A friend of mine shared a write-up about “surviving antidepressants” today with the intention of providing suggestions on how to deal with depression and anxiety following the political shifts we are experiencing right now. I clicked it curiously and was horrified by what I read. The writers story sounded extremely frustrating, with a bad experience with one antidepressant and one doctor, and I feel their pain for that. However, their conclusions made me furious. I want to talk about these conclusions individually, and share a bit of my own anecdotal evidence to the contrary as appropriate.

  • Doctors are not to be trusted, they know very little about what SSRIs are capable of, what they should and should not be used for, and how to manage coming off them. They may have misdiagnosed you, and their instinctive reaction of what’s needed to fix you might actually make you far worse.

This statement broke my heart. If you can’t trust your medical professional, you should seek a new one. This is your health and well-being on the line and having a trustworthy doctor is integral to that. One uninformed and perhaps incompetent doctor does not make the whole profession incompetent, though. I’ve had one bad relationship with a MHNP (mental health nurse practitioner), and one great one with the MHNP I currently see. It’s ok to shop around a bit and get second opinions for physical health problems, why wouldn’t it be for mental health issues?

A side note: the Effexor XR referred to in the article isn’t even actually an SSRI, it’s an SNRI which is a similar but not identical class of drug. This happens to be a medicine I currently take, and it is definitely not meant to be taken or tapered off of the way the writer was advised to, and if I were them, I would have a lot of questions for whoever oversees doctors in their area.

  • Anti depressants are a really brutal thing to put anyone through, more so than many illegal drugs. They should be used only as a last resort, after exhausting all other possible avenues. They must be tapered, coming off them the wrong way can damage you for life, as it has done to me in several ways. I have since seen others go through hell as a result of them too.

SSRIs and SNRIs are not addictive the way cocaine or heroine are, they don’t rot your teeth, or cause tremors. No one is out there selling blow-jobs for Zoloft. It IS true that various anti-depressants can have side-effects, one I tried sapped me of all my energy, the one I’m currently tapering off of helped but it was only really helping my depression, leaving me actually feeling things again but drowning in anxiety. The Effexor XR I’ve tapered onto the last couple months seems to be the just-right spot for me right now, which is a relief!

There are occasional serious side-effects, most of the papers for my meds list suicidal urges, for example, and there is a small chance of a condition known as serotonin syndrome. These are serious side effects, and the reason you taper up onto medicines over a period of weeks, under the supervision of a medical professional. If the medicine you try produces such things, your doctor should help you taper off and try something else.

  • Anti depressants do not ‘correct chemical imbalances’, they smash you in the head with a sledgehammer, giving you a chemical lobotomy in order to have a temporary holiday from negative thought cycles. You can use that holiday as an opportunity to address the causes, but the holiday itself is not a cure.

I can only imagine that the author had an amazingly horrible experience because of the high dosage and frequency that their doctor had them taking the anti-depressant they tried. I can tell you that, personally, the only medicine I’ve tried that made me feel anything like that caused my doctor and I to agree that I should stop taking within the first couple weeks. That is pretty much immediately in anti-depressant timescale terms!

For myself, and I hope for most people successfully on medicines to help treat their mental health problems, there is no sense of a “chemical lobotomy”. The thought of that is horrifying, and a significant source of the stigma that people face trying to get treated! I feel a significant amount more now on meds than I did before. I don’t spent time trapped in my own head, numb and isolated, full of grey dingy wool. I get scared, I get anxious, I get angry. I laugh, and enjoy the company of my friends. I’m a sarcastic shit sometimes, a bitter curmudgeon others, but I feel.

Before I sought out a mental health professional to help me out, I talked to a friend who had walked that road, and asked her what it was like. She told me she thought of it as something that gave her a little bit of extra space to deal with her issues, and I can see how it could feel like that. For me, it’s more like it brings me up to neutral. I’m not manic, but I have a reasonable base for my moods to go up and down from.

  • There are many ways of treating symptoms of depression and anxiety. Anti depressants allowed me to socialise, but they did not treat my social anxiety, they just masked it. CBT treated it. Anti depressants stopped negative thought cycles, but they did not treat them, they just masked them. Light therapy treated them.

The first sentence here is totally true! Our brains, our minds, and our emotions are all amazingly complex, so what might be off for any particular person might also be complex. Anti-depressants do not work the same for everyone and some are even ineffective or detrimental to particular people. However, you cannot eliminate all anti-depressants based on the results of trying one.

Cognitive Behavioral Therapy is also part of my treatment, and I have wonderful things to say about it. Being mindful of what you are feeling, and why has helped me recognize thoughts that aren’t helpful, which means I can put them aside, and remind myself of more helpful thoughts. “I am an utter failure” might become “today didn’t go well, but I have a plan about how to make tomorrow better, and I know who to ask for help.” Everything I have read and been told has stressed that the most effective treatment of major depression is a combination of therapy and medicinal treatment. These things can and do work together.

Seasonal Affective Disorder is a whole other beast, and can be treated with full spectrum lamps, extra vitamin D, or even, as in the authors case, moving to a location nearer the equator! It’s not something I personally have associated with myself, so I cannot speak to it as much. Fun Fact: there is also a strong correlation between tinnitus and depression. Thanks, brains!

  • Friends and family are often unhelpful and sometimes harmful, but they are also hugely important.

I would reword this slightly, instead of disagreeing completely. “A sturdy support network that are willing to help out is hugely important.” The stigma I am railing against above can make family who should be your strongest advocates into your worst enemies. It’s okay to try to educate them, and if that doesn’t work, cut them out of your life for awhile while you get yourself straightened out. You don’t owe the people around you the opportunity to hurt you.

So, what are some of my suggestions for dealing with depression, anxiety, and insomnia?

First of all, talk to a doctor. Your GP may be willing to treat mental health issues - mine is - or make a suggestion about a specific mental health doctor they would recommend. Your company may provide an EAP (Employee Assistance Program) which may allow you to call them, say “I need a therapist urgently please” and have them find someone and set up an appointment for you. This is how I first sought treatment and it was wonderful when I was having such a hard time to be able to offload the crappy phone-tag part to someone else. You may have to crawl through your health insurances doctor reference, in which case I feel your pain and good luck. I truly wish this was easier. If you live in the Seattle area, I’d be happy to recommend both the MHNP and the therapist I currently see. Ask me!

Second of all, take care of yourself. The term self-care is somewhat misunderstood and creatively interpreted, so let me explain what I mean when I say it. You need to meet your own minimal needs, even and especially when you don’t feel like you deserve it or have the energy for it. These are ALWAYS eating, drinking, sleeping, and washing. Can’t do a full meal? Eat a snack. Can’t sleep the whole night? talk to your doc about sleep aids, take naps as needed. I slept over my lunch hour regularly at work before I got my insomnia under control, and then ate a snack later on. If you can’t drag yourself into the shower, use a damp washcloth and dry shampoo. Self care means more than that, sometimes, though. It means being aware of your mental state and when things around you are too much of a negative stimulus, removing yourself from the situation and replacing it with something positive. Sometimes when the news is overwhelming, I watch My Little Ponies instead. I pet the office dogs when I get frustrated with my code. These are acts of self care, not because they’re self-indulgent, but because they help me regulate my mental state.

Third, use your support structure. When I’m having a hard time or feeling myself withdrawing too much, I’ll make casual plans with a friend. Knowing that they expect me is often enough to motivate me to get presentable and out the door. From there momentum does it’s job and when I go to settle down alone later it feels like recuperation, not avoidance. Ask for help. If you need someone to bring you dinner, or you won’t eat, then ask. if you just need an ear, ask for that, too. you are not a burden and you know you would help them back if they needed it so don’t be afraid to let them know what you need.

In short, take care of yourself, and let others help take care of you, too. Find mental health care you trust, and communicate honestly with your doctors about how you’re doing. Be patient, try different things. You are loved, and you deserve to be well.