wellbutrin (to combat the fatigue brought on by the aforementioned Celexa – it didn’t work); Paxil (no dice; it made me sweat like some sort of Olympic athlete and I irreparably stained all of my white blouses under the arms within a matter of months), and Cymbalta (it didn’t work but I got a lot of freebies because a pharmaceutical rep had left her a small fortune in samples, which she was happy to toss in my direction). Eventually she recommended that I take my pesky problems to Dr. Fox.
“She’s the best,” she said.
I hoped so, because I needed the best. And fast. A move to a town in which I knew no one coupled with a divorce shortly thereafter had left me bereft. I’d experienced depression my entire life, and so had my siblings and father to varying degrees of severity and frequency. By this point, I was completely convinced that I’d been born with bad genes and a measurable lack of fortitude and resilience.
Oddly enough though, when I was okay I was more than okay. I wasn’t manic, but I embraced life. I was born to love and find joy in the little stuff – my first cup of coffee, a free hour to read a great book, the anticipation of a night out with my girlfriends. Any or all of those things could bring me an almost spiritual level of happiness. I had many, many soul-level friends and I was charming, social and smart. When people met me, it wasn’t at all uncommon for someone to send me an email the next day to invite me over for dinner or out for a glass of wine. I was likable. I even liked myself most of the time.
But when I wasn’t okay, I was not okay. I would be struck with a darkness so dark that I would disappear from the world for a few weeks, retreating to my bed or praying relentlessly that someone would spare me from the pain – from one more day of sadness and suffering. Often these depressive episodes would follow a financial disappointment or a perceived failure of some sort. I lacked the tools to help myself, and so I allowed myself to fall deeper into despair, knowing that I was not strong enough to fix it.
The divorce and the move resulted in more than a situational episode of depression. I was numb, unmotivated, unable to breathe without crying, and unbearably lonely.
Dr. Fox had a beautiful downtown office with exposed brick walls, high wooden beams, lime-colored plush chairs and a library of psychological publications and New Yorkers. If she wasn’t the best at fixing depression, then she sure was the best at making a lot of money pretending she could. She also didn’t take insurance, so I was about to pay her more than I could afford to fix me. I was going all-in.
She greeted me with disinterest and intensity at the same time. Smart, no-BS, and well-dressed, Dr. Fox was impressive if not a little intimidating. She conducted our 90-minute intake with a complete lack of reaction, asking for more detail when needed but making it clear that this was not a therapy session and I was not to seek solace or a sympathetic ear. I didn’t want one. I just wanted her to figure out which complex combination of drugs would finally help me be my old self again.
She informed me that it was her practice to start her patients on one drug at the lowest possible dosage, then cycle in other drugs to fill in the gaps as needed. She warned me that this would take time and regular appointments and check-ins. She was kind enough to offer periodic phone check-ins in lieu of an office visit to mitigate some of the financial strain. She also told me that she would be trying some medications that I may have tried previously, and she relied strictly on my memory and recollection of experiences with these drugs, not medical records.
Over the next year, I went on and off what seemed to be every SSRI on the market – upping my dosage, monitoring the results and then replacing one with another or removing them altogether. It took about 6 months for us to arrive at a cocktail with which she seemed satisfied. My check-ins became less frequent. Though I didn’t feel like a new person in any sense, I wasn’t stuck in my bed anymore. I was generally functioning, if you consider a lack of emotion functioning.
I ended up on 100mg of Pristiq, 100 mg of Lamictal (“You’re not bipolar, but it will even out your extreme moods”), 30mg of Adderrall (“Depression often results in an inability to focus”) and 100mg of Vyvanse (I can’t recall why I was prescribed this one – perhaps because I commented that the Adderall high was wearing off mid-day). I was also in debt from the thousands I was now spending on seeing Dr. Fox and paying out-of-pocket for Pristiq, for which my insurance company refused to reimburse me due to other similar options like Effexor. I stopped seeing Dr. Fox, save the one monthly visit to her office for a written Rx for my narcotic medication, given to me curtly by the receptionist.
I sent Dr. Fox a Christmas card thanking her for saving me from losing everything.
Little did I know, I was losing everything again, only I had no idea why.
A year after I first saw Dr. Fox, I was reincarnated as a dull, physically exhausted, mentally and emotionally fatigued woman with no sense of humor, absolutely zero desire to socialize or leave my home, and no urgency to go to work or attend to my chldren’s busy lives. And to make things even more interesting, I was addicted to Adderall and Vyvanse, often taking 30 pills in five days because they were the only thing that temporarily made me believe I was happy. I was a pill-popping zombie.
Here are a few other things that happened in my new life:
• A lifelong runner, I had completely given up all forms of physical activity because I was either too tired or too hyper-focused on some Adderral-induced activity such as bleaching the grout between my kitchen tiles.
• Laughing was something I no longer did. In fact, I am pretty sure that I hadn’t laughed in more than a year.
• My three sisters, with whom I had shared an indelible bond in my former life, hadn’t heard from me in a year and a half despite their ceaseless attempts.
• I missed appointments, meetings and nights-out with friends so frequently that I simply stopped keeping a calendar of any kind because I didn’t care anyway.
• I no longer had any interest in painting, reading or cooking – all things I had previously found therapeutic and intensely enjoyable.
I had found drugs… and a brand new life. Unfortunately, the life I’d found was void of humanity and joy.
Fast-forward two years to today. Through a series of highly unfortunate events, I was forced to say goodbye to all of my pill friends save the Pristiq, from which I am still fighting to free myself. The brain zaps, sick stomach, inability to stand up and put my leg into my pants without falling over and the uncontrollable crying when I try to wean myself off of it preclude me from being successful.
I lost almost four years of my life, and I’ve not a doubt that it was due to those “life-saving” pills. To that end, they did work. At a time when I was doubled-over with depression, those four prescriptions kept me alive. But then they killed me slowly and brought me back as a stranger. My memories of the last four years are foggy at best; I fake remembering when my friends bring up a funny story we shared together. But I don’t remember.
I am exercising again after losing my long, lean runner’s legs and healthy heart to a sedentary life on the couch. But it will be a long road to my prior physical self.
I have recently started laughing again – sometimes hysterically. And every time I laugh it makes me want to cry because it reminds me of all the years I couldn’t.
I still don’t feel like myself. The Pristiq makes me very tired and it takes the passion out of most things. I feel sad every time I reach for that ugly orange bottle at noon to take my daily dose. When I have just one pill left, I consider what would happen if I failed to refill it; and then I just become paralyzed with fear. What if it is the one thing that is keeping you from going crazy? What if it starts all over again?
What happened to Dr. Fox? I don’t know. I often wonder if she kept my Christmas card in a drawer somewhere in her office, or if she considers me one of her professional success stories. But most of all, I wonder what I would write in that card if I were to send it today. I think it would probably go something like this:
“Dear Dr. Fox, You probably don’t remember me, but I came to see you four years ago and I just wanted to let you know that you changed my life….”
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.