What Isn’t Broken, Part 1: A Temporary Fix

I remember the time I took my very first antidepressant pill. I was just eighteen years old, still in high school, living with my parents. I remember being so nervous as they sat me down at our kitchen table, looking at me with their sad, sorry eyes.

I remember thinking it felt so wrong, expressing concern that it was going to change my personality, numb my emotions, and inhibit my creativity and artistic expression. I remember being told that these were unfounded fears, that I only felt that way because of “the stigma,” and that it would actually do the opposite: restore my creativity and help me get back to my “old self” again. I remember them convincing me I had a diseased brain, that they were so worried about me, and persuading me to just take it. They made me feel so guilty. It wasn’t about me, it was about them. I knew I wasn’t getting up from that table until I took that pill. Once I did, they patted me on the back for “doing the right thing,” saying that it was truly necessary and only temporary, after all.

I was the one who had asked to go to the doctor to get diagnosed, just a few days prior. So it felt like it was my fault that it led to this. I didn’t want a diagnosis to be put on meds, I wanted a diagnosis in order to validate the pain I was in and to be taken seriously by the adults around me. Because apparently, my parents did not perceive me as a reliable narrator when I expressed it to them myself. I’d been telling them for years, yet they were always dismissive and disbelieving. When they wouldn’t listen to my words, I would show them — by cutting myself or not eating. At worst, they wouldn’t notice; at best, they would absolutely freak out, unable to understand why I would do such a thing. Even then, they still refused to acknowledge the emotional pain itself, let alone address its causes; they only wanted to squelch the symptoms.

The doctor had assured me (and my overly controlling mother, who still insisted on coming to my appointments) that these “medicines” were “safe and effective.” They were not “addictive” and therefore would not cause withdrawal; it would be as easy to stop as it had been to start. Side effects were “mild” and “extremely rare,” meaning that they wouldn’t happen to me. In fact, he explicitly instructed me not to read the packaging insert or look up side effects on my own, as it might cause some kind of psychosomatic placebo effect. (He didn’t mention that the desired effect might be placebo as well.)

He did ask what was going on in my life at the time. I explained that I was stressed because of school and uncertainty about my future. I was applying to colleges and felt an immense amount of pressure from others’ expectations of me, yet conflicted about what I really wanted. I wasn’t sleeping enough, I wasn’t eating enough, and one of my close friends had just attempted suicide. Any one of those things alone could’ve been enough to understandably warrant the distress I felt (and that was only the tip of the iceberg). Yet, he diagnosed me with depression and anxiety “disorders,” insisting that I had a “chemical imbalance.” He did not make any connection to my mother’s behavior either: coming to the appointment with me, answering questions on my behalf, and talking over me almost the entire time.

A month later, I had a follow-up appointment with my doctor, mother in tow. I had been clear that I didn’t want to be on medication long-term (that had been part of my hesitation), and I was reassured that it would just be a temporary “boost” — for perhaps one to three months — and as soon as I felt better, I could stop taking it. So I entered the doctor’s office that day determined to prove that I was “better” already — regardless of whether this was true or not. In reality, I felt… about the same. It didn’t seem to have helped or harmed me. No, the drug had not instantly transformed my personality like I’d feared it would. I still felt like me. For now, at least.

However, my plan backfired. I succeeded in seeming “better”; that was not the problem. The problem was that this improvement was interpreted as “evidence” that the drug was “working” and therefore I needed to stay on it.

I tried to backpedal. I confessed that, well, actually I didn’t feel that much better, I really felt about the same. But my mother disagreed. She insisted that I seemed so much better, that I was back to my old self again. Was I? The doctor agreed; I did seem more cheerful this time. I tried to push back, to which my mother replied, “Well maybe you just can’t see it from the inside, but from the outside, you seem a lot better.” Huh. That’s interesting. I thought this medication was about helping me feel better. Then why would someone else’s external opinion of the way I’m feeling matter more than the way I’m actually feeling on the inside? But maybe they’re right. What do I know? Outnumbered by adults in the room, I submitted, overriding my own instincts and handing over my trust to authority figures.

As others had doubted me, I learned to doubt myself. Maybe they were right. Maybe I really did need medication. After all, I wasn’t one of those people who got on antidepressants without trying anything else first. I had already been in therapy for over a year and saw three different therapists during that time. I exercised every day and ate stereotypically “healthy.” I had a loving family. I did extremely well in school, had friends, and was active in many extracurriculars throughout high school. On paper, I was doing everything “right.” I had no “reason” to be depressed. Yet I still was. Maybe a pill was the missing piece.

Nevermind the fact that I’d been begging my mother to take me to a therapist for emotional distress since around 8th or 9th grade, yet she only started taking me once I’d developed a nervous habit of a skin-picking “disorder” that affected my appearance. Nevermind the fact that my “healthy” eating and exercising were actually an undiagnosed eating disorder (which our culture doesn’t seem able to tell apart). Nevermind the fact that despite having friends, I still felt lonely among my peers, and that despite their apparent warmth and supportiveness, my family was riddled with dysfunction — of which my overachievement was actually a symptom. Nevermind all that; it doesn’t count. It’s just a chemical imbalance.

I had thought that getting a guy in a white lab coat to sign off on my pain would make it “official” in the eyes of my parents. Because he’s a “professional” — obviously he knows more about me than I know about myself from a twelve-item questionnaire or whatever — so even if they didn’t listen to me, they would surely listen to him. Little did I know what it would eventually lead to. Little did I know that it would eventually have the opposite effect; now my pain was “official,” sure, but it was the opposite of validated. Because it was pathologized, it was no longer legitimate pain from a legitimate cause; it was a disease from within me. There was nothing externally to address; I was the cause.

The diagnosis I had sought to help me would instead betray me, blame me, scapegoat my faulty biology. Yet at the time, I naively believed that it would make my pain “valid.” Though I resisted the idea of being medicated at first, there was some kind of appeal to it on a symbolic level that I couldn’t quite put my finger on. I have real depression, I could now tell people. I have to take medication for it.

COVID-19 hit. Extended spring break turned into lockdown. The world was in chaos. I missed my friends. I was scared, angry, confused, sad, and lonely, crying all the time. The summer was filled with family conflict — screaming matches and meltdowns — with nowhere to escape to. I worried about starting college amidst a pandemic. What does this mean for my future? I wondered. Will I even get to go to college this fall? I asked my parents, yet it became clear to me that they didn’t know what was going to happen either. No one knew.

Luckily, school was back on campus that year. But most of my classes were online, so I spent the majority of my freshman year crying in my dorm room alone. I kept feeling progressively worse, and despite the obvious connection to circumstances, my doctor continued to raise my dose higher and higher. Within a year, I’d gone from the lowest dose of Zoloft to the second highest. He asked if I’d like to try the highest dose next. But what if that dose doesn’t work? I wondered. Then we’ll have nowhere to go from there. I declined. If it hadn’t been working thus far, then what reason did we have to believe it was going to work at the next dose? Maybe it just wasn’t the right drug for me.

I switched to a new psychiatrist at the end of the school year. She put me on Lexapro, then Abilify in almost immediate succession. I don’t remember tapering off Zoloft whatsoever. I was also prescribed Wellbutrin for a brief period, though I don’t remember if I ever took it. It was a tumultuous summer. I was in eating disorder treatment (reluctantly) and self-harming regularly. My family was dysfunctional as ever. Even my friendships were rocky.

Soon enough, I couldn’t cry anymore. I became completely numb. At first it felt like relief, but then the blessing became a curse. The pain was still there, I just couldn’t access it. Unable to feel, there could be no release. I felt so far from myself. Cutting became my new way of crying. Before long, all I could wear were long sleeves.

Life was feeling less like an opportunity and more like an obligation. My life wasn’t mine, my body wasn’t mine; it was theirs. First, my mother’s, my dysfunctional family’s; then doctors’, therapists’, and soon enough, seemingly everyone’s. I was merely a vessel for carrying out other people’s desires, feelings, goals. The drugs enabled this. Gradually, they carved out what little sense of self was left in me and rendered me empty, making room for other people and their agendas. It was the perfect grooming for a string of emotionally abusive relationships throughout college.

Going to my psychiatrist’s office was a nerve-wracking experience. I was always several minutes late, because I’m always several minutes late to things I dread. I didn’t even know why she made me so nervous. Maybe because she asked the same surface-level questions every appointment, and it stressed me out trying to guess the “right” answers. Or maybe because she didn’t listen. At least my mother didn’t come with me anymore.

“I think I’m feeling a lot better. Maybe I don’t need to be on so much medication anymore. Could I go down a dose in one of them?” I’d ask sheepishly.

“Oh good, then they must be working,” she would reply. “But I really don’t think that’s a good idea. You’re doing well because of the medications. It wouldn’t make sense to take that away, now, would it?”

It was a familiar script. But was that true? Was it the medications? How could we be sure? Couldn’t it have been the new friendships I had made or the new job I was enjoying? Couldn’t it have been the social belonging or the sense of purpose?

“Besides,” she would continue, “you’ve got too much at stake! Your scholarship, your future! You wouldn’t wanna go off the rails and throw that all away now, would you?”

“No, but…”

“I mean, you’re not having any side effects, are you?”

I wouldn’t have known if I had. How could I without informed consent?

“No, I don’t think so,” I’d answer carefully, “but I do feel kind of emotionally numb. Like I can’t really cry anymore. I don’t feel happy, I just feel… nothing.”

“Oh, well that’s normal,” she’d assure me, scribbling nonchalantly on her clipboard. “It’s just that you’re so used to feeling at the extremes, that you’re not used to what ‘normal’ feels like.” She put her hands out in front of her, gesturing, “Your emotional bandwidth used to be like this, now it’s like this,” bringing her hands closer together. “It means the meds are working, you just need time to get used to it.”

“Oh okay, I understand.” I smiled politely, squirming in my seat. I did not understand. But thank god our fifteen minutes were almost up.

“Alrighty then. Here’s a prescription for another refill. See you in three months. You can make your next appointment when you check out at the window.”

And that’s how it would go. Every time. There were two options: go up a dose (if I’m doing poorly), or stay at the same dose (if I’m doing well). Going down in dose or getting off a medication was not an option.

When I realized that I had spent my entire college experience medicated so far, but hadn’t gone a single semester without suicidal feelings, I knew something was off. If these meds were actually working, shouldn’t I be feeling better by now? Sure, I didn’t feel sad anymore. In fact, I didn’t feel anything. To me, that was worse. I felt uncreative, uninspired; what was life without my art? Though the drugs may have reduced my “depression,” they had only amplified my desire to die. The numbness itself was a driving factor.

I’d tried therapy. I’d tried medication. I’d tried different medications at different doses. I’d tried meditation, yoga, breathing techniques, self-help, journaling, and more. I exercised daily. I volunteered in my community. I sang in the choir, joined clubs, tried new hobbies. Nothing seemed to help. Yet there was only one thing left I hadn’t tried.

I’d only attempted to quit my medications one other time. My parents found out within a week and took me back to my psychiatrist to restart them. Yet I continued to contemplate it, like forbidden fruit.

But this time was different. First of all, because it was unplanned. I had gotten way too drunk at my friend’s twenty-first birthday party, and skipped my meds the next morning because I was too hungover to hold anything down. I’d skipped doses before, no big deal, I’d just take them the next day. But the next day came and went, and I did not take them. Then a few days passed; I still did not take them. Before I knew it, a week had passed. For some reason, I still could not bring myself to take them. Each day it was like a challenge: Let’s see how many days I can go without my meds. I’d been meaning to do this for a while, and finally, it seemed like the perfect opportunity.

At first, I felt no different. Maybe I really didn’t need them after all. However, I was nervous about my upcoming psychiatrist’s appointment the following week. How was I going to explain this to her? I hadn’t told anyone yet.

I ended up telling the truth — even the part about getting drunk and being hungover. I braced myself for her reaction.

“Well thank you for telling me that,” she said. “I’m not mad; you’re not in trouble!”

I breathed a sigh of relief and laughed nervously. Okay, see? That wasn’t so bad after all…

“But let’s get you back on those starting tomorrow, okay? Just half a pill of each for the first week, and then up to a full dose after that.”

Immediately, my spirits sank. “Wait, but why? I’m feeling fine without them…”

“Well, ’cause you might be feeling fine right now, but in the long-term it’ll increase your risk of relapse. The medications help you stabilize in case of another depressive episode.”

“Okay, but when can I get off them?”

“Mm, there’s no telling,” she shrugged. “Everybody’s different. Some people have to be on medication for life.”

“Are you saying I’ll have to be on medication for life?”

“I mean, I don’t know. You might. But I don’t have a crystal ball; I can’t tell the future! Let’s just stay on them for now, though, okay?”

My head was spinning in disbelief. Don’t have a crystal ball?! I thought. You’re a DOCTOR! Aren’t you supposed to KNOW this stuff?!?

I thought back to my very first appointment when I was prescribed just 25 mg of Zoloft. It’s a temporary fix, they promised me. Just for one to three months until you feel better.

How the hell did I get here?

How did three months turn into three years turn into the rest of my life?

It dawned on me for the first time that I’d been misled and betrayed. They’d never had any intention of getting me off those drugs, from the moment I started them. I smiled, thanked my psychiatrist for her time, and walked out of that office for the last time.

I didn’t resume taking Abilify or Lexapro the next day.

(To be continued…)