“I didn’t know what I didn’t know,” my mother says while I’m measuring a cup of flour for a batch of muffins. It’s been five years since I recovered from severe antidepressant withdrawal. Six years since I took my last antidepressant. Twenty years since I was first put on antidepressants as a teenager, in the wake of my father’s sudden death.
“All I knew,” my mother continues, “was that one day, the child psychologist called me and said, ‘You’re wasting your money. What Brooke needs is a psychiatrist, not a psychologist. I’m diagnosing an anxiety and depressive disorder and you should consider medication.’ When I asked for an explanation for this conclusion, she said she couldn’t tell me anything because of HIPAA. I’d just lost one third of my family and I couldn’t bear the idea of losing two thirds. The professionals recommended medication. I wasn’t a doctor. What else was I supposed to do?”
I nod, wiping off a measuring cup. I’m thirty-six now, back in my hometown after being away since high school. The homecoming has turned into a reckoning, allowing me to wander back through time and follow the thread of responsibility that ultimately robbed me of so much of my life. Every day I drive by statues of my past. The childhood home where I took my first antidepressant. The hospital where my father died. The child psychologist’s office. Every day I wonder who I might have been if that doctor—and all the doctors that followed—made a different recommendation.
It all happened so fast. It was 2001 in Reno, Nevada. Rifles casually rested behind couches and dial-up internet was a luxury. Generic Prozac had been recently cleared for sale. All it took was a single twenty-minute appointment with the local child psychiatrist to get a script. Sertraline gave way to venlafaxine and fluvoxamine led to bupropion. Grief turned to gray and gray became standard. I never questioned the adults around me or wondered if the medications were necessary. Of course they were necessary. A doctor said so.
Soon, my hair was falling out in clumps. I woke up in the middle of the night with excruciating leg cramps. Sometimes I randomly threw up bile. A blood test showed low thyroid function and an endoscopy confirmed Bile Reflux Disease, an uncommon condition where bile from the liver backs up into the stomach. Two doses of Synthroid and four doses of Sucralfate were prescribed for hypothyroidism and Bile Reflux Disease, respectively. Finally, I was given the standard American teen prescription for birth control, which was followed by a script for tetracycline to treat stubborn acne. All in, I was on seven different medications by the time I was old enough to order a beer. I would stay on this set of drugs for the next fifteen years.
“It all seems so obvious with beautiful hindsight,” my mother says as I stir the muffin batter. “You got on these antidepressants and suddenly we’re at the gastroenterologist every two minutes. I thought they were separate issues. No one ever suggested to me that the antidepressants could be causing all these physical symptoms. Did any of your doctors in college or in New York ever make that connection?”
I stop stirring the muffins and think back. I saw my college psychiatrist four times in four years. She was somewhere between middle-aged and elderly, kind-eyed, gray-haired, and clad in plaid button-downs and Birkenstocks. She wore her hair in a braid that hung over her right shoulder and didn’t push me to talk when it was clear that I was just there to do my due diligence. I liked that about her, and I liked the comfort of walking out of her office with a fresh new stack of prescription slips. Each scribble validated the melancholy, the lack of ambition, and the aimlessness. I was big-D Depressed. Broken enough to need pharmaceutical fixing. Broken enough not to expect much of myself or my life. Broken enough to give up trying to help myself, and young enough to think I had it all figured out.
“No one mentioned it in college,” I say, returning my attention to slipping muffin liners into tins, “and it’s not like I would have listened anyway. When you’re twenty and still in college, it’s cute to pretend you’re deep and depressed and that no one can truly understand you. But I do remember moving to Manhattan and thinking, ‘I live in an apartment. I am in charge of feeding myself with food not found in a dining hall. It’s time to at least try to get my shit together.’”
“And that’s when you went to see that awful German psychiatrist?” my mother says. “What was her name again?”
“I can’t remember,” I say, licking batter off the spatula. “I always thought of her as a lady-version of Freud, dressed in a cherry-red pants suit. I wish I had some idea of who she was, because I’d be curious to see if she still has a medical license.”
Dr. Ladyfreud was considered one of New York City’s Best Doctors, at least according to New York Magazine. She was listed as part of their annual “Best Of” issue, right next to “Best Custom Woodworkers” and “Best Psychics in New York.”
At twenty-two years old, I operated off the idea that all doctors were created equal, so it didn’t occur to me to question the idea of picking a psychiatrist off of a list printed right next to a hierarchy of New York City’s best artisanal mayonnaise. Besides, Dr. Ladyfreud was taking new patients and was in my insurance network, two requirements that proved tricky to find.
I wandered to Dr. Ladyfreud’s office on a sunny fall day, just as I was settling into my new New York City life. The bright outdoors gave way to a dark waiting room, with blue felt chairs, a male receptionist behind a glass plate.
“Before you see Dr. Ladyfreud, she needs you to watch a video and take a test. It’s about forty-five minutes long,” the receptionist said, leading me to a six-foot by six-foot room, with a single chair and an old TV. He handed me a stack of paper and a pencil. “When you’re ready, just push in the tape and press ‘play.’”
He gestured to the VCR below the TV.
“I’m sorry,” I said, confused. “You want me to take a test? Can’t I just see the doctor? I want to talk about the medication I’ve been on for six years.”
“This is part of her diagnosis. She’ll go over your results with you after you’re finished. When you’re done, just come out and find me.”
He walked out the door and turned off the main light, leaving me with nothing but the glare from the TV to illuminate my test.
I sighed and started the VCR. The old TV flickered until the intro credits ran, and soon Dr. Ladyfreud, in the cherry-red pants suit, was talking to me in a thick accent from the screen.
“Hello. I am Dr. Ladyfreud. Thank you for coming to my office. Please take this time to watch the following video closely, and to answer the corresponding questions on your test, as the video instructs. You will be given plenty of time to answer each question. Do not skip ahead and be sure to watch each part carefully before answering. It is very important that you are honest in your answers. We will begin the test now.”
The video cut to another introduction, this time with a man telling me that after he asked each question, he would pause to give me time to answer.
“Question number one,” the man continued. “For no obvious reason, I sometimes have been very angry or hostile. Answer: Not at all. Just a little. Somewhat. Moderately. Quite a lot. Very frequently. Using your pencil, please circle the option on your test that best answers this question.”
Quick to anger just like my father, I circled “moderately” and waited.
“Question number two: At times I am much more talkative or speak much faster than usual. Not at all. Just a little. Somewhat. Moderately. Quite a lot. Very frequently.” I circled, “Sometimes.” Doesn’t everyone talk faster when they’re excited or in a hurry?
I let the next set of statements come and go, growing frustrated as I realized how long it would take for the man to move on to the next question.
“At times I am much more interested in sex than usual.” Not at all.
“At times I have thoughts of death, such as not wanting to wake up in the morning or continuing thoughts of suicide.” Moderately.
“At times there have been great variations in the quality or quantity of my work.” Moderately.
“Despite getting a lot less sleep than usual, I find I am rested and full of energy.” Not at all.
“Sometimes I am mentally dull and sometimes I think very creatively.” I lose my patience with this question, realizing that this video is about determining whether or not I have bipolar disorder. I know I’m not bipolar. And even if I was, I knew it shouldn’t be diagnosed through a videotape.
I stopped the video, thumbed through the rest of the test, and went back to the receptionist. He looked at his watch and said, “It hasn’t been forty-five minutes yet.”
“I’ve always been a fast test taker,” I said, slamming the papers on the desk. I considered walking away from the appointment, but I only had one refill remaining and had already paid my copay. If nothing else, at least I could get a fresh script and save myself from this hell for another few months.
Dr. Ladyfreud called me into her office and I found her sitting behind an executive desk in a room adorned with all of her certificates, awards, and of course, clippings from each of her Best Doctor in New York mentions. I sat with her for ten minutes, told her all the medications I was taking, that I didn’t think I was bipolar, and that I was only here to talk about getting off my antidepressants or get a refill. She seemed to look through me in between glances at my test, telling me in her thick accent, “For patients like you, I do not recommend going off the medications as some of the answers on your test could be a problem.” At no point did she ask me to elaborate or ask me why I was put on the drugs. Even though I sat right in front of her, I was nothing but a data point.
“Come back when you are out of refills and we will talk then. You can make another appointment out front. Thanks for coming in.”
“I remember when you told me that story,” my mother says, peering into the muffin tins as I scoop batter into the liners. “I couldn’t believe it.”
“One of New York City’s best,” I say.
“If that was one of New York’s finest, I wonder what New York’s worst were doing.”
“Well, if my Manhattan general practitioner was any indication, they were taking new patients without giving a physical. He welcomed me to New York City, asked if I was happy with the balance of my meds, and sent over a prescription to the pharmacy. It was easy and mindless. Far less work than having to drag myself around town, spending $50 per copay, trying to find a psychiatrist who ‘got’ me. No one seemed concerned, so why would I question it?”
“I questioned it,” my mother says. “As the years went by, you seemed to be on this downward trajectory. But I knew there was nothing wrong with you. Every time I suggested that maybe the meds were part of the problem, you shut me down.”
“I guess I couldn’t hear you. I was so depressed on the drugs I couldn’t imagine how bad I would be off them.” I wipe drops of batter off the edge of the muffin tins and put the muffins into the oven. “But when I turned thirty and it dawned on me that I’d been on these drugs for more than half my life and yet I was still thinking about suicide, something finally clicked. I shouldn’t be this depressed after fifteen years of antidepressants.”
“You were finally ready,” my mother says.
I go quiet, thinking about what came next. What agony might have been avoided if I’d done more research on how to get off antidepressants? Or if I’d gotten a second opinion? Antidepressant withdrawal wasn’t an unknown occurrence in 2016. Major newspapers weren’t yet writing articles on the topic, but Giovanni Fava’s research was out there and a robust support network existed on the internet. I was thirty years old and ready to do everything right. I was ready to cooperate with a doctor who could help me. I was ready to stop fighting. I was ready to believe in the possibility of a different life, a better life.
I did everything I was supposed to do. I found a new psychiatrist and told her everything, about my dad dying, the decade and a half of drugs, the desire to get to know myself as an unmedicated adult. When she said she didn’t think it was a good idea for me to change up my meds during a time of stress and change, I pushed back and said, “Something about what’s going on with me isn’t working. I don’t know if it’s the wrong antidepressants or if these ones don’t work anymore or if I’m just so fucked in the head that this is how it’s going to be forever. I don’t see how I’m supposed to get the answer to any of those questions without getting off the prescriptions to figure out my baseline.”
She looked at the clock. Scratched something on her clipboard. Sighed and shook her head.
“If you decide to move forward with this, I think it would be better for you to try going off them one by one, starting with the Effexor because you’re already on the lowest dose so we can’t taper. The Effexor is more likely than the Wellbutrin to have withdrawal effects.”
I didn’t know that this was terrible advice, and that cold-turkey cessation of Effexor—even at the lowest dose—could set off a cascade of agonizing, enduring withdrawal effects.
“How long does all of this last?” I asked her.
She shrugged. “I can’t really say. A few days. Maybe a week. I hear it’s a little like having the flu, but it’s different from person to person. I can prescribe you Prozac to help manage those side effects. Stop taking the Effexor and see how it goes. Here’s my card. Call the office if you have questions and let’s make an appointment for a month from now.”
The oven timer beeps, and I am pulled out of the memories of withdrawal: an intolerable sensitivity to light and sound, rage so strong I bent a metal ironing board in half, graphic homicidal visions, the fear of telling my psychiatrist about all of it in case she put me on an involuntary 72-hour psychiatric hold.
“I always thought getting off the antidepressants would be as easy as getting on them. It never occurred to me that following the psychiatrist’s advice would blow up my life,” I say, turning off the timer. My mother dabs her eyes with a tissue.
“I was somehow in some sort of denial about that early on,” my mother says. “I remember one time when you came home from college and you ran out of your meds. It was a scramble to get you a refill. And you were really on edge. It didn’t land on me that we were looking at withdrawal.”
“Because it wasn’t mentioned one single time in the decade and a half I was on those drugs!”
I take the muffins out of the oven and place them on the counter, remembering how I once brushed my arm against a hot pan in the middle of antidepressant withdrawal. The burn wasn’t severe, but without the numbing armor of antidepressants, I nearly passed out from the pain. Though the scar from that burn faded long ago, emotional scars still remain.
“You were the only one who saw me as whole,” I say.
“I didn’t know how important it was at the time, but now I see that it’s critical,” my mother says. “Psychologists and psychiatrists need to view their client as whole, not as broken. Because if your doctor views you as broken, you’re going to think you’re broken.”
I ask my mother, “If you could project the ten/eleven-year-old me onto the choices I made in my late teens and early twenties, after I was medicated, do you think I would have made the same choices?”
“No,” she says. “You always said how the antidepressants dulled you, so there was no reason to have any ambition if you didn’t want to live. And so if at fifteen, we had let you grieve, and we had allowed all that depression to leave you, you still would have been the intense child that you were at ten and eleven. But you wouldn’t have been robbed of your ambition, and your joy of life. And you wouldn’t have felt so diminished.”
I hand my mother a warm muffin and watch as she peels back the paper. The warm heat from the oven and the smell of sweet banana fills the kitchen, overwhelming my senses. It is little moments like this, of time slowing down as I feel into life’s sensations, that I now latch onto. They are reminders of how far I’ve come, because the person who spent fifteen years anesthetized on antidepressants couldn’t appreciate the smell of a fresh-baked muffin or find gratitude for quiet mornings spent with the woman who gave me life. That’s what antidepressants took from me.
But it isn’t the decade and a half of hallmark experiences that I miss. It’s the years of beautiful in-between. Every flutter of a leaf. The feel of cool water across skin. The stillness just before dawn. It is the in-between that determines the richness of our life, and it is the in-between that antidepressants censor. Maybe some doctors are okay with making that sacrifice for the young and the vulnerable. But it makes me think that they too have long forgotten how to feel. Because if they knew what I know now, they would make a different choice.
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.
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